NursingCenter Blog

How Do I Prepare My Patient for an MRI?

Feb 13 2024 by Myrna Buiser Schnur, MSN, RN

If you are a nurse working in an acute care setting, you’ve likely sent patients for diagnostic imaging. One of the most common radiologic tests is magnetic resonance imaging (MRI), a non-invasive exam that produces three-dimensional images of the internal organs, bones, and soft tissues to detect or diagnose disease and monitor treatment. These scanning systems use superconducting magnets and radiofrequency signals to create sectional images of the body that are then converted to computer-generated graphics (Lippincott Advisor, 2022). The brain, spinal cord, nerves, muscles, ligaments, and tendons are seen in greater detail with MRI than with standard X-rays and computed tomography (CT) (National Institute of Biomedical Imaging and Bioengineering, n.d.). MRIs produce strong magnetic fields extending beyond the machine and exerting powerful forces on objects made of iron, some steel and other magnetizable objects (National Institute of Biomedical Imaging and Bioengineering, n.d.) and therefore require very specific precautions. What does MRI patient preparation entail?

How do I prepare my patient for an MRI?

Patient preparation includes the following (Lippincott Advisor, 2022; National Institute of Biomedical Imaging and Bioengineering, n.d.):

Assess the patient for any absolute contraindications such as:
- Implanted devices (particularly those that contain iron), such as pacemakers, vagus nerve stimulators, implantable cardioverter-defibrillators, loop recorders, insulin pumps, cochlear implants, deep brain stimulators, and capsules from capsule endoscopy
- Internal metal, such as bullets, shrapnel, surgical clips, pins, screws, metal sutures, and wire mesh
Check the patient for surgically implanted joints, valves, pumps, and pacemakers and stimulators that contain metal. Certain implants cannot be safely scanned.
If the patient requires life support such as a mechanical ventilator, call the MRI staff prior to the scan to ensure all necessary equipment is set up outside of the room. Extension tubing will be needed to safely position ventilators and IV pumps outside of the MRI area.

Confirm that the informed consent has been signed and is placed in the patient’s medical record.
Verify with the MRI staff that the scanner can accommodate the patient’s size and weight.
Note all allergies.
Patients with claustrophobia may experience anxiety and may not tolerate long scan times inside a closed tube system.
- Assist the patient with visualization techniques.
- Provide sedation as ordered.
- Play music to help calm the patient.
- An open MRI machine does not completely surround the patient; that may be an option.
Remove metal objects from the patient’s body such as transdermal medication patches containing aluminum or other metals, hearing aids, dentures, jewelry, body piercings, eyeglasses, and hairpins.
- Warn the patient that specific eye makeup and permanent eye liners containing metal fragments may cause discomfort during the MRI.
If the patient will receive contrast medium (typically containing gadolinium), start an IV and administer the medium as ordered before the procedure.

Educate the patient and family on the following (Lippincott Advisor, 2022; National Institute of Biomedical Imaging and Bioengineering, n.d.):

MRIs don’t cause pain.
X-rays and ionizing radiation aren’t used with MRI.
Fasting is not required prior to the MRI unless the abdomen or pelvis is being scanned.
The patient should remain as still as possible during the procedure.
Warn the patient that the scanner will make loud sounds such as scanner clicking and thumping (up to 120 decibels). Earplugs or music headsets should be provided to reduce the noise.
Nerve stimulation, a twitching sensation, may be experienced by the patient from the rapidly switched magnetic fields in the MRI.
Tell the patient that communication with the MRI technician will be always available during the scan and that a button will be provided to alert the technician if they should require immediate attention.
Scanning may take 30 to 90 minutes.
MRIs are more expensive than x-rays or CT scanning.

Lastly, note that patients with severe renal failure could be at risk for a rare illness called nephrogenic systemic fibrosis with the use of certain gadolinium-containing contrast agents. Dialysis patients should only receive gadolinium when necessary and dialysis should be performed as soon as possible after the scan to remove contrast from the body. In addition, MRI scans should be avoided in pregnancy, particularly during the first trimester.