Diagnostic Tests Flashcards

1
Q

Why undergo Diagnostic Testing

A
  • Tools that provide information
  • Tests may be used for basic screening as part of a wellness check
  • Tests are used to help confirm a diagnosis, monitor an illness and provide valuable information about the clients response or treatment
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2
Q

What are the 3 diagnostic testing phases

A

Pretest
Intratest
Posttest

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3
Q

The major focus of this phase is client preparation

A

Pre-test

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4
Q

Common questions that are included in Pre-test

A
  • What 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?
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5
Q

This phase focuses on specimen collection and performing or assisting with certain diagnostic testing

A

Intra-test

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6
Q

Why does the nurse need to ensure correct labeling, storage and transportation of the specimen?

A

To avoid invalid test results

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7
Q

This phase focuses on the nursing care of the client and follow-up activities and observations

A

Post-test

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8
Q

What does the nurse compare during Post-test

A

Current and previous tests results and modifies nursing interventions as needed`

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9
Q

Nursing Diagnoses in Diagnostic tests

A

Anxiety
Lack of Knowledge
Fear

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10
Q

related to possible diagnosis of accurate or chronic illness

A

Anxiety

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11
Q

related to insufficient information regarding the process for test

A

Lack Of Knowledge

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12
Q

Related to the pending conclusion of the diagnostic test

A

Fear

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13
Q

Commonly used in diagnostic test that can provide valuable information about hematologic system and many other body systems.

A

Blood Tests

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14
Q

Performed through a venipuncture by a Phlebotomist

A

Bloodtest

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15
Q

Puncture of a vein for collection of a blood specimen

A

Venipuncture

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16
Q

an individual who performs venipuncture

A

Phlebotomist

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17
Q

includes hemoglobin and hematocrit measurements, erythrocyte (RBC) count, red blood cell indices, leukocyte (WBC) count, and differential white blood cell count

A

Complete blood count (CBC)

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18
Q

Most basic screening test

A

Complete blood test (CBC)

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19
Q

The main intracellular protein of erythrocytes

A

Hemoglobin (HGB)

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20
Q

it is the iron-containing protein in the RBC that transports oxygen through the body

A

Hemoglobin (HGB)

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21
Q

What is the pigment of Hemoglobin? and what does it contain?

A

Pigment : Heme
and it contains iron and protein (globin)

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22
Q

Hemoglobin count of Men and Women

A

Men - 13.5 - 18 g/dl
Women - 12 - 15 g/dl
(grams per deciliter)

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23
Q

Causes of increased HGB

A

Polycythemia, Dehydration, COPD (chronic pulmonary disease), Heart failure

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24
Q

Causes of decreased HGB

A

Blood loss, anemia, kidney disease, cancers

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25
Q

Measures the percentage of RBCs in the total blood volume

A

Hematocrit (HCT)

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26
Q

is a fastest way to determine the percentage of RBCs in the plasma

A

Hematocrit or Packed cell volume

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27
Q

Why is HCT reported as a percentage?

A

because of concentration of RBCs in the blood

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28
Q

Total % of plasma of blood

A

55% of total blood

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29
Q

Total % of Erythrocytes of total blood

A

45% of total blood

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30
Q

Percentage of buffy coat of total blood (leukocytes and platelets)

A

<1% of total blood

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31
Q

Normal HCT count in men and women

A

Men - 40-54%
Women - 36-46%

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32
Q

causes of increased HCT

A

Dehydration
Hypervolemia
Diabetic Acidosis
Burns

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33
Q

causes of decreased HCT

A

Acute blood loss
Pregnancy
Dietary Deficiencies
Anemias

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34
Q

The number of RBCs per cubic millimeter of whole blood`

A

Red blood cell (RBC) Count

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35
Q

Low RBC counts are indicative of what condition

A

Anemia

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36
Q

Clients with chronic hypoxia may develop higher than normal count, a condition known as?

A

Polycythemia

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37
Q

RBC indices may be performed as a part of the CBC to evaluate the

A

Size, weight, and HBC Concentration of RBCs

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38
Q

What is the mean of average size of the individual RBC

A

Mean Corpuscular volume (MVC)

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39
Q

Normal MCV

A

80 - 98 per µm3 (cubic micrometer)

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40
Q

Causes of increased MCV

A

Chronic liver disease, Pernicious Anemia

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41
Q

Causes of Decreased MCV

A

Iron Deficiency anemia, Lead poisoning

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42
Q

the amount of HGB present in one cell is called

A

Mean Corpuscular Hemoglobin (MCH)

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43
Q

Normal count of MCH

A

27 - 31 pg (picograms)

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44
Q

causes of increased And Decreased MCH

A

Macrocytic Anemia

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45
Q

the proportion of each cell occupied by HGB

A

Mean Corpuscular Hemoglobin Concentration (MCHC)

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46
Q

Causes of decreased MCHC

A

Microcytic Anemia
Hypochromic anemia

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47
Q

normal % of MCHC

A

32 - 36%

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48
Q

Determines the number of circulating WBCs per cubic millimeter of whole blood

A

White blood cell (WBC) count

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49
Q

Where are high WBC count seen

A

In the presence of a bacterial infection

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50
Q

When can WBC count be low

A

If a viral infection is present

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51
Q

This information is useful for diagnosing certain disorders

A

WBC count

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52
Q

Normal WBC count for adults

A

4500 - 10,000 mm3

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53
Q

causes of increased WBC count

A

Acute infections
tissue necrosis

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54
Q

Causes of decreased WBC count

A

Viral infections
Hematopoietic diseases
Rheumatoid Arthritis

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55
Q

The proportion of each of the five types in a sample of 100 WBCs

A

WBC Differential Count

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56
Q

normal % of Neutrophils

A

50-70%

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57
Q

causes of increased Neutrophils

A

Acute infections

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58
Q

causes of decreased Neutrophils

A

Viral diseases, Luekemias, Aplastic and Iron Deficiency Anemia

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59
Q

Normal % of Lymphocytes

A

25-35%

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60
Q

Causes of increased Lymphocytes

A

Viral infection, Chronic infections, Lymphocytic Leukemia

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61
Q

Causes of decreased Lymphocytes

A

Cancers
Leukemia
Multiple Sclerosis
Renal Failure

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62
Q

Normal % of monoctyes

A

4-6%

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63
Q

Cause of decreased and Increased monocytes

A

Increased: Viral infection, Hodgkin’s Disease

Decreased: Lymphocytic Leukemia, Aplastic Anemia

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64
Q

Normal % of Eosinophils

A

1-3%

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65
Q

Causes of increased Eosinophils

A

Allergic reactions
Phlebitis
Cancer
Parasitic Infections

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66
Q

Causes of decreased Eosinophils

A
  • Stress (burns, shock)
  • Adrenocortical Hyperfunction
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67
Q

Normal % of Basophils

A

0.4 - 1.0%

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68
Q

Causes of Increased Basophils

A

Leukemia
Inflammatory Process

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69
Q

Causes of Decreased Basophils

A

-Hypersensitivity
Reaction
- Stress
- Pregnancy

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70
Q

Are cells that help blood clots

A

Platelets

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71
Q

Normal finding of platelets

A

150,000 - 400,000 microliters

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72
Q

Causes of increased Platelet count

A

Pulmonary embolism
Polycythemia vera
Acute blood loss
Splenectomy

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73
Q

Causes of decreased Platelet count

A

-Idiopathic
-Thrombocytopenic Purpura
- Cancer
- Systemic Lupus Erythematosus (SLE)

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74
Q

Normal Values of
Sodium
Potassium
Chloride
Calcium (ionized)
Magnesium
Phosphate
Serum Osmolality

A

Sodium: 135 - 145 mEq/L

Potassium: 3.5 - 5.3 mEq/L

Chloride: 95 - mEq/L

Calcium (ionized) - 4,5-5.5 mEq/L or 8.5 - 10.5 mg/dL
56% of total calcium (2.5 mEq/L or 4.0-5.0mg/dL)

Magnesium: 1.5 - 2.5 mEq/L or 1.6 - 2.5 mg/dL

Phosphate: 1.8 - 2.6 mEq/L or 1.6-2.5 mg/dL

Serum Osmolality: 280 - 300 mOsm/kg water

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75
Q

is the measure of the solute concentration of the blood

A

Serum Osmolalty

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76
Q

What is included in Serum Osmomality

A

Sodium ions
Glucose and urea (BUN)

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77
Q

how can serum osmolality be estimated

A

By doubling the serum sodium

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78
Q

What are osmolality values for

A

to evaluate fluid balance

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79
Q

Normal values of Serum Osmolality

A

280 - 300 mOsm/kg

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80
Q

what does an increase of osmolality indicate

A

a Fluid deficit

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80
Q

is often conducted when a client is taking a medication with a narrow therapeutic range

A

Therapeutic Drug monitoring

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81
Q

what does a decrease of osmolality indicate

A

Volume excess

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82
Q

indicates the highest concentration of the drug in the blood serum

A

Peak level

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83
Q

represents the lowest concentration of drug in the blood serum

A

Trough level

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84
Q

what is the ideal client peak and trough levels

A

within the therapeutic range

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85
Q

is a commonly used diagnostic tool to evaluate the partial pressures of gas in blood and acid base contenent

A

Blood Gas analysis

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86
Q

what does Blood gas analysis evaluate

A

Partial Pressures of gas in blood and acid base content

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87
Q

where is the specimen taken in arterial blood

A

radial, brachial, and femoral arteries

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87
Q

how doe we prevent hemorrhaging

A

apply pressure to the puncture site for 5-10 minutes after removing the needle

88
Q

Tests that are performed on blood serum

A

Blood Chemistry

89
Q

Enzymes that are present during common chemistry examinations

A

Lactic Dehydrogenase (LDH)
Creatine Kinase (CK)
Aspartate Aminotransferase (AST)
Alanine Aminotransferase (ALT)
Serum Glucose
Hormones

90
Q

are released into the blood during a myocardial infarction

A

Cardiac Markers

91
Q

A common test which measures blood glucose that is bound to hemoglobin

A

Hemoglobin A1C (HbA1C)
or
Glycosylated Hemoglobin

92
Q

is a reflection of how well blood glucose levels have been controlled during the prior 3-4 months

A

Hemoglobin AC1

93
Q

Normal range of HbA1C

A

4.0 to 5.5%

94
Q

what does a elevated HbA1C reflect

A

hyperglycemia in diabetic people

95
Q

The first specific blood test used to detect and guide treatment for heart failure

A

Brain natriuretic peptide test or B-type natriuretic peptide (BNP) test

96
Q

How does BNP levels increase

A

as heart failure becomes more severe

97
Q

Newborns are routinely screened for congenital metabolic conditions

A

Metabolic screening

98
Q

Tests for phenylketonuria (PKU) and Congenital hypothyrodism

A

Metabolic Screening

99
Q

Other conditions that are frequently screened for

A

sickle cell disease
galactosemia

100
Q

Taken to measure current blood glucose level

A

Capillary blood glucose

101
Q

Normal value of blood circulating glucose

A

4-6 mmo/L or 72-108 mg/dL

102
Q

Site for capillary blood glucose

A

lateral aspect of the finger or earlobe when patient is in shock

103
Q

Common blood chemistry test with clinical implications

A

ALT (Alanine Aminotransferase)
AST (Aspartate aminotransferase)
Albumin
Alkaline Phosphate
Ammonia
Bilirubin
GGT (Gamma-Glutamyl Transferase)
Prothrombin
CK (Creatine Kinase)
Myoglobin
Troponin I and T
Brain Natriuretic Peptide
Cholesterol
HDL-C
LDL
Triglycerides

104
Q

Formerly known as Serum Glutamic - Pyruvic transaminase

A

Alanine Aminotransferase

105
Q

Normal ALT findings in adult

A

10-35 units/L

106
Q

ALT is increased by

A

Acute viral hepatitis, necrosis of the liver, cirrhosis, heart failure, acute alcohol intoxication

107
Q

ALT is decreased by

A

Exercise

108
Q

Formerly known as Serum Glutamic-Oxaloacetic Transaminase

A

AST Aspartate Aminotransferase

109
Q

Normal adult findings of AST

A

8-35 units/L

110
Q

Found in heart, liver and skeletal muscle. Can also be used to indicate liver injury

A

AST (Aspartate Aminotransferase)

111
Q

a component of proteins produced by the liver

A

Liver

112
Q

normal adult findings of albumin

A

3.5-5.0 g/dl or 52-687% of total protein

113
Q

Found in the tissues of liver, bone, intestine, kidney, and placenta.

A

Alkaline Phosphate

114
Q

Used as an index of liver and bone disease when correlated with other clinical findings

A

Alkaline phosphate

115
Q

Normal Findings of Alkaline Phosphate in adults

A

4.2 - 13 unit/dL

116
Q

a by product of protein metabolism, into urea which is excreted by the kidneys

A

Ammonia

117
Q

Normal findings of ammonia in adults

A

15-26 mcg/dL

118
Q

normal findings of bilirubin in adults

A

total: 0.1 - 1.2 mg/dL
direct: 0.1- 0 .3 mg/dL
indirect : 0.1 - 1.2 mg/dL

119
Q

Results from the breakdown of hemoglobin in the RBCs; removed from the body by the liver which excretes it into the bile

A

Bilirubin

120
Q

Found primarily in the liver and kidney, with smaller amounts in the prostate, spleen, and heart muscle. is more specific for liver disease

A

GGT (Gamma-glutamyl Transferase)

121
Q

Normal findings of GGT in adults

A

4-23 IU/L for men
3-13 IU/L for women

122
Q

A protein produced by the liver for clotting the blood

A

Prothrombin

123
Q

Normal adult findings

A

10-13 seconds

124
Q

An enzyme found in the skeletal muscles and heart

A

CK (Creatine kinase)

125
Q

Total findings of CK in men and women

A

Men: 50-170 units/L
Women: 25-140 units/L

126
Q

Isoenzymes % of CK

A

MM (CK3): 90-100%
MB (CK2): 0-6%
BB (CK1): 0%

127
Q

After an MI, serum levels of this rise in 2-4 hours, making it an early marker for muscle damage

A

Myoglobin

128
Q

Normal Findings of Myoglobin in male and female

A

20-90 ng/ml
12-75 ng/ml

129
Q

is highly concentrated in the heart muscle. This test is used in the early diagnosis of MI

A

troponin I and T

130
Q

After an MI, this troponin begins to increase in 4 to 6 hrs and remains elevated for 5 to 7 days

A

Troponin I

131
Q

This troponin begins to increase in 3-4 hours and remains elevated for 10-14 days

A

Troponin T

132
Q

A hormone produced by the ventricles of the heart that is a marker of ventricular systolic and diastolic dysfunction

A

Brain Natriuretic Peptide

133
Q

Normal findings of BNP

A

<100 pg/ml or <100 ng/l

134
Q

this test is useful in diagnosis and guiding treatment for heart failure

A

Brain Natriuretic Peptide test

135
Q

This test in an important screening test for heart disease

A

Cholesterol

136
Q

Normal findings of cholesterol

A

<200 mg/dL

137
Q

A class of lipoproteins produced by the liver and intestines; the good cholesterol

A

HDL-C

138
Q

Normal HDL-C findings in adults

A

Adults: 29-77 mg/dL

139
Q

Up to 70% of the total serum cholesterol is present in LDL; the bad cholesterol

A

60-160 mg/dL

140
Q

This test evaluates suspected atherosclerosis and measures the body’s ability to metabolize fat

A

Triglycerides

141
Q

Steps in specimen collection

A
  1. Provide client comfort, privacy and safety.
  2. Explain the purpose of the specimen collection and the procedure for obtaining the specimen.
  3. Use the correct procedure for obtaining a specimen or ensure the client or staff follows correct procedure.
  4. Note relevant information in the laboratory requisition slip.
  5. Transport the specimen to the laboratory promptly.
  6. Report abnormal laboratory findings.
142
Q

Purpose of a stool specimen

A

To determine presence of occult blood, GUAIAC test - test for fecal occult blood

To analyze for dietary secretions. STRETORRHEA - excessive amount of fat in stool

To detect the presence of ova and parasites in stool

To detect the presence of bacteria and viruses

143
Q

Importance of GUAIAC Stool exam

A
  • Provide hemoglobin free diet for 3 days (no meat for 3 days)
  • Avoid red or dark colored foods
  • Temporarily discontinue iron therapy
144
Q

What does a positive guaiac stool exam indicate?

A

Peptic ulcer disease and gastric cancer

145
Q

Usually done on the first voided specimen in the morning because it tends to have a higher, more uniform concentration and more acidic pH

A

Clean Voided Urine Specimens

146
Q

done when a urine culture is ordered when identifying the microorganism causing UTI

A

Clean-catch or midstream urine

147
Q

a collection of all urine produced an voided over a specific period of time ranging from 1 to 2 hours or 24 hours

A

Timed urine specimen

148
Q

Urine specimen is obtained from a closed drainage systems by inserting a sterile needle attached to a syringe attached to a drainage port in the tubing

A

Indwelling catheter specimen

149
Q

an indicator of urine concentration or the amount of solutes present in the urine

A

Specific gravity

150
Q

used to measure the specific gravity

A

Urinometer or Hydrometer or Spectrometer or Refractometer

151
Q

Increased specific gravity indicates

A

fluid deficit or dehydration

152
Q

Normal specific gravity

A

1.010 to 1.025

153
Q

The acidity and alkalinity of urine

A

Urinary pH

154
Q

When is urine acidic or alkaline

A

if pH is above 7 it is alkaline
if below 7 it is acidic

155
Q

urine pH decrease’ kidneys excrete H ions

A

Metabolic Acidosis

156
Q

urine pH increase

A

Metabolic Alkalosis

157
Q

Measures presence of ______ in the urine

A

glucose

158
Q

Urine is tested for _____ to screen clients for DM and to access clients during pregnancy

A

Glucose

159
Q

product of the breakdown of fatty acids. Found in clients with poorly controlled diabetes

A

Ketone bodies

160
Q

Normally are too large to escape from the glomerular capillaries into the filtrate

A

Protein

161
Q

The presence of blood in urine one of the early signs of renal disease

A

Occult Blood

162
Q

Blood in urine is indicative of damage to

A

The kidney or urinary tract

163
Q

is the measure of the solute concentration of urtine

A

Osmolality

164
Q

Used to monitor fluid and electrolyte balance

A

Osmolality

165
Q

An increase of urine osmolality indicates

A

Fluid volume deficit

166
Q

Decreased in urine osmolality indicates

A

Fluid volume

167
Q

average urine osmolalty

A

200 - 800 mOsm/kg

168
Q

normal urine osmolality values

A

50 - 1200 mOsm/kg

169
Q

the secretion of mucous from the lungs, bronchi, trachea

A

Sputum

170
Q

clear liquid secreted by the salivary gland

A

Saliva

171
Q

who are the individuals that dont produce sputum

A

Healthy individuals

172
Q

how is sputum brought up from the lungs, bronchi. and trachea in to the mouth in order to expertorate

A

Coughing

173
Q

is collected from the mucosa of the oropharynx and tonsillar regions using a culture swab

A

Throat culture sample

174
Q

Technique for visualizing body organ system functions

A

Visualization Procedures

175
Q

2 types of visualization

A

Indirect Visualization (non - invasive procedures)
direct visualization (invasive procedures)

176
Q

Viewing of anal canal

A

Anoscopy

177
Q

Viewing of rectum

A

Proctoscopy

178
Q

Viewing of the rectum and the sigmoid

A

Lower GI endoscopy proctosigmoidoscopy

179
Q

things to do before lower GI endoscopy proctosigmoidoscopy procedure

A
  • Clear liquid diet for 24 hrs before procedure
  • administer laxative at night before the test as ordered
  • Cleansing enema as ordered, Laxative and cleansing enema ensure evacuation of feces for better visualization
180
Q

things to do after lower GI endoscopy proctosigmoidoscopy procedure

A
  • supine position for a few minutes to prevent postural Hypotension
  • Assess signs of perforation
  • Assess signs of vagal stimulation
  • Hot sitz bath for discomfort in the anorectal area as ordered
181
Q

viewing of the large intestine

A

Colonoscopy

182
Q

all direct visualization procedures

A
  • Anoscopy
  • Proctoscopy
  • Lower GI endoscopy proctosigmoidoscopy
  • Colonoscopy
183
Q

visualization of the lower GI tract or the colon

A

Lower GI series/ Barium Enema

184
Q

Low residue diet for 2 days before the procedure where the patient is given enema containing barium

A

Barium Enema / Lower GI series

185
Q

Nursing care after UGIS or LGIS Procedure

A
  • Laxative, barium sulfate is constipating
  • Increase fluid intake for enhanced excretion of barium sulfate
  • Inform the client that stool is white for 24 - 72 hours after procedure
186
Q

Visualization procedures to evaluate kidney function

A

Kidney, Uterus, and Bladder (KUB)
Intravenous Pyelography (IVP)
Retrograde Pyelography
Cystoscopy

187
Q

direct visualization using a cytoscope

A

Cystoscopy

188
Q

Provides a graphic recording of the heart’s electrical activity

A

Electrocardiography

189
Q

to assess the client’s response to an increased cardiac workload during exercise

A

Stress electrocardiography

190
Q

An invasive procedure wherein a radiopaque dye is injected into the vessels to be examined. Using fluoroscopy and xrays, the flow through the vessels is assessed and areas of narrowing or blockage can be observed.

A

Angiography

191
Q

Non invasive test that uses ultrasound to visualize structures of the heart and evaluate left ventricular function

A

Echocardiogram

192
Q

Also known as ventilation and perfusion (VQ) scan
the Ventilation quotient (VQ) scan measures how well air is flowing through the lungs
Perfusion scan shows where blood flows through the lungs

A

Lung scan

193
Q

A visualization of the larynx, invasive procedure with the use of laryngoscope

A

Laryngoscopy

194
Q

A visualization of the bronchi with the use of bronchoscope

A

Bronchoscopy

195
Q

Also called CT scanning, computerized tomography or computerized axial tomography (CAT)

A

Computed Tomography

196
Q

a painless noninvasive x-ray procedure that has a capability of distinguishing the densities of tissues

A

Computed Tomography

197
Q

what does CAT stand for

A

Computerized Axial Tomography

198
Q

what does MRI stand for

A

Magnetic Resonance imaging

199
Q

noninvasive diagnostic scanning technique in which the client is placed in a magnetic field

A

Magnetic Resonance Imaging

200
Q

Commonly used for visualization of the brain, spine, limbs, joints, heart, blood vessels abdomen and pelvis. The client may lie very still in a platform that moves to narrow, closed, high magnetic scanner

A

Magnetic Resonance Imaging (MRI)

201
Q

MRI takes how long

A

60-90 min

202
Q

what is the client provided to with to relieve feelings of CLAUSTROPHOBIA

A

two way communication system

203
Q

Involve the therapeutic use of radioactive isotopes for diagnostic purposes

A

Nuclear imaging studies

204
Q

studies physiology or function of an organ

A

Nuclear Imaging studies

205
Q

Non invasive radiologic studies that involve the inhalation and injection of radioisotope. This allows the study of various aspects of organ function and may include evaluation of blood flow and tumor growth

A

PET SCAN

206
Q

Is the withdrawal of fluid that has abnormally collected or to obtain specimen

A

Aspiration
Ex. Plueral cavity, abdominal cavity, cerebral spinal fluid

207
Q

The removal and examination of tissue to detect diagnosis and determine malignancy

A

Biopsy

208
Q

known as spinal tap, and cerebrospinal fluid is withdrawn through a needle inserted into the subarachnoid space of the spinal canal between the 3rd and 4th lumbar vertebrae or between the 4th and 5th lumbar vertebrae

A

Lumbar Puncture

209
Q

A procedure used to obtain fluid from abdominal cavity caused by ascites

A

Abdominal Paracentesis

210
Q

max fluid that is drained at one time to avoid hypovolemic shock

A

1500 ml

211
Q

removal of excess fluid in the pleural cavity to ease the breathing

A

THORACENTESIS

212
Q

how to position client in thoracentesis

A

-The arm is elevated and stretched forward
- the client leans forward over a pillow

213
Q

Sites of thoracentesis

A

Lower posterior chest - to remove fluid
Upper anterior chest - to remove air

214
Q

Removal of a specimen in the bone marrow for laboratory study

A

Bone marrow biopsy

215
Q

Sites of Bone marrow biopsy

A

Sternum, iliac crest, anterior and posterior ilia spines, and proximal tibia in children

216
Q

Preferred site of Bone marrow biopsy

A

posterior superior iliac crest

217
Q

A short procedure done at the client’s bedside in which a sample of tissue is aspirated

A

Liver biopsy

218
Q

The physician inserts a needle in the intercostal space between two of the right lower ribs into the liver or through the abdomen below the rib, the nurse applies pressure to the site to prevent bleeding, often positioning a client on the biopsy site

A

Liver Biopsy

219
Q

All aspiration and biopsy procedures

A

Lumbar puncture
Abdominal Paracentesis
Thoracentesis
Bone Marrow biopsy
Liver biopsy