1. Chapter 14 Special Examinations and Tests

2. Examinations and Tests
Diagnostic examination: procedure that involves physical inspection of body structures and evidence of their functions
Laboratory test: procedure that involves examining body fluids or specimens and comparing the components of a collected specimen with normal findings

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

4. Root Words and Suffixes

5. Nursing Responsibilities
Clarifying explanations
Preparing clients
Obtaining equipment and supplies
Arranging the examination area
Positioning and draping

6. Nursing Responsibilities (cont’d)
Assisting the examiner
Providing physical and emotional support
Attending to the client
Caring for specimens
Recording and reporting data

7. 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

8. 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

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

10. Positioning the Client

11. Question
Which of the following positions may be used as an alternative to the lithotomy position during a rectal examination?
a. Sims’
b. Dorsal recumbent
c. Supine
d. Modified standing

12. Answer
a. Sims’
The Sims’ position may be used as an alternative to the lithotomy position for a rectal examination as it provides access to the anus and rectum. The dorsal recumbent position, supine position, and modified standing position do not provide access to the anus and rectum.

13. Factors That Invalidate Test Results

14. Question Is the following statement true or false?
Ultrasonography uses x-rays to examine clients.

15. Answer
False.
Ultrasonography uses a transducer that projects sound waves through the body’s surface.

16. 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

17. 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

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

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

20. 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

21. 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

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

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

24. 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

25. 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