Patient Care Chp 18 Aseptic Techniques

foley catheter

indwelling catheter retained in the bladder by a balloon inflated with air or fluid

contaminated

presence or the reasonable anticipated presence of blood or other potentioally infectious materials on an item or surface

auscultation

technical term for listening to the internal sounds of the body, usually using a stethoscope; based on the latin verb "asucultare" (to listen); performed for the purposes of examining the circulatory system and respiratory system (heart sounds and breath sounds) as well as the GI system

swan ganz catheter

the flow directed balloon tipped pulmonary artery catheter (also known as the swan ganz or right heart catheter) has been in clinical use for more than 30 yrs. initally developed for the management of acute myocardial infarction, the swan ganz cath provides right heart diagnostic info to rapidly determine hemodynamic pressures, cardiac output and mixed venous blood sampling

isolette

used as an incubator for premature infants; provides controlled temperature and humidity and an oxygen supply

When handling a patient with a Foley catheter in place: a. the drainage bag should be placed at the same level or higher than the bladder. b. avoid kinks in the tubing and keep the drainage bag lower than the bladder. c. it is advisable to clamp the tubing in order to do a lengthy small bowel study. d. never let the volume of urine fill more than 30% of the collection bag capacity.

B

aseptic

describes a product or method that is free of microbiological organisms

When using a portable C-arm for a surgical hip pinning: a. sterility will be maintained using a "shower curtain" approach. b. sterile technique is unnecessary. c. the surgeon can reach through the curtain and move the C-arm manually. d. an additional sterile towel is positioned over the incision site and then removed when the C-arm is brought into the field of view for imaging.

A

All of the following situations would require aseptic techniques EXCEPT: a. insertion of a barium enema tip. b. insertion of central venous line. c. insertion of an indwelling Foley catheter. d. insertion of an angiographic catheter.

A

The purpose of the inflatable balloon portion at the tip of the Foley catheter is to: a. hold the catheter within the bladder. b. present the backflow of urine into the ureters. c. permit its visualization under fluoroscopy. d. induce the stimulus for voiding.

A

When a Foley catheter system is inserted into a patient for an expected period of 4 to 6 weeks: a. a polyvinyl chloride catheter is used. b. a suction pump is attached to the drainage bag to ensure bladder emptying. c. the patient is taught how to remove and replace the Foley using aseptic techniques. d. the catheter will most likely not have an inflatable balloon end.

A

When gowning another person: a. a nonsterile circulating person pulls the gown up and fastens the back and waistband. b. the nonsterile person picks up the opened gown and hands it to the sterile person. c. sterile masks are unnecessary. d. the sterile person grabs the gown by the waist and wraps it around the unsterile assistant.

A

When performing radiologic examinations on patients with chest tubes: a. remember that the chest drainage system has three compartments: collection chamber, water seal chamber, and suction control chamber. b. check for the color of the drainage and report any dark red color. c. the exterior chamber of the assembly must remain lower than the patient's chest level. d. all of the above are correct

A

When using a portable fluoroscopy C-arm in surgery: a. the image receptor and C-arm are draped with a snap cover for sterility. b. the surgery team members operate the fluoroscopy unit. c. the C-arm is disinfected and considered sterile. d. sterile technique is unnecessary.

A

Which of the following represents good sterile technique? a. When using a sterile setup, avoid bending or reaching over it. b. Remove sterile forceps from their container and tap them on the edge so all the solution will fall off. c. Any sterile supplies added to a sterile tray, such as cotton balls, should be returned to their containers if not used, as such waste is inefficient and costly. d. The solution in the forceps container should be checked regularly and added to when its level gets too low

A

A common neonatal chest disorder requiring portable radiography in the neonatal unit is transient tachypnea of the newborn (TTN). Radiographs are taken to visualize the chest for respiratory distress, and in doing so the imaging professional must: 1. employ the highest degree of aseptic techniques. 2. use lead protection when possible, and sterilize after each use. 3. wash hands only after the procedure is complete. 4. wrap all items that may have the potential of coming in contact with the newborn. 5. employ contact or shadow shielding for patient protection. 6. treat the procedure as a sterile procedure similar to surgery. a. 1, 3, 4, and 6 only b. 1, 2, 4, and 5 only c. 3, 4, 5, and 6 only d. 1, 3, 5, and 6 only

B

The goal of aseptic technique is to: a. protect the radiographer from infection. b. protect the patient from pathogenic microbes. c. prevent the spread of infection from the patient to any equipment in the examination room. d. protect the surgical team from an infected patient.

B

When establishing a sterile field using a sterile drape: a. it is acceptable to reach over the sterile field in order to minimize reach and air motion. b. all drape items must be clean and dry. c. inspect the expiration date to determine if you are using the sterile pack within 36 hours of the expiration date. d. open the sterile package with the top flap set to open toward the person opening the pack.

B

When performing portable radiography on neonatal infants: a. gonadal protection is not important, as the reproductive organs have yet to form. b. aseptic techniques are especially important because of the infant's weak immune system. c. the portable radiographic unit must be wiped down after the procedure within 24 hours. d. the radiographer should wash his or her hands before the procedure only.

B

Which of the following statements is FALSE? a. A sterile person may touch only what is sterile. b. Create sterile fields early in the morning while staff members are fresh and equipment is clean. c. A sterile field must be watched continually to be considered sterile. d. If a solution soaks through a sterile field to a nonsterile field, the wet area must be re-draped.

B

If the sterility of an object is unknown, which of the following should be done? a. Ask the physician if it is alright to use the object. b. Use the object as long as it has not been dropped on the floor. c. Consider the object unsterile and do not use it. d. Clean the object with a disinfectant or antimicrobial before using it.

C

The inflatable balloon portion of the Foley catheter is typically filled with: a. radiopaque contrast material. b. carbon dioxide. c. sterile water. d. mineral oil.

C

The role of the imaging technologist during cardiac pacemaker studies is to: a. assist the surgeon with sterile technique. b. position the patient into various oblique angles for static radiographic images. c. operate fluoroscopy for the physician as he or she guides the pacemaker into position. d. provide nursing care to the patient and monitor the electrophysiology data.

C

Two people in sterile attire should pass each other in which of the following ways? a. Front to back b. Back to front c. Back to back d. Front to front

C

When creating a sterile field, it is important for the imaging professional to: a. establish the sterile field as early in the day as possible to create an awareness of the scheduled procedure. b. remember that anything above the ankles is considered sterile. c. keep sterile gloves in sight and above the waist level. d. remember that any moisture that develops on the sterile field can be dried using an infrared lamp.

C

When gowning and gloving for a sterile procedure, it is important to remember that: a. the techniques are the same as gowning for medical asepsis. b. sterile gloves must be put on outside of the sterile work area. c. after gowning, the front of the gown down to the waist, and the sleeves are considered sterile. d. when passing a sterile team member, you must pass each other face to face in order to see any contamination.

C

When performing dressing changes, it is important to remember that: a. working on the dressing change as a single person is highly recommended to prevent contamination b. dressing changes can be performed once there is a color change on the dressing surface c. if the wound is purulent, gowns are recommended. d. sterile gowns are only needed if the wound is openly draining

C

When putting on a pair of sterile gloves using the self-gloving, open technique: a. jewelry may remain on during gloving. b. the glove package is open and positioned so the wearer crosses his or her arm over the left glove to reach for the right glove. c. the first glove is picked up by the inside cuff with one hand, being careful not the touch the outside of the glove. d. the remaining glove is grabbed by the outside and placed on the unsterile hand, now making it sterile.

C

Which of the following should be examined first when a sterile package is used? a. Way the package is folded b. Type of material used to wrap the package c. Expiration date d. Way the package is taped

C

You are about to assist with a sterile procedure. In scrubbing for the procedure it is important to: a. tightly wrap surgical tape around your rings and watch after scrubbing. b. keep your arms down when scrubbing to prevent fluids running up your arm. c. scrub the fingers completely, as well as the front and back of your hands, for 3 minutes. d. use a surgical antimicrobial solution such as alcohol or antiseptic soap

C

You are working as a radiographer in a busy imaging department, late into the evening. You receive a request for a portable chest radiograph on a cardiac patient in the ICU. Your co-worker comments that he just did a portable chest procedure on the same patient approximately 15 minutes earlier and questions why they are ordering another one so soon. The rationale for this next chest image would most likely be: a. the floor had a change in nursing staff and they are re-ordering the examination to make sure it was completed. b. a new resident cardiologist arrived for his shift and wants his own image. c. the patient has a central venous line and the physician wants to check the repositioning. d. the patient is now sleeping and a better image can now be achieved.

C

Hazardous drug-related waste materials: a. include only pharmaceuticals to prevent needle perforations through the collection bag b. deal with bodily discharges such as sputum and feces c. are collected in clear bags for identification d. require the labeling of needle containers and breakable items of hazardous waste

D

If you suspect the radiologist has contaminated his or her glove, which of the following should you do? a. Ignore the contamination so as not to delay the case. b. Tell the radiologist after the procedure has been completed. c. Confirm the contamination with a second person, and if he or she is in agreement, inform the radiologist. d. Make the radiologist aware of the possible contamination immediately

D

When opening a sterile tray, your fingers: a. may not touch any metal content. b. must be covered with sterile gloves. c. may not touch any cloth content. d. must never touch the inside of the tray.

D

When opening and pouring sterile solutions: a. both the inside and outside of the container are considered sterile. b. move the sterile basin to the edge of the field c. show the solution name and strength to another person before pouring. d. move the sertile basin to the edge of the sterile field and show the solution name and strength to another person before pouring are appropriate

D

When opening and pouring sterile solutions: a. remove the cap and place it on a corner of the sterile field with the lid down. b. wipe up any spills of solution using a sterile towel. c. hold the bottle approximately 12 inches above the basin when pouring, to form a steady stream of fluid. d. hold the bottle with the label facing up to prevent fluids from staining the label.

D

sterile

aseptic; free of living microorganisms

subungual

beneath a fingernail or toenail

purulent

consisting of or containing pus. the term purulent is often used with regard to drainage