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Chapter 14
Special Examinations and Tests
Chapter 14
Special Examinations and Tests
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• 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
Examinations and Tests Examinations and Tests
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Equipment Used in ExaminationsEquipment Used in Examinations
Radiography X-ray
Endoscopy Optical scopes
Radionuclide imaging
Radioactive chemicals
Ultrasonography High-frequency sound waves
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Root Words and SuffixesRoot Words and Suffixes
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Nursing ResponsibilitiesNursing Responsibilities
• Clarifying explanations
• Preparing clients
• Obtaining equipment and supplies
• Arranging the examination area
• Positioning and draping
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Nursing Responsibilities (cont’d)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 ExaminationsPositioning 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)
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)
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 ClientPositioning the Client
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QuestionQuestion
•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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AnswerAnswer
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 Factors That Invalidate Test Results
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QuestionQuestion
•Is the following statement true or false?
Ultrasonography uses x-rays to examine clients.
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AnswerAnswer
False.
Ultrasonography uses a transducer that projects sound waves through the body’s surface.
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• 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
Commonly Performed Categories of Examinations
Commonly Performed Categories of Examinations
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• 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
Commonly Performed Categories of Examinations (cont’d)
Commonly Performed Categories of Examinations (cont’d)
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QuestionQuestion
•Is the following statement true or false?
Radiography uses elements whose molecular structures are altered to produce radiation.
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AnswerAnswer
False.
Radiography uses roentgen rays, or x-rays, to produce images of body structures.
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Testing Procedures 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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QuestionQuestion
•Is the following statement true or false?
Paracentesis is the procedure for withdrawing fluid from the abdominal cavity.
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AnswerAnswer
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
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)
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