A bone scan is a nuclear medicine imaging technique that uses a radiotracer to evaluate the distribution of active bone formation in the skeleton related to malignant and benign disease, as well as physiological processes. It is a highly sensitive diagnostic tool that can detect bone abnormalities before they are visible on conventional X-rays. A bone scan can help diagnose conditions such as osteoporosis, bone infections, fractures, arthritis, and bone cancer.
However, a bone scan also involves exposure to a small amount of radiation, which may pose some risks to the patient and the nursing staff. Therefore, it is essential to implement some nursing interventions before, during, and after the procedure to ensure the safety and comfort of the patient and to optimize the quality of the images.
Assess the Patient’s History and Condition
The first nursing intervention is to assess the patient’s history and condition before scheduling a bone scan. This includes:
– Asking about any previous or current bone diseases or injuries, such as osteoporosis, fractures, arthritis, or cancer.
– Asking about any medications or supplements that may affect bone metabolism, such as steroids, bisphosphonates, calcium, or vitamin D.
– Asking about any allergies or adverse reactions to iodine, shellfish, or contrast agents.
– Asking about any pregnancy or breastfeeding status. Bone scans are not usually performed on pregnant or nursing women because of the potential radiation exposure to the fetus or infant. If there is a possibility of pregnancy, a pregnancy test should be done before the procedure.
– Asking about any other nuclear medicine scans that have been done within 24 to 48 hours before the procedure. This may interfere with the uptake of the radiotracer and affect the quality of the images.
Educate the Patient About the Procedure
The second nursing intervention is to educate the patient about the procedure and what to expect. This includes:
– Explaining the purpose and benefits of a bone scan and how it can help diagnose or monitor their condition.
– Explaining the risks and limitations of a bone scan and how they can be minimized or managed. These include radiation exposure, allergic reactions, injection site pain or swelling, and false-positive or false-negative results.
– Explaining the steps and duration of a bone scan and how they can prepare for it. These include:
– Drinking plenty of fluids before and after the procedure to flush out the radiotracer from the body.
– Wearing comfortable clothing and removing any metal objects or jewelry that may interfere with the scanner.
– Receiving an intravenous injection of a radiotracer (usually technetium-99m) in a vein in the arm or hand. The radiotracer will circulate through the bloodstream and accumulate in areas of increased bone activity.
– Waiting for two to four hours for the radiotracer to reach its peak concentration in the bones. During this time, the patient may be asked to drink more fluids, empty their bladder frequently, and avoid strenuous activity.
– Lying still on an examination table while a gamma camera moves over their body and takes images of their bones. The camera may be positioned close to their body or at different angles. The patient may be asked to change positions or hold their breath at times. The scanning process may take 30 to 60 minutes depending on the area of interest.
– Explaining what to do after the procedure and when to expect the results. These include:
– Continuing to drink fluids and urinate frequently for 24 hours after the procedure to eliminate any remaining radiotracer from the body.
– Resuming normal activities and medications unless instructed otherwise by their health care provider.
– Avoiding close contact with pregnant women, infants, or children for 24 hours after the procedure as a precautionary measure.
– Receiving a written report of their bone scan results from their health care provider within a few days. The results will show areas of normal, increased, or decreased bone activity. The interpretation of these results will depend on various factors such as their medical history, clinical symptoms, and other diagnostic tests.
Monitor and Support the Patient During and After the Procedure
The third nursing intervention is to monitor and support the patient during and after the procedure and address any issues or concerns that may arise. This includes:
– Checking for any signs of allergic reactions or complications from the injection or contrast agent, such as rash, itching, swelling, difficulty breathing, chest pain, or low blood pressure. If these occur, notify the health care provider immediately and administer appropriate treatment.
– Providing comfort measures such as warm blankets, pillows, music, or distraction techniques to help them relax and cope with any anxiety or discomfort during the scanning process.
– Encouraging them to communicate any questions or feedback they may have about their experience or expectations.
– Providing reassurance and emotional support and acknowledging their feelings and concerns.
– Evaluating their understanding and satisfaction with the procedure and providing additional information or clarification if needed.
– Documenting the procedure and the patient’s response and reporting any abnormal findings or events to the health care provider.
A bone scan is a valuable diagnostic tool that can help detect and evaluate various bone conditions. However, it also involves some risks and challenges that require careful nursing intervention. By assessing, educating, monitoring, and supporting the patient before, during, and after the procedure, nurses can ensure the safety and comfort of the patient and the quality of the images. This can ultimately lead to better outcomes and patient satisfaction.