Introduction
Nuclear medicine imaging is a method of producing images by detecting radiation from different parts of the body after a radioactive tracer is given to the patient.
Definition
Nuclear medicine uses small, safe amounts of a radioactive material through injection, inhalation, or ingestion, to show the function and structure of organs.
Principles
Nuclear medicine utilizes radioactive molecules (radiopharmaceuticals) for the diagnosis and treatment of a disease. It helps in staging the disease at the earliest, planning treatment to specific cells, and monitoring response to treatment.
Indications
- Assessing organs’ function.
- Detecting cancers.
- Identifying rejection of transplant.
- Diagnosis or treatment.
Contraindications
- Pregnancy.
- Allergic reactions.
Radioisotopes Used in Nuclear Medicine
- Technetium-99m
- Iodine-131
- Molybdenum-99
Types of Scan
| Types of Scan | Instruction for Patient Preparation |
| Bone scan | Drink extra fluids and empty the bladder often between the injection and the scan. |
| Gastric emptying study | Do not eat or drink for 6 hours before the study. Avoid caffeine for 6 hours before the study. Do not smoke the morning of the test or during imaging. Stop taking narcotic medications 2 days before the study. Ingest a small amount of food tagged with the radioactive Material. |
| Hepatobiliary iminodiacetic acid (HIDA) scan | Do not eat or drink for 6 hours before the study. Avoid caffeine for 6 hours before the study.Do not take narcotic medications 12 hours before the study. |
| Lung ventilation/perfusion (VQ) scan | Have a chest X-ray within 24 hours of the VQ scan. |
| Renal scan | Avoid ACE inhibitors and diuretics for 48 hours before your scan.’Do not drink extra fluids. |
| Stress test (myocardial perfusion scan) | Avoid eating and drinking or taking certain medications several hours prior to your test. |
| Thyroid uptake and scan | Avoid eating or drinking for 4 hours before your scan.Do not take thyroid medications for 3 days to 4 weeks before your scan, depending on the medication. |
General Instructions
- The patient will be asked to remove any jewelry or other objects that may interfere with the procedure.
- Instructed to remove clothing, he or she will be given a gown to wear.
- Perform intravenous (IV) line.
- Ensure that the patient is connected to an electrocardiogram (ECG) machine with electrodes (leads) and a blood pressure cuff will be attached to the arm.
- The patient will lie flat on a table in the procedure room.
- The radionuclide will be injected into the vein to “tag” the red blood cells. Alternatively, a small amount of blood will be withdrawn from the vein so that it can be tagged with the radionuclide.
- The patient may be asked to change positions during the test. However, once the position has been changed, the patient will need to lie still without talking.
- After the scan is complete, the IV line will be discontinued.
- The patient will be allowed to leave, unless the healthcare provider gives different instructions.
Responsibilities of Nuclear Medicine Nurses
- Patient Preparation & Education
- Explain procedures and radiation safety to patients.
- Assess medical history and ensure proper hydration before scans.
- Administration of Radiopharmaceuticals
- Assist in injecting or administering radioactive tracers for imaging studies.
- Monitor for adverse reactions and ensure proper dosing.
- Monitoring During Procedures
- Observe vital signs and patient responses during scans.
- Provide comfort and reassurance to anxious patients.
- Radiation Safety & Protocols
- Follow strict radiation protection guidelines to minimize exposure.
- Educate patients and staff on safe handling of radioactive materials.
- Emergency Response & Post-Procedure Care
- Manage unexpected reactions like allergic responses or cardiac events.
- Ensure proper discharge instructions for patients post-procedure.
Documentation
- Document the date, time, duration of procedures, and condition of the patient before and after the procedure.
- Document if any side effects were experienced.
Special Consideration
- Use shielding, distance, and time management to protect healthcare workers and patients.
- Educate patients on post-procedure precautions, such as limiting close contact after certain treatments.
- Assess renal function before administering radiopharmaceuticals, as some are excreted through the kidneys.
- Ensure hydration to promote faster clearance of radioactive substances.
- Monitor for adverse reactions, including allergic responses or unexpected radiation effects.
- Maintain strict quality control for imaging devices like PET and SPECT scanners.
- Ensure proper calibration of radiation doses to optimize diagnostic accuracy.
- Use hybrid imaging techniques (e.g., PET-CT, SPECT-CT) for enhanced diagnostic precision.
- Avoid unnecessary radiation exposure; consider alternative imaging methods.
- Use lower radiation doses and child-friendly techniques to reduce anxiety.
- Adjust protocols for age-related physiological changes affecting metabolism and clearance.
- Monitor radiation exposure levels for nuclear medicine staff.
- Implement biohazard precautions when handling radioactive materials.
- Address ergonomic concerns, such as repetitive strain injuries from equipment handling.
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
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