1. PRINCIPLES OF PATIENT CARE IN CT

2. MASLOW’S HIERARCHY OF NEEDS
PHYSIOLOGIC NEEDS
SAFETY & SECURITY
LOVE & BELONGINGNESS
SELF-ESTEEM
SELF-ACTUALIZATION

3. PATIENTS WHO COME TO RADIOLOGY DEPT
PATIENTS WHO COME TO RADIOLOGY DEPT.ARE TRYING TO SATISFY THEIR BASIC NEED - SAFETY

4. TERMINALLY ILL PATIENTS ARE GOING THROUGH THE GRIEVING PROCESS

5. THE GRIEVING PROCESS
DENIAL
ANGER
BARGAINING
DEPRESSION
ACCEPTANCE

6. PATIENT ASSESMENT VITAL SIGNS

7. TEMPERATURE
99.6 ° F R
98.6 ° F O
97.6 ° F Ax

8. PULSE DETECTION SITES APICAL RADIAL CAROTID FEMORAL POPLITEAL TEMPORAL
DORSALIS PEDIS

9. AVERAGE PULSE RATE IN ADULT MAN OR WOMAN - 60-90 BEATS/MIN
CHILD 4-10 YEARS BEATS/MIN
INFANT BEATS/MIN

10. PULSE ASSESSMENT
TACHYCARDIA
BRADYCARDIA

11. RESPIRATION RATES 10-20 B/MIN – ADULT 20-40 EARLY CHILDHOOD
30-60 NEONATAL
< 10 B/MIN FOR ADULT CYANOSIS

12. CYANOSIS

13. BLOOD PRESSURE
SYSTOLIC mmHg
DIASTOLIC mmHg

14. INFUSION AND COLLECTING CONTAINERS
IV BAG –24 “ ABOVE PATIENT
URINE COLLECTION BAG – BELOW PATIENT LEVEL
BE BAG – ABOVE PATIENT LEVEL
CHEST TUBE – BELOW PATIENT LEVEL (DO NOT BENT OR CLAMP TUBING)

15. PATIENT TRANSFER
PULL SHEET

16. SLIDING BOARD

17. WITH SPINAL CORD INJURY

19. CT EXAM
WHAT TYPE OF PROCEDURE?
NON-INVASIVE OR INVASIVE?
CONSENT?

20. CT PROCEDURES REQUIRING CONSENT
ARTHROGRAPHY
BIOPSY
CTA
MYELOPGRAPHY

21. CONSENT TYPES
INFORMED
IMPLIED

22. INFORMED CONSENT
Informed consent is the process by which a fully informed patient can participate in choices about her health care. It originates from the legal and ethical right the patient has to direct what happens to her body and from the ethical duty of the physician to involve the patient in her health care

23. IMPLIED CONSENT
The explanation of implied consent says that consent assessed when the surrounding circumstances lead a reasonable person to believe that consent has been granted even though word of agreement were not direct, express or explicit.
EMRGENCY SITUATIONS

24. IV CONTRAST PROCEDURES

25. REQUIREMENT CONSENT LABORATORY VALUES WITHIN NORMAL RANGE
BUN mg/dl
CREAT –1.2 mg/dl

26. PATIENT PREP. NPO 4 HOURS PRIOR TO THE EXAM
IODINE ALLERGY- STEROID THERAPY
(PREDNISONE)
HYPERVENTILATION BEFORE EXAM FOR BETTER BREATHOLD

32. UTILIZED

34. GAUGE SUITABLE FOR CTA
18 OR 20

35. CONTRAST ADMINISTERED WITH POWER INJECTOR

36. POWER INJECTOR PARAMETERS
VOLUME OF CONTRAST-ml
RATE ml/sec
TIME OF INJECTION – sec
SCAN DELAY TIME - sec

37. TO REDUCE ITS VISCOSITY
CONTRAST WARMER
TO REDUCE ITS VISCOSITY

38. EXTRAVASATION STEPS STOP THE INJECTION
PUT THE WARM COMPRESS ON THE INJECTION SITE

39. IODINE WATER SOLUABLE CONTRAST AND GLUCOPHAGE
WITHELD 48 PRIOR AND AFTER THE PROCEDURE

44. MOST COMMON SHOCK IN CT
ANAPHYLACTIC!

45. SHOCK: PHYSIOLOGIC REACTION TO : ILNESS, TRAUMA OR SEVERE
EMOTIONAL DISTURBANCE

46. SHOCK SYMPTOMS:
HYPOTENSION
WEAK PULSE
RAPID PULSE
RAPID BREATHING

47. SHOCK HYPOVOLEMIC SEPTIC CARDIOGENIC NEUROGENIC
ANAPHYLACTIC – MOST COMMON IN CT

48. ORAL CONTRAST PROCEDURES

49. TYPES OF ORAL CONTRAST BARIUM SULFATE WATER SOLUABLE (GASTROGRAPHIN)
AIR
CARBON DIOXIDE (EFFERVESCENT AGENTS)

50. BARIUM SULFATE CAN NOT BE USED IF:
PATIENT HAD A RECENT BIOPSY
BLEED IN THE GI TRACT
IT CAUSES BARIUM PERITONITIS IF
ESCAPES INTO PERITONEUM

51. PREPARATION LIGHT EVENING MEAL BOWEL CLEANSING
NPO AFTER MIDNIGHT (EXCEPT FOR CONTRAST AND MEDS)
DETRMINE IF PATIENT HAD BE RECENTLY!

52. BARIUM SULFATE CONCENTRATION
1-3%

53. WATER SOLUABLE CONTRAST CONCENTRATION
2-5%
EX. 100 cc OF WATER AND
20 –50 cc OF GASTROGRAPHIN

54. BIOPSY

55. You will have diet restrictions prior to the procedure, usually no solid foods 6 hours before the appointment and clear liquids ( water, black tea/coffee, apple, cranberry,grapefruit, grape juice, jello or broth) only two hours before the appointment.

56. If you take blood thinners such as coumadin you doctors needs to tell you its OK to stop this for 1 week before this procedure.

57. BLOOD LEVELS PT
PTT
PLATELETS COUNT

58. PT-PROTHROMBIN TIME Normal Values
Definition
This is a test that measures the clotting time of plasma (the liquid portion of the blood).
Why is the Test Performed?
The PT is a broad screening test for many types of bleeding disorders. It evaluates blood clotting disorders, usually bleeding.
Normal Values
The normal range is 11 to 13.5 seconds ("normal" varies somewhat in different labs). For a person on full anticoagulant therapy, the PT should be 2 to 3 times the laboratory "control" value.

59. PTT-PARTIAL THROMPOPLASTIN TIME
Definition
This is a test that measures clotting time in plasma (the liquid portion of blood). It focuses on a specific pathway in the blood clotting process.
Why is the Test Performed?
This test is used to evaluate a wide variety of disorders of blood coagulation. It is useful in the evaluation of disorders of both excessive clotting and excessive bleeding.
Normal Values
APTT: 25 to 35 seconds

60. 150,000-400,000/mm3 (millimeters cubed)
Platelet Count
Definition
This is a test to measure the number of platelets in blood. Platelets are necessary for normal blood clotting (hemostasis). Most important, they aggregate (clump together) to plug small holes in damaged blood vessels.
Why is the Test Performed?
The platelet count can be affected by many disease states. It may also be measured to assess the cause of excess bleeding.
Normal Values
150, ,000/mm3 (millimeters cubed)

61. PHARMACOLOGY
THE STUDY OF DRUG ACTIONS ON AND INTERACTIONS WITH LIVING ORGANISMS.

62. EXCRETION MOST DRUGS ARE EXCRETED BY KIDNEYS. OTHER EXCRETION ROUTES:
PERSPIRATION, TEARS, FECES,
BREAST MILK, SALIVA

63. FACTORS THAT INFLUENCE DRUG ADMINISTRATION
AGE
GENDER
HORMONAL DIFFERENCES
EMOTIONAL OR PSYCHOLOGICAL STATE
TIME OF DAY
THE CHANNEL OR ROUTE OF ADMINISTRATION

64. DRUG ADMINISTRATION ROUTES
ORAL
TOPICAL
PARENTERAL
SUBLINGUAL
INTRATHECAL
RECTAL
TRANSDERMAL
INHALATION

65. PARENTERAL DRUG ADMINISTRATION
SUBCUTANEOUS
INTRADERMAL
INTRAMUSCULAR
INTRAVENOUS
INTRATHECAL

67. INTRATHECAL

68. DRUG NAMES TRADE NAME -ASSIGNED BY THE MANUFACTURER
CHEMICAL NAME - EXACT CHEMICAL FORMULA
GENERIC NAME - GIVEN BEFORE THE OFFICIAL APPROVAL FOR USE
OFFICIAL NAME - GENERIC AND OFFICIAL NAMES ARE USUALLY THE SAME

69. ACTING ON THE NERVOUS SYSTEM
CHLORAL HYDRATE – SEDATIVE- ORAL, RECTAL
MORPHINE SULFATE – CONTROL OF SEVERE PAIN- ORAL, PARENTERAL
LIDOCAINE – ANESTHETIC- PAIN BLOCKER – TOPICAL, PARENTERAL

70. ANALGESICS, ANTIPYRETICS, ANTI-INFLAMMATORY
ASPIRIN
ACETOMINOPHEN
(TYLENOL)
IBUPROFEN
(ADVIL, MOTRIN)
ORAL

71. TO TREAT CARDIOVASCULAR DISEASE
LASIX- ( DIURETIC ACTION)- IV, ORAL
HEPARIN - IV AND COUMADIN- (ANTICOAGULANTS) ORAL
NITROGLYCERIN – (VASODILATOR)
ANGINA PECTORIS – SUBLINGUAL, TOPICAL

72. TREATMENT OF ALLERGIC RESPONSES
EPINEPHRINE (ADRENALIN) (SEVERE ALLERGIC RESPONSE)- BRONCHODILATOR-VASOCONSTRICTOR-PARENTERAL , INHALATION
BENADRYL (DIPHENHYDRAMINE) (MILD REACTION)– ORAL , PARENTERAL

73. LEGAL ASPECTS

74. ORDINARY NEGLIGENCE
Failure to exercise the care toward others which would reasonably be expected of a person in the circumstances, or taking action which a reasonable person would not.

75. GROSS NEGLIGENCE
Intentional failure to perform a duty, reckless disregard of the consequences as affecting the life or property of another

76. ASSAULT
Threat to inflict injury with an apparent ability to do so. Also, any intentional display of force that would give the victim reason to fear or expect immediate bodily harm

77. BATTERY
In many common law jurisdictions, the crime of battery involves an injury or other contact upon the person of another in a manner likely to cause bodily harm

78. FALSE IMPRISONMENT
confinement without legal authority

79. DEFAMATION OF CHARACTER
In English and American law, and systems based on them, libel and slander are two forms of defamation of making a false statement of fact that injures someone's reputation.

80. LIBEL
Written defamation that causes injury to another person

81. SLANDER
words falsely spoken that damage the reputation of another

82. FRAUD
An intentional perversion of truth; deceitful practice or device resorted to with intent to deprive another of property or other right

83. INVASION OF PRIVACY
Violation of person’s right to be left alone and free from unwarranted publicity and intrusions

84. PATIENT CONFIDENTIALITY

85. THE SECURITY OF HEALTH INFORMATION IS THREATENED BY
EMPLOYEES
SOFTWARE FAILURE
HARDWARE FAILURE
HACKERS

86. As health care providers, we all have a responsibility to uphold confidentiality for patients. In a busy hospital setting it can be difficult. Increasing workloads lead to elevator or cafeteria discussions of Mrs. Smith's metastases or Mr. Jones' pancreatitis. This is not acceptable. The person next to you in line could be a patient's friend, relative, or media member that is not entitled to this privileged information.

87. Healthcare agencies and providers must provide confidentiality and privacy of the healthcare information that they collect, maintain, use, and/or transmit. Confidentiality means that only certain individuals will have the right to access the information and that it is secure from others. Confidentiality is at risk when the potential for improper access to information exists. It is our responsibility to protect patient information.

88. LEGAL DOCTRINES

89. RESPONDEAT SUPERIOR
A legal term referring to the fact that, under specific circumstances, an employer (or principal) is legally liable for the actions of his or her employees while in the course of their employment