Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 14 Special Examinations and Tests

Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Diagnostic examination: procedure that involves physical inspection of body structures and evidence of their functions Laboratory test: procedure that involves examining body fluids or specimens and comparing the components of a collected specimen with normal findings Examinations and Tests

Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Equipment Used in Examinations RadiographyX-ray EndoscopyOptical scopes Radionuclide imaging Radioactive chemicals UltrasonographyHigh-frequency sound waves

Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Root Words and Suffixes

Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Responsibilities Clarifying explanations Preparing clients Obtaining equipment and supplies Arranging the examination area Positioning and draping

Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Responsibilities (cont’d) Assisting the examiner Providing physical and emotional support Attending to the client Caring for specimens Recording and reporting data

Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Positioning Clients During Examinations Dorsal recumbent position –Reclining position with the knees bent, hips rotated outward, and feet flat Lithotomy position –Reclining position with the feet in metal supports called stirrups

Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Positioning Clients During Examinations (cont’d) Sims’ position –The client lies on the left side with the chest leaning forward, the right knee bent toward the head, the right arm forward, and the left arm extended behind the body

Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Positioning Clients During Examinations (cont’d) Modified standing position –The client stands with the upper half of the body leaning forward Knee-chest position –The client rests on the knees and chest and turns the head, which is supported on a small pillow, to one side

Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Positioning the Client

Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Which of the following positions may be used as an alternative to the lithotomy position during a rectal examination? a. Sims’ b. Dorsal recumbent c. Supine d. Modified standing

Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer a. Sims’ The Sims’ position may be used as an alternative to the lithotomy position for a rectal examination as it provides access to the anus and rectum. The dorsal recumbent position, supine position, and modified standing position do not provide access to the anus and rectum.

Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Factors That Invalidate Test Results

Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false? Ultrasonography uses x-rays to examine clients.

Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer False. Ultrasonography uses a transducer that projects sound waves through the body’s surface.

Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Pelvic examination: physical inspection of the vagina and cervix with palpation of the uterus and ovaries Radiography: procedures that use roentgen rays, or x-rays, to produce images of body structures Endoscopy: visual examination of internal structures Commonly Performed Categories of Examinations

Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Radionuclide imaging: elements whose molecular structures are altered to produce radiation Ultrasonography: soft tissue examination using sound waves Electrical graphic recordings: recording electrical impulses from structures such as the heart, brain, and skeletal muscles Commonly Performed Categories of Examinations (cont’d)

Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false? Radiography uses elements whose molecular structures are altered to produce radiation.

Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer False. Radiography uses roentgen rays, or x-rays, to produce images of body structures.

Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Testing Procedures Sigmoidoscopy: examination of the large intestine from the rectum through the colon Paracentesis: procedure for withdrawing fluid from the abdominal cavity Lumbar puncture: procedure for withdrawing spinal fluid

Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Testing Procedures (cont’d) Throat culture: collecting infectious specimens or microorganisms from the throat and examining their characteristics with a microscope Measurement of capillary blood glucose: measuring the amount of glucose in capillary blood

Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false? Sigmoidoscopy is the procedure for withdrawing fluid from the abdominal cavity.

Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer False. Sigmoidoscopy is the examination of the large intestine from the rectum through the colon.

Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Factors to Consider When Performing Examinations and Tests on Older Adults Older adults may not be able to tolerate withholding of food or fluids for long periods Older adults are susceptible to dehydration Older adults become exhausted by preparations for gastrointestinal examinations requiring laxatives and enemas, which may also deplete electrolyte balance, leading to weakness or dizziness

Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Factors to Consider When Performing Examinations and Tests on Older Adults (cont’d) Older adults fatigue easily Older adults may need additional clothing, slippers, extra covers Cognitively compromised older adults should have a family member present during the procedure