Chapter 14 Special Examinations and Tests

Examinations and Tests Diagnostic examination: procedure that involves physical inspection of body structures and evidence of their functions

Equipment Used in Examinations Radiography X-ray Endoscopy Optical scopes Radionuclide imaging Radioactive chemicals Ultrasonography High-frequency sound waves

Root Words and Suffixes

Examinations and Tests Laboratory test: procedure that involves examining body fluids or specimens and comparing the components of a collected specimen with normal findings

General Nursing Responsibilities Box 14-1 p. 250

Nursing Responsibilities Preprocedural responsibilities Clarifying explanations Witness the client’ssignature on the consent form (box 14-2) Preparing clients Obtaining equipment and supplies Arranging the examination area

Nursing Responsibilities (cont’d) Procedural responsibilities: Positioning and draping Assisting the examiner Providing physical and emotional support

Positioning Clients During Examinations Dorsal recumbent position Reclining position with the knees bent, hips rotated outward, and feet flat Lithotomy position Reclining position with the feet in metal supports called stirrups

Positioning Clients During Examinations (cont’d) Sims’ position The client lies on the left side with the chest leaning forward, the right knee bent toward the head, the right arm forward, and the left arm extended behind the body

Positioning Clients During Examinations (cont’d) Knee-chest position (genupectoral) The client rests on the knees and chest and turns the head, which is supported on a small pillow, to one side Modified standing position The client stands with the upper half of the body leaning forward

Positioning the Client

Nursing Responsibilities (cont’d) Postprocedural responsibilities: Attending to the client Caring for specimens Recording and reporting data

Factors That Invalidate Test Results

Commonly Performed Categories of Examinations Pelvic examination: physical inspection of the vagina and cervix with palpation of the uterus and ovaries Radiography: procedures that use roentgen rays, or x-rays, to produce images of body structures Endoscopy: visual examination of internal structures

Commonly Performed Categories of Examinations (cont’d) Radionuclide imaging: elements whose molecular structures are altered to produce radiation Ultrasonography: soft tissue examination using sound waves Electrical graphic recordings: recording electrical impulses from structures such as the heart, brain, and skeletal muscles

Question Is the following statement true or false? Radiography uses elements whose molecular structures are altered to produce radiation.

Answer False. Radiography uses roentgen rays, or x-rays, to produce images of body structures.

Testing Procedures Sigmoidoscopy: examination of the large intestine from the rectum through the colon Paracentesis: procedure for withdrawing fluid from the abdominal cavity Lumbar puncture: procedure for withdrawing spinal fluid

Testing Procedures (cont’d) Throat culture: collecting infectious specimens or microorganisms from the throat and examining their characteristics with a microscope Measurement of capillary blood glucose: measuring the amount of glucose in capillary blood

Question Is the following statement true or false? Sigmoidoscopy is the procedure for withdrawing fluid from the abdominal cavity.

Answer False. Sigmoidoscopy is the examination of the large intestine from the rectum through the colon.

Factors to Consider When Performing Examinations and Tests on Older Adults Older adults may not be able to tolerate withholding of food or fluids for long periods Older adults are susceptible to dehydration Older adults become exhausted by preparations for gastrointestinal examinations requiring laxatives and enemas, which may also deplete electrolyte balance, leading to weakness or dizziness

Factors to Consider When Performing Examinations and Tests on Older Adults (cont’d) Older adults fatigue easily Older adults may need additional clothing, slippers, extra covers Cognitively compromised older adults should have a family member present during the procedure