Magnetic Resonance Imaging

• Magnetic resonance imaging provides cross-sectional images of brain tissue. It is more detailed than a CT scan
• The procedure is contraindicated to pregnant women, obesity (more than 300 lbs), claustrophobic patients, patients with metal implants (pacemaker, hip replacements and jewelries)

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Mantoux Test

• Mantoux test is done to determine the exposure to mycobacterium tuberculosis
• Positive reaction means there is an exposure to the TB bacilli
• Positive test: induration of 10 mm or more for foreign-born patient and children under 4 years old, and induration of 5 mm or more if the patient is HIV (+), with healed TB and if patient has had contact with a patient with active TB
• BCG vaccine may cause false positive reaction
• Assess the patient for previous history of TB and report it to the physician

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Mammography

• Mammography procedure detects the presence of breast tumor
• Instruct patient not to use deodorant, talcum powder, lotion, perfume and any ointment on the day of the exam since they contain calcium oxalate which may crystallize and may give a false positive result
• Inform the patient that the breast will be placed between two x-ray plates
• The procedure is best done a week after menstruation
• During the procedure, the patient will be positioned on lying down with pillow under the shoulder of the breast being examined

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Lung Scan

• Lung scan determines lung perfusion when pulmonary emboli and infarction are suspected
• It needs consent
• Assess patient for allergy to dye, iodine and sea-foods
• Remove jewelry from the chest area if any
• Sedative is given as prescribed
• The procedure involves injection of radioactive isotope into the body
• Nurse should wear gloves within 24 hour after the procedure when urine is being discarded

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Lumbar Puncture

• Lumbar puncture is a procedure to withdraw CSF and it is used to determine the abnormalities of CSF
• Empty bladder and bowel before the procedure
• Place patient on C-position
• During the procedure, the needle is inserted between L3-L4 or L4-L5
• After the procedure, increase fluid intake and place the patient on flat position to prevent spinal headache

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Liver Biopsy

• This diagnostic procedure is mainly done to rule out liver disorder
• Bleeding is a common complication, so obtain the result of hemostatis tests before procedure
• Patient is positioned on the left side or supine during biopsy
• To stabilize the position of the liver and to prevent accidental puncture to the diaphragm, instruct patient to inhale, exhale and hold breath during needle insertion
• Patient is positioned on the right side after biopsy for two hours to prevent hemorrhage
• Encourage patient to bedrest for 24 hours after biopsy

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Laparascopy

• Laparoscopy is done to evaluate the pelvic pain and infertility and treat endometriosis lesions
• Patient should NPO before the procedure
• Enema is administered prior to procedure
• Patient will have shoulder and abdominal discomfort after the procedure since the use of carbon dioxide

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IVP (Intravenous Pyelography)

• This diagnostic test is used to visualize the urinary tract
• It needs consent from patient
• Patient should NPO for 8-10 hours before the procedure
• Administer laxative to clear bowels before the procedure
• The procedure requires the use of iodine base dye
• Assess patient if has an allergy to iodine, seafoods or shellfish before the procedure
• Epinephrine should be kept at the bedside to counteract possible allergic reaction
• Inform patient that salty taste may be experienced during procedure
• Encourage patient to increase fluid intake after procedure to facilitate excretion of the dye

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Incentive Spirometry

• It is mainly used in the prevention and treatment of atelectasis
• Patient should be kept in semi-fowler's position
• Patient should take deep breath slowly and easily from the mouthpiece

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Hysterosalpingography

• Hysterosalpingography determines the patency of fallopian tube
• It also detects pathology in the uterine cavity
• It is done by x-ray examination and administration of a radiopaque dye into the uterine cavity

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Guthrie Capillary Blood Test

• It is a screening test for phenylketonuria
• Normal level of phenylketonuria is 2 mg/dl
• Patient should take a high protein diet 24-48 hour before the test

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Glucose Tolerance Test

• Glucose tolerance test is done to confirm the presence of sugar in the blood
• Procedure: patient take high carbohydrate diet 24-48 hours before the procedure is done.
• Blood is drawn after an overnight fast

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Gastric Analysis

• This procedure is done to assess ulcers or to rule out pernicious anemia
• It also used to analyze acidity, appearance and volume of gastric secretions
• Gastric samples should be refrigerated if not tested within four hours
• HCL is normal in gastric ulcer and will be elevated in duodenal ulcer

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Fetal Heart Monitoring

Fetal heart monitoring is done to assess fetal heart rate abnormalities. There are there types of result:

Early Decelerations

• It indicates fetal head compression
• Mirror image is reflected on monitor
• No specific treatment is required

Late decelerations

• It indicates placental insufficiency
• Reverse mirror image is reflected on monitor
• Patient needs oxygen administration

Variable decelerations

• It indicates cord compression
• U or W shape image is seen on monitor
• Nursing interventions: change the patient position to left lateral recumbent and administer oxygen

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NCLEX-CGFNS: Endoscopy (Gastroscopy, Esophagoscopy)

• This procedure is done to assess the esophagus and the stomach by inserting a tube into them
• It needs an informed consent
• Remove patient’s denture if any
• Patient should be in NPO 6-8 hours before the procedure of endoscopy and resume feeding after gag reflex returns

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NCLEX-CGFNS: Endoscopic Retrograde Cholangio Pancreatography (ERCP)

• It provides radiographic visualization of the bile and pancreatic ducts
• It is used to diagnose problems in the liver, gallbladder, bile ducts, and pancreas
• It is contraindicated in pancreatitis
• Patient should be kept in NPO before and after the procedure
• Keep narcan at the bedside
• There might be hoarse and sore throat several days after the procedure

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