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Diagnostic Tests

Tests, Purposes, Pre-ops, Post-ops

Phlebography Lack of filling of a vein is indicative of venous occlusion due to a thrombus
Phlebography Pre-ops/Testing Thrombi are identified as radiolucent areas in opaque-filled veins
Angiography(arteriography) indicates abnormalities of blood flow due to arterial obstruction or narrowing
Angiography Pre-ops/Testing Contrast dye is injected into the arteries and x-ray films are taken of the vascular tree
Angiography Post-op Care Disadvantages include potential allergic reactions to dye, potential irritation,or thrombosis of the injection site
*Pulmonary Function Test Detects impaired pulmonary function (follows the course of a dx and evaluates treatment repsonses)
*Pulmonary Function Pre-op/Testing Explain purpose; no smoking 4hrs before;may withhold bonchodilator meds;asked to breathe into machine
*Pulmonary Function Post-Op observe for dyspnea
*Bronchoscopy Allows visualization of larynx, trachea, and mainstem bronchi; (possible to obtain tissue biopsy, apply meds, aspirate secretions for lab exams, aspirate a mucus plug causing airway obstruction, or remove aspirated foreign objects
*Bronchoscopy Pre-op/testing explain procedure; maintain NPO 6hrs before test; ispect mouthfor infection; administer premedication-Valium,versed,demerol,atropine;remove dentures;prepare client for sore throat after procedure
*Bronchoscopy post-op sit or lie on side, remain NPO until gag reflex returns; Observe for respiratory difficulties
*Bronchoscopy complications hypotension, tachycardia, dysrhythmias, hemoptosis, dyspnea, hypoxia
*Thoracentesis aspiration of fluid or air from pleural space; to obtain specimen for analysis, relieve lung compression, obtain lung tissue for biopsy, or instill meds in pleural space
*Thoracentesis pre-op explain procedure; take vitals; shave area around needle insertion site; position pt sitting w/ arms on pillows on over-bed table or lying on side in bed
*Thoracentesis testing expect stinging sensation w/ injection of local anesthetic and feeling of pressure from needle; NO MORE than 1,000ml fluid removed at one time
*Thoracentesis Post-op auscultate BS and monitor vs frequently; check for leakage of fluid from site and pt tolerance; sterile dressing applied
Lung Biopsy Removal of lung tissue for culture or cytology
Lung Biopsy Pre-op/testing administer pre-meds (sedatives/analgesics); have pt hold breath midexpiration; preformed w/ fluoroscopic monitoring; position pt like in thoracentesis
Lung biopsy post-op monitor vs and bs q4hrs for 24hrs; chest x-ray taken after procedure for complications (pneumothorax or pul hemorrage); sterile dressing applied
Magnetic Resonance Imaging (MRI) provides detailed pictures of body structures
MRI pre-op/testing asses pt for claustrophobia; remove all metal jewelry & metal objects; ask pt if has metal implants on body (pacemaker,clips)
*Respiratory/cardiac Angiography evaluates specific areas of the arterial system
*R/C Angiography pre-op/testing remove all jewelry; pt may experience nausea, flushing, warmth, salty taste w/ injection of dye
*R/C angiography post-op assess for hematoma, distal pulses, skin temp, color, sensation in xtremeties; check vitals often
*R/C Angiography complications Vessel injury, bleeding, allergic reaction to dye, cva/stroke
*Cardiac Catheterization (usually used with angiography) introduction of catheter into chambers of heart to evaluate ventricular function and obtain chamber pressures
*Cardiac Cahteterization pre-op/testing NPO 8-12hrs; signed consent; empty bladder; check pulse; explain pt may feel heat, palpitations, desire to cough when dye injected`
*Cardiac Catheterization post-op monitor vs q15min for 2hrs, then q30min for 1hr, then q1hr for 3 hrs; check pulses, sensation, bleeding at insertion site q30min for 3 hrs; bed rest 6-8hrs with extremity with site straight
Cerebral Angiography Identifies aneurysms, vascular malformations, narrowed vessels
Cerebral Angiography pre-op/testing preprocedure sedation; skin prep and shaved site; mark peripheral pulses; pt lie flat; dye injected into femoral artery by needle/catheter; fluoroscopy and readiologic films taken after injection; may feel warmth or metallic taste with dye
Cerebral Angiography post-op neuro assessment q15-30 min until vs are stable; keep flat in bed 12-14hrs; check puncture site qhr; immobolize site for 6-8hrs; assess cms and temp of extremities; force fluids (good i&o's)
*Lumbar Puncture (LP) insertion of needle into subarachnoid space to obtain specimen, relieve pressure, inject dye or medications
*LP pre-op/testing informed consent; positioned in lateral recumbent fetal position at edge of bed
*LP post-op neuro assessments q15-30min until stable; position flat for 2-3hrs; encourage po fluids; oral analgesics for HA; observe sterile dressing at site for bleeding or drainage
Electroencephalogram (EEG) records electrical activity of brain (observes for seizure potential)
EEG pre-op/testing done in a quiet room; painless; tranqs and stimulants (indluding caffeine,cola,tea,&cigarettes) withheld for 24-48hrs prior; may be asked to hyperventilate 3-4 min and watch bright flashing lights; kept awake night before test
EEG post-op help client remove paste from hair; administer prescribed meds withheld before; observe for seizure in seizure-prone pts`
*Myelogram (x-ray) visulizes spinal column and subarachnoid space
*Myelogram pre-op/testing NPO for 4-6hrs before test; obtain allergy hx; phenothiazines,cns depressants, and stimulants withheld for 48hrs prior to test; table will be moved to various positions during test
*Myelogram post-op neuro assessment q2-4hrs; when metriazmide h2o-soluble dye used, head should be raised 30-45degrees for 3hrs; oral analgesics for HA; encourage PO fluids; assess for distended bladder; inispect injection site
*Myelogram Complications HA, fever, stiff neck, photophobia
*Liver Biopsy samplying of tissue by needle aspiration
*Liver Biopsy Pre-op/Testing administer vit k IM to decrease chance of hemorrhage; NPO am of exam-6hrs; sedative admin just before exam;teach client that he will be asked to hold his breath for 5-10seconds; supine position,lateral with upper arms elevated
*Liver Biopsy post-op position on right side for 2-3hrs with pillow under costal margin(to apply pressure); vs often; check clotting time, platelets hematocrit; expect mild local pain and mild pain radiating to right shoulder; avoid heavy lifting for 1wk
*Liver Biopsy Complications hemorrage, shock, report complaints of severe abd. pain immediately- may indicate perforation of bile duct and peritonitis
*Stomach/Esophagus Endoscopy Visualizing esophagus &/or stomach by means of a lighted flexible fiberoptic tube; used to find potential ulcerations, tumors, or to obtain tissue or fluid samples
*Stomach/Esophagus Endoscopy pre-op/testing maintain NPO at least 8 hrs before; teach pt about numbness in throat due to local anesthetic by spray or gargle
*Stomach/Esophagus Endoscopy post-op maintain NPO until gag reflex returns; inform pt to expect sore throat for 3-4 days after
*Stomach/Esophagus Endoscopy Complications vomiting of blood; respiratory distress
*Sigmoidoscopy/Proctoscopy visual of the sigmoid colon, rectum, and anal canal
*Sigmoidoscopy/Proctoscopy pre-op/testing laxative night before exam and enema or suppository morning of procedure; NPO at midnight
*Sigmoidoscopy/Proctoscopy Post-op Allow client to rest; encourage fluids (2000-3000ml)
*Sigmoidoscopy/Proctoscopy Complications Hemorrhage from perforation
*Colonscopy (contraindicated for pts on anticoagulant therapy) visualization of the colon; used as a diagnostic aid, removes foreign bodies, polyps, or tissue for biopsy
*Colonscopy pre-op/testing clear liquid diet 24-72hrs before; cathartic in evening for 2 days prior; enema on am of exam; golytely lavage solution to cleanse bowel; clear liquid diet noon day before
*Colonscopy post-op allow to rest; must pass flatus before leaving; follow up x-rays; resume regular diet
*Colonscopy complications passage of blood and abdominal pain, signs of perforation, hemorrhage, or respiratory distress
Gastric Aspirate aspiration of gastric contents to evaluate for presence of abnormal constituents such as blood, abnormal bacteria, abnormal pH, or malignant cells
Gastric Aspirate pre-op/testing NPO 8-12 hrs before test; NG tube used to aspirate stomach (normal gastric pH<4) content and sent for evaluation
Gastric Aspirate post-op encourage fluids
Upper GI series Barium Swallow ingestion of barium sulfate to determine patency and size of esophagus, size and condition of gastric walls, patency of pyloric valve, and rate of passage to small bowel
Upper GI series Barium Swallow pre-op/testing maintain NPO after midnight; inform pt that stool will be light-colored after procedure
Upper GI series Barium Swallow post-op encourage fluids; laxatives to prevent constipation; stool will be white from barium
Lower GI series Barium Enema Instillation of barium (radiopaque substance) into colon via rectum for x-rays to view for tumors, polyps, strictures, upcerations, inflammation, or obstructions of colon
Lower GI series Barium Enema pre-op/testing low-residue diet for 1-2 days; clear liquid diet and laxative evening before test; cleansing enemas until clear morning of test
Lower GI series Barium Enema post-op cleansing enema after exam to remove barium and prevent impaction; x-rays may be repeated after barium is expelled
Paracentesis needle aspiration of fluid in abdominal cavity used for diagnostic exam of ASCITIC fluid and tx of massive ASCITES resistant to other therapy
Paracentesis pre-op/testing pt in SEMI-FLOWERS position or sitting upright on edge of bed; empty bladder prior to procedure to avoid accidental perforation
Paracentesis post-op check vs frequently for shock and/or infection; report elevated temp &/or abdominal pain to physician; observe for s/sx of hypovolemic shock
Culdoscopy visualization of ovaries, fallopian tubes, uterus, via lighted tube inserted into vagina
Culdoscopy pre-op/testing local anesthetic and/or light sedation; knee-chest position during
Culdoscopy post-op position on abdomen after; avoid douching and intercourse for 2 wks; observe for vaginal bleeding
*Laparoscopy visualizing of pelvic cavity through and incision beneath the umbilicus to view structures
*Laparoscopy pre-op/testing CO2 introduced to enhance visual; general anesthesia; foley cath inserted for bladder decompression
*Laparoscopy post-op out of bed after procedure; reg diet
*Cytoscopy direct visualization by cystoscope of bladder and urethra
*Cytoscopy pre-op/testing bowel prep; force fluids; teach pt to deep-breathe to decrease discomfort; NPO
*Cytoscopy post-op monitor character and volume of urine; check for abd distention, urinary frequency, fever; urine usually pink-tinged; adb or pelvic pain indicates trauma; provide antimicrobial prophylaxis
cystourethrogram x-ray study of bladder and urethra
cystourethrogram pre-op/testing explain procedure to pt: catheter inserted into urethra, radiopaque dye injected, pt voids, x-rays taken during void
cystourethrogram post-op advise client to report any sx
*Intravenous Pyelogram provides x-ray visualization of kidneys, ureters, and bladder
*Intravenous Pyelogram pre-op/testing bowel prep; NPO after midnight; check allergies to shellfish or iodine, chocolate, eggs, milk; burning or complaints of salty taste may occur during injection of dye
*Intravenous Pyelogram post-op postprocedure x-rays usually done
*Intravenous Pyelogram Complications pt should be alert to signs of dye reaction: edema, itching, wheezing, dyspnea (medical er)
*Kidney Biopsy kidney tissue obtained by needle aspiration for pathological evaluation
*Kidney Biopsy pre-op/testing NPO 6-8hrs; x-ray taken prior to procedure; skin is marked indicate lower pole of kidney(fewer blood vessels); position: prone and bent at diaphragm, pt instructed to hold breath during needle insertion
*Kidney Biopsy post-op pressure applied to site for 20min; prone position; pressure dressing applied; check vs q15-30min for 1hr; client kept flat in bed; bedrest for 6-8hrs; intake 3,000/day
*Kidney Biopsy complications Obersve for hematuria and site bleeding
*Schilling test Diagnoses vitamin B12 deficiency (pernicious anemia)
*Schilling test pre-op/testing Radioactive vitamin B12 is administered to the pt; then a few hrs later give a nonradioactive B12; low vale excreted in urine indicated pernicious anemia (normal is >10% of dose excreted in 24 hrs)
*Schilling test post-op Vitamin B12 (cyancobalamin injection for life)
*Arterial Blood Gases (ABG's); need to know - how to obtain a specimen? 1st check allen test-checks collateral circulation; arterial blood is OBTAINED IN A HEPARINIZED SYRINGE ater venipuncture
*ABG post-op apply pressure to site for 5 min to prevent hematoma (15min if pt is receiving anticoagulants); send specimen on ice and occlude needle to avoid air; note on lab slip if pt is room air or on O2
*ABG complications check arm for swellling, discoloration, pain, numbness, tingling
Created by: akstyle