Judgment Situations forChapter 6: Vital Signs and Oxygen Administration Situation 1
As a student radiographer, you are exposed to many different situations in the health care field.On this particular day, you were asked to observe in the angiography room.The technologist has asked if you could assist with the pre-procedural vital signs on Mr. Hawkins.Eager to be a part of the team, you take Mr. Hawkins to the area where vital signs are taken.As you try to carry on a light conversation and outwardly attempt to seem confidant, you take his radial pulse, respirations, and blood pressure.You notice that the blood pressure seems high but not knowing Mr. Hawkins’ average values, you continue with the pre-procedural work-up without notifying the technologist.What action should you take?
Place an “M” next to the most appropriate response to this situation and an “L” next to the least appropriate response.
1. ____You figure that the pre-procedural vital signs are not as important as the vitals taken during and after the procedure; therefore, there is no need to notify the technologist.In addition, if this was really important, they would not have a student assume this role without direct supervision.
2.____You inform Mr. Hawkins that you are a student and that you are assisting the technologists with getting this information.As you take his blood pressure, you ask him what his normal range is to help you get the most accurate value possible.Immediately proceed by communicating the results to the technologist.
3.____ Discouraged and uncomfortable with the reading, you tell the technologist that it may be better if you just watch and not assist.
Situation 1 Answers
The least appropriate response (L) is choice 1.
The most appropriate response (M) is choice 2.
Judgment Situations forChapter 6: Vital Signs and Oxygen Administration Situation 2
You are performing a chest x-ray on an in-patient who has severe emphysema and is receiving oxygen via a nasal cannula. As you complete the first radiograph, you notice that your patient is having difficulty breathing. The patient then tells you that he thinks he needs more oxygen because he is very short of breath. What action should you take?
Place an “M” next to the most appropriate response to this situation and an “L” next to the least appropriate response.
1. ____ Call the department nurse and have her assess the patient’s breathing and oxygen before proceeding with the exam.
2. ____ Call the patient’s nurse and let her know that the patient is complaining of shortness of breath, and ask her if you should proceed or call a “Code Blue.”
3. ____ You check the oxygen flow rate and see that it is set at 2 liters per minute, so you increase it to 6 liters per minute to help the patient breathe better.
Situation 2 Answers
The least appropriate response (L) is choice 3.
The most appropriate response (M) is choice 1.
Judgment Situations forChapter 7: Basic Electrocardiogram Monitoring Situation 1
The radiographer is left alone in the room with a patient who is receiving continuous cardiac monitoring. The patient request to be placed in a sitting position and becomes very anxious. The radiographer looks at the ECG pattern on the oscilloscope and sees no change in the patient’s heart rate and rhythm; however, he notes that the patient’s respiratory rate has increased significantly. How should the radiographer proceed?
Place an “M” next to the most appropriate response to this situation and an “L” next to the least appropriate response.
1. ____ Place the patient in a sitting position and observe his response.
2. ____ Place the patient in a sitting position and assess his vital signs.
3. ____ Place the patient in a sitting position, notify the team in charge of the patient, and then begin to assess his vital signs.
Situation 1 Answers
The least appropriate response (L) is choice 1.
The most appropriate response (M) is choice 3.
Judgment Situations forChapter 7: Basic Electrocardiogram
Situation 2
The radiographer is working in the cardiac catheterization laboratory. The catheterization team is scrubbing to begin the procedure. The radiographer notes that the ECG pattern on the oscilloscope begins to change drastically. He goes to the patient and begins his assessment. The patient is calm; has no change in his heart rate, rhythm, or blood pressure; and has no complaints of pain or discomfort. How should the radiographer proceed?
Situation 2 Answer
The radiographer should call the team in charge of the patient. He or she should assess the chest leads to make certain that they are correctly placed and that patient movement has not produced artifacts. If the patient has not moved and leads are in place, the radiographer should notify the team in charge of the patient. The radiographer should also reassure the patient and wait for the team to complete the scrub.