Term
| What are the six guidelines for bedside radiography? |
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Definition
One – call the nursing station before leaving the imaging department unless responding to a stat request
Two – ask nurse about the patient's condition
Three - confirm the order in the patient's chart
Four – greet the patient and explain the procedure
Five – check patient ID birthdate on the wristband
Six – inspect and prepare the room before bringing in the x-ray equipment |
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Term
| Postanesthesia care unit (PACU) |
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Definition
-Usually adjacent to or where patients are monitored after surgical procedures until the effects of anasthesia have worn off
-exams you might do would include a chest x-ray to verify line or port placement or hip/pelvis/knee/ankle etc. to demonstrate alignment of screws and plates for fractures or artificial joint replacement |
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Term
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Definition
-This environment will take the most creativity because the patient will exhibit various levels of cooperation consciousness and or disfiguration and there are multiple activities going on at any given moment
-commonly ordered exams are chest x-ray C-spine pelvis; extremities depending on injury sustained – be prepared for just about anything |
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Term
| Neonatal intensive care and newborn nursery (NICU) |
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Definition
-NICU babies may require CXR, KUB or school radiographs to document anomalies
-nursery babies may need CXR for pneumonia or a clavicle fracture
-disinfect the x-ray machine, wash hands and wear gloves, down if necessary; cover the cassette with a pillowcase or blanket before placing under infant
-be sure to move the heat lamp out of the way before positioning the tube if the baby is in an open incubator
- be very careful of any IVs, tubing or vent equipment |
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Term
| Intensive care and coronary care units (ICU/CCU) |
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Definition
-patients in these units are critically ill and require constant monitoring
-vast majority of exams ordered ore CXR and KUB sometimes daily or multiple times daily
-you are expected to engage the nurse for exams on these patients they will want to make sure no lines are disturbed in the course of the exam
-be sure to explain the procedure to the patient and if they are conscious and able allow them to assist you
-before moving the patient make sure that all lines have plenty of slack and that all personnel are ready
- if you happen to dislodge a vent line or tubing tell the nurse right away |
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Term
| Special beds and mattresses |
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Definition
| -if the patient is on a special bed consult with Nursing staff to see what is required for placing your cassette; be careful not to snag the bed or pad material went sliding the cassette under the patient |
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Term
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Definition
-traction is the application of pressure for therapeutic reasons, generally to aid in muscle spasms
-be very careful not to bump the bed, patient or traction device, as it will be very painful for the patient |
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Term
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Definition
-surgical opening in the trachea for a temporary or permanent airway
-A patient may need a tracheostomy to do obstruction of the upper respiratory tract (Spasm, cancer, burns in the mouth or throat) or to be used with ventilation or respiratory collapse (paralysis, pulmonary Adema, trauma)
-suction equipment must be readily available |
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Term
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Definition
-patients who cannot breathe on their own are intimated (ET tube) and connected to a mechanical respirator that can supplement respiratory or completely control it
-be very careful when moving the x-ray unit around the vent to later and tubing
- Time your exposure to do with the ventilator so that you catch the pause after in elation for CXR or the pause after expiration for KUB
-if the patient is being manually Ventilated or bagged (usually just after intubation but before the mechanical vent is in place in ER) ask for a breath hold it for your exposure |
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Term
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Definition
-tubes that are inserted into the nose and down to the stomach
-maybe necessary for feeding, decompression of gas or secretions, or radiographic studies (for oral contrast admin if the patient can't or won't drink the contrast)
-KUB will often be ordered to verify placement of the two before introducing anything through it |
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Term
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Definition
-NE tubes are inserted into the stomach and peristalsis advances the tube into the small intestine
-placement is verified with KB if you hours after insertion and periodically after that if the tube has to be repositioned
-for both NG and NE tubes, try not to pull on the tubing; it is one of the more obvious tubes but it may be pinned to the patients gown and you may pull on it without realizing |
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Term
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Definition
-chest tubes can be used to drain error fluid that is trapped between the plural space through a tube into a drainage unit
-*The drainage unit must stay below the level of the chest or else they drained material will flow back into The pleural space* |
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Term
| Pulmonary artery flow – directed catheters |
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Definition
-Swan-Ganz
-inserted through the subclavian, internal or external jugular, or femoral vein
-Advanced until the tip rests in the right atrium |
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Term
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Definition
-measures cardiac output
-right heart pressures
-left heart and lung pressures indirectly
-used to diagnose right and left ventricular failure |
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Term
| Central lines/central venous catheters |
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Definition
| -used in administration of chemotherapy or other long-term drug therapy |
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Term
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Definition
-Peripherally inserted central catheter (PICC)
-Hickman
-Groshong
-Raff
-Port-A-Cath |
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Term
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Definition
-electro mechanical device that regulates the heart rate by providing electrical stimulation to the heart muscle
-they are placed just below the surface of the skin of the patient's chest and are composed of a battery pack and wire that stimulates the heart
-they may be inserted in the radiology department or in the OR, ICU, or CCU
-*The left arm must not be elevated for 24 hours after placement*
-often inserted under C-arm guidance |
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Term
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Definition
-access to the surgical suite is limited to personnel and items with a legitimate reason to be there
-special surgical attire must be worn in a surgical suite |
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Term
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Definition
-Nonsterile shirt and pants
-mask that covers nose and mouth
-Hat or a hood that covers all hair including a beard if applicable
-shoe covers may be optional
-gloves - donned to handle anything contaminated with blood |
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Term
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Definition
-The rooms are small and depending on the procedure
-you may not be able to bring in the x-ray equipment after the patient is prepped on the table with violating the sterile Corridor |
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Term
| Two classifications of the surgical's team |
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Definition
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Term
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Definition
-surgeon
-assistant to the surgeon or a physician
-non-physician assistant
-scrub person which could be a registered nurse licensed vocational nurse or surgical technologist |
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Term
| Nonsterile team members include |
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Definition
- Anesthesiologist or anesthetist
-circulating nurse or surgical technologist
- various other technologist such as biomedical, orthopedic, radiologic |
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Term
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Definition
-Area between the patient drape in the instrument table
- only those bring sterile a tire allowed in this area |
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Term
| Guidelines for sterile Corridor |
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Definition
-be aware of the sterile field
-do you not wear anything that dangles
- avoid putting in pockets objects that can fall out
- past behind the back of a sterile team member to avoid contamination |
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Term
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Definition
| Radiograph of the biliary ducts taken after the injection of a radiopaque contrast medium; usually part of a Cholecystectomy |
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Term
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Definition
| Open reduction with internal fixation for a fractured hip/Wrist/ankle/femur/tibia |
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Term
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Definition
| Ureteral stent placement post procedure CXR for open heart procedures as part of the instrument count |
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Term
| Other surgical procedures |
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Definition
-spinal procedures like vertebral fusion, laminectomy
-joint replacement procedures |
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Term
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Definition
| Methods of reducing pathogenic microorganisms in the environment and intervening in the process by which micro organisms are spread |
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Term
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Definition
| The process of creating and maintaining an area that is completely free of pathogens |
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Term
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Definition
| The complete distraction of all organisms and spores from equipment used to perform patient care or procedures; essential to surgical asepsis |
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Term
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Definition
-The immersion and soaking of clean objects in a bath of germicidal solution followed by a sterile water rinse
-not recommended for surgical asepsis |
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Term
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Definition
-an autoclave is a device that provides steam sterilization under pressure
-The most commonly used sterilization method
-quickest and most convenient means for items that can withstand heat and moisture |
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Term
| Conventional gas sterilization |
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Definition
-method that uses a mixture of gas heated to 135°F which is 57°C
-used for items that cannot be autoclaved such as:
Electrical, plastic, rubber items, and optical wear
Telephones, stethoscopes, blood pressure cuffs, and other equipment used in isolation rooms |
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Term
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Definition
-Chemical indicators that can change color when sterilization has occurred
-used to identify whether a pack has been sterilized
-placed inside and outside the pack to show that the gas, heat, steam, or gas plasma has penetrated to all surfaces |
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Term
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Definition
-defined as a micro organism – free area prepared for the use of sterile supplies and equipment
-first step and preparing a sterile field is to confirm the sterility of the packaged supplies and equipment |
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Term
| Packages are considered sterile if they meet the following criteria: |
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Definition
-they are clean, dry, and unopened
-their expiration date has not been exceeded
-there Sterility indicators of change to a predetermined color, confirming sterilization |
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Term
| Steps to establish a sterile field |
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Definition
-place the pack on a clean surface within reach of the physician
-just before the procedure begins, break the seal and open the pack
-unfold the first corner away from you, unfold the two sides one at a time, then the last fold towards you
-do not touch the inner surface
- The inner wrap, if there is one, is opened in the same manner |
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Term
| If you need to add a disposable item to the sterile field: |
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Definition
-items supplied in "peel – down" wrapper
-separate the package layers
-invert the package
- allow object to fall onto sterile field without contamination the object or the field |
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Term
| Surgical asepsis: standard principles |
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Definition
-any sterile object or field touch by an unsterile object or person becomes contaminated
-never reach across a sterile field (organisms may fall from your arm into the field and it also increases the risk of brushing the area with your uniform)
-do you not passed between the physician and the sterile field
-never leave a sterile area unattended
-A 1 inch border at the perimeter of the sterile field is considered a "buffer zone" and is treated as if it were contaminated |
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Term
True/false
If you suspect an item is contaminated examine it closely to determine |
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Definition
| False! You should discard it just in case |
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Term
| 2 important things to remember regarding the open gloving technique: |
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Definition
- Put on first glove, touching only inner surface of folded cuff
- Using gloved hand, grasp second glove under cuff
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