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01.04 CT & MR Angiography

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Overview

  1. CT and MR angiography
    1. Diagnose disease in vessels
    2. Use contrast

Nursing Points

General

  1. CT angiography
    1. Uses radiation
    2. Cross-sectional images to make 3D picture
    3. Iodinated contrast
  2. MR angiography
    1. Magnetic field and radio waves
    2. High resolution
    3. Gadolinium contrast
  3. Diagnose disease in vessels

Assessment

  1. Before
    1. Check kidney function (BUN & creatinine)
    2. Ask patient if allergic to contrast
    3. MRA -> MRI form fax to radiology
    4. Contrast consent
    5. Disconnect IV lines

Therapeutic Management

  1. During
    1. Position patient
    2. Ask to stay still
    3. MRA -> remove metal
  2. After
    1. Check IV patency (flush)
    2. Reconnect IV lines
    3. Hold metformin 48 hrs after

Nursing Concepts

  1. Patient education
    1. Still during scan
    2. Breathing directions
    3. Hold metformin 48 hrs
  2. Patient-centered care
    1. Claustrophobia considerations
    2. Contrast allergies
  3. Safety
    1. Radiation (CTA)
    2. Contrast dye (kidney function)

Patient Education

  1. Importance of staying still
  2. Follow breathing directions during scan
  3. Radiologist will interpret scan
  4. Doctor will provide results
  5. Hold metformin 48 hrs after

Reference Links

Video Transcript

Hey guys! Welcome to the lesson on CT and MR angiography. 

CT and MR angiography are used to diagnose disease in the vessels of the body like in this MRA here. CT is computed tomography, and MR is magnetic resonance. These two tests both use a type of contrast and are similar in results, but use different mechanisms to produce the pictures. Let’s explore the difference.

So the CT angiography uses radiation to bounce off of tissues and create cross-sectional images for a 3D view of the inside of the body. The type of contrast used is iodinated. Here’s a picture of a CTA showing a huge abdominal aortic aneurysm.

MR angiography uses a magnetic field to realign hydrogen atoms in the body, and radio waves to cause them to make signals used to create the pictures. MR is high resolution and uses a gadolinium contrast. Guys, look how cool this picture is and how clearly you can see the vessels in the brain. Next let’s discuss what to do to prepare the patient for these procedures. 

So before the procedure, check and make sure the BUN and creatinine lab draws have been done to view the kidney function. If they aren’t, the radiology tech will ask you to have the doctor order them before using contrast that may harm damaged kidneys. Ask the patient if they are allergic to contrast, and if they are find out what test they had previously as the contrast type is different for the CT and MR. If they are having the MR angiography, fill out that MRI form asking the patient about metal exposure and have them sign it. Fax it down to radiology so they can look it over for any issues before the test. There should be an area for contrast consent on that form as well. If the patient is having a CT angiography, have the patient sign a CT contrast consent after explaining the procedure. Disconnect any IV lines before the test because the tech will be using the IV for contrast administration. 

During the procedure, position the patient on the board. Ask the patient to stay still for clear images. If an MR is being performed, remove all metal from the patient and the room. 

After the procedure is over, check the IV patency with a saline flush and then reconnect the lines if they have IV fluids ordered. Hold the metformin for 48 hours if they take this drug for diabetes  to protect kidney function. Now let’s talk about patient education. 

Explain to your patient the importance of staying still during the procedure for a clear picture. Let them know that the tech will provide breathing instructions during the test. It’s helpful to tell them that the radiologist will interpret the picture and the doctor will explain the results to them. Tell them they can start taking their metformin again 48 hours after the test. 

The priority nursing concepts for the patient with a CT & MR angiography are patient education, patient-centered care, and safety. 

Alright, now let’s review the key points. CT and MR angiography are scans that use contrast to view the vessels in the body for diagnoses. The CT angiography uses radiation to create cross-sectional images for 3D views. MR angiography uses a magnetic field and radio waves to make a high resolution picture. Before the procedure, explain and have the patient sign the consent forms for the use of contrast. If the MR is ordered, ask the patient the questions on the MRI form before they sign. Disconnect IV lines before taking them to radiology. During the test, ask the patient to stay still for a clear picture and remove all metal from the patient and room. The radiologist will read and the doctor will provide results to the patient. 

Okay guys, that’s it on CT and MR angiography! No go out and be your best self today, and as always, happy nursing!


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