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Diagnostic Testing Notes

 Early diagnostic tests: lead to early intervention and treatment, reduce morbidity,
establish/confirm diagnosis
o Tests confirm diagnoses, aid in making differential diagnoses, or help determine
activity or stage of disease
 Tests help:
o Evaluate severity of disease
o Estimate prognosis
o Monitor course of disease (progression, stability, resolution)
o Detect disease recurrence
o Select drugs and adjust therapy
 Role of nurse: teach client, family and significant others about diagnostic procedure,
steps to be taken in preparation for test, and care following procedure. Nurse
sometimes performs procedure.
 Noninvasive: body is not entered with any instruments, skin and body tissues, organs,
and cavities remain intact
 Invasive: accessing the body’s tissue, organ, or cavity through some type of
instrumentation procedure
 Assessment data used for: formulating nursing diagnosis, creating plan of care,
establishing outcome measures in collaboration with client and other members of
health care team
 Preparation for testing:
o Appropriate test selection
o Proper client preparation (ID band, vital signs, allergies)
o Client education
 Conscious sedation: 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
o Ongoing assessment of patient required during procedure
 Airway
 Signs and symptoms of perforation of organ (change in vitals)
o Nurse responsibilities:
 Prepare room
 Gather and charge for supplies used during procedure
 Test equipment to ensure it is functional and safe
 Secure proper containers for specimen collection
 Local anesthesia: client loses sensation to a localized body part (spraying back of throat
with lidocane to decrease gag reflex)
 Regional anesthesia: client loses sensation in an area of the body (laparoscope for a
tubal sterilization)
 General anesthesia: client loses all sensation and consciousness (major surgical
procedures)
 Analyte: substance dissolved in a solution (solute)
o Common lab studies usually measure how many analytes are present in a
specimen
 Lab tests:
o Detect and quantify risk of future disease
o Establish and exclude diagnoses
o Assess severity of the disease process and determine the prognosis
o Guide the selection of interventions
o Monitor the progress of the disorder
o Monitor the effectiveness of the treatment
 Clinical value of a test is related to:
o Sensitivity: the likelihood that a diseased client has a positive result (100%
sensitivity means that all clients with a given disease will have positive
results and clients without the disease will have negative results)
o Specificity: the likelihood that a healthy individual will have negative
results (100% specificity means that all clients without a given disease
will have negative results)
o Incidence: the prevalence of a disease in a population or community
o Predictive value: the ability of screening test results to correctly identify
the disease state. A true-positive correctly identified persons who actually
have the disease, a true-negative correctly identifies persons who do not
actually have the disease
o

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