Podcast
Questions and Answers
Following a respiratory treatment, a patient's pulse is 120/min, SpO2 is 98%, RR is 16/min, and BP is 100/50. There is a decrease in expiratory wheezing in the bases of the lungs, but it remains unchanged in other areas. What is the MOST appropriate initial interpretation of these findings?
Following a respiratory treatment, a patient's pulse is 120/min, SpO2 is 98%, RR is 16/min, and BP is 100/50. There is a decrease in expiratory wheezing in the bases of the lungs, but it remains unchanged in other areas. What is the MOST appropriate initial interpretation of these findings?
- The patient's condition has completely resolved, and further treatment is unnecessary.
- The patient experienced an adverse reaction to the treatment and requires immediate intervention.
- The patient is showing some improvement in the bases of the lungs, but continued monitoring and assessment are necessary. (correct)
- The patient's vital signs indicate impending respiratory failure, requiring immediate escalation of care.
When initiating an introduction and observing a patient's overall conditionfrom a distance of 4-12 feet, which zone of personal space is the respiratory therapist utilizing?
When initiating an introduction and observing a patient's overall conditionfrom a distance of 4-12 feet, which zone of personal space is the respiratory therapist utilizing?
- Public Space
- Personal space
- Social Space (correct)
- Intimate space
What is the PRIMARY purpose of utilizing the personal space (18 inches to 4 feet) when interacting with a patient?
What is the PRIMARY purpose of utilizing the personal space (18 inches to 4 feet) when interacting with a patient?
- To provide personal care, such as bathing.
- To establish rapport and gather information through general questioning. (correct)
- To perform a detailed physical assessment and administer treatment.
- To maintain a safe distance while observing the patient's breathing pattern.
Before entering a patient's intimate space, what action should the respiratory therapist ALWAYS take?
Before entering a patient's intimate space, what action should the respiratory therapist ALWAYS take?
A patient's family member asks about the patient's medication list. What is the MOST appropriate response for the respiratory therapist?
A patient's family member asks about the patient's medication list. What is the MOST appropriate response for the respiratory therapist?
When expressing concern for a patient, which of the following nonverbal cues is MOST important?
When expressing concern for a patient, which of the following nonverbal cues is MOST important?
Which of the following actions demonstrates active listening when interacting with a patient?
Which of the following actions demonstrates active listening when interacting with a patient?
What is the primary role of a Respiratory Therapist (RT) in patient assessment?
What is the primary role of a Respiratory Therapist (RT) in patient assessment?
A respiratory therapist is discussing a patient's case in the cafeteria with a colleague. This is a violation of which rule of clinical etiquette?
A respiratory therapist is discussing a patient's case in the cafeteria with a colleague. This is a violation of which rule of clinical etiquette?
During the pre-interaction stage of patient-therapist interaction, what step is crucial for the RT to perform?
During the pre-interaction stage of patient-therapist interaction, what step is crucial for the RT to perform?
In which situation is it considered acceptable for a respiratory therapist to touch a patient without explicit permission?
In which situation is it considered acceptable for a respiratory therapist to touch a patient without explicit permission?
In the introductory stage, what is the MOST important step after introducing yourself?
In the introductory stage, what is the MOST important step after introducing yourself?
A respiratory therapist disagrees with a physician's order but voices their concerns within earshot of the patient. Which rules of clinical etiquette are being violated?
A respiratory therapist disagrees with a physician's order but voices their concerns within earshot of the patient. Which rules of clinical etiquette are being violated?
During the treatment and monitoring stage, what action should an RT take if a patient exhibits adverse effects?
During the treatment and monitoring stage, what action should an RT take if a patient exhibits adverse effects?
Within the follow-up stage of patient interaction, what should the RT communicate to the patient before leaving?
Within the follow-up stage of patient interaction, what should the RT communicate to the patient before leaving?
What critical elements should be included when documenting a respiratory treatment?
What critical elements should be included when documenting a respiratory treatment?
What is the rationale behind 'double-checking' documentation after a treatment?
What is the rationale behind 'double-checking' documentation after a treatment?
An RT notes bilateral expiratory wheezing across all lung fields during auscultation. Which section of documentation should this finding MOST accurately be recorded?
An RT notes bilateral expiratory wheezing across all lung fields during auscultation. Which section of documentation should this finding MOST accurately be recorded?
A patient’s SpO2 drops significantly during a nebulizer treatment. After stopping the treatment and stabilizing the patient, what specific documentation detail is CRUCIAL to include?
A patient’s SpO2 drops significantly during a nebulizer treatment. After stopping the treatment and stabilizing the patient, what specific documentation detail is CRUCIAL to include?
An RT is called to the ICU for a patient experiencing acute respiratory distress. After reviewing the chart and observing paradoxical chest movement, the RT anticipates the possible need for mechanical ventilation. Which cognitive skill is MOST critical for the RT to employ FIRST?
An RT is called to the ICU for a patient experiencing acute respiratory distress. After reviewing the chart and observing paradoxical chest movement, the RT anticipates the possible need for mechanical ventilation. Which cognitive skill is MOST critical for the RT to employ FIRST?
Flashcards
Social Space in Patient Assessment
Social Space in Patient Assessment
Distance of 4-12 feet from a patient; used for introductions and observing the patient's overall condition.
Personal Space in Patient Assessment
Personal Space in Patient Assessment
Distance of 18 inches to 4 feet; used for interviews and building rapport with the patient.
Intimate Space in Patient Assessment
Intimate Space in Patient Assessment
Distance up to 18 inches; used for assessment and treatment, requiring permission from the patient.
Confidentiality
Confidentiality
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Expressing Concern: Body Language
Expressing Concern: Body Language
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Expressing Concern: Appropriate Touch
Expressing Concern: Appropriate Touch
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Expressing Concern: Active Listening
Expressing Concern: Active Listening
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Clinical Etiquette: Professionalism
Clinical Etiquette: Professionalism
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Clinical Etiquette: Respect
Clinical Etiquette: Respect
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Clinical Etiquette: Confidentiality and Discretion
Clinical Etiquette: Confidentiality and Discretion
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RT's Role in Patient Assessment
RT's Role in Patient Assessment
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RT Actions Based on Tests
RT Actions Based on Tests
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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 & Monitoring Stage
Treatment & Monitoring Stage
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Follow-up Stage
Follow-up Stage
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Treatment Documentation
Treatment Documentation
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Double-Checking Documentation
Double-Checking Documentation
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Example Assessment Findings
Example Assessment Findings
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Study Notes
Role of RT in Patient Assessment
- Assists physicians in diagnosis and management
- Respiratory Therapists use cognitive skills in communication
- Respiratory Therapists select appropriate assessment tests
- Respiratory Therapists interprete results
- Respiratory Therapists formulate solutions
- Respiratory Therapists suggest and evaluate treatment plans
- Respiratory Therapists help select and interpret tests
- Respiratory Therapists determine patient's problem and take action
- In the ICU, Respiratory Therapists provide bedside help to solve problems immediately
- On general floors, Respiratory Therapists help when patients require changes in medications, procedures, or oxygen devices
Stages of Patient-Therapist Interaction
- Stages include the pre-interaction, introductory, initial assessment, treatment/monitoring, and follow-up stages
Pre-interaction Stage:
- Review patient chart
- Make initial assessment of patient
- Clarify role in patient care
Introductory Stage:
- Introduce yourself and where you're from
- Explain your purpose
- Check the armband with permission
- Establish positive rapport
- Look for resistance behavior and act appropriately
Initial Assessment Stage:
- Briefly assess and determine patient's illness
- Brief physical assessment
- Check pulse, respirations, breath sounds and SpO2
- Compare these findings to RT or nurses' notes
Treatment and Monitoring Stage:
- Start treatment after assessment
- Reassess vital signs and breath sounds after a few minutes
- Record positive and negative effects of treatment
- Stop treatment for any adverse effects, monitor, document, and inform healthcare team
Follow-up Stage:
- This stage is after treatment has ended
- Reassess vital signs
- Clean and replace equipment as needed
- Return patient to pre-treatment position if needed
- Inform patient when you will return
- Thank 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 adverse effects
- Documentation should include goals, objectives, or end-point criteria for treatment
- Documentation should include name/credentials (SRT)
- Double checking is an important step
Documentation Example:
- August 31, 2023 at 09:00 am
- Patient received a nebulizer treatment with a dose of 1.25 mg
- Before treatment: Pulse 86/min, SpO2 92%, RR 25/min, Bp 110/70, Temp 36.5
- Breath sounds included expiratory bilateral wheezing throughout all lung fields before treatment
- After treatment: Pulse 120/min, SpO2 98%, RR 16/min, Bp 100/50
- Decrease in expiratory wheeze in bases after treatment but unchanged in other areas of the lung
- Patient tolerated treatment well, wearing nasal cannula at 2L/min
Use of Space in Patient Assessment
- Social space includes four to twelve feet from patient at the edge of bed
- Use to begin your introduction
- Social space gives you the overall picture of the patient
- Assess breathing, position in bed, family members, tables, chairs, and the tray
- Personal space extends from 18 inches to 4 feet beside the bed
- Use this to interview or ask general questions
- Develop rapport in the patient's personal space
- Intimate space extends up to 18 inches
- Move slowly into the patient's intimidate space
- Assessment or treatment is administrated
- Always ask for permission before assessment or treatment
Confidentiality
- All patient information is private, including medical records and interview details
- Many patient issues are sensitive
- Discuss patient information with healthcare team only
- Refer family members' questions to the physician unless they are specific to Respiratory Therapy
- Medications, treatments, oxygen, SpO2, and vitals, should be considered confidential
Expressing Concern
- Face the patient and make eye contact
- Maintain a relaxed, open stance
- Only use appropriate touch after developing rapport
- Hands on shoulder, arm, wrist, or hand
- Keep in mind gender, age, and cultural differences
- Be an active listener
- Again, make eye contact
- Respond appropriately with head gestures or verbal responses
- Ask for clarification as needed
- Take notes after asking the patient
Ten Rules for Clinical Etiquette:
- Maintain a professional appearance
- Identify yourself, including name and role
- Call the patient by Mrs, Mr, Miss, or Ms
- Respect and maintain patient modesty
- Do not rest feet on bed, or sit on bed
- Keep patient information confidential
- Do not discuss patient prognosis with others, especially in front of them
- Do not argue in front of patients
- Do not criticize actions of other healthcare team members in front of or near patients
- Keep disagreements and criticisms out of the patient's chart
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Description
Explores the respiratory therapist's multifaceted role in patient assessment, including diagnosis support, test selection, and treatment planning. Details the stages of patient-therapist interaction, from pre-interaction to follow-up. Emphasizes RTs' problem-solving in the ICU and on general floors.
