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71 Cards in this Set
- Front
- Back
The major goal of sonographers is to master proper sonographic ----------- to ensure the production of high quality diagnostic---------- and minimal-------------- |
Techniques Sonograms Discomfort |
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Scanning technique requires more than a systematic approach to scanning: |
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. |
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_________ is also called dorsal recumbent position. |
Supine |
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In ________ , the patient lies on his side with the arms in front. |
LLD or RLD lateral position |
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In ___________ patient positioning-right side down is toward table and left side up is 90 degrees angle to table |
RLD right lateral decubitus |
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In __________ patient positioning is left side down toward table and right side is up 90 degrees |
LLD left lateral decubitus |
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Patients are placed in a ___________ position for transvaginal ultrasound examinations. |
Lithotomy |
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Modified Fowlers Position |
Head elevated 25 degrees, knees slightly flexed. Used in advanced pregnancy to avoid vena cabal hypotension. LLD will ease the problem. |
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An ___________ position is helpful in scanning a gallbladder that is positioned high up, under the ribs. |
Upright |
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Trendelburg position |
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 |
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__________ divides the body into equal right and left sides. |
Sagittal Plane |
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Divides the body into anterior and posterior portions |
Coronal/Vertical plane |
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Any plane not parallel to sagital, transverse or coronal |
oblique |
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Sonographers duties to ensure department is running smoothly: |
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 |
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What to include in a technical report |
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 |
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Do not include in technical reports |
Diagnosis |
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PACS |
Picture Archiving and Communication Systems |
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Computer assisted programs that allow electronic storage, management, distribution, and viewing of images |
PACS |
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RIS |
Radiology Information Systems |
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Computer programs designed to streamline scheduling/ordering of appointments, patient registration, work lists, billing and medical management |
RIS |
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Sonographers prepare a patient for exam by: |
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 |
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Abdominal organs NPO for ____________ hrs before exam to minimize bowel gas |
8-12 |
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Organs evaluated in abdominal ultrasound exams |
Liver, gallbladder, bile ducts, kidneys, pancreas, spleen, diaphragm, aorta, abdominal fluid collections |
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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 |
Barium |
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Urinary tract: drink ____________ an hour before test to fill urinary bladder. No urination till test is over. |
4-6 glasses |
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For elderly patients and GYN exams, US can be performed |
1) transvaginal 2) transabdominal |
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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 |
Transvaginal Sonography TVS |
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Patient prep for endovaginal exam: |
Empty urinary bladded |
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For gynecological exams, patients may need to ________ prior to exam |
Fill their bladder |
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Gynecologic sonography may require the use of one or more of these approaches |
1) transvaginal 2) transabdominal 3) transrectal |
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Amniocentesis |
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 |
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A prenatal test to detect birth defects at an early stage of pregnancy
Results 7 dayspeecu |
Chorionic villus sampling CVS |
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Percutaneous umbilical blood sampling PUBS/ cordocentesis |
A diagnostic test that examines blood from the fetal umbilical cord to detect fetal a formalities. Results in 3 days |
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Duplex imaging |
Imaging & Dopplar at the same time |
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Prime elements in blood |
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 |
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CA-125 |
Ovarian cancer |
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Prothrombin time measures |
Clotting time of blood |
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In men, elevated levels of BHCH are used to detect the presence of: |
Testicular Cancer |
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Elevated AST, ALT, Indirect bilirubin |
Liver disease (like cirrhosis) |
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Elevated Direct Biliruben, ALP |
Obstruction in GB or duct |
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AST & ALT tests are collectively called |
Liver Function Tests |
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Increased levels of amylase (more sensitive) & lipase |
Pancreatitis |
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Hematuria is presence of |
Blood in urine |
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Proteinuria is presence of |
Protein in urine |
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(BUN) blood urea nitrogen & creatine indicate |
Renal dysfunction or renal failure (more sensitive) |
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Low hematocrit levels |
Recent bleeding |
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Low platelet counts |
Uncontrollable bleeding potential |
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Lowered levels of AFP |
Down's syndrome |
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Elevated levels of AFP |
Neural tube defects, abdominal wall defects |
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Accountability |
Answerability, responsibility for actions or decisions with resulting consequences. |
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A set of rules of conduct or procedure that have been established by custom, agreement or authority |
The Law |
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Those that affect the individual rather than society as a whole |
Civil laws |
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4 types of law |
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 |
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TORT |
A civil or criminal wrong that is recognized by law as grounds for lawsuit. Harm caused to another's body, property, reputation, legal rights |
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Assault |
Unlawfully placing a person in fear of bodily harm (threaten) |
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2 types of TORT |
1) intentional- (assault, battery, invasion of privacy, false imprisonment) 2) unintentional action |
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Battery |
Unlawful touching a person w/o their consent |
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Invasion of privacy |
Giving of patient information wo authorization (exposure of patient names on scans) |
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False imprisonment |
When a person is illegally obtained with out their consent or illegally restrained of their movement |
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Unintentional action includes |
1) negligence 2) duty 3) breach |
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Master-Servant Doctrine AKA Doctrine of respondent superior "let the master reply" |
The medical institution, the sonographers and the physician may all be charged. |
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Borrowed servant and captain of the ship doctrine |
The physician and Sonographer are both liable for sonographers negligence or other actions, but employer or institution not liable. |
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Ostensible agency doctrine |
The hospital or employer is responsible for sonographers actions, even when sonographers is not an employee |
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Res Ipsa Loquitur Doctrine "Let the thing speak for itself" |
Very obvious mistake |
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Ethicsethic |
The study of right and wrong based in moral principles (standards governing conduct) |
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Ethical standards are:d |
About right and wrong conduct, rules stating what you can and cannot do legally |
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DMS code of ethics |
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 |
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Sonographer ethical dilemmas |
Abortion, commercial use of ultrasound, selective termination |
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Before providing fetal keepsakes to parents : |
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 |
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Beneficence |
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 |
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Nonmaleficence |
A principle of bioethics that asserts an obligation mr to inflict harm intentionally.
Useful in dealing with difficult issues surrounding terminally ill. |