M/S Labs & Diagnostic Tests Flashcards
What angle gives a one-dimensional view on a standard X-RAY?
Anterior-Posterior
What angle gives a two-dimensional view on a standard X-Ray?
Lateral
What are the 2 nursing responsibilities of standard X-Ray procedures
Removal of radiopaque objects
avoiding excessive exposure ( Wear Your Lead Apron!)
What dimensional picture do we get with a CT Scan
3 dimensional
What 3 categories do we use CT scans for?
soft tissue
bone abnormalities
some types of trauma
what 3 responsibilities do nurses have when explaining CT scans to patients before procedure?
procedure painless
Patient needs to remain still
If contrast, confirm no shellfish allergies
What do we need to do post CT Scan if contrast is used?
Force Fluids because of risk for nephrotoxicity
magnetic resonance Imaging uses ____ & _____ waves to view ______ tissue
radio; magnetic ; soft
During an MRI patients are placed inside a _____ _____, and we would want to ask the patient about _________ before procedure.
scanner chamber; claustrophobia
What 3 things would we want to inform patient before an MRI?
Procedure is painless
Loud ticking noises are normal
Ensure patient has no metal on or in their body
What may we administer prophylactic to help with MRI claustrophobia
anti-anxiety meds
What does Rheumatoid factor (RF) assess for
presence of autoantibody (RF) in serum
T/F Rheumatoid factor (RF) is NOT specific to RA
True, can be seen in other tissues
What is the Normal level for Rheumatoid factor (RF)
Negative
What is an erythrocyte sedimentation rate (ESR)
non-specific indication of inflammation
What is the normal rate for ESR
<30 mm/hr
Is ESR more of an acute or chronic inflammation indicator
Chronic
What 2 conditions are related to ESR in regards to musculoskeletal content?
rheumatoid arthritis and osteomyelitis
What is C-reactive protein (CRP) used to diagnose
inflammatory diseases, infections and active widespread malignancies
What is uric acid
End-product of protein metabolism
how is uric acid normally excreted
in the kidneys through the urine
although not specific, we can see increased levels of uric acid with _____
gout
Anti-citrullinated protein antibody (ACPA) or Anti-CCP is an important diagnostic for what
Rheumatoid Arthritis
In RA, which is more specific RF or ACPA?
ACPA as it may allow for earlier and more accurate diagnosis
Antinuclear antibody (ANA) assesses for antibodies capable of what
destroying nucleus of body’s tissue cells
ANA is 98% positive in what patients
Lupus or SLE
who else may show a positive RF?
Patients with RA and a Small percentage of normal population
Normal levels of antinuclear antibody (ANA) =
Negative
What does Anti-DNA antibody detect?
antibodies that react to DNA
What is an Anti-DNA antibody most specific test for ?
Lupus or SLE
Depletions in complement levels may be found in patients with what?
RA and SLE
What normal body protein is essential to both immun and inflammatory reactions?
Complement
Is a myelogram performed w/ or w/o contrast
Can be performed with both
what does a myelogram assess
pathology of the spinal cord
myelogram is a sensitive test for what
nerve impingement
In a myelogram, xrays are done after injection of contrast into where
subarachnoid space
T/F patient can be sedated during a myelogram
True, patients can be sedated PRN
what type of table is a myelogram performed on
tilt table
What do we do post myelogram with contrast
encourage fluids
What is a major risk of myelogram
Risk of spinal H/A
how long does it take a spinal H/A to resolve
1-2 days with rest & fluids
What can we do to try and PREVENT a spinal H/A
have patient lie flat for a period of time
What can we do for TREATMENT of spinal H/A
Blood patch
what is a blood patch
procedure where 20-30 ml of blood is drawn from periphery and slowly injected into the spine. This often gives immediate relief from H/A
What is a bone density Scan (DEXA)
gold standard for measuring bone mineral density (BMD
DEXA stands for what
dual-energy x-ray absorptiometry
What 3 places are usually scanned with a DEXA
spine, hips, wrist
how are bone density scans reported
as T scores compared to a standard deviation
2 things to teach preop of bone density scan
noninvasive and painless
mild porosity in bones is called
osteopenia
4 types of people that usually get bone density scans
Women < 65 with RF in additionto menopause
all women > 65
those with long-term steroid therapy
measuring response to osteoporosis drug therapy
T/F Men get bone density scans
True, men do get scans if they have RF
What is a Bone Scan
injection of radioisotope that is taken up by the bone
Where may we see increased uptake with a bone scan
osteomyelitis
osteoporosis
malignancies and certain fractures
Where we may see a decreased uptake in a bone density scan
with avascular necrosis
what is avascular necrosis
death of bone due o lack of blood supply
How long is the radioistope given before a Bone Scan
2 hours
how long does a patient have to lay still during a bone scan
1 hour
T/F Radioisotopes are harmful
False
What do we want to do post bone scan procedure
Increase FLuids
what is alkaline phosphatase produced by
osteoblasts of bone
What can elevate alkaline phosphatase
healing fractures
bone cancers
osteoporosis
what is the primary organ for calcium storage
bone
decreased calcium levels can be seen in what
renal disease
hypoparathyroidism
increased calcium levels can be seen in
hyperparathyroidism
some bone tumors
What mineral is indirectly related to calcium
phosphorous
If calcium is increased then phosphorous is _____
decreased
What does an electromyogram (EMG) evaluate
electrical potential associated with skeletal muscle contractions
how is an electormyogram performed
small gauge needles inserted into muscles and attached to leads that feed information to machine
Where are EMGs performed?
usually in an EMG lab
what do we need from the patient in an EMG
cooperation w/ voluntary movement
some things patients should know before EMG
there will be some discomfort and possible pain
Avoid stimulants/sedatives 24 hrs before procedures
