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neuro diagnostics
exam 7 alterations
Question | Answer |
---|---|
CT Scan | used to detect intracranial bleeding, space-occupying lesions, cerebral edema, infarctions, hydrocephalus, cerebral atrophy and shifts of brain structures |
CT Pre-procedure | obtain informed consent, assess for allergies to iodine and shell fish, withhold glucophage, may be hot flushed feeling and metallic taste |
CT post-procedure | provide replacement fluids, monitor for allergic reaction to dye, assess iv line |
MRI | noninvasive procedure that identifies tissue, tumors and vascular abnormalities, similar to CT but has more detailed pictures |
MRI Pre-procedure | remove all metal objects, assess for pacemaker, metal implants or vascular clips, pulse ox precautions |
MRI post procedure | client can resume normal activity, expect diuresis |
MRI contraindicated when | pregnant woman |
MRA | can provide information about the blood vessels of the brain and identify any lesions pre and post procedure is the same for MRI |
PET scan | can assess normal brain function and cerebral blood flow and volume, it can differentiate different types of dementia and can identify brain tumors |
PET pre-procedure | no coffee or alcohol or smoking 24 hours prior,assess glucose levels |
PET post procedure | encourage oral fluids to eliminate radioactive material |
cerebral angiogram | injection of contrast material through femoral artery into carotid arteries to visualize the cerebral arteries and assess for lesions |
cerebral angiogram pre procedure | obtain consent, assess allergies, assess for anticoagulation therapy, encourage hydration 2 days prior, NPO 4-6 hours before, base line neuro assessment, mark peripheral pulses |
cerebral angiogram post procedure | monitor vitals and neuro status, swelling and difficult swallowing, maintain bed rest 12 hours, elevate head of bed 15-30 degrees, keep head of bed flat if femoral artery used, assess peripheral pulses, place ice on puncture site, encourage fluid |
carotid duplex study | evaluates velocity of blood flow through carotid arteries and identifies occlusive disease. Sound waves produced by the blood flow are used to produce an image |
EEG | graphic recording of the electrical activity of the superficial layers of the cerebral cortex |
EEG pre procedure | wash clients hair, electrodes attached to head, withhold stimulants 24-48 hours prior to exam, allow client to have breakfast |
EEG post procedure | wash clients hair, maintain safety measures, side rails up |
lumbar puncture | insertion of a small needle into L3-L4 to obtain CSF, measure CSF pressure, instill air, dye or medications |
lumbar puncture pre procedure | obtain informed consent, empty bladder |
lumbar puncture intra procedure | client is in lateral recumbent position knees to chest, assist with collection of material |
lumbar puncture post procedure | monitor vitals and neuro symptoms, position client flat, encourage fluids, monitor intake and output |
EMG (electromyogram) | measures electrical activity of skeletal muscles at rest and during contraction, it is useful in diagnosing neuromuscular diseases |
EMG pre procedure | no smoking or caffeine 3 hours before test, assess meds, patient should not be on muscle relaxants, anticholinergics, or cholinergics |
EMG post procedure | serum enzyme drawn 5-10 days after procedure |
myelogram | injection of air or dye into the subarachnoid space to detect abnormalities of the spinal cord and vertebrae |
myelogram pre procedure | obtain consent, hydration 12 hours before test, assess allergies, if client is on phenothiazine withhold it, premedicate with sedation as needed |
myelogram post procedure | assess vitals and neuro status, maintain bed rest, administer pain meds for backache and headache, encourage fluids, monitor I&O, at least 30mL/hr |