Medical- Medical Radiation Technologist - Integrated Case Report - Assessment Answer

Medical Assignment

Case Scenario

You are on duty at 9pm as a Medical Radiation Technologist (MRT) in the Emergency Department and your partner who is an Emergency Department Registrar and who is coincidently also on duty that night.

You are working with Dr W an Intern in the Emergency Department. You are helping her to review images to develop her recognition skills. She is called by the Triage Nurse to attend to Ms Z who has presented with a six -hour history of severe abdominal pain.

‘I hope she doesn’t require surgery,’ says Dr W. ‘Your partner will probably scream. The theatres have been going flat out all night. Maybe she’s just drug seeking.’

‘I’m not sure we should say it like that at this stage,’ you reply tersely.

Ms Z is 22-year-old fashion sale assistant. She has experienced severe abdominal pain for the last six hours.

‘I haven’t felt all that good for the last few days,’ she says. ‘I put it down to a big weekend and pressure at work. Today I woke up with a bit of pain in my stomach. I was doing the late night shopping shift and it got worse after I came back from my break, really quite unbearable. I was sick then too. I had to leave work. It left us short at the shop but my boss ordered me a taxi to come here.’

Dr W obtains the following initial history from Ms Z to present to the Emergency Registrar.

Assignment Task

This individual PBL case study extension activity is designed to allow you demonstrate an advanced knowledge and integration of the processes that contribute to the medical imaging case management of a chosen PBL Case scenario.

This assessment task is an introductory level case study report, which is to be based on your individual analysis, and interpretation, of One of the PBL case study scenario’s. This is to be selected from any of the first four cases that we will complete.

Introduction and statement of choice:

In this medical report the patient has been reported with severe abdominal pain for last six hours. Patient also informed the care professionals that since early morning she has been suffering with minute pain in her abdomen; however the degree of pain increased with the time. The patient was referred for transvaginal ultrasound examination along with abdominal x ray.

This case scenario involves plain radiographic images for the diagnosis of the patient. The main objective a medical radiation technologist is to perform diagnosis by using x-ray technology for better understanding of the disease and other anatomical problems of a patient. In this case help through radiographic images are required as the actual reason behind her severe abdominal pain is needed to be understood for the proper treatment for her condition. Thus this case scenario is viable in terms of the professional aspects of a medical radiation technologist and will help the assessor to flourish the knowledge regarding the approach of the profession.

Professionalism, patient care and ethics:

The role of Medical Imaging Technologist (MIT) is very significant in the given case study. The essential professional skills are required to be applied for given case study. As an MIT, it is important to provide the diagnostic images with excellent quality, in order to make sure that diagnosis has been done with high standards of care (Mikla, & Mikla, 2013). In patient to practitioner interaction, necessary information must be recorded, which is related to the patient and the procedure. MIT must always comply with the given instructions, and must act professionally every time. It is also significant to gain the concern of the patient, and make them aware about the procedure. Safe and well informed procedure reflects professional practice (Medical Imaging Technologists, 2016). Practitioner to practitioner interaction requires focused skill of the MIT that must include clear communication with patient and colleagues. Healthy communication is important for the effective treatment (Umar, 2015). Appropriate radiation protection should be provided to the patient. MIT must also display awareness towards the patient and time at the time of severe pain or injury. The post procedure instructions should be clearly provided to the patient as well as involved healthcare professionals (Mikla, & Mikla, 2013). Ethical application of all the skills and practices is very essential. Ethical consideration also includes maintenance of the privacy and confidentiality of the identity of the patient. In the case scenario, professional and focused skills of a Medical Imaging Technologist (MIT) were applied and practiced ethically. The patient was correctly positioned, without creating any discomfort for her. She was informed about the procedure. Considering her condition, it was made sure that she must be taken to the emergency room immediately without wasting time. The archived images were also sent to be reviewed and reported in order to provide necessary information to the doctor.

Pathology and pathophysiological processes:

According to the pathology and Pathophysiology of the patient, the major condition associated with the disease was the unbearable pain that the patient was facing since last 6 hours. Also, patient was not feeling very good since last few days because of the discomfort in her abdominal area. The ultrasound images of the patient showed the enlarged right side ovary, small amount of adjacent free fluid, and increased flow. Endometrium was found to be heterogeneous and thickened. This findings clearly suggested inflammation in the inner walls of the uterus, which is related to oophoritis. The condition of Oophoritis is described as the Pelvic inflammatory disease, from which patient is suffering. This disease caused inflammation and pain.

Pelvic inflammatory disease is infectious and results in inflammation in the upper genital tract of the females, which further includes fallopian tubes, uterus and the pelvic structure. The high risks patients are mainly the female, who are younger than 25 years and have many sex partners, does not use contraception, or live at the places where there is high prevalence of sexually transmitted disease (STD). PID is initiated with the infection from vagina and cervix towards the upper genital tract. The sexually transmitted organism associated with PID Chlamydia trachomatis (Brunham, Gottlieb, & Paavonen, 2015). These microorganisms are called as pathogens and gains entry through vagina. The inflammation is caused in complex response of the body tissue towards harmful and dangerous stimuli. In the case of PID, a pathogen like Chlamydia trachomatis damages the tissues and body cells (Gottlieb, Xu, & Brunham, 2013). In order to remove the damaged tissues and initial cause of the cell damage, inflammation starts (Brunham, Gottlieb, & Paavonen, 2015). The damaging of the cells inside the body leads to inflammation, severe abdominal pain, menstrual disturbance and even pain during intercourse. According to the case scenario, patient suffers from discomfort and acute pain due to this cellular change.

The illness is originated through unsafe intercourse, without use of contraceptive barrier like condom, early age sex and multiple sex partners. The frequent sex with different partner can provide the opportunity to the pathogens to enter the body. The disease progress when the pathogen travels from vaginal cavity towards upper female genital tract (Gottlieb, Xu, & Brunham, 2013). Pathogen invades the lining cells, alters them and moves upward. In the absence of free oxygen, the organism, which is an anaerobic bacterium, thrives inside resulting in the infection. Infection can also enter in the upper genital organs (Gottlieb, Xu, & Brunham, 2013).

The patient may experience tenderness and abdominal pain. The menstrual disturbance could also be caused, with increase in vaginal discharge. Sometimes the patient may also complain about the changes in foul vaginal smell and color of discharge. The problem of vaginal mucus or pus, which is called as gonorrhea may be noticed. In all the cases of PID, patients report about abdominal pain, discomfort, pain during intercourse, vaginal discharge and inflammation.

Imaging:

Patient has undergone through radiographic treatments for the better understanding of the health condition. In this process practitioners have obtained a number of x-ray plates that includes varieties of properties. X-ray of the abdomen and transvaginal ultrasound was carried out. This was important because patient was complaining about severe abdominal pain. Thus, abdominal x-ray and transvaginal ultrasound could help in understanding the problem inside and to know if there was any injury.

Principles of radiographic technique

The main principles of the radiographic technique includes providing the quality images and carrying out the procedure with high standard of care. It is important to maintain the safe and comfortable environment for the patient. Radiologists must also ensure confidentiality of the information (Medical Imaging Technologists, 2016). While taking the abdominal x-ray and transvaginal ultrasound, it is important to make the patient aware about the complete procedure and gain their concern. Radiographic technique must also assure quality of the treatment and dignity of the patient.

Principles of Radiation Biology

The principles include the knowledge about the ionizing of the radiations. As per proper knowledge of the radiation, patients and others must be protected from the ionizing radiations. The cell injury could be caused if the exposure of the radiation increases. Thus, it should be controlled as per the radiation protection protocol. The quality of the images must be maintained with minimum radiations. The chances of retakes of the images must be minimized (Khaled, & Held, 2012).

This is also important to safeguard individuals from any kind of radiation harm. The safety principles must also limit the exposure of the individual towards radiation (Sherer, Visconti, Ritenour, & Haynes, 2014). The relevant dose of the exposure should not be crossed. Safety and protection of the patient must be optimized, in order to decide the individual dose so that results could be reasonably achieved.

Abdominal x-ray uses the very small dose of the radiation, in order to derive the picture of abdominal cavity. This is very beneficial in diagnosing the unexplained abdominal pain (as in the case of Ms. Z). The limitation of the abdominal x-ray lies, where they could not provide the detailed images as compared to other technology like computed tomography (CT) (Gans, Stoker, & Boermeester, 2012). In the case of pelvic ultrasound, sound waves are used to produce the images of pelvic and lower abdomen (Pelvic Ultrasound Imaging, 2016). The strength of such ultrasound is that they are easily available, less expensive and do not use ionizing radiation. However, it limitation is that it is not an ideal imaging technique, as ultrasound waves could be disrupted by gas and air. Also it is not a good option for the air-filled bowel. No major harmful effect is known for the pelvic ultrasound. The actual reason behind patient’s condition and severe abdominal pain is oophoritis for the right sided ovary. This condition further leads to pelvic inflammatory disease. The role of MIT is also significant for patient’s care, as they understand the condition of the patient. They can help the practitioners and fellow workers to draw essential care strategies. They can also inform the physicians and nursing staff about the complexities that might occur in future, and can assist to develop care plan accordingly.

Future directions and conclusion:

Sexually transmitted infections can be reduced on proper treatment and awareness. There are many factors that help in infection such as viruses. However, this situation falls under Pelvic Inflammatory Diseases and therefore, preference of antibiotics would help in reducing the abdominal pain. Usage of antibiotics is done in treating the initial stages of the disease. In some rare cases, the dosage is provided orally. Imaging helped to understand the current position of the patient’s condition. This could help in deciding the proper medication and future interventions. This could also help the healthcare professionals, to apply proper and effective nursing and healthcare strategies. Imaging is also beneficial in evaluating other associated problems or reproductive system disorders. The real time imaging, like ultrasound is beneficial tool for guiding the minimal invasive procedure (Umar, 2015). In future, if the antibiotics fail to effect and reduce the symptoms, surgical procedures may become necessary. Laparoscopy may be done depending on the current situation, as it can be noted that recurring episodes of this disease may result in scarred fallopian tube and therefore in need for prevention. Having regular gynecological checkups can help in preventing this disease. One of the future directions includes finding prevention for RTI as well. Proper treatment and prevention for cure are the two factors that need to be shed light on. RTI can lead to a complicated medical situation which includes PID. The first step in prevention is to engage in proper counseling and education. Different verbal and nonverbal communications are applied to reach out to the masses. Presentations, meetings, handouts and posters are too presented all over the city for the people to understand the principles and reasons for this disease. Proper laboratory tests can help in reducing RTI. In case of medical procedures, antibiotics and surgery procedures can be applied for total cure. Recommendations based on evidence, self-education tool and an up-to-date source can add to preventive measures. Besides, policies should be improved and trainings should be provided to manage and prevent RTI. The information gathered needs to be adapted and recommended to the hospitals, physicians and clinicians. Patient centered care must be effectively applied.

Conclusion:

Hence, from this assessment, it can be evaluated that, in this case study patient has been suffering from abdominal pain due to the sexually transmitted infections. Proper treatment and diagnosis is required for further implementation of the treatment procedures. Apart from the further consequences from the reproductive tract infection has been also discussed so that preventive measures can be suggested to the patient. Classification of the disease, degree of the disease and its pathological background has also been discussed to obtain the actual identity of the disease. A medical radiation technologist also must follow the guidelines and ethical attributes for the effective treatment. Furthermore, radiographic images have been obtained for the better understanding of the condition, moreover, this measure has also helped for the critical analysis of the abdominal complaints, the patient informed. These images have also incorporated for the assessment of the reproductive tract infections and further consequences of the infection. Recommendations and suggestive measures have also been described here to prevent the further occurrence of the disease. The relevance of this assessment in the context of the professional aspects of a MRT is also maintained here.