Torres' Patient Care in Imaging Technology by Dutton Andrea;Ryan TerriAnn;

Author:Dutton, Andrea;Ryan, TerriAnn;
Language: eng
Format: epub
Publisher: Wolters Kluwer
Published: 2019-08-15T00:00:00+00:00

Eyes Open

Extension

2

Spontaneously

14

No response

1

To voice

3

Verbal Response

To painful stimuli

2

Oriented

5

No response

1

Confused speech

4

Motor Response

Inappropriate words

3

Obeys commands

6

Incomprehensible sounds

2

Localized pain

5

None

1

Withdraws from painful stimuli

4

Abnormal flexion

3

Total points possible

15

Another indicator that a patient’s condition is deteriorating is a change in the level of consciousness (LOC). These changes can be subtle but must not be ignored. The LOC can be assessed quickly with the following three parameters:

1. Ask the patient to state certain items, such as name, date, address, and the reason for coming to the imaging department. If the patient gives these responses readily and correctly, then it can be assumed that the patient is responding to verbal stimuli and is oriented to person, place, time, and situation. Note any undue need to repeat questions and any slow response, difficulty with choice of words, or unusual irritability.

2. Note the patient’s ability to follow directions during instruction regarding positioning for the examination. Also note any movement that causes pain or other difficulty in movement, as well as any alterations in behavior or a lack of response. Report these to the physician in charge of caring for the patient. These measures provide a baseline against which changes in the patient’s mental and neurologic status can be assessed.

3. Assess the patient’s vital signs at this time if current readings are not on the chart. Chapter 6 describes how to perform baseline vital signs and the normal ranges. Baseline readings are a must to have in order to note any changes that may occur. An increasing systolic blood pressure or widening of the pulse pressure may indicate increasing intracranial pressure. Slowing of the pulse may also indicate increasing intracranial pressure. As compression of the brain increases, the vital signs change. Respirations increase, blood pressure decreases, and the pulse rate decreases further. A rapid rise in body temperature or a decrease in body temperature is also an ominous sign.

If the patient has no complaints on initial assessment, note this. If the patient begins to complain of a headache, becomes restless or unusually quiet, or develops slurred speech or a change in the level of orientation as a procedure progresses, report this to the physician immediately, stop the procedure, stay with the patient, and summon assistance. This includes requesting the emergency cart to be brought to the patient. Then, prepare the patient for oxygen and intravenous fluid administration.

WARNING!

Changes in a patient’s neurologic status or LOC must never be ignored! Stop work and notify the physician of these changes.

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