DELA SALLE MEDICAL AND HEALTH SCIENCES INSTITUTE

College of Nursing

NR-NUR112: HEALTH ASSESSMENT

DIAGNOSTIC TESTS

DIAGNOSTIC TEST/PURPOSE PREPARATION TIME NURSING RESPONSIBILITIES

A. Those that take something out of the body (specimen) to study
URINALYSIS Client should wash 1. Before the client urinates, the nurse should remind the client to wash his/her perineal area first.
- to look for problems with the urine his/her perineal area 2. Nurse should provide a clean container for the urine.
and the organs that help form it by prior to collecting 3. Nurse should emphasize to the client that the midstream urine must be collected.
assessing the color, turbidity, and specimen. 4. The nurse is also responsible for looking and describing the specimen. The nurse should note
specific gravity if the urine is red, cloudy, or looks unusual way.
5. Urinalysis should not be performed while a woman is menstruating or having a vaginal
discharge. Nurse should be aware of it.
6. Remind the client that it should not be done before an intense athletic training or heavy
physical work because it may result in small amounts of blood in the urine.
STOOL EXAM or FECALYSIS 1. The specimen should be placed in a clean container (1 inch of stool)
- obtained when diarrhea is severe 2. Remind patient not to mix the urine with stool.
and when unknown exposure to 3. Tell client to bring the specimen to the laboratory immediately.
enteric pathogens is suspected
VENIPUNCTURE The skin is cleansed about 5 minutes 1. Check the doctor’s order.
- to obtain one or more small vials of with antiseptic prior to 2. Inform the client about the procedure and its purpose.
blood for numerous tests involved in certain blood tests such 3. Prepare the necessary equipment for venipuncture.
diagnosing many conditions other as OGTT (fast for 8-12 4. The skin around the area should be wiped with an alcohol swab (or iodine prep if drawing for
than blood diseases themselves blood culture) and allowed to air dry. After the extraction of blood, clean gauze should be
hours). pressed onto the wound, and the patient instructed to apply pressure to it to minimize
Common Blood Analyses:
1. Complete Blood Count (CBC)
ecchymosis.
2. CBC with differential count 5. The needle should then be disposed of into a sharp’s container in a safe manner to avoid
3. Platelet count needlestick injury.
4. Coomb’s or anticoagulation test 6. Nurse should be responsible for labeling the vacutainer.
5. Blood culture 7. The patient should be instructed not to lift heavy objects or perform strenuous activities for
6. TSH, T3, T4 about 12 hours, otherwise bruising is likely to result.
7. Oral Glucose Tolerance Test (OGTT)
 DIAGNOSTIC TEST/PURPOSE PREPARATION TIME NURSING RESPONSIBILITIES
SEMEN ANALYSIS or SPERM COUNT .1. The patient obtains a varies from 1. Client should be informed to avoid any sexual activity that results in ejaculation for 2 to 5
- to determine male fertility semen specimen by one man to the days before a semen analysis.
- it can be used in suspected rape masturbation into a next 2. Tell client to avoid drinking alcohol for a few days before the test.
cases sterile container 3. Ask client if he is taking any medications or herbal supplements.
provided by the 4. Specimen should be placed in a clean container.
laboratory. 5. Advise client on how to collect the specimen.
2. Deliver the specimen 6. If the client collected the semen sample at home, the sample must be received at the
within 1 hour in the laboratory or clinic within 1 hour.
laboratory. 7. Keep the sample out of direct sunlight and do not allow it to get cold or hot.
3. The specimen should
not be exposed to
extreme temperature
or direct sunlight.
4. Rape cases – semen
sample is obtained
from the vagina using
aspiration syringe.
LUMBAR PUNCTURE or SPINAL TAP approximately 1. Instruct client why lumbar puncture is necessary, and then secure consent.
- provides a small amount of 30 minutes 2. lumbar puncture requires aseptic technique (sterile) and performance by qualified and skilled
cerebrospinal fluid (CSF) for medical practitioners.
laboratory analysis and is used to 3. Place patient in a left (or right) lateral position with his/her neck bent in full flexion and
diagnose viral or bacterial knees bent in full flexion up to his/her chest.
infections, brain hemorrhage and 4. Patient anxiety during the procedure can lead to increased CSF pressure, especially if the
tumors orother obstruction person holds their breath, tenses their muscles or flexes their knees too tightly against their
chest. Therefore,tell client what should be expected and to relax.
5. Watch out for moderate to severe headache, leakage of fluid and signs of infection (rare)
BIOPSY no special preparation varies (skin – 1. Inform client about the procedure to be done.
- to obtain a tissue specimen for but anticipated less than a 2. Secure consent.
microscopic examination to discomfort maybe minute, renal 3. Clean the site in a sterile way.
determine malignancy alleviated with local – about 15
anesthesia or mild minutes)
sedative
 DIAGNOSTIC TEST/PURPOSE PREPARATION TIME NURSING RESPONSIBILITIES
BONE MARROW ASPIRATION no specific preparation, 5 – 10 minutes 1. Inform the client about the procedure.
1. To diagnose leukemia and other tranquilizer or local 2. Secure consent.
cancers anesthetic may be given 3. Sterile technique should always be done.
2. To determine whether various 4. Position the client depending on the site of puncture.
cancers have metastasized 5. Watch out for bleeding, sharp, brief pain, tenderness, signs of infection or air embolism (rare)
3. To evaluate the effectiveness of
chemotherapy
4. To diagnose several types of
anemia and infections

AMNIOCENTESIS (done at least 16 weeks The mother should void About 15 1. Inform the client about the procedure.
age of gestation) prior to the test. minutes 2. Secure consent.
1. To test for birth defects and 3. Sterile technique should be done.
potential problems results – 10 to 4. Risks:
2. It can rule out Down Syndrome, 21days - Accidental puncturing of placenta
- Spontaneous abortion
amino acid disorders, Tay Sach’s - Infection
disease and neural tube disorders
such as spina bifida
3. To determine sex, fetal age and
maturity and give some indications
ofgeneral health of the fetus
 DIAGNOSTIC TEST/PURPOSE PREPARATION TIME NURSING RESPONSIBILITIES
B. Those that look through film or sound
BONE RADIOGRAPHY or X-RAY 1. No specific 15 minutes
1. To view and assess broken preparation for most
bones,cracked skull, and injured radiographs
backbone 2. Jewelry,
2. Useful in detecting more advanced eyeglasses, and
forms of cancer in bones any metal object
should be removed
3. Women should
inform their
physician if they are
pregnant

CHEST X-RAY
- To evaluate shortness of breath, a same as bone
bad persistent cough, chest pain, or a radiography
chest injury
MAMMOGRAPHY Do not apply any 5 to 15 minutes 1. Inform the client about the procedure.
- provides x-ray picture of the breast powder, lotions or 2. Tell the client what to expect.
and is used to detect tumors and perfumes to the breasts 3. Tell client not to apply powder, lotion, or deodorant because it may affect the results.
cysts and to differentiate between or deodorant to
malignant and benign tumors underarms on the day of
the test.
 DIAGNOSTIC TEST/PURPOSE PREPARATION TIME NURSING RESPONSIBILITIES
ULTRASONOGRAPHY 1. All clothing must be several 1. Inform the client about the procedure.
1. Uses sound waves or echoes to removed from the minutes to a 2. Assure that the procedure is safe.
locate and visualize internal organs area under study half hour
2. Useful in looking soft tissues 2. Other preparation
3. Used in pregnancy may be necessary
4. Very useful in examining the heart such as drinking 2
(echocardiography) quarts of fluid an
hour ahead the time
to fill the bladder
before a pelvic
sonogram of a
pregnant woman

ANGIOGRAPHY 1. Inform the client about the procedure.

1. Used to detect abnormalities such 2. Secure consent.
as aneurysms in the blood vessels 3. Ask if client is allergic to iodine.
as well as in the organs
2. Can be used to locate sites of
internal bleeding and blood clots

CARDIAC CATHETERIZATION 1. Fast – 6 hours 30 minutes to 1. Inform the client about the procedure.
1. Visualization of the heart and the prior to test 1 hour,after 2. Secure consent.
coronary arteries 2. Mild sedative is given procedure the 3. Ask if client is allergic to iodine.
2. Venous or right heart catheterization patient 4. Ask if the client has a history of stroke.
(tricuspid and pulmonary valves, 5. Watch out for the following risks:
pulmonary artery, flow of blood to the requires about
8 hours to rest - Heart attack or stroke
heart)
and - Tiredness
3. Arterial or left heart catheterization
observation - Damage to the heart and blood vessel wall
(coronary arteries, mitral and aortic
- Swelling, bleeding, infection
valves, left ventricle)
- Allergic reaction
 DIAGNOSTIC TEST/PURPOSE PREPARATION TIME NURSING RESPONSIBILITIES
ECHOCARDIOGRAPHY 15 minutes to 1 1. Inform the client about the procedure.
1. Uses sound waves to examine the hour 2. Assure that the procedure does notcause pain.
size, shape, and motion of the heart
2. To diagnose abnormalities of the
heart valves and assess cardiac
function

INTRAVENOUS PYELOGRAPHY
- allows seeing inside the kidneys,
ureters, and bladder to evaluate
functioning of the kidneys and
urinary tract
HYSTEROSALPINGOGRAPHY
- used to examine the uterus and the
fallopian tubes to confirm tubal
abnormalities or obstructions
Patient is given a approximately 60Inform the client about the procedure.
1.
laxative or enema and minutes 2. Secure consent.
3. Ask if client is allergic to iodine.
asked to fast for 8 hours 4. Watch out for the following risks:
beforehand - Burning sensation, metallic taste due to the contrast medium
- Allergic reaction to the contrast medium
- Radiation risk
patient may be asked not 15 to 45 Watch out for the following:
to eat for several hours minutes 1. cramping pain
2. tingling sensation
before the exam and 3. intravascular injection of contrast medium
may be given a laxative
and a sedative

POSITRON EMISSION TOMOGRAPHY

(PET SCAN)
1. Non-invasive nuclear imaging
technique that depicts structures,
metabolic changes and activities or
functions in tissues
2. Provides information about function
in completely healthy people
3. Can diagnose stroke and other
neurological substances
 DIAGNOSTIC TEST/PURPOSE PREPARATION TIME NURSING RESPONSIBILITIES
COMPUTERIZED AXIAL TOMOGRAPHY 1. Avoid clothing with about an hour
(CT SCAN / CAT SCAN) zippers and snaps
1. Detailed, cross-sectional views of all 2. Remove hairpins,
types of tissues jewelry, eyeglasses,
2. To study chest and abdomen hearing aids and
3. To diagnose different cancers
any removable
dental works
3. Patient is asked not
to drink anything for
one or more hour
before the exam
4. The doctor should
be informed if the
client is pregnant
5. If with contrast
media, patient
should fast for 4 to 6
hours before the
procedure
6. If the patient is
restless, sedative
may be given
 DIAGNOSTIC TEST/PURPOSE PREPARATION TIME NURSING RESPONSIBILITIES
1. Inform the staff if 60 to 90 Take note of the following individuals at risk:
MAGNETIC RESONANCE IMAGING (MRI) you have metal minutes 1. pregnant women
1. To examine the head, CNS, and objects in the body 2. those with implanted metallic objects
spine (implanted) 3. claustrophobic individuals
2. Can identify tumors, strokes, 2. Remove hairpins, 4. anxious individuals
degenerative jewelry, eyeglasses,
diseases,musculoskeletal disorders, hearing aids, or
and other abnormalities in the removable dental
organs and soft tissue work
3. Positioning
4. The patient is left in
the room while MRI
sequences areperformed
5. The patient is asked
to remain still
6. The table slides
inside a large
tunnel-like tube
within the scanner
 DIAGNOSTIC TEST/PURPOSE PREPARATION TIME NURSING RESPONSIBILITIES
C. Those that use hollow tubes and fiber optics to look inside the body directly
ENDOSCOPY 1. A mild dose of Depends on
- Can be used to inflate a body cavity tranquilizer, such as the area under
with air in order to see it better, to Valium, lasting study but is
take samples for a slide culture or about 15 to 20 usually under
biopsy, or even to perform delicate minutes, is given 30 minutes
surgery, such as a tubal ligation or intravenously during
repair of joint ligaments. endoscopy to help
allay patients'
anxiety.
2. For endoscopy of
the gastrointestinal
system,special
dietary measures,
fasting, or enemas
may be required
beforehand.

ESOPHAGOGASTRODUODENOSCOPY 1. The doctor should

(EGD) be informed of any
1. To evaluate or treat symptoms allergies, medication
relating to the upper use, and medical
gastrointestinal tract, such as: problems.
- upper abdominal or chestpain, 2. NPO at least 6-12
nausea or vomiting, difficulty hours before the
swallowing(dysphagia), bleeding exam.
fromthe upper intestinal tract.
2. To treat certain conditions, such
as an area of narrowing or bleeding
in the upper gastrointestinal tract
 DIAGNOSTIC TEST/PURPOSE
SIGMOIDOSCOPY
- Most often used in screening for
colorectal cancer or to determine
the cause of rectal bleeding
- Diagnosis of inflammatory bowel
disease and other benign diseases
ofthe lower intestine
PREPARATION TIME NURSING RESPONSIBILITIES
1. Many patients arerequired 20 to 30
to consumeonly clear minutes, during
liquids on the day before which time the
the test, and to take two patient will
enemas on the morning of remain awake
the procedure.
2. Patients may also take an
oral laxative preparation
the evening before the
sigmoidoscopy.
3. Certain medicationsshould
be avoided for a week
before having a sigmoidos-
copy such as ASA, or
products containing ASA,
Ibuprofen products
(Advil, Motrin), and Fe or
vitamins containing Fe
4. Although most prescription
medication can be taken as
usual, patients should
check with their doctor in
advance.
5. Light sedation may be
given to some patients.
 DIAGNOSTIC TEST/PURPOSE PREPARATION TIME NURSING RESPONSIBILITIES
LAPAROSCOPY Fast for at least 8 hours usually takes
1. Allows the doctor to look directly at the uterus, beforehand. less than 30
fallopian tubes, and ovaries to detect minutes
endometriosis,ectopic pregnancy, pelvic
inflammatory disease or other causes of pelvic
pain, or to determine the extent of cancer
2. May also be used to perform a tubal ligation
(sterilization)

COLONOSCOPY 1. The patient is given a liquid 30 to 60 minutes

1. To detect inflammatory or ulcerative bowel diet for 1 to 2 days before the
disease exam, followed by a laxative
2. To check for polyps or tumors and one or more enemas to
3. To locate the site of gastrointestinal bleeding. completely empty the bowels.
2. A sedative or tranquilizer may
also be given.

PROCTOSIGMOIDOSCOPY 3. The patient may be instructed 10 to 20 minutes.

1. Allows the doctor to see the rectum and the lower to have a liquid diet or to fast
part of the large intestine to detect hemorrhoids, for a few hours, followed by
polyps, and abscesses or to determine the cause an enema or suppository
of bleeding
2. Routinely used to screen for cancer after age 40,
even if there are no symptoms
COLPOSCOPY No special preparation is 15 minutes
- Allows direct visualization of the vagina and necessary.
cervix to confirm cervical cancer (aftera
positive Pap test) or to perform a biopsy
 DIAGNOSTIC TEST/PURPOSE PREPARATION TIME NURSING RESPONSIBILITIES
D. Those that Measure Performance
BRONCHOSCOPY 1. If local anesthesia is used, about 30 minutes
1. Allows the doctor to see inside the trachea a sedative may also be
and bronchial tree to check for tumors or used to help the patient
foreign bodies, to locatethe site of internal relax.
bleeding, to remove mucus or a foreign 2. The patient will be asked
body, orto obtain a tissue or secretion not to eat for 6 to 12 hours
specimen before the test,and to
2. May be used to help diagnose cancer, remove anydentures.
tuberculosis, or other pulmonary diseases
caused by bacteria, fungi, or parasites

LUNG CAPACITY TEST / PULMONARY FUNCTION 1. The patient will be told not About 45 to 60
TEST to eat a heavy meal or minutes.
1. To determine the cause of shortness of smoke for 6 hours before
breath and to detect the presence of the test
diseases or injury 2. Avoid wearing constricting
2. Often used before surgery or to evaluate clothing or taking
disability for insurance purposes analgesics.
ELECTROCARDIOGRAMS (ECG/EKG)
- Provide basic information about heart
function, including unusual rhythms,
electrolyte imbalance, enlargement of
the chambers, and evidence that the
patient has had a heart attack.
 DIAGNOSTIC TEST/PURPOSE PREPARATION TIME NURSING RESPONSIBILITIES
ELECTROENCEPHALOGRAPHY (EEG) The patient may be asked not Usually takes about
- Records the electrical activity of the to take any medications that 1hour unless a
brain and is used to diagnose have an effect on the nervous sleepEEG, which
epilepsy, tumors, brain damage, system, for 1 or 2 days before takes about 3
mental retardation, and certain the test. hours, is done.
psychological disorders

ELECTROMYOGRAPHY (EMG) The patient may be asked not 1 hour or longer,

- Studies the electrical activity of to smoke or take caffeinated depending on
muscles at rest and during contraction drinks for 2 or 3 hours before how many
to diagnose diseases that affect the the test. muscles are
muscles, peripheral nerves, and spinal being studied
cord

Edited: jcm/jmd_May 2, 2023