Examples of Advanced Practices

Category of advanced practiceExamples
Medication managementDeciding when medication needs to be stopped
Deciding when to give medication (adjunct)
Deciding what dose to give
Assessing for contraindications or drug incompatibilities
Administering medications
Responding to adverse reactions (minor and major)
Writing a report after a reaction
Nonmedical cardiac stress testingStanding in when there is no physician in the stress room
Preparing the patient
Taking the lead in cardiac stressing
Being responsible for monitoring the patient
Taking appropriate action if the patient has a problem
Deciding when to administer a radiopharmaceutical
Deciding when to cease a stress test
Responding to cardiac events; deciding when help is required
X-ray imagingRequesting before ventilation–perfusion imaging
Requesting to investigate unexplained hot areas seen on a bone scan
Requesting CT after SPECT to establish
 Precise location (could be low-dose CT)
 Diagnosis (diagnostic-quality or high-dose CT)
Surgical preparations (mark up for surgery)Being involved with nuclear medicine scanning
Identifying the nodes on a scan
Marking skin to suggest where the node is for the surgeon
Formal reports about scansDescribing what is seen
Noting whether there are incidental findings and whether they are clinically significant
Answering the clinical question
 Making a (pathologic) diagnosis or indicating normality
 Suggesting a prognosis based on scan findings
 Suggesting the next step (e.g., further imaging)
Radionuclide therapy sessionsAssessing the clinical presentation
Evaluating information from the diagnostic work-up
Deciding whether the case is suited to radionuclide therapy
Taking a lead role in calculating the dose
Preparing the patient for the dose; including assessment of contraindications
Administering the dose
Assessing the patient for complications
Following up the patient