Basic Nursing:Foundations of Skills & Concepts Chapter 27 DIAGNOSTIC TESTS

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.

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.

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.

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.

Further Nursing Responsibilities During 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.

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.

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.

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.

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.

Concerns of Nurses Regarding Diagnostic Testing

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

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.

Types of Urine Collection

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

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.

Type and Crossmatch

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

Blood Chemistry
Blood Glucose. Serum Electrolytes. Blood Enzymes. Blood Lipids.

Types of Urine Tests

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

Types of Stool Tests

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

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.

Types of Culture and Sensitivity Tests

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

Papanicolaou Test

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

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.

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

Chest X-Ray
The most common radiological study. Noninvasive, noncontrasted.

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.

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.

Angiography

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

Arteriography

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

Ultrasound
A noninvasive procedure that uses highfrequency sound waves to visualize deep body structures. Also called echogram or sonogram.

Magnetic Resonance Imaging

The MRI use of radiowaves and a strong magnetic field to make continuous crosssectional images of the body.

Electrocardiogram

A graphic recording of the hearts electrical activity.

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.

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

Electroencephologram (EEG)

The graphic recording of the brains electrical activity.

Endoscopy

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

Aspiration

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

Biopsy

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

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.

Paracentesis

The aspiration of fluid from the abdominal cavity.

Thoracentesis

The aspiration of fluid from the pleural cavity.

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