pt 3 Patient Care Essentials for Sonographers

Patient Mobility and Transfer

  • Patient Transfer Basics
    • Lower footrests and position patient's feet on them.
    • Important:
    • Do not transfer patients who cannot bear their own body weight; ask for assistance.

Patients with Tubes

  • Types of Tubing:
    • Intravenous (IV) tubing
    • Nasogastric (NG) tubes
    • Urinary catheters
    • Oxygen therapy
  • Sonographers' Responsibilities:
    • Properly manage and move patients with tubes in place.

Intravenous Therapy

  • IV Therapy: Fastest delivery method for fluids/medications.
    • Components include:
    • Sterile plastic bag of fluids
    • Drip chamber (for flow rate visibility)
    • Clamp (to stop flow)
    • Regulator (to adjust flow rate)
    • Long sterile tube leading to insertion site
  • Important Protocols:
    • Keep IV bag above arm to prevent blood reflux.
    • Common vein sites: arms/hands for adults, scalp veins for infants.
  • Risks During Movement:
    • Avoid pulling tubing to prevent withdrawal or clotting.
  • Modern Infusion Pumps:
    • Computerized for precise drip regulation and may have alarms (e.g., empty bag).
    • Action on Alarms:
    • Notify nurse if alarm persists; do not press buttons unless trained.
    • Report details like infusion type and errors to nurse accurately.

Nasogastric Tubes (NG)

  • Description:
    • Inserted through nostril, down to stomach/duodenum. Secured with tape.
  • Uses:
    • Feeding, gastric emptying, or washing toxins.
  • Caution During Care:
    • Patients should not lie flat; position at 30 degrees for scans.
    • Report respiratory symptoms to the nurse immediately.

Urinary Catheters

  • Common Type: Foley catheter.
    • Contains inner (nylon) tube for drainage and an outer (silicone) tube with a balloon.
    • Balloon prevents catheter slippage.
  • Care Guidelines:
    • Drainage bag must be below bladder level.
    • Handle with caution during patient movement to prevent discomfort or UTI risks.
    • Report any blockage or retention; may require ultrasound for assessment.
  • Texas Catheter:
    • A condom-type for incontinent males.

Oxygen Therapy

  • Importance:
    • Essential for patients with low oxygen levels; treated as a medication.
  • Delivery Methods:
    • Devices: Nasal cannula, simple mask, partial rebreather, Venturi mask.
    • Nasal Cannula: 1-6 L/min flow.
    • Simple Mask: 5-10 L/min for moderate needs.
    • Partial Rebreather: 10-12 L/min with reservoir.
    • Venturi Mask: Precise flow rates (12-15 L/min), used for COPD.
  • Care Protocol:
    • Secure tanks during transport and check levels.
  • Safety:
    • Keep oxygen cylinders away from heat and sparks to prevent combustion.

Wounds, Drains, and Dressings

  • Drain Usage:
    • Used post-surgery to aid healing by removing excess fluid/air.
    • Be cautious not to dislodge drains during patient movement.
  • Dressing Protocol:
    • Consult nurse before removing or altering dressings.
    • Use sterile supplies to address wounds during scanning.

Colostomies and Ileostomies

  • Definition:
    • Stomas created for fecal drainage post-surgery.
  • Ostomy Bag Care:
    • Ensure the bag does not get dislodged or cause leakage during scans.
    • Contact nursing staff for assistance if needed during emptying/replacement.