Diagnostic Tests: Invasive and Non-Invasive Procedures

• Diagnostic tests involve procedures used to identify diseases, measure physiological states, or assess organ function.
• These tests can be invasive or non-invasive, depending on whether they require physical entry into the body.

Invasive vs. Non-Invasive Diagnostic Tests

• Invasive tests involve instrumentation to physically enter the body.
• Non-invasive tests do not break the skin or involve contact with the mucosa or internal body cavity beyond natural orifices.

Invasive Procedures

• Bronchoscopy involves inserting a thin tube (bronchoscope) into the lungs and air passages for direct visualization, often performed by a pulmonologist.
• Abdominal Contrast Enhanced Ultrasound (CEUS) is an abdominal ultrasound using gas-filled microbubbles to visualize organs and blood vessels.
• CEUS requires little preparation, but the patient may need to avoid eating or drinking beforehand.
• Endoscopy is a diagnostic procedure that assesses the interior surfaces of an organ by inserting a tube into the body
• Endoscopic procedures are considered painless with proper patient education to reduce anxiety.
• Blood tests involve laboratory analysis performed on a blood sample to determine physiological or biochemical states.
• Blood tests can determine diseases, mineral content, drug effectiveness, and organ function
• Typical blood panels include basic metabolic panel or complete blood count and can also detect drug abuse.

Non-Invasive Radiology Procedures

• X-rays are common imaging tests used to view the inside of the body, used to examine areas of pain or discomfort and monitor disease progression.
• Eye examinations involve various tests to assess vision, focus, and identify abnormalities.
• CT scans combine X-ray images from different angles to create cross-sectional images of the body, provide more detailed information than plain X-rays.
• CT scans can be used in patients with implanted metal of who are claustrophobic.
• MRI scans use strong magnetic fields and radio waves to produce detailed images of the inside of the body
• MRI scans cannot be used on patients with implanted metal or who are claustrophobic

Sputum Collection

• Sputum is mucous secretion from the lungs and is different from saliva
• Sputum collection may be indicated for culture and sensitivity tests or cytology to identify cancer cells.

Complete Blood Count (CBC) and Blood Values

• A CBC evaluates overall health and detects disorders like anemia, infection, and leukemia.
• Reviewing overall health, diagnosing or monitoring a medical condition, and monitoring treatment are all indications for performing a CBC.
• Normal RBC values:
  • Male: 4.5-5.3 million/mm3
  • Female: 4.1-5.1 million/mm3
• Hemoglobin values:
  • Male: 13.8-18 g/dl
  • Female: 12-16 g/dl
• Hematocrit values:
  • Male: 37-49%
  • Female: 36-46%
• Mean Corpuscular Volume (MCV) indicates average RBC size
• Mean Corpuscular Hemoglobin (MCH) measures the amount of hemoglobin in one cell (25-35 pg).
• Mean Corpuscular Hemoglobin Concentration (MCHC) measures the concentration of hemoglobin in a volume of packed blood (31-37%).
• White Blood Cell Count (WBC): 4,500-11,000/mm3
• Platelet Count: 150,000-350,000/mm3

Tests for Glucose

• Tests for glucose are indicated to determine glucose levels in clients at risk for hyperglycemia or hypoglycemia.
• Tests for glucose can promote blood glucose regulation and evaluate insulin administration effectiveness.
• A Fasting Blood Sugar test requires a blood sample after an overnight fast (8 hours).
• An Oral Glucose Tolerance Test includes a fasting blood sugar measurement, followed by consumption of a sugary liquid, with blood sugar levels tested for the next two hours.
• A Glycosylated Hemoglobin (A1C) Test indicates average blood sugar level for the past 2-3 months and doesn't require fasting.
• Normal HbA1c: < 5.75%

Lipid Profile & Other Tests

• A lipid profile measures cholesterol and other fats in blood including total cholesterol, LDL, HDL and triglycerides.
• Normal Cholesterol: 150-200 mg/dl.
• A Serum Creatinine Test assesses creatinine levels to show signs of kidney disease.
• A Serum Albumin Test assesses liver and kidney function (Normal: 3.4- 5.4 g/dl).
• A Blood Uric Acid tests diagnoses gout and kidney stones.

Serum Proteins and Transferrin

• Serum Proteins estimate visceral protein stores, include hemoglobin, albumin, transferrin, and total iron-binding capacity.
• Transferrin binds and carries iron from the intestine.
• Normal transferrin range: 170 to 370 mg/dl.

Antigen Skin Testing

• Antigen Skin Testing is diagnostic tests used to diagnose infection.

Bone Mineral Density Scan

• A Bone Mineral Density Scan is a special X-ray that measures bone mineral density (BMD)
• Scan provides information about bone strength and fracture risk

Sources of Patient Data

• Charts include data source lists, consent forms, and progress notes

The Nursing Process in Data Collection

• Nurses need to conduct consistent observations for clients by understanding the importance of intake and output

Validating Patient Data

• Validation confirms that data that has been collected is both reliable and accurate
• Validation ensures the nurses' judgements are made with reliable data

Methods of Data Validation

• Recheck data collection
• Clarify data with an additional questions
• Verify the subjective data with objective data
• Compare objective data with previous subjective data

Documenting Assessment data

• Promotes effective communication between health professionals

• Accurate documentation help identify health problems, form nursing diagnoses and interventions.

• Subjective data consists of:

  • Biographical history
  • Present of Health concerns
  • Health history
  • Family History
  • Health practices

• Objective data is information from the Physical Exam including inspection, palpation, percussion and auscultation.

Assessment Forms

• Initial Assessment forms is called nursing admission or admission database
• Frequent or Ongoing Assesment forms track client progress
• Verbal communication to relay client information between staff