Download Management Techniques for the Health Unit Coordinator

Chapter 16
Other Diagnostic Studies
1
Objectives
• Explain the purpose of provided diagnostic
procedures.
• Identify the hospital department that would
perform provided procedures.
• State two purposes of an
electroencephalogram.
• State what category of medication should be
noted on the requisition when an
electroencephalogram is ordered.
Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 2
Objectives, continued
• State the difference between an invasive
procedure and a noninvasive procedure.
• Name two noninvasive diagnostic studies
related to the heart.
• Name two invasive diagnostic studies related to
the heart.
• State what category of medication should be
noted on the request when an
electrocardiogram is ordered.
Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 3
Objectives, continued
• Name six endoscopies and the parts of the body
visualized by each.
• Discuss the importance of patient preparation
before a sigmoidoscopy or a visual examination
of the colon.
• List two studies related to the gastrointestinal
(GI) system that are performed in the
endoscopy department.
Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 4
Objectives, continued
• List four diagnostic tests that are performed by
the cardiopulmonary (respiratory care)
department.
• State what category of medication should be
noted on the requisition when arterial blood
gases are ordered.
• Name two studies performed by the
cardiovascular department to diagnose vascular
diseases.
Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 5
Lesson 16.1
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Slide 6
Neurodiagnostics (Neurologic and
Neuromuscular System Electrodiagnostics)
• Neurodiagnostics may include several tests
related to the function of the nervous system
(brain and spinal cord)
• In smaller facilities, the electroencephalography
may be the only neurodiagnostic test performed
Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 7
Neurodiagnostics, continued
Neurodiagnostic tests:
• Electroencephalogram (EEG) performed to
diagnose brain disease or to confirm brain death
or cerebral silence
• Evoked potentials


Visual evoked potential (VEP)
• Auditory evoked response (AER) or
• Brainstem auditory evoked response (BAER)
Somatosensory evoked potential (SEP)
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Slide 8
Neurodiagnostics, continued
Neurodiagnostic tests:
• Electronystagmography (ENG) (electrooculography)
• Electromyography (EMG) and nerve conduction
studies (NCS)
• Caloric study (oculovestibular reflex study)
Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 9
Electroencephalography (EEG)
From Chipps E, Clanin N, Campbell V: Neurologic disorders, St. Louis, 1992, Mosby.
Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 10
Medications To Note When Ordering
Neurodiagnostic Procedures
Anticonvulsant medications:
• Phenobarbital
• Dilantin
• Tegretol
Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 11
Neurology Diagnostic Downtime
Requisition
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Slide 12
Cardiovascular Diagnostics
• The procedures carried out by this department
are related to the performance of the heart and
the vascular system
• The results of these studies aid the physician in
making a diagnosis and will affect treatment
provided
Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 13
Cardiovascular Diagnostics, continued
• Noninvasive
•
•
•
•
Electrodiagnostics
Nuclear cardiology
Cardiovascular sonography
Peripheral vascular studies
• Invasive
• Cardiac cath (catheterization) lab
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Slide 14
Cardiovascular Diagnostics Noninvasive
Electrodiagnostics:
•
•
•
•
Electrocardiogram (EKG or ECG)
Holter or cardiac monitor
Impedance plethysmography (IPG)
Exercise electrocardiogram (treadmill
stress test)
Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 15
Electrode Placement for 12-lead
Electrocardiogram (ECG)
From Ignatavicius D, Workman L: Medical-Surgical Nursing, 5th ed., Philadelphia, Saunders, 2006.
Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 16
Patient Wearing a Holter Monitor
From Canobbio MM: Cardiovascular disorders, St. Louis, 1990, Mosby.
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Slide 17
Patient Taking an Exercise Stress Test
From Canobbio MM: Cardiovascular disorders, St. Louis, 1990, Mosby.
Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 18
Cardiovascular/Nuclear Medicine Studies
Cardiovascular/nuclear medicine studies):
• Thallium stress test
• Sestamibi stress test
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Slide 19
Cardiovascular/Ultrasound Studies
Cardiovascular sonography
(ultrasound/echography):
• Echocardiogram
• Transesophageal echocardiogram (TEE)
Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 20
Cardiovascular Catheterization
Cardiac cath lab studies (cardiac catheterization):
• Coronary angiography (also discussed in
special procedures section of Chapter 15)
• Coronary angioplasty (therapeutic procedure
discussed in Chapter 17)
• Electrophysiological studies (EPS)
• Swan-Ganz catheter insertion
Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 21
Cardiovascular Catheterization, continued
From Ignatavicius D, Workman L: Medical-Surgical Nursing, 5th ed., Philadelphia, Saunders, 2006.
Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 22
Cardiovascular Catheterization, continued
• Consent form required
• Scheduling with department and physician may
be required
• Some preparation may be required (NPO)
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Slide 23
Vascular Plethysmography/Ultrasound
Studies
Peripheral vascular studies:
• Vascular plethysmography
• Vascular ultrasound
• Duplex scanning
• Venous and arterial Doppler flow
studies (e.g., carotid Doppler)
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Slide 24
Medications To Note When Ordering
Cardiac Studies
Cardiovascular medications:
• Lanoxin (digoxin)
• Nitroglycerin (NTG)
• Quinidine
• Lidocaine
• Any other cardiovascular medication
Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 25
Cardiovascular Diagnostic Downtime
Requisition
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Slide 26
Lesson 16.2
Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 27
Endoscopy
• The word endoscopy is a general term
used to indicate the visual examination of
a body cavity or hollow organ
• It is a diagnostic procedure performed by
a doctor
• During some endoscopic procedures,
biopsies are performed
Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 28
Endoscopy, continued
• A consent is needed for endoscopy
examinations
• When a visual examination of the stomach
and/or intestines is ordered, the patient would
need to be prepared for the procedure
• Barium should not be given before a
gastrointestinal visual examination
Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 29
Endoscopy, continued
Types of endoscopies
• Anoscopy
• Bronchoscopy
• Esophagoscopy
• Gastroscopy
• Endoscopic
retrograde cholangiopancreatography
(ERCP)
Organ examined
• Anal canal
• Bronchi
• Esophagus
• Stomach
• Biliary and
pancreatic ducts
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Slide 30
Endoscopy, continued
Types of endoscopies
• Esophagogastroduodenoscopy (EGD)
• Colonoscopy
• Sigmoidoscopy
• Proctoscopy
Organ examined
• Gastrointestinal tract
• Large intestine
• Sigmoid colon
• Rectum
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Slide 31
Endoscopy Downtime Requisition
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Slide 32
Bronchoscopy
From Pagana KD, Pagana TJ: Mosby’s manual of diagnostic and laboratory tests, ed 3, St. Louis, 2006, Mosby.
Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 33
Gastrointestinal Studies (GI Lab)
Some gastrointestinal (GI) studies are
performed in the endoscopy department,
usually on an outpatient basis, while
others may be performed at the bedside
by the nurse
Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 34
Gastrointestinal Studies (GI Lab),
continued
Gastrointestinal (GI) studies that may be
performed in the endoscopy department:
• Gastric analysis
• Esophageal manometry/motility and reflux
• Secretin test
Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 35
Cardiopulmonary (Respiratory Care)
• The cardiopulmonary department (also called
the respiratory care department) performs
diagnostic tests to determine lung function as
well as treatments for respiratory disease and
conditions
• Treatment orders performed by the
cardiopulmonary (respiratory care)
department will be discussed in Chapter 17
Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 36
Cardiopulmonary (Respiratory Care)
Examples of diagnostic tests performed:
• Arterial blood gases (ABG)
• Capillary blood gases (CBG)
• Pulmonary function tests (PFTs)
• Spirometry
• Oximetry (pulse oximetry, ear oximetry,
oxygen saturation)
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Slide 37
Medications To Note When Ordering
Cardiopulmonary Diagnostic Procedures
Anticoagulants:
• Heparin
• Lovenox
• Coumadin
• Aspirin (ASA)
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Slide 38
Cardiopulmonary (Respiratory Care)
Diagnostic Downtime Requisition
Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 39
Sleep Study
The sleep study department performs
studies to assess a patient’s sleep
patterns to:
• Determine nature and severity of insomnia
• Reveal presence of obstructive sleep apnea
(OSA) and the severity of the condition
• Assist in the diagnosis of narcolepsy
Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 40
Sleep Study, continued
Examples of sleep studies performed:
• Polysomnography (PSG)
• Inductive plethysmography for apnea
• Multiple sleep latency tests
• Multiple wake tests
Copyright © 2009, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Slide 41