Nursing Interventions for Diagnostic Examinations

Abdominal Scan

Informed consend, NPO 4 hrs prior if contrast is to be used, allergies to shellfish/iodine?, assess for claustrophobia, provide emesis basin, advese pt. there may be salty taste/flushing warm sensation if dye is injected,may cause diarrhea

Amniocentesis

Moniter fetal heart tones, moniter moms BP, before 20 weeks gestation-bladder needs to be full, after 20 weeks, bladder is typically emptied, if pt. complains of nausea or vertigo, allow to rest on L side few minutes, administer RhoGAM if necessary, obser

Arteriography

Inform pt. of possible warm flush feeling, NPO for 2-8 hours prior, mark site of peripheral pulse c pen. check coagulation normality, assess allergies to dye, instruct pt to void before study, BR for 8 hours, moniter v/s and bleeding at puncture site

Barium Enema

NPO after midnight, assist with bowel prep, clear liquid lunch, dulcolax after 7pm day before, suppository or enema at 6am day of exam, after exam allow pt to have normal diet, encourage fluid intake, administer milk of mag. afterwards

Barium Swallow

NPO 8 hrs prior, assess ability to swallow, advise pt that stools may be white

Blood Chemistries

NPO as indicated, water is permitted, prohibit smoking and alcohol within 24 hrs prior, observe site for bleeding, pt. needs to eat meal after proceedure

Bone Marrow Aspiration

Assess coagulation, written consent, advise that proceedure will be painful but brief, obtain order for sedative if necessary, remind pt to be still, pressure to puncture side, apply adhesive dressing, pt can have normal activity 30 to 60 min. after proce

Bone Scan

Remove all metal objects, pt needs to drink several glasses of water, assure pt that they will not be exposed to much radiation, radioactive substance is excreted within 6 to 24 hrs, encourage fluid intake

Brain scan

informed consent, NPO 4 hrs prior, no wigs, hairpins, clips or dentures, observe iodine allergies, give sedation if ordered, they will hear clicking noise, encourage fluid intake

Bronchoscopy

informed consent, NPO after midnight the night before, pt cannot eat or drink after proceedure until gag reflex is back as well as any other anesthesia effects, observe sputum for blood- a little is normal, observe for altered respirations, tell pt to do

Cardiac Catheterization

written consent, emotional support, NPO 4 to 8 hrs, dye allergies?, shave skin area to prep, mark peripheral pulses with pen, instruct to void before, obtain IV supplies, observe catheter site, encourage rest 4-8 hrs, instruct pt that results will be 1-2

Chest xray

pt cannot wear bra, gown cannot have snaps or pins, tell pt they will be asked to take deep breath and hold

colonoscopy

consent, observe for abd pain tenderness or bleeding, examine stools for blood, determine bowel is adequately cleansed (gallon of GoLYTELY), suggest warm bath afterward, encourage lots of fluids

CT (Computed Tomography)

consent, allergies to iodine, no wigs, hairpins, clips or dentures, NPO 4 hrs prior contrast, dring fluids to prevent renal complications

Cystoscopy

consent, enema as ordered, NPO after midnight if general anesthesia is used, insert foley catheter if ordered, assess ability to void 24 hrs after proceedure, record urine color, suggest sitz bath, bital signs, look for hemorrhage and sepsis, ask pt not t

Echocardiocram

consent, pt pertinent hx, painless study, 45 minutes, remoce electrodes

Electrocardiogram (ECG,EKG)

expose only chest and arms, assure pt they will not feel anything, assess for chest pain

Electroencephalogram

make sure hair is clean, do not use oils, encourage foods, explain to pt they must remain very still, cannot drive home alone

Endoscopy and Gastroscopy

consent, NPO after midnight, emotional support, remove dentures, oral hygiene, anesthetic in throat cannot be swallowed, procedure is not painful, do not bite down on endoscope, observe for bleeding, fever, pain,

Exercise Tolerance Test (Treadmill)

NPO 4 hrs prior except water, never hold heart meds, inform pt about risks, record baseline vitals, spply appropriate electrodes, obtain pretest ECG, resume diet as usual afterward, have pt in supine position for several hrs after examination, instruct no

Femoral Angiogram

allergies to dye, written consent, NPO after midnight, watch catheter site, v/s, observe extremity for numbness, tingling, pain or loss of function

Gallbladder Nuclear, Scanning

fast for 2 hrs prior, only discomfort occurs with IV injection of radionuclide, moniter side effects, resume diet as soon as series is completed

Glucose Tolerance Test (GTT)

NPO 12 hrs prior, obtain urine samples, pt empties bladder, collect urine specimen at .5, 1, 2, 3, 4 hrs after dextrose is given, dc drugs including tobacco, obtain weight, mark tubes, give pt meal afterward, report result, administer insulin if ordered

Hematest of stools (Guaiac)

assist in obtaining specimens, ask pt not to eat red meat 3 days prior, note any anticoagulants or meds, be gentle

Intravenous Pyelogram/ Urography

check for allergies to iodine, shellfish, NPO after midnight, assess pt blood urea nitrogen creatinine lecels, give enema of ordered, allow normal diet afterwards, encourage ambulation, assess urinary output

Kidney, ureter and bladder xray study

no GI contrast will be used, ensure all radiopaque clothing has been remove

Liver Biopsy

consent, assess blood coagulation, NPO after midnight, keep pt on bedrest for 24 hrs on R side, observe puncture site, avoid strenuous activity 1-2 weeks, evaluate respirations

Lumbar puncture

consent, empty bladder and bowel, explain it is very important to lie still during procedure, encourage fluids, keep in position for 12 hrs afterward if possible, assess for numbness, tingling, drainage at site

Lung Scan

consent, NPO 4 hrs, have recent chest xray, remove jewelry around chest

MRI

NO METAL, empty bladder, pt will hear thumping sounds, assess for claustrophobia

Mammography

no deoderant, some discomfort during procedure, instruct on SBE

Myelography

consent, allergies to iodine and shellfish, empty bladder and bowels, lie very still, inform pt they will be put in an up and down position, observe for fever, stiff neck, ability to void, observe for seizures

Paracentesis

consent, empty bladder, obtain weight and abd girth, syncope?, measure both afterwards, observe for hypotension, monitor serum protein and electrolyte levels

Positron Emission Tomography

consent, no alcohol, caffine, tobacco or sedatives 24 hrs prior, empty bladder, inform pt that two IVs will be inserted, instruct slow positioning, drink fluids afterwards

Proctoscopy and Sigmoidoscopy

consent, light breakfast, enamas as ordered, inform discomfort when scope is inserted, observe for fever, pt may have gas and abd pain, slight rectal bleeding may happen, fever and chills are bad signs, observe bloating

Renal Angiography

consent, NPO 2-8 hrs prior, administer cathartics as ordered, inform flushing warm feeling as dye injected, mark peripheral pulse sites, coagulation should be normal, have pt void, BR for 8 hrs

Thoracentesis

consent, cough suppressant if necessary, need xray to show where fluid is, pain is possible when fluid is removed from pleura, moniter for hemoptysis, dyspnea , turn on unaffected side for 1 hr to allow site to seal, obtain another chest xray, assess lung

Upper Gastrointestinal Series

NPO 8 hrs prior, potential discomfort from lying on hard table

Urinalysis

wash perineal area, use midstream urine collection