EXAM 2 IR

Projection

direction/path of the x-ray beam

position

how the patient or body part is placed

anteroposterior (AP) projection

beam enters anteriorly and exits posteriorly

Posteroanterior (PA) Projection

beams enter posteriorly and exit anteriorly

supine

lying on the back

prone

lying on the abdomen

decubitus

patient lying down or laterally with a horizontal beam

sagittal plane

Divides right and left of the body

coronal/frontal plane

divides body into anterior and posterior

transverse/axial plane

divides superior and inferior

chest/abdomen image

viewed as if facing the patient

patients right appears on viewers left

hand and wrist image

often taken pronated

Fingertips should be at the top

forearm image

wrist orientation at one end and elbow at the other

displayed anatomically

humerus image

The shoulder should be at the top

Foot image

toes should be at the top

ankle image

toes point downward

proximal lower extremity image

pelvis at the top

CT scan

Uses x-rays

Produced cross-sectional images

Sonography

uses sound waves

no ionizing radiation

nuclear medicine

Uses radioactive tracer/radiopharmaceutical

demonstrates organ function

Purpose of IV and IA

Administer drugs and fluids

Collect blood samples

administer drugs and fluids

Quick response

High concentration

Oral route impossible

Poor GI absorption

Restore blood volume

Control heart rate

Prevent overdose

Collect blood samples

Monitor:

Blood gases

Alcohol

Glucose

Poisons

Medications

Electrolytes

Injection methods

Bolus

Gravity infusion

Infusion pump

Bolus

injection by hand-held syringe or automatic injector over a short time

gravity infusion

bag of solution connected to tubing and needle

infusion pump

electronic control of rate and volume

standard IV height

18-20 inches above the injection site

Drip rate

Must follow the physician/pharmacy order

enteral route

movement of drugs from the outside of the body to the inside using the gastrointestinal tract

Parental routes of administration

NOT GI TRACT

Topical Administration

administration of a substance directly onto the skin or mucous membrane

Parenteral solutions

Saline (fluids)

5% Dextrose D5 (carbs)

Total parenteral nutrition (TPN) (GI nutrition)

Vitamins

Solution Check

Clarity

Expiration date

Container condition

Label check

Correct drug

Dose

Concentration

Route

IV catheters gauge

higher number= smaller diameter

24 gauge catheter

small catheter

Infant example

16-gauge catheter

Large catheter

Blood donation example

infusion pump alarm causes

battery low/not plugged in

Air or foreign body in line

Kinked line

Solution depleted

Disconnected line

Infiltration/extravasation

six rights of administering medication

Right time

Right route

Right medication

Right dose

Right patient

Right reaction/documentation

Extravasation s/s

Poor infusion

Pain

Swelling at the site

Cool skin

Pale skin at the site

Extrasavation rt response

call Rn/md

Stop IV

elevate affect part

warm compress

pull catheter and restart somewhere else

phlebitis s/s

poor infusion

Blood backing up

swollen red vein

proximal to the puncture site

Phlebitis rt response

call Rn/Md

elevate

warm compress

discontinue IV

venous thrombosis s/s

Poor infusion

Blood backup

stationary clot that may become an embolus

venous thrombosis rt response

call rn/md

Watch for pulmonary embolus

embolus s/s

traveling clot/foreign material

Sudden chest pain

appregension

dyspnea

rapid pulse

pallor

diaphroesis

clammy skin

emobolus rt response

contact rn

rapid response

infection s/s

fever

angry/red site

elevated WBC

malause

chills

headache

backache

nausea/vomiting

infection rt response

report to rn/MD

discontinue IV

antibiotics

Central venous line purpose and location

long-term medication/fluids

tip near SVC/right atrium

central venous line risks

infection

thrombosis

air embolus

displacement

PICCl line purpose and location

inserted peripherally (type of central venous line)

administration of medication, long-term IV therapy, or chemo

tip in SVC just superior to right atrium

PICC line risks

avoid tension

verify tip

pulled central line (PICC LINE)

emergency because air can enter

Direct pressure

Call for help

steep left lateral trendelenburg

Portacath purpose and location

A surgically implanted device used to administer medications, fluids, or draw blood, commonly used in cancer patients

Tip near SVC/right atrium

Swan-Ganz catheter

a cardiac catheter with a balloon at the tip that is used to measure pulmonary arterial pressure

It is flow guided through a vein into the right side of the heart and then into the pulmonary artery

ng tube location

nose -> pharynx -> esophagus -> stomach

Ng tube purpose

feeding

medications

remove gastric contents

OG tube path

mouth -> esophagus -> stomach

ne tube path

nose -> esophagus-> stomach -> duodenum/small intestine

ne tube purpose of the tube

feeding

reduces reflux regurgitation and aspiration

Dobbhoff tube

Ne tube with weighted tip and side ports

advances through the GI tract

A small lumen may clog

levin

small lumen NG tube

Intermittent suction or feeding

salem pump

double-lumen Ng tube with air vent/pigtail

gastric decompression with intermittent suction

GI tube placement and care

Placement checks

radiographic verification

incorrect location

imaging care

placement checks

aspirate stomach contents

Inject air and listen

Watch for cyanosis

radiographic verification

chest or abdominal x-ray

incorrect location

tube should not be in the lung

imaging care

avoid tension

Gently move the tube out of the field

report concern to rn/MD

colostomy

colon connected to the external abdominal wall

empties into bag

We may encounter these in fluoroscopy when performing barium enemas

ileostomy

The small intestine is connected to the external abdominal wall

ostomy care

tupperware seal

clean/dry area and reapply if dislodged

patients often manage their own

enema tip

used for cleansing enemas or barium procedures

enema

a medical procedure or treatment that involves injecting liquid directly into the rectum and lower colon through the anus

straight/cuffed tips

both may be used

triple-lumen tip

channels for barium

cuff air

colonic air

retention cuff/ring

helps retain the enema tip during the procedure

foley catheter

internal end in the bladder

The balloon holds it

external and connects to the drainage bag

Nephrostomy tube

through the back into the pelvis

kidney to the outside

drains urine or gives medication

ureteral stent

kidney to bladder

Keeps the ureter open

urinary catheterization reasons

retention

trauma

post-op

drainage/irrigation

chemotherapy

incontinence

Documentation of input and output

epidural/spinal

urinary precations

Use a water-soluble lubricant

Keep the drainage bag below the bladder

Keep the bag off the floor

Avoid tension

Stabilize the tubing to the leg if needed

High UTI risk

Treat the bladder/catheter system as sterile

oxygen

high pressure gas

nasal cannula or wall

handle portable tanks safely

endotracheal tube (ETT)

mouth or nose into the trachea

tip 3-5 cm above carina

Must remain tied

Dislodgement is a CODE

RN/RRT may suction

tracheostomy

through the neck into the trachea

Tip between the stoma and the carina halfway

Must remain secured

RN/RRT may suction

ventilator

mechanical breathing

Controls oxygen, depth, and rate

Do not disconnect: reconnect promptly if alarm/disconnection

ventilator timing

chest x-ray at full inspiration

abdomen at full expiration

Chest tube purpose

remove air or fluid from the pleural space and allow the lung to reinflate

chest tube upper thorax

often for collapsed lung/air

chest tube lower thorax

Often for fluid drainage

chest tube drainage collector

keep below the chest/insertion site

chemical name

identifies chemical structure

generic name

name given when drug becomes commercially available

trade/band name

name assigned by manufacturer

Drug family

drug with similar actions

suspension

perticles suspended

not dissolved in liquid

pharmacodynamics

what the drug does to the body

Pharmacokinetics

what the body does to the drug

Pharmacogenetics

how genetic differences affect drug response