DIAGNOSTIC PROCEDURES

Invasive- entrance into a body cavity

Non-invasive
PROCEDURE
DESCRIPTION
NURSING RESPONSIBILITIES
ELECTROCARDIOGRAM -graphical recording of the electrical activities of the
Explain the procedure
(ECG, EKG)
heart.
Inform the client that the procedure is painless and that the
-it indicates alterations in myocardial oxygenation.
patient will not experience electrocution or a shock
-first diagnostic test done when cardiovascular
Remove all jewelry from the neck, arms and wrist
disorder is suspected
Expose only the extremities, wrists and legs
-5 to 10 minutes
Shave, trim or clip parts with excessive hair
-done by HCPs, interpreted by doctors
Ask the client to relax, lie very still, breathe normally and avoid
-electrodes will be placed in the arm, legs and chest
talking
*electrodes-are capable of conducting electrical
activities from the heart to the ECG
-used to determine:
Abnormal cardiac rhythm
Coronary heart disease
MI
ECHOCARDIOGRAM
-uses ultrasound to assess cardiac structure and
Explain
(Ultrasound
mobility
Ask the client to be in a supine position, slightly turned to the left
cardiography)
-painless
side with HOB elevated to 15 to 20 degrees
-30 to 60 minutes
-no special preparation is required
ELECTROENCEPHALOG -graphical recording of spontaneous electrical
Explain
RAM (EEG)
impulses of the brain from scalp electrodes
Hair shampoo to remove oils/sprays
- test that measures and records the electrical
No caffeine and other stimulants, anticonvulsants for at least 24
activity of your brain.
hours before the procedure
-used to detect surface lesions/tumors
Instruct patient not put any hair conditioner or oil on after
- An EEG takes 1 to 2 hours.
shampooing.
-There is no pain with an electroencephalogram
Instruct client to shampoo your hair and rinse with clear water the
(EEG).
evening before or the morning of the test
- An electroencephalogram (EEG) is a very safe test.
Wash hair after the procedure to remove EEG paste
USES:

Diagnose epilepsy and see what type of

seizures are occurring. EEG is the most useful
and important test in confirming a diagnosis of
epilepsy.
Check for problems with loss of consciousness
or dementia.
Help find out a person's chance of recovery

ROENTOLOGIC
STUDIES
CHEST XRAY

KIDNEY, URETER,
BLADDER (KUB)

after a change in consciousness.

Find out if a person who is in a coma is braindead.
Study sleep disorders, such as narcolepsy.
Watch brain activity while a person is receiving
general anesthesia during brain surgery.
Help find out if a person has a physical
problem (problems in the brain, spinal cord, or
nervous system) or a mental health problem.

-X-ray visualization of the chest

- most commonly performed diagnostic x-ray
examination
- noninvasive medical test that helps physicians
diagnose and treat medical conditions.
- A chest x-ray requires no special preparation
-Patients who cannot stand may be positioned lying
down on a table for chest x-rays.
-The chest x-ray examination is usually completed
within 15 minutes.
USES:
A chest x-ray is typically the first imaging test used to
help diagnose symptoms such as:
shortness of breath
a bad or persistent cough
chest pain or injury
fever.
Physicians use the examination to help diagnose or
monitor treatment for conditions such as:
pneumonia
heart failure and other heart problems
emphysema
lung cancer
other medical conditions.

-x-ray visualization of the kidney, ureters and bladder

- Purpose
To very roughly evaluate the structure, size,
and position of the kidneys.

Explain
Instruct the remove some or all of your clothes and to wear a gown
during the exam. You may also be asked to remove jewelry, eye
glasses and any metal objects or clothing that might interfere with
the x-ray images
Ask client to don on a hospital gown
Practice the client on how to hold his breath and to do deep
breathing
Ask whether the client is pregnant- contraindicated (may have
teratogenic effects)
Nurse should wear lead shield if he/she will accompany the client
in the x-ray room
Positioning depends on the condition of the client (standing, sitting
or supine)

Explain, Inform
Assure the client that the procedure is painless
Bowel preparation to prevent gas/feces interference with
visualization (laxative as ordered)

To detect abnormalities such as kidney stones,

tumors, or other obstructions.
- This test uses standard X-ray technology to obtain
pictures of internal organs.
- No contrast dye is used when the KUB is done alone.
Usually, however, it is done in conjunction with an
intravenous pyelography (see below).
-Client will lie on his stomach on a table with the Xray equipment positioned above you.
-is a safe, low-dose x-ray of the breast.
-most effective tool for detecting breast cancer early.
- during examination, the woman's breast will be
flattened between the two plates of the X-ray
machine for a few seconds. Some women may find
this uncomfortable of painful.
- should not be done for the week before your period
if your breasts are usually tender during this time.

MAMMOGRAPHY

SKULL X-RAY

CT SCAN

-x-ray of the skull

-used to determine location of:
Intracranial calcification
(deposition/accumulation of calcium salts in
the tissues)
Tumors
Abscess
- is an X-ray technique that produces images of your
body that visualize internal structures in cross section
rather than the overlapping images typically
produced by conventional X-ray exams.
- CT scans use an X-ray unit that rotates around your
body and a powerful computer.
-The result with CT scans is a set of cross-sectional
images, like slices, of the inside of your body.
-USES:
Diagnose muscle and bone disorders, such as
bone tumors and fractures
Pinpoint the location of a tumor, infection or
blood clot

Ask client to don on a hospital gown

Instruct client to remain still in a specific position while the X-rays
are taken.

Explain, Inform
Instruct client to avoid using deodorant, powder/ointment,
perfume on the day of the exam
Inform the client that the procedure may be uncomfortable and
painful
Ask client to inform his/her doctor of any prior surgeries, hormone
use, and family or personal history of breast cancer. (These can
appear on the mammogram as calcium spots.)
Encourage client to describe any breast symptoms or problems to
the technologist performing the exam.
If possible, obtain prior mammograms and make them available to
the radiologist at the time of the current exam.
Explain, Inform
Assure the client that the procedure is painless
Remove metallic items from hair

Instruct client to inform his/her doctor if:

You're pregnant. If you're pregnant, your doctor may recommend
another type of exam to reduce the possible risk of exposing your
fetus to radiation.
You have asthma or allergies. If you have had a prior reaction to
contrast media or have asthma or allergies, there's an increased
risk of a reaction to the contrast medium.
You have certain medical conditions. Diabetes, asthma, heart
disease, kidney problems or certain thyroid conditions may
increase your risk of a reaction to contrast media
Ask client to remove your his/her clothing and wear a hospital
gown.
Remove any metal objects, such as jewelry, that might interfere

Guide procedures such as surgery, biopsy and

radiation therapy
Detect and monitor diseases such as cancer or
heart disease
Detect internal injuries and internal bleeding
- CT scans can be done even if you have a pacemaker
or an internal cardioverter defibrillator (devices
implanted in your chest to help regulate your
heartbeat).
- How you prepare for a CT scan depends on which
part of your body is being scanned.
- During a CT scan, client will lie on a table inside a
doughnut-shaped machine called a gantry.
-is a radiographic (x-ray) examination of the upper
gastrointestinal (GI) tract, specifically the pharynx
(back of mouth and throat) and the esophagus
(hollow tube of muscle extending from below the
tongue to the stomach).
- Barium is a dry, white, chalky, metallic powder that
is mixed with water to make a thick, milkshakelike drink. Barium is an x-ray absorber and
appears white on x-ray film. When swallowed,
a barium drink coats the inside walls of the
pharynx and esophagus so that the swallowing
motion, inside wall lining, and size and shape
of these organs is visible on x-ray.
- Reasons for the Procedure
A barium swallow may be performed to diagnose
structural or functional abnormalities of the pharynx
and esophagus. These abnormalities may include, but
are not limited to, the following:
cancers of the head, neck, pharynx, and
esophagus
tumors
hiatal hernia - upward movement of the
stomach, either into or alongside the
esophagus
structural problems, such as diverticula,
strictures, or polyps (growths)
esophageal varices (enlarged veins)
muscle disorders (pharyngeal or esophageal),

Barium Swallow
(Esophagography,
Esophagogram)

with image results.

If test involves a contrast medium, instruct clientto fast for a few
hours before the test.
Depending on the part of your body being scanned, instruct client
to take laxatives, enemas or suppositories as ordered, or
temporarily modify your diet.

Explain the procedure. Offer opportunity to ask any questions .

Informed consent
Instruct client to fast for eight hours before the procedure,
generally after midnight.
Instruct client to inform her physician is shes pregnant or suspect
that she may be pregnant.
Ask client to notify physician if she sensitive to or are allergic to
any medications, latex, tape, and anesthetic agents (local and
general).
Ask client to notify physician of all medications (prescribed and
over-the-counter) and herbal supplements that she is taking. The
physician may advise to withhold certain medications prior to the
procedure.
Advise client to drink plenty of fluids and eat foods high in fiber to
expel the barium from the body. (Barium may cause constipation
or possible impaction after the procedure if it is not completely
eliminated from your body. )
Administer cathartic or laxative to help expel the barium as
ordered.
Encourage patient to notify physician to report any of the
following:
difficulty with bowel movements or inability to have a bowel
movement
pain and/or distention of the abdomen
stools that are smaller in diameter than normal

such as dysphagia (difficulty swallowing) or

spasms (pharyngeal or esophageal)
achalasia - the lower esophageal sphincter
muscle does not relax and allow food to pass
into the stomach
gastroesophageal reflux disease (GERD) and
ulcers
-The barium swallow procedure may take about 30
minutes to finish. In certain cases, it may take up to
60 minutes to fill the stomach.
Barium Enema
or lower
gastrointestinal (GI)
examination

-is an X-ray examination of the large intestine

(colon and rectum).
-The test is used to help diagnose diseases and other
problems that affect the large intestine.
-A barium enema is done to:

Screen for colon polyps or colon cancer. Most

medical experts recommend colon cancer
screening beginning at age 50 for people who
do not have an increased risk of colon cancer.
Earlier screening is recommended for people
who have an increased risk of colon cancer,
such as those with a family history of colon
cancer.
Identify inflammation of the intestinal wall that
occurs in inflammatory bowel diseases, such as
ulcerative colitis or Crohn's disease. A barium
enema also may be used to monitor the
progress of these diseases.

Detect problems with the structure of the large

intestine, such as narrowed areas (strictures)
or pockets or sacs (diverticula) in the intestinal
wall.

Help correct a condition called ileocolic

intussusception
, in which the end of a
child's small intestine protrudes into the large
intestine.

Evaluate abdominal symptoms such as altered

bowel habits, anemia, or unexplained weight
loss.