Download Barbara K. Timby Fundamental Nursing Skills and Concepts

Chapter 14
Special Examinations and
Tests
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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
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Equipment Used in Examinations
Radiography
X-ray
Endoscopy
Optical scopes
Radioactive chemicals
Radionuclide
imaging
Ultrasonography High-frequency sound waves
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Root Words and Suffixes
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Nursing Responsibilities
• Clarifying explanations
• Preparing clients
• Obtaining equipment and supplies
• Arranging the examination area
• Positioning and draping
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Nursing Responsibilities (cont’d)
• Assisting the examiner
• Providing physical and emotional support
• Attending to the client
• Caring for specimens
• Recording and reporting data
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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
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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
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Positioning Clients During
Examinations (cont’d)
• 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
• Modified standing position
– The client stands with the upper half of
the body leaning forward
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Positioning the Client
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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
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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.
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Factors That Invalidate Test Results
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Question
• Is the following statement true or false?
Ultrasonography uses x-rays to examine
clients.
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Answer
False.
Ultrasonography uses a transducer that
projects sound waves through the body’s
surface.
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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
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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
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Question
• Is the following statement true or false?
Radiography uses elements whose molecular
structures are altered to produce radiation.
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Answer
False.
Radiography uses roentgen rays, or x-rays, to
produce images of body structures.
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Testing Procedures
• Paracentesis: procedure for withdrawing fluid
from the abdominal cavity
• Lumbar puncture: procedure for withdrawing
spinal fluid
• 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
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Question
• Is the following statement true or false?
Paracentesis is the procedure for
withdrawing fluid from the abdominal cavity.
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Answer
True.
Paracentesis is the procedure for
withdrawing fluid from the abdominal cavity.
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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
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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
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