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31 Cards in this Set

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What is claustrophobia?

Fear of not being able to “escape” or being trapped

What are some common places for claustrophobia reactions?

Elevator, tight tubes

What are some things in an MRI exam that the patient may be anxious about?

- Confined space of the MRI scanning bore


- Length of the examination


- Noise


- Restricted movement


- Additional equipment (RF coils) strapped on patient


- Head coil


- The Unknown


- Fear over the MRI exam/results


- Possible stress over injection of contrast

What are some visible signs of claustrophobia?

Fidgeting, Little or not eye contact, sweating, shaking/trembling, asking more questions that normal, hyperventilation

What are some non-visible signs of claustrophobia?

Dry mouth, “Butterflies” in stomach, Tightness in chest, Urge to go to the bathroom, Nausea, Headache, Accelerated heart rate, Increased blood pressure, Increases temperature

What are some impacts of claustrophobia on the department?

Wasted time on multiple scans, etc, decreased image qualtiy

What can we do to ease the patients' nerves for the exam?

- Use a more open bore magnetic


- educate the patient on what to expect for the exam (use carefully selected words)


- allow friend or family member in the room


- maintain contact with patient


- use headphones for music


- place the patient feet first


- use mirrors or face cloth


- use mild sedation

Who is able to prescribe sedatives to the patient?

The referring doctor

What are the types of monitoring?

Visual, verbal, physiological

What might you monitor?

Heart rate (ECG), Blood Pressure, Respiratory rate, apnea, O2 saturation, temperature.

What is normal adult temperature?

37°C or 98.6°F

What is considered a normal variation of adult temperature?

0.5°to 1°

What are the 4 normal sites for takingtemperature?

Oral, tympanic, rectal and axillary

What is a normal adult resting pulse rate?

60-90 beats/minute

What is the average infant heart rate?

120 beats/minute

What is Tachycardia

Abnormally fast - Over 100 beats/minute

What is Bradycardia

Abnormally slow – Below 60 beats/minute

What are normal SaO2 values? Anything below ______ means the tissue is not gettingenough oxygen

95% - 100%

85%

Remember that EKG’s are “normally” affected by the____________________.

Static Magnetic Field

• A “normal” EKG in the MRI suite will have an elevated______ wave

T

Respiratory, Nursing and Anesthesia personnel– What type of prep do they need before they can work inthe MRI environment?

• Screening


• Removal of all metal/ferromagnetic objects


• MRI safe equipment


• Education

Which magnetic field is responsible for the missile effect?

Static magnetic field

_________ is produced by the administration of drugs or combination ofdrugs that depresses the level of consciousness whileretaining the ability to maintain the patient's airway

Sedation

A state of depressed consciousness from which the patient isnot arousable and in which partial or complete loss ofprotective reflexes, including the ability to maintain apatient's airway.

Anesthesia

Describe Score 1 Sedation (Minimal sedation)

- patients may respond normally to verbal commands


- Cognitive function and co-ordination may be affected


– Respiratory and cardiac function are minimally affected

Describe Score 2 Sedation (Moderate sedation)



- airway and protective reflexes are present


– Patients may be sleeping but easily aroused with light ,tactile stimulation or verbal commands

Describe Score 3 Sedation (Deep Sedation)

- patient is not easily roused


- May be accompanied by a partial or complete loss ofprotective airway reflexes


- usually not able to respond purposefully tophysical or verbal stimulation

What are some advantages of GS over Sedation?

- the time in which unconsciousness is achieved ispredictable


- the patient will have an IV that allows for accessfor the administration of contrast or emergency drugs


- a trained anesthetist is present during both theexam and recovery should an emergency arise


- an endotracheal or laryngeal mask is inserted,thus securing the airway


- patients often wake up faster from a carefullybalanced anesthetic than they do from sedation

What are some disadvantages of GA?

- requires an anesthetist and anesthetic nurse and is thereforecostly


- requires MRI Safe or MR Conditional anesthetic equipment


- The extra personnel and equipment increase the likelihood ofa breach of magnet safety protocols


- it is somewhat disruptive to the schedule especially if severalchildren are being anesthetized in one session

What are some types of Anti Anxiety Medications?

Alprazolam (Xanax): PO


Lorazepam (Ativan): PO, IM, IV


Diazepam (Valium): PO, IM, IV

What are some types of hypnotic medications?

Midazolam (Versed), Zolpidem (Ambien)