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CT
CT
105
Agriculture
Professional
09/09/2018

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Cards

Term
Utilitarianism (Consequentialism)
Definition
Rightness Of An Action Is Measured By
Consequences

Greatest Good To Greatest Number
Term
Deontology (Non-consequentialism
Definition
Reviews A Situation Based On Rules

Consequences Are Not Taken Into
Consideration
Term
For alleged medical negligence to apply
and damages be awarded, four elements must be proven:
Definition
Is there a duty to the patient by the
technologist?

Was there a breach of duty by an act or failing to perform an act?

Actual proof of a compensable injury

Relationship between the injury and the breach of duty
Term
Simple expressed consent
Definition
Involves obtaining a patient’s
permission to perform a procedure

Generally utilized for noninvasive
procedures

Can be on a written form or
communicated orally
Term
Implied consent
Definition
Takes place in emergency situations

Patient’s decision-making capabilities are compromised

“Reasonable-person Standard”

Based on the decision a reasonable
person would make if he or she were
confronted with the same medical
situation
Term
Informed consent
Definition
Required when patient is subjected
to any type of invasive procedure

Hospitals and clinics should not rely
on the ordering physician to obtain
consent
Term
Communication can be defined as the
Definition
“process of creating meaning”
Term
You cannot really transmit meaning—only...
Definition
Messages
Term
Estimates suggest that __% to __% of a message’s meaning is lost in transmission
Definition
40%-60%
Term
Possibly 90% of the meaning derived from communication comes form nonverbal cues
Definition
Nonverbal cues
Term
Necessary information for CT exams
Definition
Signed consent form

Specific written order

Diagnosis pertinent to the procedure

Allergies-especially contrast

Laboratory Values

Medications
- Anticoagulants, sedatives, insulin, blood pressure meds, diuretics, and laxatives
Term
High-risk CT patients
Definition
Aneuria

Chronic heart disease

Recent myocardial infarctions

Renal disease

Respiratory disease

Previous reaction to contrast

History of allergies
Term
Anticoagulants are withheld if a...
Definition
Biospy is planned
Term
Any patient receiving these have increased risks
of bleeding
Definition
Anticoagulants
Term
2 common anticoagulants
Definition
Warfarin (Coumadin) - Oral medication, blocks absorption of vitamin K


Heparin
– Injected, affects activity of thrombin to prevent clot formation
Term
Generally, CT patients should fast at least
Definition
4 Hours
Term
Anticoagulants should be withheld if
Definition
A biospy is planned
Term
Antiplatlets are used for
Definition
Pts with acute ischemic event in the brain or heart
Term
Common antiplatlets
Definition
Acetylsalicylic Acid (Asprin)

Plavix (Clopidogrel)
Term
Thromblitic Agents
Definition
Used to break a clot
Term
Common Thromblitics
Definition
Altepase

Streptokinase

Urokinase
Term
Narcotics
Definition
Pharmacologic agents producing a depressed level of consciousness and respiration
Term
Two primary sedative types
Definition
Opioids - Strong respiratory depressants
- Demerol and Morphine

Benzodiazepines - Respiratory depressant
- Valium and Versed
Term
Clotting value lab reports
Definition
Prothrombin Time (PT)
- Measures activity of coagulation in Plasma
- 11-14 seconds

Partial Thromboplastin Time (PTT)
- Blood substance that aids in conversion of other clotting factors
- 25 to 35 seconds

Platlets
- 150K-400K u/L

International Organized Ratio
- Evaluates the ability of blood to clot properly
Term
BUN
Definition
- Abnormal value associated with dehydration
- 7-25 mg/dl
Term
Creatinine
Definition
- High value associated with renal impairment
- .6-1.7 mg/dl
Term
_____ _____ is a useful measurement for estimating the glomerular filtration rate of the kidneys
Definition
Creainine Values

Result of this test is an important gauge used in
assessing excretory function of the kidneys
Term
Creatinine Clearance Values
Definition
Normal: 90+

Moderate Function: 30-60

Poor Function: 15-30

Failure: Under 15
Term
True test for creatinine clearance
Definition
24 Urine Lab Test
Term
Normal BPM
Definition
Adults: 60-100/min
4-10yr: 95-100/min
Infant: 100-160/min
Term
Pulse Points
Definition
Apical - With stethoscope

Temporal/Facial

Carotid

Radial

Brachial

Femoral

Popliteal

Pedal
Term
Tachycardia
Definition
Over 100 BPM
Term
Bradycardia
Definition
Below 60 BPM
Term
Adult Temperature
Definition
98.6 (+ or - 1 is normal)

Children slightly higher
Term
4 Temperature-taking sites
Definition
Oral

Tympanic

Rectal

Axillary
Term
Pyrexia
Definition
Above normal temperature
Term
Hypothermia
Definition
Below normal temperature
Term
Normal respiration rates
Definition
Adult: 14-20 breaths/min

Child: 20-28 breaths/min

Infant: 30+/min
Term
1 breath per _ heart beats
Definition
4
Term
Oxygen Therapy
Definition
Nasal Cannula: 1-5 L/min (Adults)

Face Mask for 6 L+
- Necessary to eliminate CO2
- Humidity may be needed for high doses and long term use
Term
Natural O2 Stats
Definition
95-100%
Term
Blood pressure is measured with a
Definition
Sphygmomanometer
Term
Systolic
Definition
Highest number at ventricular contraction
Term
Diastolic
Definition
Lowest number at ventricular relaxation
Term
Normal Adult Pressures
Definition
Systolic: 90-120

Diastolic: 60-80
Term
Hypotensive
Definition
Systolic less than 90
Term
Hypertensive
Definition
Systolic greater than 140

Diastolic greater than 90
Term
Shock
Definition
Body's pathologic reaction to:

Illness

Trauma

Severe physical or emotional stress
Term
Symptoms
Definition
Decrease in Blood Pressure

Increase in Heart Rate

Rapid, shallow respirations

Mental status change
Term
Types of Shock
Definition
Hypovolemic: Loss of blood, plasma, or prolonged loss of fluids

Cardiogenic - Failure of heart to pump adequately

Septic - Microorganisms in Blood

Anaphylatic - Allergic reaction to food, drug, or chemical

Neurogenic- induced by spinal cord injuries, severe pain, neurologic damage or extreme psychological stress

Vasovagal - Stimulation of Vagus nerve (10th)
Term
Anaphylactic Shock
Definition
Most common in CT from iodinated contrast

Histamines released, contracts smooth muscles in respiratory tract

Symptons: Tightness in chest, itching, urticaria, chokeing, and wheezing

1st drug: Epinephrine
Term
Neurogenic/Vasovagal
Definition
The heart rate drops (bradycardia) instead of tachycardia

Drug to counteract: Atropine
Term
Diabetic Hypoglycemia Reaction
Definition
Abnormally low levels of glucose in the blood

Caused by an excess of insulin or oral hypoglycemic drug

Symptoms (Progressive)
- Hunger
- Nervousness & Irritability
- Tachycardia
- Profuse perspiration and clammy skin
- Slurred Speech
- Seizure
- Coma

Check chart for diabetes & call nurse/MD

Give some form of sugar
Term
Metformin
Definition
Generic form of Glucophage, can be found in other diabetic medications

Withheld 48 hours after contrast

Binds to iodine and causes blood toxicity
Term
Diabetic Ketoacidosis
Definition
Not enough insulin to process glucose

Hyperglycemic patient

Occurs more slowly than Hypoglycemia

Symptoms:
- Weakness, drowsiness, headache
- "Sweet" breath
- Orthostatic hypertension
- Warm dry skin
- Dry mucus membranes
- Polyuria
- Tachycardia
- Rapid, deep respirations
Term
Pleural Cavity Pressure
Definition
Normal pleural cavity pressure is less than atmosphere
Term
Pneumothorax
Definition
Result from increased pleural pressure (collapsed lung with free air)
Term
Hemothorax
Definition
Lung filled with blood/fluid, preventing it from expanding
Term
Chest Tubes
Definition
Thoracotomy - Chest tube placement
- Used to remove air or fluid from chest cavity

Not kinked or twisted

Keep evacuation container lower than patient
Term
Needles and Catheters
Definition
Needles are measured in gauge
- Smaller number = larger diameter

Catheters measured by French # (FR)
- Larger the # = Larger the #
Term
Airborne Precautions
Definition
Designed to prevent airborne transmission of droplet nuclei or dust particles containing infectious agents

For Pt. documented or suspected of having:
- Measles
- TB
- SARS (+ Contact)
Term
Droplet Precautions
Definition
Designed to prevent droplet (larger
particle) transmission of infectious
agents when the patient talks, coughs,
or sneezes
Term
Contact Isolation
Definition
Used to prevent transmission of organisms
from an infected patient through direct
(touching patient) or indirect (touching
surfaces or objects in the patient’s
environment) contact
Term
Drug Nomenclature (Names)
Definition
Chemical - The chemical make-up

Generic - General name
- Ibuprofen, Acetaminophen

Proprietary – Brand
- Advil, Tylenol
Term
Controlled Substances
Definition
Classified C1-C5
- "C" stands for controlled substance
- Numbers show potential for abuse (lower number -- higher potential for abuse)

C1 = Illegal for Pt use
- May be obtained only thru the DEA for research and manufacture
Term
Major Drug Classification
Definition
Cardiac Medications
- Antiarrhythmic
- Antihypertensive
- Diuretics

Blood Clotting
- Antiplatelet
- Anticoagulant
- Thromblitic

Endocrine
- Antidiabetic
- Thyroid
Term
When was venipuncture mandatory for Rad. tech programs?
Definition
1991 (ARRT)
Term
Asepsis
Definition
Technique that inhibits the growth and
spread of pathogenic micro-organisms
Term
Sterilization
Definition
Process for the complete removal of all organisms and their spores
Term
Method of injecting iodinated CM will
vary according to:
Definition
– Vascular access available

– Type of examination

– Specific clinical indication
Term
Injection Parameters
Definition
- Whether the injection is performed by hand or with the use of a mechanical injector

– Contrast volume

– Flow rate at which the contrast will be injected

– The delay between injection and scanning

– Whether a saline flush is used
Term
Vascular access may consist of:
Definition
- Standard indwelling peripheral catheter

- Central venous access devices (CVAD)

- Peripherally inserted central catheters (PICC)
Term
Using an Established Indwelling Venous Catheter
Definition
• Evaluate the site for appropriateness for CM injection

• Verify the patency of the line with a saline flush

• If other medications are running, hang an additional bag of saline and connect it to an open port on the IV tubing

• Turn off existing medication only long enough to complete the injection

• Once the injection is completed, flush the line with saline and restart medications at the identical pre-examination rate
Term
What is a CVAD?
Definition
A venous catheter designed to deliver medications and fluids directly into the superior vena cava, inferior vena cava, or right atrium
Term
What is a PICC line?
Definition
A long catheter that is inserted through the large veins of the upper arm and advanced so that its tip is located in the lower one third of the SVC
Term
(T/F) PICC lines can handle contrast flow rates
Definition
False; Find another IV
Term
When no other options exist and the PICC must be used for CM injection
Definition
–Injection rate must be slowed
–Injection should be performed by hand bolus rather than by mechanical injector
Term
Special PICC lines that are designed for contrast flow are known as:
Definition
PowerPICC
Term
Supplies for Venipuncture
Definition
Gloves

Tourniquet

Skin cleaner

Tape

Arm board or hard surface

IV catheters

Syringes of contrast and saline

Dry gauze or cotton

Band Aides
Term
__% Bleach Solution will kill Blood Pathogens
Definition
10%
Term
Starting a Peripheral IV
Definition
•Obtain basic consent

•Use aseptic technique

•Use an indwelling catheter with flexible plastic cannula whenever a mechanical injector is used

Steps involved
–Assemble supplies
–Choose site
–Place the needle
–Secure site
Term
IV access types
Definition
Hypodermic Needle
– For obtaining blood samples or single dose injection

Butterfly or Scalp
– Low dose
– Low injection rate

IV or Angio Catheter
– For pressure injectors
– Repeated use
– Continuous injections
Term
Most common venipuncture site
Definition
Median Cubital
Term
Puncture steps
Definition
Stabilize vein by pulling skin in opposite direction of the stick

Insert needle bevel up
- 30 to 45 angle to skin
- When blood appears lower the needle until almost parallel to skin and advance ¼ inch more

Watch for Flashback or blood flow
- Release Tourniquet
- Secure Needle and Tubing
- Inject--Observe at all times
Term
History of + CM
Definition
1896

- Lead subacetate in digestive system of guinea pig (Toxic, no fucking shit)

- Thorastrast, radioactive, proved digestive tract could be visualized

1910

- Barium Sulfate (low cost, low toxicity, available)

1927

- Water-soluble iodinated contrast introduced (Cerebrovascular circulation studied
Term
History of - CM
Definition
1918

- Gas injected to study hydrocephalus
Term
Methods of CM administration
Definition
Parenteral
- Injection into a vessel (Iodine)

Ingestion
- UGI & Small Bowel (Barium and/or iodine)

Retrograde
- Enema (Barium or Iodine)
- Cystogram (Iodine)

Intrathecal
- Myelogram (Air or Iodine)
Term
IV agents increase the difference in attenuation between adjacent structures because...
Definition
Different tissues often enhance differently

Iodinated CM is handled differently in normal vs abnormal tissues
Term
Atomic # of Iodine
Definition
53
Term
Osmolality
Definition
The # of particles in solution, per unit liquid, as compared with blood
Term
High-osmolality agents (HOCM) may have as much as _ times the osmolality of blood
Definition
7
Term
Low-osmolality agents (LOCM) have roughly _ the osmolality of blood
Definition
2
Term
Isosmolar agents (IOCM) have ___ ____ osmolality as blood
Definition
The same
Term
Osmolality refers to the # of particles per ____ of _____
Definition
Kilogram of Water (Weight)
Term
Osmolarity refers to the # of particles per ____ of ____
Definition
Liter of solution (Volume)
Term
OsmolALITY and OsmolARITY are used interchangeably to describe
Definition
Osmotic Activity
- Referring to the number of particles in the blood or extra-vascular fluid
Term
Osmolality of Blood
Definition
300 mOsm/kg
Term
Osmolality of Non-Ionic CM
Definition
600-800 mOsm/kg
Term
Osmolality of Ionic CM
Definition
>1300 mOsm/kg
Term
Non-Ionic CM is closer in # to blood so that...
Definition
Less stress on system, less reactions
Term
What is the primary factor in reactions?
Definition
Osmolality
Term
The goal concerning osmolality is to? Why?
Definition
Reduce osmolality

Nonionic molecules stay together, 3:1 ratio
Term
Why is a higher ratio in CM important?
Definition
Same contrast, less reactions
Term
Changes in osmotic pressure
Definition
CM injected
- Increases vascular osmolality

Fluid is drawn from extra-vascular space and RBCs
- Dilutes contrast, some particles filtered out by kidneys

Vascular fluids become hypo-osmolar to extra-cellular fluid
- Fluids reverse, flow out of vascular system to extra-vascular space

Shifts may cause many of the problems associated with iodinated CM
Term
Ionicity
Definition
Ionic agents contain molecules that will form ions in solution

Nonionic agents contain molecules that do not dissassociate
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