Diagnostic Tests: Bronchoscopy & CEUS

Invasive vs. Non-Invasive Diagnostic Tests

• Invasive diagnostic tests involve physical entry into the body using instruments.
• Non-invasive diagnostic tests do not involve physical entry.
• Examples of invasive tests include blood sampling and biopsies.

Bronchoscopy

• Bronchoscopy enables doctors to view the lungs and air passages.
• Typically performed by a pulmonologist.
• Involves inserting a thin tube ("bronchoscope") through the nose or mouth, down the throat, and into the lungs.
• Flexible bronchoscopes are commonly used, but rigid bronchoscopes may be necessary in certain situations.

Abdominal Contrast Enhanced Ultrasound (CEUS)

• CEUS enhances visualization of organs and blood vessels within the abdomen and pelvis using gas-filled microbubbles.
• Organs visualized include the liver, spleen, kidneys, pancreas, and bowel.
• CEUS requires minimal preparation, potentially including fasting.
• Patients should wear loose, comfortable clothing for examination

Blood Test

• Blood tests are laboratory analyses performed on blood samples, typically extracted from a vein in the arm or via fingerprick.
• Multiple tests can be conducted on blood samples to assess specific blood components.
• Tests include blood glucose and cholesterol tests, often grouped into a Blood Panel or Blood Work.
• Blood tests help determine physiological or biochemical states, such as diseases, mineral content, drug effectiveness, and organ function.
• Typical clinical blood panels include a basic metabolic panel or complete blood count.
• Blood tests can be used to detect drug abuse.

Endoscopy

• Endoscopy is a minimally invasive diagnostic procedure.
• A tube is inserted into the body to assess the interior surfaces of an organ.
• Endoscopic procedures are generally considered relatively painless.
• Educating clients can reduce anxiety and associated pain sensation.

Non-Invasive Tests

• Non-invasive tests do not involve breaks in the skin or contact with mucosa, skin breaks, or internal body cavities beyond natural or artificial body orifices.

Ultrasound (Sonography)

• Ultrasound imaging uses sound waves to produce images of the body's interior.
• Used to diagnose pain, swelling, and infection in internal organs, as well as examine babies in pregnant women and brains and hips in infants.

X-Ray

• X-rays help doctors view inside the body without incisions.
• Used to examine areas with pain or discomfort to locate conditions.
• Monitor progression of diseases like osteoporosis, common in elderly clients (60+).

Eye Examination

• Series of tests assessing vision, focusing ability, and other eye-related aspects.
• Conducted by ophthalmologists, optometrists, or opticians.
• Special equipment checks pupil, iris, and other eye parts for abnormalities.

CT Scan

• Combines X-ray images from various angles to create cross-sectional images (slices).
• Provides detailed information about bones, blood vessels, and soft tissues.
• Suitable for patients with implanted metal, unlike MRI.
• Can be alternative to MRI for claustrophobic patients.

MRI

• Magnetic Resonance Imaging uses strong magnetic fields and radio waves to produce detailed internal body images.
• No implanted metal because it will interfere with the procedure.
• MRI scans can examine nearly any body part, including the brain, spinal cord, bones, joints, breasts, heart, blood vessels, and internal organs.
• Not appropriate for patients with claustrophobia.

Sputum Collection

• Sputum is mucous secretion from the lungs, bronchi, and trachea.
• Is distinct from saliva, which comes from gastric juices.
• Culture and sensitivity and cytology can be performed on sputum samples.
• Cytology can identify cancer cells and their type in the lung.

Nursing Responsibilities for Samples

• Ensure appropriate sample collection.
• Precisely identify the sample.
• Verify suitability of all selected supplies.
• Transfer the specimen to the lab promptly.
• Interact with the patient.
• Label the collected specimen.
• Note down the: patients full name, medical record number, specific area of the patient
• Indicate the patients age and date/time the Sputum was collected

Complete Blood Count (CBC)

• Common blood test
• Used to evaluate overall health.
• Used to detect disorders like anemia, infection, and leukemia.

CBC: Indications

• Used to review overall physical health
• Used to diagnose medical conditions
• Used to monitor medical conditions
• Used to monitor medicatl treatments.

Red Blood Cell (RBC) Count: Normal Values

• Used in the evaluation of male patients
• 4.5-5.3 million/mm3

Complete Blood Count: Hemoglobin

• Helps determine and measure oxygen that is bound in our blood cells
• Male: 13.8-18 g/dl
• Female: 12-16 g/dl

Hematocrit Value

• Measurement of how much of blood is made up of RBC
• Male 37-49%
• Female 36-46%

MCV

• Measurement about avg size of an RBC
• Helps find problems or conditions
• Macrocytic blood cells (Larger in size)
• Microcytic blood cells (Lower in size)
• M: 78-100 um³ (cubic micrometer)
• F: 78-102 um³ (cubic micrometer)

MCH

• Amount of Hemoglobin that is present in one RBC
• Helps in identifying whether there could be problems in the body/blood
• 25-35 pg (picograms)

MCHC

• Concentration that is being measured in hemoglobin of RBC
• Packed blood
• 31-37%

WBC

• Evaluation of amount of WBC found per volume of blood
• 4,500-11,000/mm3

Differential Count

• Used to evaluate various amounts of WBC types
• Neutrophils- 55-70%
• Lymphocytes- 20-40%
• Monocytes- 2-8%
• Eosinophils- 1-4%
• Basophils- 0-2%

Platelet Count

• Normal Value of 150,000-350,000/mm3 Used as Test for Glucose.
• Helps to detect glucose levels
• Used to determine current or monitor past levels

Managing Blood sugar

• Used in determining the level of blood sugar within client
• Used in regulation and management
• effectiveness of drugs and Insulin testing

Assessment Steps

• Before testing determine steps.
• Check patients past charts and history
• Analyze skin

Complete Blood Count: Fasting Blood Sugar

• Done After a fast of 8 hours

Oral Glucose Tolerance Test

• Can evaluate a patients history for the past 2 hrs
• Measure and record blood sugar levels

Glycosylated Hemoglobin (A1c) Test

• Done when an individual fails blood sugar level tests
• Doesnt require fast
• Indicated the average sugar that is found
• Helps in oxygen transfer

Hba1c Testing

• Used when average blood sugar levels over last 2 to 3 months need measuring
• Everyone with diabetes must have this test
• Usually is done every 3 to 6 months -Healthcare professional must do this and test for the finger prick test/
• This test is mainly used for people living with diabetes

Normal Values

• 79-160 mg/dl (4.4-8.9 mmol/l)
• Pre-diabetes-160–200 mg/dl (8.9-11.1 mmol/l)
• Diabetes- > 200 mg/dl

Fasting Blood Sugar Normals

• Normal- <100 mg/dL (5.6 mmol/L).
• Prediabetes- 100 to 125 mg/dL (5.6 to 6.8 mmol/L).
• Diabetes - >126 mg/dL (7 mmol/L) or higher on two separate tests.

Normal Oral Glucose Test reading

• • Diabetes- >200 mg/dL (11.1 mmol/L) after two hours.

Normal: Hba1c

• Normal- < 5.75%
• Prediabetes- 5.7 and 6.4%
• Diabetes-> 6.5% on two separate tests

Normal Values, Lipids And Preparations

• Cholesterol
  • Not Safe to eat or drink for NPO-12Hours
• Hdl
  • Male: 35-65 mg/dl
  • Female: 35-80 mg/dl LDL:
  • <130 mg/dl Normal Creatine

Creatine test

• Help identify creatine levels
• Help see signs of disease

Certain Drugs that may cause harm to the Creatine Test

• Cimetidine – drugs for gastric ulcers, or Gastroesophageal reflux disease [GERD].
• Aspirin and Ibuprofen – Pain medications

Serum Albumin Test

• Indications of what is to occur -Insulin, and growth hormones will get tested
  • Normal-3.4- 5.4 g/dl

Blood Uric Acid Test

• Used when purine is breaking.

Blood Uric Acid Indications

• • To diagnose gout and kidney stones.
• High Sources - Meat and Poultry - Seafood - Baked foods - Alcoholic drinks - High-fat diet - Certain vegetables

Factors that may influence tests

• Alcohol • Aspirin and ibuprofen . High levels of vitamin C-Dyes used in X-ray tests *NPO (Nothing by mouth): 4 hrs F: 2.5 to 7.5 mg/dL
• M: 4.0 to 8.5 mg/dL

BUN TEST

• Liver breaks down into the Kidneys
• The test help determine whether the Creatinine level is not to high

Normal BUN Values- 7 to 20 milligrams a deciliter

Transferrin level test

• Liver is affected Test must be done and this test to determine whether patient has health issues if blood test shows they have A Anemia

Testing levels for Proteins

• Below: May mean deficiency in the clients level Normal range:- 170 to 370 mg/dl.-
• High is linked to iron deficiency
• Low is linked to liver problems

Tests

Testing the person skins on level to diagnosis of infection

• Candin (Cellular disease or infection)
• Skin testing
• TB testing requires skin samples
• Test must be read after a set amount of hours.

Bone Mineral Density Scan

• Can determine amount for radiation the client is experiencing
• Higher levels is what may effect client
• Test for fractures
• May be recent test or minor

Test

• Non Harmful
• No harmful chemicals

Guidelines

• Must remove all metal

Nursing Notes

• The best way a the health assistant has to test and keep in knowledge of the clients problems