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Ultrasound

Ultrasound. 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

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Ultrasound

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  1. Ultrasound

  2. 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

  3. 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.

  4. The Ultrasound and Doppler ultrasound

  5. 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.

  6. 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

  7. Pictures

  8. X-RAY

  9. What is it? What is it used for? Quick Painless test using radiation waves Used to view the structures inside the body

  10. 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

  11. Nursing Implications Prepare the patient for the x-ray Informing them of possible position changes

  12. Who it can & cannot be used on It is can be used on all people except Pregnant women.

  13. Pictures

  14. CT ScanComputed Tomography Scan CT scan showing the liver

  15. 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

  16. 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

  17. CT Scan: Used For Diagnose cancers, CV disease, infectious disease, appendicitis, trauma and muscular-skeletal disorders

  18. 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

  19. 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)

  20. 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

  21. 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

  22. CT of the Head

  23. PET SCAN

  24. 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

  25. PET/CT Scan

  26. How Does a PET Scan Work? FDG PET Scan Lymphoma 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

  27. 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

  28. What is a PET Scan Used For? May 2007 August 2007 • 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

  29. 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

  30. 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

  31. Magnetic Resonance Imaging More commonly known as the “MRI”

  32. 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

  33. 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.

  34. 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.

  35. 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

  36. 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.

  37. Photos of MRI’s

  38. QUESTIONS?

  39. References Black, J.M., Hawks, J.H., & Keene, A.M. (2001). Diagnostic assessment. Medical-surgical Nursing. (198-199). Philadelphia, Pennsylvania: W.B Saunders Company Coyne, K. MRI: A guided tour. Retrieved October 3, 2010, from http://www.magnet.fsu.edu/education/tutorials/magnetacademy/mri/fullarticle.html CT scan. (2010). emedicinehealth. Retreived from http://www.emedicinehealth.com/ct_ scan/article_em.htm CT scan. (2010). Radiological Society of North America. Retrieved from http://www.radiology info.org/en/info.cfm?pg=bodyct Harris, T. (2010). How CT scan works. Discovery Communications. Retrieved from http://health.howstuffworks.com/medicine/tests-treatment/cat-scan1.htm Holden, J. (January 11, 2009). What is an MRI with contrast (dye)? Retrieved October 3, 2010, from http://blog.remakehealth.com/blog_Healthcare_Consumers-0/bid/6788/What-is-an-MRI-with-contrast-dye Lippincott’s Nursing Center.com. Eye on Diagnostics: PET-CT Scans Can Improve Care for Patients with Cancer. Http://www.nursingcenter.com/library/static.asp?pageid=1012953 Magnetic resonance imaging (MRI scan). Retrieved October 3, 2010, from http://www.medicinenet.com/mri_scan/article.htm Mayoclinic.com. Ultrasound. http://www.mayoclinic.com/health/ultrasound/MY00308 Malarkey, L., M., & McMorrow, M., E. (2005). Saunders Nursing Guide to Laboratory and Diagnostic Tests.St.Louis, MO: Elsevier Inc. MRI of the body (chest, abdomen, pelvis). (March 15, 2010). Retrieved October 3, 2010, from http://www.radiologyinfo.org/en/info.cfm?pg=bodymr MRI scan patient preparation. Retrieved Oct 3, 2010, from http://www.tdic.org/mri-patient-preperation.aspx PET Scan Vancouver. PET Scan Information. http://www.petscan.ca/petinfo.htm RadiologyInfo.org. Positron Emission Tomography – Computed Tomography (PET/CT). http://www.radiologyinfo.org/en/info.cfm?pg=P ET

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