Radiological investigations, including X-rays and computed tomography (CT) scans, are critical for diagnosing and evaluating various medical conditions. These imaging techniques provide valuable insights into the body's internal structures, aiding in the detection of abnormalities, assessment of disease progression, and development of treatment strategies. This article delves into two primary radiological investigations, chest X-rays and CT scans, outlining their purpose, procedures, and the associated nursing responsibilities.
Chest X-rays
Chest X-rays are a common, non-invasive imaging technique used to screen, diagnose, and evaluate changes within the respiratory system. The procedure utilizes radiation to capture images of the chest, including the heart, lungs, and blood vessels. The X-ray can detect abnormalities such as fluid buildup, tumors, foreign bodies, and other pathological conditions.
A routine chest X-ray typically includes two views: the posteroanterior (PA) and lateral projection. These images are usually taken after full inspiration, as the lungs are best visualized when well-aerated and the diaphragm is at its lowest position.
Nursing Responsibilities for Chest X-rays
Nurses play an essential role in preparing patients for chest X-rays. Patients should be instructed to undress from the waist up and wear a gown. They must also remove any metal objects between the neck and waist, as these can interfere with the image quality. Nurses should inform patients that the procedure does not require fasting and is usually painless. However, patients need to be able to take a deep breath and hold it briefly while the image is taken. Special attention should be given to pregnant patients, as chest X-rays are generally contraindicated due to the potential risks of radiation to the fetus.
Computed Tomography (CT) Scans
CT scans provide more detailed, cross-sectional images of the body than conventional X-rays. They are especially useful for diagnosing lesions that are difficult to assess using standard X-rays, such as pulmonary nodules, small tumors near pleural surfaces, mediastinal abnormalities, and hilar adenopathy.
CT scans can be performed with or without a contrast medium, which is often iodine-based and used to enhance image clarity by highlighting specific areas of the body. However, contrast medium is contraindicated in patients with impaired kidney function, known iodine allergies, or a history of adverse reactions to contrast media. In such cases, alternative imaging techniques or non-contrast CT scans may be considered. During pregnancy, the use of contrast medium is typically avoided unless the benefits significantly outweigh the risks.
While CT scans are highly beneficial, certain factors can complicate the procedure. Severe obesity may exceed the scanner's weight limit, requiring alternative imaging methods. Claustrophobia can also affect patient comfort, but newer open or wide-bore CT scanners can help alleviate this issue. Additionally, CT scans are generally avoided during pregnancy unless necessary due to potential risks to the fetus.
Nursing Responsibilities for CT Scans
Nursing responsibilities for CT scans are similar to those for chest X-rays, with additional considerations related to the use of contrast medium. Before the procedure, nurses should evaluate the patient's blood urea nitrogen (BUN) and serum creatinine levels to assess kidney function. It is also important to determine if the patient has any allergies, particularly to shellfish (which may indicate an iodine allergy), as the contrast medium is typically iodine-based.
Patients should be well-hydrated before and after the procedure to aid in the excretion of the contrast medium. Nurses should inform patients that the injection of the contrast medium may cause a sensation of warmth and flushing. During the scan, patients must lie still on a hard table while the scanner revolves around their body.
