Ch. 20 Patient Care Pp

Front 1

Emergency

Back 1

Unexpected or sudden occasion. An urgent or pressing need

Front 2

General priorities

Back 2

The technologist should keep these in mind when working with patients in emergency situations:

1. Ensure an open Airway.

2. Control bleeding.

3. Take measures to prevent or treat shock.

4. Attend to wounds or fractures.

5. Provide emotional support.

6. Continually re-evaluate and follow up appropriately

Front 3

Emergency cart

Back 3

Also called a crash cart. This cart is a wheeled container of equipment and drugs typically required in emergency situations

Front 4

Automatic external defibrillator (AED)

Back 4

Devices used for applications of external electrical shock to restore normal cardiac Rhythm and rate

- fully automatic defibrillators

- semi automatic defibrillators

Front 5

Levels of consciousness

Back 5

1. Patient can respond fully to questions and other stimuli.

2. Patient is drowsy but can arouse to response with loud speaking or gentle physical contact.

3. Patient is unconscious and reacts only to painful stimuli.

4. Patient is comatose and unresponsive to all stimuli.

Front 6

irritability

lethargy

Slowing pulse

respiratory rate

Back 6

Findings in an alert or drowsy patient that can signify a deteriorating head injury include

Front 7

Lethargy

Back 7

A condition of indifference

Front 8

If a technologist recognizes a deteriorating head injury..

1.the first priority is maintaining an open Airway while moving the patient as little as possible.

2. Medical assistant should be obtained quickly

3. The technologist should get vital signs while waiting for help to arrive

Back 8

How should a technologist respond to a deteriorating situation?

Front 9

Shock

Back 9

Condition of profound hemodynamic and metabolic disturbance characterized by failure of the circulatory system to maintain adequate perfusion of vital organs

Front 10

Hypovolemic shock.

Cardiogenic shock.

Neurogenic shock.

Vasogenic shock.

Back 10

Types of shock include

Front 11

Hypovolemic shock or anaphylactic shock

Back 11

A technologist is most likely to encounter ___ shock or ____ shock which is a special type of vasogenic shock

Front 12

Sudden body temperature changes.

Pain.

Stress and Anxiety.

Back 12

Several factors can contribute to the likelihood that a patient will experience shock

Front 13

Signs and symptoms of shock

Back 13

Restlessness.

Apprehension or anxiety.

Decreased blood pressure.

Cold or clammy skin.

Pallor.

Front 14

Pallor

Back 14

Paleness

Front 15

Contrast media reactions (anaphylactic shock)

Back 15

Is a type of vasogenic shock and is most commonly encountered in the radiology department when iodinated contrast media is administered

Front 16

Urticaria

Back 16

AKA hives.

Vascular reaction involving upper dermis, representing localized edema

Front 17

What to do in case of anaphylactic shock

Back 17

Before contrast is administered to a patient history and ask about allergies.

If any reaction occurs The Physician should be notified immediately no matter how severe.

Mild reactions include localized itching, nausea and vomiting.

Severe reactions might include laryngeal edema, shock, and cardiac arrest: call a code and begin CPR

Front 18

Hypoglycemia

Back 18

Abnormally diminished concentration of glucose in the blood.

Patients who are experiencing this condition are intensely hungry, weak, shaky, my sweat excessively, and be confused or irritable

Front 19

What to do in case of hypoglycemia

Back 19

Ask the patient if they are diabetic.

Some patients carry glucose tablets with them. If tablets are not available, then any form of carbohydrates should be administered.

Let the patient sit quietly for 10 to 15 minutes and let the carbohydrates take effect. If the patient becomes unconscious call for help immediately.

Diabetic crisis

Front 20

Hyperglycemia

Back 20

Abnormally increased concentration of glucose in the blood.

Patients who are experiencing this condition exhibit excessive thirst and urination, dry mucosa, rapid and deep breathing, and drowsiness and confusion

Front 21

What to do in case of hyperglycemia

Back 21

This condition develops gradually over hours or days, so it is not likely to be noticed by the technologist.

If untreated this condition can lead to diabetic coma. The patient needs insulin, so if noticed, Medical help should be obtained

Diabetic crisis

Front 22

Asthma

Back 22

Chronic respiratory condition that causes respiratory distress generally characterized by wheezing

Front 23

What to do in case of asthma

Back 23

Most patients with asthma carry an inhaler. Stop the procedure and allow the patient to use their inhaler.

If medication is not available than the technologist should obtain medical assistance.

Stress can trigger an asthma attack, so it is the technologist responsibility to comfort and calm the patient

Front 24

Choking

Back 24

A person having severe difficulty in breathing because of a constricted or obstructed throat or lack of air

Front 25

What to do in case of choking

Back 25

Ask the patient if they can speak.

Also look for the universal choking sign.

If the patient is choking encourage them to cough.

If coughing is unsuccessful then the Heimlich maneuver should be used

Front 26

1. Stand behind the victim and wrap both arms around them, clutching one fist with the other hand.

2. The thumb side of the Fist is placed in the midline of the victims abdomen, above the navel and well below the sternum.

3. pressure is exerted Inward and upward. Thrust should be administered separately, but can be repeated quickly 6 to 10 times or until the obstruction is expelled

Back 26

Steps of the Heimlich maneuver

Front 27

Heimlich maneuver on unconscious patients

Back 27

Patient should be supine.

If obstruction is visible you can perform a finger sweep. If not, or the finger sweep was unsuccessful then begin CPR

Front 28

Heimlich maneuver for pregnant patients

Back 28

Thrust should be done at the center of the sternum

Front 29

Heimlich maneuver for infants

Back 29

An infants younger than one year old, a combination of back blows and chest thrusts is recommended

1. Hold the infant along your forearm, chest down.

2. Deliver 4 blows to the infant's back between the scapulas with the heel of your hand.

3. Turn the infant over and give four, two to three finger, chest thrusts on the Infant sternum just below the intermammary line

Front 30

Cardiac arrest

Back 30

sudden stoppage of cardiac output and effective circulation

Front 31

Cardiopulmonary resuscitation (CPR)

Back 31

Artificial substitution of Heart and Lung action as indicated for cardiac arrest or apparent sudden death resulting from electric shock, drowning, respiratory arrest, and other causes

Front 32

Hand position for adult and child CPR

Back 32

Two hands center of chest, lower half of breastbone

Front 33

Compression depth adult and child CPR

Back 33

At least 2 in

Front 34

Breathing adult and child CPR

Back 34

Look for chest rise.

Deliver breath over 1 second

Front 35

Compressions to breaths adult and child CPR

Back 35

30:2

Front 36

Compression rate adult and child CPR

Back 36

100/minute

Front 37

Hand position for infant CPR

Back 37

2-3 fingers in the center of the chest, lower half of the breastbone

Front 38

Compression depth for infant CPR

Back 38

About 1 1/2 inch

Front 39

One person rescue CPR

Back 39

1. Establish unresponsiveness, and call for help and proceed with CPR.

2. Position the patient on their back on a hard surface.

3. Perform chest compressions.

4. Open the airway by tilting the head back.

5. Established breathlessness.

6. perform rescue breathing.

7. Establish circulatory inadequacy.

8. Continue chest compressions.

9. Reassess after 5 completed Cycles.

Front 40

Two-person rescue CPR

Back 40

Similar protocol, but each rescuer independently performs compressions or ventilations. After 5 complete Cycles the patient is reassessed and The Rescuers switch positions

Front 41

AED steps

Back 41

1. Determine that the patient is in Cardiac Arrest.

2. Turn on the AEC.

3. Attach cables to the pads, and place the pads on the patient.

4. Initiate Rhythm analysis by pressing the analyze button.

5. If indicated, deliver the shock. After the shock press analyzed again.

6. If no shock is indicated, continue CPR.

7. After 3 shocks or 3 "no shock indicated messages", CPR should continue uninterrupted

Front 42

Ventricular fibrillation

Back 42

Disorganized cardiac rhythm

Front 43

Cerebrovascular Accident

Back 43

AKA a stroke or brain accident.

Condition with sudden onset caused by acute vascular lesions of the brain.

Often followed by permanent neurological damage.

Warning signs include Paralysis on one or both sides, slurred speech or complete loss of speech, extreme dizziness, loss of vision (particularly if only in one eye), and complete loss of consciousness

Front 44

What to do in case of cerebral vascular accident

Back 44

If the technologist observes any of these signs or symptoms, even if they are only temporary, they should be reported to a nurse or physician immediately

Front 45

Nausea

Back 45

Unpleasant sensation, vaguely referred to the epigastrium and abdomen and often culminating vomiting

Front 46

Vomiting

Back 46

Forcible expulsion of the contents of the stomach through the mouth

Front 47

What to do in case of nausea or vomiting

Back 47

Tell the patient to breathe slowly and deeply through their mouth.

If the patient is recumbent help them to turn on their side or turn their head to avoid aspiration.

Provide the patient with an emesis basin and a moist cloth

Front 48

Epistaxis

Back 48

Nose bleed; Hemorrhage from the nose

Front 49

What to do in case of epistaxis

Back 49

Have the patient lean forward and pinch the affected nostril.

If gentle pressure fails to stop the bleeding, a moist compression may be applied.

If bleeding persists after 15 minutes, medical assistant should be obtained

Front 50

Vertigo

Back 50

Illusion of movement. Spinning feeling

Front 51

Syncope

Back 51

AKA to faint, temporary suspension of Consciousness resulting from lack of blood flow to the brain

Front 52

What to do in case of vertigo or syncope

Back 52

When a patient faints the technologist obtains medical assistance and help.

Put the patient into a recumbent position with their feet elevated.

Front 53

Mild seizures

Back 53

Are characterized by a brief loss of consciousness or may seem Frozen and stare into space for a brief time

Front 54

Severe seizures

Back 54

Are characterized by involuntary contractions of the muscles

Front 55

Aura

Back 55

Subjective sensation or motor phenomenon that precedes and marks the onset of an seizure attack

Front 56

What to do in case of seizures

Back 56

If significant warning is given, the patient should be moved to the floor and a pillow should be placed under their head.

If there is no warning, the technologist must do their best to keep the patient from injuring themselves.

Never restrain the patient, it is ineffective and dangerous.

If possible, make note of the length of the seizure.

Always obtain medical assistance

Front 57

Falls

Back 57

Despite appropriate assistance and Care, a patient occasionally __ while in the radiology department

Front 58

What to do in case of a fall

Back 58

The technologist should attempt to minimize the physical impact of the Fall as much as possible

and then proceed with the appropriate emergency action as indicated by the patient's condition

Front 59

Wounds

Back 59

Bodily injuries caused by physical means with disruption of the normal continuity of structures

Front 60

Hemorrhage

Back 60

Escape of blood from vessels; bleeding

Front 61

What to do in case of wounds and hemorrhage

Back 61

The technologist should always take note of the patient's dressings.

If a dressing becomes noticeably saturated during the procedure, do not remove the dressing, apply an additional sterile bandage and press against it.

Hold bleeding extremities above the level of the heart.

Call for medical assistance

Front 62

Burns

Back 62

These injuries are typically extremely painful and disrupt the normal protective function of the skin.

Front 63

Wound dehiscence

Back 63

Separation of the layers of the surgical wound.

The patient's sutures separate allowing at dominal contents to spill out of the peritoneal cavity

Front 64

What to do in case of burns

Back 64

Maintain sterile precautions and be extra gentle when handling these patients

Front 65

What to do in case of wound dehiscence

Back 65

The technologist should try not to replace the tissue, but should apply a sterile dressing.

The patient should be placed in a seated position, someone bent forward to relieve abdominal pressure.

Medical tension should be obtained immediately