Patient Care and Assessment

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Patient Care and Assessment

• Chapter 6

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Patient Assessment

• Patients are intimidated in the hospital setting
• Patient assessment important in setting
  priorities (i.e. the triage system)
• As radiographers, we must assess patients to
  relay information to the radiologist

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Personal Concerns

• Help calm nervousness or anxiety of patients by
  reassuring them and fully communicating with them
• If you start a procedure, stay with it until it
  is complete (even if it means rescheduling your
  lunch break)
• Provide a safe place for valuables within the
  patients view (eyeglasses, keys, etc.)

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Assessing Physiological Needs

• Water dry mouth is common in sick or nervous
  people be sure you check the chart before you
  give someone a drink- sometimes fluids are
  restricted (pre-op)
• NPO latin term meaning nothing by mouth.
  Lots of patients are NPO for radiologic
  procedures
• Elimination elimination may be recorded in the
  chart on some patients (IO) assist patients to
  the restroom and help as needed- use a bedpan
  when necessary (see examples of bedpans and how
  to use them) Some patients have catheters (we
  will learn how to insert a catheter soon)
• Colostomy care large or small bowel routed to
  an outside stoma patients wear an external bag
  to collect fecal material these patients carry
  their own supplies and may have disposable or
  reusable bags may ask for your help or may
  prefer to do the care on their own.

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Taking a History (hx)

• A complete history assists the radiologist focus
  his/her interpretation to meet the referring
  physicians needs for that patient
• See chart on pp. 184 and 185 for history taking
  guidelines

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Assessing Current Physical Status

• Check the chart or check with the nurse of that
  patient
• Physical evaluation or eyeballing the patient-
  skin color, skin temperature, LOC, breathing

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Vital Signs

• Temperature
• Pulse
• Respirations
• Blood pressure

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Temperature

• Body temp will vary during the day, being lowest
  in the morning and higher in the evening
• Normal oral range is 98.6-100.4 (take 1 degree
  away from a rectal and add 1 degree for axillary)
• Fever pyrexia
• Digital thermometers are the most common in
  hospitals
• Rectal is not advised in certain cardiac patients
  as to avoid stimulating the vagus nerve
• Oral is not advised when
• Patient is on oxygen
• Has had a hot or cold beverage
• Patient is breathing through the mouth

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Pulse

• Tachycardia abnormally rapid pulse (more than
  100 beats per minute)
• Bradycardia abnormally slow pulse (less than 60
  bpm)
• Normal range is from 60-100 bpm in adults
• Apical pulse may be taken with a stethoscope over
  the apex of the heart when the pulse is slow or
  irregular

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Respirations

• To count respirations, simply note the number of
  inhalations per minute
• If you are having trouble, place a hand over the
  diaphragm
• Compare your findings with the normal range of
  12-20 breaths per minute
• Bradypnea slow breathing (less than 12 per
  minute)
• Tachypnea fast breathing (more than 20 per
  minute)

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Blood Pressure

• Hypertension abnormally high BP
• Hypotension abnormally low BP (can result in
  shock)
• Blood pressure is measured using a stethoscope
  and a sphygmomanometer
• Common BP range for adults is 110-120 systolic
  and 60-80 diastolic
• Systolic top figure that represents the pumping
  action of the heart itself
• Diastolic bottom figure that represents the
  ability of the arterial system to accept the
  pulse of blood forced into the system when the
  left ventricle contracts

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