TESTS PROCEDURE NORMAL INTERPRETATION NURSING

RANGE S RESPONSIBILI
TIES
MRI - You will be A normal Generally, MRI is BEFORE:
(magnetic positioned on the MRI, prescribed only when
resonance MRA, serious symptoms or Your doctor will
moveable
imaging) scan MRS, or negative results from explain the
examination procedure to you
is a imaging MRCP other tests indicate a
test that uses table. Straps and result is need. There often exists and offer you the
powerful bolsters may be one that strong evidence of a opportunity to ask
magnets and used to help you shows the condition that the scan any questions that
radio waves to stay still and patient's is designed to detect you might have
create pictures maintain the physical and assess. Thus, the about the
of the body. It condition results will often be procedure.
correct position
does not use to fall abnormal, confirming
during imaging. If your procedure
radiation (x- within the earlier diagnosis. At
Devices that involves the use of
rays). normal that point, further
contain coils ranges for testing and appropriate contrast dye, you
And capable of the target medical treatment is will be asked to
sending and area needed. For example, if sign a consent
CT SCAN- an receiving radio scanned. the MRI indicates the form that gives
imaging presence of a brain permission to do
waves may be
method that tumor, an MRS may be the procedure.
uses x-rays to placed around or Read the form
create pictures adjacent to the
prescribed to determine
the type of tumor so carefully and ask
of cross-
sections of the
area of the body that aggressive questions if
body. being studied. treatment can begin something is not
If a contrast immediately without clear.
material will be the need for a surgical
biospy. Generally, there is
used in the MRI
no special
exam, a nurse restriction on diet
or technologist wi or activity prior to
ll insert an MRI procedure.
an intravenous
(IV)catheter, also Before the
examination, it is
known as an IV
extremely
line, into a vein in important that you
your hand or arm. inform the
A saline solution technologist if any
may be used. The of the following
solution will drip apply to you:
through the IV to
 You are
prevent blockage
claustrophobic
of the IV catheter and think that
until the contrast you will be
material is unable to lie
injected. still while
You will be inside the
moved into the scanning
magnet of the machine, in
which case you
MRI unit and the
may be given a
radiologist and sedative
technologist will  You have a
leave the room
while the MRI pacemaker
examination is inserted, or
performed. have had heart
valves replaced
If a contrast
 You have any
material is used type of
during the implanted
examination, it pump, such as
will be injected an insulin
into the pump
intravenous line  You have
metal plates,
(IV) after an
pins, metal
initial series of implants,
scans. Additional surgical
series of images staples, or
will be taken aneurysm clips
during or  You have any
following the metallic
injection. fragments
anywhere in
When the
the body
examination is  You have
completed, you permanent
may be asked to eyeliner or
wait until the tattoos
technologist or  You are
radiologist checks pregnant or
the images in case suspect you
may be
additional images
pregnant
are needed.  You have ever
Your intravenous had a bullet
line will be wound
removed.  You have ever
MRI exams worked with
generally include metal (for
example, a
multiple runs
metal grinder
(sequences), some or welder)
of which may last  You have any
several minutes. body piercing
Depending on the  You have an
type of exam and intrauterine
the equipment device (IUD)
used, the entire  You are
wearing a
exam is usually
medication
completed in 30 patch
to 50 minutes.
As there is a
possibility that you
may receive a
sedative before the
procedure, you
should plan to
have someone
drive you home
afterward.

Based upon your

medical condition,
your doctor may
request other
specific
preparation.

DURING:

Generally, MRI of
the spine and brain
follows this
process:

 You will be
asked to
remove any
clothing,
jewelry,
eyeglasses,
hearing aids,
hairpins,
removable
dental work, or
other objects
that may
interfere with
the procedure.
 If you are asked
to remove
clothing, you
will be given a
gown to wear.
 If you are to
have a
procedure done
with contrast,
an intravenous
(IV) line will be
started in the
hand or arm for
injection of the
contrast dye.
 You will lie on
a scan table that
slides into a
large circular
opening of the
scanning
machine.
Pillows and
straps may be
 used to prevent
movement
during the
procedure.
 The
technologist
will be in
another room
where the
scanner
controls are
located.
However, you
will be in
constant sight
of the
technologist
through a
window.
Speakers inside
the scanner will
enable the
technologist to
communicate
with and hear
you. You will
have a call
button so that
you can let the
technologist
know if you
have any
problems
during the
procedure. The
technologist
will be
watching you at
all times and
will be in
constant
communication.
 You will be
given earplugs
or a headset to
wear to help
block out the
noise from the
scanner. Some
headsets may
provide music
for you to listen
to.
 During the
scanning
process, a
clicking noise
 will sound as
the magnetic
field is created
and pulses of
radio waves are
sent from the
scanner.
 It will be
important for
you to remain
very still during
the
examination, as
any movement
could cause
distortion and
affect the
quality of the
scan.
 At intervals,
you may be
instructed to
hold your
breath, or to not
breathe, for a
few seconds,
depending on
the body part
being
examined. You
will then be
told when you
can breathe.
You should not
have to hold
your breath for
longer than a
few seconds.
 If contrast dye
is used for your
procedure, you
may feel some
effects when
the dye is
injected into the
IV line. These
effects include
a flushing
sensation or a
feeling of
coldness, a
salty or metallic
taste in the
mouth, a brief
headache,
itching, or
nausea and/or
 vomiting.
These effects
usually last for
a few moments.
 You should
notify the
technologist if
you feel any
breathing
difficulties,
sweating,
numbness, or
heart
palpitations.
 Once the scan
has been
completed, the
table will slide
out of the
scanner and
you will be
assisted off the
table.
 If an IV line
was inserted for
contrast
administration,
the line will be
removed.

AFTER:

You should move

slowly when
getting up from the
scanner table to
avoid any
dizziness or
lightheadedness
from lying flat for
the length of the
procedure.

If any sedatives
were taken for the
procedure, you
may be required to
rest until the
sedatives have
worn off. You will
also need to avoid
driving.

If contrast dye is
used during your
procedure, you
may be monitored
 for a period of
time for any side
effects or reactions
to the contrast dye,
such as itching,
swelling, rash, or
difficulty
breathing.

If you notice any

pain, redness,
and/or swelling at
the IV site after
you return home
following your
procedure, you
should notify your
physician as this
could indicate an
infection or other
type of reaction.

Otherwise, there is
no special type of
care required after
a MRI scan of the
spine and brain.
You may resume
your usual diet and
activities, unless
your physician
advises you
differently.

Your doctor may

give you additional
or alternate
instructions after
the procedure,
depending on your
particular
situation.

BIOPSY - is There are various The tissue An abnormal biopsy BEFORE:

the removal of kinds of biopsy removed is Before the biopsy,
means that the tissue or
a small piece procedure, normal. your doctor may
of tissue for including: cells have an unusual order urine tests,
laboratory Bone marrow structure, shape, size, blood tests, and x-
examination. biopsy - a small or condition. rays of your
sample of bone kidneys.
This may mean you
marrow (usually You should ask
from the hip) is have a disease, such as your doctor when
removed via a cancer, but it depends you can expect to
slender needle. on your biopsy. know the biopsy
 This type of results.
biopsy helps to Arrange for a ride
diagnose diseases home after your
such as biopsy.
leukaemia. Your doctor may
Colposcopy- ask you to fast or
directed biopsy - eat lightly before
a colposcope is a your biopsy.
small microscope Talk to your
used to examine a doctor about your
woman’s cervix medicines. You
while a tissue may be asked to
sample is taken. stop taking some
This biopsy is medicines up to
usually performed one week before
to investigate the the procedure like:
reasons for an Anti-inflammatory
abnormal Pap test drugs (eg, aspirin )
result. Blood thinners like
Endoscopic clopidogrel
biopsy - the (Plavix) or
endoscope is a warfarin
flexible tube that (Coumadin)
can be inserted Anesthesia
into an orifice
(such as the You will receive a
mouth or anus) or local anesthetic to
through a small numb your skin.
skin incision. You may also
Once the lump is receive a light
reached, cutting sedative.
tools are threaded DURING:
through the A needle biopsy is
endoscope so that called a
a sample of tissue percutaneous
can be taken. biopsy. It removes
Excisional tissue using a hollow
biopsy - the lump tube called a
is entirely syringe. The needle
removed.
is passed several
Depending on the
times through the
location of the
tissue being
lump, the patient
examined. The
may need to
surgeon uses the
undergo general
needle to remove
anaesthesia. This
the tissue sample.
type of biopsy
may be used for Needle biopsies are
breast lumps. often done using CT
Incisional scan or ultrasound.
biopsy - only a These imaging tools
small slice of the help guide the
lump is removed. surgeon to the right
Depending on the area.
location of the
lump, a general or An open biopsy is
local anaesthetic surgery that uses
 may be needed. local or general
This type of anesthesia. This
biopsy may be means you are
used for lumps relaxed (sedated) or
located in asleep and pain-free
connective tissue during the
such as muscle. procedure. It is done
Needle biopsy - a in a hospital
small sample of operating room. The
the lump is surgeon makes a cut
removed via a into the affected
slender area, and the tissue
hypodermic
is removed.
needle. This can
be done either Closed biopsy uses
with or without a much smaller
local anaesthetic. surgical cut than
This type of
open biopsy. A small
biopsy may be
cut is made so that a
used to diagnose
camera-like
conditions of the
instrument can be
liver or thyroid.
inserted. This
Punch biopsy - a
instrument helps
special tool is
used to punch a guide the surgeon to
hole through the the right place to
uppermost layers take the sample.
of the skin. The
anaesthetic used
AFTER:
may be local or
topical. This type You will be
of biopsy can monitored for a
help diagnose few hours after
various skin your biopsy. You
conditions. will be asked to
Stereotactic remain lying down
biopsy - a series to reduce the
of x-rays help to chance of
guide the bleeding. Your
surgeon’s needle pulse and blood
to the lump. This pressure will be
type of biopsy is monitored. Your
usually performed biopsy samples
whenever the will be sent to the
lump is hard to laboratory for
see or feel. testing. Once you
are feeling well
and the doctor
feels it is safe, you
will be sent home.
At Home
When you return
home, do the
following to help
ensure a smooth
 recovery:
Rest to prevent
bleeding. You
should usually rest
for the first 24-48
hours after the
biopsy. Do not lift
or exercise until
your doctor says it
is okay.
Keep your biopsy
site clean and dry.
Check your urine.
You may notice
some blood in
your urine. This is
normal for the first
24 hours. If there
is bleeding for
longer than 24
hours or a lot of
bleeding, call your
doctor.
Be sure to follow
your doctor's
instructions .

Thyroid Scan A radionuclide is The thyroid A thyroid that is BEFORE:

–uses either injected appears the enlarged or pushed off
a radioactive into a vein or correct to one side could be a Do not eat or
tracer and a given to you as a size, shape, sign of a tumor. drink 2 hours
special camera pill. Timing of the and in the before or 1 hour
to measure test then depends proper Nodules will absorb after you receive
how much on the type of location. It more or less iodine and the dose of the
tracer radionuclide your appears an will look darker or compound. You
the thyroid gla doctor uses, and even gray lighter on the scan may have only a
nd absorbs whether you will color on (usually lighter if there thyroid scan, or a
from also have an the is a tumor). If part of thyroid scan with
the blood. The uptake test. If you computer the thyroid appears thyroid uptakes
tracer can be are having only a image. lighter, it could be a
swallowed or thyroid scan and thyroid problem. DURING:
can be your doctor
injected into a prefers to give a The computer will also You will be given
vein. It travels radionuclide by show the percentage of a small amount of
through your intravenous iodine that has radioactive iodine
body, giving injection, the scan collected in your to take by mouth 4
off radiationsi can be done thyroid gland. If your hours before the
gnals. The within 30-60 gland collects too much scan. After this
camera "sees" minutes. If you or too little of the time, the scan will
the signals are given radiotracer, this can be be started. You
and can radioactive iodine will lie down on an
due to
measure how in pill form, you examination table.
an underactive or overa
much tracer need to wait four A pillow will be
ctive thyroid gland.
the thyroid to six hours, and placed under your
absorbs from possibly as long shoulders to
the blood. as a day, before extend your neck
having the scan. so that the thyroid
(This gives the can be easily
radioactive iodine scanned. Pictures
time to reach your will be taken with
thyroid.) If you're a very sensitive
having both a machine, called a
scan and the gamma camera,
uptake test, you that receives and
are likely to records the
receive radiation in your
radioactive iodine thyroid gland.
in pill form. This
allows one You will be given
radionuclide to be a small amount of
used for both the radioactive iodine
scan and uptake by mouth. You
test, instead of will be asked to
two, and return either 4
eliminates the hours and 24 hours
need for an later, or only 24
injection. hours later. You
will be asked to sit
After you've
in a chair while a
received the
small probe is
radionuclide and
placed in front of
have waited the
appropriate your neck. This
amount of time, a probe detects any
technician places change from
a radioactivity normal in your
detector-a camera thyroid gland.
specially designed • The scan,
to take pictures of without uptake,
radioactive lasts about 1 hour.
objects - against • The scan,
your neck and with uptake, lasts
takes several about 1 1/2 hours.
images. The
camera itself AFTER:
doesn't expose There are no
you to any adverse effects.
radiation. This Your body rids
portion of the test itself of the
usually takes compound as it
about half an does the food you
hour. eat.
An uptake test
only takes several If you have
minutes and is questions about the
performed while procedure, please
you are sitting up. ask. Your nurse
Using a device and doctor are
that resembles a ready to assist you
Geiger counter, at all times.
the doctor or
technician places
 a probe several
inches in front of
your neck, where
the thyroid gland
is located, and
measures the
percentage of
radioactivity that
is retained by the
thyroid gland.
You return the
next day for
follow-up testing
to obtain a second
set of uptake
readings, which
are then
compared with
the first set to
determine how
much hormone
has been formed
and secreted in
the interim.

Radioactive You are asked to  6 Increased hormone Before:

Iodine swallow a liquid hou levels may be due to an Do not eat for 8
Uptake - is a or capsule rs: overactive thyroid hours before the
test of thyroid containing 3- gland caused by: test.
function. It radioactive 16
measures how iodine. %  An enlarged Your health care
much  24 thyroid gland provider will
radioactive After a certain hou that contains instruct you, if
iodine is taken period of time rs: nodules needed, to stop
up by the (usually 6 and 24 8- producing too taking drugs that
thyroid gland hours later), you 25 much thyroid may affect the test
in a certain must return to the % hormone (toxic results.
time period. testing center so nodular goiter)
that the amount ofNote:  Tell your doctor if
A single thyroid
radioactivity in Some nodule that isyou have:
the thyroid gland laboratories producing too
can be measured. only much thyroid  Diarrhea
This is done usingmeasure at hormone (may
a device called a 24 hours.  Graves disease decrease
gamma probe. Values absorption
may vary Decreased levels may of the
The probe is depending be due to: radioactive
placed over your on the iodine)
thyroid gland amount of  Factitious  Recent x-
along the outside iodine in hyperthyroidism ray test
of your neck. You your diet.  Iodine overload using
will be asked to Normal  Subacute iodine-
lie on a table value thyroiditis based
while the scanner ranges may  Silent (or contrast
moves over your vary painless) (within the
neck. slightly thyroiditis past 2
among weeks)
The scan takes different  Too little
about 30 minutes. laboratories or too
. Talk to much
your doctor iodine in
about the your diet
meaning of
your DURING:
specific
test results. For this
test, you
take a
small,
oral dose
of
radioactiv
e iodine
(radioiodi
ne). Over
time, the
iodine
collects
in your
thyroid
gland
because
your
thyroid
uses
iodine to
manufact
ure
hormones
. You'll be
checked
after two,
six or 24
hours —
and
sometime
s after all
three time
periods —
to
determine
how much
iodine
your
thyroid
gland has
absorbed.

AFTER:
 You can eat
beginning
about 1 - 2
hours after
swallowing
the
radioactive
iodine. You
can go back
to a normal
diet when
the test is
finished.

The
radioactive
iodine
leaves your
body
through your
urine. You
may need to
take special
precautions,
such as
flushing
twice after
urinating, for
24 - 48
hours after
the test. Ask
your health
care
provider or
the
radiology/nu
clear
medicine tea
m
performing
the scan.

Thyroid Normal  Levels below 0.5 are In patients

Suppression - Patients reference considered possible with persistent
used to treated for range is evidence of disease, the
diagnose differentiate approximat hyperthyroidism, and serum TSH
difficult cases ely 0.5 to levels above 5.0 should be
of d thyroid 5.0 would be considered maintained
hyperthyroidis cancer take possible evidence of below 0.1mU=L
m, now a daily hypothyroidism. indefinitely in
largely thyroid 
the absence of
replaced by hormone  TSH suppression to <
specific
 the 0.1 mU/L is indicated contraindicatio
thyrotropin- replacement in intermediate and ns.
releasing pill called high-risk disease
hormone levothyroxin  TSH maintenance at In patients
stimulation or slightly below the who are
test; e (also lower-normal limit clinically and
triiodothyroni known as (0.3-2 mU/L) may be biochemically
ne is T4). They considered for low- free of disease
administered take it both risk disease
but who
for a week to to avoid presented with
10 days, and a
reduction of hypothyroidi high risk
its uptake by sm disease,
the thyroid (underactive consideration
gland to less should be
thyroid
than half of given to
condition)
the initial maintaining
and to TSH
uptake is a
normal prevent suppressive
response. growth or therapy to
recurrence achieve serum
of their TSH levels of
thyroid 0.1–0.5mU=L
for 5–10 years.
cancer.
In patients free
of disease,
Usually they
especially
receive a T4
those at low
dose large risk for
enough to recurrence, the
suppress serum TSH
their blood may be kept
level of within the low
normal range
thyroid
(0.3–2mU=L).
stimulating
hormone In patients
(TSH) below who have not
the normal undergone
TSH range. remnant
ablation who
are clinically
free of disease
and have
undetectable
suppressed
serum Tg and
normal neck
ultrasound, the
serum TSH
may be
allowed to rise
to the low
normal range
(0.3–2mU=L).