Diagnostic Tests Flashcards
1
Q
Why undergo Diagnostic Testing
A
- Tools that provide information
- Tests may be used for basic screening as part of a wellness check
- Tests are used to help confirm a diagnosis, monitor an illness and provide valuable information about the clients response or treatment
2
Q
What are the 3 diagnostic testing phases
A
Pretest
Intratest
Posttest
3
Q
The major focus of this phase is client preparation
A
Pre-test
4
Q
Common questions that are included in Pre-test
A
- What sample will be needed and how will it be collected
- Does the client need to stop oral intake for a certain number of hours prior to the test?
5
Q
This phase focuses on specimen collection and performing or assisting with certain diagnostic testing
A
Intra-test
6
Q
Why does the nurse need to ensure correct labeling, storage and transportation of the specimen?
A
To avoid invalid test results
7
Q
This phase focuses on the nursing care of the client and follow-up activities and observations
A
Post-test
8
Q
What does the nurse compare during Post-test
A
Current and previous tests results and modifies nursing interventions as needed`
9
Q
Nursing Diagnoses in Diagnostic tests
A
Anxiety
Lack of Knowledge
Fear
10
Q
related to possible diagnosis of accurate or chronic illness
A
Anxiety
11
Q
related to insufficient information regarding the process for test
A
Lack Of Knowledge
12
Q
Related to the pending conclusion of the diagnostic test
A
Fear
13
Q
Commonly used in diagnostic test that can provide valuable information about hematologic system and many other body systems.
A
Blood Tests
14
Q
Performed through a venipuncture by a Phlebotomist
A
Bloodtest
15
Q
Puncture of a vein for collection of a blood specimen
A
Venipuncture
16
Q
an individual who performs venipuncture
A
Phlebotomist
17
Q
includes hemoglobin and hematocrit measurements, erythrocyte (RBC) count, red blood cell indices, leukocyte (WBC) count, and differential white blood cell count
A
Complete blood count (CBC)
18
Q
Most basic screening test
A
Complete blood test (CBC)
19
Q
The main intracellular protein of erythrocytes
A
Hemoglobin (HGB)
20
Q
it is the iron-containing protein in the RBC that transports oxygen through the body
A
Hemoglobin (HGB)
21
Q
What is the pigment of Hemoglobin? and what does it contain?
A
Pigment : Heme
and it contains iron and protein (globin)
22
Q
Hemoglobin count of Men and Women
A
Men - 13.5 - 18 g/dl
Women - 12 - 15 g/dl
(grams per deciliter)
23
Q
Causes of increased HGB
A
Polycythemia, Dehydration, COPD (chronic pulmonary disease), Heart failure
24
Q
Causes of decreased HGB
A
Blood loss, anemia, kidney disease, cancers
25
Measures the percentage of RBCs in the total blood volume
Hematocrit (HCT)
26
is a fastest way to determine the percentage of RBCs in the plasma
Hematocrit or Packed cell volume
27
Why is HCT reported as a percentage?
because of concentration of RBCs in the blood
28
Total % of plasma of blood
55% of total blood
29
Total % of Erythrocytes of total blood
45% of total blood
30
Percentage of buffy coat of total blood (leukocytes and platelets)
<1% of total blood
31
Normal HCT count in men and women
Men - 40-54%
Women - 36-46%
32
causes of increased HCT
Dehydration
Hypervolemia
Diabetic Acidosis
Burns
33
causes of decreased HCT
Acute blood loss
Pregnancy
Dietary Deficiencies
Anemias
34
The number of RBCs per cubic millimeter of whole blood`
Red blood cell (RBC) Count
35
Low RBC counts are indicative of what condition
Anemia
36
Clients with chronic hypoxia may develop higher than normal count, a condition known as?
Polycythemia
37
RBC indices may be performed as a part of the CBC to evaluate the
Size, weight, and HBC Concentration of RBCs
38
What is the mean of average size of the individual RBC
Mean Corpuscular volume (MVC)
39
Normal MCV
80 - 98 per µm3 (cubic micrometer)
40
Causes of increased MCV
Chronic liver disease, Pernicious Anemia
41
Causes of Decreased MCV
Iron Deficiency anemia, Lead poisoning
42
the amount of HGB present in one cell is called
Mean Corpuscular Hemoglobin (MCH)
43
Normal count of MCH
27 - 31 pg (picograms)
44
causes of increased And Decreased MCH
Macrocytic Anemia
45
the proportion of each cell occupied by HGB
Mean Corpuscular Hemoglobin Concentration (MCHC)
46
Causes of decreased MCHC
Microcytic Anemia
Hypochromic anemia
47
normal % of MCHC
32 - 36%
48
Determines the number of circulating WBCs per cubic millimeter of whole blood
White blood cell (WBC) count
49
Where are high WBC count seen
In the presence of a bacterial infection
50
When can WBC count be low
If a viral infection is present
51
This information is useful for diagnosing certain disorders
WBC count
52
Normal WBC count for adults
4500 - 10,000 mm3
53
causes of increased WBC count
Acute infections
tissue necrosis
54
Causes of decreased WBC count
Viral infections
Hematopoietic diseases
Rheumatoid Arthritis
55
The proportion of each of the five types in a sample of 100 WBCs
WBC Differential Count
56
normal % of Neutrophils
50-70%
57
causes of increased Neutrophils
Acute infections
58
causes of decreased Neutrophils
Viral diseases, Luekemias, Aplastic and Iron Deficiency Anemia
59
Normal % of Lymphocytes
25-35%
60
Causes of increased Lymphocytes
Viral infection, Chronic infections, Lymphocytic Leukemia
61
Causes of decreased Lymphocytes
Cancers
Leukemia
Multiple Sclerosis
Renal Failure
62
Normal % of monoctyes
4-6%
63
Cause of decreased and Increased monocytes
Increased: Viral infection, Hodgkin's Disease
Decreased: Lymphocytic Leukemia, Aplastic Anemia
64
Normal % of Eosinophils
1-3%
65
Causes of increased Eosinophils
Allergic reactions
Phlebitis
Cancer
Parasitic Infections
66
Causes of decreased Eosinophils
- Stress (burns, shock)
- Adrenocortical Hyperfunction
67
Normal % of Basophils
0.4 - 1.0%
68
Causes of Increased Basophils
Leukemia
Inflammatory Process
69
Causes of Decreased Basophils
-Hypersensitivity
Reaction
- Stress
- Pregnancy
70
Are cells that help blood clots
Platelets
71
Normal finding of platelets
150,000 - 400,000 microliters
72
Causes of increased Platelet count
Pulmonary embolism
Polycythemia vera
Acute blood loss
Splenectomy
73
Causes of decreased Platelet count
-Idiopathic
-Thrombocytopenic Purpura
- Cancer
- Systemic Lupus Erythematosus (SLE)
74
Normal Values of
Sodium
Potassium
Chloride
Calcium (ionized)
Magnesium
Phosphate
Serum Osmolality
Sodium: 135 - 145 mEq/L
Potassium: 3.5 - 5.3 mEq/L
Chloride: 95 - mEq/L
Calcium (ionized) - 4,5-5.5 mEq/L or 8.5 - 10.5 mg/dL
56% of total calcium (2.5 mEq/L or 4.0-5.0mg/dL)
Magnesium: 1.5 - 2.5 mEq/L or 1.6 - 2.5 mg/dL
Phosphate: 1.8 - 2.6 mEq/L or 1.6-2.5 mg/dL
Serum Osmolality: 280 - 300 mOsm/kg water
75
is the measure of the solute concentration of the blood
Serum Osmolalty
76
What is included in Serum Osmomality
Sodium ions
Glucose and urea (BUN)
77
how can serum osmolality be estimated
By doubling the serum sodium
78
What are osmolality values for
to evaluate fluid balance
79
Normal values of Serum Osmolality
280 - 300 mOsm/kg
80
what does an increase of osmolality indicate
a Fluid deficit
80
is often conducted when a client is taking a medication with a narrow therapeutic range
Therapeutic Drug monitoring
81
what does a decrease of osmolality indicate
Volume excess
82
indicates the highest concentration of the drug in the blood serum
Peak level
83
represents the lowest concentration of drug in the blood serum
Trough level
84
what is the ideal client peak and trough levels
within the therapeutic range
85
is a commonly used diagnostic tool to evaluate the partial pressures of gas in blood and acid base contenent
Blood Gas analysis
86
what does Blood gas analysis evaluate
Partial Pressures of gas in blood and acid base content
87
where is the specimen taken in arterial blood
radial, brachial, and femoral arteries
87
how doe we prevent hemorrhaging
apply pressure to the puncture site for 5-10 minutes after removing the needle
88
Tests that are performed on blood serum
Blood Chemistry
89
Enzymes that are present during common chemistry examinations
Lactic Dehydrogenase (LDH)
Creatine Kinase (CK)
Aspartate Aminotransferase (AST)
Alanine Aminotransferase (ALT)
Serum Glucose
Hormones
90
are released into the blood during a myocardial infarction
Cardiac Markers
91
A common test which measures blood glucose that is bound to hemoglobin
Hemoglobin A1C (HbA1C)
or
Glycosylated Hemoglobin
92
is a reflection of how well blood glucose levels have been controlled during the prior 3-4 months
Hemoglobin AC1
93
Normal range of HbA1C
4.0 to 5.5%
94
what does a elevated HbA1C reflect
hyperglycemia in diabetic people
95
The first specific blood test used to detect and guide treatment for heart failure
Brain natriuretic peptide test or B-type natriuretic peptide (BNP) test
96
How does BNP levels increase
as heart failure becomes more severe
97
Newborns are routinely screened for congenital metabolic conditions
Metabolic screening
98
Tests for phenylketonuria (PKU) and Congenital hypothyrodism
Metabolic Screening
99
Other conditions that are frequently screened for
sickle cell disease
galactosemia
100
Taken to measure current blood glucose level
Capillary blood glucose
101
Normal value of blood circulating glucose
4-6 mmo/L or 72-108 mg/dL
102
Site for capillary blood glucose
lateral aspect of the finger or earlobe when patient is in shock
103
Common blood chemistry test with clinical implications
ALT (Alanine Aminotransferase)
AST (Aspartate aminotransferase)
Albumin
Alkaline Phosphate
Ammonia
Bilirubin
GGT (Gamma-Glutamyl Transferase)
Prothrombin
CK (Creatine Kinase)
Myoglobin
Troponin I and T
Brain Natriuretic Peptide
Cholesterol
HDL-C
LDL
Triglycerides
104
Formerly known as Serum Glutamic - Pyruvic transaminase
Alanine Aminotransferase
105
Normal ALT findings in adult
10-35 units/L
106
ALT is increased by
Acute viral hepatitis, necrosis of the liver, cirrhosis, heart failure, acute alcohol intoxication
107
ALT is decreased by
Exercise
108
Formerly known as Serum Glutamic-Oxaloacetic Transaminase
AST Aspartate Aminotransferase
109
Normal adult findings of AST
8-35 units/L
110
Found in heart, liver and skeletal muscle. Can also be used to indicate liver injury
AST (Aspartate Aminotransferase)
111
a component of proteins produced by the liver
Liver
112
normal adult findings of albumin
3.5-5.0 g/dl or 52-687% of total protein
113
Found in the tissues of liver, bone, intestine, kidney, and placenta.
Alkaline Phosphate
114
Used as an index of liver and bone disease when correlated with other clinical findings
Alkaline phosphate
115
Normal Findings of Alkaline Phosphate in adults
4.2 - 13 unit/dL
116
a by product of protein metabolism, into urea which is excreted by the kidneys
Ammonia
117
Normal findings of ammonia in adults
15-26 mcg/dL
118
normal findings of bilirubin in adults
total: 0.1 - 1.2 mg/dL
direct: 0.1- 0 .3 mg/dL
indirect : 0.1 - 1.2 mg/dL
119
Results from the breakdown of hemoglobin in the RBCs; removed from the body by the liver which excretes it into the bile
Bilirubin
120
Found primarily in the liver and kidney, with smaller amounts in the prostate, spleen, and heart muscle. is more specific for liver disease
GGT (Gamma-glutamyl Transferase)
121
Normal findings of GGT in adults
4-23 IU/L for men
3-13 IU/L for women
122
A protein produced by the liver for clotting the blood
Prothrombin
123
Normal adult findings
10-13 seconds
124
An enzyme found in the skeletal muscles and heart
CK (Creatine kinase)
125
Total findings of CK in men and women
Men: 50-170 units/L
Women: 25-140 units/L
126
Isoenzymes % of CK
MM (CK3): 90-100%
MB (CK2): 0-6%
BB (CK1): 0%
127
After an MI, serum levels of this rise in 2-4 hours, making it an early marker for muscle damage
Myoglobin
128
Normal Findings of Myoglobin in male and female
20-90 ng/ml
12-75 ng/ml
129
is highly concentrated in the heart muscle. This test is used in the early diagnosis of MI
troponin I and T
130
After an MI, this troponin begins to increase in 4 to 6 hrs and remains elevated for 5 to 7 days
Troponin I
131
This troponin begins to increase in 3-4 hours and remains elevated for 10-14 days
Troponin T
132
A hormone produced by the ventricles of the heart that is a marker of ventricular systolic and diastolic dysfunction
Brain Natriuretic Peptide
133
Normal findings of BNP
<100 pg/ml or <100 ng/l
134
this test is useful in diagnosis and guiding treatment for heart failure
Brain Natriuretic Peptide test
135
This test in an important screening test for heart disease
Cholesterol
136
Normal findings of cholesterol
<200 mg/dL
137
A class of lipoproteins produced by the liver and intestines; the good cholesterol
HDL-C
138
Normal HDL-C findings in adults
Adults: 29-77 mg/dL
139
Up to 70% of the total serum cholesterol is present in LDL; the bad cholesterol
60-160 mg/dL
140
This test evaluates suspected atherosclerosis and measures the body's ability to metabolize fat
Triglycerides
141
Steps in specimen collection
1. Provide client comfort, privacy and safety.
2. Explain the purpose of the specimen collection and the procedure for obtaining the specimen.
3. Use the correct procedure for obtaining a specimen or ensure the client or staff follows correct procedure.
4. Note relevant information in the laboratory requisition slip.
5. Transport the specimen to the laboratory promptly.
6. Report abnormal laboratory findings.
142
Purpose of a stool specimen
To determine presence of occult blood, GUAIAC test - test for fecal occult blood
To analyze for dietary secretions. STRETORRHEA - excessive amount of fat in stool
To detect the presence of ova and parasites in stool
To detect the presence of bacteria and viruses
143
Importance of GUAIAC Stool exam
- Provide hemoglobin free diet for 3 days (no meat for 3 days)
- Avoid red or dark colored foods
- Temporarily discontinue iron therapy
144
What does a positive guaiac stool exam indicate?
Peptic ulcer disease and gastric cancer
145
Usually done on the first voided specimen in the morning because it tends to have a higher, more uniform concentration and more acidic pH
Clean Voided Urine Specimens
146
done when a urine culture is ordered when identifying the microorganism causing UTI
Clean-catch or midstream urine
147
a collection of all urine produced an voided over a specific period of time ranging from 1 to 2 hours or 24 hours
Timed urine specimen
148
Urine specimen is obtained from a closed drainage systems by inserting a sterile needle attached to a syringe attached to a drainage port in the tubing
Indwelling catheter specimen
149
an indicator of urine concentration or the amount of solutes present in the urine
Specific gravity
150
used to measure the specific gravity
Urinometer or Hydrometer or Spectrometer or Refractometer
151
Increased specific gravity indicates
fluid deficit or dehydration
152
Normal specific gravity
1.010 to 1.025
153
The acidity and alkalinity of urine
Urinary pH
154
When is urine acidic or alkaline
if pH is above 7 it is alkaline
if below 7 it is acidic
155
urine pH decrease' kidneys excrete H ions
Metabolic Acidosis
156
urine pH increase
Metabolic Alkalosis
157
Measures presence of ______ in the urine
glucose
158
Urine is tested for _____ to screen clients for DM and to access clients during pregnancy
Glucose
159
product of the breakdown of fatty acids. Found in clients with poorly controlled diabetes
Ketone bodies
160
Normally are too large to escape from the glomerular capillaries into the filtrate
Protein
161
The presence of blood in urine one of the early signs of renal disease
Occult Blood
162
Blood in urine is indicative of damage to
The kidney or urinary tract
163
is the measure of the solute concentration of urtine
Osmolality
164
Used to monitor fluid and electrolyte balance
Osmolality
165
An increase of urine osmolality indicates
Fluid volume deficit
166
Decreased in urine osmolality indicates
Fluid volume
167
average urine osmolalty
200 - 800 mOsm/kg
168
normal urine osmolality values
50 - 1200 mOsm/kg
169
the secretion of mucous from the lungs, bronchi, trachea
Sputum
170
clear liquid secreted by the salivary gland
Saliva
171
who are the individuals that dont produce sputum
Healthy individuals
172
how is sputum brought up from the lungs, bronchi. and trachea in to the mouth in order to expertorate
Coughing
173
is collected from the mucosa of the oropharynx and tonsillar regions using a culture swab
Throat culture sample
174
Technique for visualizing body organ system functions
Visualization Procedures
175
2 types of visualization
Indirect Visualization (non - invasive procedures)
direct visualization (invasive procedures)
176
Viewing of anal canal
Anoscopy
177
Viewing of rectum
Proctoscopy
178
Viewing of the rectum and the sigmoid
Lower GI endoscopy proctosigmoidoscopy
179
things to do before lower GI endoscopy proctosigmoidoscopy procedure
- Clear liquid diet for 24 hrs before procedure
- administer laxative at night before the test as ordered
- Cleansing enema as ordered, Laxative and cleansing enema ensure evacuation of feces for better visualization
180
things to do after lower GI endoscopy proctosigmoidoscopy procedure
- supine position for a few minutes to prevent postural Hypotension
- Assess signs of perforation
- Assess signs of vagal stimulation
- Hot sitz bath for discomfort in the anorectal area as ordered
181
viewing of the large intestine
Colonoscopy
182
all direct visualization procedures
- Anoscopy
- Proctoscopy
- Lower GI endoscopy proctosigmoidoscopy
- Colonoscopy
183
visualization of the lower GI tract or the colon
Lower GI series/ Barium Enema
184
Low residue diet for 2 days before the procedure where the patient is given enema containing barium
Barium Enema / Lower GI series
185
Nursing care after UGIS or LGIS Procedure
- Laxative, barium sulfate is constipating
- Increase fluid intake for enhanced excretion of barium sulfate
- Inform the client that stool is white for 24 - 72 hours after procedure
186
Visualization procedures to evaluate kidney function
Kidney, Uterus, and Bladder (KUB)
Intravenous Pyelography (IVP)
Retrograde Pyelography
Cystoscopy
187
direct visualization using a cytoscope
Cystoscopy
188
Provides a graphic recording of the heart's electrical activity
Electrocardiography
189
to assess the client's response to an increased cardiac workload during exercise
Stress electrocardiography
190
An invasive procedure wherein a radiopaque dye is injected into the vessels to be examined. Using fluoroscopy and xrays, the flow through the vessels is assessed and areas of narrowing or blockage can be observed.
Angiography
191
Non invasive test that uses ultrasound to visualize structures of the heart and evaluate left ventricular function
Echocardiogram
192
Also known as ventilation and perfusion (VQ) scan
the Ventilation quotient (VQ) scan measures how well air is flowing through the lungs
Perfusion scan shows where blood flows through the lungs
Lung scan
193
A visualization of the larynx, invasive procedure with the use of laryngoscope
Laryngoscopy
194
A visualization of the bronchi with the use of bronchoscope
Bronchoscopy
195
Also called CT scanning, computerized tomography or computerized axial tomography (CAT)
Computed Tomography
196
a painless noninvasive x-ray procedure that has a capability of distinguishing the densities of tissues
Computed Tomography
197
what does CAT stand for
Computerized Axial Tomography
198
what does MRI stand for
Magnetic Resonance imaging
199
noninvasive diagnostic scanning technique in which the client is placed in a magnetic field
Magnetic Resonance Imaging
200
Commonly used for visualization of the brain, spine, limbs, joints, heart, blood vessels abdomen and pelvis. The client may lie very still in a platform that moves to narrow, closed, high magnetic scanner
Magnetic Resonance Imaging (MRI)
201
MRI takes how long
60-90 min
202
what is the client provided to with to relieve feelings of CLAUSTROPHOBIA
two way communication system
203
Involve the therapeutic use of radioactive isotopes for diagnostic purposes
Nuclear imaging studies
204
studies physiology or function of an organ
Nuclear Imaging studies
205
Non invasive radiologic studies that involve the inhalation and injection of radioisotope. This allows the study of various aspects of organ function and may include evaluation of blood flow and tumor growth
PET SCAN
206
Is the withdrawal of fluid that has abnormally collected or to obtain specimen
Aspiration
Ex. Plueral cavity, abdominal cavity, cerebral spinal fluid
207
The removal and examination of tissue to detect diagnosis and determine malignancy
Biopsy
208
known as spinal tap, and cerebrospinal fluid is withdrawn through a needle inserted into the subarachnoid space of the spinal canal between the 3rd and 4th lumbar vertebrae or between the 4th and 5th lumbar vertebrae
Lumbar Puncture
209
A procedure used to obtain fluid from abdominal cavity caused by ascites
Abdominal Paracentesis
210
max fluid that is drained at one time to avoid hypovolemic shock
1500 ml
211
removal of excess fluid in the pleural cavity to ease the breathing
THORACENTESIS
212
how to position client in thoracentesis
-The arm is elevated and stretched forward
- the client leans forward over a pillow
213
Sites of thoracentesis
Lower posterior chest - to remove fluid
Upper anterior chest - to remove air
214
Removal of a specimen in the bone marrow for laboratory study
Bone marrow biopsy
215
Sites of Bone marrow biopsy
Sternum, iliac crest, anterior and posterior ilia spines, and proximal tibia in children
216
Preferred site of Bone marrow biopsy
posterior superior iliac crest
217
A short procedure done at the client's bedside in which a sample of tissue is aspirated
Liver biopsy
218
The physician inserts a needle in the intercostal space between two of the right lower ribs into the liver or through the abdomen below the rib, the nurse applies pressure to the site to prevent bleeding, often positioning a client on the biopsy site
Liver Biopsy
219
All aspiration and biopsy procedures
Lumbar puncture
Abdominal Paracentesis
Thoracentesis
Bone Marrow biopsy
Liver biopsy
