Rad Tech & Patient Care Exam 2

50 MC, 60 min

How should you interact with patients who don’t speak english?

Interpreters:

• on call

• full-time interpreters part of staff

• scheduled interpreter for outpatient proceducre in advance

• teleinterpreter; over webcam & microphone, telephone(language line by AT&T)

*Avoid using family: accurate information by interpreter

• look at patient not interpreter

• use nonverbal encouragement, smile and touch

How should you interact with patients who are hearing impaired?

• talk to, not about these people

• get patient’s attention before starting to speak

• face person with light on face

• speak lower & louder

• avoid noisy background situations

• rephrase when not understood

• patience

• ask patient for suggestions to improve communication

• ask patients to repeats instruction & use open ended questions

• don’t remove glasses

How should you interact with patients who are deaf?

• some can read lips and can speak limited

• use basic ASL

• use interpreter

• avoid using family

• flag chart

• pencil & paper

• allow tour of area before examination

How should you interact with patients who have impaired vision?

• they will listen to your footprints & use a cane

• they can place a hand on your shoulder/elbow

• you can put your arm around their waist to direct them verbally

• good communication

How should you interact with patients who have inability to speak?

• ask nursing staff how they have been able to communicate

• some can write

• some can nod & shake their head

Artificial Speech:

• handheld electrolarynx: placed on external throat wall & can amplify vibrations transmitted through tissues of the neck (not easy to understand)

• Esophageal speech: patient swallows air & regurgitates it (understandable but low in volume & requires practice)

• Transesophageal puncture (TEP): prosthesis placed within neck through stoma

Define aphasia

defect or loss of language function in which comprehension/expression of words is impaired as a result of injury to language centers in the brain

(inability to speak)

How should you interact with patients who have impaired mental function?

• assess patient’s ability to understand and follow instructions (vary)

• clear, simple, direct instructions

• repeat instructions for short attention span

• don’t talk like they are toddlers

How should you interact with patients who have an altered state of consciousness/comatose?

1. they can’t be relied upon to remember instructions

2. they aren’t responsible for their actions/answers

3. kept under close & constant observation

4. talk as if they can hear you, don’t say inappropiate things

Define ageism

discriminatory attitud toward the elderly that includes a belief that all elderly are ill, disabled, worthless, and unattractive

What are the 5 common stages of the grieving process?

1. denial

2. anger

3. bargaining

4. depression

5. acceptance

Name the transmission based precautions in appendix G: airborne, droplet, & contact

Airborne:

1. wear N95 masks or respiratory protection

2. Susceptible people should not enter room without mask

Droplet:

1. wear mask when working w/in 3 ft of patient

Contact:

1. clean, nonsterile gloves

2. clean, nonsterile gown

3. change gloves

4. remove gown/gloves before leaving room & ensure no contact w/ clothes

5. wash hands immediately after

Name the standard precautions in appendix F

1. hand hygiene

2. gloves

3. mask, eye protection, face shield

4. gown

5. patient care equipment

6. environmental control

7. linen

8. needles and sharps equipment

9. patient placement

10. respiratory hygiene & cough etiquette

11. Safe injection practices

12. infection control practices for special lumbar puncture procedures

What is the difference between standard precautions vs. transmission based precautions?

Standard: precautions for all patients

• designed to reduce risks of infection transmission from unrecognized sources

Transmission: precautions for specific patients with known infections

What is aspesis?

Absence of infectious agents

What is the difference between medical asepsis and surgical asepsis? Give examples of each

What is the difference between medical asepsis and surgical asepsis? Give examples of each

Medical: “clean technique”

aimed to reduce the # of pathogens or spreads during procedure

1. hand hygiene

2. PPE

3. cleaning & disinfection

4. respiratory hygiene & cough etiquette

Surgical: “sterile technique”

aimed for a completely microbe-free environment

1. sterilization

2. used when breaching body’s natural barriers (skin, mucous membranes)

1. Define nosocomial infection

2. What is it called now?

3. How is it contracted?

1. infections acquired in the course of medical care; within 48 hours after hospitalization

2. Hospital Acquired Infection or Health Care Associated Infection (HAI)

3. Person who enters the heath care facility with an infection and spreads it 

Explain the steps in proper PPE putting on (don)

1. hand hygiene

2. put on gown away from body

3. put of mask/respirator

4. put on goggles/face shield

5. put on gloves above gown cuffs

Define these modes of transmission:

1. vehicle

2. fomite

3. vector

4. droplet

5. airbone

1. food, water, drugs, blood

2. syringe, dressing, countertops (objects)

3. infected animals/insects (mosquitoes)

4. nose, mouth of the infected host

5. comes from evaporated residue left from the droplet

What is the most common site of nosocomical infections?

urinary tract

What is the portal of exit and give some examples

Route where blood, body fluids, excretions, secretions leave body

1. GI tract

2. open wound

3. respiratory tract

4. urinary tract

5. nose

6. mouth

What is the portal of entry? How can microorganisms be transmitted?

Route that microorganisms gain access into the susceptible host

1. ingestion

2. inhalation

3. injection

4. mucous membrane (nose, eyes, mouth)

5. across placenta in pregnant women

What must the reservoir of infection and/or environment must have for pathogen to thrive?

1. moisture

2. nutrients

3. suitable temperatures

Describe the cycle of infection

1. Infectious organism

2. reservoir of infection

3. portal of exit

4. susceptible host

5. portal of entry

6. transmission of disease

What are the most common health care injuries?

1. musculoskeletal disorders (back, shoulder strain)

2. repetitive motion & strain injuries

3. cumulative trauma disorders

What are the 5 classes of fire extinguishers and what are they used for?

A: paper/wood

B: flammable liquids/ gas

C: electrical equipment

D: metal alloys

K: cooking oil/ animal fat

What acronym can you use for the fire extinguisher use?

P: pull; pin, breaking seal

A: aim; nozzle

S: squeeze; handle

S: sweep; base of fire

In case of fire, what is the acronym of steps you should provide?

R: rescue (move patients 2 doors away from fire)

A: alarm

C: contain (shut doors & don’t alarm patients)

E: extinguis/evacuate if large fire

Describe oxygen safety

oxygen supports combustion so…

• use extreme care when in use

• know location of shut off valve

• no electrical equipment or smokiny nearby

How can you be prepared for a fire?

Know the:

• fire plane

• evacuation route & alternative route

• fire alarms, extinguishers, fire doors

• don’t block fire doors

• move machines out of fire route

What is validation of communication?

1. indication of a clear understanding of the message

2. talk back what you understood

What are the federal laws regarding language barriers?

1. free language assistance

2. provide interpeters: ASL, other languages

3. braille, large print, digital formats

4. post notices in common language informing patients of their right to an interpreter

5. never delay/deny treatment

What should you do if you smell smoke near an xray control panel?

turn main power switch off

Explain how to work with teenage patients

• show empathy, be nonjudgemental, be direct & honest

• don’t use authoritarian approach but professional and warm

• involve them in decision making

• give them modesty & privacy (no part exposed)

• ask about hobbies, sports, friends, school, etc.

• away from parents & peers

What are valid choices? Give some examples

acceptable alternatives that require more thought but satisfy the patient & male them feel competent and involved in their care

• ask if they want blanket

• ask where they want to sit

What is in a spill kit?

• kitty litter

• heavy plastic bags

• broom

• dustpan

• nitrile gloves

*NOT MOP

What steps should you take to ensure safety when a spill occurs?

• limit access to area 1st 

• evaluate risks involved

• determine if you have equipment & expertise to clean

• clean up spill if qualified

• call supervisor if not qualified

What are the proper body mechanics?

Minimizes the energy required to sit, stand, or walk

• Broad base of support: portion of body in contact with floor (stability)

• Center of gravity near center of base of support: point where body weight is balanced (midportion of pelvis or lower abdomen)

• Line of gravity bisects base of support:

• work at comfortable height

• when lifting, bend knees and keep back straight

• keep load well balanced and close to body

• roll/push heavy object; don’t pull/lift

List the types of microorganisms and explain their physical structure, give examples

1. Bacteria

   1. Single-celled with a cell wall and an atypical nucleus without a membrane

   2. Ex: Streptococci

2. Viruses

   1. Subcellular and smallest

   2. Ex: HIV & Hep B

3. Fungi

   1. Single-celled yeasts or long, branched, filament-like

   2. Composed of many cells

   3. Ex: yeast & mold

4. Prions

   1. Smallest of all pathogens

   2. No DNA or RNA

   3. Ex: Creutzfeldt-Jakob disease

5. Protozoa

   1. Complex, single-celled animals

   2. Ex: Giardiasis

Define virulence factors

enable bacteria to destroy/damage host cells and resist destruction by the host’s cellular defenses

-traits/molecules that make microorganism capable of causing disease

-help pathogen invade host, immune system, and cause tissue/cell damage

Explain direct contact vs. indirect contact and give examples of each

Direct: host is touched by infected person 

EX: syphyllis, HIV, skin infections

Indirect: host touches infected object

Ex: ringworm, strep, gonorrhea

Define airborne & droplet transmission

Airborne: dust that contains spores or droplet nuclei (particles of evaporated droplets containing microorganisms)

• particles <5 micrometers

• remain suspended in air for long periods

Droplet: infectious individuals cough, sneeze, speak, sing

• contact of the mucous membrane of the eyes, nose or mouth

• large droplets containing microorganisms >5 micrometers

• don’t remain suspended in air

• travel short distances ~3 ft or less

What are the types of immunity?

• Natural resistance

  • Mechanical barriers of the skin and mucous membrane

• Acquired immunity

  • An individual develops antibodies to fight off infections

• Passive immunity

  • Following an injection or preformed antibodies to infection

    • Ex: breastfeeding

List and describe six main routes of infection transmission, and name a disease that is transmitted by each route.

1. Direct contact

   1. HIV

2. Fomites

   1. Influenza

3. Vectors

   1. Mosquitos- Malaria

4. Vehicles

   1. Food poisoning

5. Airbone

   1. Varicella

6. Droplet contamination

   1. Diphtheria

What are some pediatric imaging recommendations?

• eye level contact

• safety and communication techniques

• sensitive to parent/guardian; use parents as helpers; explain procedure & address concerns

• explanation of exam to child; show equipment & sounds

• use child’s name

What are the age classifications according to the pediatric powerpoint?

Infants- birth-12 months

toddlers- 1-3 years

preschooler- 3-5 years

school age- 6-12 years

What ages are considered “pediatric”

infancy to 15 years

Before entering the NICU, how long should you wash your hands for?

3 minutes

What are some types of pediatric immobilization devices?

• Pigg-o-stat

• papoose 

• sheet immobilizers

• mummy style sheet wrap

• Posi-tot

• Tam-em board

• Infantainer

• sandbags

Regarding airborne isolation patients, do they wear a mask when leaving the room?

yes

Define “dirty tech” vs. “clean tech”

Dirty:

touches & positions patient

Clean: 

handles equipment, no contact with patient, bed, or anything they have touched

What must you wear when entering an airborne isolation room?

N-95 or respirator

What are some precautions for the immune compromised patient?

• equipment cleaned before entering room

• hand hygiene before touching patient, bed, or anything they touch

• wear masks, caps, gowns for patient

• sterile gloves & gowns for surgery

What are the duties for the “clean”and “dirty” tech for the immune compromised?

Dirty:

touches equipment

Clean:

positions patient, bed, covered IR, & clean/sterile items

(opposite of isolation technique)

What is the recommended dilution of clorox to water?

1:100 dilution of household bleach (5.25 sodium hypochlorite) for routine disinfection

1:10 dilution for stronger disinfecting blood spills or heavily contamination

What is the proper needle disposal techniques?

• place in sharps container

• don’t recap needle