Diagnostic testing

After procedure

1. Check IV patency 2. Reconnect lines 3. Hold metformin for 48 hours

Before CT

1. Explain procedure 2. If contrast: kidney function value, formal consent (its invasive), If PO contrast for GI- 2 hours prior, call the radiologist that the patient can be tested in 2 hours

Before MRI

1. Explain the purpose 2. Ask metal in the body?- then consent form 3. If contrast- consent form 4. Fax to MRI 5. Ask if claustrophobic- if so, med 6. Disconnect any IV line

Patient education for CT

1. Important not to move during the test 2. Warm sensation during IV contrast 3. Notify when okay to resume metformin

Before X-Ray

1. Inform patient 2. Ask if pregnant 3. Answer questions 4. Informal consent (no signature) 5. Empty bladder

MRI

1. More detailed pictures than CT and X-ray 2. uses magnetic resonance

Patient education for MRI

1. No metal 2. If contrast used- withhold metformin for 48 hours

After MRI

1. Transfer patient 2. Check IV patency- flush

MR angiography

1. Uses magnetic field to realign the hydrogen atom and use radio waves to cause them create images 2. High resolution imaging 3. Gadolinium contrast

Before CT & MRI angiography

1. check kidney function (BUN and creatinine) 2. Allergy to contrast 3. MRI form- ask about the metal exposure 4. Contrast consent 5. Disconnect lines

CT angiography

1. uses radiation that bounces off the tissue to create 3D view of the body 2. cross sectional image 3. Iodinated contrast

A client is scheduled for an MRI today with PO contrast. The nurse knows that the client should drink the contrast at which of the following times?

2 hours prior to MRI This allows time for the contrast to move through the body.

A client is scheduled for a pre-operative CT scan to better visualize gastric cancer. Which of the following is a priority nursing assessment prior to this exam?

Assess any allergies to contrast, IV dye, or iodine A pre-operative CT scan would require contrast, and therefore assessing for an allergy to that dye is crucial. Because the dye is made with iodine, assessing for an allergy to iodine and/or shellfish is also important.

A nurse is reviewing the allergy list for a client who is scheduled to receive a CT scan with intravenous contrast dye. Which of the following allergies would alert the nurse to a problem?

Seafood The intravenous dye is typically made of an iodine compound, therefore all clients who are receiving intravenous contrast dye should be screened for allergies to both iodine and seafood. Seafood should be screened because most fish and shellfish contain significant amounts of iodine - therefore a seafood allergy could indicate an iodine allergy

The client has a CT scan with IV contrast ordered. The nurse reviews the client's allergies and notes the client is allergic to peanuts, penicillin, and sulfa drugs. What should the nurse do next?

Send the client to CT because the allergies listed don't contraindicate getting IV contrast The client's allergies are not contraindicated for IV contrast. Shellfish and iodine allergies would mean that IV contrast is contraindicated.

A nurse is caring for a client who needs an MRI for a back injury. The client is deaf. The nurse has provided written information for the client but needs to find out if there are any questions. In which way would the nurse most likely act as the client's advocate?

Call an interpreter to talk to the client Deafness, like other language barriers, requires an interpreter to communicate between the nurse and the client. The nurse should determine if the client understands American Sign Language and should provide an interpreter.

A nurse is caring for a diabetic client who uses an insulin pump. The client is in the hospital for diagnostic testing of kidney disease and the provider has ordered an MRI. Which action of the nurse is most appropriate?

Check the client's blood glucose and remove the insulin pump just before the MRI An insulin pump is a device that can provide insulin at a regular rate without requiring frequent injections. It is a small device about the size of a deck of cards and it sends insulin into a catheter under the skin. The pump is affected by strong magnetic fields, and so it must be taken off in some situations, such as with certain diagnostic tests. In this case, the nurse should remove the pump just before sending the client for an MRI.

A client with pulmonary edema is going for a CT. When the client lays flat, she turns blue and is gasping for air. Which of the following is the priority for this client?

Sit the client up Sitting the client up will help move fluid back to the bases of the lungs and allow for the upper alveoli to open up to allow air exchange

CT & MR angiography

Diagnose disease in vessels, both use contrast

The nurse is caring for a client after surgery. The client's lung sounds are clear on the left and soft, distant crackles on the right side. The nurse reviews the image above on the morning chest x-ray. Which intervention would be most appropriate for this client?

Encourage incentive spirometer This image shows atelectasis in the right lung. Atelectasis is the collapse or closure of a the alveoli in the lungs resulting in reduced or absent gas exchange. It may affect part or all of a lung. On an x-ray, good air movement is black. Collapse, atelectasis, and fluid show up white. Atelectasis is common after surgery due to shallow breathing. The best intervention to promote lung expansion and prevent/improve atelectasis is incentive spirometry.

A nurse is caring for a client undergoing an MRI (Magnetic Resonance Imaging) scan. What is the priority nursing action prior to this scan?

Ensure client has no metal in or on their body Magnetic Resonance Imaging utilizes a large, very strong magnet. If a client has metal in or on their body, this could cause injury.

The nurse is treating a child who sustained a fall. An x-ray shows that the child's bone has been angulated beyond the limit, causing a compression in the bent side of the bone, and a slight break to the tension side of the bone. Which of the following fractures does the nurse suspect?

Greenstick fracture A greenstick fracture describes a bone fracture that resembles a green stick when it breaks. There is only a break through a part of the bone, as the bone was bent just barely beyond the limits. It is usually a closed fracture.

After CT

Not metformin after contrast for 48 hours- it may damage the kidney

If MRI

Pull out all the meals from the room, IV poles, wheel chairs,

A nurse is preparing a client for an x-ray of the nose for a possible fracture. The nurse knows the client will need which of the following?

Remove earrings Especially with facial x-rays, any metal such as earrings/piercings should be removed as this can cause metallic artifacts in the radiographic images and are of concern.

A healthcare provider orders a cat scan of a client, requesting all sagittal views. How would the nurse expect to see the images divide?

Right and left sides The sagittal plane divides the body into right and left sides, therefore this answer is correct.

A client arrives in the emergency room with rib fractures. The nurse and healthcare provider are reviewing the x-ray and would be most concerned about rib fractures in which of the following locations?

Right side, ribs 1 & 2 This location has the highest concern for the possibility of concurrent injuries. The significance of a first rib fracture is the association with cervical spine trauma, multiple rib fractures or life-threatening vascular injuries. Historically, fractures of ribs 1-3 have been associated with injuries of the brachial plexus and major vessels.

The term cineangiography refers to which of the following?

The process of taking pictures as dye moves through blood vessels Cineangiography is a radiographic technique that allows the practitioner to view the blood vessels. The procedure involves injecting dye into circulation and then taking multiple pictures as the dye moves through the blood vessels.