Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
85 Cards in this Set
- Front
- Back
|
The Patient Care Partnership: what to expect at your hospital stay |
1. High quality hospital care 2. Clean and Safe environment 3. Involvement in your care 4. Discussing your medical condition and information about medically appropriate treatment choices 5. Discussing your treatment plan 6. Getting information from you 7. Under standing your goals and healthcare values 8. Understanding who can make decisions when you cannot 9. Protection of your privacy 10. Preparing you and your family for when you leave the hospital 11. Help with your bill and filing insurance claims |
|
|
Professional ethics |
Correct moral behavior in the context of performing professional duties. |
|
|
ASRT code of ethics |
1. The radiologic technologist conducts herself or himself in a professional manner, responds to patient needs and supports colleagues and associates in providing quality patient care. 2. The radiologic technologist acts to advance the principal objective of the profession to provide services to humanity with full respect for the dignity of mankind. 3. The radiologic technologist delivers patient care and service unrestricted by concerns of personal attributes or the nature of the disease or illness, and without discrimination on the basis of sex, race, creed, religion or socioeconomic status. 4. The radiologic technologist practices technology founded on theoretical knowledge and concepts, uses equipment and accessories consistent with the purpose for which they were designed, and employs procedures and techniques appropriately. 5. The radiologic technologist assesses situations; exercises care, discretion and judgment; assumes responsibility for professional decisions; and acts in the best interest of the patient. 6. The radiologic technologist acts as an agent through observation and communication to obtain pertinent information for the physician to aid in the diagnosis and treatment of the patient and recognizes that interpretation and diagnosis are outside the scope of practice for the profession. 7. The radiologic technologist uses equipment and accessories, employs techniques and procedures, performs services in accordance with an accepted standard of practice, and demonstrates expertise in minimizing radiation exposure to the patient, herself or himself, and other members of the health care team. 8. The radiologic technologist practices ethical conduct appropriate to the profession and protects the patient’s right to quality radiologic technology care. 9. The radiologic technologist respects confidences entrusted in the course of professional practice, respects the patient’s right to privacy, and reveals confidential information only as required by law or to protect the welfare of the individual or the community. 10. The radiologic technologist continually strives to improve knowledge and skills by participating in continuing education and professional activities, sharing knowledge with colleagues, and investigating new aspects of professional practice. (Ehrlich 67)Ehrlich, Ruth A. Patient Care in Radiography: With an Introduction to Medical Imaging, 9th Edition. Mosby, 042016. VitalBook file. |
|
|
ARRT Rules of ethics |
1. Use of fraud or deceit to obtain employment or credentials.2. Dishonest conduct with respect to the ARRT examination.3. Conviction or no-contest plea to a felony, gross misdemeanor, or misdemeanor (with the exception of speeding or parking infractions).4. A failure to report to the ARRT that legal or ethical charges are pending against the person in any jurisdiction.5. The failure or inability to practice the profession with reasonable skill and safety. Practicing outside the scope of practice authorized by one’s credentials.6. Any professional practice that is illegal, contrary to prevailing standards, or that creates an unnecessary danger to the patient.7. The delegation, or acceptance of any delegation, of professional functions that might create an unnecessary danger to a patient.8. Any actual or potential inability to practice radiologic technology safely by reason of:• Illness, use of alcohol or drugs, or any physical or mental condition, or• Adjudication of mental incompetence, mental illness, chemical dependency, or posing a danger to the public9. Revealing privileged communication except as permitted by law.6910. Engaging in any unethical conduct such as deceiving, defrauding or harming the public, or the willful or careless disregard for the health, welfare, or safety of a patient. Actual injury need not be established.11. Engaging in conduct with a patient that is sexual or could be interpreted as sexual, or in any verbal behavior that is seductive or sexually demeaning or exploiting to a patient or former patient. This includes unwanted sexual behavior, verbal or otherwise.12. Knowingly engaging in or participating in abusive or fraudulent billing practices.13. The improper management of patient records, such as failure to maintain records, or any actions that may result in a false or misleading record.14. Assisting a person to engage in the practice of radiologic technology without current and appropriate credentials.15. Violating a state or federal narcotics or controlled-substance law.16. Providing false or misleading information directly related to the care of a patient.17. Making a false statement to the ARRT or failing to cooperate with an investigation conducted by the ARRT or the Ethics Committee.18. Engaging in dishonest or misleading communication with respect to one’s education, experience, or credentials.19. Failing to report to the ARRT any violation or probable violation of any rule of ethics by any registered technologist or applicant for certification by the ARRT.20. Failing to immediately report information concerning an error made in connection with imaging, treating, or caring for a patient. (Ehrlich 68-69)Ehrlich, Ruth A. Patient Care in Radiography: With an Introduction to Medical Imaging, 9th Edition. Mosby, 042016. VitalBook file. |
|
|
Ethical analysis |
In the face of an ethical dilemma, you must be prepared to assess the problem objectively and come to a conclusion that you can implement and defend. Ethical analysis is a process involving four basic steps:1. Identify the problem.2. Develop alternate solutions.3. Select the best solution.4. Defend your selection. (Ehrlich 69)Ehrlich, Ruth A. Patient Care in Radiography: With an Introduction to Medical Imaging, 9th Edition. Mosby, 042016. VitalBook file. |
|
|
6 Ethical principles |
1. Beneficence—goodness; actions that bring about good are considered right.2. Nonmaleficence—no evil; an obligation not to inflict harm.3. Veracity—truth; an obligation to tell the truth.4. Fidelity—faithfulness; an obligation to be loyal or faithful.5. Justice—fairness; an obligation to act with equity.6. Autonomy—self-determination; respecting the independence of others, and acting with self- reliance. (Ehrlich 70)Ehrlich, Ruth A. Patient Care in Radiography: With an Introduction to Medical Imaging, 9th Edition. Mosby, 042016. VitalBook file. |
|
|
Patient Rights |
Considerate respectful care Information Privacy and confidentiality Informed consent Right to refuse treatment or examination Death with dignity |
|
|
Advanced directive |
an outline of specific wishes about the medical care to be given in the event that the individual loses the ability to make or communicate decisions. Copies of these directives are usually given to the family physician and an attorney or family member and should be part of the medical record. (Ehrlich 76)Ehrlich, Ruth A. Patient Care in Radiography: With an Introduction to Medical Imaging, 9th Edition. Mosby, 042016. VitalBook file. |
|
|
Assault |
the threat of touching in an injurious way. (Ehrlich 78)Ehrlich, Ruth A. Patient Care in Radiography: With an Introduction to Medical Imaging, 9th Edition. Mosby, 042016. VitalBook file. |
|
|
Battery |
unlawful touching of a person without consent. If the patient refuses to be touched, that wish must be respected. (Ehrlich 78)Ehrlich, Ruth A. Patient Care in Radiography: With an Introduction to Medical Imaging, 9th Edition. Mosby, 042016. VitalBook file. |
|
|
Chart |
refers to a more extensive compilation of information, such as an emergency department record, the chart brought with a patient who is hospitalized, or an online record. (Ehrlich 80)Ehrlich, Ruth A. Patient Care in Radiography: With an Introduction to Medical Imaging, 9th Edition. Mosby, 042016. VitalBook file. |
|
|
False imprisonment |
the unjustifiable detention of a person against his and/or her will. (Ehrlich 76)Ehrlich, Ruth A. Patient Care in Radiography: With an Introduction to Medical Imaging, 9th Edition. Mosby, 042016. VitalBook file. |
|
|
Libel and slander |
refer to the malicious spreading of information that causes defamation of character or loss of reputation. Libel usually refers to written information, and slander is more often applied to verbal communication. (Ehrlich 78)Ehrlich, Ruth A. Patient Care in Radiography: With an Introduction to Medical Imaging, 9th Edition. Mosby, 042016. VitalBook file. |
|
|
Malpractice |
To legally establish a claim of malpractice, a claimant must prove to the court’s satisfaction that four conditions are true:1. The defendant (person or institution being sued) had a duty to provide reasonable care to the patient.2. The patient sustained some loss or injury.3. The defendant is the party responsible for the loss.4. The loss is attributable to negligence or improper practice. (Ehrlich 79)Ehrlich, Ruth A. Patient Care in Radiography: With an Introduction to Medical Imaging, 9th Edition. Mosby, 042016. VitalBook file. |
|
|
Moral agent |
Ethical analysis is being used increasingly to solve institutional problems. When several individuals have analyzed the situation, the next step may be to seek resolution through discussion, which leads to consensus. Once the question is resolved, action can be taken. The person responsible for implementing the ethical decision is called the moral agent (Ehrlich 71)Ehrlich, Ruth A. Patient Care in Radiography: With an Introduction to Medical Imaging, 9th Edition. Mosby, 042016. VitalBook file. |
|
|
Negligence |
Neglect or omission of reasonable care or caution. The radiographer is held to the standard of care and skill of the “reasonable radiographer” in similar circumstances (includes gross negligence, contributory negligence and corporate negligence) (Ehrlich 78)Ehrlich, Ruth A. Patient Care in Radiography: With an Introduction to Medical Imaging, 9th Edition. Mosby, 042016. VitalBook file. |
|
|
Types of negligence |
Gross negligence: A negligent act that involves “reckless disregard for life or limb” Example: Performing professional services while intoxicated. Contributory negligence: An act of negligence in which the behavior of the injured party contributed to the injury. Example: a patient is injured from a fall after being instructed to not get up. Corporate negligence: When the hospital as an entity is negligent. Example: Health care worker suffers from hepatitis B following a needle stick because there is no established protocol in the organization to ensure reporting and treatment in this situation. |
|
|
Torts |
Intentional misconduct: Civil lawsuits alleging personal injury are becoming increasingly common in the health care field. The torts involved can fall into one of two categories: intentional misconduct or negligence. The intentional torts that occur in a hospital setting include assault, battery, false imprisonment, invasion of privacy, libel, and slander (defamation of character). Unintentional misconduct: Unintentional torts include negligence and malpractice. Negligence refers to the neglect or omission of reasonable care or caution. In the relationship between a professional person and a patient or client, the professional has a duty to provide reasonable care. An act of negligence in the context of such a relationship is defined as professional negligence or malpractice. The radiographer is held to the standard of care and skill of the “reasonable radiographer” in similar circumstances. |
|
|
Informed consent |
Patient consent could be verbal, written, or implied. For example, if a patient arrives for emergency treatment alone and is unconscious, implied consent is assumed. A patient’s previously granted or implied consent can be withdrawn at any time. Written patient consent is required before any examination that involves greater than the usual risk, for example, invasive vascular examinations requiring the use of injected iodinated contrast agents. For lower risk procedures, the consent given on admission to the hospital is generally sufficient. (Saia 5)Saia, D.A.. Radiography PREP (Program Review and Exam Preparation), 9th Edition. McGraw-Hill Learning Solutions, 12/2017. VitalBook file. |
|
|
Conditions for Valid Patient Consent |
* The patient must be of legal age.• The patient must be of sound mind.• The patient must give consent freely.• The patient must be adequately informed about the procedure about to take place. |
|
|
Legal doctirines |
• Res ipsa loquitur—“the thing speaks for itself”• Respondeat superior—“let the master answer” |
|
|
ARRT Standards of Ethics Is Composed of |
• Preamble.• Statement of Purpose.• Code of Ethics (aspirational).• Rules of Ethics (enforceable).• Administrative Procedures. |
|
|
Patient identification |
Most facilities require checking at least two patient identifiers. Rigorous observance of “timeout” processes (verification of correct procedure, patient, and site, according to The Joint Commission) prior to procedures can avoid costly events, including those involving patient identification. |
|
|
Verbal communication is impacted by |
• Tone and rate of speech• Eye contact• Vocabulary |
|
|
Examples if non-verbal communication |
• Personal appearance• Appearance of work area• Facial expression• Touch• Eye contact• Other body language |
|
|
Cultural groups include |
• Religious groups• Age groups• Racial groups• Socioeconomic groups• Groups with disabilities• Gender groups• Sexual preference groups• Geographic groups |
|
|
Age-Specific Care |
• Infant: birth to 1 year• Toddler: 1–2 years• Preschooler: 3–5 years• School-aged: 6–12 years• Adolescent: 13–18 years• Young adult: 19–45 years• Middle adult: 46–64 years• Older adult: 65–79 years• Elderly: older than 80 years |
|
|
Body Mechanics |
To transfer the patient with maximum safety, the radiographer must correctly use certain concepts of body mechanics. First, a broad base of support lends greater stability; therefore, the radiographer should stand with his or her feet approximately 12 inches apart and with one foot slightly forward. Second, stability is achieved when the body’s center of gravity (center of the pelvis) is positioned over its base of support. For example, leaning away from the central axis of the body makes the body more vulnerable to losing balance; if the feet are close together, balance is even more difficult to maintain.Even the ambulatory outpatient might be somewhat unsteady, so a ready, supporting hand at the elbow can be very helpful. The radiographer should keep a watchful eye on the patient and assist him or her as needed. |
|
|
Rules of body mechanics |
• When carrying a heavy object, hold it close to the body• The back should be kept straight; avoid twisting• When lifting an object, bend the knees and use the leg and abdominal muscles to lift (rather than the back muscles)• Whenever possible, push or roll heavy objects (rather than lifting or pulling) |
|
|
Safety/comfort guidelines |
• Belongings secure• Hazard-free environment to avoid unnecessary/painful movement• Equipment used properly• Remove clothing first from the uninjured side• Place clothing first on the injured side |
|
|
Patient support equipment: oxygen |
Oxygen is usually available through wall outlets with adjustable flowmeters or in tanks with a flow-regulating valve and an indicator showing the quantity of oxygen left in the tank.Oxygen can be administered via nasal cannula, masks, or mechanical ventilators; oxygen supports combustion, so it must be used away from flame. |
|
|
Patient support equipment: suction |
Suction devices are used to aspirate secretions; suction is available from wall outlets or portable suction mechanisms. |
|
|
Patient support equipment: tube |
• Chest tubes function to remove fluids or air from the thoracic cavity.• NG and NI/NE tubes assist in the removal of gastric secretions or air and/or are used for the administration of water-soluble contrast material.• To prevent UTIs, urinary collection containers must be kept below the level of the bladder, and catheterization procedures must be sterile.• GI tubes can be single or double lumen and can be used for diagnostic and/or therapeutic purposes.• Continual access tubes are used for long-term care requirements. |
|
|
Vital signs |
• Body temperature• Pulse rate• Respiratory rate• Arterial blood pressure |
|
|
Normal Body Temperatures |
Adult: oral: 98.6 Rectal: 99.1-99.6 Axillary: 97.6- 98.1
Infants-children (under 4) rectal 97.9-104 Children aged 5-13: 97.9-98.6 |
|
|
Normal pulse rates |
Men = 68-75 Women= 72-80 Children= 70-100 Infants= 100-160 |
|
|
Pulse rates depend on: |
Age Sex Body exertion General state of health Certain conditions: fever, shock, organic heart disease, Alcohol/drug use |
|
|
Respiration |
serves to deliver oxygen to all body cells rid body of carbon dioxide. Radiographer MU st be able to recognize abnormalities. |
|
|
Dyspnea |
Difficult Breathing |
|
|
Abnormal respiration |
Uneven Strident Shrill Grating sound Stertous (grating sound) Orthpnic (recumbent breathing) Tachypnic (shallow breathing) Digopnic (abnormally, shallow slow) |
|
|
Blood pressure |
Degree of force appled to arterial walls as the heart pumps blood throughout the body. |
|
|
Normal blood pressure |
Systolic 90-120 Diostolic 60-80 Prehypertension Systolic: 90-120 Dystolic: 60-80 |
|
|
Orthostatic |
Occurs with sudden change when rising quickly |
|
|
Hypertension |
Can lead to renal, cardiac, or brain damage |
|
|
Hypotension |
Can result in hemorrage, anemia, & fever infection. |
|
|
Blood pressure affected by |
- cardiac output - blood volume - vascular resistance |
|
|
Physical signs |
Objective signs Color/temp/moistness of skin, ex: sweaty palms Awareness of gross/fine motor skills Conditions of brain, ex: Parkinsons Subjective (how patient feels] |
|
|
Documentation |
Charting Examination requisition Notes pertinent to history Any incident or accident should be noted and recorded |
|
|
Fall prevention: safety/guidelines |
Belongings secure Hazard free environment to avoid necessary/painful movement Equipment used properly Remove clothing first from uninjured Place clothing first on injured side Consider: Elderly Very thin Influence of drugs IV infusions Combative disoriented Difficulty communicating |
|
|
Medical emergencies |
1. Allergic reactions 2. Cardiac or respiratory arrest (CPR) 3. Physical injury or trauma 4. Other medical disorders |
|
|
Side effects vs. Toxic effects |
Side effect: harmless, offset benefit. Toxic occur due to sensitivity, overdose, poor metabolism An antidote is used to treat a toxic effect. |
|
|
Allergy |
Abnormal immune respinse. Inflammatory responses: hay fever, uritacaria, allergic rhinitis, eczema, bronchial asthma, can be produced via ingestion, inhalation, or injection. |
|
|
Latex |
Proteins can produce mild-severe allergic reactions, chemicals added during processing can cause skin reactions. Wide variety of medical supplies contain latex, PPE & household items. |
|
|
Types of reactions to latex |
Irritant contact dermatitis: itchy dry hands. Allergic contact dermatitis: allergic contact eymptoms similar to poisen ivy. Latex allergy: immediate hypersensitivity. Much more serious reaction & amount known to cause this unknown. Mild reactions-redness -hives -itching Severe -itchy, eyes, runny nose, nose, sneeze, wheezing |
|
|
Restraints vs. Immobilization
|
restraints- holdings of a person against their will. immobilization- used w/ consent to reduce motion, or involuntary tremors |
|
|
ARRT standards of ethics
|
Code of ethics- aspirational Rules of ethics- enforceable |
|
|
Ethnocentrism
|
the belief that ones own culture ways are superior to any other way.
|
|
|
Wheel chairs:
|
Wheels should be locked when not in transit.
|
|
|
Locks
|
should be used to maintain patient safety
|
|
|
Straps
|
should be used whenever possible
|
|
|
side rails
|
should be upright whenever a patient is on the stretcher.
|
|
|
Catheterization
|
Assists incontinent patient to eliminate urine. Must be sterile. Infection prevention. Common infections UTI. Container kept below bladder to prevent black flow. Care to ensure catheter does not become entangled or dislodged.
|
|
|
Oxygen
|
Radiographer must call for help in emergency, assist patient to sitting position, or semi fowler position.
|
|
|
Abnormal respiration
|
a. Uneven b. Strident c. Stertous (labored, snoring) d. Grating sound e. Shrill f. Tachypneic (shallow breathing) g. Orthopneic (recumbent difficulty) h. Digenic (abnormally shallow slow) |
|
|
Anaphylactic responses
|
i. Respiratory failure ii. Shock iii. Death w/ in minutes iv. Wheezing v. Constriction of throat (Possibly caused bylaryngeal edema) vi. Dyspnea vii. Dysphagia viii. Hypotension ix. Cardiopulmonary arrest x. Renal function:1. Concern w/ iodinated contrast with patients whohave acute kidney injury (AKI) or severe kidney disease.
|
|
|
Cardiac of respiratory arrest (CPR)
|
1. Radiographer must maintain airway. 2. Call code |
|
|
Concern w/ controlling blood sugar (metformin)
|
a. Category 1 Do not need to discontinue metformin b. Category 2 Need to discontinue metformin |
|
|
Vomiting
|
It is essential that recumbent patients have theirheads turned to the side to prevent choking from aspiration of vomitus.
|
|
|
Fx
|
An unsplinted fracture must be moved with great care,with areas proximal and distal to the fracture site adequately supported.
|
|
|
Spinal injuries
|
1. A physician must be present whenever thepatient’s position is changed. If a patient must be placed in a lateralposition, the logrolling method is advised.
|
|
|
Epistaxis (AKA nosebleed)
|
The patient should be seated or in the Fowlerposition. Cold cloths on patient’s nose and back of neck. Compressing the sidesof the nose for 6-8 min. is also helpful.
|
|
|
300lb object
|
roll or push
|
|
|
Contrast to use for perforated bowel?
|
Gastrogafin/ or other water soluble contrast media.
|
|
|
How much sulfate barium suspension to give?
|
Two 250cc cups.
|
|
|
Type of contrast best for patients with a history of asthma:
|
iodinated non ionic contrast, due to the increased risk for reactions.
|
|
|
Neurogenic shock
|
failure of arterial resistance and causes a pooling of blood in peripheral vessels and could be caused by injury to the nervous sytem such as head trauma.
|
|
|
airborne precautions:
|
varicella, chicken pox, TB, rubeola
|
|
|
droplet precaution:
|
pneumonia, rubella, mumps, influenza, H1N1
|
|
|
contact precaution:
|
Antibiotic resistant organisms: MRSA MDRSO C-difficile Mumps |
|
|
Orthostatic hypotension
|
rising from recumbent
|
|
|
BUN; normal levels
|
Blood urea nitrogen: 9-25mg
|
|
|
Creatine
|
500-2000mg *if high can cause kidney failure |
|
|
Ionic, water soluble
|
low cost, low risk
|
|
|
Priority patients or diagnostic imaging studies:
|
1. Fasting patients 2. Emergency patients 3. Pediatric and geriatric patients that are NPO 4. Diabtic patients that have put off taking insulin due to an exam that requires them to be NPO morning of exam. |
|
|
Sequencing of exams for diagnostic studies:
|
1. All radiographic exams not requiring conrast media. 2. Laboratory studies for iodine uptake (thyroid uptake.) 3. Radiographic examination of the urinary tract. 4. Radiographic examinations of the billary tract. 5. Lower GI studies (barium enemas) 6. Upper GI studies. |
