Review of Laboratory Values and Diagnostic Tests


CHAPTER 22






Review of Laboratory Values and Diagnostic Tests


 

 





LEARNING OUTCOMES






 


Upon completion of this chapter, the nurse will:



1.  Summarize the types of diagnostic and laboratory tests appropriate for reporting through telephonic care


2.  Analyze ways to discuss the importance of diagnostic and laboratory tests with clients


3.  Strategize approaches to enhance client adherence to diagnostic and laboratory testing regimens


IMPORTANCE OF LABORATORY AND DIAGNOSTIC TESTS


Diagnostic and laboratory testing is an integral part of telephonic nursing care. These tests are used to:



  Identify participation in disease management programs


  Evaluate compliance with the prescribed treatment plan


  Analyze the impact of teaching interventions on client health status


This chapter is not to replace any diagnostic and laboratory textbooks but rather is intended to highlight diagnostic and laboratory tests that you might most frequently encounter when providing telephonic care.


TYPES OF DIAGNOSTIC TESTS


Generally, a client in a wellness program will not be scheduled or reporting the results of diagnostic testing unless a symptom or problem occurs. The types of tests prescribed for the client will be closely associated with a suspected disease process and used to either rule out a problem or confirm the diagnosis. The following table categorizes the types of diagnostic tests that you might need to explain when conducting telephonic care. Keep in mind when explaining a diagnostic test that the most basic language and terms should be used. The associated teaching column in the table provides suggestions to use when explaining the test.


 



















































































































































Health Problem


Diagnostic Test


Associated Teaching


Integumentary disorders


Biopsy


Takes a piece of the skin and tests it for infections


Respiratory disorders


Pulmonary function tests


Checks to see how much obstruction or constriction is in the lungs


 


Bronchoscopy


Examines the lungs and breathing airway to check for obstructions/tumors or bleeding


 


Chest x-ray


Looks at the major structures in the chest in relation to the location of the lungs


Cardiovascular disorders


EKG


Examines the electrical activity of the heart


 


Echocardiogram


  Checks the valves in the heart


  Indirectly measures the functioning of the left ventricle in the form of ejection fraction


 


Cardiac catheterization


Checks the arteries and other structures in the heart


 


Venogram/Doppler studies


Uses sound waves to check for any blood clots in the blood vessel


 


Stress/treadmill test


Determines the function of the heart during exercise


Gastrointestinal (GI) disorders


Abdominal x-ray


Checks for any blockages or if there is free air in the bowel


 


Abdominal ultrasound


Checks the structures in the abdomen to include the pancreas, liver, and gallbladder for any blockages, stones, or masses


 


Endoscopy


Looks at the esophagus and the lining of the stomach to check for ulcers or tumors


 


Colonoscopy


Looks at the lining and structure of the colon to check for polyps, ulcers, or tumors


 


Upper GI/barium swallow


By drinking barium, the lining of the stomach and small intestine are examined for ulcers or blockages


 


Lower GI/barium enema


By using barium through an enema, the lining of the large intestine is examined for ulcers or blockages


 


Liver biopsy


Takes a small piece of the liver to check it for any problems with function


Musculoskeletal disorders


X-rays


Looks for any breaks in the bones


 


CT scan/MRI


Looks for any problems within the bones like a mass/tumor


 


Arthroscopy


Looks at the structures associated with a joint for any breaks or tears in the tissue around the joint


Neurologic disorders


Electromyogram/nerve conduction studies (EMGS/NCVs)


Checks the electrical activity generated by the nerves that feed the muscles


Myelogram


  Looks at the nerves that originate from the spinal cord


  Checks for blood flow to the nerve and for any compression from the bones in the back (vertebrae)


 


CT scan/MRI


Looks at the brain and spinal cord for any problems with blood flow, broken skull bones, broken spinal bones, and if there are any masses/tumors or bleeding


Sensory disorders


Tonometry


Checks for the amount of pressure within the eyes


 


Audiometry


Tests for hearing


Genitourinary disorders


CT scan of the kidneys


Checks for any problems with blood flow to the kidneys or if there are any masses/tumors/kidney stones


 


Cystoscopy


Looks directly at the bladder to check for any irritation or masses/tumors


 


Intravenous pyelogram


Injects dye to look at the kidneys and check for stones


 


Renal biopsy


Takes a piece of the kidney to check for a specific disease


 


Prostate biopsy


Takes a piece of the prostate to check for diseases


 


Prostate ultrasound


Checks to see the size of the prostate and if the enlargement is pressing on any other body tissues


 


Breast biopsy


Takes a piece of the breast tissue to check if a swelling/mass is cancerous


 


Breast ultrasound


Uses sound waves to look at a breast mass to see if it is solid or filled with fluid (cyst)


 


Laparoscopy


Looks at the organs in the (female) abdomen to check for location, swellings/masses, or blockages


 


Mammogram


Looks at the structures within the breasts to check for masses/tumors


TYPES OF LABORATORY TESTS


The volume of laboratory tests that could be prescribed and reported on by the client receiving telephonic care can be quite lengthy. Oftentimes, the client is unaware of what is being tested and will ask you why something was being done. The following table provides a general list of laboratory tests that may be prescribed for the clients receiving telephonic care.


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CLIENT ADHERENCE


No one likes to have blood drawn or have to place a small amount of body fluid into a cup. Scheduling for diagnostic tests can be a nightmare if work schedules need to be changed or there are issues with child care. But, ongoing diagnostic or laboratory testing is essential when evaluating the effectiveness of telephonic care.


Yes, having to collect specimens or arrive to an outpatient facility for testing is an inconvenience to the client, but the alternative could be hospitalization or surgery. Clients need to be encouraged to keep scheduled appointments for blood work, especially if medication dose adjustments will be made.


One of your many roles when contacting the clients is to:



  Remind them to schedule a blood test


  Keep an appointment for a blood test


  Schedule a follow-up appointment with the health care provider to receive blood test results

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Oct 5, 2017 | Posted by in NURSING | Comments Off on Review of Laboratory Values and Diagnostic Tests
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