Chapter 18 Aseptic Technique.

All of the following situations would require aseptic techniques except

• insertion of an angiographic catheter.

• insertion of central venous line.

• insertion of an indwelling Foley catheter.

• insertion of barium enema tip.

Answer explanation

Among the numerous imaging procedures that require sterile technique are angiography, arthrography, hysterosalpingography, and biopsies in the surgical environment. Additionally, aseptic techniques are used for line placements and indwelling urinary catheters. Barium enema examinations are not considered sterile procedures.

The goal of aseptic technique is to

• protect the radiologic and image sciences professional from infection.

• protect the patient from pathogenic microbes.

• protect the surgical team from an infected patient.

• prevent the spread of infection from the patient to any equipment in the examination room.

Answer explanation

The goals of aseptic technique are to protect the patient from infection and to prevent the spread of pathogenic microorganisms.

When establishing a sterile field using a sterile drape,

• 
  reach over the sterile field to minimize reach and air motion.

• all drape items must be clean and dry.

• inspect the expiration date to determine if you are using the sterile pack within 12 hours of the expiration date.

• 
  open the sterile package with the top flap set to open toward the person opening the pack.

Answer explanation

In most instances, a sterile field is established using a sterile drape. The first step in using a sterile drape is confirming that the package is sterile. If a package is not clean and dry, it is considered unsterile. If it appears to have been previously opened or if the expiration date has passed, it is also considered unsterile. It is not acceptable to reach over any sterile field.

The inflatable balloon portion of the Foley catheter is typically filled with

• 
  radiopaque contrast material.

• carbon dioxide.

• sterile water

• room air.

Answer explanation

On insertion of the Foley catheter, the balloon is filled with sterile water to hold the catheter in place.

When opening a sterile tray, your fingers

• must be covered with sterile gloves.

• may not touch any cloth content.

• must never touch the inside of the tray.

• may not touch any metal content.

Answer explanation

A sterile field is a specified area (such as within a tray or on a sterile towel) that is considered free of viable microorganisms. Touching the inside of the tray creates an unsterile situation and must be reported.

When creating a sterile field, it is important for the imaging sciences professional to

• keep sterile gloves in sight and above the waist level.

• 
  remember that anything above the ankles is considered sterile.

• remember that any moisture that develops on the sterile field can be dried using an infrared lamp.

• establish the sterile field for the procedure once the radiologist is notified.

Answer explanation

A sterile field is a specified area that is considered free of viable microorganisms. It is regarded to be everything above waist level.

Two people in sterile attire should pass each other in which of the following ways?

• Front to front

• Back to front

• Back to back

• Front to back

Answer explanation

To maintain sterile technique when wearing a sterile gown and gloves, persons must pass each other back to back. The backs of sterile gowns are considered unsterile.

When performing radiologic examinations on patients with chest tubes,

• the chest drainage system has three compartments: collection chamber, water seal chamber, and suction control chamber.

• check for the color of the drainage and record any pale, amber color indicating serous fluid.

• 
  the exterior chamber of the assembly must remain higher than the patient’s chest level to prevent retrograde flow.

• All of the above.

Answer explanation

Radiologic and imaging sciences professionals often perform chest radiography before and after the insertion of chest tubes to ensure proper placement. Chest drainage systems have three compartments to which chest tubes are attached. The exterior assembly of the chest tubes must always remain lower than the patient’s chest. Additionally, any change in chest fluid color must be reported, particularly a dark red color.

You are working as an imaging sciences professional 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 coworker comments that they 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

• the patient has a central venous line, and the physician wants to check the repositioning.

• 
  the patient is now sleeping, and a better image can now be achieved.

• the floor had a change in nursing staff and they are re-ordering the examination to make sure it was completed.

• 
  a new resident cardiologist arrived for his shift and wants their own image.

Answer explanation

Radiologic and imaging sciences professionals often perform chest radiography, especially portable procedures, before and after the insertion of chest tubes and vascular lines to check line placement or the presence of a pneumothorax.

The role of the imaging technologist during cardiac pacemaker studies is to

• provide nursing care to the patient and monitor the electrophysiology data.

• assist the surgeon with sterile technique.

• position the patient into various oblique angles for static digital radiographic images.

• operate fluoroscopy for the physician as they guide the pacemaker into position.

Answer explanation

The role of the radiologic and imaging sciences professional is to operate the fluoroscopy unit, which will allow the physician to place the pacemaker wires (leads) correctly.