CHAPTER 25

Diagnostic Testing
 Explain the phases Elaborate the
of diagnostic testing. examination of
Describe the stool.
complete blood Describe the urine
count testing. testing, urine
Explain the serum culture and sputum
Learning Objectives electrolyte, liver testing.
function test and Discuss the
lipid profile. radiologic and
Explain the serum endoscopic
glucose testing. procedures.
  Phases of diagnostic
testing (pre-test, intra-
test and post-test)
 Common investigations
and clinical implications
 Complete Blood Count
 Serum Electrolytes
 LFT
CHAPTER  Lipid/Lipoprotein profile
 Serum Glucose-AC, PC,
OUTLINE HbA1c
 Monitoring Capillary
Blood Glucose
(Glucometer Random
Blood Sugar-GRBS)
 Stool Routine Examination
(Types and collection of
specimen of faeces:
Observation)
 Collection of urine
specimen: Observation,
urine testing-Albumin,
Acetone, pH, Specific
Gravity
 Urine Testing- Types
 Urine Culture, Routine,
Timed Urine Specimen
 Sputum culture, Throat
Specimen, Vaginal
Specimen
 Overview of Radiologic
and Endoscopic
Procedures
 INTRODUCTION

The term diagnostic

consists of all the
activities in measuring
and interpreting the
growth lags and their
influences on the body.
 • A diagnostic test is a test that helps in
locating and identifying the
abnormality, deficiency or deviation
from the normal in the different organs
DEFINITIONS or parts of the body.
OF DIAGNOSTIC • This is a medical procedure which is
TEST performed by medically skilled
personnel to detect, identify, diagnose
and monitor the disease, its process
and then according to the condition the
course of treatment is decided.
PHASES OF DIAGNOSTIC TESTING
 PRE-TEST PHASE
• The first phase in the laboratory process.
• Includes the collection of specimen, transporting and
processing of sample.
• Includes the issues regarding the handling and collection of
the specimen.
• During the pretesting phase, which is also known as the
preanalytic phase, there are chances of errors while handling
the specimen and processing the specimen.
• Therefore, the preanalytical phase should have rigorous
control measures to avoid any unnecessary hindrances or
errors.
 INTRA-TEST PHASE

• The second phase is also known as the

analytic phase.
• This phase is usually considered as the
‘actual’ phase of the diagnostic testing
or laboratory testing and the ultimate
results of the diagnostic test.
 POST-TEST PHASE
 The post-analytic phase is the final phase of the
laboratory process.
 Thisphase culminates in the production of a final
value, result, or the case of histology, a diagnostic
pathology report.
 The testing results in transmission detection,
interpretation by doctor and treatment, follow-up
and retesting to evaluate the outcome of the
condition.
COMPLETE BLOOD COUNT
This is the process of collecting or withdrawing blood
samples through Venepuncture for routine lab
investigation to measure the various components of
blood which includes the red blood cells, white blood
cells, hemoglobin, hematocrit and platelets.
PURPOSES OF COMPLETE BLOOD COUNT
TESTING
 To evaluate any abnormality in the
blood profile.
 To supplement the diagnosis and
treatment related to a specific
condition.
 To monitor variation in the blood.
 VARIOUS RED BLOOD CELLS
 Function-Carry oxygen from the lungs or gills to all the body
COMPONENT tissues and carry carbon dioxide, a waste product of metabolism,
S to the lungs, where it is excreted.
OF  There are lots of conditions that can affect RBC production and
a few conditions may result in significant bleeding.
BLOOD  If RBCs are lost or destroyed faster than they can be replaced, or
MEASURED if bone marrow production is disrupted, or if the RBCs produced
do not function normally, or do not contain enough hemoglobin,
UNDER then this condition may lead to anemia.
COMPLETE  If too many RBCs are produced and released, then the condition
BLOOD is known as polycythemia. Polycythemia leads to thicker blood,
decreased blood flow and related problems, such as headache,
COUNT dizziness, problems with vision, and even excessive clotting or
heart attack.
NORMAL RBC VALUE
 WHITE BLOOD CELLS
• Stem cells in the bone marrow are responsible
for producing white blood cells (WBCs).
• The bone marrow then stores an estimated 80–
90% of white blood cells.
• When infection or inflammatory condition
occurs, the body releases white blood cells to
help fight the infection.
TYPES OF WHITE BLOOD CELLS
NORMAL RANGE OF WBCs
 LEUKOCYTOSIS
• Increased production of white blood cells in the body is known
as leukocytosis.
• There are certain conditions in which there are increased
productions of WBCs such as:
Conditions in which cells die such as burns, heart attack,
trauma
Conditions that involve an allergic response like an asthma
attack
Inflammatory conditions such as rheumatoid arthritis,
inflammatory bowel disease and vasculitis
Infections caused by bacteria, fungi and virus
Leukemia
 LEUKOPENIA
 Certain medical conditions are there which cause decreased production of white blood
cells and it is known as leukopenia.
 It includes the following conditions:
 Autoimmune disorders such as systemic lupus erythematosus (SLE) and human
immunodeficiency virus (HIV)
 Bone marrow damage, such as from chemotherapy, radiation therapy
 Bone marrow disorders
 Lymphoma
 Vitamin B12 deficiencies
 HEMOGLOBIN

• This is a protein in the blood cells which carries oxygen

to the different organs.
• Hemoglobin is made up of four protein molecules
(globulin chains) that are connected.
• The normal adult hemoglobin (abbreviated Hb or Hgb)
molecule contains two alpha-globulin chains and two
beta-globulin chains.
NORMAL Hb LEVEL
COMMON CAUSES OF ANEMIA
 HEMATOCRIT

Proportion of red blood cells

to the fluid component or the
plasma of the blood. The
hematocrit (Ht or Hct) is
expressed as a percentage.
For example, a hematocrit of
35% means that there are 35
milliliters of red blood cells
in 100 mL of blood.
NORMAL HEMATOCRIT LEVEL
HIGH HEMATOCRIT LEVEL
The hematocrit levels are increased in the following
conditions:
• Increased risk of Dengue Shock Syndrome (DSS)
• Polycythemia vera
• Chronic obstructive pulmonary disease (COPD)
• Erythropoietin (EPO) or Erythropoietin use
• Dehydration
• Capillary leak syndrome
• Sleep apnea
• Anabolic steroids use
 LOW HEMATOCRIT LEVEL
The hematocrit levels are reduced in the following
conditions:
• Anemia
• Pregnancy
• High altitude living
• Nutritional deficiency of iron, vitamin B12 or folate
• Kidney disease
• Bone marrow disease
• Leukemia, lymphoma or multiple myeloma
 PLATELET
• Platelets are tiny blood cells that help the body in forming
clots to stop bleeding.
• If one of the blood vessels gets damaged, it sends out signals
to the platelets. The platelets then rush to the site of damage,
they form a plug (clot) to fix the damage.
• A normal platelet count is 150,000–450,000 platelets per
microliter of blood.
• The risk for bleeding develops if a platelet count falls below
10,000–20,000.
• When the platelet count is less than 50,000, bleeding is likely
to be more serious if there is any cut or bruises in the body.
 SERUM ELECTROLYTES

Electrolytes are In nutrition, the term

involved in many refers to essential
essential processes in minerals found in
the body. They play a ‘Electrolyte’ is the blood, sweat and
vital role in umbrella term for urine. When these
conducting nervous particles that carry a minerals dissolve in a
impulses, contracting positive or negative fluid, they form
muscles, keeping the electric charge. electrolytes—positive
body hydrated and or negative ions used
regulating the pH in metabolic
levels. processes.
ELECTROLYTES FOUND IN HUMAN BODY
 SERUM SODIUM
• Osmotically active anion.
• One of the most important electrolytes in the extracellular fluid.
• Responsible for maintaining the extracellular fluid volume and also for
the regulation of the membrane potential of cells.
• Hyponatremia has neurological manifestations.
• Patients may present with headache, confusion, nausea, delirium.
• Symptoms of hypernatremia include tachypnea, sleeping difficulty and
feeling restless.
• Normal range: 135–145 mmol/L
 SERUM POTASSIUM
• Potassium is mainly an intracellular ion.
• The sodium-potassium adenosine triphosphatase pump has the primary responsibility for
regulating the homeostasis between sodium and potassium, which pumps out sodium in
exchange for potassium, which moves into the cells.
• Normal range: 3.6–5.5 mmol/L
• Potassium disorders are related to cardiac arrhythmias.
• Hypokalemia occurs when serum potassium levels are under 3.6 mmol/L—weakness,
fatigue, and muscle twitching present in hypokalemia.
• Hyperkalemia occurs when the serum potassium levels are above 5.5 mmol/L, which can
result in arrhythmias. Muscle cramps, muscle weakness, rhabdomyolysis, myoglobinuria are
presenting signs and symptoms in hyperkalemia.
 SERUM CALCIUM
Calcium has a It is involved in skeletal
It is mostly present
significant mineralization, contraction of
physiological role in
muscles, the transmission of in the extracellular
nerve impulses, blood clotting,
the body. and secretion of hormones. fluid.
A low calcium level may cause tingling (often in the
lips, tongue, fingers, and feet), muscle aches, spasms of
Normal range:
the muscles in the throat (leading to difficulty 8.8–10.7
breathing), stiffening and spasms of muscles (tetany),
seizures and abnormal heart rhythms. mg/dL
Hypercalcemia may cause abnormal heart rhythms, muscle
twitches, cramps, weakness, depression, memory loss,
confusion, coma, bone pain, osteoporosis, fractures, abdominal
pain, nausea and vomiting.
 SIGNS OF
HYPOCALCEMIA
 SERUM MAGNESIUM
• Magnesium is an intracellular cation.
• Magnesium is mainly involved in ATP metabolism,
contraction and relaxation of muscles, proper
neurological functioning, and neurotransmitter release.
• Normal range: 1.46–2.68 mg/dL
• Hypomagnesemia: Nausea, vomiting, weakness,
decreased appetite, numbness, tingling, muscle cramps,
seizures, muscle spasticity and abnormal heart rhythms.
 BICARBONATE
The acid-base status of the blood drives bicarbonate levels.

The kidneys predominantly regulate bicarbonate concentration and are responsible for
maintaining
the acid-base balance.
Kidneys reabsorb the filtered bicarbonate and also generate new bicarbonate by net acid
excretion.

Diarrhea usually results in loss of bicarbonate, thus causing an imbalance in acid-base

regulation.

Normal range: 23–30 mmol/L. It increases or decreases depending on the acid-base status.
 PHOSPHORUS
• Phosphorus is an extracellular fluid cation.
• Eighty-five percent of the total body phosphorus is in
the bones and teeth in the form of hydroxyapatite.
• Phosphate is regulated simultaneously with calcium
by vitamin D3, PTH, and calcitonin.
• The kidneys are the primary avenue of phosphorus
excretion.
• Normal range: 3.4–4.5 mg/dL
 CHLORIDE

Chloride is an anion found

predominantly in the
extracellular fluid. The
kidneys predominantly
regulate serum chloride
levels. Most of the chloride
is filtered by the glomerulus.
HOW TO LABEL A SAMPLE?
 LIVER FUNCTION TESTS (LFT)
• Liver function tests (LFTs) (also known as a liver
panel) are blood tests that measure different enzymes,
proteins, and other substances made by the liver.
• Liver function tests are most often used to diagnose
liver diseases, such as hepatitis and monitor treatment
of liver disease. These tests can show how well the
treatment is working.
 ALANINE TRANSAMINASE TEST

If the liver is damaged

Alanine transaminase or does not function
(ALT) is used to properly, ALT can be
metabolize protein in released into the blood.
the body. This causes ALT levels
to increase.
RANGE OF ALT
 ASPARTATE
AMINOTRANSFERASE TEST
• Aspartate aminotransferase (AST) is an enzyme found in the heart,
liver and muscles.
• AST levels aren’t as specific for liver damage as ALT.
• It’s usually measured together with ALT to check for liver
problems.
• When the liver is damaged, AST can be released into the
bloodstream.
• A high result on an AST test might indicate a problem with the
liver or muscles.
RANGE OF
AST
ALKALINE PHOSPHATASE TEST
• Alkaline phosphatase (ALP) is an enzyme found in the
bones, bile ducts, and liver.
• High levels of ALP may indicate liver inflammation,
blockage of the bile ducts, or bone disease.
 ALBUMIN TEST
It performs
Albumin is
many
the main
important
protein made
The normal bodily
by the liver.
range for functions.
albumin is 3.5–
5.0 grams per
An albumin test deciliter A low result on
measures how (g/dL). this test can
well the liver is indicate that
making this the liver isn’t
particular functioning
protein. properly.
 • Bilirubin is a waste product from the
breakdown of red blood cells.
• It’s ordinarily processed by the liver.
• It passes through the liver before
BILIRUBIN being excreted through the stool.
TEST • A damaged liver can’t properly
process bilirubin.
• This leads to an abnormally high
level of bilirubin in the blood.
RANGE OF BILIRUBIN
 •A lipid profile (or lipid panel)
is a blood test that measures
LIPID/ the concentrations of fats and
LIPOPROTEIN cholesterol in the blood, and
PROFILE can be used to assess ‘good
cholesterol’ versus ‘bad
cholesterol’ levels.
TYPES OF LIPIDS
 • Hemoglobin A1c is a measure of the
degree to which hemoglobin is
glycosylated in erythrocytes and is
SERUM expressed as a percentage of total
GLUCOSE – AC, hemoglobin concentration.
PC, HbA1C • HbA1c levels provide an indication
of the average blood glucose
concentration during the preceding
2–3 months, including both pre-and
postprandial glycemia.
LEVEL OF HbA1C
 Measurement of the blood
glucose level of the patient,
who is at risk of
hyperglycemia or
MONITORING hypoglycemia, using a
CAPILLARY portable glucometer by
putting the drop of blood
BLOOD GLUCOSE on the glucometer strip
(GLUCOMETER using the needle or lancet.
RANDOM BLOOD
SUGAR)
 PURPOSES OF MONITORING
CAPILLARY BLOOD GLUCOSE
• To monitor the blood glucose level of the
patient.
• To educate the patient regarding diet
management and medication.
• To encourage the patient about compliance
with the treatment regimen.
MONITORING CAPILLARY BLOOD
GLUCOSE
ARTICLES
A clean tray containing:
PROCEDURE
• Glucometer Refer book (page no.644)
• Testing strips
• Sterile lancet or 26FG sterile
needle
• Dry cotton swab and alcohol swab
• Clean gloves
• Hand rub
 FASTING BLOOD SUGAR

• This is a test that helps in determining the amount of

glucose (sugar) in a blood sample after an overnight
fast. The fasting blood glucose test is commonly used
to detect diabetes mellitus.
• The normal range for blood glucose is 70–100 mg/dL.
• A blood sample can be taken in a lab, physician’s
office, or the hospital. The test is done in the morning,
before the person has taken breakfast.
 RANDOM BLOOD SUGAR
• A random blood sugar (RBS) test is the testing of the blood sugar level
at any time or random time of the day.
• According to American Diabetes Association:
 The RBS test is done within 1 or 2 hours of eating then the RBS
normal value should be 180 mg/dL.
 The RBS normal range should be anywhere between 80 and 130
mg/dL prior to eating for healthy blood sugar levels in the body.
NORMAL RANGE OF
BLOOD GLUCOSE
 POSTPRANDIAL BLOOD SUGAR

• The word postprandial means after a meal;

therefore, PPG concentrations refer to
postprandial plasma glucose concentrations
after eating. Postprandial plasma glucose
tests show how tolerant the body is to
glucose.
 z LEVELS OF
POSTPARANDIAL BLOOD
SUGAR
 STOOL ROUTINE EXAMINATION
(TYPES AND COLLECTION OF SPECIMEN
OF FAECES: OBSERVATION)
Purpose:
To check the stool
Definition: for the presence
It is a method of of specific
obtaining stool material (blood,
specimen from the ova, parasite or
patient. bacteria like
Salmonella and
Shigella, etc.)
 STOOL ROUTINE EXAMINATION
(TYPES AND COLLECTION OF SPECIMEN OF
FAECES: OBSERVATION)
Articles Procedure
• A clean specimen container Refer book (page no. 645)
(routine examination), Sterile
specimen container (culture)
• A spatula/sterile swab stick for
stool culture
• Dry bedpan
• Clean gloves
• Disposable mask
• Tissue paper
• Laboratory requisition forms
 CULTURING THE STOOL

• The stool can be cultured for disease-causing bacteria.

• A stool sample is placed in an incubator for at least
48–72 hours and any disease-causing bacteria are
identified and isolated.
• Not all bacteria in the stool cause problems; in fact,
about half of stool is bacteria, most of which live there
normally and are necessary for digestion.
 CULTURING THE STOOL
• For a stool culture, the lab will need a fresh or refrigerated sample of stool. The
Sto best samples are of loose, fresh stool; well-formed stool is rarely positive for
ol disease-causing bacteria. Sometimes, more than one stool will be collected for
cult a culture.
ure

Sto • Culture is then tested for the presence of microorganisms (gram-positive/

ol negative or virus or bacteria).
cult
ure
• After identification of the organism, culture is then tested for antibiotics, that
Sto are effective to kill the grown microorganism. Based on the results antibiotics
ol are added to the treatment.
cult
ure
 TESTING THE STOOL FOR OVA AND
PARASITES
• Stool may be tested for the presence of parasites and ova (the egg stage
of a parasite) if a child has prolonged diarrhea or other intestinal
symptoms.
• The doctor will collect two or more samples of stool to successfully
identify parasites.
• If parasites or their eggs are seen when a smear of stool is examined
under the microscope, the child will be treated for a parasitic infestation.
• The hospital will provide a special collection container that contains
chemical preservatives for parasites.
 COLLECTION OF URINE SPECIMEN
AND URINE TESTING
COLLECTING URINE SPECIMEN FOR CULTURE
Description Purposes
• For detecting the presence • To identify the antibiotic
and growth of sensitivity of the pathogen
microorganisms in the in the urine sample.
urine sample, a small • Culture pathogenic
amount (30–60 mL) of microorganisms are
urine is collected. present in the urine.
 COLLECTING URINE SPECIMEN FOR
CULTURE

Articles Procedure
• Sterile container • Refer book (page no. 646)
• Sterile needle if required in
case of catheterized client
• Soap and water
• Bedpan
• Laboratory form
COLLECTION OF URINE SPECIMEN FOR
ROUTINE EXAMINATION (MIDSTREAM
URINE)
Procedure
Refer book
(page no. 646)
 COLLECTION OF 24 HOURS URINE
• It is a collection of the urine specimen for a period of 24 hours
Description without any spillage or wastage.

• To detect kidney, liver and cardiac conditions.

Purposes • To measure the total proteins, creatinine and electrolyte,
hormones.

• Clean container with lid

• Measuring jar
Articles • Urinal and kidney tray to collect urine at each voiding
• A complete laboratory form

Procedure • Refer book (page no.

COMMONLY USED PRESERVATIVES
FOR 24 HOURS URINE SAMPLE
URINE CONSTITUENTS
URINE COLOUR OBSERVATION
OBSERVED URINE TESTING
Urine test provides useful information in the
diagnosis and treatment of a variety of
disease conditions. Analysis of urine helps in
examining the appearance, odor, pH, specific
gravity and presence of albumin, sugar and
acetone.
 URINALYSIS

Urinalysis is a
diagnostic, physical
and chemical,
microscopic detection
of any abnormality of
urine.
PURPOSES OF URINALYSIS
Monitoring the urine
abnormality

General evaluation of health

Monitoring the conditions like

diabetes mellitus, kidney
disease
 ARTICLES FOR URINALYSIS
A clean tray containing the following articles:
Test tube holder Test tubes (4-6) on test tube stand
Spirit lamp with match box Kidney tray, paper bag
Rag pieces Dropper (2)- one for urine and
one for reagents
Litmus paper to check the Calibrated urinometer to check
reaction of urine the specific gravity
Wide mouth specimen jar Jar for urine
Bowl Clean gloves (1 pair)
 REAGENTS
For albumin hot test—Acetic acid solution 2%

For sugar testing—Benedict’s solution

For albumin cold test—Nitric acid solution

For acetone test—Sodium nitroprusside crystal

For acetone test—Ammonium sulfate crystals

 TEST FOR pH
Use litmus paper for testing pH. Dip the litmus
paper in urine and note for the change of color.
• If the red litmus turns blue, urine is alkaline.
• If the blue litmus turns red, urine is acidic.
• If there is no change in color, urine is neutral.
 CHECKING FOR URINE SPECIFIC GRAVITY
It is the measure of the solute concentration in urine
by using a calibrated urinometer and it helps in
assessing the ability of the renal tubules to concentrate
or dilute the glomerular filtrate. The specific gravity
ranges from 1.010 to 1.040.
 PURPOSES FOR CHECKING URINE
SPECIFIC GRAVITY

To determine the To measure the

concentration specific gravity
level of the urine. of the urine.
PROCEDURE
FOR
CHECKING
URINE Refer book (page no. 648)
SPECIFIC
GRAVITY
 TEST FOR ALBUMIN IN
URINE: HOT TEST
• This test (hot test) is used to find out
Description
the presence of albumin in the urine.

Procedure • Refer book (page no. 648)

RESULT FOR ALBUMIN TEST
TEST FOR ALBUMIN IN URINE: COLD
METHOD
This test (cold method) is done to find out the
presence of albumin in the urine.
PROCEDURE
Refer book (page no. 649)
TEST FOR ACETONE IN URINE

Description Procedure

Testing of the urine Refer book

specimen for (page no. 649)
identifying the
presence of acetone.
 BILE TESTS
Bile salt test Bile pigment test
Procedure Procedure
Refer book (page Refer book (page
no. 649) no. 649)
SUGAR OR GLUCOSE TEST

•PROCEDURE
Refer book (page no. 649)
RESULT FOR GLUCOSE TEST
RESULT FOR GLUCOSE TEST
REAGENT STRIP URINE TESTING

Description Procedure
Reagent strips are How to use:
available for urine Refer book (page
testing which no. 650)
yields the results
quickly. These are
available for
ketone and glucose
assessment in
urine (also called
ketostix or
diastix).
SPUTUM
A sputum culture is a
CULTURE test that checks for
bacteria or another type
of organism that may be
causing an infection in
the lungs or the airways
leading to the lungs.
DIFFERENT COLORS OF
SPUTUM
DIFFERENT COLORS OF SPUTUM
COLLECTION OF SPUTUM FOR
CULTURE

Collection of coughed out sputum

for culture to identify respiratory
pathogens (acid-fast bacillus,
streptococci, pneumococci,
diphtheria bacilli).
 PURPOSES OF COLLECTION OF
SPUTUM FOR CULTURE
Purposes Identify respiratory pathogens.

Look for the color of sputum like hemoptysis,

greenish color in bronchitis, rusty color in
pneumonia.
 COLLECTION OF SPUTUM FOR CULTURE

ARTICLES PROCEDURE
• Sterile specimen container Refer book (page no. 650)
• Tissue paper
• Sputum mug with
disinfectant
• Sterile gloves
• Disposable mask
• Requisition form
 THROAT CULTURE SWAB

• Sterile gloves • Refer book

ARTICLES

PROCEDURE
• Sterile test tube (page no. 651)
• Sterile cotton
applicator or
swab stick
 VAGINAL SWAB OR
SMEAR
ARTICLES PROCEDURE
• Two clean slides Refer book (page no.
• Cotton applicator 651)
RADIOLOGICAL PROCEDURES

Radiology is a
branch of medicine Radiology

that uses imaging

technology to
diagnose and treat Diagnostic Interventional
disease.
 DIAGNOSTIC RADIOLOGY

This branch helps in visualizing the structures

inside the body and helps the physician in
identifying certain medical conditions. Using these
diagnostic procedures doctors can monitor the
progression of the disease and the way how the
body responds to the treatment received.
DIAGNOSTIC RADIOLOGY
DIAGNOSTIC RADIOLOGY
DIAGNOSTIC RADIOLOGY
DIAGNOSTIC RADIOLOGY
 INTERVENTIONAL RADIOLOGY

A branch that deals with the assistance of

imaging tests such as CT scan, MRI to help in
performing the interventions related to the
treatment of medical conditions using or by
inserting small instruments or catheters, wires
into specific body parts.
EXAMPLES OF INTERVENTIONAL
RADIOLOGY
 ENDOSCOPIC PROCEDURE

An endoscopy procedure involves inserting a

long, flexible tube (endoscope) down the
throat and into the esophagus to visualize the
gastrointestinal system.
 ENDOSCOPY
•A procedure that is done using an endoscope to diagnose or
treat a condition.
•There are several types of endoscopy like those using natural
body openings including esophagogastroduodenoscopy (EGD)
which is often called upper endoscopy, gastroscopy and
enteroscopy.
 SIGMOIDOSCOPY

An examination of the inside of the rectum and

sigmoid colon using an endoscope—a thin, lighted
flexible tube (sigmoidoscope) inserted through the
anus.
 ENTEROSCOPY
A procedure that allows the
visualization of a greater portion of the
small bowel which is possible with
esophagogastroduodenoscopy (EGD).
PERCUTANEOUS ENDOSCOPIC
GASTROSTOMY

Percutaneous endoscopic
gastrostomy (PEG) is a
procedure through which a
flexible feeding tube is placed
with the assistance of an
endoscope through a small
incision in the abdominal wall
into the stomach.
 UPPER ENDOSCOPY
■ Upper endoscopy allows for examination of the lining of the
upper part of the gastrointestinal (GI) tract, which includes the
esophagus, stomach and duodenum (first portion of the small
intestine).
 • The term diagnostic consists of all the activities in measuring and
interpreting the growth lags and their influences on the body.
• Various diagnostic tests-complete blood count, serum electrolytes
test, liver function tests, blood sugar measurement, stool
examination, urine test, etc.
CHAPTER • Phases of diagnostic testing- pre-test phase, analytic phase and final
phase.
FOCUS • There can be errors related to specimen handling, appropriateness
of proper specimen collection, and adequacy of the specimen and
POINTS its transport to the laboratory.
• Sputum culture, throat culture swab and vaginal smear are also a
part of diagnostic tests
• Radiological procedures are of two types – diagnostic radiology
that includes CT scan, MRI, X-Ray, etc. and interventional
radiology that includes angiography, cryoablation, needle biopsies,
etc.
• An endoscopic procedure involves inserting a long, flexible tube
(endoscope) down the throat and into the esophagus to visualize the
gastrointestinal system.
“Textbook of Foundation of
Nursing" by Jyoti Kathwal