Patient-Sonographer Interaction Flashcards
Sonographer Obligations
Physically and Mentally
adequate rest, practice good nutrition, engage in physical exercise to promote physical and mental health
recognize stress and anxiety that might interfere with job performance, leave personal or family problems at home and work problems at work
Develop a good self image
view problems as challenges or opportunities, rather than stumbling blocks
this makes it easier to accept criticism as a learning opportunity and not as defeat
a good self image creates a sense of pride in his or her work and eagerness to start each day
patient rights
a sonographer is responsible for the type of care given to patients
The Patient Care Partnership: Understanding Expectations, Rights, and Responsibilities
In 2004, AHA replaced the Patient’s Bill of Rights with this plain language brochure
This brochure informs patients what to expect during their hospital stay with regard to their rights and responsibilities
patient rights:
high quality hospital care, a clean safe environment, involvement in their care, protection of their privacy, help when leaving the hospital, help with their billing claims
HIPAA
Health Insurance Portability and Acountability Act
became effective April 14, 2003
this ruling marked the first comprehensive federal protection for the privacy of health info
HIPAA does the following:
gives patients more control over their health info
sets boundaries on the use and release of their health records
establishes appropriate safeguards that health care providers must achieve to protect the privacy of health info
holds violators accountable with civil and criminal penalties that can be imposed
strike a balance when public responsibility requires disclosure of some forms of data (protects public health)
enables patients to find out how their info was made used and what disclosure of their info was made
limits the release of info to the minimum reasonably needed for the purpose of the disclosure
gives patients the right to examine and obtain a copy of their own health records and to request corrections
what must the sonographer do?
put patient info away after hours
take files out of sight of any lingering staff and custodians
set screensavers on computers for the shortest time possible
remove patient identification from any scan that will be used for publication or presentation
keep any patient charts filed with the names facing the wall to ensure that passerby or visitors to the ultrasound suites cannot see the names or any info on the charts
patient environment
it is the sonographer’s duty to keep the exam room and equipment clean and organized
provide a warm blanket or extra sponges, pillows, etc. to make your patient comfortable
there should be proper ventilation and comfortable temperature, safe furnishings, and a private area for disrobing, and storing personal articles
remember to ask, Is there anything else I can do for you?
scripting
emotinal surroundings
the sonographer must treat the patient as an individual
patient privacy should be respected at all times, especially during dressing and undressing, during the ultrasound exam, and during the use of bathroom facilities
If patients require assistance at any of these, the sonographer should provide it in a mature and completely professional manner
It is important to introduce yourself and explain the procedure you will be doing
patients should be allowed to freely express their thoughts, opinions, or beliefs
The sonographer must be a good listener and not impose his/her beliefs on the patient
Patients response to illness
since we spend so much time with our patients during scanning, we may see changes that occur due to disease and disability
they include the following:
anger, anxiety, frustration and hellplessness, grief, guilt, depression, dependency, and suspicion
anger
towards others may be expressed verbally or physically
anxiety
feelings of apprehension may cause patients to be unwilling to adjust to their new situation and cry, fear being left alone, hostile, or withdrawn
anxiety can also cause physical changes such as rapid pulse, increased blood pressure and respiration. headaches, nervousness, excessive perspiration, or rapid speech
frustration and helplessness
the longer it takes to diagnose and treat the illness, the more frustrated the patient can become
in American society, men are more vulnerable to this feeling
grief
the process of adjusting to a loss
may be the loss of health, or a pregnancy
shock, denial, anger, bargaining, guilt, and depression are some common feelings
guilt
particularly with the loss of a pregnancy, a woman tends to examine every part of her life to discover where she was at fault
may go through withdrawal, blame, fault finding, or physical complaints
may feel their illness was caused due to something they did or did not do as a punishment
depression
feelings of helplessness and sadness
loss of energy
depressed patients complain of insomnia, early morning fatigue, loss of appetite, and many other physical complaints
dependency
some patients may become highly demanding, or try to do things they are not capable of due to their illness
suspicion
feelings of mistrust may overcome some patients and make them fearful that everyone and everything is against them
if a patient responds negatively to being scanned and becomes upset, the sonographer should not get upset as well
try to be patient and understanding and secure enough to let patients know they care
vital signs
pulse, temperature, respiration, blood pressure
indicators of how body is functioning
pulse
taken at the radial artery
indicates the patient heart rate
average heart rates:
women, children, and elderly normally have higher pulse rates
athletes in good condition have a slower pulse <60bpm
adults 60-100bpm
children 100-120bpm
newborm 140bpm
fetus 120-160bpm
bradycardia- rate<60bpm
tachycardia- rate >60bpm
any variation of the normal rhythm is called arrhythmia and includes premature beats or palpitations
coffee, tea, tobacco, or certain drugs can cause arrhythmia
shock and hemorrhage can cause a weak thready pulse
fever can produce a bounding pulse
respiration
the oxygen and carbon dioxide exchange that occurs in the lungs is known as respiration
normal breathing is quiet, effortless, and regular in rhythmn
occurs at a rate of 16-20 breaths/min in the normal adult
dyspnea-difficulty in breathing
respiration should be counted with the patient unaware
count for 30 sec and multiply by 2 for breaths/min
blood pressure
the pressure that the circulating blood exerts against the arterial walls
the pressure is the highest when the heart contracts (systolic)
the pressure is the lowest when the heart rests between beats (diastolic)
normal blood pressure in adult = less than 120/80
hypertension > 140/90
hypotension < 80/50
strong emotions, pain, exercise, and some diseases can increase BP
resting, depression, and hemorrhage/shock can cause BP to drop
blood volume
hemorrhage decreases blood volume, causing BP to drop
fatty deposits in arteries (arteriosclerosis), causing resistance to blood flow, and higher readings
low blood volume in the legs, caused by blockage, reduces ankle pressure compared to brachial pressure (ABI)
pulse oximeters
measures oxygen concentration in arterial blood
normal range is 95%-100%
used to prevent hypoxia and evaluate the effectiveness of respiratory therapy
scanning patients with tubes, catheters, and oxygen
IV tubing-important to keep the patients arm straight and not to pull too tight on the tubing
when moving or rolling the patient, make sure the tubing can move freely
unless specifically instructed, do not change the rate or volume
the IV bag must be kept higher than the needle insertion
NG Tubes (Nasal Gastric Tubes)
can be used for feeding, to obtain specimens, to treat intestinal obstructions, to prevent distention after surgery, or to drain fluids from the patients stomach by suction
do not pull on the tube when moving or rolling the patient
these patients are NPO
Nasal Cannulas/Masks
when patients come to the department and wall oxygen is available, place the patient on the wall oxygen
be careful to set the same amount of oxygen
be sure to follow department safety procedures
body mechanics
protection for your patients and yourself
standard precautions
standard precautions apply to blood, all body fluids, secretions, excretions, nonintact skin, and mucous membranes
1) hands are washed if contaminated with blood or body fluid, immediately after gloves are removed, between patient contact, and when indicated to prevent transfer of microorganisms between patients or between patients and environment
2) gloves are worn when touching blood, body fluids, secretions, excretions, nonintact skin, mucous membranes or contaminated items
gloves should be removed and hands washed between patient care
3) masks, eye protection, or face shields are worn if patient care activities may generate splashes or sprays of blood or body fluid
4) gowns are worn if soiling of clothing is likely from blood or body fluid
perform hand hygiene after removing gown
5) patient care equipment is properly cleaned and reprocessed and single-use items are discarded
6) contaminated linen is placed in leak proof bags to prevent skin and mucous membrane exposure
7) all sharp instruments and needles are discarded in a puncture-resistant container
CDC recommends that needles be disposed of uncapped or mechanical device be used for recapping
nosocomial infections
infections acquired by stays in the hospital
E-coli due to poor hand washing
TB-hospital workers must have an annual PPD shot
Methicillin-resistant *Staphylococcus *aureus (MRSA)- antibiotic resistant infection
Vancomycin-resistant Enterococcus (VRE) antimicrobial resistant pathogen
