1. Introduction to Laboratory Testing NURS B20

2. The Nurse’s Role in Diagnostic Testing Nursing responsibilities extend to all 3 phases of the testing process- the pretest, intratest, and the posttest periods. The nursing process can be utilized to determine patient needs and desired outcomes during the testing process

3. Nurse’s Role in Diagnostic Testing Support clients Apply the nursing process Communicate effectively Follow standards

4. The Nursing Process During the Testing Process Assessment Focuses upon procuring a data base about the client to facilitate testing and assure accurate outcomes Nursing Diagnosis Derived, like all nursing diagnoses, from analysis of data collected during assessment

5. The Nursing Process During the Testing Process Planning Flows from nursing diagnoses and focuses on the total patient Take into account client’s age, developmental stage, setting that testing takes place, information needs, coping style, cultural diversification, whether patient is inpatient/ outpatient.

6. The Nursing Process During the Testing Process Implementation Addresses actual work and process of executing the plans of pretest, intratest, or posttest. Emphasis is placed upon specimen collection, educaton, proper preparation, comfort, support, safety, infection control, and prevention of complications. Evaluation Provides data about interpretation of test results, if goals were met or not met, effectiveness of care and client status. Also considered is whether to continue with, adjust, or discontinue each plan component.

7. Communication Imperative that care-givers are able to communicate effectively. When applying the nursing process it is important for the success of all endeavors that we communicate effectively with clients and family Communication includes: giving information, instructions, education, explanations, comfort and reassurance, etc.

8. Standards of Care The nursing role is based on standards, these standards influence and govern nursing responsibilities and practice. Standards come from: American Nurses Association - ANA Joint Commission on Accreditation of Health Care Occupational Health and Safety Act- OSHA Centers for Disease Control and Prevention- CDC

9. Nursing Process During Testing Process Pretest Assess indications for testing Interferences and contraindications Develop nursing diagnoses Prepare and educate patient Use standards and precautions

10. Nursing Process During Testing Process Intratest Use standard precautions Collect specimens Perform procedures Provide reassurance Prevent complications Communicate and collaborate

11. Nursing Process During Testing Process Posttest Evaluate outcomes Assess compliance React to critical values Modify nursing diagnoses Monitor for complications Follow standards Provide support for unexpected outcomes

12. Evaluating Particular Diagnostic Tests Physician orders test Assess indications for testing Review any pretest preparation, instructions, or education required Identify normal test findings/ ranges, what values are considered WNLs When test results are available compare client’s test results with normal ranges and look for values out of range (either above or below normal ranges) Report findings to physician Consider the implications to care that out of range values have on your client

13. Utilizing Available Resources Identify ordered test in your resource (Laboratory and Diagnostic Testing book) Review what the test is examining Identify the indications for the test Identify normal ranges (can find this in resource but is usually given with the laboratory report) As deviations from the normal ranges are identified, review potential causes of the deviations and compare those causes to your client’s condition. Make an educated guess as to the reason for deviation. Make adjustments to care plan as necessitated by diagnostic test findings.

14. Review of Specific Lab Tests Define the following tests and identify normal ranges: CBC UA Chemistry Panel (different names given to this test by different labs)