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

2. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Overview of Noninvasive and Invasive Diagnostic Testing Noninvasive –Body not entered with any instrument Invasive –Accessing tissue, organ, or cavity through instrumentation

3. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nursing Care of the Client Preparing client for diagnostic testing –Client identification and assessment Baseline vital signs Allergies –Client teaching (continued)

4. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nursing Care of the Client Preparing client for diagnostic testing –Nursing interventions: NPO status –Nothing by mouth Medications (continued)

5. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nursing Care of the Client Preparing client for diagnostic testing –Evaluate client’s knowledge, anxiety, comfort, and safety –Report significant findings –Document (continued)

6. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nursing Care of the Client Care of client during diagnostic testing –Continually assess –Prepare room –Gather supplies –Test equipment –Secure specimen collection containers (continued)

7. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nursing Care of the Client 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

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

9. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Specimen Collection Point-of-care testing (POCT) Venipuncture Arterial puncture Capillary puncture Central lines Implanted port (continued)

10. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Specimen Collection Urine collection –Random collection –Timed collection –Closed drainage system –Clean-voided specimen Stool collection (continued)

11. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Specimen Collection Hematologic system –Red blood cells –White blood cells –Red cell indices –Platelets –Sickle cell test (continued)

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

13. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Specimen Collection Blood chemistry –Blood glucose –Serum electrolytes –Blood enzymes –Prostate-specific antigens (PSAs) –Blood lipids –Therapeutic drug monitoring –Arterial blood gases (continued)

14. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Specimen Collection Urine analysis –Routine urinalysis Macroscopic Microscopic –Collect in morning after first voiding –Evaluate within one hour (continued)

15. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Specimen Collection Stool analysis –Occult blood –Parasites Culture and sensitivity tests Papanicolaou (Pap) test

16. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Radiologic Studies Radiography –Noninvasive –Invasive Contrast-mediated studies Plain films –Chest x-ray (continued)

17. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Radiologic Studies Risks of exposure to radiation –Gonadal and somatic cells –Children and pregnant women –Adverse effects: Genetic mutations Cancer Congenital anomalies (continued)

18. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Radiologic Studies Mammography Angiography studies –Cardiac angiography –Others

19. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Ultrasonography Ultrasound –Noninvasive study –Uses high-frequency sound waves –Visualizes deep body structures Echocardiogram Doppler ultrasonography

20. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Non-Nuclear Scan Studies Computed tomography (CT) Magnetic resonance imaging (MRI)

21. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Radioactive Studies Radionuclide imaging –Nuclear scanning –Images of changes in body structure (continued)

22. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Radioactive Studies Radionuclide imaging –Results reveal: Congenital abnormalities Lesions Skeletal changes Infections Gland and organ enlargement

23. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Electrodiagnostic Studies Use devices to measure electrical activity of heart, brain, and skeletal muscles –Electrocardiography –Signal-averaged electrocardiography –Stress test Radionuclide studies –Electroencephalography

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

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

26. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Aspiration and Biopsy Amniocentesis Bone marrow Paracentesis Thoracentesis Cerebrospinal fluid aspiration