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NCLEX-RN (1) Fundamentals > Diagnostic Tests > Flashcards

Flashcards in Diagnostic Tests Deck (73)
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1
Q

What is informed consent (in a healthcare setting) and who signs it?

A

The form that the client signs before an invasive procedure that indicates that the client understands the risks of the procedures as explained by the HCP.

The client signs the form and the nurse can sign as a witness.

2
Q

Can the nurse explain the risks of a procedure to a client?

A

No. That is the HCP’s responsibility.

The nurse does need to know what the risks are in order to provide appropriate interventions.

3
Q

Define:

NPO

A

Nothing by mouth:

  • the client is not allowed to eat or drink
  • NPO is very common before diagnostic tests, procedures, and surgeries
4
Q

What is conscious sedation?

A

A combination of medicines to help the client relax (a sedative) and to block pain (an anesthetic) during a medical or dental procedure.

The client may still be awake, but may not be able to speak.

5
Q

What medication is commonly given for conscious sedation?

A

IV midazolam

Midazolam is a benzodiazepine.

6
Q

Will a client under conscious sedation be able to breathe on their own?

A

Yes, the client will be awake, be able to respond if asked a question and will be able to breathe.

7
Q

What is the priority nursing care for a client undergoing conscious sedation?

A
  • ensure patent airway
  • monitor vital signs
  • maintain correct position to prevent injuries
  • administer CPR if client stops breathing
8
Q

What is an Ultrasound?

A

An image of a part of the body using sound waves.

9
Q

What is an Echocardiogram?

A

An ultrasound of the heart.

10
Q

What is an X-ray?

A

An image of a part of the body using radiation.

They are best for finding broken bones, tumors, dental decay, and the presence of foreign bodies.

11
Q

What is a Computed tomography scan (CT scan)?

A

Multiple images on any part of the body using radiation that is more detailed than an x-ray.

  • typically lasts 5 minutes
  • good for seeing organs and bony detail
  • machine is “donut-shaped”
  • may use contrast dye

12
Q

What is a Magnetic resonance image (MRI)?

A

Multiple images on any part of the body using magnetic fields. It does not use radiation.

  • can last 30 minutes or more
  • good for seeing soft tissue
  • machine is “tanning-bed” shaped

13
Q

What is a Magnetic resonance angiography (MRA)?

A

Multiple images of blood vessels (arteries) using magnetic fields.

It may or may not have contrast dye.

14
Q

What is a Positron emission tomography scan (PET scan)?

A

Multiple images of a part of the body that uses a special dye with radioactive tracers that the client swallows, inhales or gets injected into the arm depending on the area of the body.

It can show abnormalities at the cellular level such as cancer.

  • It can take 30-60 minutes
  • machine looks like a CT scan (donut-shaped)

15
Q

What does an MRI machine look like?

A

It looks like a big tube.

MRIs take around 40 minutes to complete.
MRI = magnetic resonance imaging.

16
Q

What does a CT scanner look like?

A

It looks like a big donut.

A CT scan takes about 5 minutes to complete.
CT = computed tomography.

17
Q

What type of client CANNOT get an x-ray?

A

Pregnant clients CANNOT get an x-ray due to radiation to the fetus​.

18
Q

What needs to be removed from the client’s body before getting an x-ray?

A

Any metal or jewelry because it interferes with the image.

19
Q

What is central venous pressure (CVP)?

A

CVP is blood pressure in the vena cava, which is blood returning to the right atrium. It is used to determine the severity of heart failure.

  • The right atrium is the chamber where deoxygenated blood goes so it can go to the right ventricle, then into the lungs to get oxygenated again
  • normal value: 0 - 8 cm H2O
  • the higher the number the more fluid back-up and pressure

20
Q

What is an Endoscopy and Bronchoscopy?

A

Both are procedures to diagnose abnormalities.

  • an endoscopy looks at the digestive tract and goes down the esophagus
  • a bronchoscopy looks at the respiratory system and goes down the trachea

An endoscope or bronchoscope is a flexible tubing with a camera/scope on the end that is inserted into the mouth to visualize the insides of a client.

21
Q

What are the pre-procedure nursing interventions for an endoscopy or bronchoscopy?

A
  • invasive: ensure informed consent is signed
  • NPO at 4-8 hours beforehand
  • start IV access
  • remove eyeglasses, dentures, contacts
  • hold blood thinners
  • give meds for conscious sedation
22
Q

What are the post-procedure nursing interventions for an endoscopy or bronchoscopy?

A
  • check gag reflex afterward (will come back in 2 hours)
  • monitor for signs of perforation and bleeding
23
Q

What is a Colonoscopy?

A

A flexible tubing with a camera/scope on the end inserted into the colon and large intestine.

24
Q

What are the pre-procedure nursing interventions for a colonoscopy?

A
  • invasive: ensure informed consent is signed
  • give polyethylene glycol (GoLytely) to clean out bowels
  • liquid diet 24 hours before procedure and NPO at midnight
  • give meds for conscious sedation
  • monitor for fluid and electrolyte imbalances
25
Q

What are the post-procedure nursing interventions for a colonoscopy?

A
  • monitor for signs of perforation and bleeding
  • monitor for fluid and electrolyte imbalances
26
Q

What are signs of perforation for procedures that involve scopes?

A
  • pain
  • bleeding: increased HR and decreased BP
  • difficulty swallowing: if from an upper scope procedure
  • elevated temperature
27
Q

What type of test has the word “-gram” or “-graphy” in it?

A

Are images of a part of the body with the possible use of dye.

Examples are:

  • CT scan (computed tomography)
  • echocardiogram
  • angiogram
  • intravenous pyelogram

28
Q

What are the pre-procedure nursing interventions for a test that ends in -gram or -graphy?

A

If contrast dye is used:

  • assess for iodine/seafood allergies
  • assess kidney function (BUN and creatinine)
  • hold metformin (anti-diabetic) 24 hours before and 48 hours afterward: is toxic to kidneys
  • teach that client may feel a warm sensation, urge to urinate, cough, nausea, or palpitations as the dye is being injected
29
Q

What are the post-procedure nursing interventions for a test that ends in -gram or -graphy?

A

If contrast dye is used, encourage fluids to flush dye out of kidneys.

30
Q

What are the pre-procedure nursing interventions for an MRI or MRA?

A
  • no pregnancy
  • no pacemakers or metal
  • assess for claustrophobia
  • give a sedative to calm client
31
Q

What is an electroencephalography (EEG)?

A

Involves electrodes placed on the scalp to record electrical activity of the brain. It is used to assess seizures, effects of tumors or braiin injuries.

No dye is used.

32
Q

What are the pre-procedure nursing interventions for an EEG?

A
  • no stimulates or caffeine 24 hours beforehand
  • hold sedatives
  • wash hair and not metal on head
  • not NPO, may drink and eat beforehand
  • may be asked to hyperventilate for 3-4 minutes and watch a flashing light to diagnose seizures
33
Q

What are the post-procedure nursing interventions for an EEG?

A
  • wash hair due to stickers on head
    • fall precautions if was sedated
34
Q

What is an IV pyelogram?

A

An image of kidneys with use of dye.

35
Q

What are the pre-procedure nursing interventions for an IV pyelogram?

A

May get an enema or polyethylene glycol to clean out bowels and see kidneys better.

36
Q

What are the post-procedure nursing interventions for an IV pyelogram?

A

Encourage fluids to flush out kidneys.

37
Q

What is a myelogram or myelography?

A

An image of the spinal cord with use of dye.

38
Q

What are the post-procedure nursing interventions for a myelogram/myelography?

A

Encourage fluids to flush out kidneys.

39
Q

What is a halo sign for cerebral spinal fluid (CSF)?

A

A test to see if spinal fluid is leaking from the nose or ears.

If positive, there will be concentric rings of red and yellow (blood and CSF).

40
Q

What is a lumbar puncture?

A

A needle inserted into the spinal canal to get a sample of cerebral spinal fluid to check for infection.

41
Q

What are the pre-procedure nursing interventions for a lumbar puncture?

A
  • void beforehand to prevent fidgeting and trauma
  • fetal position or “C” position for needle insertion
42
Q

What are the post-procedure nursing interventions for a lumbar puncture?

A
  • lay supine and flat 2-3 hours afterward to promote healing
  • encourage fluids to replace fluids taken out
  • headache is common due to CSF shifts: lay down and give analgesics
43
Q

What is an electromyography?

A

Aneedle is inserted into the muscle and records electrical activity. It is used to test for diseases with muscle weakness.

No stimulates or sedatives before test since it will interfere with results.

44
Q

What is an upper GI tract study with barium sulfate (barium swallow)?

A

A group of x-rays as the client swallows barium to assess the GI tract.

Barium is a white liquid that is visible on x-rays.

45
Q

What is a barium enema?

A

A series of x-rays of the colon as a barium enema is administered.

46
Q

What are the pre-procedure and post-procedure nursing interventions for an upper GI tract study with barium sulfate (barium swallow) and barium enema?

A
  • pre-procedure nursing interventions:
    • NPO for 4-8 hours
  • post-postprocedure nursing interventions:
    • causes chalky white stools
    • encourage fluids and give laxatives to prevent constipation
47
Q

What is a biopsy?

A

A sample of tissue to diagnose cancer or other abnormalities by using a needle to collect the tissue sample.

48
Q

What are the general pre-procedure and post-procedure nursing interventions for a biopsy?

A
  • ensure informed consent is signed
  • make sure sample is in a sterile cup and sent to the lab
  • keep a dressing on the site and monitor for bleeding and infection
49
Q

What are the specific post-procedure nursing intervention after a liver biopsy?

A

Lay on the right side for 2 hours to prevent bleeding.

50
Q

What is a 24-hour urine collection test?

A

It measures what is in the urine to see if there are problems with the kidneys or other organs.

51
Q

What are the pre-procedure nursing interventions for a 24-hour urine collection test?

A
  • check for diet or med restrictions
  • at start time, void and discard first sample
  • keep all urine on ice or refrigerated
  • put a sign up that says, “SAVE ALL URINE”
  • at end of time, have client void and keep that sample
52
Q

What is a TB skin test/Mantoux test/PPD?

A

A small amount of fluid is inserted into the skin to diagnose tuberculosis.

It is read 48-72 hours after administration.

53
Q

How is the TB skin test / Mantoux test / PPD diagnosed?

A

TB skin test: a red bump will be on the arm, if:

  • >15 mm of induration: positive with no risk factors
  • >10 mm of induration: positive with medium risk factors (clients that live in group homes)
  • >5 mm of induration: positive with high risk factors (HIV or drug user)
54
Q

What is a culture diagnostic test?

A

Detects and identifies bacteria that causes infections.

55
Q

When should a wound be cultured - before or after starting antibiotics?

A

Before starting antibiotics.

This is to know what bacteria is growing so that the appropriate antibiotic can be given.

56
Q

When should a sputum culture be collected?

A

In the morning.

Typically there is more mucus collected in the lungs overnight. The client should cough up the sputum (about 15 mL), not just spit into the cup.

57
Q

What is a UA & CS?

A

A urinalysis & culture and sensitivity test

  • Urinalysis: appearance, concentration, and content of the urine to diagnose kidney diseases
    • it includes several components
  • Culture and sensitivity:
    • culture to determine what bacteria is growing
    • sensitivity is the medication that will best treat the infection
58
Q

What are the pre-procedure nursing interventions for a UA & CS?

A
  • clean perineal area and use a sterile container for collection
  • collect a midstream sample (called a clean catch)
  • get 10-15 mL of first morning urine
  • if menstruating, note on the form
  • straight cath the client if they are unable to void
59
Q

Urinalysis:

What color should the urine color normally be?

What does it indicate when the urine is cloudy?

A
  • normal color: amber-yellow color
  • cloudy: infection
60
Q

Urinalysis:

What does a foul odor and sweet odor of urine indicate?

A
  • foul odor indicates infection
  • sweet odor indicates uncontrolled diabetes mellitus

Normal urine has an ammonia odor.

61
Q

Urinalysis:

What does it indicate when the urine is positive for proteins?

A

Renal disease or pre-eclampsia.

62
Q

Urinalysis:

What does it indicate when the urine specific gravity is high or low?

A
  • LOW: < 1.005 indicates that the urine is diluted and is in fluid volume overload
  • HIGH: > 1.030 indicates that the urine is concentrated and is in fluid volume deficit

Normal urine specific gravity: 1.005 - 1.030

63
Q

Urinalysis:

What does it indicate when the urine is positive for leukocyte esterase?

A

Urinary tract infection.

64
Q

Urinalysis:

What does it indicate when the urine is positive for nitrates?

A

Possible urinary tract infection.

65
Q

Urinalysis:

What does it indicate when the urine is positive for ketones?

A

Poorly controlled diabetes mellitus.

66
Q

Urinalysis:

What does it indicate when the urine is positive for bilirubin?

A

Possible liver disease.

67
Q

Urinalysis:

What does it indicate when the urine has crystals in it?

A

Kidney stones.

68
Q

Urinalysis:

What does it indicate when the urine is positive for glucose?

A
  • blood sugar is >180 mg/dL (10 mmol/L)
  • if pregnant: gestational diabetes
69
Q

Urinalysis:

What does it indicate when the urine is positive for white blood cells?

A

>5 indicates urinary tract infection

Vaginal discharge can falsely elevate.

70
Q

Urinalysis:

What does it indicate when the urine has WBC and RBC casts in it?

A

Renal disease.

71
Q

What does a bladder scanner measure?

A

It checks for how much urine is still in the bladder after urinating called post-void residual (PVR).

72
Q

What does a peak flow meter measure?

A

It estimates how much air is exhaled for those with asthma/COPD.

If it measures < 80% of personal best, give albuterol.

73
Q

What does a pulse oximeter measure?

A

Pulse and venous oxygen saturation.