Diagnostis Flashcards
Used to pick up soft tissue abnormalities such as changes within the cells, tumors, and necrotic tissue, degenerative changes w/in brain.
o Patient teaching:
o Pt. may experience claustrophobia,
o Remove anything metal than may be on or in person, such as IUD’s, hearing aids.(pt’s w/ metal prostesis such as hip or shoulder replacements are not candidates for this test.) Mri tech needs to know if pt has pacemaker, artifical heart valve.
▪ Empty bladder before test
MRI
- For pt who have stroke
- Tia – transient ischemic attack
- What angina is to a heart attack, TIA is to stroke
- We will study the blood flow going to the brain
- Estimated that when PP (pulse pressure) get to 60 – 70 their arteries are 50% blocked by 80: 60 to 70% blocked
- It is risk for stroke
- In this case we will monitor blood going into the brain which can ID stroke
Carotid Doppler
– non-invasive – used to detect arterial stenosis, occlusion or plaque.
o Ultrasound waves are used to evaluate carotid artery blood flow.
Doppler
• Inject dye
• Look at blood circulation of blood In brain
• Most probably look for AV malformation:
o Malformation in the connection between arteries and veins
o Is congenital/birth defect and run in families
o 2-3 out of 10 are AV malformation and Aneurism
o Usually asymptomatic
o If BP is kept within healthy range Av malformation will not cause any trouble at all for duration of life span.
Cerebral angiography
–an x-ray of cerebral circulation. Invasive. Radio opaque dye is injected into carotid or femoral artery via catheter.,
• ASSESS FOR ALLEGY TO DYE
o Data regarding aneurysms, tumors
o AV malformations – artery/vein malformation – when they grow into each other because of missing capillary bed. Arteries and veins get intertwined.
Patient teaching:
Patient will experience a warm flushed feeling in the face once dye is injected.
o Patient needs to be hydrated
o Empty bladder
o A lot of swelling and discomfort – use ice bags
o Check pulses frequently –ESP DISTAL – check for adequate circulation to extremities
Cerebral angiography
very invasive
o Pt is in a side lying fetal position
o Insert long needle in between L3 & L4 or L4 & L5 – subarachnoid space
o DO NOT DO with ICP – can cause herniation of brain into brain stem
o Takes out CSF to be evaluated (CSF should be clear and colorless,
Spinal tap
- The lumbar puncture needle is a very long needle
- It is possible that CSF will continue to drain out through opening of syringe
- We will do what is called epidural patch – take pt blood and inject it into hole to seal it off.
- It is not a foreign object - it is their own blood - it will seal off puncture so CSF will not leak out.
Spinal tap complications
• Lay pt in flat position – which prevents spinal headache
• Give lots of fluids since pt needs to rebuild CSF
• Check epidural patch dressing to make sure its not draining
o Examine carefully
• Treat spinal headache
o Usually top of forehead will be throbbing when sitting or standing
• Remind Dr. not to remove too much fluid.
• Pt with increase ICP CAN’T get a lumbar puncture
o When pressure is increased in brain with a door is opening at the bottom of spinal cord, brain stem will herniate and pt will die (brain stem will come down)
• Most important NI is to assess pt for s/s of increased ICP prior to lumbar puncture
Nursing interventions for spinal tap
– actual images of brain function
Measures blood flow
Tissue composition
Brain metabolism
Excellent for picking up lesions and brain tumors.
Radioactive tracer injected or inhaled which crosses blood brain barrier, and combines with electrons in the brain.
Patient teaching:
o No ETOH, no smoking, no caffeine prior to test.
o Pt may get dizzy or light headed
o Headaches when inhaling isotope
o After test is complete be sure pt voids to get rid of radioactive substance in body.
PET scans
