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List the ways in which patient exposure can be substantially reduced:
use of motion reduction techniques, proper X-ray beam limitation devices, filtration of X-ray beam, shielding specific areas, suitable technical exposure factors, appropriate digital image processing, and elimination of repeat radiographic exposures
True/False: grids aid in limiting patient dose
false
True/False: treat the whole person, not just the area of interest
true
Holistic patient care begins with effective _____________ between the radiographer and patient
communication
Communication can be accomplished through
verbal messages, body language, and clear, concise instructions
Effective communication reduces _________ and __________ ___________, as well as ___________ ___________
anxiety; emotional stress; repeat exposures
Effective communication enhances the __________ ________ of the radiographer and increases chances for a __________ _______
professional image; successful exam
Patient protection begins with clear and concise/confusing and elaborate instructions
clear and concise
When explaining procedures, use simple/complex terms
simple
True/False: always answer questions truthfully, even if you have to say "I am not sure, let me find someone who knows"
true
Create a sense of ________ between you and your patient
trust
__________ ___________ are attributed to poor communication
repeat exposures
Blurred images/images with motion have little to no __________ _________ and require repeats
diagnostic value
Voluntary motion is controlled by
will
Voluntary motion can be eliminated through
patient cooperation
Involuntary motion is controlled
unwilfully
Involuntary motion examples may include
digestion or heartbeat
True/False: breathing is an involuntary motion
false; both
How can you minimize involuntary motion
shorten the exposure time
Protective shielding minimizes potential exposure of
radiosensitive organs or tissues
Protective shielding reduces or eliminates ________ harm
biologic
Areas that should be shielded whenever possible
lens of eye, breasts, thyroid gland, and gonads (though gonads are no longer on the textbook publisher's list)
AAPM recommended _______ and _______ shielding be discontinued
gonadal; fetal
NCRP recommends discontinuation of gonadal and fetal shielding during ________ and _______ exams only
abdominal; pelvic
Gonadal shielding should be used when reproductive organs are within ____ of the x-ray beam
5 cm
True/False: Gonadal shielding is a replacement for collimation
false
Gonadal shielding is a _________ protective measure
secondary
Female reproductive organs receive ___ ______ exposure than males
3x more
Flat contact shield reduces exposure approximately ____ for females and ________ for males
50%; 90-95%
Use the ____________ _________ to locate the pubic symphysis, which is at the level of the testes
greater trochanter
Move the shield 1 inch medial to each _____ to locate the ovaries
ASIS
Shielding ultimately reduces ___________ ____________ gonad dose
cumulative population
Standardization in the processing of digital images, which includes regular monitoring and maintaining of all processing and image display equipment
quality control program
Suspended from above the beam, hangs over the patient and casts a shadow in the primary beam over the reproductive organs
shadow shield
These are made of transparent lead-acrylic material impregnated with approximately 30% lead by weight
clear lead shield
Cup-shaped radiopaque device that encloses the male reproductive organs to protect them from exposure to ionizing radiation
shaped contract shield
Campaign to promote lowering the amount of radiation used in medically necessary imaging procedures and eliminating unnecessary procedures in adult medical imaging
image wisely
The recorded detail in the radiographic image
spatial resolution
Select the four basic types of gonadal shielding devices that can be used during a diagnostic x-ray procedure.
flat contact shield, shaped contact shield, shadow shield, and clear lead shield
The air-gap technique reduces the amount of scatter reaching the IR by increasing the
OID (object to image receptor distance)
An interaction that produces a satisfying result through an exchange of information
communication
A campaign to change long-established practice by raising awareness about methods for lowering radiation dose during pediatric medical imaging exams
image gently
Areas on the patient that can be used to guide placement of a testicular or ovarian shield
external anatomic landmarks
Primary function of the epidermis
to protect underlying tissues and structures
Alternative to the use of a grid for reducing scattered radiation during certain exams
air-gap technique
Individual responsible for ordering radiologic exams
referring physician
The decision to order a radiologic examination by a physician should depend upon whether:
the benefit of the exam outweighs the risk
Which of the following can be used to specify the amount of radiation a patient receives from exposure to x-rays? 1. Gonadal dose 2. Entrance skin exposure 3. Bone marrow dose
1, 2, and 3
Why can an accurate determination of a patient's skin dose be made with a thermoluminescent dosimeter (TLD)?
Because the lithium fluoride detector reacts similarly to human tissue when exposed to ionizing radiation
Unconscious actions, or nonverbal messages, that if understood as intended will promote effective communication between radiographer and patient
body language
Devices used on patients during diagnostic x-ray procedures to protect reproductive organs from exposure when these organs are within 5 cm of a properly collimated beam
gonadal shielding
Most commonly reported and simplest way to specify the amount of radiation received by a patient from a diagnostic imaging procedures
entrance skin exposure
Radiation exposure received by the male and female reproductive organs
gonadal dose
The practice of using fluoroscopy to determine the exact location of the central ray before taking a radiographic exposure
fluoroscopically guided positioning
Which shield is not suited for non-recumbent positions or projections other than AP or PA
flat contact shield
The EqD to the reproductive organs that, if received by every human, would be expected to bring about an identical gross genetic injury to the total population, as does the sum of the actual doses received by exposed individual members of the population
Genetically significant dose (GSD)
________ is of great importance because it contains large numbers of stem cells that could be either depleted or even eliminated by substantial exposure to ionizing radiation
bone marrow
Which members of a population would be excluded from the genetically significant dose?
Individuals beyond reproductive years (post-menopausal)
The NCRP recommends that radiologic exams be performed during ___________________ to minimize the possibility of irradiating an embryo
the first few days of menses
Shaped shields can be used for
AP, oblique, and lateral (upright or recumbent) projections
What shield is used for scoliosis exams
clear lead shields
What shield is commonly used in sterile fields
shadow shields
True/False: there is a correct way to shield, and you must do it as such
true
There is no harm in shielding a patient upon request if the shield is
not in the primary beam or does not obscure any anatomy of interest
True/False: SID and filtration contribute to determining technical exposure factors
true
True/False: technique charts replace the need for critical thinking
false
The use of a higher kVp permits a ______ mAs setting
lower
Advantage of the Air Gap technique
improves image contrast
Disadvantage of the air gap technique
increased magnification
Any image that must be performed more than once because of human or mechanical error
repeat images
During a repeat image, the patients' skin and gonads receive _______ dose (or more if the technical factors increase)
double
Reduce the need for repeats by
correctly positioning the patient and selecting appropriate technical factors
Digital radiography changed the _____ of repeats
cause
5-17% of digital repeats are due to
positioning errors
True/False: patient mispositioning, motion, external foreign bodies/artifacts, or clipping of anatomy are reasons for unacceptable images
true
True/False: striving for perfection is a good reason to repeat an image
false
True/False: radiographers are more careful when they know images are being reviewed and analyzed
true
Values of a repeat analysis program include
process improvement, minimizing patient exposure, increasing awareness, and improving overall performance
Nonessential radiologic exams are performed in the absence of
definite medical indications
True/False: The ASRT views fluoroscopy-guided positioning as an ethical practice since it double checks the work of the rad tech
false; it increases patient dose and should never be used in place of appropriate skills required of a competent rad tech
Skin dose is the dose to the
epidermis
True/False: Gonadal dose differs for males and females
true
The estimated genetically significant dose for the U.S. is
0.20 mSv
What structure in the body contains stem cells
bone marrow
Exposure to ionizing radiation can deplete or eliminate stem cells, and may induce ________
leukemia
The developing embryo-fetus is very radiosensitive/resistant
radiosensitive
When a radiologic exam is not urgent, and can be postponed, it is considered an
elective booking
Signs in the X-ray rooms that tell patients to let techs know if there is a possibility of pregnancy
patient postings
Female patients of _______________ age should be questioned regarding the possibility of pregnancy or _____
childbearing; LMP
When imaging a known pregnant patient, select the __________ technical factors that will yield a diagnostically acceptable image
smallest
The risk of a child developing radiation-induced leukemia is ___ that of adults
2x
In order to reduce motion in a pediatric patient, employ a
very short exposure time and high mAs (400+)
Precise collimation is especially significant for which patients
pediatrics and pregnant women
If a parent must hold their child during an exam, it is preferable for it to be the
father
What is the overall purpose of DEXA
a low dose way of looking at bone health; determines the degree of bone loss by measuring bone mineral density
What does DEXA stand for
dual energy x-ray absorptiometry
Which modality is used for osteoporosis diagnoses
DEXA
Why is it better for the father to be leaded up to hold their child instead of the mother
males can regenerate sperm, whereas women are born with a set amount of eggs; there is also a chance of pregnancy ALWAYS