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What is the basis of triage?
determining which patient is the sickest and therefore the priority
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In triage, if you determine that two patients are equally urgently sick, how do you determine who goes first?
chest is priority, and then determine which procedure can be done the easiest and the quickest.
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What is the best thing a radiographer can do to relief anxiety of the patient?
communication
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What should you check if a patient asks for water?
check the chart; there cannot be an order of NPO
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What is the most common form of urine collection bag?
foley catheter
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Where are sanitary supplies most commonly found?
in CT
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Describe the substance known as Melena:
stool that resembles coffee grounds, with a strong odor, usually caused by a g.i. bleed
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In taking a history, name some ways to accomplish facilitation:
- nod
- encourage more details
- let the pt tell their story
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What are the three main vital signs that should be assessed?
- temperature
- pulse
- respirations
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Define vital signs:
the measurement of temperature of pulse rate, temperature, blood pressure, and respiratory rate
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A lack of sufficient oxygem in the tissues:
Cyanotic (cyanosis)
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What is the medical term for fainting?
syncope
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What is the medical term for a "cold sweat"?
diaphoretic (precedes a cardiovascular attack)
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When is the body's temperature the lowest? highest?
- lowest: morning
- highest: evening
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What is the normal oral temperature range?
98.2 - 99.6 F
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What is the normal rectal temperature range?
.5 to 1 degree higher than oral
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What is the normal axillary temperature range?
.5 to 1 degree lower than oral
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Which method of taking a temperature is the most accurate? the least accurate?
- most accurate: rectal
- least accurate: axillary
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Give two alternate names for a fever:
- pyrexia
- hyperthermia
- (also febral describes a patient that has fever)
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An increase in body metabolism, usually in response to an infectious disease:
fever
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Give some reasons why you would not use the oral method to obtain a body temperature:
- pt has recently had something to drink
- receiving oxygen
- pt is breathing through the mouth
- pt under 6 years old
- pt is disoriented or confused
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When you would not use rectal method of obtaining a temperature?
for a cardiac patient because it could stimulate the vagus nerve
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How much insertion is required for a rectal temperature reading?
- 1/2" for children
- 1 1/2" for adults
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Name some different types of thermometers:
- digital electronic (1 minute or less)
- glass
- tympanic
- disposable
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give the fahrenheit to celcius conversion formula and vice versa:
- C = (F - 32) / 1.8
- F = (C * 1.8) + 32
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The advancing pressure wave in an artery when the left ventricle contracts:
pulse
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What is the average pulse range?
60 to 100 bpm
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A heart rate over 100 bpm is a condition called:
tachycardia
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A heart rate less than 60 bpm is a condition called:
bradycardia
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What is a normal range of respirations?
12-20 breaths per minute
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difficulty or pain breathing:
dyspnea
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difficulty breathing in a supine position:
orthopnea
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rapid breathing (usually short, shallow breaths):
tachypnea
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When too much oxygen has been inhaled?
hyperventilation
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Slow respirations:
bradypnea
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How do you address hyperventilation?
have the pt breath in a bag, so that the pt is rebreathing their carbon dioxide instead of more oxygen
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a measure of the force exerted by blood on the arterial walls during contraction and relaxation of the heart:
blood pressure
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the constant pressure that is still exerted on the arterial vessels by the blood even when the heart is relaxed:
diastolic pressure
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the peak pressure that is present during contraction of the heart:
systolic pressure
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How is blood pressure visually recorded?
systole/diastole
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What are normal systolic pressure ranges:
95 to 140 mm hg (mm of mercury)
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What are normal diastolic pressure ranges:
60 to 90 mm HG
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What is a condition when systole is over 120 and/or diastole is over 80?
pre-hypertension
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What is a condition when diastolic pressure is greater than 90 and/or systole is greater than 120 mm HG?
Hypertension (more common in men younger than 50; more common in women older than 50)
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What is a condition when diastolic pressure is less than 50 mm HG and/or systole is less than 90?
Hypotension
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What is more likely to occur from hypertension?
- stroke
- congestive heart disease
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What is likely to occur from acute hypotension?
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Name some pieces of equipment used to auscultate blood pressure:
- sphygmomanometer
- stethescope
- mercury-gravity (being phased out)
- anaroid - uses air pressure, more common is rad rooms
- electronic - usually in ER and ICU
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When taking blood pressure, how is the systolic pressure determined?
the first sound heard
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When taking blood pressure, how is the diastolic pressure determined?
when the sound of blood flowing through the arm can no longer be heard
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What are some common monitoring devices?
- pulse oximeter
- ECG or EKG
- EEG
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Where are the adhesive disks used for an EKG placed?
- two on the anterior chest, one on each side of the sternum at the level of the second intercostal space
- one on side of chest at level of sixth or seventh intercostal space
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measures the pulse rate and the oxygen saturation of the blood:
pulse oximeter
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can display and record the heart rate and rhythm through the use of electrodes placed on the chest:
ECG or EKG (electrocardiogram)
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a device that records the electrical activity of the brain by using electrodes placed on the scalp:
EEG (electroencephalogram)
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What are some reasons for performing an EEG?
- to evaluate seizure disorders
- in determination of legal death
- cases of organ donation
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What is a PVC:
- a premature ventricular contraction
- (#1 cause of death from heart attacks)
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For a normal pulse pressure, what should the distance from diastolic to systolic be?
around 40
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What is a medical term for a flatline of the heart?
asystole
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What are BUN and creatinine?
- nitrogenous wastes that are excreted by the kidneys
- (Blood Urea Nitrogen = blood)
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Why should the BUN and creatinine levels be checked before administering contrast?
elevated levels indicate that the kidneys are not functioning properly and contrast can cause renal failure
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Give normal BUN values:
- children: 5-18 mg/dl
- adults: 7-18 mg/dl
- adults over 60: 8-20 mg/dl
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Give normal creatinine values:
- infants to 3 yrs: .3-.7 mg/dl
- children 3-18 yrs: .5-1 mg/dl
- adults 18 and over: .6-1.3 mg/dl
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What are normal values of oxygenated blood?
95-100% (100% is desired)
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What patients might have unreliable pulse oximeter readings and why?
- COPD patients
- pts with heart problems
- because of impaired circulation
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Where are arterial catheters usually placed:
in the superior vena cava to provide cardiac monitoring over time.
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What are normal blood glucose levels?
70-100 mg
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What is a condition in which the blood glucose level is higher than 100 mg?
hyperglycemia
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What is a condition in which the blood glucose level is lower than 70 mg?
hypoglycemia
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Blood glucose level should be checked before administering:
glucogon, because it raises the blood sugar (relaxes muscles of the g.i. tract, slowing peristalsis)
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What are normal ranges for the total glucose level?
170-199 mg
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What is happening during fibrillation?
the heart quivers and loses its ability to contract effectively
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What distance should you maintain from a patient that is being shocked for defib?
2 ft away!!!
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What is a surgically formed fistula from the small bowel through the abdominal wall?
iliostomy
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What is a surgically formed fistula from the large bowel through the abdominal wall?
colostomy
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What is an external opening of a surgically formed fistula through the abdominal wall?
stoma
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What is the reconnection of bowel after a temporary surgical fistula?
anastomosis
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How many levels of consiousness are there and what are they?
- 1. alert and consious
- 2. drowsy but responsive
- 3. unconsious but reactive to painful stimuli
- 4. comatose
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When would it be important to take a pedal pulse rate?
- when preparing to catheterize the femoral artery
- when checking extremity circulation
- following application of a cast to lower extremeties
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when would a femoral pulse rate most likely be taken?
- for specials
- for severe trauma
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