Transcript Day 2 - Porterville College

Day 2
Diagnostic Tests
Computer Tomography Scan - CT
•
Description
–
–
X-rays  computer
generated 3-D picture
Distinguishes tissue
density
•
–
–
–
Tumors
Machine moves around
still patient
Non-invasive & painless
With or without
contrast medium
Computer Tomography Scan - CT
• Nursing Considerations
– Explain procedure
• 30-60 minutes
• Lying still
– If contrast medium is
used
• P for iodine & shellfish
allergies
• NPO (4 hrs)
• Push fluids after
procedure
• watch for S&S of hICP
Positron Emission Tomography (PET)
Description
•
Computerized nuclear
imaging  actual organ
functioning
•
Via radioactive
substances
•
Used to ID:
–
–
Blood supply
Metabolic activity
•
glucose
Positron Emission Tomography (PET)
Nursing Considerations
• Teach inhalation technique &
warn about unusual sensation
that might occur
– Dizziness
– Lightheadedness
– Headaches
• Pre-op
– No caffeine
– No smoke
– NPO
• Post-op
– Push fluids
Magnetic Resonance Imaging
MRI
Description
•
Magnetic field + radio
waves
•
Used to ID:
–
–
–
•
Moved into a tube
–
•
•
•
Edema
Hemorrhage
Tumors
Claustrophobia
Takes 45-60 min
Lay flat & motionless
Noisy
Magnetic Resonance Imaging
MRI
Nursing Considerations
• Remove all metal
–
–
–
–
–
Aneurysm clips
Orthopedic hardware
Pacemakers
Heart valves
Intrauterine devices
(IUD’s)
– Cochlear implants
– Watches, credit cards,
metal
• Relaxation techniques
Cerebral angiography
Description
•
X-ray of cerebral
circulation with contrast
agent
•
Used to ID
–
–
•
Vascular disease
Aneurysms
Tread catheter
–
–
–
Femoral artery 
Aortic arch 
Carotid artery 
Cerebral angiography
Nursing Considerations
• Pre-op
–
–
–
–
Well hydrated
Mark peripheral pulses
P for iodine allergies
contrast medium injected
 feeling of warmth
Cerebral angiography
Nursing Considerations
• Post-procedure
–
–
–
–
–
–
Sand bag leg
Bed rest over night
VS and neuro checks
Observe puncture site
P Distal pulses
Bradycardia/hypotension
= vagal stim
– P for difficulty breathing
• h ICP
– Monitor LOC
Myelography
Description
• X-ray of the spinal
sub-Arachnoid space
• Injection of contrast
medium
• via lumbar puncture
Myelography
Nursing Considerations
• Explain
• NPO
• Post-procedure
– Lie HOB h 30 o – 45 o
– Bed rest x 3 hrs
– h fluids
• Bad signs
– H/A
– h Temp
– Stiff neck
– Photophobia
– Seizures
Electroencephalography (EEG)
Description
•
Measures electrical impulses
of the brain
–
•
Electrodes applied to the
scalp
–
•
Seizures
Coma
Brain death
Obtain an baseline
–
•
- 16
Used to diagnosis
–
–
–
•
brain waves
Quiet & dark
Stimulation
–
Flashing lights
Electroencephalography (EEG)
Nursing Considerations
• Duration: 1 hour
• h seizures
– sleep deprivation
• No anti seizure meds,
tranquilizers, stimulants,
depressants
• No caffeine
• OK to eat
Electromyography
Description
•
Needle electrodes put
into skeletal muscles
•
Measure changes in
electrical potential of the
muscle.
•
Used to diagnose
–
Neuromuscular
disorders
Electromyography
Nursing Considerations
• Explain
– not going to be
electrocuted
• Needle, like a IM
injection
• Muscles may ache
Lumbar Puncture
Description
•
Puncture of lumbar
Subarachnoid space
•
@ L 3-4 level
•
Used to
–
–
–
–
Extract CSF
Relieve h ICP
Test Spinal fluid
pressure
Introduce
•
•
•
antibiotics
radiopaque dyes
anesthesia
Lumbar Puncture
Nursing Considerations
• Pre-procedure
– Side lying with legs
pulled close to chin
– Do not move
– Painful – pressure
– Shooting pain down
leg
– 10 minutes
Lumbar Puncture
• Post-procedure
– Bed rest
– h Fluid (unless…)
– Observe for side
effects
Lumbar Puncture
• Post-puncture headaches
– Duration
• Hrs to days
– Cause
• Unknown
– Tx. / prevention
•
•
•
•
Bed rest
Quiet dark room
Analgesics
h fluids