Can a nurse obtain informed consent for a CT /MRI scan? - page 3

by KEVIN88GT

17,870 Views | 23 Comments

I overheard a physician saying how they are short staffed and wanted a nurse to obtain informed consent for CT/ MRI scans.... is this legal? From what I know it isnt.... this is in New York if it matters... Read More


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    mike RT thanks for the info...luckily at my facility we require a BUN under 32 or a Creatnine 1.5 or lower which would cover renal impairment... thanks for the info though...
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    Quote from kevin88gt
    mike rt thanks for the info...luckily at my facility we require a bun under 32 or a creatnine 1.5 or lower which would cover renal impairment... thanks for the info though...
    a bun under 32 or a creatnine 1.5 or lower does not cover renal impairment. i've seen a creatnine of 1.1 and after calculating the gfr it was below 50. it depends on the patients age and race. the bun is of no consequence when considering ct contrast.

    a gfr needs to be calculated and needs to be under 60 for ct contrast to be considered renal safe, followed by 80 ounces of caffeine-free fluids the day of and day after the contrast infusion.


    a gfr of 30-60 requires mucomyst x 3 plus a 250 cc 0.45%/sodium bicarb iv infusion pre and post contrast.


    a gfr of less than 30 requires an order from a nephrologist.
    Last edit by DutchgirlRN on Mar 25, '08
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    Quote from mike rt
    http://radiology.rsnajnls.org/cgi/reprint/183/2/519.pdf
    http://ndt.oxfordjournals.org/cgi/reprint/15/3/301.pdf

    if your patients are at risk of contrast induced nepropathy (cin) this article may be of help:
    http://content.nejm.org/cgi/reprint/354/26/2773.pdf

    this is the premedication regime that the radiologists @ my facility use for patients with prior contrast media reactions:
    http://ndt.oxfordjournals.org/cgi/reprint/15/3/301.pdf

    americal college of radiology (acr) guidelines for mri contrast (gadolinium) safety:
    http://www.acr.org/secondarymainmenu...ium-based.aspx

    acr guidelines on iodinated contrast media:
    http://www.acr.org/secondarymainmenu...st_manual.aspx


    i hope this helps - its all about the patient
    mike
    thanks mike! there's always something new to be learned
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    Informed consent is required for essentially any procedure which carries risks of complications unless those complications are minor or extremely rare. While I am not familiar with all state law, I do know that California requires the physician who will be performing the procedure to expain the rationale for the procedure, the risks, benefits and options and must obtain the patient's consent. A nurse may not obtain informed consent because the likihood of risks/benefits and other medical options are outside of nursing scope of practice and the nurse is not the one performing the procedure. While a nurse may be able to explain the procedure, answer questions, etc., it is fundamentally a physician's duty to obtain informed consent (at least in California). This should be distinguished from having a patient sign a piece of paper stating that the risks and benefits have been explained to them and they consent to the procedure (after the physician has already obtained informed consent and documented such consent in the medical record.)


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