Introduction to Laboratory Testing

NURS B20

The Nurse’s Role in Diagnostic Testing

Nursing responsibilities extend to all 3 phases of the testing process- the pretest, intratest, and the posttest periods.

The nursing process can be utilized to determine patient needs and desired outcomes during the testing process

Nurse’s Role in Diagnostic Testing

Support clients Apply the nursing process Communicate effectively Follow standards

The Nursing Process During the Testing Process

Assessment Focuses upon procuring a data base about the

client to facilitate testing and assure accurate outcomes

Nursing Diagnosis Derived, like all nursing diagnoses, from analysis

of data collected during assessment

The Nursing Process During the Testing Process

Planning Flows from nursing diagnoses and focuses on the

total patient Take into account client’s age, developmental

stage, setting that testing takes place, information needs, coping style, cultural diversification, whether patient is inpatient/ outpatient.

The Nursing Process During the Testing Process

Implementation Addresses actual work and process of executing the plans

of pretest, intratest, or posttest. Emphasis is placed upon specimen collection, educaton,

proper preparation, comfort, support, safety, infection control, and prevention of complications.

Evaluation Provides data about interpretation of test results, if goals

were met or not met, effectiveness of care and client status.

Also considered is whether to continue with, adjust, or discontinue each plan component.

Communication

Imperative that care-givers are able to communicate effectively.

When applying the nursing process it is important for the success of all endeavors that we communicate effectively with clients and family

Communication includes: giving information, instructions, education, explanations, comfort and reassurance, etc.

Standards of Care

The nursing role is based on standards, these standards influence and govern nursing responsibilities and practice.

Standards come from: American Nurses Association - ANA Joint Commission on Accreditation of Health Care Occupational Health and Safety Act- OSHA Centers for Disease Control and Prevention- CDC

Nursing Process During Testing Process

Pretest Assess indications for testing Interferences and contraindications Develop nursing diagnoses Prepare and educate patient Use standards and precautions

Nursing Process During Testing Process

Intratest Use standard precautions Collect specimens Perform procedures Provide reassurance Prevent complications Communicate and collaborate

Nursing Process During Testing Process

Posttest Evaluate outcomes Assess compliance React to critical values Modify nursing diagnoses Monitor for complications Follow standards Provide support for unexpected outcomes

Evaluating Particular Diagnostic Tests Physician orders test Assess indications for testing Review any pretest preparation, instructions, or

education required Identify normal test findings/ ranges, what values are

considered WNLs When test results are available compare client’s test

results with normal ranges and look for values out of range (either above or below normal ranges)

Report findings to physician Consider the implications to care that out of range values

have on your client

Utilizing Available Resources Identify ordered test in your resource (Laboratory and

Diagnostic Testing book) Review what the test is examining Identify the indications for the test Identify normal ranges (can find this in resource but is

usually given with the laboratory report) As deviations from the normal ranges are identified,

review potential causes of the deviations and compare those causes to your client’s condition. Make an educated guess as to the reason for deviation.

Make adjustments to care plan as necessitated by diagnostic test findings.

Review of Specific Lab Tests

Define the following tests and identify normal ranges: CBC UA Chemistry Panel (different names given to

this test by different labs)