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Test 3 > Chp 34 Diagnostic Testing Study Guide > Flashcards

Chp 34 Diagnostic Testing Study Guide Flashcards

1
Q

Insertion of a need directly into the vein

A

venipuncture

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2
Q

involved removing fluid from the peritoneal cavity

A

paracentesis

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3
Q

sof tissue radiographs that allow visualization of the underlying breast tissue

A

mammogram

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4
Q

radiologic procedure in which the use of a special scanner allows cross-sectional images of an organ to be visualized

A

computed tomography (CT)

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5
Q

involves removing a larger collection of cells, as in a tumor or mass, and may be used to detect cancer in the skin, breast or liver

A

biopsy

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6
Q

involves the use of a superconducting magnet and radio frequency waves that cause hydrogen nuclei to emit signals

A

magnetic resonance imaging (MRI)

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7
Q

a procedure that provides visualization of soft tissue organs by recording and meaning the reflection of sonic waves

A

ultrasound

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8
Q

removes fluid from the pleural space

A

thoracentesis

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9
Q

contains chemically altered filter paper that change color when stool containing blood is placed on it

A

hemoccult

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10
Q

recording of the electrical current generated by the heart during depolarization and repolarization of the cardiac muscle

A

electrocardiogram

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11
Q

What are the components of a CBC

A

Include the RBC count, hemoglobin level, hematocrit (HCT), red cell indices, while blood cell count (WBC), and differential WBC

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12
Q

The nurse anticipate that testing will be done for the patient who is taking an anticoagulant. Identify at last two specific test that may be ordered to asses this patient’s status

A

Tests of patient on anticoagulants are platelets, bleeding time, prothrombin time/international normalized ratio (PT/INR), activated partial thromboplastin time, and fibrinogen

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13
Q

Glucose testing is done to determine the presence of which pathologic condition

A

Diabetes mellitus

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14
Q

The patient asks about “good cholesterol” Which one of these should the nurse identify to the patient. LDL HDL

A

High density lipoprotein is the good cholesterol

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15
Q

What are expected findings for a urinalysis are

A

Clear to slightly hazy and negative protein

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16
Q

C reactive protein (CRP is used as a marker for which disorders

A

Has been used in the past as a marker for inflammatory and autoimmune disorders, such as rheumatoid arthritis, lupus, and inflammatory bowel syndrome. High sensitivity CRP is considered a marker for vascular inflammation. CRP is now used as a screening for coronary artery disease and as a predictor of future cardiac events

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17
Q

The following cardia markers may be ordered for the attitude to determine possible tissue damage

A

myoglobin, troponin T, total creatine kinase

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18
Q

the patient has stools that tare black and tarry in appearance. The nurse recognizes this finding as associated with

A

bleeding in the upper GI tract

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19
Q

Which test is performed for the patient with a suspected tapeworm and how must the sample be sent to the laboratory

A

A test for fecal ova and parasites is done, with the sample sen to the laboratory still warm

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20
Q

The patient is to have a culture and sensitivity done. How do you explain this test to the patient

A

For suspected infection, a specimen (urine, blood, sputum etc.) is sent to the lab, where a section is placed on a culture medium. If bacteria are found to grow, it is a positive result. After identification of the bacteria, it is exposed to different antibiotics to see which one would be most effective tin treating the infection

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21
Q

what disorders can be diagnosed with a chest radiograph

A

pulmonary disorders, such as TB, cancer, and pneumonia

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22
Q

The patient had a diagnostic test with contrast media. Following the test, the nurse notices that the patient has developed a rash and does not feel well. What does the nurse suspect that the patient may be experiencing

A

allergic reaction ,which may progress to anaphylaxis

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23
Q

What tests requires the patient to fast

A

cholesterol, low density lipoprotein

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24
Q

The patient is to have an MRI, What instruction would the nurse provide to the patient for this test

A

Contraindicated in patient with pacemakers, inner ear implants, fragments from gunshot wounds, or any other metal object in the body. All jewelry is removed before the test. Some patients experience claustrophobia because the test is sometimes performed in a tunnel like machine for 30-90 minutes. Rarely people with a tattoo have reported burning and swelling in the ear of the tattoo after MRI

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25
Q

What should screening for colorectal cancer for individuals older than age 50 include

A

Fecal occult blood test annually, Flexible sigmoidoscopy every five years or colonoscopy every 10 years (or double contrast barium enema or computed tomography (CT) colonography every five years)

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26
Q

What is ultrasound commonly used to determine

A

pregnant women, abnormal organ growth, lesions or tumors, and structural damage can also be seen with ultrasound

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27
Q

What is a critical question to ask young and middle adult female patients who are having diagnostic test

A

Chance of pregnancy? Last menstrual period?

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28
Q

What is the most critical area to monitor during bronchoscopy

A

Respiratory status

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29
Q

Thoracentesis nursing care

A

Position the patient to the unaffected side for at last an hour
Monitor vital signs until stable
Check the dressing frequently
Assess the puncture site for bleeding or crepitus
Assess respiratory status, including breath sounds and symmetry during respiration, and monitor for signs of distress

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30
Q

Lumbar puncture nursing care

A 
Instruct the patient to lie flat for 4-8 hours
Encourage fluids
Perform neurologic assessment as ordered
Assess the puncture site for drainage
Administer analgesics PRN
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31
Q

The nurse is going to perform a venipuncture and asks the UAP to get a collection tubes for the blood chemistry and blood culture. The UAP is told to get the tubes with what color stoppers

A

Blood culture - yellow

Blood chemistry - red, red/black, green (stat chemistry)

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32
Q

National Patient Safety Goals

A

Identifying patients correctly continues to be a top National Patient Safety Goal
Two patient identifiers are used when collecting blood samples and other specimens for clinical testing
The patient’s room number or physical location is NOT used as an identifier
Containers used for blood and other specimens are labeled in the presence of the patient

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33
Q

Standard precautions for venipuncture

A

hand washing is done before and after, gloves are worn throughout the procedure, and sharps are disposed of immediately after specimen collection

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34
Q

Standard precautions for urine collection

A

hand washing is done before and after, gloves are worn during the procedure, and the specimen is store din a plastic bah or biohazard container for transport to the lab

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35
Q

While the patient is going through a procedure what can the nurse do to provide support and comfort

A

maintain a necessary position, pad bony prominences, explain what is happening, and offer emotion support, like holding the patients hand

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36
Q

How does the nurse carefully manage collection and transfer of specimen

A

placed in appropriate container, correctly identified, handled with aseptic technique, and sent to the lab in a timely manner

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37
Q

For timed urine collection, what should be done with the initial voiding? What should be done if a voiding is not collected during the time period?

A

The first riding is discarded for the timed urine collection

If a coding is discarded, the timed collection needs to be restarted

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38
Q

Sputum collection is usually ordered when what disease processes are suspected

A

Respiratory disease, such as pneumonia or T, It can also be done to evaluate the effectiveness of antibiotic/antiviral therapy or identify the presence of abnormal cells (tumors)

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39
Q

The correct procedures for sputum collection are

A

Samples should be collected first thing in the morning, clean containers are used, specimen of 2-10mL is needed, the patient expectorates directly into the container

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40
Q

The patient starts to gag during the throat culture. The nurse should?

A

instruct them to sit upright and say AHHH place the swab off center and swab quickly

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41
Q

After most procedures, the nurse should minor the patients

A

vital signs, airway, oxygenation status, and site of the procedure, if bleeding may occur

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42
Q

Results female patient RBC 3.7 cells/mm3

A

RBC decreased - anemia, bone marrow suppression, chronic infection, hemorrhage, renal disease, vitamin B or folic acid deficiency. Normal value 4.2-5.4

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43
Q

Results for 8 year old child, WBC 8000cells/mm3

A

WBC increased - acute leukemia, infections, surgery, trauma. Normal value 5000-10000

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44
Q

Lab results Platelets 75,000 cells/mm3

A

Platelets decreased - anemias, transfusions of packed cells, HIV infection, chemo/radiation therapy. Normal value 150,000-400,000

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45
Q

Lab value BUN 30 mg/dL

A

BUN increased - acute glomerulonephritis, congestive heart failure, drabbest mellitus, high protein diet, nephrotic syndrome, renal disease, severe dehydration, secure infections shock. Normal value 10-20

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46
Q

CT of scan can be used to diagnose

A

abscesses, cerebral infarctions (strokes), aneurysms, hemorrhage hydrocephalus, and tumors

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47
Q

To verify the presence of Crohn disease, the nurse anticipates that there will be an order for which test

A

sigmoidoscopy or colonoscopy

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48
Q

Diabetes mellitus under control

A

hgb A 1c 7% to 11%

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49
Q

The nurse is teaching the UAP how to collect a specimen for blood glucose monitoring. The patient demonstrates correct technique when

A

calibrating the meter to the strip

50
Q

When obtain a urine specimen for a urinalysis from a patient with an indwelling catheter the nurse should

A

clamp the drainage tubing for 30-60 minutes before specimen collection begins

51
Q

The patient is going to have a cystoscopy tomorrow. The nurse is aware that a possible complication of this procedure is

A

hematuria

52
Q

Neutrophils percentage and function

A

55-70%. First defenders against bacterial and fungal infections, foreign antigens, and cell debris

53
Q

Lymphocytes (T and B cells) % and function

A

20-35%. Recognize foreign antigens; create memory cells; produce antibodies

54
Q

Monocytes percent and function

A

3-8%. Involved in phagocytosis; become macrophages

55
Q

Eosinophils percentage and function

A

1-3%. Destroy parasites; involved in allergic reactions

56
Q

Basophils percentage and function

A

less than 1%. Involved in the inflammatory response to injury; release histamine

57
Q

electrolytes

A

Sodium (Na+), potassium (K+), calcium (Ca++), magnesium (Mg++), chloride (CI-), bicarbonate (HCO3-) and phosphate (HPO4-)

58
Q

fluid portion of blood

A

plasma

59
Q

the major plasma protein, maintains fluid balance by providing colloidal osmotic pressure in the blood

A

albumin

60
Q

fibrinogen facilitates coagulation by converting into fibrin threads in the presence of ionized ? Essential component of blood clots

A

(Ca++) calcium

61
Q

classified as alpha, beta, and gamma

A

globulins

62
Q

Normal structures of blood plasma

A

Electrolytes, proteins (albumin, fibrinogen, globlins), nutrients (glucose, amino acids, fatty acids, vitamins), hormones, and waste products

63
Q

used for arterial blood gases

A

arterial sample

64
Q

information on oxygen and carbon dioxide transport and immune/inflammatory response

A

CBC

65
Q

CBC components

A

RBC count, RBC indices (mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and MCH concentration (MCHC)), hemoglobin level and hematocrit, WBC count, and differential WBC count

66
Q

Blood vessel injury activates

A

Vascular spasm
Plug formation
Blood clotting

67
Q

Five clotting tests

A 
Platelets
Bleeding time
Prothrombin time (PT/INR)
APTT
Fibrinogen
68
Q

RBC value adult male and female

A

4.7-6.1 and 4.2-5.4

69
Q

RBC count newborn and child 8-12

A

N - 4.8-7.1. C - 4.0-5.5

70
Q

Hemoglobin value

A

Male - 14-8. Female - 12-16

71
Q

Hematocrit %

A

Male - 42-52. Female 37-48

72
Q

WBC (cells/MM2)

A

Adult - 5000-10,000. Child less than 2 - same as above. Newborn - 9000-30000

73
Q

Hemoglobin A1c (Hgb A1c) is

A

glycosylated hemoglobin

74
Q

Patients without diabetes have what percent of hemoglobin(HGB, A1c)

A

3-5%

75
Q

Diabetics under control have what percentage of hemoglobin

A

7-11%

76
Q

Diabetics with poor control have what percentage of hemoglobin

A

greater than 11%

77
Q

a steroid found in cell membranes; a precursor for other steroids in the body

A

cholesterol

78
Q

transporters of cholesterol from the liver to the body. “bad cholesterol” because of its role in atherosclerotic disease

A

Low density lipoproteins

79
Q

transports excess cholesterol from the tissues back to the liver, where it is broken down and excreted in bile “good cholesterol”

A

high density lipoprotein

80
Q

composed of fatty acids, proteins, and glucose

A

triglycerides

81
Q

LDL formula

A

LDL= total cholesterol-HDL-(0.20x total triglycerides)

82
Q

levels controlled by glucagon and insulin

A

glucose

83
Q

Liver function tests

A

Albumin - plasma protein synthesized by liver
Prealbumin - plasma protein synthesized by liver
Bilirubin - component of bile, byproduct of hemolysis
Alanine aminotransferase (ALT) 0 enzyme found primarily in the liver and also in kidneys, heart and skeletal muscle
Alkaline phosphatase (ALP) - enzyme found primarily in the liver
Aspartate aminotransferase (AST) 0 enzyme found primary in the heart, liver and muscle
Gamma-glutamyltransferase (GGT) - enzyme found primarily in the liver and biliary tract

84
Q

Urea is a byproduct of protein metabolism, it is excreted by the kidneys and is measured as?

A

BUN

85
Q

normal ration of BUN to creatinine should be?

A

6:1 to 20:1

86
Q

why is serum creatinine used to test renal impairment

A

it is a waste product of skeletal muscle metabolism and is excreted via the kidneys. Because creatinine is exerted at a more consistent rate than BUN, serum level values tend to be more sensitive in detecting renal impairment

87
Q

troponin I and troponin T are found exclusively in

A

cardiac muscle

88
Q

used to detect mycardial damage resulting from coronary artery occlusion

A

cardiac markers (creatine kinase, hemocysteine, brain natriuretic peptide, C-reactive protein, arterial blood gas and myglobin)

89
Q

an enzyme found primarily in skeletal muscles, cardiac muscle, and brain tissue

A

creatine kinase

90
Q

an oxygen transporting and storage protein found in cardia and skeletal muscle

A

myoglobin

91
Q

hight levels are associated with an increased risk of cardiovascular disease (one of the cardiac markers)

A

hemocysteine

92
Q

Elevated levels are often found in patients with heart failure and can be used to assess severity

A

Brain natriuretic peptide (BNP)

93
Q

Appears in blood in response to inflammation, tissue damage, and infection; used as a screening for coronary artery disease and as a predictor of future cardiac events

A

C-reactive protein (CRP)

94
Q

used to assess oxygenation status and acid base balance

A

ABG Arterial blood gas

95
Q

detects very small amounts of blood in stool

A

occult blood

96
Q

steatorrhea

A

fecal fat

97
Q

urobilinogen levels

A

breakdown of bilirubin

98
Q

common sites of cultures

A

blood, throat, sputum, stool ,urine, and wounds

99
Q

noncontrast studies

A

chest x ray, bones, mammogram

100
Q

use of x-rays to visualize bones, organs, and soft tissues of abnormalities. X rays are electromagnetic vibrations that travel in a straight line

A

radiography

101
Q

Upper GI series includes

A

esophagus, stomach, duodenum, and upper portion of jejunum

102
Q

Lower GI series includes

A

ascending, transverse, descending, and sigmoid colon and rectum

103
Q

radiologic procedure in which the use of a special scanner allows cross sectional images of an organ to be visualized

A

CT

104
Q

a recording of the electrical current generated by the heart during depolarization and depolarization of the cardiac muscle

A

Electrocardiogram ECG

105
Q

general term used to describe the examination of the interior of an organ or cavity by means fiberoptic scope

A

endoscopy

106
Q

colorectal cancer guidelines for people of average risk who are asymptomatic

A

fecal occult test starting at age 50 (if positive, colonoscopy is performed), flexible sigmoidoscopy every five year starting at age 50 (if positive, same as above), OR colonoscopy every 10 years starting at ave 50
OR double contrast barium enema every 5 years
OR CT colonography every 5 years

Patients considered at greater risk have tests more often

107
Q

Nurses responsibilities

A 
Monitor patient and assist HCP
Monitor VS and oxygenation
Provide supportive interventions
Assist in positioning
Provide emotional support
Answer any questions
Maintain precautions
Assist maintaining sterile field
Ensure specimens are labeled correctly
108
Q

collecting blood through venipuncture accesses it through

A

a vein

109
Q

collecting blood through arterial puncture accesses

A

an artery

110
Q

a fingerstick collects

A

capillary samples

111
Q

Venipuncture Considerations

A

Invasive and can potentially expose the nurse to blood borne organisms and contaminated needles
WEAR GLOVES throughout procedure and property dispose of the collection immediately after specimen is obtained
When venipuncture is required, the timing of the test may be important

112
Q

an increased concentration of RBCs compared with plasma volume

A

hemoconcentration

113
Q

the breakdown of RBSc and the subsequent release of hemoglobin

A

hemolysis

114
Q

Venipuncture Safe Practice Alert

A

Assess the site in patients who are on anticoagulant therapy (Coumadin, heparin, Lovenox) or take aspirin on a daily basis.

115
Q

Collaboration and Delegation

A

Blood glucose testing MAY be delegated to UAP with nurse assistance.
UAP should report: completion, timely notification of results, difficulties
UAP should be instructed: timing of procedure (freq. before meals and bedtime), Avoidance of cuts or bruises, preferred site (fingers and forearms depending on testing meter)

116
Q

When a urine sample is needed for culture and sensitivity what is needed?

A

clean catch or midstream collection

117
Q

When patients are being tested for occult blood with a guaiac based fecal occult blood test, it is important that patients

A

adhere to 72 hour diet free of meat, poultry, fish, and leafy green veggies before testing.

Medications such last aspirin and anti-inflammatory agents, iron, and oxidizing drugs and potassium preparation may cause fast positive results and ascorbic acid ay result in false NEGATIVE results

118
Q

sputum mucus is found

A

lungs, bronchial tubes, and trachea when inflammation or infection is present

119
Q

a sputum sample is often ordered when?

A

infectious disease such as pneumonia or TB is suspected.

Sputum can be used to evaluate medication therapy

It can identify abnormal cells that may indicate presence of tumor or malignancy

120
Q

Can sputum specimen be delegated?

A

Only if suctioning techniques are NOT used

121
Q

Can delegation of throat culture be delegated to UAP

A

Nope

Test 3 (15 decks)

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