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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
