RADT 101: Ch 11 TEST 3

Advance Directive, living will

Key Terms:

• Legal document prepared by a living, competent adult to provide guidance to the health care team if the individual should become unable to make decisions regarding their medical care;

• may also be called a ______ ____ or durable power of attorney for health care.

• Sometimes a durable power of attorney is given to another person because a person simply does not want to make any of these decisions themself

Communication, documentation

Key Terms:

• Exchange of information, thoughts, or messages; includes interpersonal rapport; also includes the accurate conveyance of information, clear self-expression, and transmission of information and ideas to others.

• Medical charting and ___________ are forms of communication between health care professionals

Emotional Intelligence (EI)

Key Terms:

Ability to evaluate, perceive, and control emotions

Gerontology

Key Terms:

the study of aging in diseases of older adults

• continues to increase in size

Inpatient

Key Terms:

Someone who has been admitted to the hospital for diagnostic studies or treatment

Maslow’s Hierarchy of Needs

Key Terms:

• Model of human needs developed by Abraham Maslow,

• original Hierarchy identifies two types of needs: deficiency and growth needs

  • further divided into seven levels,

  • four at the deficiency needs level (physiologic, safety, belongingness and love, and esteem)

  • three in the upper growth needs level (need to know and understand, aesthetic, and self-actualization); the current

• Hierarchy reflects five levels,

  • two at the base reflecting the basic needs

  • two in the middle section reflecting psychological needs and the top which reflects self-fulfillment needs

Nonverbal Communication

Key Terms:

Exchange of information, thoughts, or messages using methods other than the actual words of speech

• ex) , tone of voice, speed of speech, facial expressions, and position of the speaker’s extremities and torso (body language)

Outpatient

Key Terms:

Patient who comes to a health care facility for diagnosis or treatment but does not usually occupy a bed overnight

Palpation

Key Terms:

Application of light pressure with the fingers

Paralanguage

Key Terms:

Music of language; cadence and rhythm of speech

Patient Assessment

Key Terms:

Objective evaluation and determination of the status of a patient

Patient Autonomy

Key Terms:

Ability and right of patients to make independent decisions regarding their medical care

Verbal Communication

Key Terms:

Messages sent using spoken words; the exchange of information or thoughts; can be dramatically shaped by vocabulary, clarity, tone, pitch of voice, and even the organization of sentences

emotions

Personal Understanding:

• One of the best ways to learn how to communicate with others in to first learn to understand ________of patients and their own

appropriate

Personal Understanding:

• patients come in at a range of emotions, it is important for radiologic and imaging professionals to recognize the exhibited emotions and communicate with patients in a way that is appropriate for their emotional state.

awareness, regulation, empathy

Personal Understanding:

• the following traits are deemed essential to those with Emotional Intelligence (EI)

  • self-__________

  • self-__________

  • motivation

  • _________

  • social skills

Self-Actualization

Personal Understanding:

• What is the highest level in Maslow’s Hierarchy of Needs?

• characterized by confidence in who the person is and what the person’s goals are in life.

Physiologic

Personal Understanding:

• What is the lowest level in Maslow’s Hierarchy of Needs?

Maslow’s Hierarchy of Needs

Personal Understanding:

• What is this ranking system called?

1) Self actualization

2) Aesthetics

3) Need to Know and Understand

4) Esteem

5) Belongingness and Love

6) Safety

7) Physiologic

conscience, environment, cope

Patient Needs:

• patients may be in an altered state of __________

  • in unfamiliar _________

  • have lack of control

• patient may present as arrogant, impatient, rude, overly talkative, or or exhibit other characteristics as they attempt to ____ with

  their situation.

physiologic

Patient Dignity:

• The patient may arrive for care at the first level of Maslow’s Hierarchy of Needs, which is the _________ or survival level.

  • are simply seeking basic needs (i.e., a pillow, blanket, or

    food).

illness, character

Patient Dignity:

• ________ or trauma may have altered many physiologic functions,

  which in turn may cause the patient to behave out of _________.

patient assessment, chart, procedure, history

Patient Dignity:

• Initial _______ _______ by the radiologic and imaging science professional usually comes in the form of _____ or ________ request, review, or both.

• information can be learned from reviewing these two sources concerning patient _______ and indications for or contraindications to the requested procedure.

introduce, history

Patient Dignity:

• All health care professionals should _________ themselves to their patients, explain the procedure to patients, and obtain a brief ______.

informed consent

Patient Dignity:

• if a patient is scheduled to have an invasive procedure or if the use of intravascular contrast media is required, obtaining ________ ______ is often the responsibility of the radiologic and imaging sciences professional.

Inpatient, 24

Inpatients:

• An ________ is someone who has been admitted to the hospital for diagnostic studies or treatment.

• In general, these persons occupy a hospital bed for longer than __ hours.

experiences, responds

Inpatients:

• Previous ____________ in the hospital may have shaped the manner in which the patient _________ to these initial interactions with the radiologic and imaging sciences professional.

transported

Inpatients:

• The inpatient may be ___________ to the radiology department by wheelchair, cart/gurney, or may walk (ambulate).

prior, appointment, circumstances

Outpatient:

• Outpatients arrive in the radiology department with ______ expectations.

• They often expect to be seen immediately on arriving in the department because they have a scheduled __________.

• Maintaining a schedule in any medical setting is difficult because of unforeseen __________.

insurance, status

Outpatient:

• Because outpatients often have __________ or government benefits of some type, they may expect priority treatment.

• A professional should provide the same care and attention to all patients regardless of _______.

attention, critique

Interacting with the Patient’s Family and Friends:

• The patient’s family and friends who are visiting also must receive _________.

• Because they spend much time waiting, they tend to _______ everything about the radiologic and imaging sciences professional, from appearance to tone of voice to smile (or lack thereof).

interpretation, illegal, information

Interacting with the Patient’s Family and Friends:

• It is common to be asked about _________ of the images

  • Any statements in response to this type of question may be construed as diagnosing, which is practicing medicine without a license and is ______.

• The best response is usually to indicate that the findings are available to the referring physician and that only they can provide the _______.

explanation, attention

Interacting with the Patient’s Family and Friends:

• A smile and brief ________ of the procedure, with extra _________ when delays occur, goes a long way in making everyone feel more relaxed and confident.

Accurate, timely

Methods of Effective Communication:

• ________ and _______ care if essential to providing high quality patient care

Vocabulary, appropriate

Verbal Skills - Speech and Grammar:

• ________, clarity of voice, and even the organization of sentences must be at a level appropriate for the patient.

Face to face, attention, time

Verbal Skills - Speech and Grammar:

• verbal communication should occur ______-__-_______

• This approach typically makes others believe that they have your _______, that your concern is only for them, and that they are the only person about whom you care at this specific point in _____.

humor, cultural, references

Verbal Skills - Humor:

• Using ______ to relax and open conversation is acceptable

• careful to avoid ________ slurs and ________ to age, gender, diseases, and the abilities of other health professionals.

signals, attitude, volume, voice

Nonverbal communication - Paralanguage:

• Patients receive ____ about your ______ toward them from the pitch, stress, tone, pauses, speech rate, _____, accent, and quality of your ____.

statements

Nonverbal communication - Paralanguage:

• ask __________ that gives patients times to recall what they said and to think specifically about the statement before being asked to answer

nonverbal, extremities

Nonverbal Communication - Body Language and Facial Expressions:

• Patients quickly perceive _________ communication such as the tone of

  voice, speed of speech, and position of the speaker’s _______ and torso

  (body language).

confusing, different

Nonverbal Communication - Body Language and Facial Expressions:

• Radiologic and imaging science professionals must be cautious to avoid giving __________ signals to patients by saying one thing and acting in a totally ______ manner.

Eye, speaking

Nonverbal Communication - Body Language and Facial Expressions:

• _____ contact in many cultures, but not all, is seen as reassurance that the

  person is concentrating only on the individual with whom they are

  ________.

communicate

Nonverbal Communication - Body Language and Facial Expressions:

• Facial expressions __________ the inner feelings and health professionals must watch what we show to patients

emotional, emphasis, palpation

Nonverbal Communication - Touch:

The radiologic and imaging sciences professional commonly uses three

types of touch:

(1) touching for ______ support,

(2) touching for _______,

(3) touching for ________.

reassurance

Nonverbal Communication - Touch:

• Gentle support under the arm to assist patients to and from the imaging room and onto and off of the table often provides _________ to the patient that they are being cared for by a professional practitioner.

specify, locations

Nonverbal Communication - Touch:

• Touching for emphasis involves using touch to highlight or to _______ instructions or _______.

landmarks, fingertips, permission

Nonverbal Communication - Touch:

• Palpating to locate various bony radiographic ________ when positioning patients is advisable and helpful.

• Effective and precise palpation requires the gentle use of ________

  • Before touching a patient, ________ to do so should be obtained.

abilities, competent

Professional Appearance:

• Professional dress helps the patient feel comfortable and confident in the radiologic and imaging sciences professionals’ ________.

• Gaining the patient’s confidence and trust is a considerable part of being a __________ radiologic and imaging sciences professional.

length, banned

Personal Hygiene:

• Nails should be kept at a manageable ______, without the use of acrylics, which have been ________ in many health care institutions.

strong, negatively, communicate

Personal Hygiene:

• The use of _______ perfumes, colognes, and aftershaves should also be avoided.

• Patients may react to certain smells by becoming nauseated by any smell that may affect them _________.

• A patient will not ________ with someone with whom they do not desire to be in close contact.

Posture, nonverbal, instructions

Physical Presence:

• ________ is important because it is perceived as relating to confidence and self-esteem.

• Facial expressions are vital ________ cues that give people information on the ___________ of instructions and questions

  • gives positive and negative reinforcement of their actions and statements.

pain, anxiety, instructions

Seriously Ill and Traumatized Patients:

• A seriously ill or traumatized patient may act differently from other patients because of _____, stress, or ______.

• In these instances, the patient must hear and understand _______, if at all possible.

level, consciousness, unable, communication

Seriously Ill and Traumatized Patients:

• The radiologic and imaging sciences professional should try to communicate with the patient while determining their coherence _______.

• initial communication can provide cues regarding the level of consciousness and coherency of the patient.

  • Some patients may be ______ to respond, others may make incoherent statements, and still others may respond coherently but uncooperatively.

  • Inability or unwillingness to _________ can be caused by many factors, including pain, shock, medication reaction, and disorientation.

communicate, reassuring

Seriously Ill and Traumatized Patients:

• Working quickly and efficiently while continuing to _______ with the patient is important, even with no response

• Letting the patient know what is going on during a procedure can be ________, even when no apparent sign of understanding

communicate, visual

Seriously Ill and Traumatized Patients:

• Because seriously ill and traumatized patients may not be able to _________ effectively, watch for _____ indications of changes in vital signs

  • Ex) blueness of skin (cyanosis)

  • ex) involvement of abdominal muscles (retraction)

  • ex) flaring nostrils

COVID

Covid Patients:

• Rad Tech workers are front line for patients with _______ due to the respiratory system involvement of the disease

daily

Covid Patients:

• COVID patients in the intensive care unit (ICU) are typically imaged ______ to determine improvement or decline in health

prognosis

Cancer Patients:

• Cancer patients fear the unknown ________ of their disease.

professional, instructions

Visually Impaired Patients:

• __________ should attempt to gain the patient’s confidence as soon as possible by giving clear _________ before the examination, as well as informing them of what is occurring at all times.

lips

Visually Impaired Patients:

• Inquire if the patient is able to have slight sight, write, or read ____.

communication

Speech-Impaired and Hearing-Impaired Patients:

• For persons who can read, the primary means of ____________ can be writing.

demonstration

Speech-Impaired and Hearing-Impaired Patients:

• Pantomime and ________ work well with deaf or hard of hearing patients.

• psychological, emotional, diabilies

Mentally Impaired Patients:

• mental impairment means any mental or __________ disorder.

• These types of disorders include

  • intellectual disability,

  • organic brain syndromes,

  • ________ or mental illnesses

  • specific types of learning ________.

• range from mild to severe and cover a very broad spectrum, inclusive of all age groups.

positive

Mentally Impaired Patients:

• Communicating with gentle tones and smiles will often illicit a ________ response

conversation

Mentally Impaired Patients:

• A continuous ____________ while preparing the

  patient for the examination usually helps keep the patient calm and aware

  that the radiologic and imaging sciences professional is working with them.

restrained

Substance Abusers:

• These patients may not be totally aware of where they are or what they are doing and may need to be ________ from leaving the room or from playing with tubes, wires, or high-voltage cables.

directions

Substance Abusers:

• Some substance abusers respond well to firm ________ about what to do, whereas others are best handled by requesting that they return for examination later when the effects have diminished considerably.

name, procedure

MOBILE AND SURGICAL EXAMINATIONS:

• Begin by calling the patient’s ______, identifying yourself to the patient, and explaining the _______.

procedure, exposure

MOBILE AND SURGICAL EXAMINATIONS:

• When interacting with the patient’s family and friends, you should introduce yourself, explain the _________ briefly, and explain why they must leave the immediate area during the _________ if applicable (i.e., use of ionizing radiation).

• level

Pediatric Patients:

• getting down to the child’s _____—physically, in language, and in spirit—establishes a positive relationship.

Non accidental trauma

Pediatric Patients:

• Radiologic and imaging sciences professionals need to be aware of their facility’s policies and procedures on reporting suspected child abuse, also called ____ _______ ______ (NAT).

security object

Pediatric Patients:

• Never try to separate a child from a _____ ____ such as a blanket or toy unless absolutely necessary for image quality.

procedure

Pediatric Patients:

• Explain the _________to the parents and allow them to stand outside of the room (ie. ionizing radiation)

• Explain the procedure to the child as well

image gently

Pediatric Patients:

• with children, always remember to “______ ____”

Infants, position, swaddling

Birth to 1 Year:

• _________

• communication: facial expressions, body language movements, nonverbal behaviors, and vocalizations

• ask about favorite _________(s)

• respond well to being held in tight blankets (_________)

Neonatal Intensive Care Unit

Birth to 1 Year:

• _______ ____ ___ _____ (NICU) infants are usually premature and ill with multiple wires and tubes attached

anxiety

Birth to 1 Year:

• 8 months of age, being to express _____ when removed from favorite person, permitting the parents to assist is possible with proper protection

toddlers, others

1 to 3 years:

• _______

• thinking is to events and cannot take the viewpoint of _______

• speak in simple terms

Preschoolers, attention span

3 to 5 years:

• ________

• can not logically understand cause and effect

• must see or hear something to understand and must be actively involved to maintain ______ _______

Adolescents, embarrassment

10 to 25 years:

• __________

• need of special consideration to avoid __________when changing clothes and during examinations

• are able to reason logic and can be explained procedures

young adults

25 to 45 years:

• _______ _______

• usually experience new roles of responsibility at home/ work

Mature-Young Adults

45 to 65:

• ______ _____ _____

• typically are comfortable with their roles and success (or lack of it)

• with poor ______, primary concern may be over other responsibilities such as family and work

• will often push back health concerns

Mature Adult

65 years and older:

• ____ _____

• do not consider themselves old, see themselves as middle aged

• 10% of age group will experience memory loss/ senility (NOT a natural part of aging)

• age group continues to grow

age, gentle, time

Gerontology:

• to avoid insult to ____, treat patients as mature adults

• accommodate older adults by using

  • ______handing

  • extra _____ for movements/ verbal responses

Primary aging

Gerontology:

• _____ _____: the gradual and inevitable process of deterioration that begins in childhood an extends through old age

Secondary aging

Gerontology:

• ________ _____: consists of disease, abuse, and disuse, which are often within control of the individual

Nervous, move, think, read, ear

Physical changes of aging:

• Body system: _______

• physical change:

  • slowing of psychomotor responses

    • give pt. time to _____

  • slowing of information processing

    • give pt time to _____

  • decreased visual ability

    • stand directly infront of pt.

    • hold items where they can ____/ see

    • give pt time to adjust eyes to room lighting

  • decreased hearing ability

    • speak directly into pt. ___

    • move closer

    • talk more loudly

respiratory, decreased, time

Physical changes of aging:

• Body system: _______

• physical change: _______ cough reflex

  • avoid aspiration by giving pt ____ to swallow when drinking

Musculoskeletal, joint, moving

Physical changes of aging:

• Body system: _______

• physical change:

  • osteoporotic loss of bone mass

    • inc sensitivity to pt paranoia about potential falls

  • arthritis

    • expect dec. ______ flexibility

  • dec muscle

    • prepare to provide assistance in ______

  • atrophied muscle mass

    • dec tolerance to hard table surfaces

Cardiovascular, blood, blankets

Physical changes of aging:

• Body system: _______

• physical change:

  • dec cardio. efficiency

    • avoid orthostatic hypotension by allowing time for _____readjustment when standing/ sitting up

  • Arteriosclerosis

    • provide extra ______and sheets.

Integumentary

• Physical changes of aging:

  • Body system: _______

  • physical change: Loss of texture and elasticity

    • Avoid skin lacerations

Gastrointestinal, difficulty, comfort

• Physical changes of aging:

  • Body system: _______

  • physical change:

    • Decreased secretions

      • Expect _______when requiring a patient to drink quickly or from a recumbent position.

    • Decreased gastrointestinal motility

      • Expect delays during completion of small bowel studies. (Prepare for long-term patient comfort via extra blankets, pillow under knees,

    • Decreased sphincter muscle tone

      • Prepare for potential loss of barium from rectum during lower gastrointestinal examinations.

closed awareness

terminal illness:

• _____ _______: patients who are not told of their condition

suspicious awareness

terminal illness:

• _____ ______: patients who may watch for clues to their condition but attempt to keep the health care team from knowing exactly how much they understand

mutual pretense

terminal illness:

• ______ _____: exists when patient, staff, and family all know but are pretending not to know in hopes of avoiding interpersonal conflicts

open awareness

terminal illness:

• ____ _____: permits everyone to work through the various stages that precede death

Kubler-Ross

stages of grief were defined by Elisabeth _____-_____

Denial/ Isolation

What is the first stage of grief?

Anger

• Second stage of grief

• typically presents in PT. by complaints of health care

bargining

• third stage of grief

• pt may become more religious to reduce stress