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Chest X-Ray
Katelynn Jurek
What is a Chest X-Ray?
“To assist in the evaluation of cardiac, respiratory,
and skeletal structure within the lung cavity and
diagnose multiple diseases such as pneumonia and
congestive heart failure” (Nursing Central, 2013,
paragraph 1.) It also “helps diagnose heart failure
and can verify placement of pacemakers and
pulmonary artery catheters” (Smeltzer, Bare, Hinkle
& Cheever, 2010, p.707)
“A chest x-ray is taken by a radiology technologist.
It is then read by a radiologist. A family doctor, an
internist, or a surgeon may review the chest x-ray”
(Healthwise Staff, 2013, paragraph 1)
The patient will stand with their front against an xray plate for the pictures. But they may be able to sit
or lie down if necessary. It is important to remain
still and the patient will be asked to take a deep
breath and hold it for a few seconds. Most hospitals
have portable x-ray machines and it will be done at
the bedside. The x-ray typically takes between 5-15
minutes (Healthwise staff).
To provide a clearer picture the patient may need to
undress, everything but their underwear, and put on
a gown. (Healthwise staff).
Two views are usually taken. From the back
(posterioanterior projection) and one from the side
(lateral projection) of the body. Other positions may
be necessary (Healthwise staff).
Nurses Role
Normal findings: Normal lung fields, cardiac
size, mediastinal structures, thoracic spine,
Positively identify patient
Inform patient about procedure
Obtain history including allergies
Remove all metallic objects
No food, drink, or medication restrictions
Provide modesty for patients with cultural issues
Reinforce information regarding the results of the
Identify if patient is pregnant
ribs and diaphragm.
Critical findings: Foreign body, malposition of
tube, line or device, pneumonia, spine fracture,
pneumothorax, pneumoperitoneum (Nursing
Central, 2013).
(Nursing Central, 2013)
Chest X-Ray
Current Research
In the article “Routine chest x-rays in intensive care
units: a systematic review and meta-analysis” the
researchers reviewed studies from 1948 to 2011 to
investigate any clinical changes in critically ill adults
and children that received routine daily chest x-rays
and those that had restrictive chest x-rays. Nine
Interfering factors: Pregnancy, metallic objects in
field, improper adjustment of equipment with obese
and thin patients, incorrect positioning, and inability
of patient cooperation because of age, pain or
mental status.
paralyzed patients, working with children, and the
elderly. Also, religious and cultural beliefs that are
concerned with modesty (Nursing Central, 2013).
studies were included with a total of 9,611 patients
and 39,358 chest x-rays. In the conclusion of the
article the analysis did not show any harm with the
restrictive chest x-ray strategy. But this study could not
make the determination that using the restrictive
strategy would be as safe as using the routine tests.
The confidence intervals were wide and harm could
not be assessed (Ganapathy, Adhikari, Spiegelman &
Scales, 2012).
NCLEX Questions
1. When instructing the patient who is having a
chest x-ray, all should be included except
a. The test will take between 5-15 minutes
b. All metal objects must be removed
c. No medications may be given prior to x-ray
Ganapathy, A., Adhikari, N., Spiegelman, J., & Scales,
D. (2012). Routine chest x-rays in intensive care units: a
systematic review and meta-analysis. Critical Care,
16(2), doi: 10.1186/cc11321
d. Take deep breath and hold during image and
exhale after image is taken
Smeltzer, S. C., Bare, B. G., Hinkle, J. L., & Cheever, K.
H. (2010). Medical-surgical nursing. (12 ed., Vol. 1, p.
707). Philadelphia, PA: Lippincott Williams and
2. Which one of these is not considered part of
a nurse’s role for a patient that is having/had a
chest x-ray?
Healthwise Staff. (2013, January 16). Chest x-ray: How
it is done. Retrieved from
a. Identify if patient is pregnant or possibility
b. Inform patient about the results of x-ray
c. Identify patient
Nursing Central. (2013). Chest x-ray. Unbound
Medicine. Retrieved from mobile application.
Answers: 1. C Nursing central
2. b nursing central
d. Obtain history including allergies