nursing laboratory and diagnostic tests demystified: part 2

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(bq) part 2 book “nursing laboratory and diagnostic tests demystified” has contents: computed tomography scan, magnetic resonance imaging and positron emission tomography scan, ultrasound scan, cardiovascular tests and procedures , female and maternity tests and procedures,… and other contents.

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chapte r<br /> <br /> 12<br /> <br /> Computed<br /> Tomography Scan<br /> L EARNING OB JE C TIVES<br /> 1 <br /> <br /> Full-Body CT Scan<br /> <br /> 2 <br /> <br /> CT Scan of the Head<br /> <br /> 3 <br /> <br /> CT Scan of the Spine<br /> <br /> 303<br /> <br /> Keogh _CH12_p303-316.indd 303<br /> <br /> 08/04/17 1:21 PM<br /> <br /> 304<br /> <br /> N U R S I N G L A B O R ATO R Y A N D D I A G N O S T I C T E S T S DeMYS TiFieD<br /> <br /> KEY WORDS<br /> Computed tomography<br /> Contrast material<br /> CT myelogram<br /> Intrathecal space<br /> Intrathecally<br /> Intravenous pyelogram<br /> <br /> Iodine dye<br /> Kidneys, ureters, and bladder (KUB)<br /> Positron emission tomograph (PET)<br /> Shellfish allergy<br /> Temporomandibular disorder<br /> <br /> A computed tomography (CT, CAT) scan is a radiology imaging test that creates detailed images of structures within the body using a doughnut-shaped<br /> X-ray machine. The patient lies within the doughnut-shaped scanner and an<br /> X-ray beam rotates around him/her creating an image that represents a thin<br /> slice of him/her. Each rotation takes less than 1 second.<br /> All sliced images are stored on a computer. The computer is used to reassemble sliced images of the patient enabling the healthcare provider to identify<br /> any abnormalities. Typically, the healthcare provider will print the image of<br /> any slices that indicate an abnormality, which is then saved with the patient’s<br /> chart.<br /> The patient may be administered contrast material such as iodine dye. The<br /> contrast material makes structures within the patient’s body stand out on the<br /> computer by differentiating them with white, black, and shades of gray. Contrast material is administered intravenously or into joints or cavities of the<br /> body. The patient may also be asked to ingest other kinds of contrast material.<br /> A CT scan may be used for staging cancer to assess if the cancer has spread<br /> to other sites in the body. CT scans are also used to identify masses or tumors,<br /> as well as fluid and the infection process. CT scans guide the healthcare provider when performing a procedure such as a biopsy.<br /> You will learn about different types of CT scans in this chapter.<br /> <br /> 1.  Full-Body CT Scan<br /> A full-body CT scan creates an image of the patient’s entire body. A healthcare<br /> provider orders a full-body CT scan if it is suspected that the patient may have<br /> disorders throughout the body and the healthcare provider is unable to narrow<br /> the disorder to specific areas of the body. This situation may occur if the patient<br /> is involved in a severe motor vehicle accident.<br /> <br /> Keogh _CH12_p303-316.indd 304<br /> <br /> 08/04/17 1:21 PM<br /> <br /> Chapter 12 C o m p u t e d T o m o g r a p h y S c a n<br /> <br /> 305<br /> <br /> NURS I NG A L E RT<br /> Typically, a healthcare provider orders a CT scan for a specific part of the body<br /> rather than ordering a full-body scan. A full CT scan is time consuming and usually<br /> provides more than enough information necessary for the healthcare provider to<br /> diagnose the patient’s disorder. Some healthcare providers feel that a full-body<br /> scan identifies benign growths and other disorders that do not adversely affect<br /> the patient but could lead to additional tests and surgery that are unnecessary.<br /> <br /> The result of a CT scan is commonly compared with the results of a positron<br /> emission tomograph (PET) to identify cancer.<br /> <br /> NURS I NG A L E RT<br /> Determine if the patient is allergic to shellfish or iodine. Contrast material may<br /> contain iodine and other substances that could cause the patient to have an allergic reaction. Also determine if the patient will be administered a sedative to relax<br /> her/him during the CT scan. If so, make sure that the patient does not drive any<br /> vehicle following the CT scan until the sedative has worn off.<br /> <br /> What Is Being Examined?<br /> • Head<br /> • Thorax<br /> • Abdomen<br /> • Kidneys, ureters, and bladder (KUB)<br /> • Intravenous pyelogram for urinary tract blockage<br /> • Liver<br /> • Pancreas<br /> • Bile ducts<br /> • Gallbladder<br /> • Adrenal glands<br /> • Spleen<br /> • Pelvis (ovaries, fallopian tubes, uterus, prostate gland)<br /> • Extremities<br /> <br /> Keogh _CH12_p303-316.indd 305<br /> <br /> 08/04/17 1:21 PM<br /> <br /> 306<br /> <br /> N U R S I N G L A B O R ATO R Y A N D D I A G N O S T I C T E S T S DeMYS TiFieD<br /> <br /> How Is the Test Performed?<br /> • Depending on the nature of the CT scan, the patient may be administered<br /> an enema or asked not to eat after midnight prior to the CT scan.<br /> • If contrast material is required for the test, then the patient is administered the contrast material before the test. The method for administering<br /> the contrast material depends on the nature of the CT scan.<br /> • Approximately 40 minutes before the test, the patient may be asked to<br /> ingest contrast material.<br /> • Contrast material may be administered in a vein or in a cavity, such as<br /> the bladder or rectum, immediately before the test.<br /> • The patient removes jewelry and clothes and is given a gown to wear<br /> during the test.<br /> • The patient lies on the CT scanner table.<br /> • The patient must lie still during the test.<br /> • The patient will be in the CT room alone.<br /> • The CT scan technician is in the next room observing through a window.<br /> • The patient and the CT scan technician are able to converse during the test<br /> using an intercom.<br /> • The CT scanner table moves into the opening of the CT scanner.<br /> • The CT scanner moves around the patient when taking images of<br /> him/her.<br /> • The patient hears a clicking sound as the CT scanner moves.<br /> • The CT scan can take up to 2 hours.<br /> • A radiologist, who is a medical doctor, interprets the results of the CT<br /> scan and writes a report that is given to the patient’s healthcare provider.<br /> • The patient is asked to drink large amounts of water and other fluids for<br /> 24 hours following the CT scan to flush the contrast material from the<br /> body.<br /> <br /> Rationale for the Test<br /> • Assess for<br /> • Growths<br /> • Obstructions<br /> • Inflammation or infection<br /> <br /> Keogh _CH12_p303-316.indd 306<br /> <br /> 08/04/17 1:21 PM<br /> <br /> Chapter 12 C o m p u t e d T o m o g r a p h y S c a n<br /> <br /> 307<br /> <br /> • Foreign objects<br /> • Bleeding<br /> • Fluid collection<br /> • Pulmonary embolism<br /> <br /> Nursing Implications<br /> • Assess if the patient<br /> • Has allergies (shellfish, iodine).<br /> • Is breast-feeding since contrast material can pass to the baby in<br /> breast milk. The patient should give formula to the baby instead of<br /> breast milk for 2 days following the CT scan if contrast material is<br /> administered.<br /> • Has heart disorder, asthma, thyroid or kidney disorders, or diabetes.<br /> • Takes Glucophage.<br /> • Has taken Pepto-Bismol 4 days prior to the CT scan.<br /> • Determine if the patient<br /> • Is claustrophobic<br /> • Can lie still during the test<br /> <br /> Understanding the Results<br /> • The results are available within 2 days.<br /> • Normal test results indicate<br /> • Normal size of organs and blood vessels<br /> • No blockages<br /> • No bleeding<br /> • No abnormal fluid collection<br /> • No growths<br /> • No inflammation<br /> • Abnormal test results indicate<br /> • Abnormal size of organs and blood vessels<br /> • Blockages<br /> • Bleeding<br /> <br /> Keogh _CH12_p303-316.indd 307<br /> <br /> 08/04/17 1:21 PM<br /> <br />



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