Diagnostic Testing Flashcards
Tools that provide information about clients.
Diagnostic and laboratory tests
May be used for basic screening as part of a wellness check.
Diagnostic and laboratory tests
One primary role of the nurse is to
teach the client and family or significant other how to prepare for the test and the care that may be required following the test.
Nurses must also know the implications of the test results in order to
provide the most appropriate nursing care for the client.
_ occurs in many environments.
Diagnostic testing
The traditional sites of diagnostic testing include
hospitals, clinics, and the primary care provider’s office.
Many test sites, however, are moving to the _. Examples, include the
community
home, workplace, shopping malls, and mobile units.
The more complex diagnostic tests are performed at _ specifically built to provide those tests.
diagnostic centers
Diagnostic testing involves three phases:
pretest, intratest, and post-test
The major focus of the _ is client preparation.
pretest phase
A thorough assessment and data collection (e.g., biologic, psychological, sociologic, cultural, and spiritual) assist the nurse in determining communication and teaching strategies.
Pretest
The nurse also needs to know what equipment and supplies are needed for the specific test.
Pretest
Pretest
Common questions include the following:
What type of sample will be needed and how will it be collected? Does the client need to stop oral intake for a certain number of hours prior to the test? Does the test include administration of dye (contrast media) and, if so, is it injected or swallowed? Are fluids restricted or forced? Are medications given or withheld? How long is the test? Is a consent form required?
This phase focuses on specimen collection and performing or assisting with certain diagnostic testing.
Intratest
The nurse uses standard precautions and sterile technique as appropriate.
Intratest
During the procedure the nurse provides emotional and physical support while monitoring the client as needed (e.g., vital signs, pulse oximetry, ECG).
Intratest
The nurse ensures correct labeling, storage, and transportation of the specimen to avoid invalid test results.
Intratest
The focus of this phase is on nursing care of the client and follow-up activities and observations.
Post-test
The nurse compares the previous and current test results and modifies nursing interventions as needed. The nurse also reports the results to appropriate health team.
Post-test
Preparing for Diagnostic Testing
(7)
• Instruct the client and family about the procedure for the diagnostic test ordered (e.g., whether food is allowed prior to or after testing, and the length of time of the test).
• Explain the purpose of the test.
• Instruct the client and family about activity restrictions related to testing (e.g., remain supine for 1 hour after testing is completed).
• Instruct the client and family on the reaction the diagnostic test may produce (e.g., flushing if a dye is injected).
• Provide the client with detailed information about the diagnostic testing equipment.
• Inform the client and family of the time frame for when the results will be available.
• Instruct the client and family to ask any questions so that the health care provider can clarify information and allay any fears.
Nursing Diagnoses
(3)
• Anxiety or Fear related to possible diagnosis of acute or chronic illness pending conclusion of diagnostic testing
• Impaired Physical Mobility related to prescribed bed rest and restricted movement of involved extremity after testing
• Deficient Knowledge (state diagnostic test) related to misperceptions received from others regarding process for test.
_ are commonly used diagnostic tests that can provide valuable information about the hematologic system and many other body systems.
Blood tests
A _ (puncture of a vein for collection of a blood specimen) can be performed by various members of the health care team.
venipuncture
A _, a person from a laboratory who performs venipuncture, usually collects the blood specimen for the tests ordered by the primary care provider.
phlebotomist
In some institutions, nurses may draw blood samples.
Nurse-Phlebotomist
BLOOD TESTS
The nurse needs to know the _.
guidelines for drawing blood samples for the facility and also the state’s nurse practice act.
A _ is a blood test used to evaluate your overall health and detect a wide range of disorders, including anemia, infection and leukemia.
Complete Blood Count (CBC)
_ is the main intracellular protein of erythrocytes.
Hemoglobin (Hgb)
The _ is a measure of the total amount of hemoglobin in the blood.
hemoglobin test
The _ measures the percentage of RBCs in the total blood volume.
hematocrit (Hct)
Normal values for both hemoglobin and hematocrit vary, with _ having higher levels than _.
males
females
_ and _ are often ordered together and commonly referred to as “H&H” when ordering laboratory tests.
Hemoglobin and hematocrit
_ are responsible for transporting oxygen from your lungs to your body’s tissues.
Red blood cells (RBC)
_, which is the number of RBCs per cubic millimeter of whole blood.
red blood cell (RBC) count
Low RBC counts are indicative of _.
anemia
Clients with chronic hypoxia may develop higher than normal counts, a condition known as _.
polycythemia
_ may be performed as part of the CBC to evaluate the size, weight, and hemoglobin concentration of RBCs.
Red blood cell (RBC) indices
A cellular component of the blood that lacks hemoglobin, has a nucleus, is capable of motility, and defends the body against infection and disease by ingesting foreign materials and cellular debris, by destroying infectious agents and cancer cells, or by producing antibodies.
White blood cell (WBC) “leukocyte or white corpuscle”
_ are often routinely ordered for any client admitted to a hospital as a screening test for electrolyte and acid–base imbalances.
Serum electrolytes
_ is a blood test that measures levels of the body’s main electrolytes.
Serum Electrolytes
The most commonly ordered serum tests are for _, _, _, and _.
sodium, potassium, chloride, and bicarbonate ions
Components of Serum Electrolytes
Sodium
Chloride
Potassium
Bicarbonate
Components of Serum Electrolytes
_, which helps control the amount of fluid in the body. It also helps your nerves and muscles work properly.
Sodium
Components of Serum Electrolytes
_, which also helps control the amount of fluid in the body. In addition, it helps maintain healthy blood volume and blood pressure.
Chloride
Components of Serum Electrolytes
_, which helps your heart and muscles work properly.
Potassium
Components of Serum Electrolytes
_ which helps maintain the body’s acid and base balance. It also plays an important role in moving carbon dioxide through the bloodstream.
Bicarbonate
The _ is a measure of the different solutes in plasma.
serum or plasma osmolality
It is primarily determined by sodium and its corresponding anions (chloride and bicarbonate), glucose, and urea.
Serum Osmolality
Serum osmolality values are used primarily to _.
evaluate fluid balance
Serum Osmolality
Normal values are _ to _.
280 to 300 mOsm/kg
_ is often conducted when a client is taking a medication with a narrow therapeutic range (e.g., digoxin, theophylline, aminoglycosides).
Therapeutic drug monitoring
This monitoring includes drawing blood samples for peak and trough levels to determine if the blood serum levels of a specific drug are at a therapeutic level and not a subtherapeutic or toxic level.
Drug Monitoring
Drug Monitoring
The _ indicates the highest concentration of the drug in the blood serum, and the _ represents the lowest concentration.
peak level
trough level
_ is a blood test that requires a sample from an artery in your body to measure the levels of oxygen and carbon dioxide in your blood.
Arterial Blood Gas (ABG) Test
Arterial Blood Gas:
O2CT
pH
PaCO2
PaO2
HCO3
O2Sat
Normal Range: ?
O2CT - 15-23% per 100 mL of blood
pH - 7.35-7.45
PaCO2 - 35-45 mmHg
PaO2 - 80-100 mmHg
HCO3 - 22-26 mEq/L
O2Sat - 95-100%
Blood Chemistry
Enzymes/acids:
Uric acid
SGOT/SGPT
Rheumatoid factor
Anti-DNA antibody
CK-MB, LDH and Troponin
Purpose: ?
Uric acid - Gout detection
SGOT/SGPT - Liver function test
Rheumatoid factor - For Rheumatoid arthritis
Anti-DNA antibody - SLE diagnosis
CK-MB, LDH and Troponin - Identifies cardiac damage or muscle damage