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Patient Care
Chapter 18, 20,&21 Quiz #7
43
Anatomy
Undergraduate 1
12/01/2017

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Term
What are the six guidelines for bedside radiography?
Definition
One – call the nursing station before leaving the imaging department unless responding to a stat request
Two – ask nurse about the patient's condition
Three - confirm the order in the patient's chart
Four – greet the patient and explain the procedure
Five – check patient ID birthdate on the wristband
Six – inspect and prepare the room before bringing in the x-ray equipment
Term
Postanesthesia care unit (PACU)
Definition
-Usually adjacent to or where patients are monitored after surgical procedures until the effects of anasthesia have worn off
-exams you might do would include a chest x-ray to verify line or port placement or hip/pelvis/knee/ankle etc. to demonstrate alignment of screws and plates for fractures or artificial joint replacement
Term
Emergency trauma unit
Definition
-This environment will take the most creativity because the patient will exhibit various levels of cooperation consciousness and or disfiguration and there are multiple activities going on at any given moment
-commonly ordered exams are chest x-ray C-spine pelvis; extremities depending on injury sustained – be prepared for just about anything
Term
Neonatal intensive care and newborn nursery (NICU)
Definition
-NICU babies may require CXR, KUB or school radiographs to document anomalies
-nursery babies may need CXR for pneumonia or a clavicle fracture
-disinfect the x-ray machine, wash hands and wear gloves, down if necessary; cover the cassette with a pillowcase or blanket before placing under infant
-be sure to move the heat lamp out of the way before positioning the tube if the baby is in an open incubator
- be very careful of any IVs, tubing or vent equipment
Term
Intensive care and coronary care units (ICU/CCU)
Definition
-patients in these units are critically ill and require constant monitoring
-vast majority of exams ordered ore CXR and KUB sometimes daily or multiple times daily
-you are expected to engage the nurse for exams on these patients they will want to make sure no lines are disturbed in the course of the exam
-be sure to explain the procedure to the patient and if they are conscious and able allow them to assist you
-before moving the patient make sure that all lines have plenty of slack and that all personnel are ready
- if you happen to dislodge a vent line or tubing tell the nurse right away
Term
Special beds and mattresses
Definition
-if the patient is on a special bed consult with Nursing staff to see what is required for placing your cassette; be careful not to snag the bed or pad material went sliding the cassette under the patient
Term
Orthopedic traction
Definition
-traction is the application of pressure for therapeutic reasons, generally to aid in muscle spasms
-be very careful not to bump the bed, patient or traction device, as it will be very painful for the patient
Term
Tracheostomies
Definition
-surgical opening in the trachea for a temporary or permanent airway
-A patient may need a tracheostomy to do obstruction of the upper respiratory tract (Spasm, cancer, burns in the mouth or throat) or to be used with ventilation or respiratory collapse (paralysis, pulmonary Adema, trauma)
-suction equipment must be readily available
Term
Mechanical ventilation
Definition
-patients who cannot breathe on their own are intimated (ET tube) and connected to a mechanical respirator that can supplement respiratory or completely control it
-be very careful when moving the x-ray unit around the vent to later and tubing
- Time your exposure to do with the ventilator so that you catch the pause after in elation for CXR or the pause after expiration for KUB
-if the patient is being manually Ventilated or bagged (usually just after intubation but before the mechanical vent is in place in ER) ask for a breath hold it for your exposure
Term
Nasogastric tubes
Definition
-tubes that are inserted into the nose and down to the stomach
-maybe necessary for feeding, decompression of gas or secretions, or radiographic studies (for oral contrast admin if the patient can't or won't drink the contrast)
-KUB will often be ordered to verify placement of the two before introducing anything through it
Term
Nasoenteric tubes
Definition
-NE tubes are inserted into the stomach and peristalsis advances the tube into the small intestine
-placement is verified with KB if you hours after insertion and periodically after that if the tube has to be repositioned
-for both NG and NE tubes, try not to pull on the tubing; it is one of the more obvious tubes but it may be pinned to the patients gown and you may pull on it without realizing
Term
Closed – chest drainage
Definition
-chest tubes can be used to drain error fluid that is trapped between the plural space through a tube into a drainage unit
-*The drainage unit must stay below the level of the chest or else they drained material will flow back into The pleural space*
Term
Pulmonary artery flow – directed catheters
Definition
-Swan-Ganz
-inserted through the subclavian, internal or external jugular, or femoral vein
-Advanced until the tip rests in the right atrium
Term
Swan-Ganz
Definition
-measures cardiac output
-right heart pressures
-left heart and lung pressures indirectly
-used to diagnose right and left ventricular failure
Term
Central lines/central venous catheters
Definition
-used in administration of chemotherapy or other long-term drug therapy
Term
Common catheters
Definition
-Peripherally inserted central catheter (PICC)
-Hickman
-Groshong
-Raff
-Port-A-Cath
Term
Pacemakers
Definition
-electro mechanical device that regulates the heart rate by providing electrical stimulation to the heart muscle
-they are placed just below the surface of the skin of the patient's chest and are composed of a battery pack and wire that stimulates the heart
-they may be inserted in the radiology department or in the OR, ICU, or CCU
-*The left arm must not be elevated for 24 hours after placement*
-often inserted under C-arm guidance
Term
Surgical suite
Definition
-access to the surgical suite is limited to personnel and items with a legitimate reason to be there
-special surgical attire must be worn in a surgical suite
Term
Surgical clothing
Definition
-Nonsterile shirt and pants
-mask that covers nose and mouth
-Hat or a hood that covers all hair including a beard if applicable
-shoe covers may be optional
-gloves - donned to handle anything contaminated with blood
Term
Surgical environment
Definition
-The rooms are small and depending on the procedure
-you may not be able to bring in the x-ray equipment after the patient is prepped on the table with violating the sterile Corridor
Term
Two classifications of the surgical's team
Definition
Sterile and nonsterile
Term
Sterile members include
Definition
-surgeon
-assistant to the surgeon or a physician
-non-physician assistant
-scrub person which could be a registered nurse licensed vocational nurse or surgical technologist
Term
Nonsterile team members include
Definition
- Anesthesiologist or anesthetist
-circulating nurse or surgical technologist
- various other technologist such as biomedical, orthopedic, radiologic
Term
Sterile Corridor
Definition
-Area between the patient drape in the instrument table
- only those bring sterile a tire allowed in this area
Term
Guidelines for sterile Corridor
Definition
-be aware of the sterile field
-do you not wear anything that dangles
- avoid putting in pockets objects that can fall out
- past behind the back of a sterile team member to avoid contamination
Term
Cholangiography
Definition
Radiograph of the biliary ducts taken after the injection of a radiopaque contrast medium; usually part of a Cholecystectomy
Term
ORIF
Definition
Open reduction with internal fixation for a fractured hip/Wrist/ankle/femur/tibia
Term
Retrograde urograms
Definition
Ureteral stent placement post procedure CXR for open heart procedures as part of the instrument count
Term
Other surgical procedures
Definition
-spinal procedures like vertebral fusion, laminectomy
-joint replacement procedures
Term
Medical asepsis
Definition
Methods of reducing pathogenic microorganisms in the environment and intervening in the process by which micro organisms are spread
Term
Surgical asepsis
Definition
The process of creating and maintaining an area that is completely free of pathogens
Term
Sterilization
Definition
The complete distraction of all organisms and spores from equipment used to perform patient care or procedures; essential to surgical asepsis
Term
Chemical sterilization
Definition
-The immersion and soaking of clean objects in a bath of germicidal solution followed by a sterile water rinse
-not recommended for surgical asepsis
Term
Autoclaving
Definition
-an autoclave is a device that provides steam sterilization under pressure
-The most commonly used sterilization method
-quickest and most convenient means for items that can withstand heat and moisture
Term
Conventional gas sterilization
Definition
-method that uses a mixture of gas heated to 135°F which is 57°C
-used for items that cannot be autoclaved such as:
Electrical, plastic, rubber items, and optical wear
Telephones, stethoscopes, blood pressure cuffs, and other equipment used in isolation rooms
Term
Sterility indicators
Definition
-Chemical indicators that can change color when sterilization has occurred
-used to identify whether a pack has been sterilized
-placed inside and outside the pack to show that the gas, heat, steam, or gas plasma has penetrated to all surfaces
Term
Sterile field
Definition
-defined as a micro organism – free area prepared for the use of sterile supplies and equipment
-first step and preparing a sterile field is to confirm the sterility of the packaged supplies and equipment
Term
Packages are considered sterile if they meet the following criteria:
Definition
-they are clean, dry, and unopened
-their expiration date has not been exceeded
-there Sterility indicators of change to a predetermined color, confirming sterilization
Term
Steps to establish a sterile field
Definition
-place the pack on a clean surface within reach of the physician
-just before the procedure begins, break the seal and open the pack
-unfold the first corner away from you, unfold the two sides one at a time, then the last fold towards you
-do not touch the inner surface
- The inner wrap, if there is one, is opened in the same manner
Term
If you need to add a disposable item to the sterile field:
Definition
-items supplied in "peel – down" wrapper
-separate the package layers
-invert the package
- allow object to fall onto sterile field without contamination the object or the field
Term
Surgical asepsis: standard principles
Definition
-any sterile object or field touch by an unsterile object or person becomes contaminated
-never reach across a sterile field (organisms may fall from your arm into the field and it also increases the risk of brushing the area with your uniform)
-do you not passed between the physician and the sterile field
-never leave a sterile area unattended
-A 1 inch border at the perimeter of the sterile field is considered a "buffer zone" and is treated as if it were contaminated
Term
True/false

If you suspect an item is contaminated examine it closely to determine
Definition
False! You should discard it just in case
Term
2 important things to remember regarding the open gloving technique:
Definition
  • Put on first glove, touching only inner surface of folded cuff
  • Using gloved hand, grasp second glove under cuff
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