W5 Diagnostic Testing 1.30.18 Student Diagnostic Testing Chapter 34 NUR 216 Professor Stefanie Haynes MSN, FNP-C Professor Sherry Rickan MSN, RN

Diagnostic Testing Chapter 34 NUR 216 Professor Stefanie Haynes MSN, FNP-C Professor Sherry Rickan MSN, RN Learning Objectives  Describe the nurses role for each of the phases involved in diagnostic testing  List common blood tests  Discuss the nursing responsibilities for specimen collection  Explain the rationale for the collection of each type of specimen  Describe how to collect and test stool specimens  Compare and contrast the different types of urine specimens  Describe how to collect sputum and throat specimens  Describe visualization procedures that may be used for the client with GI, urinary, and cardiopulmonary alterations Learning Objectives Continued  Compare and contrast CT, MRI, and nuclear imaging studies  Describe the nurses role in caring for clients undergoing aspiration/biopsy procedures  Verbalize the steps used in:  Obtaining a capillary blood specimen to measure blood glucose  Collecting a urine specimen for culture and sensitivity by clean catch  Recognize when it is appropriate to delegate diagnostic testing skills to unlicensed assistive personnel  Demonstrate appropriate documentation and reporting of diagnostic testing information Diagnostic Testing Phases Pretest, Intratest, Post-Test Pretest Client preparation is the major focus Assessment Data collection Collect all special equipment if needed Are medications to be held or given prior Fasting? How long is the test? Is a consent form required? Patient education Cultural, spiritual, psychological Female client Intratest Focuses on specimen collection and performing or assisting with certain diagnostic testing Uses standards precaution s and sterile technique as appropriate Nurse provides emotional and physical support while monitoring the client as needed (e.g. vital signs, pulse oximetry, ECG) Nurse ensures correct labeling, storage, and transportation of the specimen to avoid invalid test results Post-Test Focus is care of the client and follow up activities and observations Nurse compares previous and current test results and modifies nursing interventions as needed Nurse reports the results as appropriate to health care team National Patient Safety Goals identify the importance of reporting critical results and diagnostic procedures DOCUMENT, DOCUMENT, DOCUMENT! Who did you tell, when? And what? Nursing Diagnoses  Anxiety or Fear related to possible diagnosis of acute or chronic illness pending conclusion of diagnostic testing  Impaired Physical Mobility related to prescribed bedrest and restricted movement of involved extremity after testing  Deficient Knowledge (state diagnostic test) related to misperceptions received from others regarding process for test Which role would the nurse perform in the intratest phase? 1. Assess the data. 2. Collect the specimen. 3. Observe the client. 4. Prepare the client. What will the nurse do during the post-test phase of diagnostic testing for a client? Select all that apply: 1. Ensure a procedural consent was signed. 2. Compare the previous and current test results. 3. Prepare the client for the test. 4. Modify nursing interventions as necessary. 5. Report the results to appropriate health team members. Blood Tests Blood Tests Commonly used diagnostic tests that can provide valuable information about the hematologic system and many other body systems Venipuncture = puncture of a vein for collection of a blood specimen; may be performed by various members of the health care team Phlebotomist = a person from a laboratory who performs venipuncture, usually collects the blood specimen for the tests ordered by the primary care provider In some institutions, nurses may draw blood samples Nurses must know guidelines for drawing blood samples for the facility and also the states nurse practice act -and-Politics/np_ Process for Collecting Specimens  Pre-test:  ID pt  Inform pt/explain procedure  Allergies  Bleeding disorders, anticoagulant therapy, previous lab results, medication  Inform pt of how long it will take  Explain that there may be discomfort, apply topical analgesic prn  Intra-test:  Hand hygiene/ID pt  Standard precautions  Label tubes  Perform venipuncture  Invert spec  Remove needle, apply pressure, observe, secure  Transport specimen to lab in appropriate bag Complete Blood Count .....................................continued..................................................................