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244 Cards in this Set
- Front
- Back
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In what type of bx is a tissue specimen sent directly to the lab and its results are relayed to the operating room to aid in subsequent surgery?
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Open
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What are some signs of respiratory distress in the pt who has just had a lung bx?
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Elevated pulse & SOB
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What is the most appropriate nursing diagnosis for a pt who has just had a bone marrow aspiration?
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Acute pain
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A Sentinel lymph node bx is CI in a pt with....?
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An allergy to radioactive dye
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A nursing priority following a liver bx would be to.....?
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Position the pt on their right side for 3-4 hours
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Two major complications following a lung bx are......?
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Pneumothorax and bleeding
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An important precaution following a bx of the upper GI tract would be to.....?
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Keep the pt NPO until the gag reflex is present
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Following a renal bx, the nurse should explain to the pt the importance of....?
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Lying flat on their back w/o moving for at least 12 hrs
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What are two things required to obtain an accurate histologic dx from a specimen?
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Complete tissue specimen (procured w/ good technique); proper specimen handling and storage; and knowledge of the tissue's origin
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The preferred site for a bone marrow aspiration would be the...?
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Posterior iliac spine
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The most common exposure that a DTH tests for is...?
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Tuberculosis (TB)
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The purpose of the red blood cell survival time is to...?
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Help evaluate unexplained anemia
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A patch test is used to confirm....?
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Allergic contact sensitivity
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The blue contrast medium used for the lymphangiography will discolor urine, stool, skin and vision for how long?
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48 hrs
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A D-xylose absorption test might be ordered by the physician for which signs and symptoms?
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Weight loss, generalized malnutrition, weakness and diarrhea
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A delayed-type hypersensitivity test (DTH) requires the reaction to be measured after....?
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48-72 hrs
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What is the most serious reaction a nurse should observe pt for when doing the DTH?
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Anaphylactic shock
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During a lymphangiography, an incision will be made where on the pt?
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Both feet
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Lymphangiography examines the....?
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Lymphatic sytem
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A Gallium scan is usually performed how long after the IV injecton of radioactive gallium?
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24-48 hrs
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A routine urinalysis tests for....?
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Renal and urinary tract dz
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Which urine test is used to help detect Wilson's dz, chronic active hepatitis?
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Urine copper
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Urine always includes.....?
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Water, urea, uric acid and sodium chloride
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Hormones can be classified into 3 groups. Amines, proteins and......?
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Steroids
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What is a class of biochemical compounds essential for growth and metabolism that are classified into 2 groups according to their solubility?
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Vitamins
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Which is the most frequently performed urine enzyme test?
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Urine amylase
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Urinary calculi if not passed spontaneously may require surgical extraction or......?
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Extracorporeal shock wave lithotripsy
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The nurse knows that a pt diagnosed w/ gout might have this test completed.
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Urine uric acid
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A nurse knows that this test helps to identify diabetic ketoacidosis (DKA)/
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Ketones
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In the kidneys, where does metabolic waste, drugs and other foreign substances from the blood get filtered for eventual excretion in the urine?
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Nephrons
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What is histology?
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The study of the microscopic structure of tissues and cells
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Accurate histologic dx requires?
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A representative or complete tissue specimen; procured w/ good technique to prevent damage; proper specimen handling and storage, usually in a fixative, and knowledge of the tissue's origin, the suspected dx, previous biopsies at the site and any current treatments
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What are the 5 different types of biopsies?
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Excision
Shaving Needle Aspiration Punch incision |
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Incisional biopsy - definition?
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A scalpel, a cutting or aspiration needle, or a punch is used to remove a portion of tissue from large, multiple, hidden lesions. Incision of a hidden lesion is called a closed, or blind, biopsy
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Excisional biopsy - definition?
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A scalpel is used to removal abnormal tissue from the skin or subcutaneous tissue. A brush biopsy is used to obtain tissue samples from the urinary system
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Excision biopsy
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Surgical removal of entire lesion from any tissue; may be excised under local anesthetic
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Shaving biopsy
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Tissue shaved from raised surface lesion on the skin
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Needle biopsy
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Removal of a core of tissue from bone, bone marrow, breast, lung, pleura, lymph node, liver, kidney, prostate, synovial membrance or thyroid
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Aspiration biopsy
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Aspiration of tissue sample from bone marrow or breast
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Punch incision
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Removal of tissue specimen from core of lesion in skin or cervix
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What does "fixing tissue" mean?
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A process that arrests cellular structures and prevents decomposition
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What influences tissue preparation for study?
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Temperature; cold slows decomposition and heat speeds it up
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What is a frozen section and why is it important?
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Permits rapid, accurate analysis of potentially malignant tissue during surgery. Freezing fixes the tissue, hardening it to allow cutting into microscopic sections. This technique usually allows pathologic diagnosis within 10-15 mins after excision
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Breast biopsy - purpose
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To differentiate between benign and malignant breast tumors
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Breast bx - type of bx procedure used
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Needle bx and open bx
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Breast bx - precautions
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Open breast bx is CI is the pt w/ a condition that precludes surgery. Send the specimen to the lab immediately
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Prostate gland bx - purpose
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To confirm prostate cancer; to determine the cause of prostatic hyperplasia
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Prostate gland bx - type of bx procedure used
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1. perineal approach
2. transrectal approach 3. transurethral approach |
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Prostate gland bx - precautions
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Complications may include transient painless hematuria & bleeding into the prostatic urethra and bladder
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Lymph node bx - purpose
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To determine the cause of lymph node enlargement; to distinguish b/t benign & malignant lymph node processes; to stage metastatic cancer
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Lymph node bx - type of bx procedure used
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Excisionsal
Needle bx |
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Lymph node bx - precautions
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Storing the tissue specimen in normal saline solution instead of 10% formalin solution allows part of the specimen to be used for cytologic impression smears, which are studied along w/ the bx specimen
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Sentinel lymph node bx - purpose
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To identify the sentinel lymph node and evaluate it for the presence or absence of tumor cells, indicating nodal metastasis
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Sentinel lymph node bx - type of bx procedure used
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Lymphoscintigraphy &
Injection of blue dye |
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Sentinel lymph node bx - precautions
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B/c 99mTc is a radioactive substance, all radiation precautions must be implemented. Staff members need to be monitored for radiation exposure. Radiation levels need to be determined in the nuclear medicine suite and the operating room postsurgically
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Skin bx - purpose
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To provide differential dx among basal cell carcinoma, squamous cell carcinoms, malignant melanoma and benign growths; to dx cronic bacterial or fungal skin infections
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Skin bx - type of bx procedure used
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Shave bx, punch bx and excisional bx
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Skin bx - precautions
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Send the specimen to the lab immediately
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Percutaneous liver bx - purpose
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To dx hepatic parenchymal dz, malignant tumors and granulomatous infections
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Percutaneous liver bx - type of bx procedure used
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Aspiration bx
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Percutaneous liver bx - clinical alert
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Immediately report bleeding or signs of bile peritonitis such as tenderness and rigidity around the bx site. Be alert for signs of pneumothorax, such as rising respiratory rate, depressed sounds, dyspnea, persistent shoulder pain, and pleuritic chest pain. Report such complications immediately
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Percutaneous liver bx - Precautions
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It is CI in a pt w/ a platelet count below 100,000/uL; PT time longer than 15 seconds; empyema of the lungs, pleural, peritoneum, biliary tract, or liver, vascular tumor, hepatic angiomas, hydatid cyst; or tense ascites. If extrahepatic obstruction is suspected, ultrasonography or subcutaneous transhepatic cholangiography should rule this condition before bx is considered
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Lung bx - purpose
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To confirm a dx of diffuse parenchymal pulmonary dz and pulmonary lesions
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Lung bx - types of bx procedure used
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Excision (closed or open)
Closed includes needle and transbronchial brushing and video-assisten thoracotomy. Open includes limited and standard thoracotomies |
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Lung bx - clinical alert
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Check the pt's VS q 15 mins for 1 hr, q 30 mins for 2 hrs, q hr for 4 hrs and then q 4 hrs.
Watch for bleeding, dyspnea, elevated pulse rate, diminished breath sounds on the bx side and, eventually, cyanosis. Complications include pneumothorax and bleeding. |
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Lung bx - precautions
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During bx, observe for signs of respiratory distress, SOB, elevated pulse rate and cyanosis (late sign).
Keep pt still and calm. Coughing and movement during bx can cause lung tearing by the bx needle. |
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Bone bx - purpose
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to distinguish between benign and malignant bone tumors
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Bone bx - type of bx procedure used
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Drill bx and open bx
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Bone bx - clinical alerts
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For several days after the bx, watch for & report indications of bone infection: fever, HA, pain on movement and redness or abscess near the bx site
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Bone bx - precautions
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Bone bx should be performed cautiously in the pt w/ coagulopathy. Send specimen to lab immediately.
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Bone marrow aspiration and bx - purpose
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To dx thrombocytopenia, leukemias, and granulomas as well as aplastic, hypoplastic and pernicious anemias; to dx primary and metastatic tumors; to determine the cause of infection; to aid in the staging of dzs such as Hodgkin's dz; to evaluate the effectiveness of chemotherapy and monitor myelosuppression
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Bone marrow aspiration and biopsy - type of bx procedure used
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Aspiration or needle
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Bone marrow aspiration and biopsy - precautions
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Bone marrow bx is CI in the pt w/ a severe bleeding disorder. Send the tissue specimen or slides to the lab immediately.
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Microbiology is the study of....?
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Microorganisms - bacteria, fungi, viruses and protozoa
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Gram stain smear identifies....?
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Separates bacteria into 2 classifications - either Gram-positive or Gram-negative, which typically allows tentative identification of the suspected organism.
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Acid-fast identifies organisms of....?
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The genus Mycobacterium such as TB
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Cultures are used to....?
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Conclusively dx TB
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Sensitivity testing is used to....?
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Determine an isolated microbe's susceptibility to specific antimicrobials and to determine the dosage needed to inhibit or kill an organism in vivo
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Parisitology is...?
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The study of organisms that live in or on other biological species to take nourishment from them - e.g. protozoa, helminths and arthropods
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What are the primary causes of the transmission of parasites?
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Sanitation, diet and climate
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What are 3 different types of common parasite infestations?
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G. lamblia, Trichomonas vaginalis, Plasmodium
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How is Plasmodium malariae transmitted?
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By the bites of blood-sucking insects
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How is Giardia lamblia transmitted?
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Mechanical vectoring by flies and other insects
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How is Trichomonas vaginalis transmitted?
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Sexual intercourse. Also ingestion of parasitic cysts contained in fecally contaminated food, water or soil.
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How are Plasmodium malariae, Giardia lamblia and Trichomonas vaginalis identified?
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Requires microscopic identification
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Urine culture - purpose
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To dx UTI; to monitor microorganism colonization after urinary catheter insertion
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Urine culture - common organisms found?
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No growth is normal
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Urine culture - precautions
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Wear gloves when performing the procedure and handling specimens. Collect at least 3 mL of urine, but don't fill specimen cup more than halfway
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Stool culture - purpose
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To identify pathogenic organisms caused by GI dz; to identify carrier states
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Stool culture - common organisms found?
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Non-spore forming bacilli, clostridia and anaerobic streptococci
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Stool culture - precautions
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Wear gloves; avoid contaminating the stool specimen with urine. Be sure to include mucoid and bloody portions. Put specimen and contained in a leak-proof bag; send to lab immediately. Specimens should be collected before antimicrobial therapy is started
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Throat culture - purpose
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To isolate and identify group A beta-hemolytic streptococci; to screen asymptomatic carriers of pathogens, especially N. meningitidis
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Throat culture - common organisms found?
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Nonhemolytic and alpha-hemolytic streptococci, Neisseria staphylococci pneumococci, yeasts, enteric Gram-negative rods, spirochetes
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Throat culture - precautions
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Procure the throat specimen before beginning antimicrobial therapy; wear gloves; send specimen to lab immediately.
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Throat culture - clinical alert
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Laryngospasm may occur after the culture is obtained if the pt has epiglottiditis or diphtheria. Keep resuscitation equipment nearby.
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Nasopharyngeal culture - purpose
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To identify pathogens causing upper respiratory tract symptoms; to id proliferation of normal nasopharyngeal flora which may be pathogenic in debilitated and other immunocompromised pts. To id B. pertussis and N. meningitidis esp. in very young, elderly or debilitate pts and asymptomatic carriers
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Nasopharyngeal culture - common organisms found?
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Non-hemolytic streptococci, alpha-hemolytic streptococci, Neisseria species, staphylococcus epidermidis and S. aureus
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Nasopharyngeal culture - precautions
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Wear gloves. Don't let swab touch the sides of pt's nostril or his tongue to prevent specimen contamination.
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Nasopharyngeal culture - clinical alert
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Laryngospasm in pts w/ epiglottiditis or diphtheria
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Sputum culture - purpose
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To isolate & id the cause of pulmonary infection thus aiding in the dx of respiratory dzs such as bronchitis, TB, lung abscess and pneumonia.
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Sputum culture - common organisms found?
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Alpha-hemolytic streptococci
Neisseria species diphtheroids |
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Sputum culture - precautions
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Tracheal suctioning is CI in pts w/ esophageal varices.
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Sputum culture - clinical alert
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In a pt w/ asthma or chronic bronchitis, watch for aggravated bronchospasms when using normal saline solution or acetylcysteine in an aerosol.
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Blood culture - purpose
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To confirm bacteremia;
To id the causative organism in bacteremia and septicemia |
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Blood culture - common organisms found?
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Normally, they are negative for pathogens.
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Blood culture - precautions
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Wear gloves; send specimen to lab immediately; don't draw blood from an existing IV catheter. Use a vein below an IV catheter or in the opposite arm.
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Wound culture - purpose
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To id an infectious microbe in a wound.
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Wound culture - common organisms found?
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Normally, no pathogenic organisms are present in a clean wound.
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Wound culture - precautions
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Wear gloves; clean area around wound thoroughly to limit contamination of the culture by normal skin flora; make sure no antiseptic enters the wound. Obtain exudate from the entire wound using more than one swab if necessary. Place in culture tube quickly to limit exposure to O2; keep specimen container upright & send to lab within 15 mins.
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Stool exam (ova and parasites) - purpose
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To confirm or R/O intestinal parasitic infection and dz.
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Stool exam - common organisms found?
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No parasites or ova should appear in stool.
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Stool exam - precautions
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Don't contaminate stool specimen with urine/ don't collect stool from a toilet bowl; send specimen to lab immediately; use gloves.
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Sputum exam - purpose
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To id pulmonary parasites
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Sputum exam - common organisms found?
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Normally, no parasites or ova are present in sputum
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Sputum exam - precautions
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Be sure to wear gloves and protective eyewear when performing procedures and handling specimens.
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Sputum exam - clinical alerts
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Don't perform tracheal suctioning on the pt w/ esophageal varices.
If the pt has asthma or chronic bronchitis, watch for aggravated bronchospasms. |
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Delayed hypersensitivity skin tests - purpose
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To assess for exposure to or activation of certain dzs - most commonly TB.
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Delayed hypersensitivity skin tests - precautions
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If pt is suspected of being hypersensitive to the antigens, apply them first in low concentration. If arm is not free from dz (e.g. atopic dermatitis) use other site such as back.
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Delayed hypersensitivity skin tests - interfering factors
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Use of antigens that have expired or have been exposed to heat and light or to bacterial contamination; poor injection technique; inaccurate dilution of antigens; strong immediate reaction to the antigen at injection site; oral contraceptives
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Lymphangiography - purpose
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To detect and stage lymphomas and to id metastatic involvement of the lymph nodes; to distinguish primary from secondary lymphedema; to suggest surgical treatment or evaluate the effectiveness of chemotherapy and radiation therapy in controlling malignancy; to investigate enlarged lymph nodes detected by CT or ultrasonography
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Lymphangiography - precautions
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CI in the pt w/ hypersensitivity to iodine, pulmonary insufficiencies, cardiac dzs or severe renal or hepatic dz
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Lymphangiography - clinical alert
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Watch for pulmonary complications, such as SOB, pleuritic pain, hypotension, low-grade fever, and cyanosis caused by embolization of the contrast medium
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Lymphangiography - interfering factors
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Inability to cannulate the lymphatic vessels (precludes use of this test)
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Gallium scanning - purpose
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To detect primary or metastatic lesions when the site of the dz hasn't been clearly defined; to evaluate malignant lymphoma & id recurrent tumors following chemotherapy or radiation therapy; to clarify focal defects in the liver when liver-spleen scanning and ultrasonography prove inclusive; to evaluate bronchogenic carcinoma
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Gallium scanning - precautions
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This test should precede barium studies b/c barium retention may hinder visualization of gallium activity in the bowel. Gallium scanning is usu. CI in a child & during pregnancy or lactation; however, it may be performed if the potential diagnostic benefit outweighs the risks of exposure to radiation.
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Gallium scanning - interfering factors
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Hepatic and splenic intake (possible false-negative scans due to possible obscuring of abnormal para-aortic nodes in Hodgkin's dz); fecal accumulation in the bowel (poor imaging of retroperitoneal space); residual barium from other tests done 1 wk before the scan (possible poor imaging)
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The purpose of urinalysis and special studies of the renal function provide....?
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Valuable info about the integrity of renal & urinary function and also serve as sensitive indicators about overall health
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The kidneys remove.....?
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Metabolic wastes, drugs and other foreign substances, excess fluids, inorganic salts and acid and base substances from the blood for eventual excretion in the urine.
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The urine composition is......?
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Water, urea, uric acid and sodium chloride
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Urine volume depends on....?
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Fluid intake, the concentration of solutes in the filtrate, cardiac output, hormonal influences, physical activity and fluid loss through the lungs, large intestine, and skin
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Polyuria
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Urine volume that exceeds 2,000 mL/day
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Oliguria
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Excretion of less than 500 mL/day
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Anuria
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Excretion of less than 100 mL of urine per day for 2 to 3 days despite high fluid intake
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Nocturia
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Urine volume greater than 500 mL at night
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Routine urinalysis - purpose
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To screen the pt's urine for renal or urinary tract dz; to help detect metabolic or systemic dz unrelated to renal disorder; to detect substances (drugs)
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Routine urinalysis - precautions
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Strain specimen to catch stones or stone fragments if the pt is being evaluated for renal colic. Refrigerate specimen if analysis will be delayed longer than 1 hr
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Routine urinalysis - interfering factors
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Strenuous exercise b/f routine UA; insufficient urinary volume, less than 2 mL; foods such as beets, berries and rhubarb; certain drugs; highly dilute urine such as in diabetes insipidus
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Urine protein - purpose
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To aid in the dx of pathologic states characterized by proteinuria, primarily renal dz
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Urine protein - precautions
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Tell pt not to contaminate the urine w/ toilet tissue or stool; refrigerate the specimen or place it on ice during the collection period
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Urine protein - interfering factors
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Contamination of specimen w/ toilet tissue or stool; very dilute urine, such as from forcing fluids
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Urine creatinine - purpose
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To help assess glomerular filtration; to check the accuracy of 24 hr urine collection, base on the relatively constant levels of creatinine excretion
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Urine creatinine - precautions
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Refrigerate specimen or keep it on ice during collection period; send to lab immediately
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Urine creatinine - interfering factors
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Failure to observe restrictions, to collect all urine during the test period; to properly store the specimen or to send it to lab immediately; corticosteroids, gentamicin, tetracyclines, diuretics
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Creatinine clearance - purpose
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To assess renal function (primarily glomerular filtration); to monitor progression of renal insufficiency
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Creatinine clearance - precautions
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Refrigerate or keep on ice and send to lab immediately after collection
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Creatinine clearance - interfering factors
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Failure to observe restrictions, to collect all urine during test period, to properly store specimen or to send to lab immediately after collection
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Urine hemoglobin - purpose
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To aid in the dx of hemolytic anemias, infection, or severe intravascular hemolysis from a transfusion reaction
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Urine hemoglobin - precautions
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Menstruating pts should reschedule test b/c contamination w/ menstrual blood alters results.
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Urine hemoglobin - interfering factors
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Failure to send specimen to lab immediately after collection, nephrotoxic drugs and anticoagulants; large doses of Vitamin C
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Urine bilirubin - purpose
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To help id the cause of jaundice; to compare urine and serum bilirubin levels and other liver enzyme tests
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Urine bilirubin - precautions
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Use only a freshly voided specimen. Bilirubin disintegrates after 30 mins of exposure to room temperature or light. Send to lab immediately. If tested at bedside, make sure 20 secs elapse b/f interpreting the color change on the dipstrip.
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Urine bilirubin - interfering factors
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Failure to test specimen promptly or to send to lab at once; large amounts of ascorbic acid and nitrite; exposure of specimen to room temperature or light
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Ketones - purpose
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To screen for ketonuria; to id DKA and carbohydrate deprivation; to distinguish between a diabetic and nondiabetic coma; to monitor control of diabetes mellitus, ketogenic weight reduction and treatment of DKA.
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Ketones - precautions
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Test specimen within 60 mins or you must refrigerate it; allow refrigerated specimens to return to room temp b/f testing; don't use strips or tablets that have discolored or darkened
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Ketones - clinical alerts
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If pt is taking levodopa or phenazopyridine or has recently received sulfobromophtalein, use Acetest tablets
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Ketones - interfering factors
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Failure to keep reagent container tightly closed to prevent absorption of light or moisture or bacterial contamination of the specimen; failure to test specimen within 1 hr or to refrigerate it; levodopa, et al.
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Urine sodium and chloride - purpose
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To help evaluate fluid and electrolyte imbalance; to monitor effects of a low-salt diet; to help evaluate renal and adrenal disorders
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Urine sodium and chloride - precautions
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Tell pt not to contaminate specimen w/ toilet tissue or stool
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Urine sodium and chloride - interfering factors
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Failure to collect all urine during test period; sodium bicarbonate & thiazide diuretics; steroids; ammonium chloride and potassium chloride
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Urine potassium - purpose
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To determine whether hypokalemia is caused by renal or extra renal disorders
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Urine potassium - precautions
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Don't contaminate specimen; refrigerate if can't be sent to lab immediately
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Urine potassium - interfering factors
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Excess dietary potassium; contamination of specimen; potassium-wasting meds; excess vomiting or stomach suctioning.
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Identify components of the urinary system
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kidneys
ureters bladder urethra |
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Function of kidneys?
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Clean blood of metabolic wastes and regulating retention of substances required to preserve the body's fluid, electrolyte and acid-base balances
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Function of ureters?
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Narrow, muscular tubes that transport urine from the kidneys to the bladder
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Function of bladder?
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Muscular sac that serves as a reservoir for urine
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Function of male urethra?
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Serves as a conduit for urine and the products of the genital system
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Function of the female urethra?
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To conduit urine out of the body
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Why are a complete history and physical examination important before recommending tests?
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To establish the presence of clinical abnormalities associated with urologic dz
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What special considerations should we remember in performing these urinary exams?
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Make sure fluid intake is adequate;
Administer a laxative to remove overlying gas or stool; Monitor intake and output after invasive procedures; Watch for signs of urinary sepsis (fever, chills or hypotension); Minimize anxiety by explaining all procedures. |
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Kidney-ureter-bladder radiography - purpose
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To evaluate the size, structure and position of the kidneys; to screen for abnormalities such as calcifications in the region of the kidneys, ureters and bladder
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Kidney-ureter-bladder radiography - precautions
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A male pt should have gonadal shielding to prevent irradiation of the testes
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Kidney-ureter-bladder radiography - interfering factors
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Gas, stool, contrast medium or foreign bodies in intestine; calcified uterine fibromas or ovarian lesions
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Renal CT - purpose
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To detect and evaluate renal abnormalities, such as a tumor, an obstruction, calculi, polycystic kidney dz, congenital anomalies and abnormal fluid accumulation around the kidneys; to evaluate the retroperitoneum
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Renal CT - precautions
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Watch for signs of hypersensitivity to the contrast medium
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Renal CT - clinical alert
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Check pt's hx for hypersensitivity to shellfish, iodine or contrast medium
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Renal CT - interfering factors
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Inability to remain still; presence of contrast media from other recent test or of foreign bodes such as catheters or surgical clips
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Renal ultrasonography - purpose
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To determine size, shape and position of kidneys;
To evaluate and localize urinary obstruction and abnormal fluid accumulation; To assess and dx complications after kidney transplantation; To detect renal or perirenal masses; To differentiate between renal cysts and solid masses; To verify placement of a nephrostomy tube |
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Renal ultrasonography - interfering factors
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Retained barium from a previous test;
An obese pt |
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Cystourethroscopy - purpose
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To dx and evaluate urinary tract disorders by direct visualization of urinary structures
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Cystourethroscopy - precautions
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CI in the pt w/ acute forms of urethritis, prostatitis or cystitis b/c instrumentation can lead to sepsis; CI in the pt w/ bleeding disorders
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Retrograde cystography - purpose
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To evaluate the structure and integrity of the bladder
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Retrograde cystography - precautions
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CI during exacerbation of an acute UTI or in the pt w/ an obstruction that prevents passage of a urinary catheter
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Retrograde cystography - interfering factors
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Gas, stool or residual barium from recent dx tests of the bowel
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MRI of the urinary tract - purpose
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To evaluate genitourinary tumors and abdominal or pelvis masses; to detect prostate stones and cysts; to detect cancer invasion into seminal vesicles and pelvic lymph nodes
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MRI of the urinary tract - precautions
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CI in pts w/ metal implants, rods or screws or prosthetic devices; CI in the pregnant pt; can't be used in extremely obese pts; remove all metal objects and dentures
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MRI of the urinary tract - interfering factors
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Uncooperative behaviors, unstable medical conditions or inability to remain still during procedure. Use of IV pumps or assistive life-support equipment.
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What does a urinalysis detect?
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Renal or urinary tract dz
metabolic or systemic dz substances (drugs) - Gives info on integrity of renal urinary function; also can be a sensitive indicator about overall health |
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Which urine test require a 24 hour collection of urine?
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?????
(It looks like just about all of them do!) |
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Explain what in urine would indicate heart failure?
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High specific gravity
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What can be seen with a KUB x-ray?
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Abnormalities such as calcifications
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What can a renal CT show the physician?
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Renal abnormalities such as tumor, an obstruction, calculi, polycystic kidney dz, congenital anomalies and abnormal fluid accumulation around the kidneys
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What can a cystography do?
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Evaluates the structure and integrity of the bladder
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When looking at a blood creatinine level it is usually reviewed with what other test?
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?????
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What is the procedure for performing a cystography?
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Involves the instillation of contrast medium into bladder, followed by radiographic examination
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Why does the nurse monitor urine output post cystoscopy?
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To observe for hematuria
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Which x-ray test is used most to evaluate the urinary system?
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KUB radiography
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What is a complication of intravenous pyelography?
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Adjacent organs can be punctured. Watch for pain in abdomen or flank, pneumothorax, decreased breath sounds and tachycardia
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Which test is an indirect and rough measurement of renal function?
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???
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Routine urinalysis evaluates?
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Physical characteristics such as color, ordor, turbidity and opacity of urine; determines specific gravity and pH; detects and measure protein, glucose and ketone bodies and examines sediment for blood cells, casts and crystals
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Explain what urine cytology is for?
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Can aid in dx of urinary tract dz. Detects cancer & inflammatory dzs of the renal pelvis, ureters, bladder and urethra. Can determine whether bladder lesions on xrays are benign or malignant. Detects cytomegalovirus infection and other viral dzs
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What is the purpose of a urinalysis?
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To screen urine for renal or urinary tract dz
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What affects the concentration or dilution of urine?
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Fluid intake. Increased intake - kidneys excrete more water; when intake is decreased, they excrete less.
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What is an interfering factor for urine concentration or dilution test?
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Glycosuria; diuretics and nephrotoxic drugs
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What urine test would be ordered for acute pancreatitis?
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Urine amylase
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What is aldosterone?
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The principal mineralocorticoid secreted by the adrenal cortex. Helps regulate BP and fluid and electrolyte balance
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What does urine catecholamine test for?
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Epinephrine, norepinephrine and dopamine
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What is the purpose of total urine estrogen?
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To evaluate ovarian activity and to help determine cause of amenorrhea and female hyperestrogenism; to aid in dx of tumors of ovarian, adrenocortical or testicular origin.
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What does an elevated urine pregnanetriol level indicate?
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Adrenogenital syndrome
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What urine test is used to dx Waldenstrom's macroglobulinemia?
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Bence Jones protein
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How do you dx proteinuria?
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Urine protein
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What is the purpose of creatinine clearance?
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To asess renal function and to monitor progression of renal insufficiency
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What is hematuria?
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Intact RBCs in urine
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What is the purpose of urine bilirubin?
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To help id the cause of jaundice; to compare urine and serum bilirubin levels and other liver enzyme tests
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What is the purpose of urine urobilinogen?
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To aid in the dx of extrahepatic obstruction such as blockage of the common bile duct
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What organs make up the urinary system?
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Kidneys, ureters, bladder, urethra
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What is the purpose of the ureters?
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Transport urine from the kidneys to the bladder
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Who is at risk of having contrast-induced renal failure?
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An elderly or dehydrated pt
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What is the purpose of renal computerized tomography?
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To detect and evaluate renal abnormalities such as tumors, an obstruction, calculi, polycystic kidney dz, congenital anomalies and abnormal fluid accumulation around the kidneys
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What does a renal ultrasound look for?
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Kidney abnormalities
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The retrograde urethrography is exclusively used for?
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Men
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What is another name for Intravenous Pyelography?
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Excretory urography
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What renal test uses fluoroscopy?
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Renal angiography??
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What is the purpose of the voiding cystourethrography?
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Assesses the bladder and urethra
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What is the method of choice for obtaining a urine specimen?
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Clean-catch (or clean-voided) midstream collection
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Explain how to obtain a midstream catch urine specimen
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Pt voids first and then collects a sample in midstream
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What are the nursing actions following a bronchoscopy?
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Observe pt for signs of hypoxemia, laryngospasm, bronchspasm, pneumothorax
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What site would be used to obtain blood cultures?
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Use a vein below an IV catheter or in the opposite arm
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What is required for an accurate histological dx?
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Complete tissue specimen (procured w/ good technique); proper specimen handling and storage; knowledge of the tissue's origin
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How does temperature affect specimen preservation?
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Cold slows decomposition; heat speeds it up
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What is histology?
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The study of the microscopic structure of tissues and cells
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What does the sensitivity show, in a culture and sensitivity test?
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A microbe's susceptibility to specific antimicrobials
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When doing a colony count it will show what?
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Bacterial counts of 100,000/mL or more of a single microbe species indicate a probable UTI
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Which test is used to dx Shigella or Salmonellae?
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Stool culture
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What is the purpose of a Gallium scan?
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To detect primary or metastatic neoplasms and inflammatory lesions
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What is the purpose of a lymphangiography?
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To detect and stage lymphomas and to id metastatic involvement of the lymph nodes
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Which is the most common DTH?
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for TB
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Which test interferes with a Gallium scan?
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Barium tests done 1 week prior to scan.
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What would be a contraindication for a thyroid bx?
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A pt w/ coagulation defects
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What is a serious reaction of recall antigen test?
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Anaphylactic shock (urticaria, respiratory distress and hypotension)
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What is a complication to monitor for following a ?lymphangiography?
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Pulmonary complications
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Explain how and when to do a tape test for pinworms?
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** Collect early in the a.m. before pt bathes or defecates. Place a piece of cellophane tape, sticky side out, on the end of a tongue blade and press firmly on the anal area. Transfer tape, sticky side down, to a slide.
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How can you contaminate a stool specimen?
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With urine or by collecting from a toilet bowl
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How many ccs is enough to do a urinalysis?
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At least 15 mLs
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