– Procedure that involves physical inspection of body structures and evidence of their function.
– Facilitate by use of technical equipment and techniques such as:
– Radiography (x-rays)
– Radionuclide imaging
– Ultrasonography (high frequency sound waves)
– Electrical graphic recordings
– Laboratory test
– See table 13.1 (P. 210)General Nursing Responsibilities
– Nursing responsibilities before, during and after the procedure. (See Box 13-1, P. 210)
– Preprocedural care- include: consent must contain
– Preparing clients (NPO, V/S, Bath, Shaving, illness, Dress, emotion support, instruction test)
– Obtaining equipment and supplies
– Arrange the examination room
– Position and drape the clientPositions for Procedures
– Dorsal recumbent position
– Lithotomy position
– Sim’s position
– Knee-chest position
– Modified standing position
– See Table (13-2, P. 312)
– Attend to the client’s comfort (position)
– Assess vital signs and client stability
– Care for specimens (samples of tissue or body fluids) “See P. 214”
– Record and report data
Common factors that invalidate examination or test results
– Incorrect diet preparation.
– Failure to remain fasting.
– Insufficient bowel cleaning.
– Drug interaction.
– Inadequate specimen volume.
– Failure to deliver specimen in a timely manner.
– Incorrect or missing test requisition.
Common Diagnostic Tests
– Pelvic Examination-Physical inspection of the vagina and cervix, with palpation of the uterus and ovaries.
– Magnetic Resonance Imaging (MRI)
– Contrast Medium-substance that adds density to a body organ or cavity
– Fluoroscopy-displays an image in real time
Related Nursing Responsibilities
– Assess vital signs before and after testing
– Remove any metal items
– Request a lead apron to shield a fetus or vulnerable body parts
– Determine if the client is allergic to iodine
– Know location of emergency equipment
– Encourage large amounts of fluid to clear iodine
– Check on bowel elimination for 2 days after barium studies
– General term for procedures that use x ray.
– Chest x ray (anterior, posterior or lateral views) used to detects pneumonia, broken ribs and lung tumors.
– Upper gastrointestinal x-ray (barium swallow, meal) aids in diagnosis of ulcer, GI tumors, narrowing of esophagus.
– Lower gastrointestinal x-ray (lower GI or barium enema).
– Cholecystography (x-ray of the gallbladder) gallstones
– Angiography (x-ray of blood vessels)
– Myelography (x-ray of spinal canal) spinal tumor, rupture.
– Visual examination of internal structures
– Prevent aspiration withhold food and fluid or advise the client to do so before the procedure
– Conscious sedation-monitor vital signs, breathing, oxygen saturation, and cardiac rhythm
– Withhold food or fluids following procedure until gag reflex returns
– Report any pain
– Soft tissue examination that uses sound waves
– Schedule abdominal and pelvic ultrasound before barium studies
– Instruct clients undergoing abdominal ultrasonography to drink 5-6 full glasses of fluid 1-2 hours before the examination
Electrical Graphic Recordings
– Clean skin and clip hair where electrode tabs are placed
– Attach adhesive electrode tabs to skin
– Do not attach to bones, scars, or breast tissue
– Instruct client having EEG to shampoo hair before and after the test
– Withhold coffee, tea, and cola for 8 hours before the test
– If sleep deprived EEG, instruct client to stay awake after midnight before the examination
– Is a procedure for withdrawing fluid from the abdominal cavity.
– Explain procedure.
– Vital signs, weight.
– Prepare equipment (gloves, mask, paracentesis kit).
– Empty bladder.
– Sitting position.
– Measure the volume of fluid withdraw.
– Anesthesia, Label specimen.
– Impaired Adjustment
– Decisional conflict
– Health-seeking Behaviors
– Spiritual Distress