DIAGNOSTIC PROCEDURESInvasive- entrance into a body cavity

Non-invasive

PROCEDUREDESCRIPTIONNURSING RESPONSIBILITIES

ELECTROCARDIOGRAM (ECG, EKG)-graphical recording of the electrical activities of the heart.

-it indicates alterations in myocardial oxygenation.

-first diagnostic test done when cardiovascular disorder is suspected-5 to 10 minutes

-done by HCPs, interpreted by doctors-electrodes will be placed in the arm, legs and chest*electrodes-are capable of conducting electrical activities from the heart to the ECG

-used to determine:

Abnormal cardiac rhythm

Coronary heart disease

MI Explain the procedure Inform the client that the procedure is painless and that the patient will not experience electrocution or a shock

Remove all jewelry from the neck, arms and wrist

Expose only the extremities, wrists and legs

Shave, trim or clip parts with excessive hair

Ask the client to relax, lie very still, breathe normally and avoid talking

ECHOCARDIOGRAM (Ultrasound cardiography)-uses ultrasound to assess cardiac structure and mobility

-painless

-30 to 60 minutes

-no special preparation is required Explain

Ask the client to be in a supine position, slightly turned to the left side with HOB elevated to 15 to 20 degrees

ELECTROENCEPHALOGRAM (EEG)-graphical recording of spontaneous electrical impulses of the brain from scalp electrodes

- test that measures and records the electrical activity of your brain.-used to detect surface lesions/tumors

- An EEG takes 1 to 2 hours.

-There is no pain with an electroencephalogram (EEG).

- An electroencephalogram (EEG) is a very safe test.USES:

Diagnose epilepsy and see what type of seizures are occurring. EEG is the most useful and important test in confirming a diagnosis of epilepsy.

Check for problems with loss of consciousness or dementia.

Help find out a person's chance of recovery after a change in consciousness.

Find out if a person who is in a coma is brain-dead.

Study sleep disorders, such as narcolepsy.

Watch brain activity while a person is receiving general anesthesia during brain surgery.

Help find out if a person has a physical problem (problems in the brain, spinal cord, or nervous system) or a mental health problem.

Explain

Hair shampoo to remove oils/sprays

No caffeine and other stimulants, anticonvulsants for at least 24 hours before the procedure

Instruct patient not put any hair conditioner or oil on after shampooing. Instruct client to shampoo your hair and rinse with clear water the evening before or the morning of the test Wash hair after the procedure to remove EEG paste

ROENTOLOGIC STUDIES CHEST XRAY-X-ray visualization of the chest

- most commonly performed diagnostic x-ray examination

- noninvasive medical test that helps physicians diagnose and treat medical conditions.

- A chest x-ray requires no special preparation

-Patients who cannot stand may be positioned lying down on a table for chest x-rays.

-The chest x-ray examination is usually completed within 15 minutes.

USES:

A chest x-ray is typically the first imaging test used to help diagnose symptoms such as:

shortness of breath

a bad or persistent cough

chest pain or injury

fever.

Physicians use the examination to help diagnose or monitor treatment for conditions such as:

pneumonia heart failure and other heart problems

emphysema lung cancer other medical conditions.

Explain

Instruct the remove some or all of your clothes and to wear a gown during the exam. You may also be asked to remove jewelry, eye glasses and any metal objects or clothing that might interfere with the x-ray images Ask client to don on a hospital gown Practice the client on how to hold his breath and to do deep breathing

Ask whether the client is pregnant- contraindicated (may have teratogenic effects)

Nurse should wear lead shield if he/she will accompany the client in the x-ray room

Positioning depends on the condition of the client (standing, sitting or supine)

KIDNEY, URETER, BLADDER (KUB)-x-ray visualization of the kidney, ureters and bladder

- Purpose

To very roughly evaluate the structure, size, and position of the kidneys.

To detect abnormalities such as kidney stones, tumors, or other obstructions.

- This test uses standard X-ray technology to obtain pictures of internal organs.

- No contrast dye is used when the KUB is done alone. Usually, however, it is done in conjunction with an intravenous pyelography (see below).

-Client will lie on his stomach on a table with the X-ray equipment positioned above you. Explain, Inform

Assure the client that the procedure is painless

Bowel preparation to prevent gas/feces interference with visualization (laxative as ordered) Ask client to don on a hospital gown

Instruct client to remain still in a specific position while the X-rays are taken.

MAMMOGRAPHY-is a safe, low-dose x-ray of the breast.

-most effective tool for detecting breast cancer early.

- during examination, the woman's breast will be flattened between the two plates of the X-ray machine for a few seconds. Some women may find this uncomfortable of painful.- should not be done for the week before your period if your breasts are usually tender during this time. Explain, Inform Instruct client to avoid using deodorant, powder/ointment, perfume on the day of the exam

Inform the client that the procedure may be uncomfortable and painful

Ask client to inform his/her doctor of any prior surgeries, hormone use, and family or personal history of breast cancer. (These can appear on the mammogram as calcium spots.) Encourage client to describe any breast symptoms or problems to the technologist performing the exam. If possible, obtain prior mammograms and make them available to the radiologist at the time of the current exam.

SKULL X-RAY-x-ray of the skull

-used to determine location of:

Intracranial calcification (deposition/accumulation of calcium salts in the tissues)

Tumors

Abscess Explain, Inform Assure the client that the procedure is painless

Remove metallic items from hair

CT SCAN- is an X-ray technique that produces images of your body that visualize internal structures in cross section rather than the overlapping images typically produced by conventional X-ray exams.

- CT scans use an X-ray unit that rotates around your body and a powerful computer.

-The result with CT scans is a set of cross-sectional images, like slices, of the inside of your body.

-USES:

Diagnose muscle and bone disorders, such as bone tumors and fractures

Pinpoint the location of a tumor, infection or blood clot

Guide procedures such as surgery, biopsy and radiation therapy

Detect and monitor diseases such as cancer or heart disease

Detect internal injuries and internal bleeding

- CT scans can be done even if you have a pacemaker or an internal cardioverter defibrillator (devices implanted in your chest to help regulate your heartbeat).- How you prepare for a CT scan depends on which part of your body is being scanned.

- During a CT scan, client will lie on a table inside a doughnut-shaped machine called a gantry. Instruct client to inform his/her doctor if:

You're pregnant. If you're pregnant, your doctor may recommend another type of exam to reduce the possible risk of exposing your fetus to radiation.

You have asthma or allergies. If you have had a prior reaction to contrast media or have asthma or allergies, there's an increased risk of a reaction to the contrast medium.

You have certain medical conditions. Diabetes, asthma, heart disease, kidney problems or certain thyroid conditions may increase your risk of a reaction to contrast media

Ask client to remove your his/her clothing and wear a hospital gown.

Remove any metal objects, such as jewelry, that might interfere with image results.

If test involves a contrast medium, instruct clientto fast for a few hours before the test.

Depending on the part of your body being scanned, instruct client to take laxatives, enemas or suppositories as ordered, or temporarily modify your diet.

Barium Swallow

(Esophagography, Esophagogram)

-is a radiographic (x-ray) examination of the upper gastrointestinal (GI) tract, specifically the pharynx (back of mouth and throat) and the esophagus (hollow tube of muscle extending from below the tongue to the stomach).- Barium is a dry, white, chalky, metallic powder that is mixed with water to make a thick, milkshake-like drink. Barium is an x-ray absorber and appears white on x-ray film. When swallowed, a barium drink coats the inside walls of the pharynx and esophagus so that the swallowing motion, inside wall lining, and size and shape of these organs is visible on x-ray.- Reasons for the Procedure

A barium swallow may be performed to diagnose structural or functional abnormalities of the pharynx and esophagus. These abnormalities may include, but are not limited to, the following:

cancers of the head, neck, pharynx, and esophagus

tumors

hiatal hernia - upward movement of the stomach, either into or alongside the esophagus

structural problems, such as diverticula, strictures, or polyps (growths)

esophageal varices (enlarged veins)

muscle disorders (pharyngeal or esophageal), such as dysphagia (difficulty swallowing) or spasms (pharyngeal or esophageal)

achalasia - the lower esophageal sphincter muscle does not relax and allow food to pass into the stomach

gastroesophageal reflux disease (GERD) and ulcers-The barium swallow procedure may take about 30 minutes to finish. In certain cases, it may take up to 60 minutes to fill the stomach.

Explain the procedure. Offer opportunity to ask any questions .

Informed consent

Instruct client to fast for eight hours before the procedure, generally after midnight.

Instruct client to inform her physician is shes pregnant or suspect that she may be pregnant.

Ask client to notify physician if she sensitive to or are allergic to any medications, latex, tape, and anesthetic agents (local and general).

Ask client to notify physician of all medications (prescribed and over-the-counter) and herbal supplements that she is taking. The physician may advise to withhold certain medications prior to the procedure.

Advise client to drink plenty of fluids and eat foods high in fiber to expel the barium from the body. (Barium may cause constipation or possible impaction after the procedure if it is not completely eliminated from your body. )

Administer cathartic or laxative to help expel the barium as ordered.

Encourage patient to notify physician to report any of the following:

difficulty with bowel movements or inability to have a bowel movement

pain and/or distention of the abdomen

stools that are smaller in diameter than normal

Barium Enema

or lower gastrointestinal (GI) examination

-is an X-ray examination of the large intestine (colon and rectum).

-The test is used to help diagnose diseases and other problems that affect the large intestine. -A barium enema is done to:

Screen for colon polyps or colon cancer. Most medical experts recommend colon cancer screening beginning at age 50 for people who do not have an increased risk of colon cancer. Earlier screening is recommended for people who have an increased risk of colon cancer, such as those with a family history of colon cancer.

Identify inflammation of the intestinal wall that occurs in inflammatory bowel diseases, such as ulcerative colitis or Crohn's disease. A barium enema also may be used to monitor the progress of these diseases.

Detect problems with the structure of the large intestine, such as narrowed areas (strictures) or pockets or sacs (diverticula) in the intestinal wall.

Help correct a condition called ileocolic intussusception, in which the end of a child's small intestine protrudes into the large intestine.

Evaluate abdominal symptoms such as altered bowel habits, anemia, or unexplained weight loss.