Skills & Concepts Chapter 27 DIAGNOSTIC TESTS
Dec 15, 2015
Types of Diagnostic Tests
Noninvasive: The body is not entered with any type of instrument.
Invasive: The body’s 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
Evaluating the client’s anxiety level. Teaching relaxation techniques, such as
deep breathing and imagery. Evaluating the client’s level of safety and
comfort.
Nursing interventions used during diagnostictesting include:
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 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.
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 client’s prediagnostic level of functioning.
Client is monitored for signs of respiratory distress and bleeding.
With some diagnostic tests, the client’s 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 practitioner’s order must be transcribed onto the
correct requisition form. All information must be written on form. Pertinent data that could influence the test’s 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 RegardingDiagnostic 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 client’s 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 client’s blood type and determines the compatibility to blood between a potential donor and recipient (client).
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 body’s structure and function.
Reveals the motion of organs.
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 high-frequency 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 cross-sectional images of the body.
Stress Test
A measure of the client’s 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.
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.