Basic%20Nursing:Foundations%20of%20Skills%20

1
Basic NursingFoundations of Skills Concepts
Chapter 27

• DIAGNOSTIC TESTS

2
Types of Diagnostic Tests

• Noninvasive The body is not entered with any
  type of instrument.
• Invasive The bodys tissues, organs, or cavities
  are accessed through some type of procedure
  making use of instruments.
• Most invasive procedures require informed consent
  of the client.

3
Preparing the Client for Diagnostic Testing

• Nurses prepare clients by ensuring client
  understanding and compliance with preprocedural
  requirements.
• Clients, families, and significant others must be
  involved in the testing process and should be
  advised as to the estimated time required to
  perform the test.

4
Preparing the Client for Diagnostic Testing
Nursing interventions used during
diagnostic testing include

• Evaluating the clients anxiety level.
• Teaching relaxation techniques, such as deep
  breathing and imagery.
• Evaluating the clients level of safety and
  comfort.

5
Role of the Nurse in Diagnostic Testing

• To facilitate the scheduling of tests.
• To perform client teaching.
• To perform or assist with procedures.
• To assess clients for adverse responses to
  procedures.

6
Further Nursing ResponsibilitiesDuring
Diagnostic Testing

• Preparing the procedure room (e.g. ensuring
  adequate lighting).
• Gathering and charging for supplies to be used
  during the procedure.
• Testing the equipment to ensure it is functional
  and safe.
• Securing proper containers for specimen
  collection.

7
Conscious Sedation

• A minimally depressed level of consciousness
  during which the client retains the ability to
  maintain a continuously patent airway and respond
  appropriately to physical stimulation or verbal
  commands.

8
Care of the Client After Diagnostic Testing

• Directed toward restoring the clients
  prediagnostic level of functioning.
• Client is monitored for signs of respiratory
  distress and bleeding.
• With some diagnostic tests, the clients intake
  and output (I O) is monitored for 24 hours.
• Clients received written instructions upon
  discharge.

9
Reasons for Laboratory Tests

• To detect and quantify the risk of future
  disease.
• To establish or exclude diagnoses.
• To assess the severity of the disease process and
  formulate a prognosis.

• To guide the selection of interventions.
• To monitor the progress of the disorder.
• To monitor the effectiveness of the treatment.

10
Accuracy in Laboratory Testing

• The following are required
• The practitioners order must be transcribed onto
  the correct requisition form.
• All information must be written on form.
• Pertinent data that could influence the tests
  results must be included.
• Collection of the specimen from the correct
  client must be confirmed by checking the
  identification band.
• Laboratory results must be placed in the correct
  medical record.

11
Concerns of Nurses RegardingDiagnostic Testing

• Nurses should schedule diagnostic testing to
  promote
• Client comfort.
• Cost containment.

12
Types of Specimen Collection

• Venipuncture the use of a needle to puncture a
  vein to aspirate blood.
• Arterial puncture.
• Capillary puncture.
• Central Lines refers to a venous catheter
  inserted into the superior vena cava through the
  subclavian or internal or external jugular vein.
• Implanted port a port that has been implanted
  under the skin.
• Urine collection.

13
Types of Urine Collection

• Random (routine analysis)
• Timed (24-hour urine)
• Collection from a closed urinary drainage system.
• Sterile specimen (catheterized)
• Clean-voided specimen.

14
Procedures for Stool Collection

• Explain to client the reason for collection.
• Refrigerate stools if collected for a prolonged
  period of time.

• Label container with clients name, date and
  time, and test to be performed on the specimen.
• Place stool specimens in biohazard bag before
  transport to laboratory.

15
Type and Crossmatch

• Identifies the clients blood type and determines
  the compatibility to blood between a potential
  donor and recipient (client).

16
Blood Chemistry

• Blood Glucose.
• Serum Electrolytes.
• Blood Enzymes.
• Blood Lipids.

17
Types of Urine Tests

• Urine pH.
• Specific Gravity.
• Urine Glucose.
• Urine Ketones.
• Urine Cells and Casts.

18
Types of Stool Tests

• Urobilinogen.
• Occult blood (blood in the stool detected only
  with a microscope or by chemical means).
• Parasites.

19
Culture and Sensitivity Tests

• Culture refers to the growing of microorganisms
  to identify the pathogen.
• Sensitivity tests are performed to identify both
  the nature of the invading organism and its
  susceptibility to commonly used antibiotics.

20
Types of Culture and Sensitivity Tests

• Blood Culture.
• Throat (Swab) Culture.
• Sputum Culture.
• Urine Culture.
• Stool Culture.

21
Papanicolaou Test

• A smear method of examining stained exfoliative
  cells, commonly called a Pap smear.

22
Radiography

• The study of film exposed to x-rays or gamma rays
  through the action of ionizing radiation.
• Used by the practitioner to study internal organ
  structure.

23
Fluoroscopy

• Immediate, serial images of the bodys structure
  and function.
• Reveals the motion of organs.

24
Chest X-Ray

• The most common radiological study.
• Noninvasive, noncontrasted.

25
Computed Tomography

• The radiological scanning of the body.
• X-ray beams and radiation detectors transmit data
  to a computer that transcribes the data into
  quantitative measurement and multidimensional
  images of the internal structures.

26
Barium Studies

• The use of barium, a chalky white contrast
  medium, in a preparation that permits
  roentgengraphic visualizations of the internal
  structures of the digestive tract.

27
Angiography

• Visualization of the vascular structures through
  the use of fluoroscopy in conjunction with a
  contrast medium.

28
Arteriography

• The radiographic study of the vascular system
  following injection of a radiopaque dye through a
  catheter.

29
Ultrasound

• A noninvasive procedure that uses high-frequency
  sound waves to visualize deep body structures.
• Also called echogram or sonogram.

30
Magnetic Resonance Imaging

• The MRI use of radiowaves and a strong magnetic
  field to make continuous cross-sectional images
  of the body.

31
Electrocardiogram

• A graphic recording of the hearts electrical
  activity.

32
Stress Test

• A measure of the clients cardiovascular fitness.
• It demonstrates the ability of the myocardium to
  respond to increased oxygen requirements by
  increasing the blood flow to the coronary
  arteries.

33
Thalium Test

• Thalium201 is a radioactive isotope that emits
  gamma rays and closely resembles potassium.
• Often performed in conjunction with ECG.

34
Electroencephologram (EEG)

• The graphic recording of the brains electrical
  activity.

35
Endoscopy

• The visualization of a body organ or cavity
  through a scope.

36
Aspiration

• A procedure that is performed to withdraw fluid
  that has abnormally collected or to obtain a
  specimen.

37
Biopsy

• The excision of a small amount of tissue,
  obtained during aspiration or in conjunction with
  other diagnostic tests.

38
Amniocentesis

• The withdrawal of amniotic fluid to obtain a
  sample for examination.
• Indicated when client is
• Over 35.
• Has had a spontaneous abortion with a previous
  pregnancy.
• Has a family history of genetic, chromosomal, or
  neural tube defects.

39
Paracentesis

• The aspiration of fluid from the abdominal cavity.

40
Thoracentesis

• The aspiration of fluid from the pleural cavity.

41
Lumbar Puncture

• The aspiration of cerebrospinal fluid (CSF) from
  the subarachnoid space.
• Also called spinal tap.