neuro diagnostic evaluation

Question 1

CT

Answer 1

what is it?
- scan that can be done with or without contrast
- usually performed without contrast first then with
- pt lies on table while scanning system rotates around and shows cross sectional images

what does it show?
- tumor or other masses, infarction, hemorrhage, displacement of ventricles, cortical atrophy

nursing stuff:
- a review of relaxtion techniques may be helpful as they have to lie still and be quiet
- assess for allergies beforehand
- assess kidney function
- increase fluid intake to flush out dye

Question 2

MRI

Answer 2

what is it?
- giant ass magnet
- can be done with or without contrast

what does it do?
- can provide info about changes in cells
- particularly useful in diagnosis of brain tumor or stroke

nursing stuff:
- may take an hour or longer to complete, not used in emergency situations
- ask about any metal that could possibly be in or on their body
- painless, but if you cant lie flat you cant tolerate it

Question 3

PET

positron emission tomography

Answer 3

what is it?
- nuclear imaging

what does it do?
- meausures blood flow, tissue composition, and brain metabolism
- shows metabolic changes, lesions, and necrosis

nursing stuff:
- the injection and inhalation of radioactive substance can have side effects, idk what they are, just that they are there

Question 4

SPECT

single photon emission computed tomography

Answer 4

what is it?
- type of CT except 3D
- perfusion study

what does it do?
- useful in detecting the extent and location of abnorally perfused areas of the brain
- good for stroke

nursing stuff:
- provide education
- pregnancy and breast-feeding are contraindicated
- monitor for allergic reactions

Question 5

cerebral angiography

Answer 5

what is it?
- xray study with contrast injected into an artery
- catheter is thread up and vascular systems are evaluated in brain

what does it do?
- determines vessel patency, provide details on vascular anaomalies

nursing stuff:
- assess kidney labs
- hydrate
- assess allergies and explain the dye insertion shit
- observe for bleeding from site and hematoma
- check peripheral pulses

Question 6

myelography

Answer 6

what is it?
- xray of subarachnoid space with contrast in there from lumbar puncture

what does it do?
- shows any distortion of the spinal cord by cysts, herniated discs, or other lesions

nursing stuff:
- recommended to remain in bed for 4-24hrs after test
- hydrate to reduce incidence of post lumbar puncture headache
- assess vitals and LOC

Question 7

transcranial doppler

Answer 7

what is it?
- noninvasive doppler to record blood flow of intracranial vessels

what does it do?
- helpful in assessing vasospasm, altered cerebral blood flow, other cerebral pathologies, and brain death

nursing stuff:
- describe procedure to patient
- can be perfromed at bedside

Question 8

EEG

electroenchepalogram

Answer 8

what is it?
- like an EKG but for the brain, electrodes all over the head and assesses cerebral electrical activity

what does it do?
- useful for diagnosing and evaluating seiazure disorders, coma, or brain death

nursing stuff:
- may be sleep deprived EEG, no stimulants can be given and nothing to help you fall asleep, hold any antiseizure meds for 24-48hrs

Question 9

EMG

electromyography

Answer 9

what is it?
- needles are inserted into skeletal muscles to measure electrical changes

what does it do?
- useful in determining the presence of neuromuscular disorders and myopathies

nursing stuff:
- warn to expect a sensation similar to IM injection as needle is inserted
- muscles may ache for short time after procedure

Question 10

nerve conduction studies

Answer 10

what is it?
- stimulating a peripheral nerve at several points and recording action potentials that result
- surface or needle elctrodes are used

what does it do?
- useful in the study of peripheral neuropathies and is often included as part of EMG

nursing stuff:
- explain the test

Question 11

lumbar puncture

Answer 11

pre procedure:
- verify consent and explain procedure
- instruct patient to void before

procedure:
- positioning -> curl up in fetal position with back towards physician
- use pillows to keep in place
- instruct not to make any sudden movements to avoid a traumatic tep
- local anesthetic is used and giant needle is put in there
- specimen collected and sent to lab immediately

post procedure:
- instruct to lie prone to reduce CSF leakage
- monitor for complications
- encourage fluid intake to reduce risk of postprocedure headache

Question 12

what are some complications of lumbar puncture

Answer 12

• headache
• herniation of spinal contents
• spinal epidural abscess or hematoma
• meningitis
• temporary voiding issues
• backache or back spasms
• stiffness of neck