Rad258 Patient Care

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Patients must receive a full explanation of the procedure and its risks and benefits and sign the consent form before being sedated or anesthetized.
• •A patient must be competent in order to sign

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Informed Consent

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No schedules or other documents that include patient names may be posted in public areas.
• •Use only patients' first names when summoning them from public areas. Avoiding the use of last names is preferred to preserve a degree of anonymity.

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HIPAA

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implies that the patient's modesty will be respected and that every effort will be made to maintain the patient's sense of personal dignity

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right to privacy

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. This means that if death is imminent, no effort at resuscitation is to be attempted

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DNR

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an outline of specific wishes about medical care to be followed in the event that an individual loses the ability to make or communicate decisions

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advanced directive

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unlawful touching of a person without consent

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battery

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the threat of touching in an injurious way

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assault

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omission of reasonable care or caution

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negligence

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based on the doctrine of the reasonably prudent person. This requires that a person perform as any reasonable person would perform under similar circumstances.

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standard of care

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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

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malpractice

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unjustifiable detention of a person against his or her will. This can be the use of restraints when hospital policy does not allow for it

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False Imprisonment

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malicious spreading (in writing) of information that causes defamation of character or loss of reputation

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libel

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malicious spreading ( verbal) of information that causes defamation of character or loss of reputation

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slander

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means, literally, “the thing speaks for itself.” This doctrine is sometimes applied when negligence and loss are so apparent that they would be obvious to anyone

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res ipsa loquitur

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to place legal responsibility on the highest authority possible; the employer is liable for employees' negligent acts that occur in the course of their work

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respondeat superior

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a form of communication that can include body language and facial expression

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nonverbal

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deals with reducing the probability of infectious organisms being transmitted to a susceptible individual.

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medical asepsis

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is the complete destruction of all organisms and spores from equipment used to perform patient care or procedures

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surgical asepsis

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this is used to open a myelogram tray prior to a procedure

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sterile technique

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Microorganisms capable of causing disease

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pathogens

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An object that has been in contact with pathogenic organisms

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fomite

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an arthropod in whose body an infectious organism develops or multiplies before becoming infective to a new host.

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vector

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any medium that transports microorganisms

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vehicle

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an infection that a patient acquires while in the hospital for a different reason

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nosocomial infection

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For infections to be transmitted, there must be an infectious organism, a reservoir of infection, a portal of exit, a susceptible host, a portal of entry, and a means of transporting the organism from the reservoir to the susceptible individual.

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cycle of infection

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any place where pathogens can thrive in sufficient numbers to pose a threat

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source or reservoir of infection

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This transmission mode requires that the host is touched by an infected person and that the organisms are placed in direct contact with susceptible tissue

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contact contamination

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occurs when an infectious individual coughs, sneezes, speaks, or sings in the vicinity of a susceptible host

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droplet contamination

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particles of evaporated droplets; microorganisms that remain suspended in the air for long periods

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airborne/suspended contamination

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designed to reduce the risk of transmission of unrecognized sources of bloodborne and other pathogens in health care institutions

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Standard Precautions

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Length of time recommended for handwashing

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20 seconds

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type of mask that protects against airborne transmission of infection

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particulate respirator

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what vessel is an infusion port chemotherapy, blood tarnfusions, or samping of blood.

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superior vena cava

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These tubes are placed in the stomach and peristalsis advances them into the small intestine.

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Nasointestinal

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a surgical procedure that creates an opening into the trachea to provide a temporary or permanent artificial airway

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tracheotomy

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These tubes are inserted through the urethra into the bladder, allowing urine to be continuously emptied into an attached collection bag

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urinary catheter

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Avg. heart rate for a child 3-12 years old

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85-110

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Avg. respiratory rate for a child 3-12 years old

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16-26

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Avg. heart rate for adult

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60-100

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Avg. respiratory rate for adult

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12-20

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a fracture in which the splintered ends of bone are forced through the skin

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compound fx

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In this fracture the bone is splintered or crushed at the site of impact, resulting in two or more fragments

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comminuted fx

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In this fracture one fragment is firmly driven into the other, such as the shaft of the bone being driven into the head or end seg

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Impacted fx

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This fracture of the wrist in which the distal radius is fractured with the distal fragment displaced posteriorly

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colles fx

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This fracture most commonly involves the distal fifth metacarpal with an apex posterior angulation best demonstrated on the lateral vi

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boxer's fx

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This fracture extends through the pedicles of C2 with or without subluxation of C2 upon C3

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hangman's fx

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involves collapse of a vertebral body resulting from flexion or axial loading, most often in thoracic or lumbar regions

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compression fx

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Kyphosis is an abnormal or exaggerated convex curvature of the thoracic spine that results in stooped posture and reduction in height

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kyyphosis

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Four levels of consciousness

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Alert and conscious; Drowsy, but responsive; Unconscious, but reactive to painful stimuli; Comatose

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Loss of blood from injury or internal hemorrhage; loss of plasma from burns, or other cause of severe dehydration

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Hypovollemic shock

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Injury to the nervous system caused by head or spinal trauma

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Neurogenic Shock

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Cardiac failure caused by interference with heart function. May be caused by embolism, cardiac tamponade, or complications of anesthesia.

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Cardiogenic shock

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Massive infection, usually by Gram-negative bacteria.

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Septic Shock

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Contact with foreign substances, usually proteins, to which the individual has become sensitized (including bee stings and some medications). Iodine contrast agents for radiographic imaging may precipitate a similar response.

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Anaphylactic Shock

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high-density pharmacologic agents used to visualize low-contrast tissues in the body, such as the vasculature, kidneys, gastrointestinal (GI) tract, and biliary tree

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Radiopaque contrast media

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atomic number of iodine

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53

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atomic number of barium

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56

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this contrast media do not dissociate into ionic particles when introduced to the bloodstream

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nonionic

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Contraindications for use of barium

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perforation; obstruction

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Contraindications for use of Iodine contrast media

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Allergies, elevated BUN/Creatine

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Put the following in order that they should be scheduled:
1)Lower gastrointestinal series (barium enema)
2) Radiographic examinations of the urinary tract 3) All radiographic examinations not requiring contrast media and any laboratory studies for iodine uptake 4) Radiographic examinations of the biliary system 5) Upper GI series

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3, 2, 4, 1, 5

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drug and blood leakage into the tissues surrounding the vein.

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extravasation

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application of a drug directly onto the skin or mucous membrane

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topical route

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administered by injection

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parenteral route

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The four most common methods by which drugs are administered parenterally

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intradermal, subcutaneous, intramuscular, and intravenous

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beneath the layers of skin, yet above the muscle

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subcutaneous

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Predictable action or effect of a drug other than that desired

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side effect

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Prior sensitization to an initial dose of the medication or one of its components;
Hives, asthma attack, bronchospasm

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Allergic Response

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A “light-headed” or dizzy sensation that is common after prolonged bed rest

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orthostatic hypotension

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nosebleed

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epistaxis

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Standard things included in taking a history

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Onset, duration, specific location, quality of pain, what aggravates, what alleviates

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bluish coloration in the skin and indicates a lack of sufficient oxygen in the tissues

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cyanotic

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frequently called a “cold sweat.”

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diaphoretic

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a form of chronic obstructive pulmonary disease that prevents patients from exhaling effectively, limiting their capacity for inhaling fresh air

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emphysema

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abnormally rapid pulse

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Tachycardia

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pulse is taken over the instep of the foot

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dorsalis pedis or pedal pulse

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The most common site for palpation of the pulse

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radial

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a measurement taken by listening to the heartbeat through a stethoscope that is placed over the apex of the heart

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apical pulse

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abnormally high blood pressure

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hypertension

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blood pressure cuff

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sphygmomanometer

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The top figure in a blood pressure; is a measure of the pumping action of the heart muscle itself.

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systolic pressure

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bottom figure in a blood pressure; indicates the ability of the arterial system to accept the pulse of blood forced into the system when the left ventricle contracts

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diastolic pressure

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abnormally slow heart rate

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bradycardia

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cessation of heartbeat

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cardiac arrest

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cessation of breathing

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respiratory arrest

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refer to the placement of any tube, it is most commonly used to indicate the placement of an airway into the trachea

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intubation

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a mechanical respirator device powered by compressed air that controls the respiratory rate, inspiratory volume, and oxygen content.

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ventilator

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the medical term for what is also called a heart attack

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Myocardial infarction (MI)

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blood in the pleural space

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hemothorax

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air in the pleural space

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pneumothorax

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excessive bleeding

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hemorrhage

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Fainting

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syncope

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reddening of the skin

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erythema

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hives

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urticaria