Fundamentals of Nursing: Laboratory, Diagnostic Examinations, and Nursing Procedures

Comprehensive vocabulary practice flashcards for nursing competency appraisal covering urine, stool, blood, and sputum specimens, diagnostic procedures, and nursing interventions.

Clean-catch midstream urine specimen

A urine specimen collection technique where the client voids a small amount, pauses, and collects midstream urine into a container to minimize contamination from external urethral flora.

24-hour urine specimen

A quantitative urine collection that begins and ends on an empty bladder; the initial voided urine is discarded and all subsequent urine is collected over a $24\text{-hour}$ period in a container stored on ice or with preservatives.

Creatinine clearance test

A $24\text{-hour}$ urine collection test used to evaluate the glomerular filtration rate (GFR); requires avoiding high-protein food intake and strenuous physical exercise prior to testing.

Schilling's test

A diagnostic $24\text{-hour}$ urine test used as a confirmatory test for pernicious anemia, vitamin B12 deficiency, and intrinsic factor deficiency anemia.

Vanillylmandelic acid (VMA) test

A $24\text{-hour}$ urine test measuring epinephrine metabolites to diagnose pheochromocytoma, an adrenal medulla adenoma characterized by severe hypertension.

Second voided urine

Freshly formed urine collected after discarding the first morning void and administering a glass of water; required to evaluate glucose levels (glucosuria) and albumin (albuminuria).

Fecalysis

Laboratory examination of stool to evaluate gross appearance and check for ova or parasites; requires $2.5\,\text{cm}$ ($1\,\text{inch}$) of formed stool or $15\text{--}30\,\text{ml}$ of liquid stool free of urine or toilet paper.

Melena

Dark, black, or tarry stool containing blood, indicating upper gastrointestinal (UGI) bleeding.

Hematochezia

The passage of fresh, bright red blood in the stool, indicating lower gastrointestinal (LGI) bleeding.

Fecal occult blood test (Guaiac Stool Exam)

A diagnostic test detecting hidden blood in stool for colorectal cancer screening; requires avoiding red meat, dark foods, iron, NSAIDs, steroids, aspirin, anticoagulants, and Vitamin C for $3\,\text{days}$ prior.

Allen's test

An assessment performed prior to arterial puncture for ABG analysis to verify collateral blood circulation in the hand by compressing and releasing radial and ulnar arteries.

Acid-fast bacilli (AFB) test

A confirmatory diagnostic test for active pulmonary tuberculosis (PTB) involving sputum specimen collection on $3$ consecutive mornings prior to breakfast.

PPD test (Purified Protein Derivative Test)

An intradermal skin test for tuberculosis exposure read $48\text{--}72\,\text{hours}$ post-injection; induration of $\ge 5\,\text{mm}$ is positive in immunocompromised clients, while $\ge 10\,\text{mm}$ is positive in non-HIV high-risk clients.

Bronchography

A diagnostic imaging procedure where a radiopaque contrast medium is instilled directly into the trachea and bronchi through a bronchoscope to visualize the bronchial tree.

Bronchoscopy

Direct visualization of the larynx, trachea, and bronchi using a flexible fiber-optic bronchoscope; requires written consent, NPO for $6\text{--}12\,\text{hours}$, and Lidocaine spray to suppress the gag reflex.

Thoracentesis

Surgical aspiration of fluid or air from the pleural space, performed with the client sitting upright and leaning on an overbed table.

Holter monitor

Continuous $24\text{-hour}$ ambulatory electrocardiographic (ECG) monitoring via a portable telemetry unit to evaluate dysrhythmias and chest pain during daily activities.

Cardiac catheterization

An invasive procedure inserting a catheter into femoral or brachial vessels to evaluate coronary artery status; requires NPO for $4\text{--}6\,\text{hours}$, groin/brachial shaving, and iodine allergy assessment.

Neurovascular status assessment

Evaluation of peripheral tissue perfusion including skin color, skin temperature, sensation (paresthesia), capillary refill ($< 3\,\text{seconds}$), and distal pulse quality ($0$ to $+4$).

Magnetic resonance imaging (MRI)

A noninvasive imaging modality using radio frequency and electromagnetic waves; contraindicated in clients with cardiac pacemakers, prosthetic valves, or metallic clips.

Upper GI series (Barium swallow)

An X-ray examination using ingested barium contrast to diagnose strictures, ulcers, or tumors in the upper GI tract; produces white-colored stools for $24\text{--}48\,\text{hours}$ post-test.

Lower GI series (Barium enema)

Fluoroscopic examination of the large intestine following rectal administration of barium; requires a low-residue diet for $1\text{--}3\,\text{days}$, evening laxatives, NPO after midnight, and clear enemas.

Liver biopsy

Percutaneous aspiration of liver tissue using a Menghini needle ($14\text{--}16\,\text{gauge}$) inserted between the 6th and 7th ribs while the patient exhales and holds their breath; positioned right lateral post-procedure for $4\,\text{hours}$.

Paracentesis

Transabdominal aspiration of fluid from the peritoneal cavity to relieve ascites or analyze fluid in peritonitis; requires the client to void beforehand to prevent bladder perforation.

Blumberg sign

Rebound tenderness elicited upon release of abdominal pressure, indicating peritoneal inflammation or acute appendicitis.

Rovsing sign

Pain elicited in the right lower quadrant when palpation pressure is applied to the left lower quadrant of the abdomen, indicative of acute appendicitis.

Lumbar puncture

Insertion of a spinal needle into the L3-L4 intervertebral space to collect CSF; the client must lie flat for $8\,\text{hours}$ post-procedure to prevent spinal headaches.

Kernig sign

A diagnostic sign of meningeal irritation where knee extension beyond $135^\circ$ produces pain or resistance when the hip and knee are flexed at $90^\circ$.

Brudzinski sign

A diagnostic sign of meningitis characterized by involuntary flexion of the hips and knees when the neck is passively flexed forward.

Nuchal rigidity

Severe stiffness of the neck muscles preventing passive forward flexion of the head, representing a hallmark sign of meningitis.

Steam inhalation

A dependent nursing intervention applying warm moist steam $12\text{--}18\,\text{inches}$ away from the nose to induce vasodilation and loosen airway secretions.

Airway suctioning

Clearance of airway secretions using a catheter ($12\text{--}18\,\text{Fr}$ for adults) applied intermittently for a maximum of $15\,\text{seconds}$ during withdrawal at $80\text{--}120\,\text{mmHg}$ suction pressure, pre- and post-hyperoxygenated with $100\%\,\text{O}_2$.

Nutritionist vs. Dietitian

A nutritionist focuses on pre-pathologic disease prevention and community health education, whereas a dietitian manages pathologic conditions in clinical settings through therapeutic diets and enteral feedings.

Nasogastric tube (NGT) insertion

Insertion of a tube measured from nose tip to earlobe to xiphoid process; advanced into the nasopharynx with neck hyperextended, then advanced into the stomach while tilting head forward and swallowing.

Residual feeding volume

The volume of unabsorbed enteral formula aspirated prior to feeding; a volume exceeding $100\,\text{ml}$ indicates delayed gastric emptying, requiring feedings to be held and the physician notified.

Enema administration

Instillation of liquid solution into the rectum via a tube inserted $3\text{--}4\,\text{inches}$ (in adults) with the irrigation container elevated $18\,\text{inches}$ above the rectum; flow is temporarily stopped if abdominal cramps occur.

Ileostomy

A surgical stoma created in the ileum discharging continuous liquid to semi-formed stomal effluent rich in digestive enzymes, requiring continuous pouch wear and low-fiber diet.

Kock pouch

A continent intra-abdominal ileal reservoir that does not require an external drainage bag, emptied periodically via self-catheterization every $3\text{--}4\,\text{hours}$.

Double-barrel stoma

An ostomy where the bowel is surgically severed into two distinct stomas: a functioning proximal stoma discharging fecal matter and a distal stoma discharging mucus.

Colostomy irrigation

A procedure performed primarily for sigmoid colostomies using $500\text{--}1000\,\text{ml}$ of warm normal saline via an irrigation cone inserted $3\text{--}4\,\text{inches}$ into the stoma to promote regular bowel elimination.

Urinary catheterization

Insertion of a urinary catheter ($14\text{--}16\,\text{Fr}$ for males, $12\text{--}14\,\text{Fr}$ for females) using strict sterile technique; male catheters are inserted $6\text{--}9\,\text{inches}$ and female catheters $3\text{--}4\,\text{inches}$.