Patient Education Assessment RTEC 93 Venipuncture Question The

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Patient Education & Assessment RTEC 93 Venipuncture

Patient Education & Assessment RTEC 93 Venipuncture

Question? • The patient’s doctor ordered the exam, therefore the patient must be able

Question? • The patient’s doctor ordered the exam, therefore the patient must be able to have contrast material

Question? • The patient must have been told by an ordering physician or nurse

Question? • The patient must have been told by an ordering physician or nurse about what is going to happen during this examination in x-ray.

Patient Education • The way we are told is directly related to the way

Patient Education • The way we are told is directly related to the way we will react to the information

Patient Education • Careful explanation and a confident, understanding attitude can help the patient

Patient Education • Careful explanation and a confident, understanding attitude can help the patient relax. • A relaxed patient makes venipuncture easier. • Vasoconstriction

Information • A consent must be provided in terms the patient can understand. In

Information • A consent must be provided in terms the patient can understand. In a language they can understand. • The patient’s questions must be answered in “layman’s” language.

Procedure • Explain the steps in • Address any “horror” stories the procedure patient

Procedure • Explain the steps in • Address any “horror” stories the procedure patient may have heard • Expected duration • Any limitations or restrictions • Post care instructions • Results of the Exam

Never, Never • Never tell the patient that inserting a needle for venipuncture does

Never, Never • Never tell the patient that inserting a needle for venipuncture does not hurt. • Especially children, they will never trust the medical staff again.

Always be truthful • The technologist must tell the truth and explain that the

Always be truthful • The technologist must tell the truth and explain that the amount of pain experienced varies with each patient. • You will do your best to keep the discomfort to a minimum and TRY to get it right the first time.

Shell fish allergies… Too bad for the patient… Not important in Radiology!

Shell fish allergies… Too bad for the patient… Not important in Radiology!

Reactions to Contrast • Let the patient know what is normal (expected) or abnormal

Reactions to Contrast • Let the patient know what is normal (expected) or abnormal reactions to contrast material • Expected: Flash of heat from head to toe – Strange or metallic taste in the mouth – Feeling like they have to urinate or are urinating – Increased heart rate

Let me know if…… • You have difficulty breathing • You feel itchy •

Let me know if…… • You have difficulty breathing • You feel itchy • You feel nauseous • You feel faint • Your arm starts to hurt or burn

Contrast Reactions • If a patient is going to have a contrast reaction it

Contrast Reactions • If a patient is going to have a contrast reaction it will happen within the first 1 -5 minutes after injection. • If the patient is going to have a life threatening reaction it will happen almost immediately

Patient Assessment • The patient must be assessed before any medication is administered. •

Patient Assessment • The patient must be assessed before any medication is administered. • Information about a history of allergy must be obtained and documented. • The patient must be screened thoroughly by the technologist for contraindications of contrast media.

Venipuncture • Before venipuncture is performed, the technologist needs to be aware of: –

Venipuncture • Before venipuncture is performed, the technologist needs to be aware of: – Potential for an allergic reaction – Contraindications for contrast material – Site preparation for injection – Adverse reaction to contrast – How to deal with medical emergencies

Patient Assessment • You need to clear EVERY patient for contrast administration. • Every

Patient Assessment • You need to clear EVERY patient for contrast administration. • Every time with no exceptions!

Check List Do you have any allergies?

Check List Do you have any allergies?

Patient Assessment Check List

Patient Assessment Check List

BLOOD WORK LAB TESTS to check function of kidneys prior to injection of contrast

BLOOD WORK LAB TESTS to check function of kidneys prior to injection of contrast • WATCH THE UPPER LIMITS • BUN = BLOOD UREA NITROGEN • Merrills pg 214 range is 8 to 25 pg 242 range is 10 - 20 always check with RAD when level above 20 • CREATINE levels range: • pg 214 (0. 6 - 1. 5) pg 242 (0. 05 - 1. 2) always check with RAD when level above 1. 2 • Indicates function of kidneys • Diseases / dehydration / kidney failure

BUN & Creatinine • BUN – Blood urea nitrogen – Measure the amount of

BUN & Creatinine • BUN – Blood urea nitrogen – Measure the amount of urea nitrogen in the blood – Could be elevated due to dehydration – Normal = 8 -25 mg/dl • Creatinine – Measures the amount of creatine in the blood – Normal = 0. 05 -1. 5 mg/dl (milligrams per deciliter)

Creatinine clearance vs Creatinine In general, creatinine clearance is the removal of creatinine from

Creatinine clearance vs Creatinine In general, creatinine clearance is the removal of creatinine from the body. ¢ In renal physiology, creatinine clearance (CCr) is the volume of blood plasma that is cleared of creatinine per unit time. ¢ The result of this test is an important gauge used in assessing excretory function of the kidneys ¢

Creatinine clearance vs Glomerular filtration rate (GFR) Clinically, creatinine clearance is a useful measure

Creatinine clearance vs Glomerular filtration rate (GFR) Clinically, creatinine clearance is a useful measure for estimating the glomerular filtration rate (GFR) of the kidneys. ¢ creatinine clearance overestimates actual GFR by 10 -20%. ¢ This margin of error is acceptable considering the ease with which creatinine clearance is measured ¢

Normal ranges *According to wikipedia. org ¢ For most patients, a GFR over 60

Normal ranges *According to wikipedia. org ¢ For most patients, a GFR over 60 ml/min is adequate. But, if the GFR has significantly declined from a previous test result, this can be an early indicator of kidney disease requiring medical intervention.

Normal ranges *According to wikipedia. org Normal reference ranges for creatinine clearance are: ¢

Normal ranges *According to wikipedia. org Normal reference ranges for creatinine clearance are: ¢ Low High Male 55 146 ml/minute/1. 73 m 2 Female 52 134 ml/minute/1. 73 m 2 ¢

Patient Assessment Check List • Have you had an exam like this before? •

Patient Assessment Check List • Have you had an exam like this before? • Have you had iodine before, x-ray dye, contrast, or an x-ray exam where they have put something in your vein? • If Yes – did anything bad happen after the injection?

Allergic to Iodine • General Rule: No Contrast – Pre – medication is available

Allergic to Iodine • General Rule: No Contrast – Pre – medication is available

Check List • Check for Diabetes • Anyone over the age of 50 or

Check List • Check for Diabetes • Anyone over the age of 50 or – Glucophage or anyone with a Metphormin history of renal – Renal failure must have there BUN level • Renal Failure and creatinine level – Diabetic evaluated. To – Removal of determine renal Kidney function.

Renal Failure Patients • General rule: No Iodine – Renal insufficiency – Renal failure

Renal Failure Patients • General rule: No Iodine – Renal insufficiency – Renal failure • 2 types of patients

Post Care • Drink plenty of H 20 for the rest of the day

Post Care • Drink plenty of H 20 for the rest of the day • At least 8 glasses today • Other types of fluids are good as well

Take Good Care of Your Patient’s!

Take Good Care of Your Patient’s!

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