Patient Care

Front 1

The major goal of sonographers is to master proper sonographic ----------- to ensure the production of high quality diagnostic---------- and minimal--------------

Back 1

Techniques

Sonograms

Discomfort

Front 2

Scanning technique requires more than a systematic approach to scanning:

Back 2

1) Need an understanding of common diseases to recognize situations calling for unusual views or patient prep.

2) Need adequate knowledge of anatomy, disease processes, and sonographic data.

3) Need to compile clinically relevant data through chart review

4) Need to obtain additional history and data

5) Need to communicate technical findings verbally or in writing.

Front 3

_________ is also called dorsal recumbent position.

Back 3

Supine

Front 4

In ________ , the patient lies on his side with the arms in front.

Back 4

LLD or RLD lateral position

Front 5

In ___________ patient positioning-right side down is toward table and left side up is 90 degrees angle to table

Back 5

RLD right lateral decubitus

Front 6

In __________ patient positioning is left side down toward table and right side is up 90 degrees

Back 6

LLD left lateral decubitus

Front 7

Patients are placed in a ___________ position for transvaginal ultrasound examinations.

Back 7

Lithotomy

Front 8

Modified Fowlers Position

Back 8

Head elevated 25 degrees, knees slightly flexed. Used in advanced pregnancy to avoid vena cabal hypotension. LLD will ease the problem.

Front 9

An ___________ position is helpful in scanning a gallbladder that is positioned high up, under the ribs.

Back 9

Upright

Front 10

Trendelburg position

Back 10

A bed position in which the body is laid flat on the back with head of the bed tilted downward about 30-40 degrees.

Useful when fetal parts obscure the lower uterine segment of the fetal lie

Front 11

__________ divides the body into equal right and left sides.

Back 11

Sagittal Plane

Front 12

Divides the body into anterior and posterior portions

Back 12

Coronal/Vertical plane

Front 13

Any plane not parallel to sagital, transverse or coronal

Back 13

oblique

Front 14

Sonographers duties to ensure department is running smoothly:

Back 14

1) Quality assurance testing-to ensure the ultrasound unit is performing high quality images.

2) Cleaning of transducers-done between patient studies and prior use.

3) ordering and maintaing supplies- linens, towels, gel, bedpan, emesis basin, etc.

4) review patient schedule- in order to review any pertinent lab results or previous diagnostic test results before the scan begins

5) image generation- recording images, producing hard copy images or transmitting images to archiving system.

6) documentation of technical reports- written report of technical findings

Front 15

What to include in a technical report

Back 15

1) san plane and location

2) comments on echogenicity patterns

3) measurements and location

4) presence of shadowing or accoustic enhancement

5)presence and location of masses

6) presence and locations of Fluid collections

Front 16

Do not include in technical reports

Back 16

Diagnosis

Front 17

PACS

Back 17

Picture Archiving and Communication Systems

Front 18

Computer assisted programs that allow electronic storage, management, distribution, and viewing of images

Back 18

PACS

Front 19

RIS

Back 19

Radiology Information Systems

Front 20

Computer programs designed to streamline scheduling/ordering of appointments, patient registration, work lists, billing and medical management

Back 20

RIS

Front 21

Sonographers prepare a patient for exam by:

Back 21

1) review patients chart

2) verify accuracy of request form

3) include results of prior ultrasound or diagnostic test in Pt work up

4) mentally review sonographic protocols for specific type of exam

5) inform patient of purpose of exam and determine if any preps have been carried out

6)obtain brief patient history (latex allergies)

7) instruct pt on robing

8) position patient

Front 22

Abdominal organs NPO for ____________ hrs before exam to minimize bowel gas

Back 22

8-12

Front 23

Organs evaluated in abdominal ultrasound exams

Back 23

Liver, gallbladder, bile ducts, kidneys, pancreas, spleen, diaphragm, aorta, abdominal fluid collections

Front 24

Perform ultrasound exam before any other diagnostic tests requiring the use of sound-beam blocking contrast agents , such as _________ used in CT and upper GI exams

Back 24

Barium

Front 25

Urinary tract: drink ____________ an hour before test to fill urinary bladder. No urination till test is over.

Back 25

4-6 glasses

Front 26

For elderly patients and GYN exams, US can be performed

Back 26

1) transvaginal

2) transabdominal

Front 27

The ultrasonic examination of the vagina, uterus, Fallopian tubes, ovaries, and bladder achieved by inserting a specialized transducer into the vagina..aka endovaginal is called

Back 27

Transvaginal Sonography TVS

Front 28

Patient prep for endovaginal exam:

Back 28

Empty urinary bladded

Front 29

For gynecological exams, patients may need to ________ prior to exam

Back 29

Fill their bladder

Front 30

Gynecologic sonography may require the use of one or more of these approaches

Back 30

1) transvaginal

2) transabdominal

3) transrectal

Front 31

Amniocentesis

Back 31

A needle is placed into the uterus through the anterior abdominal wall. Done around 16th week. For genetic testing, chromosome analysis.

Results in 15 days

Front 32

A prenatal test to detect birth defects at an early stage of pregnancy

Results 7 dayspeecu

Back 32

Chorionic villus sampling CVS

Front 33

Percutaneous umbilical blood sampling PUBS/ cordocentesis

Back 33

A diagnostic test that examines blood from the fetal umbilical cord to detect fetal a formalities.

Results in 3 days

Front 34

Duplex imaging

Back 34

Imaging & Dopplar at the same time

Front 35

Prime elements in blood

Back 35

1) plasma- liquid component, over half of the total blood volume is plasma

2) formed elements or corpuscles (cells and fragments of cells)- 1) erythrocytes (red)-carries oxygen 2) Leukocytes (white)- fighting infection through destruction of pathogens 3) Platelets (thrombocytes)-blood clotting

Front 36

CA-125

Back 36

Ovarian cancer

Front 37

Prothrombin time measures

Back 37

Clotting time of blood

Front 38

In men, elevated levels of BHCH are used to detect the presence of:

Back 38

Testicular Cancer

Front 39

Elevated AST, ALT, Indirect bilirubin

Back 39

Liver disease (like cirrhosis)

Front 40

Elevated Direct Biliruben, ALP

Back 40

Obstruction in GB or duct

Front 41

AST & ALT tests are collectively called

Back 41

Liver Function Tests

Front 42

Increased levels of amylase (more sensitive) & lipase

Back 42

Pancreatitis

Front 43

Hematuria is presence of

Back 43

Blood in urine

Front 44

Proteinuria is presence of

Back 44

Protein in urine

Front 45

(BUN) blood urea nitrogen & creatine indicate

Back 45

Renal dysfunction or renal failure (more sensitive)

Front 46

Low hematocrit levels

Back 46

Recent bleeding

Front 47

Low platelet counts

Back 47

Uncontrollable bleeding potential

Front 48

Lowered levels of AFP

Back 48

Down's syndrome

Front 49

Elevated levels of AFP

Back 49

Neural tube defects, abdominal wall defects

Front 50

Accountability

Back 50

Answerability, responsibility for actions or decisions with resulting consequences.

Front 51

A set of rules of conduct or procedure that have been established by custom, agreement or authority

Back 51

The Law

Front 52

Those that affect the individual rather than society as a whole

Back 52

Civil laws

Front 53

4 types of law

Back 53

1) The Constitution- basic rules and guidelines, not specific

2) Statutory Law- state or federally enacted and enforced (state requiring licensure of x-ray techs) written by fed and state legislators

3) Administrative Law- enacted by agencies under government agencies (osha)

4) Common Law- laws enacted and enforced by court, based on custom and usage. Malpractice

Front 54

TORT

Back 54

A civil or criminal wrong that is recognized by law as grounds for lawsuit.

Harm caused to another's body, property, reputation, legal rights

Front 55

Assault

Back 55

Unlawfully placing a person in fear of bodily harm (threaten)

Front 56

2 types of TORT

Back 56

1) intentional- (assault, battery, invasion of privacy, false imprisonment)

2) unintentional action

Front 57

Battery

Back 57

Unlawful touching a person w/o their consent

Front 58

Invasion of privacy

Back 58

Giving of patient information wo authorization (exposure of patient names on scans)

Front 59

False imprisonment

Back 59

When a person is illegally obtained with out their consent or illegally restrained of their movement

Front 60

Unintentional action includes

Back 60

1) negligence

2) duty

3) breach

Front 61

Master-Servant Doctrine

AKA Doctrine of respondent superior "let the master reply"

Back 61

The medical institution, the sonographers and the physician may all be charged.

Front 62

Borrowed servant and captain of the ship doctrine

Back 62

The physician and Sonographer are both liable for sonographers negligence or other actions, but employer or institution not liable.

Front 63

Ostensible agency doctrine

Back 63

The hospital or employer is responsible for sonographers actions, even when sonographers is not an employee

Front 64

Res Ipsa Loquitur Doctrine

"Let the thing speak for itself"

Back 64

Very obvious mistake

Front 65

Ethicsethic

Back 65

The study of right and wrong based in moral principles (standards governing conduct)

Front 66

Ethical standards are:d

Back 66

About right and wrong conduct, rules stating what you can and cannot do legally

Front 67

DMS code of ethics

Back 67

Inform the patient, promote privacy, maintain confidentiality, promote patient safety, collaborate with professional colleagues, recognize that ethical dilemmas, engage in ethical billing practices and only legal arrangements

Front 68

Sonographer ethical dilemmas

Back 68

Abortion, commercial use of ultrasound, selective termination

Front 69

Before providing fetal keepsakes to parents :

Back 69

1) supervising physician review images first (deny if abnormalities are found)

2) keepsake should not demonstrate not seen on diagnostic study

3)written policy in place

Front 70

Beneficence

Back 70

A duty to promote good and act in the best interest of the patient and society.

The doing of active goodness, kindness, or charity including all actions intended to benefit others

Front 71

Nonmaleficence

Back 71

A principle of bioethics that asserts an obligation mr to inflict harm intentionally.

Useful in dealing with difficult issues surrounding terminally ill.