FSCh25DiagnosticTests

Chapter 25: Diagnostic Tests

Nursing's Role in Diagnostic Tests

• Key Responsibilities:

  • Noting the health-care provider’s order

  • Occasionally scheduling the test or procedure

  • Educating the patient regarding the process involved

  • Administering laxatives or enemas, if required

  • Ensuring written consent is obtained

  • Knowing when to withhold food and fluids before the test

  • Preparing the patient appropriately for the procedure

  • Assisting the examiner during the test or procedure

Patient Care During and After

• Ongoing Responsibilities:

  • Checking for allergies before proceeding

  • Obtaining specimens and submitting them to the laboratory

  • Notifying health care professionals of abnormal results promptly

  • Providing care for the patient during and after the procedure

  • Relay findings to the provider, keeping them informed

  • Importance of notifying the health care provider regarding any abnormal findings

Knowledge Required

• Essential Knowledge for Nurses:

  • Understanding various diagnostic testing purposes

  • Knowledge of necessary preparation for testing

  • Awareness of the significance of normal and abnormal results

Categories of Diagnostic Tests

• Types Include:

  • Laboratory tests

  • Radiology and imaging tests and procedures

  • Ultrasonography

  • Endoscopic exams

  • Graphic recording tests

Laboratory Tests

Hematology

• Includes:

  • Complete blood cell count (CBC)

  • White cell count and differential (lymphocytes, neutrophils, eosinophils, basophils, and monocytes)

  • Red cell count, hemoglobin, and hematocrit levels

  • Platelet count

  • Differential - breakdown of total WBC into types

Blood Chemistry Tests

• Can include:

  • Blood glucose levels

  • Electrolyte levels (K+, Cl–, Na+, Mg2+, Ca2+, PO4–)

  • Enzymes and isoenzymes

  • Blood urea nitrogen (BUN)

  • Serum creatinine levels

  • Total protein and total bilirubin measurements

Other Blood Tests

• Includes:

  • B-type natriuretic peptide (BNP): Diagnoses heart failure

  • Cardiac enzymes (myoglobin, troponin, creatine kinase) to assess for myocardial infarction (MI)

  • Lipase: Digestive enzyme from the pancreas

  • Glycosylated hemoglobin (A1C): Measure of hemoglobin bound with glucose

Urine Tests

• Types of Tests:

  • Urinalysis: Evaluating color, odor, appearance, specific gravity, pH, glucose, protein, etc.

  • Glomerular filtration rate (GFR): Measures kidney function using a 24-hour urine specimen

Imaging and Procedures

Radiology and Imaging Tests

• Common Examples:

  • Chest x-ray: Shows lungs and heart

  • Flat plate of abdomen (KUB x-ray): Evaluate abdominal organs

  • Magnetic Resonance Imaging (MRI): Uses magnets to create detailed images

  • Computed Tomography (CT): Cross-sectional imaging to view internal structures

  • Angiography (arteriography and venography): Visualizes blood vessels

  • Computed tomography angiography (CTA) and magnetic resonance angiography (MRA)

Ultrasonography

• Used for imaging organs using sound waves; can assess conditions in the abdomen and other organs.

Endoscopic Exams

• Procedures Include:

  • Esophagogastroduodenoscopy (EGD): Visualizes upper GI tract

  • Colonoscopy: Visualizes the colon for abnormalities

  • Capsule endoscopy: Patient swallows a camera to image the digestive tract.

Follow-Up Questions and Tests

• Understanding which imaging tests require consideration of implanted metal (e.g., MRI)

• Graphic recording tests (e.g., telemetry) and stress tests (chemical vs. exercise)

Other Diagnostic Tests

• Additional Procedures:

  • Lumbar puncture (spinal tap) for cerebrospinal fluid analysis

  • Bone marrow aspiration for blood cell production assessment

  • Thoracentesis and paracentesis: Procedures to remove fluid from the chest and abdomen, respectively.

Concluding Notes

• Demonstrating understanding of testing roles includes knowledge imparting about tests, patient preparation, and careful observation of results to ensure patient safety and care.