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 minutes Lying still – If contrast medium is used  for iodine & shellfish allergies NPO (4 hrs) Push fluids after procedure watch for S&S of  ICP

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: – Edema – Hemorrhage – Tumors Moved into a tube – Claustrophobia Takes 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 –  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 –  Distal pulses – Bradycardia/hypotension = vagal stim –  for difficulty breathing  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  30  – 45  – Bed rest x 3 hrs –  fluids Bad signs – H/A –  Temp – Stiff neck – Photophobia – Seizures

Electroencephalography (EEG) Description Measures electrical impulses of the brain – brain waves Electrodes applied to the scalp – - 16 Used to diagnosis – Seizures – Coma – Brain death Obtain an baseline – Quiet & dark Stimulation – Flashing lights

Electroencephalography (EEG) Nursing Considerations Duration: 1 hour  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 L 3-4 level Used to – Extract CSF – Relieve  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 –  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  fluids