Merrill’s Atlas of Radiographic Positioning & Procedures, Essay Example

The doctor is requesting a lateral sternum x-ray on a patient that is unable to stand. The nurse has approved the technician to image the patient in a seated upright position. Before the patient is brought into the x-ray area, the room will need to be prepared to ensure that the imaging is performed as quickly as possible due to the patient’s disability and the need to prevent her from experiencing discomfort. Before the patient is brought to the x-ray area, the room will be equipped with a stool for the patient to sit on in addition to a 10×12 image receptor placed on a vertical grid device. The SID will be set at a distance of 72 inches.

Goal

The goal is to get the clearest image possible despite the patient’s lack of ability to stand in the manner dictated by the imaging protocol. The image should be obtained without breast and upper arm flesh obstruction of the lower portion of the sternum. The image should display the sternum in its entirety. The manubrium should be free of superimposition of soft tissue.

Observations

The patient is an obese older women who was involved in a car accident. She is unable to stand for the x-ray and the nurse will allow the patient to sit for this test.

Consequences

The nurse could be potentially subject to radiation exposure. The nurse will have to hold the patient’s breast to the so they will not be in the way of the sternum while the image is captured. In addition, the nurse should be present to help the patient during the imaging to ensure that an adequate image is captured. However, it is important to consider that the radiologist may receive a poor image and may not be able to make a correct diagnosis.

Options

The nurse will hold the breasts to position them out of the way of the x-ray imaging detection. To minimize risk to the nurse, bandaging or tape could be used to do so. A second radiograph could be conducted with increased penetration if it is found that the breast is still obscuring the view of the sternum.

Reason for Decision

With the education that I have received, I was able to make these decisions in the best interest of the patient, which were conducted in a professional manner. While the x-ray of the patient’s sternum will be difficult to obtain, it is a necessary piece of evidence in diagnosing her condition. While moving the breast out of the way during the examination is a concern, it is necessary step in ensuring the patient’s health. The patient will need to be made aware of this necessity and be informed of the steps that will be taken to ensure the imaging is performed correctly. Unfortunately, this will cause the patient some level of discomfort, but seating accommodations during the test are necessary as are the additional measures to ensure that the image is captured in a manner that will lead to accurate diagnosis. The patient will be given options as to how the healthcare staff could position her breast to avoid its capture in the image to ensure that she is comfortable throughout the process. If the initial procedure she chooses does not work, it will be necessary to switch to one of the alternatives.

References

Frank ED, Long BW, Smith BJ, Farst F. (2011). Merrill’s Atlas of Radiographic Positioning and Procedures. Mosby.