Patient Care Review

Cultural diversity

The acknowledgment and examination of various societies to understand their similarities and differences.

Discrimination

The act of treating people unequally based on their diversity traits.

Bias

The tendency to think negatively of others without justification.

Prejudice

The preconceived negative opinion about others without justification.

Cultural Competency

The possession of attitudes, behaviors, and policies that enable effective interactions in cross-cultural environments.

Communication

The process of effectively exchanging information, which requires emotional intelligence, reading the patient's body language, and adjusting the level of care, voice, and manner of working accordingly.

Maslow's hierarchy of needs- concept

A model that explains the different levels of human needs and emphasizes the importance of addressing basic needs before higher-level needs.

5 stages of coping with death

1. denial & isolation 2. anger 3. bargaining 4. depression 5. acceptance.

Chief complaint

The primary reason why a patient is seeking medical attention.

objective data

Observable data. Test results, visible injury, swelling, bruising, deformity, wheezing

#1 cause of injury in our field

Back injuries, which are the most common type of injury experienced by healthcare professionals in this field.

Good body mechanics

The practice of using proper posture and movement techniques to maintain a wide base of support, keep the back straight, lift with arms/legs, and engage core stomach muscles to prevent injury.

Wheelchair transfers

The process of safely transferring a patient from a wheelchair to another surface, involving techniques such as a 45° pivot from the table, a 2-person lift parallel to the table, or the use of a Hoyer lift.

Immobilization

Using radiolucent, easy to use tools aiming to reduce the need for repeated repositioning and minimize patient dose.

Radiolucent

Materials that allow X-rays to pass through, commonly used for immobilization devices to ensure clear imaging.

Examples of immobilization tools

Sponges, sandbags, tape, pigg-o-stats, backboards, Velcro straps, stability bars

Vitals

Measurements of various body functions, such as heart rate, blood pressure, body temperature, and respiratory rate, used to assess a patient's overall health.

Homeostasis

The state of balance and stability in the internal environment of the body, maintained through various natural adaptive responses.

Natural adaptive responses

The body's automatic physiological responses, including heartbeat, blood pressure, body temperature regulation, respiratory rate, and electrolyte balance, that help maintain homeostasis.

Body temperature

The measurement of the degree of heat in the body, including normal ranges and variations, as well as conditions such as fever and hypothermia. Normal oral 98.6℉ or 37℃

Respiratory rate

The measurement of the number of breaths per minute, with normal ranges varying based on age groups, and conditions such as tachypnea (rapid breathing) and bradypnea (slow breathing). Normal adult 12-20 breaths/min

Blood pressure

The measurement of the force exerted by blood on the walls of arteries, consisting of systolic pressure (during heart contraction) and diastolic pressure (during heart relaxation), with normal ranges varying based on age groups. Normal adult less than 120 over less than 80

Pulse rate

The measurement of the heart rate, typically taken at various sites on the body, with normal ranges varying based on age groups. Normal adult 60-100 beats/min

Pulse Oximetry

A non-invasive method of measuring the oxygen saturation level in the blood, used to assess the presence of hypoxemia (low oxygen levels) or hypoxia (insufficient oxygen supply to tissues). Normal adult 95-100%

Oxygen Therapy

The administration of supplemental oxygen to patients to prevent brain damage and improve oxygenation, involving various methods and devices.

Endotracheal tube (ET)

A tube inserted into the trachea (windpipe) to assist with breathing, typically used in cases of severe respiratory distress or during surgery. Distal tip 1-2" superior to the carina.

Tracheostomy tube

A tube inserted into a surgically created opening in the trachea, used to bypass upper airway obstructions or provide long-term ventilation support.

Thoracostomy Tube

A tube inserted into the chest to drain air, blood, or fluid, commonly used in cases of collapsed lung or pleural effusion.

Nasogastric Tube

A tube inserted through the nose and down into the stomach, used for various medical purposes such as feeding or administering medications.

Central Venous Lines

Catheters inserted into large veins for various medical purposes, such as delivering medications or fluids, with different types available based on specific needs. Distal tip in the SVC, 2-3cm superior to the right atrial junction

Pulmonary Arterial Line

A catheter inserted into the pulmonary artery to monitor pressures within the heart and lungs, commonly used in critical care settings. Distal tip rests inside the pulmonary artery.

Infection Control

The practices and protocols aimed at preventing the spread of infections in healthcare settings, involving understanding the steps of infectious disease transmission and the chain of infection.

Microorganisms

Organisms, such as bacteria, viruses, and fungi, that can cause infections and infectious diseases when they harm the body's tissues.

Chain of Infection

The series of steps required for an infection to occur, including the pathogen, reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host.

Health Care Associated Infections (HAIs)

Infections acquired by patients during their stay in healthcare settings, with higher risk for individuals with compromised or weakened immune systems.

Defenses of the Body

The mechanical, chemical, and cellular defense mechanisms that the body employs to protect itself against infections and maintain overall health.

Pharmacokinetics

The study of how a drug is absorbed, distributed, metabolized, and excreted by the body, influencing its effectiveness and potential side effects.

Reactions

The different types of responses a patient may have to a drug, including side effects, toxic effects, allergic reactions, and idiosyncratic reactions.

5 Rights of drug administration

The fundamental principles of safe drug administration, including the right drug, right amount, right patient, right time, and right route.

Routes of drug administration

The different methods by which drugs can be administered to patients, including enteral (oral or through the gastrointestinal tract), topical (on the skin), and parenteral (injection or infusion).

Contrast media

Substances used in medical imaging procedures to enhance the visualization of low subject contrast areas, available in both positive and negative contrast forms.

Contrast contraindications

The conditions or factors that make the use of contrast media in medical imaging procedures inappropriate or potentially harmful, including allergies to contrast, diminished kidney function, and certain diabetes medications.

subjective data

Information only the patient can perceive, pain level, sharp/dull pain, pressure in the chest, heart palpitations.

Vector

mosquito, flea, or tick

fomite

inanimate object that harbors and transmits pathogens

-statics

inhibit further growth of microorganisms

-cidals

kill microorganisms

airborne illnesses

tuberculosis, measles, chicken pox

droplet illnesses

streptococcus (Strep), mumps, meningitis, flu

contact illnesses

MRSA, CDiff, Staph, Hep A, chicken po

surgical asepsis

procedure used to prevent contamination by microbes before, during, or after surgery using sterile technique

medical asepsis

prevents reinfection and the spread of infection to other people- reduces microorganisms

aseptic procedures (fluoro)

myelograms, lumbar punctures, arthrograms, HSG

types of shock

hypovolemic, cardiogenic, neurogenic, vasogenic

hypovolemic shock

shock resulting from blood or fluid loss

cardiogenic shock

Shock caused by inadequate function of the heart, or pump failure.

neurogenic shock

Circulatory failure caused by paralysis of the nerves that control the size of the blood vessels, seen in patients with spinal cord injuries.

Vasogenic Shock

caused by sepsis, deep anesthesia, or anaphylaxis

anaphylactic shock

Type of vasogenic shock caused by an allergic reaction possibly to contrast

hyperglycemia

insulin deficiency; blood glucose more than 180-200 mg/dL

hypoglycemia

excessive insulin present; blood glucose less than 70 mg/dL

respiratory distress

pulmonary function compromised- increased work of breathing; a sensation of shortness of breath

cardiac crisis

heart function is compromised

cerebrovascular accident (CVA)

disruption in the normal blood supply to the brain; stroke

drug dosage forms

tablets, inhalants, suppositories, capsules, solutions, suspensions, transdermal patches

drug routes

enteral, parenteral, topical

barium sulfate

not water soluble; contraindicated for suspected perforations

ionic iodinated contrast

water-soluble; high osmolality; higher rate of reactions

non-ionic iodinated contrast

water-soluble; lower osmolality

HIPAA (Health Insurance Portability and Accountability Act)

Privacy, security, & establishment of standards for electronic transfer of PHI

torts

wrongful acts for which an injured party has the right to sue

assault

threat or attempt to injure

battery

unlawful touching of another person without consent

False Imprisonment

restraining an individual or restricting an individual's freedom

defamation

the action of damaging the good reputation of someone; slander or libel.

slander

spoken defamation

libel

written defamation

fraud

willful and purposeful misrepresentation that could cause, or has caused, loss or harm to people or property

Privacy of Records

in patient bill of rights, confining the records/images in secured area; a patient's right to their own records unless they are a minor or unstable

negligence

careless neglect, often resulting in injury

res ipsa loquitor

the thing speaks for itself; patient could not be responsible for injury

respondeat superior

"let the master answer" A doctrine under which a principal or an employer is held liable for the wrongful acts committed by agents or employees while acting within the course and scope of their agency or employment.

Corporate Liability

The legal concept that allows employers to be charged with a crime resulting from their employees' actions while carrying out corporate business

consent

permission for something to happen or agreement to do something.

implied consent

the consent it is presumed a patient or patient's parent or guardian would give if they could, such as for an unconscious patient or a parent who cannot be contacted when care is needed

informed consent

an ethical principle that research participants be told enough to enable them to choose whether they wish to participate. full explanation of procedure, risks, alternatives

Patient Bill of Rights

a development by the American Medical Association that guarantees a patient the right to receive courteous, considerate,respectful treatment in a clean/safe environment; appropriate healthcare; information about his/her health treatment plan in a way that he or she understands; a continuity of care; confidentiality privacy;participation in planning care and treatment; refusal of care; use of grievance mechanisms; treatment without discrimination;an itemized bill and explanation of all charges; and review of the medical record and/or copy at reasonable fee.

information required on radiographs

patient name, patient ID number, study date, study time, performing facility, and physical markers

The Sacred Seven: Localization

Determination of a precise area, usually through gentle palpation or careful wording of questions.

Use touching for emphasis ("does it hurt more here or here?") and palpation (gently palpating the olecranon process of the elbow, for instance).
If the patient is experiencing radiating pain, then document that the pain is nonlocalized.

The Sacred Seven: Chronology

The duration since onset, frequency and course of the symptoms.
For example, the onset of a chest problem may have been several weeks before the examination, the duration of coughing may average 10-15 seconds, the frequency may be several times per hour, and the course may reveal that it is worse during the night and in the morning.

Avoid giving dates or days as chronology to prevent the radiologist from having to search for a calendar.

The Sacred Seven: Quality

Describes the character of the symptoms.

Examples include the color and consistency of body fluids, the presence of clots or sores, the size of lumps or lesions, the type of cough, and the character or pain.

When pain is involved, it should be described as acute (having a sudden onset), or chronic (having a prolonged course).
It should also include specific descriptors such as: burning, throbbing, dull, sharp, cutting, aching, prickling, radiating, pressure, and crushing.

The Sacred Seven: Severity

Describes the intensity, quantity, or extent of the problem.
Examples are the intensity of pain, the number of lesions or lumps, and the extent of a burn.
It's the difference between whether the patient describes a light burning sensation or a very intense burning sensation.

The Sacred Seven: Onset

The patient explaining what he or she was doing when the illness or condition began.
For example, a patient might have had a series of mild headaches before a seizure.

The Sacred Seven: Aggravating or Alleviating Factors

The patient describing activities that make the symptoms better or worse

The Sacred Seven: Associated Manifestations

Determining whether other symptoms accompany the chief complaint.
For example, the patient may describe gastrointestinal symptoms as a part of, or separate from a cardiac condition.

Maslow's Hierarchy of Needs- physiologic

1st level; basic needs; shelter, food, water, sleep

Maslow's Hierarchy of Needs- safety

security and protection from physical and emotional harm

Maslow's Hierarchy of Needs- belongingness

love, friendship, acceptance by others

Maslow's Hierarchy of Needs- esteem

self-esteem, confidence, achievement, respect of others, respect by others

Maslow's Hierarchy of Needs- need to know

expand education, learn new skills