Care Of Patients During Special Procedures Flashcards
1
Q
Definition of special procedures
A
- special procedures are ones that require the involvement of imaging the anatomy of a patient with close scrutiny
- some of these patients have a life threatening illness, and are under going a special procedure to either confirm or rule out the illness.
2
Q
Role of RT in special procedures
A
- the RT has many different responsibilities
- educating patient( pre and post care)
- prepping patient
- setting up sterile tray
- making sure the equipment is running properly
- assisting the physician
- communicating with the patient
3
Q
Actions to be taken by the RT in special procedures
A
- sets up contrast material to be used, if any
- runs equipment to be used during the procedure
- responsible for imaging the case
- O2 and suction available
- takes a history from the patient
- these are just a few tasks
4
Q
Caring for the patient in special procedures
A
- communication is key
- education of the procedure before starting
- expectations of the procedure and of the patient
- use a calm, soft, and comforting voice. Be confident
- patients are in our care, make them feel comfortable
- warm blankets are a blessing
- tell them where you will be, so they know they are not alone
- never leave patient alone
- a soft touch to the hand tells them you care
- post exam care instructions
5
Q
Types of special procedures
A
• cardiac catheterizations • cat scan • ultra sound • MRI • Pet scan * radionuclide Imaging • radiation therapy • mammography • dexa scan
6
Q
Cardiac catheterization
A
- procedure is performed to diagnose coronary artery patency
- it can also be used to treat atherosclerosis
7
Q
The RT’s role in cardiac catheterization
A
- responsible for the overall care of the patient
- responsible for all the equipment, including the injector, fluoroscope, digital subtraction angiography, and monitoring equipment are working properly
- watches the ekg waves as well
- have suction, O2, emesis basin, blankets, crash cart, epinephrine,
- sterile tray set up
- assist radiologist/cardiologist perform surgical scrub
- educate and assess the patient( consent, possible complications, NPO after midnight, allergies)
- take vitals, locate pulse for procedure (usually the nurse does this)
- assist with contrast administration; check expiration dates, color, crystallization, and dexterity
8
Q
Communication with the patient
A
- make sure to discuss the procedure in detail
- discuss any anxieties the patient is having
- be clear and concise with your instructions
9
Q
Computed tomography
A
- computerized tomography is a diagnostic imaging procedure that produces cross sectional anatomical images. It scans body tissues in different planes, using x-ray and computer technology
- it aids in diagnosing pathology of the brain and other organ tissues
10
Q
Patient care during CT
A
- educate the patient to be NPO for certain CT exams
- are they diabetic?
- instructions for patients taking metformin
- labs for creatinine
- oral prep for abdomen/pelvis exams
- breathing instructions
- explain what to expect of the patient and what they should expect
- tell them when to expect results and how to obtain them
11
Q
RT’s role in CT
A
- the CT tech warms up the machine and scans the patient
- explains the procedure and what to expect
- consents the patient
- checks protocol with the radiologist
- checks for allergies
- takes the patients history
- gives the radiologist as much information as possible about the patient’s history
- labels the patient with a BB marker for are of pain
- sets up injector
- sets protocol for exam in computer
- has suction, O2, emesis basin ready and available
- charges for any supplies
- prepares prep tray in sergical CT exams
- performs aseptic surgical scrub
12
Q
CT techs role
A
- has crash cart available for drug reactions
* gives patient post CT instructions
13
Q
Ultrasound
A
- uses sound waves to diagnose any pathology in the soft tissue structures of the body
- it does not use radiation to obtain images. It is noninvasive, and does not require contrast medium
- it does require water
14
Q
Patient care during ultrasound
A
- Prep procedures; NPO, full bladder, no barium exams before
- consent to invasive procedures
- explain the procedure and how long it will take
- when will the patient get the results
15
Q
US tech’s role
A
- these procedures are performed by RT that are specially trained for this
- US techs are responsible for explaining the procedure to the patient; length of exam, expectations, when they will get results
- they make patient comfortable, again using warm blankets. Warm gel is used so that the transducer moves smoothly across the patient and so its more comfortable for the patient
- the patients history taken
- patient is screened before, to be sure of proper prep is done
- the patient is told exactly what is going to happen. No surprises
- the technologist gives the radiologist a preliminary report of the findings
- patient is told when to hold breath
- they use a transducer to move around the patients body, and take images of what is visualized
- little post care instruction is given after these exams
- the technologist also aids the radiologist in doing more technical procedures; thoracentesis, paracentesis, sonohysterography and ultrasound guided biopsies
16
Q
Magnetic Resonance Imaging
A
- noninvasive procedure that uses hydrogen atoms, and high radio frequency pulses to image the soft tissues of the body
- it is used for diagnosing neoplasms, as well as vascular, bone and joint pathology
17
Q
Patient care during MRI
A
- patient is prescreened for metal in their bodies; dentures, cochlear implants, pacemakers, metal implants, aneurysm clips
- they are told how long the exam takes
- patients have little preparation(unless claustrophobic
- discuss claustrophobia issues
- patient should look at the machine, if anxious
- possibility of anti-anxiety meds
18
Q
Patient care in MRI
A
- Patient is informed of the importance of holding still
- possibility of contrast injection
- consent for procedure
- allergies
19
Q
RT role in MRI
A
- MRI is performed by a radiologic technologist, or a person who is educated to do MRI
- performs quality assurance testing each morning
- sets up the protocols for each patients exam
- discusses protocols with the radiologist
- positions patients in the magnet
- monitors the patients condition during the procedure
20
Q
MRI techs role
A
• give injections of gadolinium
• explains noises being heard
• makes patient feel at ease
• tells patient to communicate with the microphone
• speaks frequently to patient during exam
* obtains patients medical history
• screens patient for metal
• little post instruction needed unless contrast or sedatives are given
• tells patient when results will be ready
21
Q
Pet scan
A
Positron emission tomography is a cross between cat scan and nuclear medicine. It uses a radioactive isotope that is positively charged (positrons). When it interacts with an electron, both are destroyed and gamma rays are emitted. These rays are then recorded on a computer
• studies the blood flow, volume and protein metabolism
•it is imaged using cat scan
• it is very expensive, and few hospitals have it
22
Q
Patient care during pet scans
A
• explain the procedure
* obtain informed consent
• no tranquilizers or sedatives, they interfere with the exam
• no breast feeding afterwards for mothers
• patient may be instructed to do verbal games during brain scans
• recall and cognitive structures are scanned
• family member may stay near the patient if needed
• dementia patients have high anxiety
23
Q
RT role in pet scan
A
- runs the scanner
- explains the exam to the patient
- obtains informed consent
- no caffeine, nicotine, or alchohol before exam
- gives radioactive isotope
- works along side a pathologist
24
Q
Radionuclide imaging
A
- aka: nuclear medicine
• uses a radioactive isotope to image pathology. The isotope accumulates in areas of body that are abnormal. This could be an old fracture, a tumor, or a lesion
• a gamma ray detector is used to detect these areas
25
Care of patients during nuc med
• patients are consented to the procedure
• told they will be given a small amount of radiation
• told to be NPO for several hours before the procedure(unless looking at gallbladder
* can increase fluid intake afterwards to excrete the isotope
* patient told to lie still and rest comfortably during scan
• only one radionuclide scan per day
• isotope will excrete within 24 hours
26
Nuc meds role
* procedures are not necessarily performed by an RT
* nuc med techs go to a specialized school
* responsible for the patient's care
* explain the exam
27
Radiation therapy
* is a treatment to radiate cancer cells. This procedure involves a precisely positioned amount of x-ray to radiate cancer cells in the body
* radiation used is therapeutic(kills cells), not diagnostic
* the patient is tattooed. The radiation therapist controls the location and the amount of radiation to treat the patient with, at the location of the body
28
Patient care during radiation therapy
* these patients are very sick
* their immune system is weak
* keep them warm
* let them know you care
* dont rush them. They may have very fragile bones
* they may be in different mental stages of the grieving process. Don't try to fix the problem, but have a big ear for listening
* explain the procedure
* consent the patient, explaining the radiation level involved is toxic but controlled
* tell them what to expect during the procedure and that they will have toxic effects afterward
29
Radiation therapists role
* radiation therapists get a specialized education in this field of practice
* they follow the prescribed order of therapy for each patient
* each patient is different
* they make the patient as comfortable as possible
* explain all steps involved in the treatment
30
Mammography
* mammography is an imaging modality to detect breast cancer in patients. It involves the compression of breast tissue and radiation, to obtain radiographs of breast tissue
* the american cancer society recommends women at the age of 45 to have this done every other year, and at age 55 have one done every year there after
31
Patient care during mammography
* patient is too to not wear any deodorants, lotions or perfumes the day of the exam
* they sign an informed consent, if they have implants
* asked if they have had surgery, such as implants, lumps, pain and history of breast cancer
* doing a procedure for a lump, pain or discharge, patient must identify, to do a proper work-up
* there also needs to be an order from the physician for a diagnostic exam
* patient changes into a gown
* most facilities have patients fill out a reminder card for the next exam.
* some facilities require patients to bring their old mammograms for comparison
32
RTs role during mammography
• the mammography is liscened in mammography. They have to have special training and follow strict continuing education guidelines by the AART and the RHB
* the mammography is responsible for educating each patient on how to give self breast exams
33
Mammographers role
* the tech obtains the patients medical history
* explains the exam
* screens for deodorant, perfumes or lotions
* the importance of compression and holding still
* positions the patient
* palpates any lumps and marks them with a BB marker
* also marks any moles
* sets technical factors
* obtains images through development through a computerized processor
* uses computer aided detection device
* involves the radiologist in diagnostic exams
* works with ultrasound techs to do sonograms
* performs quality assurance testing daily, weekly, monthly, quarterly, and annually
