What are the benefits of effective communication?
-Obtaining accurate medical history
-ensuring the pt understands what is expected
-improved pt safety
-improved exam quality
-improved pt retention
What are some barriers to communication?
-language, power struggles, misreading boy language, fuzzy transmission, receiver distortion, assumptions, preconceptions, past experiences, cultural differences
_______% of meanings comes from nonverbal cues
90
What are some forms of nonverbal communication?
visual, tactile, vocal, use of time and space, objects or values
Habits to avoid:
false reassurance, ignoring pt's wishes, assuming unresponsive pt can't hear, converting with coworker while pt is present, blaming the pt
Habits to adopt:
good listening, using focused questions, using pt's name, explaining before acting
What is some room prep?
sheet on table, contrast drawn, tube warm-up, shields
What kind of consent is needed for CT scans?
-informed consent prior to invasive procedure (biopsy, abscess drainage)
-simple/basic consent
-implied consent (pt is unconscious or is physically unable to consent)
Lab values:
-BUN: 7-25 mg/dL
-Serum creatinine: 0.6 to 1.7 mg/dL
-Glomerular filtration rate (GFR): >60
-PT: 11 to 14 seconds
-PTT: 25 to 35 sec
-platelet count: 150,000 to 400,000 mm3
What is pt immobilization used for?
-pt safety
-improve quality of exam
-explain to pt and family
-know rules
Assessment monitoring:
temp, pulse, BP, respiration
Adult pulse normal:
60 to 100 bpm
Child pulse normal:
95 to 110 bpm
Normal respiration for adults
14-20 breaths per minute
Blood pressure is written as:
systolic/diastolic
Normal blood pressure for adults
120/80 mm Hg
What type of contrast agents can we use?
intravascular
gastrointerinal
intrathcal
What is osmolality?
structural property of a liquid, # of particles in solution, per unit of liquid, compared to blood with a known osmolality
What is viscosity?
the resistance of a liquid to flow;
thickness or friction of a fluid as it flows
What affects viscosity?
-molecular structure (brand)
-temp
-concentration of iodine
What is ionicity?
will molecules in contrast agents separate into charged particles when dissolved in an aqueous solution
What is clearance?
excreted by the kidneys
what is the peak excretion time?
3 min
Dialysis before or after contrast injection in dialysis patients
after
What is contrast induced nephrotoxicity (CIN)?
decline in renal function
Most reactions happen within ?
5 minutes
Positive vs. negative in gastrointestinal contrast medium
negative- fatty milk, air
positive- barium and iodinated contrast agents
gastronintestinal contrast is used to
distinguish fluid filled loops of bowel from cyst, abscess