MRI

- mengatur obat selamat persetujuan protokol

- mengkaji pasien dan mengidentifikasi kontradiksi dan komplikasi yang terjadi

- Perawat menemani dan mengawasi pasien (pasien anak-anak)

- perawat menetapkan pasien yang bisa atau tidak dalam menjalankan pemeriksaan diagnostik tersebut

- memberikan obat penenang atau sedation kepada pasien untuk mengurangi rasa sakit pada saat pengambilan gambar

-

EEG

- Mengetahui riwayat pasien untuk membantu diagnosa dokter- Mencegah pasien dari kerusakan otak khusunya pada pasien seizure- Mencapai pemenuhan dalam pemberian obat anticonvulsant- Memberitahu pasien apa yang akan terjadi jika pasien juga diperlukan untuk melakukan

operasi- Mengetahui riwayat pasien melalui riwayat nursing untuk membuktikan EEG pada

diagnosa- Mengevaluasi pasien dengan mengobservasi pasien apakah ada efek yang timbul atau

tanda-tanda dari keracunan obat- Melakukan pemenuhan obat untuk pasien dengan berkonsultasi dengan dokter tentang

jadwal pemberian dosis obat

SPECT

The most common uses of SPECT are to help diagnose or monitor brain disorders, heart problems and bone disorders.

Brain disorders SPECT can be helpful in determining which parts of the brain are being affected by:

Dementia Clogged blood vessels Seizures Encephalitis Head injuries

Heart problems Because the radioactive tracer highlights areas of blood flow, SPECT can check for:

Clogged coronary arteries. If the arteries that feed the heart muscle become narrowed or clogged, the portions of the heart muscle served by these arteries can become damaged or even die.

Reduced pumping efficiency. SPECT can show how completely each heartbeat empties blood from the lower chambers of your heart.

Bone disorders Areas of bone healing or cancer progression usually light up on SPECT scans, so this type of test is being used more frequently to help diagnose hidden bone fractures. SPECT scans can also diagnose and track the progression of cancer that has spread to the bones.

RisksBy Mayo Clinic staff

For most people, SPECT scans are safe. If you receive an injection or infusion of radioactive tracer, you may experience:

Bleeding, pain or swelling where the needle was inserted in your arm Rarely, an allergic reaction to the radioactive tracer

SPECT scans aren't safe for women who are pregnant or breast-feeding because the radioactive tracer may be passed to the developing fetus or the nursing baby.

Risks of radiation Your health care team uses the lowest amount of radiation possible in order to perform the scan. In general, a SPECT scan exposes you to radiation levels similar to those you might encounter naturally in the environment over the course of a year. Talk to your doctor if you're concerned about your exposure to radiation during a SPECT scan.

How you prepareBy Mayo Clinic staff

How you prepare for a SPECT scan depends on your particular situation. Ask your health care team whether you need to make any special preparations before your SPECT scan.

In general, you should:

Leave metallic jewelry at home Inform the technologist if you're pregnant or breast-feeding Bring a list of all the medications and supplements you take

What you can expectBy Mayo Clinic staff

SPECT scan

During your SPECT scan SPECT scans involve two steps: receiving a radioactive dye (called a tracer) and using a SPECT machine to scan a specific area of your body.

Receiving a radioactive substance You'll receive a radioactive substance through an intravenous (IV) infusion into a vein in your arm. The tracer dose is very small, only a few drops, and you may feel a cold sensation as it enters your body. You may be asked to lie quietly in a room for 15 minutes or more before your scan while your body absorbs the radioactive tracer. In some cases, you may need to wait several hours between the injection and your SPECT scan.

Your body's more active tissues will absorb more of the radioactive substance. For instance, during a seizure, the area of your brain causing the seizure may retain more of the radioactive tracer, which allows doctors to pinpoint the area of your brain causing your seizures.

Undergoing the SPECT scan The SPECT machine is a large circular device containing a camera that detects the radioactive tracer your body absorbs. During your scan, you lie on a table while the SPECT machine rotates around you. The SPECT machine takes pictures of your internal organs and other structures. The pictures are sent to a computer that uses the information to create 3-D images of your body.

How long your scan takes depends on the reason for your procedure.

After your SPECT scan Most of the radioactive tracer leaves your body through your urine within a few hours after your SPECT scan. Your doctor may instruct you to drink more fluids, such as juice or water, after your SPECT scan to help flush the tracer from your body. Your body breaks down the remaining tracer over the next day or two.

IV. PROCEDUREA. Patient Preparation1. Pregnancy and breast-feeding: See the Society ofNuclear Medicine Procedure Guideline for GeneralImaging.

2. Before arrival: See the specific Society of NuclearMedicine Procedure Guideline for the SPECT radiopharmaceuticalused.3. Before injectiona. See the specific Society of Nuclear MedicineProcedure Guideline for the SPECT radiopharmaceutical

used.b. For either a CT scan done for attenuation correction/anatomic localization (AC/AL) or a diagnosticCT scan of the abdomen or pelvis, an intravenousor intraluminal gastrointestinal contrast agent maybe administered to provide adequate visualizationof the gastrointestinal tract unless medically contraindicatedor unnecessary for the clinical indication(see Section E.2.b).

B. Information Pertinent to Performing ProcedureSee also the Society of Nuclear Medicine ProcedureGuideline for General Imaging and the specific Society ofNuclear Medicine Procedure Guideline for the SPECTradiopharmaceutical used.1. A focused relevant history related to the type ofSPECT study performed2. Patient’s ability to lie still for the duration of theacquisition (15–45 min)3. History of claustrophobia4. Patient’s ability to put his or her arms overhead, ifApplicable

Peran perawat

- Menemani pasien dan memonitor pasien selama transport ke depatemen pengobatan nuklir

- Menginjeksi pasien dengaan agen kontras sebelum dilakukannya SPECT scan- Mengajari pasien apa yang akan dilakukan sebelum pemeriksaan diagnostik dan

meyakinkan pasien mampu kooperatif selama pemeriksaan- Mempersiapkan untuk menginjeksi pasien, dan membersihkan dengan normal

saline- Mengidentifikasi kejadian dari seizure- Mempersiapkan dan mengatur radiopharmaceutical- Mencampur isotop (Tc99m) dengan sebotol kecil HMPAO - Melihat dosis, mengecek waktu dan berapa mls yang dibutuhkan untuk dosis

target- Menarik ke jarum suntik yang sesuai dengan jumah mls- Menguji kadar dosis di kalibrator- Menempatkan jarum suntik di pelindung jarum suntik

CT SCAN

Purpose

CT scans are used to image a wide variety of body structures and internal organs. Since the 1990s, CT equipment has become more affordable and available. In some diagnoses, CT scans have become the first imaging exam of choice. Because the computerized image is so sharp, focused, and three-dimensional, many tissues can be better differentiated than on standard x rays. Common CT indications include:

Sinus studies. The CT scan can show details of sinusitis, and bone fractures. Physicians may order CT of the sinuses to provide an accurate map for surgery.

Brain studies. Brain scans can detect hematomas, tumors, and strokes. The introduction of CT scanning, especially spiral CT, has helped reduce the need for more invasive procedures such as cerebral angiography.• Body scans. CT scans of the body will often be used to observe abdominal organs, such as the liver, kidneys, adrenal glands, spleen, and lymph nodes, and extremities.

Aorta scans. CT scans can focus on the thoracic or abdominal aorta to locate aneurysms and other possible aortic diseases.

Chest scans. CT scans of the chest are useful in distinguishing tumors and in detailing accumulation of fluid in chest infections.

Precautions

Pregnant women or those who could possibly be pregnant should not have a CT scan unless the diagnostic benefits outweigh the risks. Pregnant patients should particularly avoid full body or abdominal scans. If the exam is necessary for obstetric purposes, technologists are instructed not to repeat films if there are errors. Pregnant patients receiving CT or any x-ray exam away from the abdominal area may be protected by a lead apron; most radiation, known as scatter, travels through the body and is not blocked by the apron.

Contrast agents are often used in CT exams and the use of these agents should be discussed with the medical professional prior to the procedure. Patients should be asked to sign a consent form concerning the administration of contrast media. One common ingredient in contrast agents, iodine, can cause allergic reactions. Patients who are known to be allergic to iodine (or shellfish) should inform the physician prior to the CT scan.

CT procedure

The patient will feel the table move very slightly as the precise adjustments for each sectional image are made. A technologist watches the procedure from a window and views the images on a monitor.

It is essential that the patient lie very still during the procedure to prevent motion blurring. In some studies, such as chest CTs, the patient will be asked to hold his or her breath during image capture.

Following the procedure, films of the images are usually printed for the radiologist and referring physician to review. A radiologist can also interpret CT exams on a special viewing console. The procedure time will vary in length depending on the area being imaged. Average study times are from 30 to 60 minutes. Some patients may be concerned about claustrophobia but the width of the gantry portion of the scanner is narrow enough to preclude problems with claustrophobia, in most

Peran perawat

- Memberitahukan informasi dan memberikan pendidikan kepada pasien dan keluarga pasien

- Melakukan pengkajian data objektif kepada pasien termasuk

- Mengetahui riwayat pasien, karena bisa saja meninggikan resiko penyakit yang dideritanya

- Melakukan pengkajian fisik, administrasi dan titrasi dari pengobatan yang ada pada penulisan obat

- Mengkaji status hemodinamik pasien untuk mendapatkan dan menegakkan tujuan - Berkolaborasi dengan tim neurosurgical mengenai hasil tes, respon pasien terhadap

treatment yang diberikan dan merencanakan untuk mengulang kemabli tes- Meriview pengobatan pasien-

Doppler Ultra sound

Doppler ultrasound: What is it used for? Basics

With Mayo Clinic emeritus hypertension specialist

Sheldon G. Sheps, M.D.

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Biography of

Sheldon G. Sheps, M.D.

Sheldon Sheps, M.D.

Dr. Sheldon Sheps, emeritus professor of medicine and former chair of the Division of Nephrology and Hypertension in the Department of Medicine at Mayo Clinic, has been with Mayo Clinic since 1960.

Dr. Sheps, a Winnipeg, Manitoba, native, is board certified in internal medicine and specializes in hypertension and peripheral vascular diseases. He developed a multidisciplinary approach with specially trained nurses, dietitians, technicians and educators to help form a team approach to the treatment of patients with abnormal blood pressure.

"I have always believed in involving the patient and family in their health care," Dr. Sheps says. "I have asked for their understanding of the illness and issues and for participation in decisions. The Web is a natural extension of that, and now many more people can be informed."

Dr. Sheps chaired the sixth working group, and he participated in the fourth, fifth and seventh groups that developed the then-latest guidelines for hypertension under the auspices of the National Heart, Lung, and Blood Institute (NHLBI). He helped write the latest American Heart Association (AHA) report on blood pressure measurement. He chaired an AHA group that produced an online accreditation for blood pressure measurement for health professionals.

Dr. Sheps has co-authored books, newsletters, CD-ROMs and other Mayo Clinic health information material. He joined Mayo Clinic's Web team in 1998. He was medical editor-in-chief of both editions of the "Mayo Clinic on High Blood Pressure" book; the last edition was published in 2003. He was also medical editor-in-chief of "Mayo Clinic 5 Steps to Controlling High Blood Pressure," published in 2008.

In addition, Dr. Sheps was section editor for each of the first three editions of "Hypertension Primer" for the American Heart Association.

Dr. Sheps was also chairman of the Science Base Subcommittee and the National High Blood Pressure Education Program, and he was a consultant to the Hypertension Initiative of the World Health Organization. In 1997, he was honored with the Individual Achievement Award on the 25th anniversary of the National High Blood Pressure Education Program of NHLBI. In 2009, he was honored as a Distinguished Mayo Alumnus.

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Question

Doppler ultrasound: What is it used for?

What is a Doppler ultrasound?

Answer

from Sheldon G. Sheps, M.D.

Doppler ultrasound is a noninvasive test that can be used to measure your blood flow and blood pressure by bouncing high-frequency sound waves (ultrasound) off circulating red blood cells. A regular ultrasound uses sound waves to produce images, but can't show blood flow.

A Doppler ultrasound may help diagnose many conditions, including:

Blood clots Poorly functioning valves in your leg veins, which can cause blood or other fluids to pool in

your legs (venous insufficiency) Heart valve defects and congenital heart disease A blocked artery (arterial occlusion) Decreased blood circulation into your legs (peripheral artery disease) Bulging arteries (aneurysms) Narrowing of an artery, such as those in your neck (carotid artery stenosis)

A Doppler ultrasound can estimate how fast blood flows by measuring the rate of change in its pitch (frequency). During a Doppler ultrasound, a technician trained in ultrasound imaging (sonographer) presses a small hand-held device (transducer), about the size of a bar of soap, against your skin over the area of your body being examined, moving from one area to another as necessary. This test may be done as an alternative to more-invasive procedures such as arteriography and venography, which involve injecting dye into the blood vessels so that they show up clearly on X-ray images.

A Doppler ultrasound test may also help your doctor check for injuries to your arteries or to monitor certain treatments to your veins and arteries.

Electromyography Written by Danielle Moores | Medically Reviewed by George Krucik, MDPublished on August 7, 2012

According to Cedars-Sinai, an EMG is a useful way to find the cause, or causes, of certain symptoms (Cedars-Sinai). Some symptoms that may call for an EMG include:

tingling muscle weakness numbness muscle pain or cramping paralysis

involuntary muscle twitching

Conditions that may cause these symptoms could include:

muscle disorders (such as muscular dystrophy) disorders affecting the ability of the motor neuron to communicate to the muscle

(such as myasthenia gravis) peripheral nerve disorders (such as carpal tunnel syndrome), which affect nerves

outside the spinal cord nerve disorders like amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig’s

disease)

How to Get Ready for an EMG

If you have a pacemaker or implantable defibrillator, or if you suffer from a bleeding disorder or lymphedema, you may not be able to have an EMG.

It’s also important to talk to your doctor before the test if you are taking blood thinners or any other medications, or if you have other medical conditions.

If you are able to have an EMG, you should do the following beforehand:

Don’t smoke for at least three hours before the exam. Bathe or take a shower to remove any oils from the skin and don’t apply any lotions or

creams after washing. Wear comfortable clothing that does not obstruct the area that your doctor will test. You

may also be asked to change into a gown.

What Happens During an EMG?

The EMG usually has two parts:

a nerve conduction study, which uses electrodes taped to your skin to evaluate your motor neurons

a needle electrode exam, which uses a small needle inserted into your muscles to evaluate your muscles’ electrical activity

During the EMG, you will lie down on an exam table or recline comfortably in a chair. Your doctor may ask you to move into different positions during the exam.

Some patients report pain and discomfort during an EMG. If at any point the test becomes too painful, you can ask your doctor to take a break.

The entire procedure should take between 30 and 60 minutes.

Nerve Conduction Study

During this part of the procedure, your doctor will apply several small electrodes to the surface of your skin. This will evaluate how well your motor neurons communicate with your

muscles. The electrodes will deliver electrical stimuli to your nerves, and the information is transferred to a small computer as waveforms.

You may feel a tingling or twitching sensation during this portion of the test. Once the test is complete, the electrodes are removed.

Needle Electrode Exam

Next, your doctor will sterilize specific parts of your body and insert a small, thin needle. You may feel slight discomfort or pain while the needle is being inserted.

The needle electrodes evaluate electrical activity in your muscles, both when at rest and when contracted. The computer translates this electrical activity visually as waveforms and audibly as popping sounds.

Once the test is complete, the needle electrode is removed.