X-Ray (Xray)

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Outline

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

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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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Concepts Covered:

  • Cardiac Disorders
  • Acute & Chronic Renal Disorders
  • Disorders of Pancreas
  • Neurological Emergencies
  • Noninfectious Respiratory Disorder
  • Pregnancy Risks
  • Postpartum Complications
  • Gastrointestinal Disorders
  • Musculoskeletal Trauma
  • Hematologic Disorders
  • Respiratory Disorders
  • Legal and Ethical Issues
  • Preoperative Nursing
  • Basic
  • Factors Influencing Community Health
  • Fundamentals of Emergency Nursing
  • Integumentary Disorders
  • Emotions and Motivation
  • Delegation
  • Prioritization
  • Test Taking Strategies
  • Basics of NCLEX
  • Communication
  • Concepts of Mental Health
  • Health & Stress
  • Urinary Disorders
  • Urinary System
  • Digestive System
  • Central Nervous System Disorders – Brain
  • Integumentary Disorders
  • Tissues and Glands
  • Developmental Theories
  • Renal Disorders
  • Newborn Care
  • Upper GI Disorders
  • Substance Abuse Disorders
  • Prenatal Concepts
  • Fetal Development
  • Labor and Delivery
  • Labor Complications
  • Postpartum Care
  • Newborn Complications
  • Childhood Growth and Development
  • Adulthood Growth and Development
  • Hematologic Disorders
  • Oncologic Disorders
  • Endocrine and Metabolic Disorders
  • EENT Disorders
  • Cardiovascular Disorders
  • Renal and Urinary Disorders
  • Neurologic and Cognitive Disorders
  • Musculoskeletal Disorders
  • Infectious Disease Disorders
  • Eating Disorders
  • Oncology Disorders
  • Vascular Disorders
  • Intraoperative Nursing
  • Postoperative Nursing
  • Circulatory System
  • Emergency Care of the Cardiac Patient
  • Shock

Study Plan Lessons

Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Nursing Care and Pathophysiology for Hemorrhagic Stroke (CVA)
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Postpartum Hemorrhage (PPH)
Pediatric Gastrointestinal Dysfunction – Diarrhea
Fractures
Nursing Care and Pathophysiology for Anemia
Asthma
Advance Directives
Legal Considerations
HIPAA
Brief CPR (Cardiopulmonary Resuscitation) Overview
Fire and Electrical Safety
Fall and Injury Prevention
Isolation Precaution Types (PPE)
Maslow’s Hierarchy of Needs in Nursing
Delegation
Prioritization
Triage
Overview of the Nursing Process
Therapeutic Communication
Defense Mechanisms
Abuse
Patient Positioning
Complications of Immobility
Urinary Elimination
Bowel Elimination
Pain and Nonpharmacological Comfort Measures
Hygiene
Overview of Developmental Theories
Intake and Output (I&O)
Blood Glucose Monitoring
Specialty Diets (Nutrition)
Enteral & Parenteral Nutrition (Diet, TPN)
Head to Toe Nursing Assessment (Physical Exam)
Menstrual Cycle
Family Planning & Contraception
Gestation & Nägele’s Rule: Estimating Due Dates
Gravidity and Parity (G&Ps, GTPAL)
Fundal Height Assessment for Nurses
Maternal Risk Factors
Physiological Changes
Discomforts of Pregnancy
Antepartum Testing
Nutrition in Pregnancy
Chorioamnionitis
Gestational Diabetes (GDM)
Disseminated Intravascular Coagulation (DIC)
Ectopic Pregnancy
Hydatidiform Mole (Molar pregnancy)
Gestational HTN (Hypertension)
Infections in Pregnancy
Fetal Development
Fetal Environment
Fetal Circulation
Process of Labor
Mechanisms of Labor
Leopold Maneuvers
Fetal Heart Monitoring (FHM)
Prolapsed Umbilical Cord
Placenta Previa
Abruptio Placentae (Placental abruption)
Preterm Labor
Precipitous Labor
Dystocia
Postpartum Physiological Maternal Changes
Postpartum Discomforts
Breastfeeding
Mastitis
Initial Care of the Newborn (APGAR)
Newborn Physical Exam
Body System Assessments
Newborn Reflexes
Babies by Term
Meconium Aspiration
Transient Tachypnea of Newborn
Hyperbilirubinemia (Jaundice)
Newborn of HIV+ Mother
Care of the Pediatric Patient
Vitals (VS) and Assessment
Growth & Development – Infants
Growth & Development – Toddlers
Growth & Development – Preschoolers
Growth & Development – School Age- Adolescent
Eczema
Impetigo
Pediculosis Capitis
Burn Injuries
Sickle Cell Anemia
Hemophilia
Nephroblastoma
Fever
Dehydration
Vomiting
Celiac Disease
Appendicitis
Intussusception
Constipation and Encopresis (Incontinence)
Conjunctivitis
Acute Otitis Media (AOM)
Tonsillitis
Bronchiolitis and Respiratory Syncytial Virus (RSV)
Cystic Fibrosis (CF)
Congenital Heart Defects (CHD)
Defects of Increased Pulmonary Blood Flow
Defects of Decreased Pulmonary Blood Flow
Obstructive Heart (Cardiac) Defects
Mixed (Cardiac) Heart Defects
Nephrotic Syndrome
Enuresis
Cerebral Palsy (CP)
Meningitis
Spina Bifida – Neural Tube Defect (NTD)
Autism Spectrum Disorders
Attention Deficit Hyperactivity Disorder (ADHD)
Scoliosis
Rubeola – Measles
Mumps
Varicella – Chickenpox
Pertussis – Whooping Cough
ABGs Nursing Normal Lab Values
ABG (Arterial Blood Gas) Interpretation-The Basics
Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Alkalosis
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic Alkalosis
Base Excess & Deficit
Isotonic Solutions (IV solutions)
Hypotonic Solutions (IV solutions)
Hypertonic Solutions (IV solutions)
Potassium-K (Hyperkalemia, Hypokalemia)
Sodium-Na (Hypernatremia, Hyponatremia)
Chloride-Cl (Hyperchloremia, Hypochloremia)
Red Blood Cell (RBC) Lab Values
Hemoglobin (Hbg) Lab Values
Hematocrit (Hct) Lab Values
White Blood Cell (WBC) Lab Values
Platelets (PLT) Lab Values
Coagulation Studies (PT, PTT, INR)
Albumin Lab Values
Cholesterol (Chol) Lab Values
Ammonia (NH3) Lab Values
Blood Urea Nitrogen (BUN) Lab Values
Creatinine (Cr) Lab Values
Urinalysis (UA)
Glucose Lab Values
Hemoglobin A1c (HbA1C)
X-Ray (Xray)
Computed Tomography (CT)
Magnetic Resonance Imaging (MRI)
Cerebral Angiography
Cardiovascular Angiography
Echocardiogram (Cardiac Echo)
Ultrasound
Biopsy
Informed Consent
Preoperative (Preop)Assessment
Preoperative (Preop) Education
Preoperative (Preop) Nursing Priorities
General Anesthesia
Local Anesthesia
Moderate Sedation
Malignant Hyperthermia
Post-Anesthesia Recovery
Postoperative (Postop) Complications
Discharge (DC) Teaching After Surgery
Hemodynamics
Preload and Afterload
Performing Cardiac (Heart) Monitoring
Normal Sinus Rhythm
Sinus Bradycardia
Sinus Tachycardia
Atrial Fibrillation (A Fib)
Premature Ventricular Contraction (PVC)
Ventricular Tachycardia (V-tach)
Ventricular Fibrillation (V Fib)
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Pacemakers
Nursing Care and Pathophysiology of Hypertension (HTN)
Nursing Care and Pathophysiology for Cardiomyopathy
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Cardiogenic Shock
Nursing Care and Pathophysiology for Distributive Shock