Chest X-ray (Chest Radiography)
Chest X-ray (Chest radiography, CXR) is one of the most frequently performed radiological examinations. A chest
x-ray is a painless, non-invasive test that uses electromagnetic waves to produce visual images of the heart, lungs,
bones, and blood vessels of the chest. Air spaces normally seen in the lungs appear dark on the chest films. A
basic chest x-ray includes a posteroanterior (PA) view, in which x-rays pass from the back to the front of the body
and a left lateral view. Other projections such as lateral decubitus, lordotic views, or oblique views can also be
requested. For critically ill patients who cannot leave the nursing unit, a portable x-ray machine is performed at the
bedside using anteroposterior (AP) projections with an addition of a lateral decubitus view if a free flow fluid or air
is suspected.
Chest images should be examined in full inspiration and erect if feasible to reduce cardiac magnification and
demonstrate fluid levels. Expiration images may be needed to identify a pneumothorax or locate foreign materials.
Rib detail images may be taken to delineate bone pathology, helpful when chest radiographs illustrate metastatic
lesions or fractures. In the onset of the disease process of asthma, tuberculosis, and chronic obstructive pulmonary
disease, chest x-ray results may not correlate with the patient’s clinical status and may even be normal.
Nurses are responsible for ensuring the patient’s comfort while at the x-ray room since some may experience pain
from injury or symptoms from a disease condition, as well as the apprehension about what the result may show. In
addition, producing a good quality image relies on the ability of the patient to cooperate, such as holding breath for
a while. Providing a calm and relaxed environment for the patient is indeed vital.
This diagnostic and laboratory procedure study guide can help nurses understand their tasks and responsibilities
during a chest x-ray.
Indications of Chest X-ray
Here are some of the reasons why a Chest x-ray is performed:
● Assist in the diagnosis of diaphragmatic hernia, lung tumors, and metastasis
● Detect known or suspected pulmonary, cardiovascular, and skeletal disorders
● Identify the presence of chest trauma
● Confirm correct placement and position of the endotracheal tube, tracheostomy tube, chest tubes,
central venous catheters, nasogastric feeding tube, pacemaker wires, intra aortic balloon pump,
Swan-Ganz catheters, and automatic implantable cardioverter defibrillator
● Evaluate positive purified protein derivative (PPD) or Mantoux test for pulmonary tuberculosis.
● Monitor progressions, resolutions, or maintenance of disease
● Evaluate the patient’s response to a therapeutic regimen (antibiotic, chemotherapy)
Contraindication
Chest X-ray is not advisable for:
● Patients who are pregnant or suspected of being pregnant unless the potential benefits of a
procedure using radiation outweigh the risk of maternal and fetal damage
Chest X-ray (Chest radiography, CXR) is one of the most frequently performed radiological examinations. A chest
x-ray is a painless, non-invasive test that uses electromagnetic waves to produce visual images of the heart, lungs,
bones, and blood vessels of the chest. Air spaces normally seen in the lungs appear dark on the chest films. A
basic chest x-ray includes a posteroanterior (PA) view, in which x-rays pass from the back to the front of the body
and a left lateral view. Other projections such as lateral decubitus, lordotic views, or oblique views can also be
requested. For critically ill patients who cannot leave the nursing unit, a portable x-ray machine is performed at the
bedside using anteroposterior (AP) projections with an addition of a lateral decubitus view if a free flow fluid or air
is suspected.
Chest images should be examined in full inspiration and erect if feasible to reduce cardiac magnification and
demonstrate fluid levels. Expiration images may be needed to identify a pneumothorax or locate foreign materials.
Rib detail images may be taken to delineate bone pathology, helpful when chest radiographs illustrate metastatic
lesions or fractures. In the onset of the disease process of asthma, tuberculosis, and chronic obstructive pulmonary
disease, chest x-ray results may not correlate with the patient’s clinical status and may even be normal.
Nurses are responsible for ensuring the patient’s comfort while at the x-ray room since some may experience pain
from injury or symptoms from a disease condition, as well as the apprehension about what the result may show. In
addition, producing a good quality image relies on the ability of the patient to cooperate, such as holding breath for
a while. Providing a calm and relaxed environment for the patient is indeed vital.
This diagnostic and laboratory procedure study guide can help nurses understand their tasks and responsibilities
during a chest x-ray.
Indications of Chest X-ray
Here are some of the reasons why a Chest x-ray is performed:
● Assist in the diagnosis of diaphragmatic hernia, lung tumors, and metastasis
● Detect known or suspected pulmonary, cardiovascular, and skeletal disorders
● Identify the presence of chest trauma
● Confirm correct placement and position of the endotracheal tube, tracheostomy tube, chest tubes,
central venous catheters, nasogastric feeding tube, pacemaker wires, intra aortic balloon pump,
Swan-Ganz catheters, and automatic implantable cardioverter defibrillator
● Evaluate positive purified protein derivative (PPD) or Mantoux test for pulmonary tuberculosis.
● Monitor progressions, resolutions, or maintenance of disease
● Evaluate the patient’s response to a therapeutic regimen (antibiotic, chemotherapy)
Contraindication
Chest X-ray is not advisable for:
● Patients who are pregnant or suspected of being pregnant unless the potential benefits of a
procedure using radiation outweigh the risk of maternal and fetal damage
