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01.01 X-Ray (Xray)

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Overview

  1. X-ray
    1. Diagnostic test
    2. View inside matter of body
    3. Radiation

Nursing Points

General

  1. Electromagnetic wave radiation
    1. Tissues absorb differently
    2. More dense show as white (bones)
    3. Air shows as black (inside lungs)
    4. Fat and muscle grey
  2. Purpose
    1. Broken bones
    2. Suspicion of lung disease (pneumonia)
    3. Digestive issues (constipation and pain)
    4. Confirm placement of tubes or devices

Assessment

  1. Before
    1. Inform patient of procedure
    2. Ask if pregnant (may cause damage to unborn child)
    3. Answer any questions
    4. Ask for informal consent (no signiture needed)
    5. Empty bladder (full may interfere with picture)

Therapeutic Management

  1. During
    1. Position patient according to body part being viewed
    2. Protective lead shielding
      1. Areas of body not being viewed
    3. Encourage patient to stay still during X-ray
  2. After
    1. Remove protective shielding
    2. No special cares

Nursing Concepts

  1. Communication ->clear explanation to patient
  2. Patient-centered care ->positioning depends on area of body to be viewed
  3. Safety -> radiation protection

Patient Education

  1. Do not move during X-ray
  2. Radiologist will read the X-ray
  3. Physician will provide results

Reference Links

Video Transcript

Hey guys! In this lesson we will explore what an X-ray is, why the patient might have one, and what your role as the nurse is. 

So an X-ray is a diagnostic test that allows us to view matter inside the body by using electromagnetic wave radiation. Let’s explore how this works. 

So tissue absorbs the electromagnetic waves differently, so they show differently on the X-ray picture. More dense tissue like bones show as white like here, air shows as black like here in the lungs, and fat and muscle show greyish colored. Now why would we need to do an X-ray?

So of course if there is a suspected broken bone like in the arm, an X-ray should show the break. Any suspicion of lung disease like pneumonia can be visualized like in this X-ray where it is greyish and foggy looking in the lungs. If a patient has digestive issues like severe constipation and abdominal pain, the doctor may order an X-ray to look inside for any disease processes. Another common reason for an X-ray is if a tube or device was placed in the body like an NG tube where you will have to make sure the tip of the NG is in the stomach. Now let’s discuss what you as the nurse will do to prepare the patient for an X-ray. 

When the doctor orders an X-ray, you will inform the patient of what it is and why they are getting one. Make sure the patient isn’t pregnant as the radiation can harm the unborn child. Answer any questions that the patient has about the test, and if there is something you don’t know, call down and ask a radiology technician. Get informed consent, meaning ask the patient if they are agreeable to having the X-ray. No signature is needed because this is noninvasive. Lastly, make sure the patient empties the bladder so that the radiologist will get a clear picture without a full bladder in the way. Now let’s move on to the procedure. 

You will assist with positioning the patient according to the body part being viewed. A protective lead shield will be placed over sensitive areas of the body that aren’t being viewed to avoid unnecessary radiation. Encourage the patient to stay still during the X-ray so that a clear picture is taken. You will not remain in the room, but instead step out so that you aren’t exposed to the radiation. 

When the X-ray is over, you will remove the protective shielding. There are no special cares required after the X-ray. Let’s explore patient education next. 

So explain the importance of staying still during the procedure so that another X-ray isn’t needed to clarify. Let the patient know that a radiologist will interpret the X-ray picture so that the doctor can read the results, and the physician will explain the results to the patient. 

Alright, so the priority nursing concepts for a patient with an X-ray are communication, patient-centered care, and safety. 

Alright, let’s review the key points. So an X-ray is a diagnostic test that uses electromagnetic radiation waves to diagnose disease or verify line or device placement inside of the body. Before the X-ray, explain the procedure to the patient, obtain informal consent, and ask the patient to empty their bladder. During the procedure, position the patient according to the area being looked at, and place protective shielding on the parts of the body not being looked at. After the X-ray, remove the shielding. There isn’t any special care that the patient will need after the procedure. Let the patient know that the radiologist interprets the X-ray, and the doctor will provide the results to the patient. 

Alright, that’s it on X-ray nursing considerations! Now go out and be your best self today, and as always, happy nursing!

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