DEXA Scans for Osteoporosis (Nursing)

00:01 Hi, welcome to our video series on Geriatric Nursing.

00:05 Now in this one, we're going to talk about DEXA scans that are for osteoporosis.

00:09 So you may be asking, what does DEXA scan stand for? I know we use so many words in healthcare that are shortened.

00:17 But here's why.

00:19 Look what DEXA stands for.

00:21 D is for dual, E is for energy, X is for X-ray and the A is for absorptiometry.

00:30 That is a big word is it not, which is why we say DEXA scan.

00:35 Now, what it is, is a type of medical imaging test, it uses very low levels of X-rays to measure bone density.

00:44 Now, this is a really cool test.

00:46 So that's why we wanted to make sure that we spend some time explaining it to you and what it does and what it will be like for the patient.

00:55 Because we want you to understand what your patient should expect in a DEXA scan procedure.

01:01 Now there's some things we want you to take a look at, let's start at the one side of the screen, that big square block.

01:09 You'll notice that the client is laying on a table, and they've got their feet propped up on that big block.

01:14 So it's relatively comfortable for them to have this test.

01:18 But you put the feet up high, you elevate them.

01:21 So they'll have a flatter spine, that's what we're looking at.

01:25 So you want to make sure they're comfortable and they can stay in that position because the test is going to last about 30 minutes.

01:32 Now look at the middle, you've got that X-ray apparatus in the middle, right.

01:36 So it shoots up through the bottom, remember very low levels, and then it's picked up by that sensor in the middle.

01:44 Okay, now who's over on the right? Well, the images that are being picked up by that low level X-ray, you see you have them showing up on a screen there.

01:54 And that's a technician who knows how to administer the test.

01:57 So this is what it'll look like when one of your clients or patients experiences a DEXA scan.

02:03 But I want you to be aware of what to do before the DEXA scan.

02:08 These are really important questions to discuss with your client.

02:11 So you want to make sure the DEXA scan is accurate.

02:14 I mean, there's no reason to do it if we don't get an accurate exam.

02:17 So three things before the scan.

02:21 I want you to make absolutely sure that you've discussed with the patient.

02:26 In order to get an accurate DEXA scan, the patient cannot have had any GI testing with barium within two weeks of the DEXA scan.

02:36 So you want to ask them have you had any GI testing? Have you swallowed any barium within two weeks of this test because we'll need to schedule it out later if they have.

02:47 Now they're taking calcium supplements, which odds are, it's really high that they could be taking calcium supplements because remember, we're testing for osteoporosis.

02:56 The client will need to hold those calcium supplements for 24 hours before the DEXA scan begins.

03:03 Otherwise, the test may kind of pick up the calcium and interpret that or misinterpret that as bone.

03:11 Now the third thing, make sure the clients clothing does not have any metal or plastic because this will also obscure the DEXA results.

03:19 So pause for just a minute.

03:22 Stop and think.

03:23 Don't look at your notes.

03:25 What are three things you need to make sure that you discuss with the client before a DEXA scan to make sure the results are as accurate as possible.

03:34 Don't look at your notes.

03:35 See what you can pause and recall.

03:45 Now why would I have you do that? Hey listen, doesn't this sound like a really appropriate kind of question talking about patient education on an exam or the big exam, the NCLEX? Sure it does.

03:58 So make sure you know it could come at you in a question like, which of the following statements requires immediate intervention if made by the patient about to receive a DEXA scan? See how they'd word it.

04:11 Oh, you know what, I had a GI test like just last week, this doesn't seem as complicated.

04:16 That would require immediate follow up or if they said the only medication I took this morning was my calcium supplements.

04:23 Okay, needs follow up because we know that'll mess the test.

04:27 What about, "Ah, let me move this zipper around a little bit.

04:30 This plastic zipper is kind of uncomfortable on my clothing." That's how you can take the information and see it come on an exam.

04:39 That's just one type of question.

04:42 So what I want you to think about as we're going through these slides is think about why would a nurse need to know this? How would it keep a patient safe? This is just one example.

04:53 Knowing what the client needs to avoid before having the test is our responsibility to educate them to make sure they get a safe and accurate exam.

05:06 Now let's talk about some care strategies for DEXA scans.

05:10 Now the test is relatively quick and painless.

05:13 The patient will need to get up onto the table and then lie down.

05:17 Now some patients will need assistance with this and the the nurse or the technician is available to help them do that safely.

05:24 Depends on the patient's height, I know I'm so short, it would probably be harder for me to get on the table than someone who has a regular height.

05:32 So make sure that you help the patient onto the table so they can do that safely.

05:38 Now we talked about their legs being propped up on that square pillow, that's to help keep that flat spine.

05:44 So really, it's not that uncomfortable once you can get them positioned.

05:48 Now the arm of the machine we talked about that earlier.

05:51 That's what will pass over their body while they're being tested.

05:56 Now the test takes about 30 minutes so we said it's it's relatively quick, but it's still 30 minutes that the client is going to have to lay there.

06:05 Now let's take a look at a DEXA scan report.

06:08 Looks pretty cool, doesn't it what you got go in there.

06:10 See the scanner translates the bone density measurement data and it makes pictures and graphs.

06:16 Now this will be looked at by a radiologist or another physician.

06:21 Now this test has a very high precision and accuracy for diagnosing osteoporosis.

06:28 We'll talk about the kind of cues that you look for signs of osteoporosis.

06:32 But this test is truly the gold standard for this type of diagnosis, looking at the bones, determining what their density is and identifying the risk or presence of osteoporosis.

06:46 Because remember DEXA and diagnosing osteoporosis, it's the gold standard.