Podcast
Questions and Answers
What cognitive skill is most crucial for a respiratory therapist (RT) when collaborating with a physician during patient diagnosis and management?
What cognitive skill is most crucial for a respiratory therapist (RT) when collaborating with a physician during patient diagnosis and management?
- Proficiency in performing complex statistical analysis on patient data to identify subtle trends.
- Expertise in the calibration and maintenance of advanced respiratory equipment.
- Skill in rapidly administering emergency medications during critical situations.
- Ability to effectively communicate assessment findings and proposed solutions to the physician. (correct)
In what scenario would an RT's immediate bedside determination be MOST critical in an intensive care unit (ICU)?
In what scenario would an RT's immediate bedside determination be MOST critical in an intensive care unit (ICU)?
- When performing routine equipment maintenance to ensure optimal functionality.
- When assisting with the scheduling of diagnostic tests for stable patients.
- When providing education to the patient's family about long-term respiratory care.
- When a patient exhibits a sudden, life-threatening change in respiratory status. (correct)
During the pre-interaction stage with a new patient, why is it MOST important for the RT to review the patient's chart?
During the pre-interaction stage with a new patient, why is it MOST important for the RT to review the patient's chart?
- To understand the patient's medical history and current condition for initial assessment. (correct)
- To determine the patient's preferred method of communication for optimal interaction.
- To identify billing codes for respiratory treatments.
- To confirm the patient's insurance coverage for the prescribed therapies.
During the introductory stage, what action BEST establishes a positive rapport and ensures patient safety?
During the introductory stage, what action BEST establishes a positive rapport and ensures patient safety?
During the initial assessment stage, what is the MOST important reason for comparing the current vital signs and physical assessment findings to previous RT or nurses' notes?
During the initial assessment stage, what is the MOST important reason for comparing the current vital signs and physical assessment findings to previous RT or nurses' notes?
In the treatment and monitoring stage, what action should an RT take FIRST if a patient exhibits an adverse reaction to a respiratory treatment?
In the treatment and monitoring stage, what action should an RT take FIRST if a patient exhibits an adverse reaction to a respiratory treatment?
During the follow-up stage, what is the MOST important reason for informing the patient when you will return?
During the follow-up stage, what is the MOST important reason for informing the patient when you will return?
When documenting a respiratory treatment, what information is MOST critical to include in order to ensure comprehensive record-keeping and continuity of care?
When documenting a respiratory treatment, what information is MOST critical to include in order to ensure comprehensive record-keeping and continuity of care?
Following a respiratory treatment, a patient's vital signs show a pulse rate of 120/min, SpO2 of 98%, respiratory rate of 16/min, and blood pressure of 100/50. The expiratory wheezing has decreased in the bases of the lungs but is unchanged elsewhere. What is the most appropriate initial interpretation of these findings?
Following a respiratory treatment, a patient's vital signs show a pulse rate of 120/min, SpO2 of 98%, respiratory rate of 16/min, and blood pressure of 100/50. The expiratory wheezing has decreased in the bases of the lungs but is unchanged elsewhere. What is the most appropriate initial interpretation of these findings?
A respiratory therapist is about to enter a patient's room to conduct an initial assessment. According to the guidelines for using space during patient assessment, at what distance should the therapist initially position themselves to begin their introduction and observe the patient's overall condition?
A respiratory therapist is about to enter a patient's room to conduct an initial assessment. According to the guidelines for using space during patient assessment, at what distance should the therapist initially position themselves to begin their introduction and observe the patient's overall condition?
During an interview with a patient, the respiratory therapist notices the patient becoming increasingly uncomfortable when asked about their smoking history. What would be the MOST appropriate next step for the therapist?
During an interview with a patient, the respiratory therapist notices the patient becoming increasingly uncomfortable when asked about their smoking history. What would be the MOST appropriate next step for the therapist?
A patient's family member approaches a respiratory therapist and asks for specific details about the patient's medication regimen and oxygen settings. According to confidentiality guidelines, what is the respiratory therapist's MOST appropriate response?
A patient's family member approaches a respiratory therapist and asks for specific details about the patient's medication regimen and oxygen settings. According to confidentiality guidelines, what is the respiratory therapist's MOST appropriate response?
A respiratory therapist is communicating with a patient who is visibly anxious. What should the respiratory therapist do to demonstrate they are actively listening and expressing concern?
A respiratory therapist is communicating with a patient who is visibly anxious. What should the respiratory therapist do to demonstrate they are actively listening and expressing concern?
During a routine check, a respiratory therapist notices that a patient's IV line has infiltrated, but another member of the healthcare team is nearby and seems engrossed in conversation. Following rules of clinical etiquette, what is the MOST appropriate immediate action?
During a routine check, a respiratory therapist notices that a patient's IV line has infiltrated, but another member of the healthcare team is nearby and seems engrossed in conversation. Following rules of clinical etiquette, what is the MOST appropriate immediate action?
A respiratory therapist is working with a patient who has a different cultural background. The patient avoids direct eye contact and maintains a significant distance. What should the respiratory therapist consider FIRST when interpreting this behavior?
A respiratory therapist is working with a patient who has a different cultural background. The patient avoids direct eye contact and maintains a significant distance. What should the respiratory therapist consider FIRST when interpreting this behavior?
A respiratory therapist overhears two nurses discussing a patient's prognosis in a public area. What principle of clinical etiquette is being violated, and what action should the respiratory therapist take FIRST?
A respiratory therapist overhears two nurses discussing a patient's prognosis in a public area. What principle of clinical etiquette is being violated, and what action should the respiratory therapist take FIRST?
Flashcards
Social Space
Social Space
Distance of 4-12 feet from a patient, used for introductions and assessing the overall situation.
Personal Space
Personal Space
Distance of 18 inches to 4 feet, optimal for interviewing and building rapport with the patient.
Intimate Space
Intimate Space
Distance up to 18 inches, reserved for physical assessments and treatments; requires explicit permission.
Confidentiality
Confidentiality
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Expressing Concern
Expressing Concern
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Active Listening
Active Listening
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Calling patients
Calling patients
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Professional Conduct
Professional Conduct
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RT Role in Patient Assessment
RT Role in Patient Assessment
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Pre-interaction Stage
Pre-interaction Stage
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Introductory Stage
Introductory Stage
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Initial Assessment Stage
Initial Assessment Stage
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Treatment and Monitoring Stage
Treatment and Monitoring Stage
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Follow-up Stage
Follow-up Stage
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Treatment Documentation
Treatment Documentation
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Example Assessment Findings
Example Assessment Findings
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Study Notes
Role of RT in Patient Assessment
- Respiratory therapists assist physicians in diagnosis and management.
- This is achieved through cognitive skills in communication
- Proper selection of assessment tests
- Interpretation of results
- Formulation of solutions
- Suggesting and evaluating treatment plans.
- Respiratory therapists help select and interpret tests to determine the problem.
- In the ICU, respiratory therapists provide bedside assistance to solve problems immediately.
- On general floors, they address changes needed in medications, procedures and oxygen devices.
Stages of Patient-Therapist Interaction
- The interaction occurs in stages
Pre-interaction stage
- Review the patient's chart
- Conduct an initial assessment of the patient
- Clarify your role in the patient's care.
Introductory stage
- Introduce yourself, stating your name and where you are from
- Explain your purpose to the patient.
- Check the patient's armband after getting permission.
- Attempt to establish positive rapport with the patient.
- Watch the patient for any resistance behavior.
Initial assessment stage
- Conduct a brief assessment to determine the patient's illness.
- Perform a brief physical assessment.
- Check pulse, respirations, breath sounds, and SpO2 levels.
- Compare these findings to respiratory therapist or nurse's notes.
Treatment and monitoring stage
- Begin treatment after the initial assessment.
- Reassess vital signs and breath sounds a few minutes later.
- Notes both positive and negative effects of the treatment.
- Stop the treatment, if there are any adverse effects
- Monitor, document, and inform the appropriate healthcare team.
Follow-up stage
- Happens after the treatment has ended
- Reassess the patient's vital signs.
- Clean and replace equipment as needed
- Return the patient to their pre-treatment position if needed
- Let the patient know when you will return.
- Thank the patient.
Documenting Assessment Findings
- Documentation should include date and time
- Documentation should include type of treatment/procedure (ABG's)
- Documentation should include drugs and dosages.
- Documentation should include result of response to treatment, including any adverse effects.
- Documentation should include goals, objectives, or end-point criteria for treatment.
- Documentation should include your name and credentials (SRT).
- It is very important to double-check all documentation.
Example Documentation of Assessment
- On August 31, 2023, at 9:00 AM, the patient received a medical nebulizer treatment with a dose of 1.25 mg.
- Pre-treatment measurements were: pulse 86/min, SpO2 92%, RR 25/min, Bp 110/70, Temperature 36.5.
- Breath sounds included expiratory bilateral wheezing throughout lung fields.
- Post-treatment measurements were: pulse 120/min, SpO2 98%, RR 16/min, Bp 100/50.
- There was a decrease in expiratory wheezing in the bases, unchanged in other areas of the lung.
- The patient tolerated the treatment well, wearing a nasal cannula at 2L/min.
Use of Space in Patient Assessment
- Use 3 types of space in patient assessment
Social Space
- Maintain a distance of 4-12 feet from the patient (e.g., edge of the bed).
- Use this space to begin your introduction
- This space allows you to get an overall picture of the patient
- You can assess breathing, position in bed, family members, table and chairs, and if tray needs moving
Personal Space
- Maintain a distance from 18" to 4 feet (beside bed).
- Use this space for interviewing and asking general questions.
- This space helps develop rapport with the patient.
Intimate Space
- Maintain a distance up to 18"
- Move slowly into this area
- Use this space to assess patient or do treatment
- Always ask permission before doing treatment
Confidentiality
- Information gained from the patient is private (medical records and interview).
- Many patient issues are sensitive
- Any discussion should be done with the healthcare team only
- Family members who ask questions beyond RT scope refer to the physician
- Medications, treatments, oxygen, SpO2, and vitals should be confidential unless for RT task
Expressing Concern to Patient
- Face the patient and make appropriate eye contact.
- Maintain a relaxed and open stance.
- Use touch appropriately and only after developing rapport.
- Hands can be placed on the shoulder, arm, wrist, or hand
- Keep in mind the person's gender, age, and any cultural differences.
- Be an active listener.
- Make eye contact.
- Respond appropriately with head gestures or verbal responses (e.g saying "I see").
- Ask for clarification as needed.
- Take notes, ask for patient's consent beforehand.
Ten Rules for Clinical Etiquette
- Maintain a professional appearance.
- Identify yourself with your name and role.
- Call patients by Mrs, Mr, Miss, or Ms.
- Respect and preserve the patient's modesty.
- Do not rest your foot on the bed or sit on the bed.
- Keep the patient's information confidential.
- Do not discuss the patient's prognosis with others in front of the patient.
- Do not argue in front of the patient.
- Do not criticize the actions of others on the healthcare team in front of or near the patient.
- Keep disagreements and criticisms out of the patient's chart.
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Description
Respiratory therapists play a crucial role in patient assessment by assisting physicians in diagnosis and management. They use cognitive skills to select appropriate tests, interpret results, and formulate solutions. Additionally, they suggest and evaluate treatment plans, providing bedside assistance in the ICU and addressing medication and procedure changes on general floors.
