patient care ppt board review

what type of consent is for when the patient is unconscious and it's based on the assumption that the patient would approve care?

implied consent

what type of consent is this?

-pt must be mentally competent

-provided in terms where pt can understand

-consent is offered voluntarily

-must be of legal age

-procedure carefully explained and risks involved

-pt has right to information

informed consent

what type of consent needs to be written, oral, or implied?

informed consent

written consent is for _____ risk procedures (iodinated contrast)

high

verbal consent is for _____ risk procedures (chest)

low

what does HIPAA stand for?

health insurance portability and accountability act

what is a DNR also called?

no code

what is a health care proxy?

a legal document in which pt appoints an agent to legally make healthcare decisions on their behalf when they are incapable of making and executing the healthcare decisions

what is an advanced directive?

a document by which a person makes provision for healthcare decisions before becoming incapacitated

what are the two types of advance directive?

living will and durable power of attorney for health care

what is a living will?

a written statement detailing a person's desires regarding their medical treatment in circumstances in which they are no longer able to express informed consent

what is a durable power of attorney?

a personal representative to make decisions regarding medical care if pt is unable to communicate; talk ahead of time

what does subjective information mean?

it's information perceived by the affected person

what does objective information mean?

it's information that is perceptible to senses

what is the sacred seven of patient history?

1. localization

2. chronology

3. quality

4. severity

5. onset

6. aggravating/alleviating factor

what is an examination requisition?

a written order for the exam

what is the sequencing order for diagnostic exams?

-not requiring contrast

-exams of the urinary tract

-exams of the biliary tract

-lower GI

-upper GI

what things give authorization to order a radiographic exam?

-MD with valid credentials

-MD signature

-necessity of exam

what needs to be on the order for it to be valid?

-pt name, DOB, SS#, med record #

-exact region or part imaged

-suspected or existing diagnosis

-ordering physician

-date

what is the most overlooked thing on an order in terms of required clinical information?

the date

________ maintains the responsibility for proper patient identification

radiographer

name this common legal terminology: threat of touching in an injurious way

assault

name this common legal terminology: unlawful touching without consent, image taken against pts will, image taken on wron pt/wrong body part

battery

name this common legal terminology: confidentiality not maintained, body unnecessarily exposed or touched

invasion of privacy

name this common legal terminology: unjustifiable detention ( pt wishes to leave), inappropriate use of restraints

false imprisonment

name this common legal terminology: defamation by written or printed word

libel

name this common legal terminology: defamation by word

slander

name this common legal terminology: intentional/unintentional act resulting in injury, violations of civil law (personal injury), malpractice

tort

name this common legal terminology: the thing speaks for itself, cause of the negligence is obvious, defendant to prove innocenece

res ipsa loquitur

name this common legal terminology: let the master answer, employer can be held liable

respondeat superior

name this common legal terminology: an action that is done for the benefit of others

beneficence

name this common legal terminology: also called unintentional misconduct, neglect, or omission of reasonable care, based on a reasonably prudent person

negligence

name this common legal terminology: reckless disregard

gross negligence

name this common legal terminology: injured person is contributing party to injury

contributory negligence

name this common legal terminology: improper, illegal, or negligent professional activity or treatment (pt is injured)

malpractice

4 conditions needed to establish malpractice

1. establishment of a standard of care

2. standard of care was violated

3. loss or injury caused by radiographer

4. loss or injury actually occurred and is a result of negligence

the 7 C's of malpractice prevention

1. Competence

2. Compliance

3. Charting

4. Communication

5. Confidentiality

6. Courtesy

7. Carefulness

is this a restraint or immobilization?

used to limit movement and ensure pt safety

restraint

is this a restraint or immobilization?

prevent unwanted motion-improved diagnostic quality

immobilization

is this a restraint or immobilization?

patients unable to cooperate (senile, inebriated, ped)

restraint

is this a restraint or immobilization?

must be ordered by a physician

restraint

is this a restraint or immobilization?

used to eliminate or minimize movement

immobilization

is this a restraint or immobilization?

things like sandbags, velcro straps, cervical collars, restraint boards, pig-o-stat, communication

immobilization

is this a restraint or immobilization?

cannot be removed without a physician's order

restraint

true or false: radiographic images are a legal document

true

true or false: manipulation of the exposure indicator, brightness/contrast, or masking/cropping is considered tampering or altering a legal document.

true

what two things do the ARRT standards of ethics consist of?

code of ethics and rules of ethics

is this code of ethics or rules of ethics?

serve as a guide for professional conduct

code of ethics

is this code of ethics or rules of ethics?

mandatory standards of minimally acceptable professional conduct

rules of ethics

who is the ARRT standards of ethics written by?

ASRT

who is the ARRT standards of ethics enforced by?

ARRT

what mode of communication is this?

-be clear and distinct

-terms used must be in a language the patient can understand

-presentation

-attitude

-tone

verbal/written

what mode of communication is this?

-conveys the radiographer's attitude and demeanor

-touching

-facial expressions

-appearance

non-verbal

what mode of communication is this?

-sensitivity to the needs of others

empathy

what mode of communication is this?

-calm firm expression of feelings or opinions

assertiveness

true or false: in all communication, the radiographer does not need to be a good listener

false, it is crucial

what are some challenges in communication when having interactions with others?

language barriers, cultural/social factors, physical/sensory impairments, age, emotional status, acceptance of condition

do we need to explain things in terms and words that the patient understands?

yes

are we required to answer patient questions regarding procedures?

yes

what are the 5 stages of grief?

1. Denial

2. Anger

3. Bargaining

4. Depression

5. Acceptance

true or false: we need to explain the purpose and length of the procedure

true

what type of consent is used for non-invasive exams?

verbal

what type of consent is used for invasive procedures or those involving the administration of contrast?

written

what are some possible preparation instructions for upper/lower GI and biliary procedures?

low residue diet, increase fluid intake, liquid diet 24 hrs prior, or laxatives

what modality has the highest dose?

CT

what modality uses magnetic fields with no radiation exposure?

MRI

what modality has higher patient absorbed dose due to low kVp?

mammography

what modality uses ultrasonic waves with no radiation exposure?

sonography

what modality has radioactive isotopes injected, and the pt emits radiation?

nuclear medicine

what modality has dual energy xray absorption (DEXA) and is low dose?

bone densitometry

what type of patient transfer is this?

-standby assist transfer

-assisted standing pivot transfer

-two-person lift

-hydraulic lift

wheelchair

what type of patient transfer is this?

-patient-assisted

-moving device or draw sheet/slicker board

stretcher/gurney

what type of patient transfer is this?

-pts with spinal injuries, metastatic disease, fracture, and subluxation

-requires 5 people

log rolling

how many inches do we have to maintain above the level of the vein with an IV?

18-20 inches

L/min and O2 saturation of a nasal cannula

L/min: 1-6

O2 sat: 21-60%

L/min of an oxygen mask

L/min: >5

O2 saturation of a non-rebreather mask

O2 sat: 60-90%

what medical equipment is this?

-mechanical respirators

-care not to dislodge

ventilators

what medical equipment is this?

-surgical opening (artificial airway)

-periodic suction clear airway

-tube in opening, care not to dislodge

-all connections secure, tubing does not obstruct radiograph

tracheotomy

what medical equipment is this?

-nose to stomach (feeding or gastric suction)

-clamps or plugs secured, leaking secretions

-care not to dislodge

nasogastric tube

what medical equipment is this?

-removes fluid or free air from pleural cavity

-care not to disconnect, results in collapsing lung

-keep drainage container lower than chest

chest drainage or chest tube

what medical equipment is this?

-drainage and collection of urine

-care not to dislodge

-keep collection bag lower than bladder

urinary catheters (foley)

what are the three main types of vital signs?

1. pulse

2. BP

3. respiratory rate

normal pulse rate for adults

60-100

normal pulse rate for children

90-100

normal pulse rate for infants

80-120

is this tachycardia or bradycardia?

fast rate, >100 bpm

tachycardia

is this tachycardia or bradycardia?

slow rate, <60 bpm

bradycardia

what artery are we using at the neck for checking the pulse?

carotid artery

what artery are we using in the upper extremity for checking the pulse?

radial artery

what does systolic mean in terms of BP?

pressure during contraction (left ventricle)

what does diastolic mean in terms of BP?

pressure with the heart at rest

is this hypertension or hypotension?

high arterial BP; >140 mmHg systolic/90 mmHg diastolic

hypertension

is this hypertension or hypotension?

low arterial BP; <95 mmHg systolic/ 50 mmHg diastolic

hypotension

normal BP in adults

systolic: 110-140

diastolic: 60-80

normal BP in children

systolic: 70-112

diastolic: 26-70

normal BP in infants

systolic: 60-105

diastolic: 22-60

normal respiratory rates in adults

12-20

normal respiratory rates in children

30-60

what is tachypnea?

rapid breathing