Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Chapter 28 Diagnostic Testing.

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Chapter 28

Diagnostic Testing


Overview of Noninvasive and Invasive Diagnostic Testing

• Noninvasive– Body not entered with any instrument

• Invasive– Accessing tissue, organ, or cavity through

instrumentation


Nursing Care of the Client

• Preparing client for diagnostic testing– Client identification and assessment

• Baseline vital signs

• Allergies

– Client teaching

(continued)



• Preparing client for diagnostic testing– Nursing interventions:

• NPO status– Nothing by mouth

• Medications

(continued)



• Preparing client for diagnostic testing– Evaluate client’s knowledge, anxiety, comfort,

and safety

– Report significant findings

– Document

(continued)



• Care of client during diagnostic testing– Continually assess

– Prepare room

– Gather supplies

– Test equipment

– Secure specimen collection containers

(continued)



• Care of client after diagnostic testing– Based on:

• Nature of test

• Administration of anesthesia

– Monitoring of respiratory distress and bleeding

– Discharge instructions

– Follow-up appointment


Laboratory Tests

• Detect risk of future disease

• Establish and exclude diagnoses

• Assess severity of disease process– Determine prognosis

• Guide selection of interventions

• Monitor progress of disorder

• Monitor treatment effectiveness


Specimen Collection

• Point-of-care testing (POCT)

• Venipuncture

• Arterial puncture

• Capillary puncture

• Central lines

• Implanted port

(continued)


Specimen Collection

• Urine collection– Random collection

– Timed collection

– Closed drainage system

– Clean-voided specimen

• Stool collection

(continued)


Specimen Collection

• Hematologic system– Red blood cells

– White blood cells

– Red cell indices

– Platelets

– Sickle cell test

(continued)


Specimen Collection

• Type and cross-match– Test that identifies blood type

– Determines compatibility of blood between donor and recipient

– Blood types:• A, B, AB, and O positive or negative

(continued)


Specimen Collection

• Blood chemistry– Blood glucose

– Serum electrolytes

– Blood enzymes

– Prostate-specific antigens (PSAs)

– Blood lipids

– Therapeutic drug monitoring

– Arterial blood gases

(continued)


Specimen Collection

• Urine analysis– Routine urinalysis

• Macroscopic

• Microscopic

– Collect in morning after first voiding

– Evaluate within one hour

(continued)


Specimen Collection

• Stool analysis– Occult blood

– Parasites

• Culture and sensitivity tests

• Papanicolaou (Pap) test


Radiologic Studies

• Radiography– Noninvasive

– Invasive

• Contrast-mediated studies

• Plain films– Chest x-ray

(continued)


Radiologic Studies

• Risks of exposure to radiation– Gonadal and somatic cells

– Children and pregnant women

– Adverse effects:• Genetic mutations

• Cancer

• Congenital anomalies

(continued)


Radiologic Studies

• Mammography

• Angiography studies– Cardiac angiography

– Others


Ultrasonography

• Ultrasound– Noninvasive study

– Uses high-frequency sound waves

– Visualizes deep body structures

• Echocardiogram

• Doppler ultrasonography


Non-Nuclear Scan Studies

• Computed tomography (CT)

• Magnetic resonance imaging (MRI)


Radioactive Studies

• Radionuclide imaging– Nuclear scanning

– Images of changes in body structure

(continued)


Radioactive Studies

• Radionuclide imaging– Results reveal:

• Congenital abnormalities

• Lesions

• Skeletal changes

• Infections

• Gland and organ enlargement


Electrodiagnostic Studies

• Use devices to measure electrical activity of heart, brain, and skeletal muscles– Electrocardiography

– Signal-averaged electrocardiography

– Stress test• Radionuclide studies

– Electroencephalography


Endoscopy

• Visualization of body organ or cavity through scope

• Light at end of scope allows practitioner to assess for lesions and structural problems

• Several areas of body can be visualized using endoscope


Aspiration and Biopsy

• Aspiration– Withdraw abnormally collected fluid to obtain

specimen

• Biopsy– Excise small amount of tissue during aspiration

or with other diagnostic tests

(continued)


Aspiration and Biopsy

• Amniocentesis

• Bone marrow

• Paracentesis

• Thoracentesis

• Cerebrospinal fluid aspiration

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Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Chapter 28 Diagnostic Testing.

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