01.02 Computed Tomography (CT)

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Included In This Lesson

Outline

Overview

  1. Computed tomography (CT)
    1. Detailed X-ray of body
    2. Used to diagnose disease

Nursing Points

General

  1. Narrow beamed X-ray
    1. Uses radiation
    2. Motorized rotating scanner
    3. Cross-sectional images put together to make 3D picture
  2. Purpose
    1. Find abnormalities
      1. Tissue
      2. Organs
      3. Vessels
      4. Bone

Assessment

  1. Before
    1. Explain procedure
    2. If contrast
      1. Check kidney function (BUN & creatinine)
      2. Obtain formal consent (invasive)
      3. PO-> patient drinks two hours prior to CT
      4. Notify radiology technician when patient has finished drinking contrast

Therapeutic Management

  1. During
    1. Position patient
    2. If IV contrast, disconnect IV lines prior
    3. Ask patient not to move
  2. After
    1. Radiologist interprets picture
    2. Doctor provides results
    3. No metformin after contrast at least 48 hrs (may damage kidney function)

Nursing Concepts

  1. Safety
    1. Radiation safety
    2. IV contrast considerations
  2. Patient Education
    1. Before, during, and after procedure
  3. Patient-Centered Care
    1. Part of body scanned depends on symptoms
    2. Contrast considerations

Patient Education

  1. Explain importance of staying still during procedure
  2. Explain warm sensation during IV contrast
  3. Notify when okay to resume metformin

Transcript

Hey guys! Welcome to the lesson on computed tomography. 

Computed tomography or CT scans are narrow beamed X-rays that use a motorized rotating scanner to take cross-sectional images and put them together to make a 3D picture. This results in a more detailed picture of the inside of the body to help diagnose disease. Let’s discuss the purpose of the CT scan. 

The doctor will order a CT scan to get a clearer and more detailed picture to help see if there are any abnormalities or signs of disease in the patient’s body. CT scans will show tissue and can detect tumors. They show the organs like in this picture and help diagnose disease like pneumonia or heart disease. They show the vessels and any clots within them. Complex bone fractures that aren’t seen with regular X-rays can be visualized with the CT scan. Next let’s talk about what to do before the scan. 

So when the doctor orders  a CT scan for your patient, you will let them know and explain the procedure to them and tell them why they’re having this test done. For example, if the patient’s D-dimer was elevated and they were short of breath, the test may be ordered to look for pulmonary embolisms in the lungs. Sometimes the doctor will order a CT with contrast, in which case you will need to get a formal consent filled out and have the patient sign. Check and make sure that the patient has had a lab draw for BUN and creatinine to ensure that their kidney function is good because contrast can affect the kidneys. The radiology tech will not be able to do the test until you have the consent done because contrast is invasive. The contrast may be inserted in the IV, by mouth, or both. If the patient has to drink contrast, you will measure it out as ordered and add it to juice or soda. I usually mix it into sprite to hide the taste. The patient will drink the contrast two hours before the CT scan is done. Let the radiology technician know when the patient finishes the contrast so that they know when the patient will be coming. 

During the CT, you will help to position the patient on this table according to the test ordered. If IV contrast is used, you will disconnect the IV lines so that the radiology tech may administer the contrast. Ask the patient not to move during the test so that a clear picture may be taken. 

So after a regular CT scan, there aren’t any special considerations. The radiologist will interpret the results, and the doctor will inform the patient of the results.  If contrast was used, it is important to hold metformin for at least 48 hours after the test to avoid kidney damage. Now let’s move on to patient education. 

Make sure you explain the importance of staying still during the test so the doctor may get a clear picture to help diagnose. Let them know they will feel a warm sensation throughout the body, almost like they are peeing during the IV contrast administration. Let your patient know exactly when they may resume their metformin. 

The priority nursing concepts for a CT scan are patient education, safety, and patient-centered care. 

Alright, let’s review the key points. CT scans are more detailed 3D X-rays that are ordered by the doctor to view tissue, vessels, organs, or bones to help diagnose disease. Before the scan, you will inform the patient of the reasoning for the test and what to expect during. During the test you will position the patient according to the test ordered, and disconnect IV lines if the patient needs IV contrast. The radiology tech will administer the contrast. After the test, hold metformin for at least 48 hours. The radiologist will interpret the results, and the doctor will provide the results to the patient. 

That’s it on CT scans! No go out and be your best self today, and as always, happy nursing!