Patient Care Overview

Radiography

Uses electromagnetic energy in the form of X-rays to create medical images

Cardiovascular interventional imaging

Uses X-rays to visualize human blood vessels and heart anatomy

Requires the use of a catheter and the injection of X-ray contrast material to visualize anatomy

Angiography

Invasive procedure that demonstrates vessels by use of contrast

Angiocardiogram

Is a contrast study that visualizes the interior of the heart chambers and the vessels that enter and exit the heart

Interventional radiography

Non-surgical treatment or correction of a vascular anomaly often at the time that it is diagnosed or located radiographically

Nuclear medicine

Uses the energy of the atom to create images

Energy form is gamma radiation

Uses radioactive isotopes to create gamma radiation

Nuclear medicine

Radiation does not come from camera it comes from isotopes

Technetium 99m most common half life 6 hours

Radiation therapy

Uses very high energy ionizing radiation to treat malignant tumors

Computed tomography

Uses X-ray energy and sophisticated software to create sectional images of the human body

Creates hundreds of views of patient anatomy

Unit called a Gantry but has an X-ray tube

Produces axial images or slice-like images that can be “reconstructed” By the computer to show more detail

Magnetic Resonance imaging

Uses the energy of high strength magnetic fields and radio waves to create images of the human body

Nonionizing imaging modality

Unit that houses magnet also called Gantry like CT

A noninvasive diagnostic modality that does not use ionizing radiation

Slice like images too

Uses a rare earth element Gadolinium

PET Positron Emission Tomography

Highly specialized nuclear medicine technique

CT and nuc med combined

Modality becoming used more often but it costs more

Cancer patients

Joint Review Committee on Education in Radiologic Technology

Concerned with compliance with education standards developed by and for the profession of radiologic technology

Voluntary process

Purpose: to promote excellence in education and elevates the quality and safety of patient care through the accreditation of educational programs in radiography, radiation therapy, magnetic resonance, and medical dosimetry

American Society of Radiologic Technologists (ASRT)

Oldest and largest national professional association of imaging sciences

Responsible for advancement of our profession by promoting to maintain high standards of education and quality patient care

RadCARE bill

Establishes minimum educational and credentialing standards for radiologic technologists, radiation therapists and medical physicists

Stressors

Any event that adds stress to your life

AIDET

Acknowledge

Introduce

Duration

Explanation

Thank you

Who is JCHAO

Joint commission on the accreditation of healthcare organizations

Now known as THE JOINT COMMISSION (TJC)

They set standards for healthcare organizations and issues accreditation to organizations that meet those standards

Strengthens community confidence in the quality and safety or care, treatment and services

Benefits of accreditation from TJC

Provides deeming authority for Medicare certification

Recognized by insurers and other third parties

May reduce liability insurance costs

What are NPSG

National patient safety goals

Goals are announced annually

Sentinel event

Is an unexpected occurrence involving death or serious physical or psychological injury, or risk thereof

Reporting of sentinel events is a voluntary act

Ethnicity

Relates to a person’s distinctive racial, national, religious, linguistic, or cultural heritage

Racism

Belief in racial superiority

Assimilation

Is described as the process by which persons of a diverse (different) culture, over time, give up their original cultural language and identify with, and try to merge into, another culture (usually the majority)

Requires the person to give up some of their values, accomplishments, beliefs, and so on, in order to “blend in” with the mainstream

Biculturalism

The ability of individuals to be able to negotiate competently two or more cultures: the mainstream culture and the individuals own culture

A comfortable balance for the individual, between cultures

RACE

Rescue , alarm, confine, extinguish. In case of a fire

PASS

Pull, Aim, Squeeze, Sweep

Hassles

Minor changes

Inpatient

Someone who has been admitted to the hospital for diagnostic studies or treatment

Generally occupy a hospital bed for 24 hours or longer

Outpatient

Someone who has come to the hospital or outpatient center for diagnostic testing or treatment but does not usually occupy a bed overnight

Aphasia

Loss of language

Dealing with death and loss Stages of grief

Denial

Anger

Bargaining

Depression

Acceptance

Objective Data

Perceptible to senses

Able to be measured

Sings that can be seen, heard, felt, and so on

Subjective Data

Patient feelings

Pain level

Attitude

Opinion of observer

Subject to interpretation

Things to consider for a detailed history

Onset

Duration

Specific location

Quality of pain

What aggravates

What alleviates

Sacred seven

Localization

Chronology

Quality

Severity

Onset

Aggravating or alleviating factors

Associated manifestations

Onset

Patient may also explain what he or she was doing when illness or condition began

Can help determine whether predictable events occurred that preceded the recurrence of a symptom

Duration

Described in seconds, minutes hours, days, weeks, or months

Ex. Cough lasting 10-15 seconds, several times an hour, worse at night than in morning

SOAP method

S – Subjective data from patient or patient family

—O - objective data acquired by observation, inspection, or testing — A - relates to the assessment or Dx of the patient’s current situation / progress made throughout the course of treatment

—P - represents the actual patient care plan

Body mechanics

3 concepts

Base of support

Center of gravity

Line of gravity

Base of support

Broad base of support provides stability for body position and movement

Portion of the body in contact with the floor

Stand with feet apart and one foot slightly advanced

Center of gravity

This is the point around which the body weight is balanced

Load size and position can affect your center of gravity

Line of gravity

The body is most stable when the line of gravity bisects the base of support

Imaginary vertical e line passing through the center of gravity

Mobility muscles

Extremity muscles

Stability muscles

Muscles of the torso

Stroke patients

Assist patients on their weak side

Fracture of lower extremity

Support the side that is affected

Stretcher transfer

When transferring the patients bed and stretcher need to be horizontal and parallel to each other

Use single sheet or you can use the pad

Restraints

Ensure patient safety

Physicians order for adulation must be updated every 24 hours

Immobilization methods

Prevent undesired motion during imaging procedures

What is everyone’s goal according to Maslow’s hierarchy of needs

Self actualization

Leading question

Undesirable method of questioning that provides information that may direct the answer toward a suggested symptom or complaint

Microbial flora

Normal flora

Microorganisms that live on or inside the body without causing disease

Pathogens

Pathogenic organisms

Microorganisms that cause disease

Bacteria

Does not need a host to replicate

Very small, single cell organisms, cell wall ( for survival) and an atypical nucleus that lacks a membrane

Reside in host as a group or cluster called a colony

Endospores

Resistant form of the bacterium that is formed within the cell when environmental conditions are unfavorable

Resistant to destruction

Rickettsiae

Atypical bacteria

Smaller than most bacteria

Grow only inside animal cells

Viruses

Smallest known disease causing organisms

Capsid- outer protein covering that protects genetic material

MUST HAVE A HOST

Fungi

Size much larger than bacteria

Single called yeasts

Molds- long branched composed of many cells

Prions

A type of protein that can trigger normal proteins in the brain to fold abnormally

Smallest and least understood of all microbes

“ infectious proteins”

Parasitic Protozoa

Organisms are neither plant nor animal

Larger than bacteria

Classified by their motility

Establishment of infectious disease

1. Encounter
2. Entry
3. Spread
4. Multiplication
5. Damage
6. Outcome

Most direct way to break the cycle of infection

Is to prevent transmission of the infectious organism from the reservoir to the susceptible host

6 main routes of transmission

Direct contact

Fomite- indirect

Vector- indirect

Vehicle- indirect

Airborne contamination - indirect

Droplet contamination- indirect

HAI

Infection acquired by a person before he or she enters a health care facility

Natural resistance

Provided by mechanical barriers of intact skin and mucous membranes

Acquired immunity (long term)

Occurs when an individual develops antibodies to a particular organism as a result of either infection or immunization

Passive immunity

Occurs following an injection of preformed antibodies to a particular infection

Staph

Bacteria that is carried on the skin or in nose of healthy people

25-30% of the US carry staph on their bodies at any time

Treated with antibiotics

MRSA

Bacteria resistant to some kinds of antibiotics

Culture

Tracheostomy

It is recommended that only properly trained personnel suction the tracheostomy patient

Remain lower than the patients chest

Exterior assembly of the chest tubes must always

Urinary catheters 2 types

Retention balloon

Straight type

Indwelling catheter

Drainage bag must be kept lower than patients bladder at all times to prevent retrograde flow into bladder

Cathartics

Strong laxatives

Enema tip insertion

Patient in sims position

Direct tip superiorly and anteriorly 2-4’’

Aim for belly button

Do not insert more than 4 inches

Hang enema bag 18’’ above level of anus

Gastrograffin

Used when barium is a contraindication

Ex. Perforated GI suspected

Barium enema

Fill bag with 1500ml Barium and the rest with tap water for a total of 2000ml in bag

Always clamp bag

Bag hung 24-30 above table

Barium peritonitis

Extravasation of barium into peritoneal cavity (VERY BAD)

Single contrast barium enema

Uses larger volume of barium

Colostomies

From the large colon

Ileostomies

From the small bowel

Stoma

Artificial opening

Auscultation

Listening to sounds of the body

Diaphoresis

Profuse sweating

Diastolic

Period of dilatation

Systolic

Pertaining to contraction

Hypoxia

Low oxygen

Anoxia

Absence of oxygen

Pneumothorax

Presence of air or gas in the pleural cavity that separates the lung from the chest wall and which may interfere with normal breathing

Cyanotic

Bluish in color in skin

Orthropnea

Inability to breathe when lying down

Palliative

Relieving pain or alleviating a problem without dealing with the underlying cause

ET tube (endotracheal tube)

For oxygen administration only

Correct positioning of the tip is just above the carina

PCXR will be used to confirm placement

Thoracostomy tube (chest tube)

Drain the intrapleural space either due to accumulation of air or fluid

Drainage for air - placed higher

Drainage for fluid- placed lower near base of lung

Central venous lines

Are inserted into a large vein

Tip placement is in the SVC 2-3cm above the right atrial junction

Different lumens

Flushed with heparin

General priorities in trauma situations

Ensure an open airway

Golden hour

Victims of massive trauma who survive the injury have a greater chance of recovery if stabilized within the first hour

Triage

Process of identifying victims, perform initial assessment and assigns order for further care

Head trauma

May not be visible externally

May result in contrecoup or concussion

Hypovolemic shock

Loss of large amounts of blood or plasma