Most Commonly Asked Procedures

7/30/2019 Most Commonly Asked Procedures

1/59

MOST COMMONLY ASKED

PROCEDURES


2/59

ABDOMINAL ASSESSMENT

Detects abnormalities in the abd area e.g.

mass; abn bowel sounds

Order: IAPP

Palpation: last (?)

C.I. w/ wilms tumor & abd aortic

aneurysm


3/59

ALPHA-FETO CHON

Assess presence of neural tube defects &

down syndrome

High AFP = neural tube defects

Low AFP = down syndrome


4/59

AMNIOCENTESIS

Assess fetal growth & maturity; det. geneticD/O & sex of the fetus

14-16 wksassess for chromosomalaberration

After 35 wksassess fetal lung maturity

2:1 fetal lung maturity* Report fetal hyper/hypoactivity, vag

bleeding, chills, fever, fluid leakage


5/59

APGAR SCORING

1st minute

5 minute

5 Criteria:

0-3 poor

4-6 fair7- 10 good


6/59

ABG ANALYSIS


7/59

ARTERIOGRAPHY

Evaluation tool before coronary artery

surgery to detect suspected congenital

anomalies

Assess for allergy to iodine or seafood,

shellfish

Epinephrine at B.S.


8/59

BARIUM ENEMA

Assess large colon

Laxative before:

Laxative after:


9/59

BARIUM SWALLOW

Assess esophagus & stomach

NPO 6-8 H

Laxative after

Increase OFI


10/59

Blood coagulation test

Det presence of bleeding D/O

N PTT: 60-70 secs

Critical level: 175 secs

*N PT: 11-12 secs

Critical level : 24 secs*Clotting Time: 9 mins

Critical level: 12 mins


11/59

Blood coagulation test

When pt.s blood value is above critical

value, w/hold the next dose of

anticoagulant


12/59

BRAIN SCAN

Detects neoplasms, brain abscess & subdural

Hematoma

Consent, inc OFI after test


13/59

BRONCHOSCOPY

Exam of bronchial tree

Consent, NPO before & after, Semi F,

Suction at B.S.


14/59

CALORIC STIMULATION

TEST Detects D/O of inner ear like meneires

dse, use of alternating warm & cold H2O.

Warm H2O: N 8th C.N. = horizontal

nystagmus

Cold H2O: N brainstem = horizontal

nystagmus

N inner ear = severe nystagmus


15/59

CALORIC STIMULATION

TEST

Cold H2O: menieres dse = moderate

nystagmus

: acoustic neuroma = no

nystagmus


16/59

CARDIAC

CATHETERIZATION Measure O2 sat, conc, det need for cardiac

surgery

Assess for allergy, NPO 6H before test

Check peripheral & apical pulses Q 15

minutes for 2-4 H. check for bleeding.

Keep a 20 lb sandbag for P. keep extextended for 4-6 H


17/59

CXR

Detects abn of organs in the thoracia area

Px women: lead shield


18/59

CHOLANGIOGRAM

Visualization of the bile ducts

Check for allergy to iodine

Epinephrine at B.S.


19/59

CHOLECYSTOGRAM

Assess gallstones

NPO p midnoc, low fat diet


20/59

COLONOSCOPY

Visualization of L.I.

Informed consent, clear liq diet 48H prior

to the test

Laxative evening before the test


21/59

CRANIAL NERVE

ASSESSMENT Detects abnormality in brainstem activity


22/59

CT SCAN

Photograph of tissue densities w/ the use of

radiation

Check allergies, NPO 4 H if dye is used

C.I: claustrophobic pts., allergy to dye, Px

women, obesity (>300 lbs)


23/59

CVP

Ind of P at RA 4th ICS- 0 level at

manometer

Tip SVC

N CVP= 212 mmHg


24/59

CYSTOSCOPY

Inspect bladder & urethra

Informed consent, NPO if gen anesthesia;

liq diet if local anesthesia

After: force fluids

Sitz bath for abd pain

N: pink tinged or tea-colored urine

Notify Dr if bright red urine or clots


25/59

DOPPLER UTZ

Evaluates patency of veins & arteries in the

lower ext

PAINLESS


26/59

ECG

Records electrical waves of the heart

Tell pt to lie still, breath N,

ST elevation or T wave inversion = MI


27/59

EEG

Records the electrical activity of the brain,

detects intracranial he & tumors

Shampoo pt.s hair, avoid caffeine beforethe test, w/hold stimulants,

antidepressants,tranquilizers,

anticonvulsants for 24-48 H prior the test


28/59

EMG

Monitor electrical activity of the mm

Avoid stimulants & sedatives before the

procedure

Ask the Pt. to contract mm slowly &

progressively

Inform Pt that a needle will be inserted into

the mm


29/59

ENDOSCOPIC

RETROGRADE CHOLANGIO

PANCREATOGRAPHY Radiographic visualization of the bile &

pancreatic ducts

C.I.: in pancreatitis, NPO before & afterthe procedure

Narcan at B.S.


30/59

ENDOSCOPY

(GASTROSCOPY,

ESOPHAGOSCOPY) Assess esophagus & stomach

Consent, remove dentures, NPO 6-8H

before the procedure

Resume feeding after gag reflex returns


31/59

FBS LEVEL

Detects DM

N: 70-110 or 80120 mg/dl

> 140 mg/dl = DM


32/59

GASTRIC ANALYSIS

Assess ulcers or to R/O pernicious anemia,

to analyze acidity, appearance & vol of

gastric secretions Refrigerate gastric samples if NOT tested

w/in 4H

Gastric ulcerHcl N

Doudenal ulcerHcl elevated


33/59

GTT

Confirms presence of sugar in the blood

High CHO given 24-48 H before the test

Blood drawn after an overnight fast


34/59

GUTHRIE CAPILLARY

BLOOD TEST Screen test for PKU

N level: 2mg/dl

Give high CHON diet 24-48 H before the

test


35/59

HYSTEROSALPINGOGRAPH

Y Det patency of F.T. & to detect pathology

in the uterine cavity.

X-ray exam administration of aradiopaque dye into the uterine cavity


36/59

INCENTIVE SPIROMETRY

Used in prevention & txt of atelectasis

Semi F, take slow, easy deep breath fr the

mouthpiece


37/59

IVP

Visualization of the urinary tract

Obtain consent, NPO 8 -10H before the

procedure. Laxative to clear the bowelsounds. Check allergy to iodine

Epinephrine

Salty taste during the test


38/59

LAPAROSCOPY

Evaluates pelvic pain & infertility & treats

endometriosis lesions

NPO before the procedure

Enema before the procedure

Shoulder or abd discomfort after procedure

due to use of CO2


39/59

LIVER BIOPSY

R/O liver D/O

Consent, bleeding most common

complicationPosition: L side or supine

Instruct to inhale, exhale, & hold breath

during procedureAfter: position on R side for 2H to prevent

Hge


40/59

LP

W/draw CSF to determine abnormalities

Before: empty bladder & bowel

Position: C-position

Needle bt L3-L4 or L4-L5. S.C ends at L2.

After: position flat to prevent(?)

Inc fluid intake


41/59

LUNG SCAN

Det lung perfusion when pulmo emboli &

infarction are suspected

Consent. Check allergy. Remove jewelriesfr the chest area. Sedatives as ordered.

Gloves w/in 24 H


42/59

MAMMOGRAPHY

Det presence of tumors

Avoid deodorants, talcum powder, lotion,

perfume, ung.

Breast will be placed bet 2 Xray plates

Best done a wk after menses

Position: lying down w/ pillow under the

shoulder of the breast being examined


43/59

MANTOUX TEST

(+) induration 10 mm or more

(+) induration of 5 mm or more in HIV;

healed TB

(+) rxn = exposure TB bacilli


44/59

MRI

Provides C-sectional images of brain

tissues, more detailed than a CT scan

C.I.: Px women, claustrophobic Pts,Pts w/metal implants like pacemaker, hip

replacements & jewelries


45/59

MULTIPLE GATED

ACQUISITION SCAN Detects valvular abn of the heart, coronary

artery dse, determines effects of CV drug

therapy Consent, PAINLESS, use of gloves if

contact w/ urine


46/59

MYELOGRAM

Detects herniated intervertebral discs,

visualization of the S.C.

HOB elevated if H2O based dye(amipaque)

Flat on Bed if Oil based dye (pantopaque)


47/59

NEEDLE BIOPSY OF THE

KIDNEY Obtain specimen/tissue sample fr the

kidney

NPO 6-8 H, check bleeding

Position on prone w/ pillow under the abd

P to puncture site

Inc fluid intake to 3000ml


48/59

PARACENTESIS

Examine contents of the peritoneal fluid & to

relieve SOB when ventilation is impaired

Consent.

Sitting position feet on footstool. Void

immediately before the test

Check: Wt

Abd girth

RR


49/59

PERICARDIOCENTESIS

Aspirate fluid from the pericardial sac

Monitor dysrrhythmias, puncture of lungs,

stomach, liver & laceration. Listen fordecrease intensity of heart sounds or

muffled heart sounds = CARDIAC

TAMPONADE


50/59

RAIU TEST

Detects hyperthyroidism &

hypothyroidism

Increase iodine uptake=

Decrease iodine uptake =


51/59

RINNE TEST

Differentiate bet conductive &

sensorineural hearing losses

Vibrating tuning fork 2 positions:

Mastoid bone (bone conduction)

Ear canal (air conduction)

CONDUCTIVE HEARING LOSS=bone

conduction longer than air conduction


52/59

SCHILLINGS TEST

Detects Vit B12 absorption

Requires 24 H urine specimen

NPO except for H2O 8-12 H before the test

N= 8-40%; >40%=anemia


53/59

SIGMOIDOSCOPY

Assess sigmoid colon

Consent, Full liq diet evening before the

test

Enema before the procedure(?)

Bleedingmost common complication


54/59

SWAN-GANZ

CATHETERIZATION Monitor pulmonary artery P & PCWP

Catheter 4 lumens

1. CVP2. For fluid infusion

3. Monitor PAP & PCWP

4. Deflation of balloonN PAP= 20-30mmHg

NPCWP= 8-13 mmHg


55/59

SWEAT CHLORIDE TEST

Detects cystic fibrosis

N Cl level= 90-110 mg/dl (serum)

= 10-35 meq/L (sweat)

Pilocarpine- to induce sweating


56/59

SUCTIONING

Obtain sputum sample, relieve congestion

hyperO2 before & after

Intermittent suction on withdrawal of the

catheter (10-15 secs)


57/59

THORACENTESIS

Aspiration of fluid & or air from pleural

space

Consent. Orthopneic position.

After: position on the unaffected side


58/59

TONOMETRY

Measures IOP

N reading 12-21 mmHg

Increase = glaucoma


59/59

WEBER TEST

Detects presence of unilateral hearing loss

Tuning fork set into vibration & placed on

the pts forehead or teeth.

Documents

Most Commonly Asked Procedures