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Day 2
Diagnostic Tests
Computer Tomography Scan - CT
 Description
 X-rays  computer
generated 3-D picture
 Distinguishes tissue
density
 Tum...
Computer Tomography Scan - CT
 Nursing Considerations
 Explain procedure
 30-60 minutes
 Lying still
 If contrast med...
Computer Tomography Scan - CT
Computer Tomography Scan - CT
 Brain abscess  Blood flow after pTA
Computer Tomography Scan - CT
 Area of brain not
getting blood flow
Computer Tomography Scan - CT
5 month old
meningitis
Computer Tomography Scan - CT
Positron Emission Tomography
(PET)
Description
 Computerized nuclear
imaging  actual
organ functioning
 Via radioactive...
Positron Emission Tomography
(PET)
Nursing Considerations
 Teach inhalation technique &
warn about unusual
sensation that...
 Blood flow and glucose uptake are measured by PET in order to identify seizure sites in the brain. In 80% of
patients th...
 Patients have a higher
than normal blood flow
to the basal ganglia on
the opposite side to the
effected limbs. L-dopa
re...
 PET scans show in patients
with mild Alzheimer's and in
more advanced cases
glucose metabolism is
reduced in both the te...
Magnetic Resonance Imaging
MRI
Description
 Magnetic field + radio
waves
 Used to ID:
 Edema
 Hemorrhage
 Tumors
 Mo...
Magnetic Resonance Imaging
MRI
Nursing Considerations
 Remove all metal
 Aneurysm clips
 Orthopedic hardware
 Pacemake...
 CT scan  MRI
 Eye CA  Pineal CA
 Aneurysm
 28yrs old Female smoker
 Aneurysm
 28yrs old Female smoker
 Brain CA  Brain CA
Brain Abscess
 Note herniation
Cerebral angiography
Description
 X-ray of cerebral
circulation with
contrast agent
 Used to ID
 Vascular disease
 Ane...
Cerebral angiography
Nursing Considerations
 Pre-op
 Well hydrated
 Mark peripheral pulses
  for iodine allergies
 c...
Cerebral angiography
Nursing Considerations
 Post-procedure
 Sand bag leg
 Bed rest over night
 VS and neuro checks
 ...
 MRI
 28yo female
 Angiography
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  30 ο
– 45 ο
 Bed rest x 3 hrs
  fluids
...
Electroencephalography (EEG)
Description
 Measures electrical
impulses of the brain
 brain waves
 Electrodes applied to...
Electroencephalography (EEG)
Nursing Considerations
 Duration: 1 hour
  seizures
 sleep deprivation
 No anti seizure ...
 Normal
 Petite Mal  Generalized Seizure
Electromyography
Description
 Needle electrodes put
into skeletal muscles
 Measure changes in
electrical potential of
th...
Electromyography
Nursing Considerations
 Explain
 not going to be
electrocuted
 Needle, like a IM
injection
 Muscles m...
Lumbar Puncture
Description
 Puncture of lumbar
Subarachnoid space
 @ L 3-4 level
 Used to
 Extract CSF
 Relieve  IC...
Lumbar Puncture
Nursing Considerations
 Pre-procedure
 Side lying with legs
pulled close to chin
 Do not move
 Painful...
Lumbar Puncture
 Post-procedure
 Bed rest
  Fluid (unless…)
 Observe for side
effects
Lumbar Puncture
 Post-puncture
headaches
 Duration
 Hrs to days
 Cause
 Unknown
 Tx. / prevention
 Bed rest
 Quiet...
Day 2 Diagnostic Tests Computer Tomography Scan - CT
Day 2 Diagnostic Tests Computer Tomography Scan - CT
Day 2 Diagnostic Tests Computer Tomography Scan - CT
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Day 2 Diagnostic Tests Computer Tomography Scan - CT

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Day 2 Diagnostic Tests Computer Tomography Scan - CT

  1. 1. Day 2 Diagnostic Tests
  2. 2. 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
  3. 3. Computer Tomography Scan - CT  Nursing Considerations  Explain procedure  30-60 minutes  Lying still  If contrast medium is used   for iodine & shellfish allergies  NPO (4 hrs)  Push fluids after procedure  watch for S&S of ICP
  4. 4. Computer Tomography Scan - CT
  5. 5. Computer Tomography Scan - CT  Brain abscess  Blood flow after pTA
  6. 6. Computer Tomography Scan - CT  Area of brain not getting blood flow
  7. 7. Computer Tomography Scan - CT 5 month old meningitis
  8. 8. Computer Tomography Scan - CT
  9. 9. Positron Emission Tomography (PET) Description  Computerized nuclear imaging  actual organ functioning  Via radioactive substances  Used to ID:  Blood supply  Metabolic activity  glucose
  10. 10. 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
  11. 11.  Blood flow and glucose uptake are measured by PET in order to identify seizure sites in the brain. In 80% of patients there is an increase in blood flow and glucose metabolism during a seizure in the cerebral cortex. However, between seizure there tends to be a lower than normal glucose uptake and blood flow
  12. 12.  Patients have a higher than normal blood flow to the basal ganglia on the opposite side to the effected limbs. L-dopa reduces the blood flow to the basal ganglia but over time can increase the local metabolic rate. There is also a lack of communication between the frontal and parietal and the frontal occipital lobes.
  13. 13.  PET scans show in patients with mild Alzheimer's and in more advanced cases glucose metabolism is reduced in both the temporal and parietal lobes. Patients with a greater amount of language dysfunction than problems with spatial sight display a significant reduction in metabolism in the left frontal, temporal and parietal lobes. Cases with greater visual spatial impairment have a diminished glucose metabolism in the right parietal lobe
  14. 14. Magnetic Resonance Imaging MRI Description  Magnetic field + radio waves  Used to ID:  Edema  Hemorrhage  Tumors  Moved into a tube  Claustrophobia  Takes 45-60 min  Lay flat & motionless  Noisy
  15. 15. 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
  16. 16.  CT scan  MRI
  17. 17.  Eye CA  Pineal CA
  18. 18.  Aneurysm  28yrs old Female smoker  Aneurysm  28yrs old Female smoker
  19. 19.  Brain CA  Brain CA
  20. 20. Brain Abscess  Note herniation
  21. 21. 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 
  22. 22. Cerebral angiography Nursing Considerations  Pre-op  Well hydrated  Mark peripheral pulses   for iodine allergies  contrast medium injected  feeling of warmth
  23. 23. Cerebral angiography Nursing Considerations  Post-procedure  Sand bag leg  Bed rest over night  VS and neuro checks  Observe puncture site   Distal pulses  Bradycardia/hypotensio n = vagal stim   for difficulty breathing   ICP  Monitor LOC
  24. 24.  MRI  28yo female  Angiography
  25. 25. Myelography Description  X-ray of the spinal sub-Arachnoid space  Injection of contrast medium  via lumbar puncture
  26. 26. Myelography Nursing Considerations  Explain  NPO  Post-procedure  Lie HOB  30 ο – 45 ο  Bed rest x 3 hrs   fluids  Bad signs  H/A   Temp  Stiff neck  Photophobia  Seizures
  27. 27. Electroencephalography (EEG) Description  Measures electrical impulses of the brain  brain waves  Electrodes applied to the scalp  - 16  Used to diagnosis  Seizures  Coma  Brain death  Obtain an baseline  Quiet & dark  Stimulation  Flashing lights
  28. 28. Electroencephalography (EEG) Nursing Considerations  Duration: 1 hour   seizures  sleep deprivation  No anti seizure meds, tranquilizers, stimulants, depressants  No caffeine  OK to eat
  29. 29.  Normal
  30. 30.  Petite Mal  Generalized Seizure
  31. 31. Electromyography Description  Needle electrodes put into skeletal muscles  Measure changes in electrical potential of the muscle.  Used to diagnose  Neuromuscular disorders
  32. 32. Electromyography Nursing Considerations  Explain  not going to be electrocuted  Needle, like a IM injection  Muscles may ache
  33. 33. Lumbar Puncture Description  Puncture of lumbar Subarachnoid space  @ L 3-4 level  Used to  Extract CSF  Relieve  ICP  Test Spinal fluid pressure  Introduce  antibiotics  radiopaque dyes  anesthesia
  34. 34. 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
  35. 35. Lumbar Puncture  Post-procedure  Bed rest   Fluid (unless…)  Observe for side effects
  36. 36. Lumbar Puncture  Post-puncture headaches  Duration  Hrs to days  Cause  Unknown  Tx. / prevention  Bed rest  Quiet dark room  Analgesics   fluids

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