M/S Labs & Diagnostic Tests Flashcards by Jennifer Cowley

What angle gives a one-dimensional view on a standard X-RAY?

Anterior-Posterior

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What angle gives a two-dimensional view on a standard X-Ray?

Lateral

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What are the 2 nursing responsibilities of standard X-Ray procedures

Removal of radiopaque objects

avoiding excessive exposure ( Wear Your Lead Apron!)

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What dimensional picture do we get with a CT Scan

3 dimensional

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What 3 categories do we use CT scans for?

soft tissue

bone abnormalities

some types of trauma

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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

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What do we need to do post CT Scan if contrast is used?

Force Fluids because of risk for nephrotoxicity

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magnetic resonance Imaging uses ____ & _____ waves to view ______ tissue

radio; magnetic ; soft

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During an MRI patients are placed inside a _____ _____, and we would want to ask the patient about _________ before procedure.

scanner chamber; claustrophobia

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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

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What may we administer prophylactic to help with MRI claustrophobia

anti-anxiety meds

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What does Rheumatoid factor (RF) assess for

presence of autoantibody (RF) in serum

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T/F Rheumatoid factor (RF) is NOT specific to RA

True, can be seen in other tissues

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What is the Normal level for Rheumatoid factor (RF)

Negative

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What is an erythrocyte sedimentation rate (ESR)

non-specific indication of inflammation

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What is the normal rate for ESR

<30 mm/hr

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Is ESR more of an acute or chronic inflammation indicator

Chronic

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What 2 conditions are related to ESR in regards to musculoskeletal content?

rheumatoid arthritis and osteomyelitis

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What is C-reactive protein (CRP) used to diagnose

inflammatory diseases, infections and active widespread malignancies

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What is uric acid

End-product of protein metabolism

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how is uric acid normally excreted

in the kidneys through the urine

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although not specific, we can see increased levels of uric acid with _____

gout

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Anti-citrullinated protein antibody (ACPA) or Anti-CCP is an important diagnostic for what

Rheumatoid Arthritis

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In RA, which is more specific RF or ACPA?

ACPA as it may allow for earlier and more accurate diagnosis

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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