WEEK 2: Chapters 10, 11, 12Chapter 10 – Human Diversity
• Define human diversity.
• List some of the human diversity characteristics.
• Describe the human diversity traits of age, ethnicity or national origin, race, gender or sexual
orientation, and mental and physical ability.
• Name the values that are prescribed to U.S. mainstream culture.
• List the elements associated with cultural competency.
• Discuss valuing diversity.
• Know the empathetic practices that help foster cultural insight and produce improved
outcomes.
• Describe the six areas of human diversity that health care providers need to understand to
provide high-quality and effective care.
• Discuss ways in which professional medical imaging organizations have expressed valuing
human diversity.
Chapter 11 – Patient Interactions
• Identify qualities needed to be a caring radiologic technologist.
• Specify needs that cause people to enter radiologic technology as a profession.
• Discuss general needs that patients may have according to Maslow’s hierarchy of needs.
• Relate differences between the needs of inpatients and those of outpatients.
• Explain why patient interaction is important to patients, as well as their family and friends.
• Analyze effective methods of communicating with patients of various ages.
• Explain appropriate interaction techniques for various types of patients.
• Discuss considerations of the physical changes of aging with regard to radiologic procedures.
• Discuss appropriate methods of responding to terminally ill patients.
Chapter 12 – History Taking
• Describe the role of the radiologic technologist in taking patient clinical histories.
• Describe the desirable qualities of a good patient interviewer.
• Differentiate objective from subjective data.
• Explain the value of each of the six categories of questions useful in obtaining patient histories.
• Describe the importance of clarifying the chief complaint.
• Detail the important elements of each of the sacred seven elements of the clinical history.
WEEK 5: Chapters 15, 20
Chapter 15 – Vital Signs, Oxygen, Chest Tubes, and Lines
• Discuss the significance of homeostasis.
• Explain the mechanisms that adapt and maintain homeostasis.
• Discuss the significance of each of the four vital signs: temperature, respiration, pulse, and
blood pressure.
• Identify the normal range for each of the vital signs.
• Explain the implications of abnormal vital signs.
• Describe how vital signs are assessed.
• Explain the indications for administering oxygen therapy.
• Differentiate high-flow and low-flow oxygen-delivery devices.
• Explain why caution must be used when performing radiographic procedures on patients
receiving oxygen therapy.
• Describe the uses of, or indications for, the following thoracic tubes and lines to manage
compromised patients: endotracheal tubes, thoracostomy tubes, and central venous lines.
• Describe the radiographic appearance and proper placement of endotracheal tubes,
thoracostomy tubes, and central venous lines.
• Differentiate various types of central venous lines.
• Recognize the clinical complications associated with use and placement of tubes and lines used
in the thorax.
Chapter 20 – Medical Emergencies
• Define terms related to medical emergencies.
• List the objectives of first aid.
• List general priorities for working with patients in acute situations.
• Explain the purpose of an emergency cart and its contents.
• Differentiate between the two primary types of external cardiac defibrillators.
• Explain the four levels of consciousness.
• Describe the signs and symptoms of various medical emergencies.
• Discuss methods of avoiding the factors that contribute to shock.
• Discuss factors that contribute to the development of hypoglycemia.
• Describe the appropriate procedure for handling patients with various medical emergencies.
• Describe the correct procedure for administration of cardiopulmonary resuscitation.
• Describe the general procedure for the use of an automatic external cardiac defibrillator.
• Demonstrate appropriate principles of cardiopulmonary resuscitation.
Chapter 10
Human Diversity
Copyright © 2012, 2007, 2002, 1997, 1991, 1984, 1979 by Saunders, an imprint of Elsevier Inc. All rights reserved.
1
Objectives
1. Define human diversity.
2. List some of the human diversity characteristics.
3. Describe the human diversity traits of age, ethnicity or national
origin, race, gender or sexual orientation, and mental and physical
ability.
4. Name the values that are prescribed to U.S. mainstream culture.
5. List the elements associated with cultural competency.
6. Discuss valuing diversity.
7. Know the empathetic practices that help foster cultural insight and
produce improved outcomes.
8. Describe the six areas of human diversity that health care providers
need to understand to provide high-quality and effective care.
9. Discuss ways in which the professional medical imaging
organizations have expressed valuing human diversity.
Copyright © 2012, 2007, 2002, 1997, 1991, 1984, 1979 by Saunders, an imprint of Elsevier Inc. All rights reserved.
2
Human Diversity
• Also known as cultural diversity
• Deals with the variety of human societies and cultures
and examines their similarities and differences
• These differences are what make each person unique
and valuable in his or her own right
• Society is made up of many cultures
• Cultures establish behaviors of people
• Cultures can be for a lifetime and provide comfort
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3
Cultural Globalization
• Globalization means that people now cross
borders into other countries to work, go to
school, receive medical care, visit, and live
• Nations, societies, and businesses have become
increasingly cross-cultural or multicultural
• Affected by changing world society
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4
Human Diversity Characteristics
• Age
• Ethnicity or national
origin
• Race
• Gender or sexual
orientation
• Mental and physical
ability
• Work style or ethic
• Geographic location
• Lifestyle
• Physical features
• Economic conditions
• Political beliefs
• Religious beliefs
• First language
• Disability
• Education
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5
Personal Biases
• Everyone has some degree of bias.
• Bias is a real human characteristic and
needs to be addressed.
• Personal biases, even without conscious
thought, play a major role in how
individuals perceive others.
• Dealing with bias requires education and
knowledge of other cultures.
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6
U.S. Mainstream Values
• Activity and hard work
• Personal achievement and success
• Individualism
• Efficiency and practicality
• Affluence, consumerism, and material comfort
• Competition
• Openness, directness, and being well informed
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7
Assimilation vs. Biculturalism
• Assimilation
• Biculturalism
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8
Key Diversity Traits
• Age
• Ethnicity or national origin
• Race
• Gender
• Sexual orientation
• Mental ability
• Physical ability
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9
Embracing Diversity
• Knowledge of cultural differences is key
• Respect for others and self
• Know your personal biases
• Understand the values of the individual
regardless of his or her condition in life
• Seek to learn from others you meet and interact
with
• Appreciate the societal value of multiculturalism
• Empathy for others
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10
Cultural Competency
• A set of attitudes, congruent behaviors, and policies that
come together in an agency, in a system, or among
professionals, enabling effective interactions in a crosscultural or multicultural environment
• Five key elements
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11
Becoming Culturally Competent
• Gain knowledge of other cultures.
• Be willing to engage other cultures.
• Become an excellent multicultural
communicator.
• Recognize the value of empathy and
practice it.
• Help others understand the value of
multiculturalism.
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12
Cultural Diversity and Health Care
•
•
•
•
•
•
Communication
Space
Time
Environmental control
Biologic variations
Social organizations
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13
Conclusion
“Always remember that you
are unique, just like
everybody else.”
Anonymous
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14
Chapter 11
Patient Interactions
Copyright © 2012, 2007, 2002, 1997, 1991, 1984, 1979 by Saunders, an imprint of Elsevier Inc. All rights reserved.
1
Objectives
1. Identify qualities needed to be a caring radiologic technologist.
2. Specify needs that cause people to enter radiologic technology as a
profession.
3. Discuss general needs that patients may have according to
Maslow’s hierarchy of needs.
4. Relate differences between the needs of inpatients and those of
outpatients.
5. Explain why patient interaction is important to patients, as well as
their family and friends.
6. Analyze effective methods of communicating with patients of various
ages.
7. Explain appropriate interaction techniques for various types of
patients.
8. Discuss considerations of the physical changes of aging with regard
to radiologic procedures.
9. Discuss appropriate methods of responding to terminally ill patients.
Copyright © 2012, 2007, 2002, 1997, 1991, 1984, 1979 by Saunders, an imprint of Elsevier Inc. All rights reserved.
2
Patients’ Needs
• Understand that if patients had a choice
between a nice restaurant and visiting the
x-ray department, they would naturally
choose…!
• They are in an altered state of awareness
• Fear of the unknown is profound
• Fear of loss of control
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3
Maslow’s Hierarchy of Human Needs
• People strive from a basic
level of physiologic needs
toward a level of selfactualization.
• Each level of needs must
be satisfied before an
individual proceeds to the
next level.
• Patients are often at the
lower levels of Maslow’s
hierarchy.
FIG. 11-1 Maslow’s hierarchy of needs.
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4
Patient Dignity
• Deals with a patient’s self-esteem
• Patients feel a strong loss of power over their
fate
• Embarrassing situation that they feel isolates
them from others
• Loss of privacy and access to loved ones
• Feelings of guilt on several fronts
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5
Communication Is Critical to Success
“If there were one aspect of healthcare
delivery an organization could work on
that would have the greatest impact on
patient safety, it would be improving the
effectiveness of communication on all
levels—written, oral and electronic.””
Richard K. Croteau, MD, Executive Director for Strategic Initiatives
for TJC
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6
Communication Process
Message
Receiver
Sender
Feedback
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7
Communication Essentials
• Patient care communication must be patientfocused.
• Communication needs to be accurate and timely.
• Always remember to consider communication
and relating with patient’s family and visitors.
• As a technologist, communicate within your
Scope of Practice.
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8
Verbal Communication
• Spoken words
• Written words
• Voice intonation
• Slang and jargon
• Organization of sentences
• Humor
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9
Nonverbal Communication
• Paralanguage
• Body Language
• Touch
• Professional Appearance
• Physical Presence
• Visual Contact
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10
Touch
FIG. 11-6 Proper palpation is accomplished by using fingertips to provide precise and gentle
localization information. A, Proper use of a single fingertip. B, Proper use of several fingers. C,
Improper use of the palm.
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11
Points to Consider
• Average American reads at the 8th to 9th
grade level
• 44% of people age 65 and older read at
about the 5th grade level or lower
• 48% to 80% of patients age 60 and older
have inadequate functional health literacy
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12
Common Patient Types
• Seriously Ill and Traumatized Patients
• Visually Impaired Patients
• Speech- and Hearing-Impaired Patients
• Non–English-Speaking Patients
• Mentally Impaired Patients
• Substance Abusers
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13
Mobile and Surgical
Patient Communication
• These unique patient care environments
require special patient communication
considerations.
• Begin by calling the patient’s name, identifying
yourself to the patient, and explaining the
procedure.
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14
Communication with Patient Family
and Friends
• Professionally introduce yourself.
• Briefly explain the procedure.
• Explain why they must leave the immediate
area during the exposure.
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15
Age as a Communication Factor
• Patient age must be factored into
communication techniques.
• Age is not a barrier to effective
communication.
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16
Age Groups
• Infant
• Birth to 1 year old
• Toddlers
• 1-3 years old
• Preschoolers
• 3-5 years old
• School-aged
children
• 5-10 years old
• Adolescents
• 10-25 years old
• Young adults
• 25-45 years old
• Middle-aged adults
• 45-65 years old
• Mature adults
• 65 years old and
older
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17
Pediatric Patients
• Come down to their eye
level to talk.
• Speak softly and less
authoritatively.
• Set up equipment before
the child enters the exam
room.
• Soften room lighting.
• Avoid loud and dramatic
equipment movements.
• Use gentle touch.
• Maintain eye contact.
FIG. 11-7 “To stand tall in pediatrics, you have to get down on your
knees.” Entering the child’s environment by squatting to the child’s eye
level can begin a rewarding relationship.
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18
Physical Changes of Functional Aging
• Slowing psychomotor responses
• Slowing of information processing
• Decreased visual acuity
• Decrease in senses
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19
19
Respiratory System
• Decreased cough reflex
• Shallow breathing
• Decreased pulmonary capacity
• Kyphosis
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20
20
Musculoskeletal System
• Osteoporosis
• Arthritis
• Decreased muscle strength
• Atrophied muscle mass
• Fear of fractures
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21
21
Cardiovascular System
• Decreased cardiac efficiency
• Orthostatic hypotension
• Arteriosclerosis
• DVT
• General feeling of tiredness
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22
22
Integumentary System
• Loss of skin elasticity
• Change of skin texture
• Loss of touch sensation
• Diminished sensation of heat or cold
• Loss of subcutaneous fatty layer
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23
23
Gastrointestinal System
• Loss of appetite
• Decreased secretions
• Decreased GI motility
• Decreased sphincter muscle control
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24
24
Dealing with Older Patients
• Maintain eye contact.
• Speak clearly and more slowly.
• Speak to them, not away from them.
• Keep them warm if needed.
• Ask permission to touch.
• Demonstrate compassion.
• Ask them what makes them more comfortable.
• Explain thoroughly and keep them informed.
• Treat them with respect and patience.
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25
Terminal Patients
• It is important to understand that death is
part of the cycle of life.
• Radiologic sciences professionals often
deal with the dying process as part of
acute death events.
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26
Terminal Patients
• Society’s attitudes toward death and dying have
changed to become more open and respectful of
the terminal patient’s wishes and rights.
• Dying patients and their families and loved ones
need to work through the grieving process in a
natural and individualized timeframe.
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27
Five Stages of Grieving Process
1.
2.
3.
4.
5.
Denial and Anger
Bargaining
Depression
Preparatory Depression
Acceptance
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28
Conclusion
• Communication skills are essential to good medical
imaging.
• A good communication process is a closed loop.
• Communication strategies need to accommodate the
uniqueness of each patient.
• Patients enter the health care setting feeling vulnerable
and outside their comfort zone.
• Medical professionals recognize these feelings and act
with compassion and empathy for the patient’s welfare.
• Aging and terminal patients present their own set of
patient care challenges.
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29
Chapter 12
History Taking
Copyright © 2012, 2007, 2002, 1997, 1991, 1984, 1979 by Saunders, an imprint of Elsevier Inc. All rights reserved.
1
Objectives
1. Describe the role of the radiologic technologist in taking
patient clinical histories.
2. Describe the desirable qualities of a good patient
interviewer.
3. Differentiate objective from subjective data.
4. Explain the value of each of the six categories of
questions useful in obtaining patient histories.
5. Describe the importance of clarifying the chief
complaint.
6. Detail the important elements of each of the sacred
seven elements of the clinical history.
Copyright © 2012, 2007, 2002, 1997, 1991, 1984, 1979 by Saunders, an imprint of Elsevier Inc. All rights reserved.
2
Patient History Process
• Look at taking a patient history as an interview of the
patient.
• In many cases the radiologic sciences professional is the
eyes, ears, and mouth of the radiologist.
• Possessing good history-taking skills is an essential
responsibility of the radiologic and imaging sciences
professional.
• Information gathered needs to be accurate and specific
in detail, if possible.
• Genuine interest in what the patient has to say,
attentiveness, and an aura of professional competence
can provide patients with a real sense of caring.
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3
Qualities of Interviewer
•
•
•
•
•
•
•
•
•
•
•
Acknowledge patient’s anger, if present
Respect for patient
Be genuine
Empathy (not sympathy) for patient’s condition
Patients need to feel the information they are providing is
important
Don’t intimidate patients
Attention to detail
Accurate note-taking skills
Good questioning skills
Multi-tasking, communication skills
Maintain a polite and professional demeanor
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4
Data Collection Process
• Most patients understand the importance of a
history and will provide information as
requested.
• Remember, the information needed by the
radiologist is specific to the patient’s reason for
the examination.
• Never disregard anything the patient says,
especially if it does not fit with the opinion you
are forming about the patient’s symptoms.
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5
Questioning Skills
• Use open-ended questions.
• Facilitate a response from the patient.
• Remain quiet to get a response.
• Use probing questions to focus in on more
detail.
• Repeat patient response to clarify and confirm.
• Summarize to verify accuracy.
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6
Data Collection Process
Objective Data
Subjective Data
• Perceptible to
senses
• Able to be
measured
• Signs that can
be seen, heard,
felt, and so on
• Patient feelings
• Pain level
• Attitude
• Opinion of
observer
• Subject to
interpretation
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7
What do radiologists
want to know about the
patient history?
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8
Why is this examination
being done ?
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9
Elements of the Clinical History
• Chief Complaint
– MDs tend to focus on this.
– Permit the patient to add more than a single
complaint when it appears multiple complaints
are valid.
– Ignoring all symptoms except the most
predominant can cause you to miss other
important clinical information.
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10
Sacred Seven of Medical Histories
• Localization
• Chronology
• Quality
• Severity
• Onset
• Aggravating or Alleviating Factors
• Associated Manifestations
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11
Patient History Considerations
• Does patient history data match requisition?
• Do symptoms support exam?
• Verify symptoms with exam request
• How would you describe pain?
– Localized vs. general
– Where
– How long
– Duration
– Old vs. new
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12
Role of Technologist
• Act as good listener
• Take accurate notes and record them
appropriately
• Essential responsibility of technologist
• Get answers to key clinical questions
• Present a professional image
• Important role in interacting with patient
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13
Conclusion
• Consider the patient history as an interview with the
patient.
• Demonstrate respect, compassion, and empathy for the
patient’s condition.
• Clearly identify the patient’s chief complaint.
• Gather all pertinent information relative to the procedure.
• Look for objective and subjective data.
• Present a professional image.
• Take accurate notes with attention to details.
• Never forget, you may be the eyes, ears, and voice of
the radiologist with the patient.
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14
Chapter 15
Vital Signs, Oxygen, Chest
Tubes, and Lines
Copyright © 2012, 2007, 2002, 1997, 1991, 1984, 1979 by Saunders, an imprint of Elsevier Inc. All rights reserved.
1
Objectives
1. Discuss the significance of homeostasis.
2. Explain the mechanisms that adapt and maintain
homeostasis.
3. Discuss the significance of each of the four vital signs:
temperature, respiration, pulse, and blood pressure.
4. Identify the normal range for each of the vital signs.
5. Explain the implication of abnormal vital signs.
6. Describe how vital signs are assessed.
7. Explain the indications for administering oxygen
therapy.
Copyright © 2012, 2007, 2002, 1997, 1991, 1984, 1979 by Saunders, an imprint of Elsevier Inc. All rights reserved.
2
Objectives
8. Differentiate high-flow and low-flow oxygen-delivery devices.
9. Explain why caution must be used when performing radiographic
procedures on patients receiving oxygen therapy.
10. Describe the uses of, or indications for, the following thoracic tubes
and lines to manage compromised patients: endotracheal tubes,
thoracostomy tubes, and central venous lines.
11. Describe the radiographic appearance and proper placement of
endotracheal tubes, thoracostomy tubes, and central venous lines.
12. Differentiate various types of central venous lines.
13. Recognize the clinical complications associated with use and
placement of tubes and lines used in the thorax.
14. Describe the electroconduction system of the heart in correlation
with normal and abnormal electrocardiographic findings.
Copyright © 2012, 2007, 2002, 1997, 1991, 1984, 1979 by Saunders, an imprint of Elsevier Inc. All rights reserved.
3
Patient Homeostasis
• The body’s “steady state” maintained by
adaptive responses that promote healthy
survival
• Monitored by physiologic feedback loops
• Feedback loops may be two types
• The body’s feedback loops are
predominantly negative loops
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4
Mechanisms for Homeostasis
• Heartbeat
• Blood pressure
• Body temperature
• Respiratory rate
• Electrolyte balance
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5
Vital Signs
•Body temperature
•Pulse rate
•Blood pressure
•Respiratory rate
Fig. 15-1 A common method for measuring body temperature is
the oral route; the thermometer is placed under the tongue.
•Mental state
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6
Normal Vital Signs
• Temperature
– 97.7° to 99.5° F
• Respirations
– Adult
– Child
12 to 20 breaths per minute
20 to 30 breaths per minute
• Pulse
– Adult
– Child
60 to 100 BPM
70 to 120 BPM
• Blood Pressure
– Systolic
– Diastolic
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