Healthcare Examination Procedures Quiz

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Questions and Answers

Which patients should be scheduled early for examinations?

Pediatric and elderly patients (correct)

Patients with cardiac problems

Diabetic patients

Patients with renal failure

What does GFR estimate in kidney function assessments?

The overall health of the liver

The amount of urea in the blood

The strength of kidney contractions

The percentage of blood passing through the glomeruli each minute (correct)

What should be checked in blood chemistry for normal ranges in adults?

BUN levels between 25 - 30 mg/100 mL

Creatinine level between 0.6 - 1.5 mg/dL (correct)

Glucose levels between 70 - 130 mg/dL

Potassium levels between 3.5 - 5.5 mmol/L

In what scenario is a contrast overdose most likely to occur?

In infants or adults with renal or cardiac failure Signup and view all the answers

What patient condition could lead to an anaphylactic reaction from contrast?

Dehydration or renal failure Signup and view all the answers

Which type of gloves is used specifically for chemotherapy procedures?

Chemotherapy gloves Signup and view all the answers

What is the main purpose of surgical scrubbing?

To facilitate the removal of transient microbes Signup and view all the answers

Which of the following correctly identifies an example of a respiratory protective equipment?

Surgical mask Signup and view all the answers

How long can it take to effectively remove transient microbes from the skin?

7 to 8 minutes Signup and view all the answers

What is the main characteristic of resident microbes found on the skin?

They are typically non-pathogenic and difficult to remove. Signup and view all the answers

Which of the following describes analgesia?

Absence of pain Signup and view all the answers

What is a primary sign of shock?

Cool and clammy skin Signup and view all the answers

What should be the first step in the radiographer's response to a patient in shock?

Stop the procedure Signup and view all the answers

Which type of shock is characterized by loss of blood volume?

Hypovolemic shock Signup and view all the answers

In which type of shock does blood pool in peripheral vessels due to nerve damage?

Neurogenic shock Signup and view all the answers

Which of the following is NOT a symptom of shock?

Excessive energy levels Signup and view all the answers

What should be done to the patient's legs during a shock emergency?

Elevate them above the heart Signup and view all the answers

What is a consequence of anaphylactic shock?

Fluid leaking into lungs Signup and view all the answers

What does intrathecal administration involve?

An injection into the spinal canal Signup and view all the answers

Which of the following substances must be handled with standard precautions?

Blood and body fluids Signup and view all the answers

What is the primary goal of using standard precautions?

To protect healthcare workers and patients from infection Signup and view all the answers

Which action is NOT recommended under standard precautions?

Recap needles after use Signup and view all the answers

Which type of personal protective equipment (PPE) is specifically recommended for the eyes?

Safety glasses or goggles Signup and view all the answers

What is the best method to prevent the spread of infection according to standard precautions?

Handwashing Signup and view all the answers

What should be done with uncapped needle syringe units?

They must be discarded in biohazard containers Signup and view all the answers

Which of the following statements about masks during CPR is true?

Masks or mouthpieces should be used when providing breaths Signup and view all the answers

What is the primary benefit of using warm compresses for extravasation of contrast medium?

Increases circulation to encourage uptake of the extravasated contrast medium Signup and view all the answers

Which factor is NOT associated with an increased risk of extravasation?

Injection performed in the shoulder Signup and view all the answers

What complication is characterized by inflammation of a vein due to trauma during venipuncture?

Phlebitis Signup and view all the answers

Which of the following treatments is NOT recommended for phlebitis?

Increase activity levels to promote circulation Signup and view all the answers

What is the recommended fasting time before a procedure requiring NPO status?

8 to 12 hours Signup and view all the answers

Which route of medical administration is considered parenteral?

Intravenous injections Signup and view all the answers

Which of the following is a sign of phlebitis at the injection site?

Swelling Signup and view all the answers

Which of the following methods helps minimize risks associated with extravasation during injection?

Flush as a test prior to injecting contrast Signup and view all the answers

Which of the following best describes the purpose of a negative pressure room?

To keep airborne microorganisms from entering the room. Signup and view all the answers

What precaution should be taken by radiographers when dealing with patients with neutropenia?

Use standard PPE and wash hands. Signup and view all the answers

For patients requiring droplet precautions, what is the recommended mask type for the radiographer when within 3 feet?

Surgical mask. Signup and view all the answers

Which of the following conditions is NOT typically associated with needing droplet precautions?

Tuberculosis. Signup and view all the answers

When should gloves be worn in a contact precautions scenario?

When entering the room. Signup and view all the answers

What is the main reason for wearing an N95 mask instead of a regular surgical mask?

To filter out smaller airborne particles. Signup and view all the answers

What should be done with equipment after leaving a room under contact precautions?

Clean it with an antiseptic solution. Signup and view all the answers

Which of the following is a characteristic of reverse isolation?

Reduces the risk of infections to the patient. Signup and view all the answers

Study Notes

Hypoglycemia

Hypoglycemia occurs when the blood sugar or glucose level drops.
It's also known as low blood sugar or low blood glucose.
This is common in people with diabetes, especially Type 1.
TYPE 1 DIABETES occurs when the body doesn't produce insulin.
TYPE 2 DIABETES occurs when the body can't use insulin properly.

Seizures

Seizures are caused by various diseases, trauma, genetics, structural abnormalities, or tumors in the brain.
Seizures can last for several minutes.
During a seizure, remove objects that could harm the patient and loosen tight clothing.
Do not put your hand in the patient's mouth.
Turn the patient's head to the side.
Gently restrain the patient to prevent injury.
PETIT MAL seizures are characterized by a brief loss of consciousness (10-30 seconds), and eye or muscle fluttering.
GRAND MAL seizures are characterized by a loss of consciousness, falling, and generalized muscle spasms.

Anesthesia

General anesthesia makes a patient unconscious and unaware of sensations.
Regional anesthesia numbs a body area to prevent pain during surgery.
Anesthesiologist or RNA injects local anesthesia near the nerves that provide sensation to the area undergoing surgery.
Two common types are spinal and epidural anesthesia, and nerve blocks are another type.
Sedation (sometimes called "monitored anesthesia care") causes the patient to feel drowsy and relaxed, and they can respond to questions.
Deep sedation uses Propofol and places the patient in a state of sleep and they can breathe without assistance.
Local anesthesia numbs a small area, offering pain relief for procedures such as dental work.

Terminology with Anesthesia

Anesthesia is the loss of sensation with/without loss of consciousness in all or part of the body.
Analgesia is the absence of pain.
Amnesia is the loss of memory.
Paralysis is a loss of muscle function.
Sedation is decreased consciousness.
Unconsciousness is loss of consciousness.

Assessment of Changing Patient Conditions

Visual observation of the patient.
Changes in skin color (cyanotic or pale).
Patient verbalizations of discomfort or dizziness.
Cyanosis of lips or nail beds.
Patient is cool and diaphoretic (sweating) to the touch.
Vital signs monitoring equipment used including ECG, blood pressure monitor, and pulse oximeter.

Shock

Shock is a critical medical emergency.
This occurs due to insufficient blood (oxygen) flow to vital organs.
Symptoms and signs of shock include low blood pressure, rapid pulse, rapid breathing, lack of body temperature control, flushed skin, clammy skin, gray or bluish tinge to lips/fingernails, nausea or vomiting, enlarged pupils, weakness, dizziness, fainting, or changes in mental status or behavior (anxiety or agitation).
Three types of shock include Hypovolemic, Cardiogenic, and Distributive.
Distributive shock has three subtypes: Neurogenic, Septic, and Anaphylactic.

Radiographer's response to shock

Stop the procedure immediately.
Place the patient in a Trendelenburg position or elevate their legs above their heart.
Obtain immediate help or activate a code.
Determine the patient's blood pressure.
Administer oxygen.
Accurately document the time and any actions taken.

Crash Cart

Contains procedural supplies, oral airway supplies, venipuncture supplies, emergency medications, intravenous fluids, and pediatric intubation supplies.

Crash Cart Items

Backboard, stethoscope, blood pressure cuff, ambu bag, laryngoscope, flashlight, batteries, extension cord, oxygen flow meter, tourniquet, airways, and more.
Includes endotracheal tubes, nasopharyngeal tubes, suction catheters, Levine tubing, Jelco cannulas, tracheal tubes, cut-down trays, suction bottles, hemostats, scissors, sterile gloves, various sizes of syringes, needles, and a checklist.

Crash Cart - Common Medications

A list of common medications, with their corresponding clinical indications.

GI System or Urinary System - Patient Preparation

Low-fiber or clear liquid diet.
NPO (nothing by mouth) for 8-12 hours.
Cathartics and enemas to cleanse the GI system.
Patients should be asked to explain the procedure.
Remove clothing covering the area of interest.
Remove all radiopaque objects from the area of interest.

History and Patient Care Preceding Injection of Iodinated Contrast Media

Determining history of allergies or previous hypersensitivity to contrast media.
Reviewing patient's medical problems and medications.
Determining the presence of possible contraindications to the contrast medium being used.
Verifying pertinent laboratory values, including blood urea nitrogen (BUN), creatinine, and glomerular filtration rate (GFR).
Verifying appropriate dosage related to patient weight and age.
Locating all emergency equipment.
Obtaining informed consent.
Carefully observing the patient (skin colour, voice pitch, and presence of apprehension or anxiety)

Contrast Media - Negative

Creates a higher density on the image.
Air is the most commonly used negative contrast agent.
Others include carbon dioxide and nitrogen.
Chest x-rays are a common x-ray using a negative contrast.
Organs become radiolucent.
Produces optimal density on the images.
Air can be used with positive contrasts for a double-contrast study.

Contrast Media - Positive

Positive contrast agents include barium or iodinated contrast.
Barium sulfate has an atomic number of 56 and iodine has an atomic number of 53.
Provides a lower density of the final image.
Increases contrast between different structures.

Barium Sulfate (BASO4)

Inert salt, colloidal suspension
Used orally and rectally for upper GI series and esophagograms
Most palatable when mixed with cold water
Barium enema bags are mixed with approximately 100°F water (body temperature).

Iodine

Iodine has an atomic number of 53.
Water-soluble contrast
Introduced orally, urinary, IV, rectally.
Used in perforations, pre/post-surgery.
Non-ionic compounds containing 3 iodine atoms (opacifying agents)
Will not form into separate ions, therefore less chance of reaction.

Contrast Media - lonic vs Non-ionic

Contraindications to use of iodinated contrast media include previous sensitivity to contrast agents, known sensitivity to iodine, asthma, hay fever, and shellfish allergies.
Both ionic and nonionic contrast agents are iodinated; however, the amounts can differ.

Important points about IV Iodinated contrast

Age and weight affect the amount administered.
Previous urinary system surgeries affect the amount administered.
Diabetes status
Hydration status
Kidney function should be considered based on blood work.
Previous contrast studies and allergies should be considered.

Most Common Drugs Administered for Reaction to Iodine

Benadryl (diphenhydramine hydrochloride, antihistamine)
Epinephrine (adrenalin, vasoconstrictor and bronchodilator)
Prednisone (steroid, given prophylactically).

Osmolality

Measurement of dissolved particles per unit of water in serum.
Higher osmolarity = more water in the blood system (hypertonic).
Lower osmolarity = less water in the system (hypotonic).
Isotonic is a normal range (275-295 mOsm/kg).

Viscosity

Increased viscosity is thicker and more difficult to inject, causing more heat due to friction.
Viscosity increases as room temperature decreases.

Toxicity

Greater osmolality, especially with ionic contrasts.

Miscibility

Contrast agents should be ready-to-mix with blood.

Contraindications for Barium in GI tract

Do not use barium if perforation is suspected.
Use water-soluble iodinated contrast media (e.g., gastrografin or gastroview) for GI tract procedures.

Aftercare Instructions for Barium Studies

Barium can become thickened (inspissation) due to water absorption, leading to constipating symptoms.
Encourage the patient to drink plenty of fluids.
Adhere to the doctor’s protocol.

Scheduling of Multiple Exams

Prioritise sonography, endoscopy, and CT procedures without contrast.
Next, schedule antegrade urinary tract exams (e.g., IVU) because of quick excretion.
Schedule imaging of the biliary system (e.g., gallbladder studies) after urinary tract exams.
Barium Sulfate studies should be scheduled last.
Consider scheduling UGI and small bowel follow-through based on the individual's condition and other scheduled procedures.
Consider the specific ordering of examinations based on whether there is any need to be aware of a period of time that can adequately be used to allow a person to recover before being exposed to another part of a procedure.

Patient Preparation

Low-residue diet/low-fiber or clear liquid diet
NPO (nothing by mouth) for 8 to 12 hours
Use cathartics and enemas to cleanse the GI tract, if needed.

Standard Precautions

Blood, body fluids, secretions, excretions, and mucous membranes should be considered potential sources of infection.
Wear gloves when touching a body fluid or exposure is likely.
Use protective gowns and aprons when necessary.
Masks and eye protection for splashes or splashes of body substance.
Discard contaminated articles in labeled biohazard containers.

Standard PPE

The right PPE equipment for the body area exposed to the potential hazard.
PPE items listed include eye protection (safety glasses, goggles), ear protection (earplugs, muffs), face protection (shield), hand protection (gloves), foot protection (shoe coverings), torso/body protection (fluid-resistant gowns, splash suits), and respiratory protection (N95 respirator, surgical mask).

Transient Microbes

Exist on skin surfaces
These are considered temporary.

Resident Microbes

Consist of bacteria which live deep within the skin.

The Microbial World

The world of infectious agents is broken down into four main parts.
Bacteria, Viruses, Fungi, Protozoan Parasites.

Cycle of Infection

All factors are involved in the spread of disease including an Infectious Agent, Susceptible Host, Portal of Entry, Mode of Transportation, Reservoir, Portal of Exit.

Mode of Transmission

Exogenous- Transmission outside of the body.
Endogenous- Transmission inside of the body.
Vehicle- The pathogen is transported by a medium (e.g., blood, saliva, food, water, contaminated equipment).
Fomite- A non-living object carrying an infection.
Vector - A living organism transmitting a disease (e.g., flies, mosquitoes).

Isolation Techniques

Three sets of guidelines for isolation techniques, Contact, Droplet, Airborne.
Airborne transmission droplets remain in the air for a long time, potentially travelling to another person.

Patients with Neutropenia

Neutropenia is decreased white blood cell count.
Usually due to treatments like chemotherapy or an immune system suppression.
Radiographers should follow strict protocols to prevent further infection in neutropenic patients.
These guidelines may include wearing PPEs and rigorous handwashing.
Some hospitals may use Reverse Isolation or Protective Isolation protocols for patients with compromised immune systems.

Droplet Precautions

Droplets expelled through coughing, sneezing, or talking can infect others.
Droplets typically travel within 3 feet.
Patients and healthcare workers should wear a surgical mask.

Contact Precautions

Used in conjunction with standard precautions for infections spread through close contact.
Includes infections spread through body fluids, including respiratory tract, eyes, nose, mouth sores, conjunctiva.
Maintain the private room, clean equipment, and use "clean versus dirty" techniques.

Handwashing

Cleaning hands thoroughly is a crucial component in infection control.
Routine handwashing removes dirt and transient microorganisms.
Hand antisepsis uses antimicrobial soap to destroy soil.
Hand rub/degerming and surgical hand scrubs use antimicrobial solutions to kill microorganisms in a limited area or more comprehensively.

Medical Asepsis (Disinfection)

Reduction in the number of harmful pathogens but doesn't eliminate them all.
Soap and water, alcohol-based hand sanitizers, chemical disinfectants.

Surgical Asepsis (Sterilization)

Kills all microorganisms, including spores, through various methods.
Chemical, dry heat, boiling, autoclaving, and gas sterilization.

Handling and Disposal of Hazardous Waste

Familiarisation with material safety data sheets (MSDS).
Proper handling and disposal of potentially infectious or hazardous waste.
Use of appropriate containers and labels, following CDC guidelines for standard precautions.

Equipment - Ventilator

Forcing oxygen into the patient’s airway until they can breathe on their own or for long-term mechanical ventilation.

Equipment - Endotracheal tube

Used for oxygen or anesthesia administration
Proper placement ensures adequate air exchange

Equipment - Tracheostomy

An artificial airway placed in the trachea to help oxygen reach the lungs

Equipment - Chest Tube

Removes air or fluid from the pleural space, resolving pneumothorax or hemothorax.

Equipment - Thoracentesis

Procedure to remove extra fluid from the pleural cavity.

Equipment - Nasogastric (NG) tubes

Used for feeding, suction, and medication delivery for patients unable to swallow. Insertion verification through fluoroscopy or X-ray.

Equipment - Levin and Salem Sump Tubes

Short-term feeding, suction, or decompression

Equipment - Placement of NG tubes - X-ray

The use of an X-ray to ensure correct placement.

Equipment - Tube Feeding (Enteral Nutrition)

Various tubes including Nasogastric (NG), Nasoduodenal (ND), and Nasojejunal (NJ) to feed patients unable to swallow.
Gastrostomy (G-tube), Jejunostomy (J-tube), or Gastrostomy-Jejunostomy (GJ-tube) tubes are permanent placements for long-term feeding.

Equipment - Percutaneous Endoscopic Gastrostomy (PEG)

Method to provide long-term access to the stomach for nutrition.
The location is typically under the skin for easy access

Equipment - Urinary Catheters(Foley/Suprapubic)

Allows for continuous drainage of urine.
Placed in the bladder and connected to a drainage bag to maintain patency in the urethra.

Equipment - Foley Catheter

A catheter that is placed through the urethra into the bladder for urine drainage.
Usually temporary and uses a balloon for retention.

Equipment - Straight-Type Catheter

Usually used one time and discarded.
Intermittent catheterisation is needed for patients with paralysis or nerve problems that hinder bladder function.

Equipment - Suprapubic Catheter

Placement of a catheter through an incision in the abdomen and introduced into the bladder for long-term urine drainage.
Used in situations where a person cannot use a regular Foley catheter.

Equipment - Central Venous Line Catheters (CVC): Hickman, Cook, Groshong, Broviac, Portacath, PICC, and Vascath

Used for long-term access for chemotherapy, dialysis, intravenous medications, and total parenteral nutrition (TPN).
Have specialized features for long-term use.
Important considerations to ensure appropriate placement for these catheters

Equipment - Total Parenteral Nutrition (TPN)

Method to provide nutrients intravenously when patients cannot ingest food orally.

Equipment - Access Sites for CVC

Placement site options and considerations for various central lines.

Tunneled Central Venous Catheters (CVC)

Placement process, imaging confirmation for proper placement, and long-term use.

Tunneled Femoral Vein Catherization

Femoral central vein catheter as a long-term use.

Subclavian Central Venous Line Groshong

Tunneled central venous catheter using a three-way valve that opens outward in infusion and inward in blood aspiration to reduce the risk of clotting or blood reflux.

Non-Tunneled Central Venous Catheters (CVCs)

Used for short-term access, particularly for emergency situations, requiring the placement via insertion in multiple areas in the body to access the superior vena cava.

Non-Tunneled Femoral Central Venous Catheters (CVC)

Used when there is scar tissue or other reasons the usual placement sites are not suitable.

PICC Line

Peripherally inserted central catheter, a long-term central venous access.

Ports

Implanted central venous access port;
Usually placed under the skin close to the large veins to avoid risk of infection.
Accessible through a needle for fluids, medications, blood.
Ports are generally useful for long-term care.

Swan-Ganz Catheter

Catheterization for diagnostic information about the heart for critically ill patients

Greenfield Filter

A filter placed in the inferior vena cava to trap blood clots before they can travel to the lungs.

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Test your knowledge on essential healthcare procedures and patient assessments in this quiz. Questions cover topics such as kidney function, blood chemistry, chemotherapy safety, and shock management protocols. Ideal for healthcare professionals looking to refresh their understanding of clinical practices.