chapter 20: bedside radiography - special conditions and environments

radiographic procedures performed at the patient’s bedside

mobile radiography

what are the two types of units generally used in mobile radiography?

portable machine and the C-arm

produces dynamic images for real-time viewing and is also capable of producing radiographs of a relatively small anatomic area

C-arm

tension-type treatment used to correct a bone deformity

orthopedic traction

used to care for very ill patients who require frequent, if not constant monitoring

ICU and CCU

what radiograph is most often called for in the ICU and CCU?

chest

designed and staffed for close observation and care of patients after operative procedures that require an anesthetic agent

post-anesthesia care unit (PACU)

who establishes the priorities in the trauma unit?

the trauma physician

failure of the lungs to expand completely

atelectasis

may be used to provide an environment of extra warmth, moisture, and oxygen while reducing exposure to airborne infection

enclosed incubator

why do beds that have a rocking motion or waves of alternating pressure need to be turned off during x-ray exposures?

to avoid motion blur on the radiograph

why would some patients need to lie on an alcohol or water filled pad?

to raise or lower body temperature

if a patient has a warming or cooling pad, where is the IR placed?

on top of the pad to avoid artifact

very effective in reflecting body heat back toward the patient

surfaces of Mylar warming blankets or pads

version of a warming blanket; has two layers; the layer in contact with the patient is a flat non-woven fabric and under this layer lies a series of connected plastic tubes that are filled with warm air

the Bair Hugger

the IR must be _____ of reflective blankets.

on top

mechanical method using weights to provide a constant pull on part of the body for therapeutic reasons

orthopedic traction

surgical procedure that creates an opening into the trachea to provide a temporary or permanent artificial airway

tracheotomy

a tube in an opening of the trachea to provide an open airway

tracheostomy

patients with new tracheostomies are monitored in the ___.

ICU

what are the precautions of a tracheostomy?

monitor patients closely, NEVER untie the tapes holding the tube in place, and have suction immediately available

machine that provides breathing through a tube passed through the mouth and into the trachea

mechanical ventilation

how should you time exposure for a patient on mechanical ventilation?

time it to the machine’s respiration to obtain a motion-free image

what are the purposes of an NG tube?

feeding, decompression or draining, radiographic examination, and medication administration

tubes that are passed through the nose and down into the stomach or small intestine

NG or NE tube

removal of gas and draining of secretions by suction, is prescribed to prevent vomiting in patients who have recently had surgery or have an intestinal obstruction

decompression

NE tubes are passed from ____.

nose to duodenum

NG tubes are passed from ____.

nose to stomach

method used to remove fluid or air that has accumulated in the pleural space

closed chest drainage

the closed chest drainage unit must remain _____ of the patient’s chest.

below the level

placed to help monitor and manage critical patients and patients requiring long-term care

specialty catheters

where are specialty catheters placed?

in the pulmonary artery, central vein (CVC), or peripherally (PICC)

what is often used to verify placement of specialty catheters?

mobile images

measure cardiac output, the pressures on the right side of the heart, and indirectly, the left heart and lung pressures

pulmonary artery flow-directed catheters

example of pulmonary artery flow-directed catheters.

Swan-Ganz catheter

facilitate the administration of chemotherapy or another long-term drug therapy, total parenteral nutrition, dialysis, or blood transfusions; may facilitate the drawing of blood and allow central venous pressure monitoring

central lines or CVCs

an electromechanical device that regulates the heart rate by providing low levels of electrical stimulation to the heart muscle to replace the stimulation that is normally provided by nerve impulses

pacemaker

a pacemaker is often inserted under ___ guidance.

C-arm

which precaution must be followed when obtaining a lateral chest x-ray on a patient who has recently had a pacemaker implanted?

a) do not abduct the left arm

b) do not abduct the right arm

c) do not allow the patient to sit upright

d) do not allow the patient to lie flat

a) do not abduct the left arm

which of the following actions is/are essential before performing a bedside radiographic examination?

a) check with the patient’s nurse to inquire about the patient’s condition

b) confirm the order in the patient’s medical record

c) greet the patient, check the armband, and prepare the room

d) all of the above

d) all of the above

nasogastric tubes are placed in patients for purpose of:

a) feeding

b) decompression of gas and fluids

c) imaging

d) all of the above

d) all of the above

an example of a nasogastric tube used to feed the patient is a ___ tube.

a) Dobbhoff

b) Miller-Abbott

c) Harris

d) Cantor

a) Dobbhoff

the tip of a PICC or any central venous catheter should be visualized in the:

a) pulmonary artery

b) right atrium

c) right ventricle

d) superior vena cava

d) superior vena cava

when a Swan-Ganz catheter is in a wedged capillary position, it lies in:

a) right or left pulmonary artery

b) the right ventricle

c) the branch of the pulmonary artery

d) the left atrium

c) the branch of the pulmonary artery

which of the following is NOT a central venous catheter?

a) Hickman

b) Groshong

c) Swan-Ganz

d) PICC

c) Swan-Ganz

bedside radiography may be advantageous for patients in:

a) special care units

b) isolation

c) orthopedic traction

d) all of the above

d) all of the above

an implanted device that electrically stimulates the herat to control its rate is called a:

a) pacemaker

b) salem sump

c) central venous catheter

d) mechanical ventilator

a) pacemaker

a surgical opening into the trachea that provides a temporary or permanent artificial airway is called a:

a) tracheotomy

b) tracheostomy

c) pacemaker

d) ventilator

b) tracheostomy