zayrah joyce p

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Zayrah Joyce P. Mabong January 5, 2012

BSN-3B

Diagnostic Exams:

1. CT Scan- is an x-ray procedure that combines many x-ray images

with the aid of a computer to generate cross-sectional views and, if

needed, three-dimensional images of the internal organs and structures

of the body. Computerized axial tomography is more commonly

known by its abbreviated names, CT scan or CAT scan. A CT scan is

used to define normal and abnormal structures in the body and/or

assist in procedures by helping to accurately guide the placement of

instruments or treatments.

Preparation:

1. Patients are often asked to avoid food, especially when contrast

material is to be used.

2. Inquire about allergies and any previous adverse reaction to contrast

agent.

3. Be sure that a consent form has been signed.

4. No special preparation required; non invasive procedure that can be

done on an out patient basis.

5. Instruct patient that he must lie perfectly still while the test is beingcarried out.

Procedure:

1. Patients are placed on a movable table, and the table is slipped into the

center of a large donut-shaped machine which takes the x-ray images

around the body. The actual procedure can take from a half an hour to

an hour and a half.

2. If specific tests, biopsies, or intervention are performed by the

radiologist during CT scanning, additional time and monitoring may

be required.

3. It is important during the CT scan procedure that the patient minimize

any body movement by remaining as still and quiet as is possible.

This significantly increases the clarity of the x-ray images.


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4. The CT scan technologist tells the patient when to breathe or hold

his/her breath during scans of the chest and abdomen.

5. If any problems are experienced during the CT scan, the technologist

should be informed immediately. The technologist directly watches

the patient through an observation window during the procedure, and

there is an intercom system in the room for added patient safety.

2. Magnetic Resonance Imaging- is a medical imaging technique used

in radiology to visualize detailed internal structures. MRI makes use

of the property ofnuclear magnetic resonance (NMR) to image nuclei

of atomsinside the body.

Preparation:

1. Patient removes all metallic objects and lies in a flat form that will bemoved into a table containing magnet.

2. Explain that nothing will be felt during the scanning process but the

thumping sound of the magnetic coils as the magnetic field is being

pulsed will be heard.

3. No special preparation, diet, reduced activity, and extra medication is

necessary.

Procedure:

1. You will be positioned on the moveable examination table.

2. Straps and bolsters may be used to help you stay still and maintain

the correct position during imaging.

3. Devices that contain coils capable of sending and receiving radio

waves may be placed around or adjacent to the area of the body

being studied.

4. If a contrast material will be used in the MRI exam, a nurse or

technologist will insert an intravenous (IV) line into a vein in your

hand or arm. A saline solution may be used. The solution will dripthrough the IV to prevent blockage of the IV line until the contrast

material is injected.

5. You will be moved into the magnet of the MRI unit and the

radiologist and technologist will leave the room while the MRI

examination is performed.
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6. If a contrast material is used during the examination, it will be

injected into the intravenous line (IV) after an initial series of

scans. Additional series of images will be taken during or

following the injection.

7. When the examination is completed, you may be asked to wait

until the technologist or radiologist checks the images in case

additional images are needed.

8. Your intravenous line will be removed.

9. MRI exams generally include multiple runs (sequences), some of

which may last several minutes.

10. Depending on the type of exam and the equipment used, the entire

exam is usually completed in 15 to 45 minutes.

3. Myelography- an imaging examination that involves the introduction

of a spinal needle into the spinal canal and the injection ofcontrast

material in the space around the spinal cord and nerve roots (thesubarachnoid space) using a real-time form ofx-ray called

fluoroscopy.

Preparation:

1. Secure consent.

2. Reinforce the physicians explanation of procedure.

3. NPO after liquid breakfast.

4. Usually patients are advised to increase their fluid intake the day

before a scheduled myelogram, as it is important to be well

hydrated.

5. Patient maybe given a light sedative prior to procedure as ordered

6. You should inform your physician of any medications you are taking

and if you have any allergies, especially to barium or iodinated

contrast materials. Also inform your doctor about recent illnesses or

other medical conditions.

7. Specifically, the physician needs to know if (1) you are taking

medications that need to be stopped a few days before the procedure

and (2) whether you have a history of reaction to the contrastmaterial used for the myelogram.

Procedure:
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1. As the patient lies face-down on the examination table, the radiologist

will use the fluoroscope, which projects radiographic images in a

movie-like sequence onto the monitor, to visualize the spine and

determine the best place to inject the contrast material.

2. The contrast material usually is injected into the lowerlumbarspinal

canal, because it is considered easier and safer. Occasionally, if it is

deemed safer or more useful, the contrast material will be injected into

the uppercervical spine.

3. At the site of the injection, the skin will be cleaned and then numbed

with a local anesthetic.

4. Depending on the location of the puncture, the patient will be

positioned on his/her side or on the abdomen or in a sitting position as

the needle is inserted. The needle is advanced, usually under

fluoroscopic guidance, until its tip is positioned within the

subarachnoid space within the spinal canal, at which time a free slowflow of fluid is obtained.

5. If requested by the referring physician, a small amount of

cerebrospinal fluid may be withdrawn and sent for laboratory studies.

6. The contrast material is then injected through the needle, the needle is

removed and the skin at the puncture site is again cleaned. The patient

is then positioned on the table, usually lying on their abdomen.

7. Again using the fluoroscope for guidance, the radiologist then slowly

tilts the x-ray table allowing the contrast material to flow up or down

within the subarachnoid space and to surround the nerve roots or the

spinal cord.

8. As the table is tilted, the radiologist monitors the flow of contrast

material with fluoroscopy, focusing on the area that correlates with

the patient's symptoms.

9. At this point, the patient may be repositioned on his/her side, and

additional x-ray images may be obtained by the radiologist and

technologist; while such images are being obtained, it is important for

the patient to remain still to reduce the possibility of blurred images.

10. When these images have been completed, the table is returned to the

horizontal position, and the patient is allowed to roll onto his/her backand assume a position of greater comfort while the images are

checked by the radiologist.

11. A myelography examination is usually completed within 30 to 60

minutes. A CT scan will add another 15 to 30 minutes to the total

examination time.
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4. Complete Blood Count- is one of the most commonly ordered blood

tests. The complete blood count is the calculation of the cellular

(formed elements) of blood. These calculations are generally

determined by special machines that analyze the different components

of blood in less than a minute. A major portion of the complete blood

count is the measure of the concentration ofwhite blood cells, red

blood cells, andplatelets in the blood.

Preparation:

1. No special preparations are needed. Wear a short-sleeve shirt on the

day of the test can make things easier for the technician who will be

drawing blood.

Procedure:

1. Not much blood is drawn in a CBC. A health professional will usually

draw the blood from a vein.

2. If the blood is being drawn from a vein, the skin surface is cleaned

with antiseptic, and an elastic band (tourniquet) is placed around the

upper arm to apply pressure and cause the veins to swell with blood.

3. A needle is inserted into a vein (usually in the arm inside of the elbow

or on the back of the hand) and blood is withdrawn and collected in avial or syringe.

4. After the procedure, the elastic band is removed.

5. Once the blood has been collected, the needle is removed and the area

is covered with cotton or a bandage to stop the bleeding.

6. Collecting blood for this test will only take a few minutes.

Normal values for:

RBC- 4.2 to 5.9 million cells/cmm or 4.2 to 5.9 x 10 12 cells per liter.

WBC- 4,300 and 10,800 cells per cubic millimeter (cmm) or 4.3 to10.8 x 10 9 cells per liter.

Hemoglobin- 8.1 to 11.2 millimoles/liter for men,

7.4 to 9.9 for women

Hematocrit- 45% to 52% for men and 37% to 48% for women.

Platelet- 150,000 to 400,000/ cmm (150 to 400 x 109/liter).
http://www.medicinenet.com/script/main/art.asp?articlekey=6017http://www.medicinenet.com/script/main/art.asp?articlekey=5260http://www.medicinenet.com/script/main/art.asp?articlekey=5260http://www.medicinenet.com/script/main/art.asp?articlekey=4941http://www.medicinenet.com/script/main/art.asp?articlekey=6017http://www.medicinenet.com/script/main/art.asp?articlekey=5260http://www.medicinenet.com/script/main/art.asp?articlekey=5260http://www.medicinenet.com/script/main/art.asp?articlekey=4941


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5. Electromyography- is a test that checks the health of the muscles and

the nerves that control the muscles.

Preparation:

1. No special preparation is usually necessary. Avoid using any creams

or lotions on the day of the test.

2. Body temperature can affect the results of this test. If it is extremely

cold outside, wait in a warm room for a while before the test is

performed.

Procedure:

1. The health care provider will insert a very thin needle electrode

through the skin into the muscle.

2. The electrode on the needle picks up the electrical activity given off

by your muscles. This activity appears on a nearby monitor, and may

be heard through a speaker.

3. After placement of the electrodes, you may be asked to contract the

muscle. For example, bending your arm. The electrical activity seen

on the monitor provides information about your muscle's ability to

respond when the nerves to your muscles are stimulated.

4. A nerve conduction velocity test is usually performed along with anEMG.

6. Prothrombin Time- is a blood test that measures how long it takes

blood to clot. A prothrombin time test can be used to check for

bleeding problems. PT is also used to check whether medicine to

prevent blood clots is working.

Preparation:

1. Many medicines can change the results of this test. Be sure to tell your

doctor about all the nonprescription and prescription medicines you

take, as well as any supplements or herbal remedies you use.
http://www.nlm.nih.gov/medlineplus/ency/article/003927.htmhttp://www.webmd.com/food-recipes/tc/dietary-supplements-topic-overviewhttp://www.nlm.nih.gov/medlineplus/ency/article/003927.htmhttp://www.webmd.com/food-recipes/tc/dietary-supplements-topic-overview


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Procedure:

1. The health professional drawing blood will:

Wrap an elastic band around your upper arm to stop the flow of blood.

This makes the veins below the band larger so it is easier to put aneedle into the vein.

Clean the needle site with alcohol.

Put the needle into the vein. More than one needle stick may be

needed.

Attach a tube to the needle to fill it with blood.

Remove the band from your arm when enough blood is collected.

Put a gauze pad or cotton ball over the needle site as the needle is

removed.

Put pressure to the site and then a bandage.

Normal Value: 11-13 seconds

7. Cerebral angiography- is a procedure that uses a special dye

(contrast material) and x-rays to see how blood flows through the

brain.

Preparation:

1. You must sign a consent form.2. Your health care provider will explain the procedure and its risks.

3. Routine blood tests and examination of the nervous system will be

done before the procedure.

4. Tell the health care provider if you:

Are allergic to shellfish or iodine substances

Have a history of bleeding problems

Have had an allergic reaction to x-ray contrast dye or any iodine

substance

May be pregnant

5. You may be told not to eat or drink anything for 4 to 8 hours before

the test.

6. When you arrive at the testing site, you will be given a hospital gown

to wear.

7. You must remove all jewelry.


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Procedure:

1. Cerebral angiography is done in the hospital or large radiology

center.

2. You will be asked to lie on an x-ray table.

3. Your head is positioned and held still using a strap, tape, or

sandbags, so you do not move during the procedure.

4. The health care provider will attach electrocardiogram (ECG)

leads to your arms and legs, which monitor your heart activity

during the test.

5. Before the test starts, you will be given a mild sedative to help

you relax.

6. An area of your body, usually the groin, is cleaned and numbed

with a local numbing medicine (anesthetic).

7. A thin, hollow tube called a catheter is placed through an arteryand carefully moved up through the main blood vessels in the

belly area and chest and into an artery in the neck. Moving x-

ray images help the doctor position the catheter.

8. Once the catheter is in place, a special dye (contrast material) is

injected into catheter. X-ray images are taken to see how the

dye moves through the artery and blood vessels of the brain.

The dye helps highlight any blockages in blood flow.

9. After the x-rays are taken, the needle and catheter are

withdrawn. Pressure is immediately applied on the leg at the

site of insertion for 10 - 15 minutes to stop the bleeding.

10. After that time, the area is checked and a tight bandage is

applied. Your leg should be kept straight for 4 - 6 hours after

the procedure.

11.Watch the area for bleeding for at least the next 12 hours.

12.Digital subtraction angiography (DSI) uses a computer to

"subtract" or take out the bones and tissues in the area viewed,

so that only the blood vessels filled with the contrast dye are

seen.

8. Barium swallow- is a test that may be used to determine the cause of

painful swallowing, difficulty with swallowing, abdominal pain,

bloodstained vomit, or unexplained weight loss.
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Preparation:

1. You may be asked to eat a low-fiber diet for 2-3 days before the

barium swallow test.

2. You will be asked not to eat or smoke after midnight before the

exam.

3. You will be placed in a hospital gown and told to remove all

jewelry including body jewelry such as nipple and belly-button

rings, dentures, hair clips, or other objects that might show up

on an x-ray.

4. You will receive a form requesting your consent to perform the

test. Read this form carefully. You should make sure you

understand the form and agree with it before signing it.

5. Ask your doctor any questions you have before you sign the

form.

Procedure:

1. You will drink about 1 1/2 cups of a barium preparation-a chalky

drink with the consistency (but not the flavor) of a milk shake.

Children will drink less.

2. The barium can be seen on an x-ray as it passes through the digestive

tract.

3. The barium swallow procedure may take about 30 minutes to finish.

In certain cases, it may take up to 60 minutes to fill the stomach.4. You will be strapped securely on your back to a table that tilts

forward. X-rays to examine yourheart, lungs, and abdomen will be

taken before you drink the barium. You then will be asked to swallow

the barium mixture.

5. X-rays will be taken again as the barium moves through the digestive

system. You will be asked to take more swallows so more pictures can

be taken.

6. As the barium moves down your digestive system, the table will be

tilted at various angles to help spread the barium for different views.Pressure may be applied to your abdomen to spread the barium.

Finally, you will be placed horizontally, asked to take a few more

swallows of barium, and x-rayed again.
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9. Barium Enema- is a special x-ray of the large intestine, which

includes the colon and rectum.

There are two types of barium enemas:

Single contrast barium enema uses barium to highlight your large

intestine.

Double contrast barium enema uses barium, but also delivers air into

the colon to expand it. This allows for even better images.

Preparation:

1. You must completely empty your bowels before the exam.

2. This may be done using an enema or laxatives combined with a clear

liquid diet.3. Your health care provider will give you specific instructions.

4. Thorough cleaning of the large intestine is necessary for accurate

pictures.

Procedure:

1. You will lie flat on your back on the x-ray table and an x-ray will be

taken.

You will then be told to lie on your side. The health care provider willgently insert a well-lubricated tube (enema tube) into your rectum.

The tube is connected to a bag that holds a liquid containing barium

sulfate. It is placed in the rectum.

The liquid is a type of contrast material that highlights specific areas

in the body, creating a clearer image. The barium flows into your

colon, and eventually passes out of your body with your stools.

2. A small balloon at the tip of the enema tube may be inflated to help

keep the barium inside your colon. The health care provider willmonitor the flow of the barium on an x-ray fluoroscope screen, which

is like a TV monitor.

3. You will be asked to move into different positions and the table will

be slightly tipped to get different views. At certain times when the x-

ray pictures are taken, you will hold your breath and be still for a few

seconds so the images won't be blurry.
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4. The enema tube will be removed after the pictures are taken. You will

be given a bedpan or helped to the toilet, so you can empty your

bowels and remove as much of the barium as possible. One or two x-

rays may be taken after you use the bathroom.

10. Cholecystogram- is an x-ray procedure used to help evaluate the

gallbladder. For the procedure, a special diet is consumed prior to the

test and contrast tablets are also swallowed to help visualize the

gallbladder on x-ray. The test is used to help in diagnosing disorders

of the liver and gallbladder, including gallstones and tumors.

Preparation:

1. The day before the test, you will have to eat a noon meal which is rich

in high-fat, such as fatty meats, butter, milk and eggs.2. In the evening you will have to eat a low-fat meal such as vegetables,

fruit, tea, coffee, bread and lean meat.

3. A couple of hours after this, you will have to swallow the 6 contrast

dye tablets, one by one.

4. After this, you should not drink anything until the test is over.

5. Consult your doctor if you are pregnant, since the radioactive material

may harm the fetus. Also inform your doctor if you have any allergies.

Procedure:

1. The test is performed by a specialized x-ray technician, either in the

doctors clinic or in a hospitals radiology department, where the specialized

equipment is available.

2. 6 tablets have to be swallowed on the night before the oral

cholecystogram test. These contain a special contrast medium, which helps

to show better images of the gall bladder.

3. The next day, when you go to the hospital, you will be given a drink

which is a special high-fat liquid. This causes the gallbladder to contract andrelease quantities of bile, which show up better on x-ray pictures.

4. You will then have to lie on a special x-ray table.

5. You will have to change position and turn from time to time, to aid better

x-ray pictures.


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6. X-ray pictures will be taken at timed intervals, and will be shown up

immediately on a TV monitor screen.

7. The entire procedure takes about one hour.

Lanie Ann A. Eviota January 5, 2012BSN-3B

Diagnostic Exams:

1. Cholangiography- is the imaging of thebile duct (also known asthe biliary tree) byx-rays. There are at least two kinds ofcholangiography:
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percutaneous transhepatic cholangiography(PTC):Examination ofliver and bile ducts by x-rays. This isaccomplished by the insertion of a thin needle into the livercarrying a contrast medium to help to see blockage in liver and

bile ducts. endoscopic retrograde choledochography(ERC). Although this

is a form of imaging, it is both diagnostic and therapeutic, andis often classified with surgeries rather than with imaging.

Preparation:

1. Preparation of the patient for the intravenous method requiresrestriction of fluids to concentrate the dye and may also includecleansing of the intestinal tract on the day prior to the examination

with a laxative or enema so that fecal material and gas will notobscure the biliary tract.

Procedure:

1. For IV cholangiography the contrast agent is given slowly byvein, and x-ray films are taken of the region of the gallbladder.

2. Operative and postoperative cholangiography use the injectionof contrast material into the common bile duct via a drainage T-tube inserted during surgery to reveal any small, residual

gallstones that are present.3. In percutaneous transhepatic cholangiography the contrastmaterial is injected through a long needle or needle catheter,

which is introduced directly through the skin into the substanceof the liver.

4. Endoscopic retrograde cholangiography is accomplished bycannulating the ampulla of Vater through a flexible fiberopticduodenoscope and instilling radiopaque material directly intothe common bile duct.

2. Myelography- an imaging examination that involves theintroduction of a spinal needle into the spinal canal and theinjection ofcontrast material in the space around the spinal cordand nerve roots (the subarachnoid space) using a real-time form ofx-raycalled fluoroscopy.

Preparation:
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1. Secure consent.2. Reinforce the physicians explanation of procedure.3. NPO after liquid breakfast.4. Usually patients are advised to increase their fluid intake

the day before a scheduled myelogram, as it is importantto be well hydrated.

5. Patient maybe given a light sedative prior to procedure asordered

6. You should inform your physician of any medications youare taking and if you have any allergies, especially to

barium or iodinated contrast materials. Also inform yourdoctor about recent illnesses or other medical conditions.

7. Specifically, the physician needs to know if (1) you are

taking medications that need to be stopped a few daysbefore the procedure and (2) whether you have a historyof reaction to the contrast material used for themyelogram.

Procedure:

1. As the patient lies face-down on the examination table,the radiologist will use the fluoroscope, which projectsradiographic images in a movie-like sequence onto the

monitor, to visualize the spine and determine the bestplace to inject the contrast material.

2. The contrast material usually is injected into the lowerlumbar spinal canal, because it is considered easier andsafer. Occasionally, if it is deemed safer or more useful,the contrast material will be injected into the uppercervical spine.

3. At the site of the injection, the skin will be cleaned andthen numbed with a local anesthetic.

4. Depending on the location of the puncture, the patientwill be positioned on his/her side or on the abdomen or ina sitting position as the needle is inserted. The needle isadvanced, usually under fluoroscopic guidance, until itstip is positioned within the subarachnoid space within thespinal canal, at which time a free slow flow of fluid isobtained.
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5. If requested by the referring physician, a small amount ofcerebrospinal fluid may be withdrawn and sent forlaboratory studies.

6. The contrast material is then injected through the needle,the needle is removed and the skin at the puncture site isagain cleaned. The patient is then positioned on the table,usually lying on their abdomen.

7. Again using the fluoroscope for guidance, the radiologistthen slowly tilts the x-ray table allowing the contrastmaterial to flow up or down within the subarachnoidspace and to surround the nerve roots or the spinal cord.

8. As the table is tilted, the radiologist monitors the flow ofcontrast material with fluoroscopy, focusing on the areathat correlates with the patient's symptoms.

9. At this point, the patient may be repositioned on his/herside, and additional x-ray images may be obtained by theradiologist and technologist; while such images are beingobtained, it is important for the patient to remain still toreduce the possibility of blurred images.

10. When these images have been completed, the tableis returned to the horizontal position, and the patient isallowed to roll onto his/her back and assume a position ofgreater comfort while the images are checked by theradiologist.

11. A myelography examination is usually completed within30 to 60 minutes. A CT scan will add another 15 to 30minutes to the total examination time.

3. Gastroscopy- is a test where a doctor looks into the upperpart of your gut (the upper gastrointestinal tract). The upper gutconsists of the oesophagus (gullet), stomach and duodenum.The operator uses an endoscope to look inside your gut.Therefore, the test is sometimes called endoscopy.

Preparation:

1. You should get instructions from the hospital department beforeyour test. The instructions given commonly include:
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Do not eat for 4-6 hours before the test. The stomach needs tobe empty. (Small sips of water may be allowed up to two hoursbefore the test.)

If you have a sedative you will need somebody to accompanyyou home.

Advice about medication which may need to be stopped beforethe test.

Procedure:

1. The operator may numb the back of your throat byspraying on some local anaesthetic, or give you ananaesthetic lozenge to suck.

2. You may be given a sedative to help you to relax. This is

usually given by an injection into a vein in the back ofyour hand. The sedative can make you drowsy but it doesnot 'put you to sleep'. It is not a general anaesthetic.

3. You lie on your side on a couch. You are asked to put aplastic mouth guard between your teeth. This protects

your teeth and stops you biting the endoscope.4. The operator will then ask you to swallow the first section

of the endoscope. Modern endoscopes are quite thin andeasy to swallow.

5. The operator then gently pushes it further down your

oesophagus, and into your stomach and duodenum. Thevideo camera at the tip of the endoscope sends pictures toa screen. The operator watches the screen forabnormalities of the oesophagus, stomach andduodenum.

6. Air is passed down a channel in the endoscope into thestomach to make the stomach lining easier to see. Thismay cause you to feel 'full' and want to belch.

7. The operator may take one or more biopsies (smallsamples) of parts of the inside lining of the gut -depending on why the test is done and what they see. Thisis painless.

8. The biopsy samples are sent to the laboratory for testing,and to look at under the microscope. The endoscope isthen gently pulled out.


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9. A gastroscopy usually takes about 10 minutes. However,you should allow at least two hours for the wholeappointment, to prepare, give time for the sedative to

work (if you have one), for the gastroscopy itself, and torecover. A gastroscopy does not usually hurt, but it can bea little uncomfortable, particularly when you first swallowthe endoscope.

4. CT Scan- is an x-ray procedure that combines many x-rayimages with the aid of a computer to generate cross-sectional

views and, if needed, three-dimensional images of the internalorgans and structures of the body. Computerized axial tomographyis more commonly known by its abbreviated names, CT scan orCAT scan. A CT scan is used to define normal and abnormal

structures in the body and/or assist in procedures by helping toaccurately guide the placement of instruments or treatments.

Preparation:

1. Patients are often asked to avoid food, especially whencontrast material is to be used.

2. Inquire about allergies and any previous adverse reactionto contrast agent.

3. Be sure that a consent form has been signed.

4. No special preparation required; non invasive procedurethat can be done on an out patient basis.

5. Instruct patient that he must lie perfectly still while thetest is being carried out.

Procedure:

1. Patients are placed on a movable table, and the table isslipped into the center of a large donut-shaped machine

which takes the x-ray images around the body. The actualprocedure can take from a half an hour to an hour and ahalf.

2. If specific tests, biopsies, or intervention are performed bythe radiologist during CT scanning, additional time andmonitoring may be required.


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3. It is important during the CT scan procedure that thepatient minimize any body movement by remaining asstill and quiet as is possible. This significantly increasesthe clarity of the x-ray images.

4. The CT scan technologist tells the patient when to breatheor hold his/her breath during scans of the chest andabdomen.

5. If any problems are experienced during the CT scan, thetechnologist should be informed immediately. Thetechnologist directly watches the patient through anobservation window during the procedure, and there is anintercom system in the room for added patient safety.

5. Colonoscopy- is an internal examination of the colon (largeintestine) and rectum, using an instrument called a colonoscope.

Preparation:

1. You will need to completely cleanse your intestines. Your healthcare provider will give you instructions for doing this. This mayinclude a combination of enemas, not eating solid foods for 2 or

3 days before the test, and taking laxatives.2. You will usually be told to stop taking aspirin, ibuprofen,naproxen, or other blood-thinning medications for several days

before the test.3. You will be asked to drink plenty of clear liquids for 1 - 3 days

before the test. Examples of clear liquids are:

Clean coffee or tea Fat-free bouillon or broth Gelatin Sports drinks Strained fruit juices Water

4. Unless otherwise instructed, continue taking any regularlyprescribed medication.


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5. Stop taking iron medications a few weeks before the test, unlessyour health care provider tells you otherwise. Iron can producea dark black stool, which makes the view inside the bowel lessclear.

6. Outpatients must plan to have someone take them home afterthe test, because they will be woozy and unable to drive.

Procedure:

1. You will lie on your left side with your knees drawn uptoward your chest.

2. After you have received a sedative and pain reliever, thecolonoscope is inserted through the anus.

3. It is gently moved into the beginning of the large boweland sometimes into the lowest part of the small intestine.

4. Air will be inserted through the scope to provide a betterview. Suction may be used to remove fluid or stool.

5. Because the health care provider gets a better view as thecolonoscope is pulled back out, a more carefulexamination is done while the scope is being pulled out.

6. Tissue samples may be taken with tinybiopsyforcepsinserted through the scope. Polyps may be removed withelectrocauterysnares, and photographs may be taken.

7. Specialized procedures, such as laser therapy, may also bedone.

6. Electromyography- is a test that checks the health of themuscles and the nerves that control the muscles.

Preparation:

1. No special preparation is usually necessary. Avoid using anycreams or lotions on the day of the test.
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2. Body temperature can affect the results of this test. If it isextremely cold outside, wait in a warm room for a while beforethe test is performed.

Procedure:

1. The health care provider will insert a very thin needle electrodethrough the skin into the muscle.

2. The electrode on the needle picks up the electrical activity givenoff by your muscles. This activity appears on a nearby monitor,and may be heard through a speaker.

3. After placement of the electrodes, you may be asked to contractthe muscle. For example, bending your arm. The electricalactivity seen on the monitor provides information about your

muscle's ability to respond when the nerves to your muscles arestimulated.4. Anerve conduction velocitytest is usually performed along with

an EMG.

7. Serum Ammonia- measures the amount of ammonia in theblood. Most ammonia in the body forms when protein is brokendown by bacteria in the intestines. The liver normally convertsammonia into urea, which is then eliminated in urine.

Ammonia levels in theblood rise when the liver is not able to

convert ammonia to urea. This may be caused bycirrhosis orsevere hepatitis.

Preparation:

1. Do not eat, drink anything other than water, or smoke for 8hours before having an ammonia blood test.

2. Avoid strenuous exercise just prior to having this test.3. Tell your doctor if you:

Are taking any medicines. Many medicines can interfere withtest results. Your doctor may instruct you to stop taking certainmedicines for several days before having an ammonia test.

Smoke or drink alcohol.
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4. Talk to your doctor about any concerns you have regarding theneed for the test, its risks, how it will be done, or what theresults may mean.

5. To help you understand the importance of this test, fill out themedical test information form.

Procedure:

1. If the sample is taken from a vein

The health professional taking a sample of your blood will:

Wrap an elastic band around your upper arm to stop the flow ofblood. This makes the veins below the band larger so it is easierto put a needle into the vein.

Clean the needle site with alcohol. Put the needle into the vein. More than one needle stick may be

needed. Attach a tube to the needle to fill it with blood. Remove the band from your arm when enough blood is

collected. Put a gauze pad or cotton ball over the needle site as the needle

is removed. Put pressure on the site and then put on a bandage.

2. If the sample is taken from an artery

A sample of blood from an artery is usually taken from the inside ofthe wrist (radial artery), but it can also be taken from an artery in thegroin (femoral artery) or on the inside of the arm above the elbowcrease (brachial artery). You will be seated with your arm extendedand your wrist resting on a small pillow. The health professionaldrawing the blood may rotate your hand back and forth and feel for apulse in your wrist.

Normal Value: 15 - 45 micrograms per deciliter (mcg/dL).

8. Serum Amylase-A test can be done to measure the level of thisenzyme in your blood. Amylase may also be measured with a urinetest
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Preparation:

1. No special preparation is needed.2. However, you should avoid alcohol before the

test. The health care provider may ask you to stoptaking drugs that may affect the test.

3. NEVER stop taking any medications without firsttalking to your doctor.

Drugs that can increase amylase measurements include:

Asparaginase Aspirin Birth control pills

Cholinergic medications Ethacrynic acid Methyldopa Opiates (codeine, meperidine, morphine) Thiazide diuretics

Normal Value: 23 to 85 units per liter (U/L)

9. Magnetic Resonance Imaging- is a medical imagingtechnique used in radiology to visualize detailed internal

structures. MRI makes use of the property ofnuclearmagnetic resonance (NMR) to image nuclei of atomsinside the body.

Preparation:

1. Patient removes all metallic objects and lies in a flatform that will be moved into a table containing magnet.

2. Explain that nothing will be felt during the scanning

process but the thumping sound of the magnetic coilsas the magnetic field is being pulsed will be heard.3. No special preparation, diet, reduced activity, and extra

medication is necessary.

Procedure:
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1. You will be positioned on the moveableexamination table.

2. Straps and bolsters may be used to help you staystill and maintain the correct position during

imaging.3. Devices that contain coils capable of sending andreceiving radio waves may be placed around oradjacent to the area of the body being studied.

4. If a contrast material will be used in the MRIexam, a nurse or technologist will insert anintravenous (IV) line into a vein in your hand orarm. A saline solution may be used. The solutionwill drip through the IV to prevent blockage of theIV line until the contrast material is injected.

5. You will be moved into the magnet of the MRI unitand the radiologist and technologist will leave theroom while the MRI examination is performed.

6. If a contrast material is used during theexamination, it will be injected into theintravenous line (IV) after an initial series of scans.Additional series of images will be taken during orfollowing the injection.

7. When the examination is completed, you may be

asked to wait until the technologist or radiologistchecks the images in case additional images areneeded.

8. Your intravenous line will be removed.9. MRI exams generally include multiple runs

(sequences), some of which may last severalminutes.

10. Depending on the type of exam and theequipment used, the entire exam is usuallycompleted in 15 to 45 minutes.

10.SGOT(serum glutamic-oxaloacetic transaminase)- isoften part of an initial screening for liver disease.

Preparation:

1. No special preparations are needed for this test.
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2. You should tell your doctor about any medications yourchild is taking because certain drugs might alter thetest results.

3. On the day of the test, wear a short-sleeve shirt can

make things faster and easier for the technician whowill be drawing the blood.

Procedure:

1. A health professional will usually draw the blood from avein.

2. If the blood is being drawn from a vein, the skin surfaceis cleaned with antiseptic, and an elastic band(tourniquet) is placed around the upper arm to apply

pressure and cause the veins to swell with blood.3. A needle is inserted into a vein (usually in the arm

inside of the elbow or on the back of the hand) andblood is withdrawn and collected in a vial or syringe.

4. After the procedure, the elastic band is removed.5. Once the blood has been collected, the needle is

removed and the area is covered with cotton or abandage to stop the bleeding.

6. Collecting blood for this test will only take a fewminutes.

Normal Value: 5 to 40 units per liter of serum (the liquid partof the blood).

zayrah joyce p

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