CHEST X-RAY AND ANGIOGRAM

RLE II-9.5 Talledo, Princess Reida Tampos, Gabriel Jacob Tan, Alyssa Marie Tan, Hazel Vera Tanquieng Ella Mae Tayamen, Anne Corinne Tenefrancia, Maria Desiree Tengco, Arianna Jenica

X-ray
Created by Wilhelm Rontgen in 1985 Scientific measurement of radiation dose (or effective dose) is millisievert (mSv) 0.02 (CXR) - 10 mSv (abdomen CT)

X-ray machine
has an X-ray tube with electrodes/conductors (cathode & anode) Cathode- filament that releases energy with introduction of electrical current (electrons) Anode- disk of tungsten that attracts electrons. Cathode + Anode = release of photons channeled through a LED cylinder with a series of filters that create an X-ray beam (high energy beam that can only be absorbed by dense body tissues)

How to make x-rays

Created in an x-ray tube Electrons are heated by the heated filament and SHOT towards a metal (usually tungsten) As the electrons approach the metal, they slow down energy is lost from the electrons Via law of conservation of energy, the energy that was in the electron before is emitted as x-rays This is called Bremsstrahlung radiation (German: braking radiation)

How to make an image

X-rays pass through the body, they interact with the electrons in it They may either be absorbed or scattered If they are ABSORBED: they bump the electron, push them out of the atom, and replace the spot of the electron This is called the photoelectric

 If they are SCATTERED: the x-rays are redirected to another direction (note: xrays travel in STRAIGHT LINES) They are redirected because of the electric field of the nucleus
This is known as Compton Scattering

X-rays that pass through the body without being absorbed appear black/grey X-rays that were absorbed by the body appear white

Nursing Responsibilities:
If a female client, assure that she is not pregnant. Assist the client in changing his clothes to a more loose one, usually a patients gown. Make sure that the client is not wearing any jewelries. Assist the client in positioning for chest x-ray. Make sure he is upright, clavicle touching the cassette of the x-ray, and hands in the hips. Before the actual image taking, instruct the client to hold his breath for 2 to 3 seconds after inspiring maximally in the actual image taking.

ANGIOGRAM
PRINCIPLE INVOLVED: It uses an x-ray machine to check for any obstructions in the blood vessels. It is done by injecting an iodine dye or any contrast dye into the blood stream via an arterial access site like the femoral artery.

NURSING RESPONSIBILITIES
1. Ask for any history of hypersensitivity to iodine or other dyes 2. Maintain bed rest for 2-6 hours 3. Keep a pressure dressing, sandbag, or ice pack in place over the arterial access site. 4. Check for any bleeding signs 5. Avoid flexing or hyper-extending the affected extremity for 12-24 hours

SPECIAL PRECAUTIONS
Patients with kidney disease, diabetes, high blood pressure or on anticoagulant drugs have to take special precautions and an angiogram should only be done if there are good clinical reasons.

ANGIOGRAM IVP
Intravenous Pyelogram (IVP) is an x-ray examination of the kidneys, ureters, and urinary bladder. An IVP study uses a contrast material to enhance the x-ray images. The contrast material is injected into the patient's arm and travels though the body to the kidneys. Its progress through the urinary tract is then recorded by a series of quickly taken x-rays. The exam enables the radiologist to review the anatomy and the function of the kidneys and urinary tract.