A female client with a suspected brain tumor is scheduled for computed tomography (CT). What should the nurse do when preparing the client for this test?
A. Immobilize the neck before the client is moved onto a stretcher.
B. Determine whether the client is allergic to iodine, contrast dyes, or shellfish.
C. Place a cap on the client’s head.
D. Administer a sedative as ordered.
Correct Answer: B. Determine whether the client is allergic to iodine, contrast dyes, or shellfish.
Because CT commonly involves the use of a contrast agent, the nurse should determine whether the client is allergic to iodine, contrast dyes, or shellfish. In some patients, contrast agents may cause allergic reactions, or in rare cases, temporary kidney failure. IV contrast agents should not be administered to patients with abnormal kidney function since they may induce a further reduction of kidney function, which may sometimes become permanent.
Option A: Neck immobilization is necessary only if the client has a suspected spinal cord injury. Unlike a conventional x-ray—which uses a fixed x-ray tube—a CT scanner uses a motorized x-ray source that rotates around the circular opening of a donut-shaped structure called a gantry. During a CT scan, the patient lies on a bed that slowly moves through the gantry while the x-ray tube rotates around the patient, shooting narrow beams of x-ray through the body.
Option C: Placing a cap over the client’s head may lead to misinterpretation of test results; instead, the hair should be combed smoothly. Metal objects, including jewelry, eyeglasses, dentures, and hairpins, may affect the CT images. Leave them at home or remove them prior to the exam. The client may also be asked to remove hearing aids and removable dental work. Women will be asked to remove bras containing metal underwire. The client may be asked to remove any piercings, if possible.
Option D: The physician orders a sedative only if the client can’t be expected to remain still during the CT scan. Though the scanning itself causes no pain, there may be some discomfort from having to remain still for several minutes. If the client has a hard time staying still, is claustrophobic, or has chronic pain, they may find a CT exam to be stressful. The technologist or nurse, under the direction of a physician, may offer some medication to help tolerate the CT scanning procedure.
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