Ultrasound

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Ultrasound
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What is an Ultrasound?

• Quick diagnostic test done to examine the inner
  body
• Commonly ultrasound uses sound wave to depict
  soft tissue
• Most commonly this procedure is non-invasive
• The Doppler ultrasound is to used to measure
  blood flow and pressure by using high frequency
  sounds
• the ultrasound cannot see
• all areas of the body

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How does it work?

• It makes detailed pictures of the internal
  structures in the body by using the frequency of
  the sound waves .
• Despite the minimal risks of this diagnostic
  procedure the sound waves do not travel well
  through bone or air.

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The Ultrasound and Doppler ultrasound
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Nursing Implications

• There are no special implications
• for this test
• Inform the patient of why they need
• this test and of what to expect
• Commonly takes 30min to 1 hour
• In some cases there are special procedures that
  need to be done to ensure that the organ can be
  seen well
• There is no special care that is needed after the
  ultrasound is completed.

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Who uses it?

• There are multiple reasons to
• have an ultrasound done some are
• Dx of gallbladder disease
• Guide a needle biopsy
• Dx certain forms of infection and cancer
• Evaluate abnormalities of the muscles and tendons
• Evaluate a fetus

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Pictures
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X-RAY
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What is it? What is it used for?

• Quick Painless test using radiation waves
• Used to view the structures inside the body

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How does it work?

• Small doses of radiation beams passed through the
  body
• Absorbed differently in bone, air, fat, muscle
• Some use contrast
• Multiple Views

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Nursing Implications

• Prepare the patient for the x-ray
• Informing them of possible position changes

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Who it can cannot be used on

• It is can be used on all people except Pregnant
  women.

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Pictures
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CT ScanComputed Tomography Scan
CT scan showing the liver
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CT Scan What is it?

• A noninvasive medical procedure that helps
  diagnose medical conditions
• In the past only seen through surgery or autopsy
• Internal organs,
• bones, soft tissue and
• blood vessels
• Greater clarity,
• more detail
• Than X-ray

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CT Scan How does it work?

• 2D cross sectional image
• Electromagnetic energy from all angels
• Different body parts absorb beams differently
• Contrast material (dye)
• enhances images

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CT Scan Used For

• Diagnose cancers, CV disease, infectious disease,
  appendicitis, trauma and muscular-skeletal
  disorders

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CT scan Equipment

• Large box-like machine with
• hole in the middle
• Pt. lies on narrow table that
• slides in and out of this hole
• X-ray tube and electronic x-ray
• detectors rotate around you (gantry)
• Computer processes the information and is
  operated by a technologist who works scanners and
  monitors the exam

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CT Scan Nursing Interventions and Client Teaching

• Comfortable clothing (gown
• may be provided
• Metal objects (jewellery, glasses, dentures,
  etc.)
• Fast from food or drink (especially if dyes are
  being used)
• Allergies and medication
• Medical conditions (asthma, diabetes, heart
  disease, thyroid problems, etc.)
• Pregnant woman need to inform the physician
  prior to the scan (or even the possibility of
  pregnancy)

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Nursing Interventions Client Teaching -During
Procedure

• Fast, easy and painless
• Mild sedative may be used (as ordered by
  physician)
• Offer patient reassurance and explain procedure
• Explain that the technologist can see, hear and
  speak to them at all times
• For pediatric patients, parents wear lead apron

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CT Scan Not for

• Pregnant women
• If dye is used, nursing mothers should wait 24h
  before resuming feedings
• Allergies to iodine
• Limitations a very large person may not fit in
  the scanner and the table has a limit of 450 lbs

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CT of the Head
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PET SCAN
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What is a PET Scan?

• Positron Emission Tomography
• A type of nuclear medicine imaging
• Non-invasive procedure
• Uses small amounts of radioactive material to
  detect diseases
• Locates abnormal metabolic activity in the body
• Measures body functions
• Blood flow, O2 use, cellular glucose metabolism
• Shows how well organs and tissues are functioning

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PET/CT Scan
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How Does a PET Scan Work?

• Radiotracer FDG is injected into a vein,
  swallowed, or inhaled
• Absorbed by the diseased tissues/ organs in the
  body
• Tracer gives of energy as gamma rays which is
  detected by the PET scanner as FDG is broken down
  by cells
• PET scan records this energy that is emitted

FDG PET Scan Lymphoma
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The PET Scanner

• Has round hole in middle, with short tunnel
• Pt. lies on narrow exam table that slides in and
  out of tunnel
• Imaging information in separate room

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What is a PET Scan Used For?

• To detect cancer/cancer spread in the body/return
  of cancer after Tx
• Show blood flow to the heart muscle
• Show effects of an MI on parts of the heart or
  part requiring a procedure
• Evaluate brain abnormalities/brain function

May 2007
August 2007
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Nursing Implications of PET Scan

• PET shows cellular glucose uptake
• Pt. not to eat, glucose level below 150mg/dL
• Glucose too high scan rescheduled
• Diabetic Pts receive special instructions re
  glucose level control
• Ask Pt to remain calm, still, and quiet during
  scan
• Keep Pt warm
• Assess Pt. For claustrophobia

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Nursing Implications of PET Scan

• Teach your Pt
• What the PET scan looks like
• Fasting protocol specific to your facility
• Inform Pt. that scan will be complete in 2hrs
• Alert radiology staff if experiencing hives,
  flushing, itching, difficulty breathing during
  the scan
• ?fluid intake after scan to flush from body
• Ask women if breastfeeding/could be pregnant

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Magnetic Resonance Imaging

• More commonly known as the MRI

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What Is An MRI?

• An MRI is a non invasive medical test that uses a
  magnetic field, radio frequency pulses, and a
  computer to produce images of your inner body
  (including bone, soft tissues, and organs)
• MRIs can better evaluate the body in comparison
  to X Ray, ultrasound, or CT Scans.
• Roughly, about 20 of MRIs are ordered with
  contrast. MRI contrast is used in specific
  circumstances and  enhances the MRI scan images.
  Dye may be used if there is
• History of tumor, cancer, or surgery
• Looking for infection, inflammation, or cancer
• Evaluating blood vessels
• Investigate a finding on the pre-contrast part of
  the scan

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How Does an MRI Work?

• The magnet aligns the hydrogen atoms protons in
  our body.
• They are exposed to radio waves creating a faint
  picture.
• The magnetic field is produced by passing
  electricity through wire coils.
• The photo produced is a thin slice, and can be
  interpreted at different angles.

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Nursing Implications

• Teach your patient about the MRI, including the
  common feeling of claustrophobia inside the
  machine.
• Explain to patient they must stay very still and
  hold their breath while images are being taken,
  or the images will not be effective.
• A mother who is given contrast dye may choose not
  to breast feed for 24 hours after the scan,
  however research suggests there will be no harm
  to the baby.

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What Can An MRI Find?

• Tumours of the chest, abdomen or pelvis.
• Certain types of heart problems.
• Blockages or enlargements of blood vessels,
  including the aorta, renal arteries, and arteries
  in the legs.
• Diseases of the liver, such as cirrhosis, and
  that of other abdominal organs, including the
  bile ducts, gallbladder, and pancreatic ducts.
• Diseases of the small intestine, colon, and
  rectum
• Cysts and solid tumours in the kidneys and other
  parts of the urinary tract.
• Tumours and other abnormalities of the
  reproductive organs (e.g., uterus, ovaries,
  testicles, prostate).
• Causes of pelvic pain in women, such as fibroids,
  endometriosis and adenomyosis.
• Suspected uterine congenital abnormalities in
  women undergoing evaluation for infertility.
• Breast cancer

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Who Cannot Have An MRI?

• Patients cannot have halter monitors, telemetry
  units, nerve stimulation units or a IV pump in
  the magnet room.
• No metal can enter the exam room, clothing with
  metal snaps or pins should not be worn.
• Heart pacemaker or pacing wires, cerebal aneurysm
  or Swan Ganz catheter. Pregnancy is a
  contraindication and will require patient consent
  for an MRI.

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Photos of MRIs
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QUESTIONS?
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References

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  m
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  dye
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• MRI scan patient preparation. Retrieved Oct 3,
  2010, from http//www.tdic.org/mri-patient-prepera
  tion.aspx
• PET Scan Vancouver. PET Scan Information.
  http//www.petscan.ca/petinfo.htm
• RadiologyInfo.org. Positron Emission Tomography
  Computed Tomography (PET/CT). http//www.radiolog
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