- Encounter details:
- Format: performed (supervised)
- Pt. gender: female
- Pt. age: 65 years
- Radiographer initials: K
- Clinical Site: Deakin University
- Unit: 108HTD
- Clinical indications: Chest pain /soreness
- Patient location: General medicines
- Examination (radiographic projections): Chest PA erect
- Exposure (radiographic technique, and EI or equivalent): 1300- 1600
- Reflection:
- ReportingThe patient Mrs. S had a diagnosis of breast cancer around 3 years ago after having lumpectomy and hook wire localization. There was a recurrence of the tumor which led to radical mastectomy, chemotherapy and radiation for her auxiliary lymphatic. Due to the procedures, there was definite scarring along with swelling that led to a restricted movement of her left arm. The chemotherapy also led to exhaustion. The results of the Nuclear Medicine Bone scan indicated hot spots in her ribs and in the thoracic spine. The patient reports shortness of breath and there is a possibility of pathology in the right lung.
- Responding
While interacting with the patient, I felt sad because she had been through immense suffering. Yet again she was diagnosed with a mass in her right lung. She seemed to be a good human being, but her illness was making her less tolerant and cooperative. I chose to treat her the same way I would have treated my loved ones (Watts, Botti and Hunter, 2010).
- Relating
65 yearsThe behavior change in the patient was due to aggressive cancer treatment (Bower, 2008). Behavioral symptoms are one of the most anticipated side effects of breast cancer diagnosis and the treatment. The patients have trouble sleeping, low energy, mood swings and cognition. Appropriate assistance is required to effectively manage the symptoms (Redd, Montgomery and Duhamel, 2001). It was important to get a lateral CRX for the patient so that a clear and precise diagnosis could be made for the presence of a mass in the right lung.
- Reconstructing
As a nurse, I need to be able to sympathize with the feelings that the patient is undergoing while keeping my emotional feelings aside, so that I can do my best in providing help to the patient (Krishnasamy, 1996). This reflection has been enlightening to me as I learnt to deal with cancer patients.
- Clinical Site: As a nurse, I need to be able to sympathize with the feelings that the patient is undergoing while keeping my emotional feelings aside, so that I can do my best in providing help to the patient (Krishnasamy, 1996). This reflection has been enlightening to me as I learnt to deal with cancer patients.
- Image Critique

Projection: Chest PA erect
Side Marker: Superior and Lateral Marker orientation PA on the left side
Collimation: I can see four borders of collimation. Centre: T7 Thoracic vertebra, Shutter A: lung apices. Shutter B: lung fields laterally.
Exposure Index: 100 kVp, 4 mAs. Adequate exposure to visualize the Lungs, Heart and the lung markings. The ribs and thoracic vertebra are visible
Contrast: Well exposed film and clear visibility of the lungs, spine and heart. Pleural vessels are also visible.
Artifacts: There is no abnormal shadow seen on the x-ray because of a degraded image quality
Image quality: Quality is good, well balanced exposure and contrast.
Sharpness: The image has sharpness and provides detailed view.
Positioning: No rotation seen because the medial ends of the clavicles equidistant from the spine
Tilt: No tilt seen as the thoracic inter-vertebral spaces and the inter-vertebral foramina are open.
Functioning state: Optimum