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Questions and Answers
Which drug is recommended to be withheld prior to a barium swallow test to improve image clarity?
Which drug is recommended to be withheld prior to a barium swallow test to improve image clarity?
What is the primary purpose of a barium swallow test?
What is the primary purpose of a barium swallow test?
Why should antidiarrheal medications be withheld before the barium swallow test?
Why should antidiarrheal medications be withheld before the barium swallow test?
What is one of the primary purposes of the Enzyme-Linked Immunosorbent Assay (ELISA)?
What is one of the primary purposes of the Enzyme-Linked Immunosorbent Assay (ELISA)?
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Which condition is NOT diagnosed using a barium swallow test?
Which condition is NOT diagnosed using a barium swallow test?
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What effect do anticholinergic drugs have on the barium swallow test results?
What effect do anticholinergic drugs have on the barium swallow test results?
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Which condition is ELISA commonly used to identify antibodies associated with?
Which condition is ELISA commonly used to identify antibodies associated with?
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Which hormone is measured using an ELISA in a clinical setting?
Which hormone is measured using an ELISA in a clinical setting?
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Laxatives are sometimes withheld after bowel prep for which reason?
Laxatives are sometimes withheld after bowel prep for which reason?
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What is the role of the barium solution in a barium swallow test?
What is the role of the barium solution in a barium swallow test?
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Which of the following statements about ELISA is true?
Which of the following statements about ELISA is true?
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What type of infections can ELISA help to identify antibodies for?
What type of infections can ELISA help to identify antibodies for?
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Which of the following symptoms would likely lead a physician to request a barium swallow test?
Which of the following symptoms would likely lead a physician to request a barium swallow test?
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What role does ELISA play in blood safety?
What role does ELISA play in blood safety?
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In what context is ELISA used for monitoring disease outbreaks?
In what context is ELISA used for monitoring disease outbreaks?
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Which substance is notably measured by ELISA to assess the presence of cancer?
Which substance is notably measured by ELISA to assess the presence of cancer?
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What is the primary purpose of cholangiography?
What is the primary purpose of cholangiography?
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Which condition can cholangiography help diagnose?
Which condition can cholangiography help diagnose?
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What might antacids do prior to a cholangiography test?
What might antacids do prior to a cholangiography test?
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Which of the following cholangiography methods is NOT mentioned in the content?
Which of the following cholangiography methods is NOT mentioned in the content?
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A common symptom that cholangiography can help assess is:
A common symptom that cholangiography can help assess is:
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What is the normal diameter range for the common bile duct?
What is the normal diameter range for the common bile duct?
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Which of these drugs should be withheld prior to cholangiography to ensure accurate results?
Which of these drugs should be withheld prior to cholangiography to ensure accurate results?
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Cholangiography can aid in which of the following therapeutic interventions?
Cholangiography can aid in which of the following therapeutic interventions?
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Study Notes
Case Sharing - Adventist Medical Center College
- Presented to the faculty of the School of Nursing Adventist Medical Center College, Brgy. San Miguel, Iligan City
- In Partial Fulfillment of Care of Clients with problems in Oxygenation, Fluid and Electrolytes, Infectious, Inflammatory and Immunologic Response, Cellular Aberrations, Acute and Chronic.
- Submitted by: De La Cruz, Jon Rusty; Gutierrez, Cherry Mae; Ibrahim, Al-fhaiz; Jabutay, Mariah Cecille May; Latuhan, Uziel; Masbod, Sittie Hafsah; Ollodo, Jhanna Mae; Pagente, Lyrah Faith
- Submitted to: Shella G Dello, RN, MAN; Raymond M. Salvador, RN, MN
- Date: October 21, 2024
Table of Contents (Page 2)
- Objectives
- Introduction
- Serum Glutamic Pyruvic Transaminase / Alanine Aminotransferase
- Serum Glutamic Oxaloacetic Transaminase / Aspartate Aminotransferase
- Arthroscopy
- Antinuclear Antibodies
- Western Blot
- Bilirubin Test (Direct, Indirect, Total)
- Enzyme-Linked Immunosorbent Assay (ELISA)
- Atrial Natriuretic Peptide (ANP)
- Barium Enema / Lower GI Series
- Barium Swallow / Upper GI Series
- Cholangiography
- Cystoscopy
- Electroencephalogram (EEG)
- Electromyography (EMG)
- Bone Scan
- Radioallergosorbent Test (RAST)
- Single-Photon Emission Computed Tomography (SPECT)
- Venereal Disease Research Laboratory (VDRL)
Objectives (Page 3)
- General Objectives: Present a comprehensive, concise discussion of 20 diagnostic tests in 4 hours.
- Specific Objectives (Presenters): Explain definitions and purposes of diagnostic tests, describe normal and abnormal findings with examples/case studies, outline nursing responsibilities before, during, and after tests, and identify interfering factors with strategies to minimize impact.
- Specific Objectives (Learners): Understand definitions & indications of tests in clinical settings, recognize differences between normal vs abnormal findings with implications, apply knowledge of nursing responsibilities for optimal outcomes, identify interfering factors to test results and determine how to address them in practice.
Introduction (Page 4)
- Diagnostic tests are crucial for evaluating, diagnosing, and managing various health conditions.
- They provide objective data to complement clinical assessments.
- Diagnostic tests support accurate diagnoses and effective treatment.
- Key roles of healthcare professionals in diagnostic testing include patient preparation, guidelines adherence, and post-test support.
Serum Glutamic Pyruvic Transaminase/Alanine Aminotransferase (Page 6)
- Introduction: SGPT/ALT (also known as ALT) is an enzyme primarily found in the liver.
- Purpose/Indication: Detecting liver injury, diagnosing liver diseases, monitoring liver conditions (like hepatitis, cirrhosis, fatty liver), and assessing liver response to medications.
- Normal Values: 29-33 IU/L (males); 19-25 UI/L (females)
- Abnormal Findings: Elevated levels indicate hepatitis, alcoholic/autoimmune hepatitis, chronic liver damage & non-alcoholic fatty liver disease (NAFLD).
Nursing Responsibilities (Page 7)
- Before: Informing patients about the test, confirming fasting requirements, reviewing medications,
- During: Assisting with venipuncture, ensuring proper sample collection, labeling and transport
- After: Monitoring the venipuncture site, informing patients of the results timelines and reinforcing follow-up test needs if necessary
- Interfering Factors (Page 7): Recent strenuous activity, blood sample hemolysis, medications (like statins and antibiotics).
Drugs Withhold Prior To The Test (Page 8)
- Statins: Can cause mild to moderate increases in liver enzymes due to hepatic metabolism.
- Acetaminophen: High doses can lead to acute liver failure due to its toxic metabolite.
- Antibiotics: Certain types can be hepatotoxic especially with long-term usage.
Serum Glutamic Oxaloacetic Transaminase/Aspartate Aminotransferase (Page 9)
- Introduction: SGOT/AST is an enzyme found in the liver, heart, muscles, etc.
- Purpose/Indication: Assessing liver function, detecting liver damage, monitoring liver disease progression, and for evaluating heart/muscle damage
- Normal Values: 8-33 U/L
- Abnormal Findings: Elevated levels indicate liver diseases (hepatitis, cirrhosis), heart damage (MI), or muscle injuries.
Arthroscopy (Page 11)
- Introduction: Minimally invasive surgical procedure using a fiber-optic camera.
- Purpose/Indication: Diagnosing and treating joint problems with minimized damage to optimize recovery.
- Normal Values Healthy cartilage, smooth, intact surfaces with no wear or tears. Firm and intact ligaments without stretching or tears. Clear synovium: the lining of the joint should not be inflamed or thickened.
- Abnormal Findings: Cartilage damage ranging from small defects to extensive degeneration, or ligament tears (ACL/Meniscus). Synovitis: Inflammation of the synovial membrane, which can cause joint swelling and pain.
Bilirubin Test (Direct, Indirect, Total) (Page 24)
- Introduction: Bilirubin is a yellowish pigment produced during hemoglobin breakdown.
- Purpose/Indication: Evaluating liver function, diagnosing liver/gallbladder disease, monitoring existing liver conditions, and assessing red blood cell breakdown disorders (like hemolytic anemia).
- Normal Values (Adults) Total bilirubin: 0.3-1.0 mg/dL; Indirect bilirubin: 0.2-0.8 mg/dL; Direct bilirubin: 0.1-0.3 mg/dL; (Newborns) Total bilirubin: 1.0-12.0 mg/dL
- Abnormal Findings: Elevated total bilirubin levels suggest liver/bile duct problems or hemolytic anemia. High direct bilirubin indicates bile duct blockage; high indirect bilirubin highlights rapid red blood cell breakdown (like hemolytic anemia or Gilbert syndrome).
Enzyme-Linked Immunosorbent Assay (ELISA) (Page 29)
- Introduction: A widely used lab technique for detecting/quantifying proteins, antibodies, or antigens in biological samples.
- Purpose/Indication: Detecting antibodies for various infections, autoantibodies for autoimmune conditions, measuring hormone levels (follicle-stimulating hormone, testosterone), and monitoring disease outbreaks (e.g. chlamydia, influenza)
- Application: Diagnosing/monitoring viral/bacterial/fungal infections, autoimmune diseases, disease outbreaks, verifying blood safety (HIV), and substance abuse.
Atrial Natriuretic Peptide (ANP) (Page 38)
- Introduction: Hormone produced by the heart's atria in response to increased blood volume/pressure.
- Purpose/Indication: Regulating blood pressure and fluid balance, inhibiting the release of renin/aldosterone (hormones for water retention). Identifying conditions like heart failure.
- Normal Values: 20-77 pg/mL
- Abnormal Findings: Elevated levels suggest heart failure, hypertension, or fluid overload.
Barium Enema/Lower GI Series (Page 41)
- Introduction: A radiologic procedure visualizing the large intestine.
- Purpose/Indication: Diagnosing unexplained GI symptoms (abdominal pain, rectal bleeding), screening for colorectal cancer, and assessing inflammatory bowel disease (IBD).
- Normal: Smooth colon contours without abnormalities
- Abnormal: Areas indicating tumors, polyps, inflammation, narrowing, or obstructions.
Barium Swallow/Upper GI Series (Page 46)
- Introduction: An imaging test evaluating the upper GI tract — including the mouth, esophagus, stomach, and duodenum.
- Purpose/Indication: Diagnosing swallowing difficulties, esophageal disorders, structural issues (like diverticula, polyps), hiatal hernia, GERD, and ulcers.
- Normal: Smooth passage of barium through the upper GI organs. No reflux, obstructions, or other abnormalities identified.
- Abnormal: Esophageal stricture/achalasia/motility disorders, hiatal hernia, gastroesophageal reflux disease (GERD) and related issues, presence of diverticula, polyps, ulcers, tumors, or perforations.
Cholangiography (Page 48)
- Introduction: Visualizes the biliary tree and gallbladder.
- Purpose/Indication: Evaluating biliary obstructions/blockages (jaundice, cholangitis), identifying bile duct problems (stones, strictures, etc.), and guiding surgical procedures and postoperative care.
- Normal: Normal bile duct diameters; unobstructed dye passage.
- Abnormal Findings: Common bile duct dilation (more than 8mm), and filling defects hinting at potential tumors, stones, or strictures.
Cystoscopy (Page 55)
- Introduction: Invasive procedure for direct visualization of the bladder and urethra.
- Purpose/Indication: Diagnosing urinary abnormalities (infections, stones, tumors), & assessing treatment effectiveness.
- Normal: Normal bladder/urethra sizes and structures.
- Abnormal: Presence of tumors, diverticula, obstructions, stones, strictures, infections, inflammation, polyps, or prostatitis.
Electroencephalogram (EEG) (Page 59)
- Introduction: Measures electrical activity within the brain.
- Purpose/Indication: Diagnosing epilepsy, sleep disorders, brain injuries.
- Normal: Specific patterns of electrical waves corresponding to levels of consciousness (e.g. awake, asleep).
- Abnormal: Epilepsy/seizure disorders, abnormal bleeding/hemorrhage, sleep disorders, encephalitis (brain swelling), brain tumors, excessive alcohol/drug use, and head injury.
Electromyography (EMG) (Page 62)
- Introduction: Measures the electrical activity of muscles and nerves.
- Purpose/Indication: Diagnosing nerve/muscle disorders (like peripheral neuropathy, nerve compression syndromes, muscle disorders, amyotrophic lateral sclerosis [ALS], myasthenia gravis).
- Normal: Little electrical activity in resting muscles. Muscle contraction increases activity following specific stimulation.
- Abnormal: Amyotrophic Lateral Sclerosis (ALS), Carpal Tunnel Syndrome, Myasthenia Gravis. Other conditions such as Guillain-Barré syndrome, muscle weakness/paralysis, other neuropathies.
Bone Scan (Page 65)
- Introduction: A nuclear medicine imaging technique examining skeletal structures for abnormalities.
- Purpose/Indication: Diagnose fractures, tumors, infections, inflammation, and bone disorders. Identifies the source of skeletal distress (if the cause is unclear) and to track diseases spreading to the bones
- Normal: Uniform tracer uptake across the skeleton, no hot spots or cold spots, balanced symmetrical uptake
- Abnormal Findings: Hot spots (increased uptake) may indicate infection (osteomyelitis), inflammation (septic arthritis/rheumatoid arthritis), trauma (fractures, stress fractures), and tumors. Cold spots (decreased uptake) may reveal avascular necrosis or specific types of bone tumors.
Papanicolaou Test (PAP) (Page 68)
- Introduction: A cervical cancer screening test using a brush to collect cells from the cervix.
- Purpose/Indication: Detecting precancerous/cancerous cervical abnormalities, detecting infections or inflammation.
- Normal: Healthy cells without inflammation or atypical features. Absence of precancerous cells.
- Abnormal: Atypical squamous cells (ASCUS): Undetermined significance, low grade squamous intraepithelial lesion (LSIL), high grade squamous intraepithelial lesions (HSIL), squamous cell carcinoma.
Radioallergosorbent Test (RAST) (Page 72)
- Introduction: Blood test to detect specific IgE antibodies associated with allergies.
- Purpose/indication: Diagnosing/monitoring allergies by measuring IgE antibody concentrations.
- Normal: Negative result; low or no IgE antibodies to tested allergens
- Abnormal: Positive results indicating high levels of specific IgE to allergens.
Single-Photon Emission Computed Tomography (SPECT) (Page 76)
- Introduction: Nuclear imaging technique providing 3D images of organ functions (e.g. blood flow, metabolism).
- Purpose/Indication: Diagnosing/assessing various medical conditions (e.g., heart disorders, brain disorders, some cancers). Also used to evaluate the effectiveness of treatment.
- Normal: Uniform tracer uptake across organs and tissues
- Abnormal: Reduced uptake in areas suggesting reduced blood flow; increased uptake suggesting inflammation/tumors.
Venereal Disease Research Laboratory (VDRL) (Page 80)
- Introduction: A blood test to detect syphilis, a sexually transmitted disease.
- Purpose/Indication: Screening for syphilis in its early stages, helping to monitor HIV treatment. Tracks the progression of the infection.
- Positive Result: Suggests current or past syphilis infection; confirmation by other tests needed.
- Negative Result: No evidence of antibodies to the organisms associated with syphilis.
Please note that these are abridged summaries; the original documents present more detailed information and explanations. Consult original documents for thorough understanding.
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