DIAGNOSTIC PROCEDURES 1.

CT SCAN How the Test is Performed You will be asked to lie on a narrow table that slides into the center of the CT scanner. Once you are inside the scanner, the machine's x-ray beam rotates around you. (Modern "spiral" scanners can perform the exam without stopping.) A computer creates separate images of the body area, called slices. These images can be stored, viewed on a monitor, or printed on film. Three-dimensional models of the body area can be created by stacking the slices together. You must be still during the exam, because movement causes blurred images. You may be told to hold your breath for short periods of time. Generally, complete scans take only a few minutes. The newest scanners can image your entire body, head to toe, in less than 30 seconds. How to Prepare for the Test Certain exams require a special dye, called contrast, to be delivered into the body before the test starts. Contrast helps certain areas show up better on the x-rays. Let your doctor know if you have ever had a reaction to contrast. You may need to take medications before the test in order to safely receive this substance. Contrast can be given several ways, and depends on the type of CT being performed.

It may be delivered through a vein (IV) in your hand or forearm. It may be given through the rectum using an enema. You might drink the contrast before your scan. When you actually drink the contrast depends on the type of exam being done. The contrast liquid may taste chalky, although some are flavored to make it taste a little better. The contrast eventually passes out of your body through your stools.

If contrast is used, you may also be asked not to eat or drink anything for 4-6 hours before the test. Before receiving the contrast, tell your health care provider if you take the diabetes medication metformin (Glucophage) because you may need to take extra precautions. If you weigh more than 300 pounds, find out if the CT machine has a weight limit. Too much weight can cause damage to the scanner's working parts.

You will be asked to remove jewelry and wear a hospital gown during the study. How the Test Will Feel Some people may have discomfort from lying on the hard table. Contrast given through an IV may cause a slight burning sensation, a metallic taste in the mouth, and a warm flushing of the body. These sensations are normal and usually go away within a few seconds. Why the Test is Performed CT rapidly creates detailed pictures of the body, including the brain, chest, spine, and abdomen. The test may be used to:

Diagnose an infection Guide a surgeon to the right area during a biopsy Identify masses and tumors, including cancer Study blood vessels

Results: Clients findings: Pontine Hemorrhage, midline 2cc

2. Chest X-ray How the Test is Performed The test is performed in a hospital radiology department or in the health care provider's office by an x-ray technician. Two views are usually taken: one in which the x-rays pass through the chest from the back (posterior-anterior view), and one in which the x-rays pass through the chest from one side to the other (lateral view). You stand in front of the machine and must hold your breath when the x-ray is taken. How to Prepare for the Test Inform the health care provider if you are pregnant. Chest x-rays are generally avoided during the first six months of pregnancy. You must wear a hospital gown and remove all jewelry. How the Test Will Feel There is no discomfort. The film plate may feel cold. Why the Test is Performed Your doctor may order a chest x-ray if you have any of the following symptoms:

A persistent cough Chest injury Chest pain Coughing up blood Difficulty breathing

Analysis: Clients result: Cardiomegaly Congestion

3. ELECTROCARDIOGRAM How the Test is Performed You will be asked to lie down. The health care provider will clean several areas on your arms, legs, and chest, and then attach small patches called electrodes to the areas. It may be necessary to shave or clip some hair so the patches stick to the skin. The number of patches used may vary. The patches are connected by wires to a machine that turns the heart's electrical signals into wavy lines, which are often printed on paper. The test results are reviewed by the doctor. You usually need to remain still during the procedure. The health care provider may also ask you to hold your breath for a few seconds as the test is being done. Any movement, including muscle tremors such as shivering, can alter the results. So it is important to be relaxed and relatively warm during an ECG recording. Sometimes this test is done while you are exercising or under minimal stress to monitor changes in the heart. This type of ECG is often called a stress test. How to Prepare for the Test Make sure your health care provider knows about all the medications you are taking, as some can interfere with test results. Exercising or drinking cold water immediately before an ECG may cause false results. How the Test Will Feel An ECG is painless. No electricity is sent through the body. The electrodes may feel cold when first applied. In rare cases, some people may develop a rash or irritation where the patches were placed. Why the Test is Performed An ECG is used to measure:

Any damage to the heart How fast your heart is beating and whether it is beating normally The effects of drugs or devices used to control the heart (such as a pacemaker) The size and position of your heart chambers

An ECG is usually the first test done to determine whether a person has heart disease. Your doctor may order this test if:

You have chest pain or palpitations You are scheduled for surgery

You have had heart problems in the past You have a strong history of heart disease in the family

There is no reason for healthy people to have yearly ECG tests.