Patient Care CH15 review

It would be inappropriate to:

ask the patient leading questions regarding his or her symptoms.

when asking about a patient's pain, it is effective to:

ask the patient to locate or touch the area that hurts and record that on the requisition

Orthostatic hypotension typically results from which of the following?

being in bed for long periods of time

Which of the following is not one of the sacred seven of medical histories?

birth date

How can the severity of orthostatic hypotension be minimized?

by moving slowly

dyspnea

difficult or labored breathing

orthopnea

difficulty breathing except when sitting or erect

Which of the following types of wheelchair transfers requires minimal assistance by the radiographer?

standby assist

When questioning patients to obtain an accurate patient history,

start with open ended questions and then follow up with more direct inquiries.

In preparing to radiograph a patient who has come to the medical imaging department with a complaint of abdominal pain, you begin to question the patient as part of the history. Which of the following the most beneficial initial question to ask the patient?

"Can you please tell me about the nature of your pain?"

The patient coming to you for an abdominal examination states, "My belly hurts." A logical question to ask next would be

"Can you touch the area of your belly that hurts?"

list indications for why endotracheal tubes would be used.

(1) a need for mechanical ventilation or oxygen delivery because of inadequate ventilation (breathing), inadequate arterial oxygen-ation, severe airway obstruction, shock, and parenchymal dis-eases that impair gas exchange; (2) upper airway obstruction; (3) impending gastric acid reflux or aspiration; and (4) provi-sions for tracheobronchial lavage.

in determining a patient's description of his/her pain, a good question to ask would be

(all) - how would you describe the pain? - When did the pain first happen? - if the pain comes and goes, how often does it occur, and what is the time span between the occurrences?

To best answer this sentence: An imaging sciences professional

(does none of the below) -relates his/her personal experiences to the patient's when taking a history - uses "pet names" - relies exclusively on objective patient data

On a patient's examination requisition for a KUB, you notice that the history recorded by the emergency department staff states "R/O appendicitis." In an effort to gain more precise information about the patient's condition, questions to ask that would be important to this examination (KUB) would be: 1. "How would you describe the pain?" 2. "Have you had previous appendix surgery?" 3. "Do you know if the emergency department called in a sonographer?" 4. "Can you touch the area that specifically hurts?" 5. "Are you sure it's not your kidneys?" 6. "Does the pain appear to be in your appendix?"

1&4 only

Orthostatic Hypotension

A sudden drop in blood pressure in the brain when a person stands up quickly from a sitting or supine position, causing the oxygen in the brain to drop and the person to become dizzy and prone to falling.

palpation

Application of light pressure with the fingers

quality

Description of the character of the symptoms—for example, the color, quantity, and consistency of blood or other body substances; size or number of lumps or lesions; frequency of urination or coughing; or character of pain

localization

Determination of a precise area, usually through gentle palpation or careful wording of questions

Base of support

Foundation on which a body rests or stands; when people stand, their feet and the space between the feet define the base of support.

center of gravity

Hypothetical point around which all mass appears to be concentrated.

sacred seven

Localization • Chronology • Quality • Severity • Onset • Aggravating or alleviating factors • Associated manifestation

Maslow's Hierarchy of Needs

Model of human needs developed by Abraham Maslow, original hierarchy identifies two types of needs: deficiency and growth needs were further divided into seven levels, four at the deficiency needs level (physiologic, safety, belongingness and love, and esteem) and three in the upper growth needs level (need to know and understand, aesthetic, and self-actualization)

mobility muscles

Muscles that are found in the four extremities and designed for movement; examples include the biceps femoris, biceps brachii, and gastrocnemius. These muscles have long white tendons and are also called white muscles.

stability muscles

Muscles that support the torso and are designed to provide postural stability; examples include the latissimus dorsi, abdominal group, and erector spinae. These muscles tend to have thick red muscle bellies and are also called red muscles.

Blood pressure taking

Need sphygmomanometer & stethoscope. Put band around arm halfway between elbow and axilla. Stethoscope goes near elbow. Pump balloon to cut off blood flow, slowly release pressure. When you here blood rushing to forearm this is systolic pressure, when the sound goes quiet again this is diastolic pressure. Both of these numbers are read from the manometer.

outpatient

Patient who comes to a health care facility for diagnosis or treatment but does not usually occupy a bed overnight

objective

Perceptible to the external senses (#, vitals)

subjective

Pertaining to or perceived only by the affected individual; not perceptible to the senses

where should the ET tube placement be located?

Properly positioned tubes will show the distal tip 1 to 2 inches (3 to 5 cm) superior to the tracheal bifur-cation (Fig. 15.27). The cuff is inflated with air and is positioned at midtrachea; however, the cuff is not radiographically appar-ent.

inpatient

Someone who has been admitted to the hospital for diagnostic studies or treatment

how is blood pressure read? (units of measurement)

Systolic/ Diastolic mm Hg

chronology

Time element of the history, usually including the onset, duration, frequency, and course of the symptoms

Most radiologists have one key question they want answered when it relates to any medical imaging examination. That question most likely would be:

Why is the patient having this exam?

ambulatory

able to walk

tachypnea

abnormal rapid breathing

atelectasis

absence of gas from part or the whole of the lungs as a result of failure of expansion or re-absorption of gas from the alveoli

The ideal way to perform a transfer is to:

allow the patient to do as much as they can

When transferring a patient from a wheelchair to a radiographic table,

allow the patient to help with the transfer if it is safe based upon their capabilities.

When positioning a patient in a rolling motion transfer:

always move the patient towards you

center of gravity for a standing patient is:

at approximately the second sacral segment

Which of the following is the foundation on which a body rests?

base of support

An important piece of information regarding a patient's need for medical care is sought by physicians and medical professionals. Many times, patients are vague about their pain or reason for seeing the doctor. It is important to discover the patient's _____ for seeking medical care.

chief complaint

objective data regarding a patient's history:

consists of a patient's vital signs

What causes patients to feel lightheaded, queasy, or faint when they stand up quickly from a sitting or supine position?

decreased blood pressure

hypoxemia

decreased oxygen tension in the blood

In the process of questioning a patient about the reason for having the requested x-ray examination, the patient becomes irritated and complains that she "is getting pretty tired of saying the same things over and over to all these nurses." An effective method to deal with this patient's attitude would be to:

explain that each person asking questions is trying to find out additional important information about her condition.

Stability muscles are found in the extremities

false

where would the placement be for the insertion site for a chest tube? be specific.

for fluids: the 5th to 6th intercostal spaces and laterally at the midaxillary line. (can go as high as 4th and as low as 8th) for gas/air: the 2nd to 3rd intercostal space at the midclavicular line is preferred.

It would be professionally appropriate for the imaging professional to

gently touch the patient to clarify the location of his or her pain.

velcro straps

help keep patient in place and are useful for patients that are not fully cognizant.

a pulse oximeter can be used to measure pulse and what else?

hemoglobin oxygen saturation of arterial blood

list the steps and equipment involved in order to measure blood pressure properly.

https://www.suntechmed.com/blog/entry/4-bp-measurement/42-10-steps-to-accurate-manual-blood-pressure-measurement

If a patient arrives in a wheelchair and on a sling, which type of transfer is indicated?

hydraulic lift

pleural effusion

increased amounts of fluid within the pleural cavity, usually the result of infalmmation

intubation

insertion of a tubular device into a canal, hollow organ, or cavity

sphygmomanometer

instrument for measuring blood pressure

When lifting patients it is important to:

keep your back stationary and lift with your legs

hyperthermia

low body temperature

When taking a patient history, it is important to:

maintain a polite and professional demeanor when gathering information.

what is a Swan-Ganz catheter used to measure and what is the normal direction of the path insertion?

measure pulmonary arterial pressure. CV lines inserted from a right-sided approach will follow the course of the subclavian vein in a lateromedial direction and then descend through the right brachiocephalic vein. From the right brachiocephalic vein, the catheter passes into the superior vena cava, where it should terminate above the right atrium.

A sudden drop in a patient's blood pressure caused by standing or sitting upright is called:

orthostatic hypotension

febrile

pertaining to or characterized by fever

systolic

pertaining to tightening, or a period of contraction of the heart, especially that of the ventricles

list conditions that would necessitate the use of a chest tube placement

pneumothorax, hemothorax, pleural effusion, and empyema.

As a patient begins to explain his reasons for coming to the clinic for a radiographic examination, he begins to use medical terms to describe his conditions. His information appears to be accurate medically and helps clarify his symptoms. To deal with this patient, you should:

politely listen, record his comments, and repeat his statements to clarify.

Which of the following immobilization devices is used for a lateral chest film on a non-ambulatory patient?

positioning sponge

pneumothorax

presence of gas or air in the pleural cavity

diaphoresis

profuse swetting

stability bar

purpose is to move the patient's arms above their head and out of the area of interest as well as providing stability and steadiness.

In recording a patient history for the radiologist, you note that the patient has an open sore on her ankle. In your description, you indicate that the sore is draining and has a foul odor. This information deals with the _____ of a patient history.

quality

tachycardia

rapid heart rate, usually defined as a heart rate greater than 100BPM

As you prepare to take a PA chest radiograph on a patient who is suspected of having a lung collapse, you note that the patient has an extremely difficult time taking in a deep inspiration. An imaging sciences professional would

record the depth of inspiration as a measure of the quality of the symptom.

As you perform a STAT skull series on a conscious patient from the emergency department (ED), you notice that the patient has a large swelling over his left temporal region. The patient requisition states that the patient had trauma, and nothing else is provided. An imaging sciences professional would

record the swelling on the requisition and ask the patient what kind of injury he experienced.

what are some common reasons for oxygen administration?

reduce the increased cardiopulmonary workload, correct hypoxemia or possible hypoxia

sandbags

reduce voluntary motion, are radiopaque= should not be in the x-ray or IR finished view

positioning sponges

reducing physical strain on the patient from having to hold a position, and allow for increased accuracy in positioning by supporting the patient or anatomic area of interest in the correct position

hypoxia

reduction of oxygen supply to the tissue

Good history taking involves the collection of objective and subjective data. All of the following are examples of subjective data EXCEPT the patient's:

respiratory rate

The purpose of a patient transfer is to:

safely move a patient from one area to another

According to the U.S. Department of Labor, one of the most common work-related injuries resulting in lost work time and disability is

strains, sprains, and musculoskeletal injuries

What is a common recumbent position where a person lays on their back and faces up?

supine

what are the differences between a PICC line and a Port-A-Cath?

the PICC is peripherally inserted and the Port-A-Cath is totally implanted

In a two-person lift, who should lift at the torso region?

the stronger person

Which of the following statements applies to all types of wheelchair transfers?

transfer towards the patient's strong side

Which of the following wheelchair transfers is used for non-weight bearing?

two-person lift

list objective ways in which you can immediately asses a patient's physiological condition.

vital signs (body temperature, pulse rate, blood pressure, and respiratory rate)