HA DIAGNOSTIC TESTING Flashcards
What are the nurse’s responsibilities
- Prepare patient mentally, explain procedure
- Collaborate with laboratory personnel in
proper collection and
transport of samples. - Proper labeling and
documentation.
2 types of diagnostic testing
Invasive
Non-Invasive
accessing the body’s tissue, organ, or cavity through
some type of instrumentation procedure.
Invasive
E.g. Most of Laboratory Exams, Biopsy (Excisional and Incisional),
lumbar puncture
Invasive
body is not entered with any type of instrument
Non-Invasive
E.g. EEG, ECG, Stress Test, Holter ECG (24 hrs), Chest X-ray, Sputum
exam, Urine and Stool examinations
Non-Invasive
Phases of Diagnostic Testing
-Pretest Phase
-Intra-Test Phase
-Post-Test Phase
client preparation.
Pretest Phase
specimen collection, standard
precautions and aseptic technique in collection of samples.
Intra-Test Phase
nursing care of the client and follow- up activities and observation. (comparison of
previous and current test results and modifies nursing interventions as needed)
Post-Test Phase
How do doctors reach a diagnosis?
-Initial DIagnostic Assessment
-Differential Diagnosis, and Ordering of Diagnostic Tests.
-Referral, COnsultation, Treatment & Follow-Up
PREPARING FOR THE DIAGNOSTIC TESTING Assessment
- Verify patient identification.
- Check medical history (current medications, herbal supplements, allergies
and hypersensitivities, recorded findings of previous diagnostic tests relative
to the procedure. - Assess for presence, location, and characteristics of physical and
communicative limitations or preexisting conditions. - Monitor the client’s knowledge of why the test is being performed.
- Obtain vital to establish baseline data.
- Monitor level of hydration and weakness for clients who are NPO
(nothing by mouth), especially geriatric and pediatric populations. - Check general patient condition, preparedness for the test, anxiety level.
PREPARING FOR THE DIAGNOSTIC TESTING
Client Teaching : (IMPORTANT- INFORMED CONSENT)
- Explain reason for test and what to expect, how long it will take.
- RESTRICTIONS (activities, food, etc.)
- What is the specimen to be collected? Give proper instruction on collection.
a. Sputum: cough deeply, do not clear throat.
b. Urine: voided, clean-catch specimen, time to collect.
c. Blood: What food were taken, fasting? - No objects (jewelry or hair clips) to obscure x-ray film.
- If dyes are to be ingested or injected, explain.
E.g. Barium: taste, consistency, aftereffects (stools lightly colored for 24–
72 hours, can cause obstruction or impaction).
Glucose drink for PPBS - Post test instructions.
PREPARING THE CLIENT FOR DIAGNOSTIC TESTING
Documentation
Record the following:
1. Who performed the procedure.
2. Reason for the procedure.
3. Type of anesthesia, dye, or other medications administered.
4. Type of specimen obtained and where it was delivered.
5. Vital signs and other assessment data, such as client’s tolerance of
the procedure or pain and discomfort level.
6. Any symptoms of complications.
7. Who transported the client to another area (designate the names of
persons who provided transport and place of destination).
Patient and Clinical factors
that can affect test results:
- Time of day
- Fasting
- Postprandial
- Supine, upright position
- Age
- Gender
- Climate
- Effects of drugs
- Effects of diet
DIFFERENT SAMPLES
FOR DIAGNOSTIC
TESTING
Blood
Semen
Urine
Gastric lavage
Stool
Swabs
Sputum
Secretions
Tissue biopsy
CSF
BLOOD
is the liquid, cell-free part of blood, that has been treated with anti-coagulant.
Plasma
BLOOD
is the liquid part of blood after coagulation, therefore devoid of clotting factors as fibrinogen.
Serum
ORDER OF DRAW
yellow
Blood Cultures - SPS
ORDER OF DRAW
Light Blue
Citrate Tube
ORDER OF DRAW
Gold and TIger
Serum Separator Tubes
ORDER OF DRAW
Red
Serum Tube
ORER OF DRAW
Orange
Rapid Serum Tube
ORDER OF DRAW
Green na tiger
Plasma Separator Tube
ORDER OF DRAW
Green
Heparin Tube
ORDER OF DRAW
Lavender
EDTA Tube
ORDER OF DRAW
Pearl/White
PPT Separator Tube
ORDER OF DRAW
Gray
Fluoride Tube
Blood
o CBC
o Arterial Blood Gas
o Glucose determination
o Blood chemistry
o Culture/CS
o Immuno-serology
o Blood transfusion
BLODD
The CBC
OBTAINED: Capillary prick, Venipuncture, Arterial sampling.
BLOOD
information about the types and numbers of cells in the blood.
CBC
BLOOD
Purpose of CBC
- Preoperative - determine oxygen carrying capacity of the blood and hemostasis
- Infection - ANEMIA and monitor progress of treatment
- Chronic Illness or blood disorders
- Monitor effects of CHEMOTHERAPHY
BLOOD
Different Types of White Blood Cells
- Neutrophils
- Eosinophils
- Basophils
- Lymphocytes
- Monocytes
TYPE OF WHITE BLOOD CELL
first to respond to bateria or a virus
Neutrophils
TYPE OF WHITE BLOOD CELL
Known for their role in allergy symptoms
Eosinophils
TYPE OF WHITE BLOOD CELL
Fight infections by producing antibodies
Lymphocytes
TYPE OF WHITE BLOOD CELL
Clean up dead cells
Monocytes
TYPE OF WHITE BLOOD CELL
Known for their role asthma
Basophils
BLOOD
Do you know how
many RBCs are
there in one drop of
blood?
250 M
BLOOD
The life cycle
of a normal
RBC is ___
days.
120
TRIVIA
The spleen
helps
remove old
RBCs.
BLOOD
TRIVIA
For CBC- use purple top (EDTA )
For babies, you may do capillary prick
(heel of toe);
Finger prick for Glucometer sample
Stress or Fear affects some hematology
values.
BLOOD
Avoid
AVOID:
> prolonged application
of tourniquet.
>IV site.(hemodiution)
>small gauge needle
(hemolysis).
>hematoma or bruises,
or open wound.
> Over or undersampling.
>use (Vacutainer)
less hassle
>take blood when
patient is sitting down
>Do not introduce air.
> Avoid contamination
or cross -
contamination
BLOOD
Drugs that may INCREASE RBC count:
Methyldopa, Gentamycin
BLOOD
Drugs that may DECREASE RBC count:
Quinidine, hydantoins, chloramphenicol,
chemotherapeutic drugs
BLOOD
Drugs that may increase hemoglobin:
Erythropoietin, iron supplements.
BLOOD
Drugs that may decrease hemoglobin:
Aspirin, antibiotics, sulfonamides,
trimethadione, anti-neoplastic drugs, indomethacin, doxapram, rifampin, and
primaquine.
BLOOD
is helpful in diagnosing and
assessing blood diseases,
nutritional deficiencies, and
hydration status.
HCT
BLOOD
LOW HEMOGLOBIN
: Nutritional deficiencies, blood loss,
renal problems, sickle cell anemia, bone
marrow suppression, leukemia, lead
poisoning, Hodgkin’s lymphoma
BLOOD
High HEMOGLOBIN
Dehydration, cigarette smoking,
polycythemia vera, tumors, erythropoietin
abuse, lung diseases.
BLOOD
Low Hematocrit
: Overhydration, nutritional deficiencies, blood
loss, bone marrow suppression, leukemia, lead
poisoning, Hodgkin’s lymphoma, chemotherapy
treatment, anemia, bone marrow disorder.
BLOOD
High Hematocrit
Dehydration, hypoxia, cigarette smoking,
polycythemia vera, tumors, erythropoietin abuse, lung
diseases, blood doping, erythrocytosis.
BLOOD
iron-deficiency anemia,
thalassemia
microcytic
BLOOD
Vit B1 or Folic acid deficiency,
hypothyroidism, alcoholism
Macrocytic
BLOOD
Drugs that may increase white blood cells:
Corticosteroids, heparin, betaadrenergic agonists, epinephrine, granulocyte colony-stimulating factor,
lithium.
BLOOD
Drugs that may decrease white blood cells:
Diuretics, chemotherapeutic
drugs, histamine-2 blockers, captopril, anticonvulsants, antibiotics,
antithyroid drugs, quinidine, chlorpromazine, terbinafine, clozapine,
sulfonamides, ticlopidine