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diagnostic test


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What is included in a CBC?
erythrocyte count
leukocyte count (wbc)
red blood cell indices
differential white cell count
hemoglobin measures ?
the total amount of hemoglobin in the blood.
hematocrit measures
the percentage of red blood cells in the total blood volume
Normal values of hemoglobin and hematocrit will vary depending on the clients?
Hemoglobin and hematocrit both increase in cases of ?
Hemoglobin and hematocrit both decrease in cases of?
hypervolemia and resulting hemodilution
Low RBC counts are related to
RBC varies in client according to ?
Clients with hypoxia will have an increase or a decrease in RBC?
increase a condition AKA polycythemia
Red blood cell indices is a measurement of?
hemoglobin concentration
A Leukocytes count (WBC) determine?
the total number of white blood cells per cubic millimeter of whole blood.
An increase in WBC indicated?
bacterial infection
A decrease in white blood cells indicates?
a viral infection
A normal Neutrophils % in the differential count is?
An increase in neutrophils, indicates?

acute infection
A decrease in the neutrophil count indicates?

hint: R.A.D
radiation therapy
aplastic anemia
dietary deficiency
A normal lymphocyte percent is ?
20-40 %
An increase in lymphocytes indicates?

hint. CI-vI-m
chronic infection
viral infection
A derease in lymphocytes percent indicates?

The normal percent of monocytes is ?
An increase in the monocyte percent indicates?

chronic inflammatory disorders
chronic ulceratie colitis
A decrease in the monocyte percent indicates?
drug therapy prednisone
An increased eosinophils percent indicates?

parasitic infections
allergic infections
A normal eosinophil count is?
1-4 %
A decrease in eosinophil percent indicates?
increased adrenosteroid production
A normal basophil percent is ?
AN increased basophil count indicates?

hint: L
A decreased basophil count indicates?

acute allergic reaction
What counts could be used to determine leukemia?
decreased lymphocytes
increased eosinophils
increased basophils
decreased platelet count
A normal platelet count within the WBC differential count is ?
150-350 X 10^3/ml^3
An increased platelet count indicates?

malignant disorders
rheumatoid arthritis
iron deficiency anemia
Serum electrolytes are used to measure?
acid base -electrolyte imbalances
If a client is being treated with diuretics for hypertension or heart failure, what common test would be performed to measure electrolyte balances?
serum electrolytes
The most commonly order serum electrolytes test are ?
bicarbonate ions
What type of test is a serum electrolyte ?
venous blood test.
Normal lab. value of sodium
135-145 mEg/L
What is the normal lab. potassium value ?
3.5 5.0-mEq/L
What is normal lab value for chloride?
95-105 mEq/L
What is a normal lab value for calcium?
4.5-5.5 mEq/L
What is a normal lab value for Magnesium?
1.5-2.5 mEq/L or 1.6-2.5 mg/dl
WHat is a normal lab value for Phosphate (phosphorus)?
1.8-2.6 mEq/l
Normal serum osmolality ?
280-300 mOsm/kg. water
Serum osmolality is a measure of ?
solute concentration of the blood.
particles include glucose, sodium ions, and urea (BUN)
serum osmolality is used to evaluate a client's -------?
fluid balance.
AN increase in serum osmalality indicates?
a fluid volume deficit.
A decrease in serum osmolality indicates?
a fluid volume increase.
What is an important consideration after the specialty trained nurse draws an arterial blood gas ?
apply pressure for 5-10 minutes to prevent hemorrhaging.
Blood gas sample are usually drawn from the ?
Hemoglobin A1c is a measurement of ?
blood glucose during the prior 3-4 months.
An elevated HbA1c indicates?
hyperglycemia in diabetic clients
To help the client avoid gagging while obtaining a throat culture the nurse would have the client ?
extend the tongue and say AHHHHHH,
indirect visualization is what type of procedure?
non invasive
Direct visualization is what type of procedure?
What are two positions used when a client is having a thoracentesis?
sitting on one side with arms held up and in front.

sitting and leaning forward over a pillow.
Reasons for a thoracentesis?
remove excess fluid
to ease breathing
to introduce chemotherapy drugs intrapleurally.
When the nurse is preparing a client for a thoracentesis, she should remember.
explain the procedure.
explain the client may feel pressure from the needle.
takes only a few minutes.
client should not cough during needle insertion.
explain when, where, and who will be there.
position and cover client
During a thoracentesis a nurse should remember.
place a sterile dressing over the puncture site.
After a thoracentesis a nurse should remember?
position client at 30 degree angle for 30 min. to expand lungs.
document relevant information.
transport sample.
The injection site for a lumbar puncture.
between the 4 and 5 lumbar vertebra
The nurses role before a lumbar puncture procedure.
explain procedure
have client empty their bladder and bowels.
explain when, where, and who
necessary to lie still for 15 minutes
feel pressure at injection site.
position/drape client
open lumbar set.
The nursing role during a lumbar puncture.
support the back of client's knees and neck.
reassure and explain procedure
encourage normal breathing
observe client for headache, respirations, skin color, or persistent pain
handle specimen accordingly
place sterile dressing at site.
The nurses role after a lumbar puncture.
ensure comfort and safety
client in dorsal recumbent position with only one head pillow for 1-12 hours.
give analgesics if ordered
monitor swelling or bleeding at site.
monitor neurological status.
determine is client has numbness, tingling, or pain that radiates down the legs.
To prepare a client for an abdominal paracentesis
explain it takes about 15 min,
remind client to remain still
tell who, what, where, and when
to void = avoid puncturing bladder
help position in bed, edge of chair,
maintain clients privacy.
THe nurses role during the abdominal paracentesis.
encourage client
observe for signs of distress=abnormal pulse, skin color, and BP
observe for signs of hypovolemic shock induced by loss of fluid.
place a sterile dressing on site.
Normal white blood cell count.
5-10 x 10^3 /ml.^3
An increased white blood cell count indicates AKA Leukocytosis
A decreased WBC count AKA leukopenia, indicates?
autoimmune disease
drug toxicity
bone marrow failure
during an abdominal paracentesis what is the maximum amount of fluid that can be withdrawn to avoid hypovolemic shock?
1500 ml. at one time
Draining the fluid during an abdominal paracentesis what speed is best to avoid hypovolemia?
slow speed and less than 1500 ml
What is a common site for a liver biopsy?
intercostal space between two of the right lower ribs and into the liver.


through the abdomen below the right rib cage=sub-costally
For a bone marrow biopsy how much marrow is withdrawn?
using a 10 ml. syringe 1-2 ml. of marrow is withdrawn.
After a liver biopsy, what position helps to prevent pressure to the site?
postioning the client on the biopsy site
In advance of a liver biopsy what two blood test are commonly performed?
the prothrombin and platelet count: if the results are abnormal the biopsy is contraindicated.
After what test would the nurse need to offer oral fluids to help restore the CSF?
A lumbar puncture.
commonly used areas for a bone marrow biopsy.
iliac crest
anterior or ****posterior iliac spine is the perfered place.
Lung scan aka V/Q records?
emissions from radioisotope that indicate how well gas and blood are traveling through the lungs
For a sterile stool culture, the nurse should dip the swab into stool that contains?
where purulent fecal matter is present
The hemoccult test has a reagent that is used to detect?
presence of the enzyme peroxidase in the hemoglobin molecule
A color other than blue or no color, is what type of occult blood finding?
A blue result when testing for occult blood is what type of finding?
Occult blood, what foods can give a false-positive result?
recently eaten beef, lamb, liver, or processed meats.
raw veggies or fruits=turnips, radishes, horse-radish, melons.
taken iron, aspirin, NSAIDS, anticoagulant.
Amount of urine needed when a urine culture is to be done from a clean catch specimen?
30-60 ml
Amount of urine needed for routine urinalysis?
10 ml.
Amount of urine needed when doing a urine culture on a catheter urine sample?
3 ml. for a urine culture
30 ml. for routine urinalysis
Sputum sample important points.
usually done first thing in the morning.
client who cannot cough the nurse would use pharyngeal suctioning.
The nurse follows what steps when collecting a sputum sample.
offer mouth care
ask client to breathe deeply and cough
up 1-2 TBLS or 15-30 ml.
wear gloves or other precautions
client will spit sputum in container
offer mouth care
label/sent to laboratory (bacterial cultures ASAP, others can be refrigerated)
gastrointestinal direct visualization techniques include?
anascopy- anal canal
colonscopy-large intestines
Indirect visualization of the gastrointestinal tract is done by?
CT SCANNING- 3-D image
non invasive x-ray procedure
distinguishes minor differences in the density of tissues
3-d image
more sensitive than x-ray
Magnetic Resonance Imaging
non invasive
client placed in a magnetic field
no radiation exposure
use of non iodine contrast
better contrast between normal and abnormal tissue than a CT scan
An MRI is commonly used to visualize what structures of the body?
blood vessels
abdomen and pelvis
Nursing considerations for a client having an MRI
explain there is a two way communication device to monitor client.
client must lie still.
earplugs are offered d/t noise.
procedure last 60-90 minutes
What clients cannot undergo an MRI?
implanted metal devices i.e. pacemakers, metal hip prosthesis
Nuclear Imaging Studies measure?
physiology or function of an organ.
Types of nuclear imaging studies.
positron emission tomography
Signs of hypovolemic shock
drop in BP
restlessness or anxiety
Abdominal paracentesis- preparing the client.
How long does the procedure take?
What should the client do before?
What position should client be in?
procedure time=15 min.
client should void= avoid puncturing the bladder.
position=sitting in chair or bed
Abdominal paracentesis- after the procedure the nurse should monitor for ?
What does the nurse measure?
hypovolemic shock
scrotal sac edema
monitor VS, urine output, drainage q 15 min for 2-4 hour.
measure-abdominal girth before and after.
For a client with urinary health problems , which of the following test is performed using indirect visualization? IVP, KUB, retrograde pyleography, or cystoscopy
KUB it is a X-ray
lung scan
MRI are all examples of what type of test?
non invasive
barium enema
intravenous pyelography
angiography are all examples of what type of test?
invasive =direct visualization
Acidity (pH)
7.35 - 7.45
98 - 106 mEq/L
0.6 - 1.2 mg/dL
Erythrocyte Sedimentation Rate (ESR or Sed-Rate)
Male: 1 - 13 mm/hr
Female: 1 - 20 mm/hr
Tested after fasting: 70 - 110 mg/dL
Platelet Count
150,000 - 350,000/mL
3.5 - 5.0 mEq/L
Normal value for Prothrombin (PTT)
25 - 41 sec
Red Blood Cell Count (RBC)
4.2 - 6.9 million/µL/cu mm
135 - 145 mEq/L
Urea Nitrogen (BUN)
10-20 mg/dl
Normal values for creatinine
females =O.5-2.2 mg/dl
males=0.6-1.2 mg/dl

***elderly have decreased values
Normal cholesterol values
<5.20 mmol/l
Creatinine Phosphokinase
males= 55-170 U/L
female= 55-170 U/L
females =30-135 U/L
males= 30-135 U/L
T=<0.2 ng/ml

Prothrombin time
11.0-12.5 seconds
International Normalized Ratio
depending on clinical stituation.
Normal values for Uric Acid
Male= 4.0-8.5 mg/dl
female=2.7-7.3 mg/dl
Reason for a low RBC count
over hydration
dietary deficiency
sickle cell anemia
chronic illness
organ failure
Reasons for high level of RBC's

congenital heart failure
chronic obstruction pulmonary disease
Purpose of Sed. Rate test.
non-speific test used to detect illness associated with acute and chronic infection, inflammation,neoplasm and tissue necrosis or inraction
Causes of a low SED. Rate?
Causes of an increased SED rate?
chronic renal failure
malignant diseases
bacterial infection
inflammatory diseases
necrotic diseases
The purpose of of the CPK (MB) creatinine phosphokinase
support the diagnosis of myocardial muscle injury (infarction)
indicates neurologic or skeletal muscle diseases.
qualifies the degree of M.I. & timing the onset of infarction
Purpose of a Troponin test.
performed on clients with chest pain in order to determine if the pain is due to cardiac ishemia.

Specific indicator of cardiac muscle injury.

predictor of future cardiac events.
The purpose of Prothrombin time (PT).
evaluate the adequacy of the extrinsic system and common pathway in the clotting mechanism
The purpose of a Partial Thromboplastin time (PPT)
used to assess the intrinsic system and the common pathway of clot formation.

used to monitor HEPARIN therapy.

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