6.5 : Radiological Investigation III: Pulmonary Angiogram and PET Scan

Radiological investigations are paramount in the diagnosis and management of various pulmonary diseases. Two essential investigations are the Pulmonary Angiogram and the Positron Emission Tomography (PET) Scan.

Pulmonary Angiogram

A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this technique due to their less invasive nature. However, when less invasive tests yield inconclusive results, particularly in detecting congenital abnormalities of the pulmonary vascular tree, a Pulmonary Angiogram may be utilized.

Purpose

The primary purpose of a Pulmonary Angiogram is to locate obstructions or pathological conditions such as a pulmonary embolus. It provides a detailed view of the pulmonary vessels, thereby aiding in the diagnosis and treatment planning of pulmonary diseases.

Positron Emission Tomography (PET) Scan

The PET scan, on the other hand, is a non-invasive procedure that uses an IV radioactive glucose preparation to distinguish between benign and malignant pulmonary nodules. Malignant lung cells have an increased glucose uptake, which can be demonstrated using a PET scan.

Purpose

PET scans are crucial for distinguishing between benign and malignant pulmonary nodules, aiding cancer staging and management. PET scans can accurately differentiate between normal and diseased tissue by demonstrating an increased glucose uptake in malignant cells.

Nursing Responsibilities

Nursing responsibilities for both procedures involve pre-procedure and post-procedure care. For the Pulmonary Angiogram, the nurse must ensure that informed consent has been obtained, assess for known allergies that may suggest allergies to radiopaque agents (e.g., iodine and shellfish), assess the anticoagulation status and renal function, and ensure that the patient has not eaten or had anything to drink, for 4 hours before the procedure. Post-procedure, the nurse should monitor vital signs, level of consciousness, oxygen saturation, and the vascular access site for bleeding or hematoma.

For PET scans, checking the patient's blood glucose levels pre-procedure is essential, as high levels may interfere with the test. Food and fluids other than water may be restricted for 4-6 hours before the procedure. Post-procedure, the nurse should encourage fluid intake to facilitate the elimination of radioactive substances.

In both procedures, the nurse plays a critical role in patient education, explaining the procedure, potential risks, and what to expect during and after the procedure. The ultimate goal is to ensure the patient's safety, comfort, and understanding throughout the process.