NURSING JOURNAL

Nursing responsibilities for the patient will undergo Computed Tomography Scan.

Computed tomography (CT) scan, also known as computerized axial tomography (CAT), or CT scanning
computerized tomography is a painless, non-invasive diagnostic imaging procedure that produces cross-
sectional images of several types of tissue not clearly seen on a traditional X-ray.

CT scans may be performed with or without contrast medium. A contrast may either be an iodine-based
or barium-sulfate compound that is taken orally, rectally, or intravenously which can enhance the
visibility of specific tissues, organs, or blood vessels. The duration of the procedure will depend on the
area being scanned.

The roles and responsibilities of a nurse extend throughout the whole duration of the CT scan
procedure — from taking patient’s history, obtaining informed consent, preparing the patient, and
providing education. To ensure the safety and accuracy of the procedure, learn about the nursing
interventions and concepts behind computed tomography (CT) scan.

The protocol and procedures for computed tomography (CT) scan varies per area but generally, the
following steps are followed:

The patient is positioned on an adjustable table inside an encircling body scanner (gantry); straps and
pillows may be used to help in maintaining the correct position.

1. The patient may be instructed to hold his breath during the scanning.
2. A series of transverse radiographs are taken and recorded
3. The information is reconstructed by a computer and selected images are photographed.
4. Once the images are reviewed, an I.V. contrast enhancement may be ordered and additional
images are obtained.
5. The patient is assessed carefully for adverse effects to the contrast medium.

TYPES

Abdominal and pelvic Orbital

Bone and skeletal Pancreas

Cardiac calcium scoring Renal

Ear Spinal

Liver and Biliary Tract Thoracic

CONTRAINDICATION

Computed tomography (CT) is contraindicated in:

 Pregnant patient (absolute contraindication)

 Patients with a known allergy to iodine
 Patients with claustrophobia
 Patients with renal impairment unless the benefits outweigh the risks
 Patients with hyperthyroidism or toxic goiter (induce thyrotoxic crisis)
 Patients with complications after a previous administration of a contrast
 Patients with severe obesity (usually more than 300 pounds)

Interfering Factors

Retained oral or I.V. contrast material from previous diagnostic studies may affect the visibility of the
images.

Metal objects including eyeglasses, dentures, jewelry, and hairpins

Nursing Responsibilities for CT Scan

The following are the nursing interventions and nursing care considerations for a patient undergoing
computed tomography:

Before the procedure

The following are the nursing interventions before computed tomography:

Informed Consent. Obtain an informed consent properly signed.

Look for allergies. Assess for any history of allergies to iodinated dye or shellfish if contrast media is to
be used.

Get health history. Ask the patient about any recent illnesses or other medical conditions and current
medications being taken. The specific type of CT scan determines the need for an oral or I.V. contrast
medium

Check for NPO status. Instruct the patient to not to eat or drink for a period amount of time especially if
a contrast material will be used.

Get dressed up. Instruct the patient to wear comfortable, loose-fitting clothing during the exam.

Provide information about the contrast medium. Tell the patient that a mild transient pain from the
needle puncture and a flushed sensation from an I.V. contrast medium will be experienced.
Instruct the patient to remain still. During the examination, tell the patient to remain still and to
immediately report symptoms of itching, difficulty breathing or swallowing, nausea, vomiting, dizziness,
and headache.

Inform about the duration of the procedure. Inform the patient that the procedure takes from five (5)
minutes to one (1) hour depending on the type of CT scan and his ability to relax and remain still.

After the procedure

The nurse should be aware of these post-procedure nursing interventions after computed tomography
(CT) scan:

Diet as usual. Instruct the patient to resume the usual diet and activities unless otherwise ordered.

Encourage the patient to increase fluid intake (if a contrast is given). This is so to promote excretion of
the dye.

Normal Results

The following are the expected normal results of computed tomography (CT) scan:

Specific type of CT scan reveals normal findings

Normal findings on a CT scan shows bone (which has the densest tissue) appears as white areas. Tissues
densities will show as shades of gray, and fat tissue appear as black or dark gray. Cerebrospinal fluid (has
no tissue) will appear as black. Air will also look black and darker than fat.

Abnormal Results

The abnormal results of a computed tomography (CT) scan varies per area.

The specific type of CT dependent on the area of study (see abnormal results above).