CLINICAL LABORATORY TECHNIC FOR NURSES
CONTENTS PART I LABORATORY TESTS CHAPTER USING LABORATORY DATA HEMATOLOGY TESTS ROUTINE URINALYSIS AND OTHER URINE TESTS RENAL FUNCTION TESTS FOUR COMMONLY MEASURED ELECTROLYTES ARTERIAL BLOOD GASES AND RELATED TESTS THREE LESS COMMONLY MEASURED ELECTROLYTES AND VITAMIN D TESTS TO MEASURE THE METABOLISM OF GLUCOSE AND OTHER SUGARS TESTS TO MEASURE LIPID METABOLISM AND OTHER CARDIAC RISK FACTORS TESTS RELATED TO SERUM PROTEIN LEVELS, TUMOR MARKERS, AND CANCER GENOMICS TESTS TO MEASURE THE METABOLISM OF BILIRUBIN TESTS TO MEASURE ENZYMES AND CARDIAC MARKERS COAGULATION TESTS AND TESTS TO DETECT OCCULT BLOOD SEROLOGIC TESTS: IMMUNOHEMATOLOGY MICROBIOLOGY AND IMMUNOLOGY ENDOCRINE TESTS CULTURE AND SENSITIVITY TESTS AND RAPID TESTS FOR INFECTIONS THERAPEUTIC DRUG MONITORING AND TOXICOLOGY SCREENS TESTS PERFORMED IN PREGNANCY, THE NEWBORN PERIOD, AND FOR GENETIC SCREENING PART II CASE STUDIES PRACTICE INTERPRETATION OF LABORATORY DATA PART III DIAGNOSTIC PROCEDURES DIAGNOSTIC RADIOLOGIC TESTS BODY SCANS: CT, DXA, MRI, PET, AND SPECT NUCLEAR SCANS: DIAGNOSTIC TESTS WITH RADIONUCLIDES OR RADIOISOTOPES DIAGNOSTIC ULTRASONOGRAPHY COMMON NONINVASIVE DIAGNOSTIC TESTS COMMON INVASIVE TESTS STRESS TESTS, CARDIAC CATHETERIZATIONS, ELECTROPHYSIOLOGIC STUDIES, AND SYNCOPE TESTS ENDOSCOPIC PROCEDURES DIAGNOSTIC PROCEDURES RELATED TO CHILDBEARING YEARS I PART LABORATORY TESTS 2 PART I LABORATORY TESTS LABORATORY REPORTS, EVIDENCE- BASED PRACTICE, AND THE NURSING PROCESS NURSING FUNCTIONS IN LABORATORY TESTING ”NORMAL” REFERENCE VALUES AND THE VARIABILITY OF TEST RESULTS FALSE-POSITIVE AND FALSE-NEGATIVE TESTS NEW TECHNOLOGY FOR DIAGNOSTIC TESTING MEASUREMENTS IN LABORATORY REPORTS METABOLIC PANELS AND OTHER SCREENING TESTS LABORATORY PERSONNEL CHANGES RELATED TO HEALTHCARE REFORM OBJECTIVES 1 DESCRIBE HOW LABORATORY DATA CAN BE USED IN THE FRAMEWORK OF THE NURSING PROCESS AND HOW THE USE OF DATA DIFFERS IN NURSING AND MEDICINE 2 DESCRIBE THE FUNCTIONS OF NURSES IN RELATION TO LABORATORY TESTS, INCLUDING GENETIC TESTING 3 EXPLAIN THE MEANING OF CLIA WAIVED TESTS FOR POINT-OF-CARE TESTING 4 IDENTIFY THE TWO NONDISEASE FACTORS THAT CAUSE THE GREATEST VARIATIONS IN NOR- MAL REFERENCE VALUES FOR LABORATORY TESTS 5 COMPARE THE MEANINGS OF THE TERMS SPECIFI CITY AND SENSITIVITY IN RELATION TO DIAGNOSTIC TESTS 6 EXPLAIN THE MEANING OF THE MEASUREMENT SYMBOLS IN THE CONVENTIONAL LABORA- TORY SYSTEM AND IN THE SI SYSTEM 7 DESCRIBE THE PURPOSE OF EACH OF THE BASIC DIAGNOSTIC SCREENING TESTS RECOM- MENDED FOR ASYMPTOMATIC ADULT POPULATIONS 8 DEFI NE HOW NURSES CAN FOSTER SMOOTH WORKING RELATIONSHIPS WITH PERSONNEL IN THE LABORATORY DEPARTMENT IN DISCUSSING SEVERAL ISSUES THAT ARE PERTINENT TO THE NURSE’S UTILIZATION OF LABORA- TORY DATA, THIS CHAPTER TOUCHES BRIEFL Y ON THE NURSING PROCESS, ON THE DIFFERENCES BETWEEN NURSING CARE AND MEDICAL CARE, AND ON THE TRADITIONAL ROLES OF THE NURSE IN RELATION TO DIAGNOSTIC TESTS TECHNOLOGICAL ADVANCES HAVE NOW MADE IT POS- SIBLE FOR NURSES TO PERFORM MANY TESTS AT THE POINT OF CARE EMPHASIS IS GIVEN TO THE MANY FACTORS THAT INFL UENCE TEST RESULTS, SUCH AS PHYSIOLOGY, DRUG INTERFERENCE, AND THE STATISTICAL METHODS USED TO DETERMINE “NORMAL” RANGES A COMPARISON OF USING LABORATORY DATA CHAPTER CHAPTER 1 USING LABORATORY DATA CONVENTIONAL MEASUREMENTS AND SI UNITS IS INCLUDED, AND THE PURPOSE OF SCREENING TESTS IS EXPLORED THE LAST SECTION IN THE CHAPTER DISCUSSES WAYS THAT THE NURSE CAN EFFECTIVELY WORK WITH PERSONNEL IN OTHER DEPARTMENTS LABORATORY REPORTS, EVIDENCE-BASED PRACTICE, AND THE NURSING PROCESS UP TO THE EARLY 1970S, PROBLEM SOLVING WAS EMPHASIZED AS A WAY OF THINKING ABOUT THE NEEDS OF CLIENTS ABOUT THAT TIME, MOST NURSING EDUCATORS STARTED TURNING TO THE NURSING PROCESS, WHICH IS AN ELABORATION OF THE PROBLEM-SOLVING TECHNIQUE USED BY ALL DISCIPLINES IN ESSENCE, THE NURSING PROCESS IS A WAY OF SYSTEMATICALLY IDENTIFYING THE NEEDS OF PATIENTS OR CLIENTS AND THEN LOGICALLY PLANNING THE APPROPRIATE NURS- ING ACTIONS TO MEET THOSE NEEDS (THE TERM CLIENT IS USED IN THIS BOOK, BUT PATIENT MAY BE SUBSTITUTED IF ONE WISHES ) MOST PRACTICING NURSES USE THE NURSING PROCESS EVEN THOUGH THEY MAY BE UNSURE ABOUT HOW TO DESCRIBE IT STEP-BY-STEP IN WRITING HOWEVER, NURSING STUDENTS LEARN TO DEVELOP CARE PLANS BASED ON THE NURSING PRO- CESS IN A VERY SYSTEMATIC MANNER YET, WHETHER WRITTEN OR NOT, THE NURSING PROCESS, AS A WAY OF THINKING, HELPS THE NURSE PROVIDE NURSING CARE THAT IS BASED ON MORE THAN GUESSWORK OR GENERALIZATIONS ABOUT CLIENTS THIS PROCESS IS A DELIBERATE WAY OF USING DATA TO MAKE THE ASSESSMENTS AND TO IDENTIFY THE PROBLEMS THAT ARE UNDER THE JURISDICTION OF THE NURSE THE EVALUATION AND MODIFI CATION OF CARE ARE ALSO ESSENTIAL COMPONENTS OF THE NURSING PROCESS THE FORMAT FOR A WRITTEN NURSING CARE PLAN IS SHOWN IN TABLE 1–1 TABLE 1–1 USE OF LABORATORY DATA IN NURSING PROCESS COLLECTION OF DATA (ASSESSMENT) NURSING DIAGNOSIS OR STATEMENT OF PROBLEMS (ANALYSIS) CLIENT/ NURSE GOALS (PLANNING) INTERVENTIONS (NURSE-TO- NURSE ORDERS IMPLEMENTATION) EVALUATION AND MODIFI CATION NEEDED (EVALUATION) CANNOT USE LEFT ARM TO HOLD GLASS: MOUTH IS DRY; SKIN TURGOR POOR; I&O FOR LAST 24 H I = O =