![References:
Audrey Berman . . . [et al.]. – 9th ed. (2012) KOZIER &
ERB’S Fundamentals of NURSING Concepts, Process, and
Practice.](https://image.slidesharecdn.com/03laboratorytestspart3-210313154228/85/laboratory-tests-part-3-68-320.jpg)
laboratory tests part 3
- 1. Diagnostic Tests Part III Mr. JHONEE BALMEO
- 2. Visualization Procedures Visualization procedures include indirect visualization (noninvasive) and direct visualization (invasive) techniques for visualizing body organ and system functions.
- 3. Clients with Gastrointestinal Alterations Direct visualization techniques include anoscopy, the viewing of the anal canal;
- 5. Clients with Gastrointestinal Alterations proctoscopy, the viewing of the rectum
- 6. Clients with Gastrointestinal Alterations proctosigmoidoscopy, the viewing of the rectum and sigmoid colon
- 7. Clients with Gastrointestinal Alterations colonoscopy, the viewing of the large intestine.
- 8. Clients with Gastrointestinal Alterations Indirect visualization of the gastrointestinal tract is achieved by roentgenography. X-rays of the gastrointestinal tract can detect strictures, obstructions, tumors, ulcers, inflammatory disease, or other structural changes such as hiatal hernias
- 9. Clients with Gastrointestinal Alterations
- 10. Clients with Gastrointestinal Alterations Visualization of the tract is enhanced by the introduction of a radiopaque substance such as barium.
- 11. Clients with Gastrointestinal Alterations For examination of the upper gastrointestinal tract or small bowel, the client drinks the barium sulfate. This examination is often referred to as a barium swallow. For examination of the lower gastrointestinal tract, the client is given an enema containing the barium. This examination is commonly referred to as a barium enema.
- 12. Clients with Gastrointestinal Alterations These x-rays usually include fluoroscopic examination; that is, projection of the xray films onto a screen, which permits continuous observation of the flow of barium. *Nurses are responsible for preparing clients before these studies and for follow-upcare.
- 13. Clients with Gastrointestinal Alterations
- 14. Clients with Urinary Alterations Visualization procedures also may be used to evaluate urinary function. An x-ray of the kidneys/ureters/bladder is commonly referred to as a KUB
- 15. Clients with Urinary Alterations
- 16. Clients with Urinary Alterations In an IVP (IV Pyelogram), contrast medium is injected intravenously; during retrograde pyelography, the contrast medium is instilled directly into the kidney pelvis. Following injection or instillation of the contrast medium, x-rays are taken to evaluate urinary tract structures. via the urethra, bladder, and ureters
- 17. Clients with Urinary Alterations
- 18. Clients with Urinary Alterations Renal ultrasonography is a noninvasive test that uses reflected sound waves to visualize the kidneys.
- 19. Chinese man's body riddled with tapeworm parasites Xray can reveal many uses in diagnosing our client’s disease
- 21. Clients with Urinary Alterations During a cystoscopy, the bladder, ureteral orifices, and urethra can be directly visualized using a cystoscope, a lighted instrument inserted through the urethra. Nurses are responsible for preparing clients before these studies and for follow-up care
- 22. Cystoscopy (normal and abnormal)
- 23. Clients with Cardiopulmonary Alterations A number of visualization procedures can be done to examine the cardiovascular system and respiratory tract.
- 24. Clients with Cardiopulmonary Alterations Electrocardiography provides a graphic recording of the heart’s electrical activity. Electrodes placed on the skin transmit the electrical impulses to an oscilloscope or graphic recorder.
- 25. Clients with Cardiopulmonary Alterations With the wave forms recorded, the electrocardiogram (ECG) can then be examined to detect dysrhythmias and alterations in conduction indicative of myocardial damage, enlargement of the heart, or drug effects.
- 26. Clients with Cardiopulmonary Alterations Stress electrocardiography uses ECGs to assess the client’s response to an increased cardiac workload during exercise. As the body’s demand for oxygen increases with exercising, the cardiac workload increases, as does the oxygen demand of the heart muscle itself. Clients with coronary artery disease may develop chest pain and characteristic ECG changes during exercise.
- 27. Clients with Cardiopulmonary Alterations Angiography is an invasive procedure requiring informed consent of the client. A radiopaque dye is injected into the vessels to be examined. Using fluoroscopy and x-rays, the flow through the vessels is assessed and areas of narrowing or blockage can be observed.
- 28. Clients with Cardiopulmonary Alterations Coronary angiography is performed to evaluate the extent of coronary artery disease; pulmonary angiography may be performed to assess the pulmonary vascular system, particularly if pulmonary emboli are suspected.
- 30. Clients with Cardiopulmonary Alterations Other vessels that may be studied include the carotid and cerebral arteries, the renal arteries, and the vessels of the lower extremities.
- 31. ? The client has a urinary health problem. Which procedure is performed using indirect visualization? 1. Intravenous pyelography (IVP) 2. Kidneys, ureter, bladder (KUB). 3. Retrograde pyelography 4. Cystoscopy
- 32. ? The nurse needs to collect a sputum specimen to identify the presence of tuberculosis (TB). Which nursing action(s) is/are indicated for this type of specimen? Select all that apply. 1. Collect the specimen in the evening. 2. Send the specimen immediately to the laboratory.. 3. Ask the client to spit into the sputum container. 4. Offer mouth care before and after collection of the sputum specimen.. 5. Collect a specimen for 3 consecutive days..
- 33. Clients with Cardiopulmonary Alterations An echocardiogram is a noninvasive test that uses ultrasound to visualize structures of the heart and evaluate left ventricular function. Images are produced as ultrasound waves reflect back to a transducer after striking cardiac structures. The nurse should tell the client that this test causes no discomfort, although the conductive gel used may be cold.
- 34. Laryngoscopy and bronchoscopy Laryngoscopy and bronchoscopy are sterile procedures that are conducted with a laryngoscope and bronchoscope, respectively. Tissue samples may also be taken for biopsy. A local anesthetic is usually given before the examination.
- 35. Laryngoscopy and bronchoscopy A local anesthetic is sprayed on the client’s pharynx to prevent gagging; alternatively, the client gargles with an anesthetic to anesthetize the throat. The bronchoscope is then inserted to visualize the larynx or bronchi
- 39. Computed tomography (CT), also called CT scanning, computerized tomography, or computerized axial tomography (CAT) It is a painless, noninvasive x-ray procedure that has the unique capability of distinguishing minor differences in the density of tissues. The CT produces a three- dimensional image of the organ or structure, making it more sensitive than the x-ray machine.
- 42. Magnetic resonance imaging (MRI) is a noninvasive diagnostic scanning technique in which the client is placed in a magnetic field. Clients with implanted metal devices (e.g., pacemaker, metal hip prosthesis) cannot undergo an MRI because of the strong magnetic field. There is no exposure to radiation. If a contrast media is injected during the procedure, it is not an iodine contrast. Another advantage to the MRI is that it provides a better contrast between normal and abnormal tissue than the CT scan. It is, however, more costly.
- 45. The MRI is commonly used for visualization of the brain, spine, limbs and joints, heart, blood vessels, abdomen, and pelvis. The procedure involves the client lying on a platform that moves into either a narrow, closed, high magnet scanner, or into an open, low-magnet scanner. SAFETY ALERT: Advise clients to inform the MRI operator if they have a tattoo or permanent makeup and to let the operator know of any unusual sensations felt at the site of the tattoo during the MRI.
- 47. Positron emission tomography (PET) is a noninvasive radiologic study that involves the injection or inhalation of a radioisotope. Images are created as the radioisotope is distributed in the body. This allows study of various aspects of organ function and may include evaluation of blood flow and tumor growth
- 48. Aspiration/Biopsy Aspiration is the withdrawal of fluid that has abnormally collected (e.g., pleural cavity, abdominal cavity) or to obtain a specimen (e.g., cerebrospinal fluid). A biopsy is the removal and examination of tissue. Biopsies are usually performed to determine a diagnosis or to detect malignancy. Both aspiration and biopsy are invasive procedures and require strict sterile technique
- 49. Lumbar Puncture In a lumbar puncture (LP, or spinal tap), cerebrospinal fluid (CSF) is withdrawn through a needle inserted into the subarachnoid space of the spinal canal between the third and fourth lumbar vertebrae or between the fourth and fifth lumbar vertebrae. At this level the needle avoids damaging the spinal cord and major nerve roots. The client is positioned laterally with the head bent toward the chest, the knees flexed onto the abdomen, and the back at the edge of the bed or examining table.
- 51. Abdominal Paracentesis Normally the body creates just enough peritoneal fluid for lubrication. The fluid is continuously formed and absorbed into the lymphatic system. However, in some disease processes, a large amount of fluid accumulates in the abdominal cavity; this condition is called ascites.
- 52. Normal ascitic fluid is serous, clear, and light yellow in color. An abdominal paracentesis is carried out to obtain a fluid specimen for laboratory study and to relieve pressure on the abdominal organs due to the presence of excess fluid.
- 53. The primary care provider makes a small incision with a scalpel, inserts the trocar (a sharp, pointed instrument) and cannula (tube), and then withdraws the trocar, which is inside the cannula. Tubing is attached to the cannula and the fluid flows through the tubing into a receptacle.
- 54. If the purpose of the paracentesis is to obtain a specimen, the primary care provider may use a long aspirating needle attached to a syringe rather than making an incision and using a trocar and cannula. Normally about 1,500 mLis the maximum amount of fluid drained at one time to avoid hypovolemic shock.
- 55. Thoracentesis Normally, only sufficient fluid to lubricate the pleura is present in the pleural cavity. However, excessive fluid can accumulate as a result of injury, infection, or other pathology. In such a case or in the case of pneumothorax, a primary care provider may perform a thoracentesis to remove the excess fluid or air to ease breathing. Thoracentesis is also performed to introduce chemotherapeutic drugs intrapleurally.
- 58. Bone Marrow Biopsy Another type of diagnostic study is the biopsy. A biopsy is a procedure whereby tissue is obtained for examination. Biopsies are performed on many different types of tissues, for example, bone marrow, liver, breast, lymph nodes, and lung. A bone marrow biopsy is the removal of a specimen of bone marrow for laboratory study. The biopsy is used to detect specific diseases of the blood, such as pernicious anemia and leukemia.
- 60. Once the needle is in the marrow space, the stylet is removed and a 10-mL syringe is attached to the needle. The plunger is withdrawn until 1 to 2 mL of marrow has been obtained. The primary care provider replaces the stylet in the needle, withdraws the needle, and places the specimen in test tubes and/or on glass slides.
- 62. Liver Biopsy A liver biopsy is a short procedure, generally performed at the client’s bedside, in which a sample of liver tissue is aspirated. A primary care provider inserts a needle in the intercostal space between two of the right lower ribs and into the liver
- 63. Because many clients with liver disease have blood clotting defects and are prone to bleeding, prothrombin time and platelet count are normally taken well in advance of the test. If the test results are abnormal, the biopsy may be contraindicated.
- 65. ? A primary care provider is going to perform a thoracentesis. The nurse’s role will include which action? 1. Place the client supine in the Trendelenburg position. 2. Position the client in a seated position with elbows on the overbed table.. 3. Instruct the LPN to measure vital signs. 4. Administer an opioid analgesic.
- 66. Which noninvasive procedure provides information about the physiology or function of an organ? 1. Angiography 2. Computerized tomography (CT) 3. Magnetic resonance imaging (MRI) 4. Positron emission tomography (PET)
- 68. References: Audrey Berman . . . [et al.]. – 9th ed. (2012) KOZIER & ERB’S Fundamentals of NURSING Concepts, Process, and Practice.
Editor's Notes
- #48: the distribution of the isotope in normal tissue is equal, uniform, and gray. Hyperfunction of an organ shows darkerimagesthatarereferredtoas“hot”spots. Incontrast,hypofunctioningofanorganappears as lighter images that are called “cold” spots