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Definition
A chest x ray is a procedure used to evaluate organs and structures within the chest for symptoms of disease. Chest x rays include views of the lungs, heart, small portions of the gastrointestinal tract, and the bones of the chest area. X rays are a form of radiation that can penetrate the body and produce an image on an x ray film. Another name for the x ray image is radiograph.
Purpose
Chest x rays are ordered for a wide variety of diagnostic purposes. In fact, this is probably the most frequently performed x ray exam. In some cases, chest x rays are ordered for a single check of an organ's condition, and at other times, serial x rays are ordered to compare to previous studies. Some common reasons for chest x rays include:
Pulmonary disorders
Pneumonia shows up on radiographs as a patchy white area of density, as a result of fluid in the lung(s). If the bronchi, which are usually not visible, can be seen, a diagnosis of bronchial pneumonia may be made. Widening of the spaces between ribs, or very large, dark lung fields, also can be a radiographic sign of emphysema.
Other pulmonary diseases may also be detected or suspected through chest x ray.
Cancer
In nearly all patients with lung cancer, some sort of abnormality can be seen on a chest radiograph. Hilar masses (enlargements at that part of the lungs where vessels and nerves enter) are one of the more common signs, as are abnormal masses and fluid buildup on the outside surface of the lungs or surrounding areas. Interstitial lung disease, which is a large category of disorders, many of which are related to exposure to substances (such as asbestos fibers), may be detected on a chest x ray as fiber- like deposits, often in the lower portions of the lungs.
Cardiac disorders
Although less sensitive than echocardiography to evaluate the heart, chest x ray is preferred to check for disorders such as congestive heart failure or pulmonary edema. Pericardial effusion (fluid surrounding the heart), if present, and cardiac size will also be noted on the chest x ray.
Other
Congestive heart failure and other cardiac diseases may be diagnosed on the view of the heart and lung in a chest radiograph. Fractures of the sternum and ribs are
sometimes also detected as breaks in the bone visible on the film. In some instances, the view of the diaphragm may indicate an abdominal problem. Foreign bodies which may have been swallowed or inhaled can usually be located by the radiologist as they will see the object either in the esophagus, or the upper part of the stomach, and will look different from any other tissue or structure in the chest. Serial chest x rays may be ordered to track changes in the position of an object over a period of time.
Precautions
Pregnant women, particularly those in the first or second trimester, should not have chest x rays unless absolutely necessary. If the exam is ordered, women who are, or could possibly be, pregnant must wear a protective lead apron, with the full coverage adjusted for the direction of the x-ray beam. Because the procedure involves radiation, care should always be taken to avoid overexposure, particularly for children. However, the amount of radiation from one chest x ray procedure is minimal.
Description
Routine chest x rays consist of two views: the frontal view (referred to as posterior-anterior or PA) and the lateral (side) view, with the left side against the x-ray board. It is preferred that the patient stand for this exam.
The patient must remain motionless, and will be asked to take in a big breath for each x ray. Filling the lungs with air expands the lung fields, and shows the anatomy at its most optimum. In addition, the deep inspiration of air also helps the patient remain motionless, which is critically important in such a short x-ray exposure.
The chest x ray may be performed in a physician's office or referred to an outpatient radiology facility or hospital radiology department. In some cases, particular- ly for bedridden patients, a portable chest x ray may be taken. Portable films are sometimes of poorer quality than those taken with permanent equipment, but are the
Preparation
There is no advance preparation necessary for chest x rays. Once the patient arrives at the exam area, the patient will undress to the waist, and wear a gown or drape as provided by the facility. All necklaces will be removed as well.
Aftercare
No aftercare is required by patients who have chest x rays.
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Author Info: Debra Novograd B.S.,R.T.(R)(M), The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Nursing and Allied Health, 2002 |
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