Basic Nursing:Foundations of

Skills & Concepts

Chapter 27
DIAGNOSTIC
TESTS
Types of Diagnostic Tests

 Noninvasive: The body is not entered with

any type of instrument.
 Invasive: The body’s tissues, organs, or
cavities are accessed through some type
of procedure making use of instruments.
 Most invasive procedures require
informed consent of the client.
Preparing the Client for
Diagnostic Testing

 Nurses prepare clients by ensuring client

understanding and compliance with
preprocedural requirements.
 Clients, families, and significant others
must be involved in the testing process
and should be advised as to the estimated
time required to perform the test.
 Preparing the Client for
Diagnostic Testing

Nursing interventions used during diagnostic

testing include:
 Evaluating the client’s anxiety level.
 Teaching relaxation techniques, such as
deep breathing and imagery.
 Evaluating the client’s level of safety and
comfort.
Role of the Nurse in
Diagnostic Testing

 To facilitate the scheduling of tests.

 To perform client teaching.
 To perform or assist with procedures.
 To assess clients for adverse responses
to procedures.
Further Nursing Responsibilities
During Diagnostic Testing

 Preparing the procedure room (e.g. ensuring

adequate lighting).
 Gathering and charging for supplies to be
used during the procedure.
 Testing the equipment to ensure it is
functional and safe.
 Securing proper containers for specimen
collection.
Conscious Sedation

 A minimally depressed level of

consciousness during which the client
retains the ability to maintain a
continuously patent airway and respond
appropriately to physical stimulation or
verbal commands.
Care of the Client After
Diagnostic Testing

 Directed toward restoring the client’s

prediagnostic level of functioning.
 Client is monitored for signs of respiratory
distress and bleeding.
 With some diagnostic tests, the client’s
intake and output (I & O) is monitored for 24
hours.
 Clients received written instructions upon
discharge.
Reasons for Laboratory Tests
 To detect and quantify
the risk of future disease.
 To establish or exclude
diagnoses.
 To assess the severity of
the disease process and
formulate a prognosis.
 To guide the selection of
interventions.
 To monitor the progress
of the disorder.
 To monitor the
effectiveness of the
treatment.
Accuracy in Laboratory Testing

The following are required

 The practitioner’s order must be transcribed onto the
correct requisition form.
 All information must be written on form.
 Pertinent data that could influence the test’s results
must be included.
 Collection of the specimen from the correct client
must be confirmed by checking the identification
band.
 Laboratory results must be placed in the correct
medical record.
Concerns of Nurses Regarding
Diagnostic Testing

 Nurses should schedule diagnostic

testing to promote:
 Client comfort.

 Cost containment.
Types of Specimen Collection

 Venipuncture: the use of a needle to puncture a vein to

aspirate blood.
 Arterial puncture.
 Capillary puncture.
 Central Lines: refers to a venous catheter inserted into
the superior vena cava through the subclavian or internal
or external jugular vein.
 Implanted port: a port that has been implanted under the
skin.
 Urine collection.
Types of Urine Collection

 Random (routine analysis)

 Timed (24-hour urine)
 Collection from a closed urinary drainage
system.
 Sterile specimen (catheterized)
 Clean-voided specimen.
Procedures for Stool Collection

 Explain to client the  Label container with

reason for collection. client’s name, date and
time, and test to be
performed on the
 Refrigerate stools if specimen.
collected for a prolonged
period of time.  Place stool specimens in
biohazard bag before
transport to laboratory.
Type and Crossmatch

 Identifies the client’s blood type and

determines the compatibility to blood
between a potential donor and recipient
(client).
Blood Chemistry

 Blood Glucose.
 Serum Electrolytes.
 Blood Enzymes.
 Blood Lipids.
Types of Urine Tests

 Urine pH.
 Specific Gravity.
 Urine Glucose.
 Urine Ketones.
 Urine Cells and Casts.
Types of Stool Tests

 Urobilinogen.
 Occult blood (blood in the stool detected
only with a microscope or by chemical
means).
 Parasites.
Culture and Sensitivity Tests

 Culture refers to the growing of

microorganisms to identify the pathogen.
 Sensitivity tests are performed to identify
both the nature of the invading organism
and its susceptibility to commonly used
antibiotics.
Types of Culture and
Sensitivity Tests

 Blood Culture.
 Throat (Swab) Culture.
 Sputum Culture.
 Urine Culture.
 Stool Culture.
Papanicolaou Test

 A smear method of examining stained

exfoliative cells, commonly called a Pap
smear.
Radiography

 The study of film exposed to x-rays or

gamma rays through the action of ionizing
radiation.
 Used by the practitioner to study internal
organ structure.
Fluoroscopy

 Immediate, serial images of the body’s

structure and function.
 Reveals the motion of organs.
Chest X-Ray

 The most common radiological study.

 Noninvasive, noncontrasted.
Computed Tomography

 The radiological scanning of the body.

 X-ray beams and radiation detectors
transmit data to a computer that
transcribes the data into quantitative
measurement and multidimensional
images of the internal structures.
Barium Studies

 The use of barium, a chalky white

contrast medium, in a preparation that
permits roentgengraphic visualizations of
the internal structures of the digestive
tract.
Angiography

 Visualization of the vascular structures

through the use of fluoroscopy in
conjunction with a contrast medium.
Arteriography

 The radiographic study of the vascular

system following injection of a radiopaque
dye through a catheter.
Ultrasound

 A noninvasive procedure that uses high-

frequency sound waves to visualize deep
body structures.
 Also called echogram or sonogram.
Magnetic Resonance Imaging

 The MRI use of radiowaves and a strong

magnetic field to make continuous cross-
sectional images of the body.
Electrocardiogram

 A graphic recording of the heart’s

electrical activity.
Stress Test

 A measure of the client’s cardiovascular

fitness.
 It demonstrates the ability of the
myocardium to respond to increased
oxygen requirements by increasing the
blood flow to the coronary arteries.
Thalium Test

 Thalium is a radioactive isotope that

201

emits gamma rays and closely resembles

potassium.
 Often performed in conjunction with ECG.
Electroencephologram (EEG)

 The graphic recording of the brain’s

electrical activity.
Endoscopy

 The visualization of a body organ or cavity

through a scope.
Aspiration

 A procedure that is performed to withdraw

fluid that has abnormally collected or to
obtain a specimen.
Biopsy

 The excision of a small amount of tissue,

obtained during aspiration or in
conjunction with other diagnostic tests.
Amniocentesis

 The withdrawal of amniotic fluid to obtain a

sample for examination.
 Indicated when client is:
 Over 35.
 Has had a spontaneous abortion with a
previous pregnancy.
 Has a family history of genetic,
chromosomal, or neural tube defects.
Paracentesis

 The aspiration of fluid from the abdominal

cavity.
Thoracentesis

 The aspiration of fluid from the pleural

cavity.
Lumbar Puncture

 The aspiration of cerebrospinal fluid

(CSF) from the subarachnoid space.
 Also called spinal tap.