COLLEGE OF NURSING

MAHARAJA SUHEL DEV

AUTONOMOUS STATE MEDICAL
COLLEGE AND MBH ,BAHRAICH
U.P.
•UNIT - 6
•TOPIC –Diagnostic Testing
• PREPARED BY –
Mr Talib Ali
Nursing Tutor
 DIAGNOSTIC TESTING
 INTRODUCTION-
• Diagnostic tests are either non-invasive or
invasive. Non-invasive means that the body is not
entered with any type of instrument; the skin and
other body tissues, organs, and cavities remain
intact. Invasive means that the body's tissues,
organs, or cavities are accessed through some type
of instrument.
• The need for diagnostic tests is determined after a
thorough history and physical examination. Results
of diagnostic procedures are used to formulate a
medical diagnosis and plan a course of treatment.
 • PREPARING THE CLIENT FOR DIAGNOSTIC
TESTING
• The nurse plays a key role in scheduling and preparing
the client for diagnostic testing. Nursing measures to
ensure client safety are: establish baseline, vital signs,
identify known allergies, and assess teaching
effectiveness.
• During Preparation, Assessment of Client by Nurse
• Ensure that the client is wearing an identification band
• Review the medical record for allergies and previous
adverse reactions to dyes, a signed consent form
• Monitor level of hydration and weakness for clients
 Care of the Client during Diagnostic Testing-
• Care during the diagnostic testing must be individualized.
• Standard precautions are used when possible exposure to body
fluids may occur.
• Protective barriers, such as gloves, gown and goggles, should be
used during invasive procedures.
• Label all specimens with the client's name, date, time and specime
• Some specimens may need to be taken immediately, to the lab, or
placed on ice (e.g., arterial blood gases)
 Document the details of test by recording in client's, medical
record:
o Person who performed the procedure
o Reason for the procedure
o Type of anesthetic, dye or medications administered
o Type of specimen obtained
o Vital signs and other assessment data
• Common Investigations
 Blood tests.-
1.Complete blood count (CBC)
• A routine complete blood count (CBC) test checks for levels of
different components of every major cell in the blood:
• white blood cells, red blood cells, and platelets. Important
components measured by this test include red blood cell count,
hemoglobin, and hematocrit.
 Abnormal levels of these components may indicate:
• Nutritional deficiencies, such as vitamin B-6 or B-12.
• Iron deficiency.
• bone marrow issues.
• tissue inflammation. &Infection.
• heart conditions.
• cancer.
• Based on the results, follow-up tests are required to confirm abnormal
levels and a possible diagnosis.
• The normal ranges for a complete blood count (CBC)
 Hemoglobin normal range:- Male (ages 15+): 13.0 17.0 g/dL
Female (ages 15+): 12-15.5g/dL
 Hematocrit normal range:
• Male: 40-55%
• Female: 36-48%
 Platelet Count normal range:
• Adult: 150,000-400,000/mL
 White blood cell (WBC) normal range:
• Adult: 5,000-10,000/Ml

• A CBC test is done to test for anemia. Anemia is a medical condition in

which the red blood cell count or the hemoglobin is less than normal.
• In men, anemia is typically defined as a hemoglobin level of less than 13
gram/100 ml In women as hemoglobin of less than 12.0 gram/100 ml.
 2. Serum Electrolytes
• Sodium, calcium, potassium, chloride, phosphate, and magnesium are all
electrolytes.
• The individual gets them from the foods he eats and the fluids he drinks.
• The levels of electrolytes in the body can become too low or too high.
• This can happen when the amount of water in the body changes.
• This test requires the person to fast for at least eight hours before the blood is
drawn.
• Abnormal results may indicate kidney disease, diabetes, or hormone
imbalances.
• The following tests will be performed to diagnose any of these conditions.
 Normal adult laboratory values of electrolytes
• Serum Sodium: 135-145 MEq/L (135-145 mmol/L)
• Chloride: 96-106 mmol/L
• Potassium: 3.5-5 MEq/L (3.5-5 mmol/L)
• Calcium: 8.5 to 10.5 mg/dL
• Phosphorous: 2.5-4.5 mg/dL
• Magnesium: 1.4 to 2.2 mg/dL
 (3) Liver Function Tests
• Liver function tests check the levels of certain enzymes and proteins in the blood.
• Levels that are higher or lower than normal can indicate liver problems.
 Some common liver function tests include
• Albumin
• Total protein
• Alkaline phosphatase (ALP)
• Alanine aminotransferase (ALT)
• Aspartate aminotransferase (AST)
• BilirubinGamma-glutamyltransferase (GGT).
• L-lactate dehydrogenase (LD).
• Prothrombin time (PT).
1.Albumin and total protein.
• Albumin is one of several proteins made in the liver. Your body needs these proteins
to fight infections and to perform other functions.
• Lower-than-normal levels of albumin and total protein may indicate liver damage or
disease.
2.Alkaline phosphatase (ALP).
ALP is an enzyme found in the liver and bone and is important for breaking down protein
3.Alanine transaminase (ALT),
• ALT is also called Serum Glutamic Pyruvic
Transaminase (SGPT) ALT is an enzyme found in the
liver that belts convert proteins into energy for the liver
cells When the liver is damaged.
• ALT is releaxed into the bloodstream and levels increase
4.Aspartate transaminase (AST).
• AST is also called Serum Glutamic Oxaloacetic
Transaminase (SGOT).
• AST is an enzyme that helps metabolize amino acids.
Like ALT.
• AST is normally present in blood at low levels. An
increase in AST levels may indicate liver damage,
disease, or muscle damage.
5.Bilirubin.
• Bilirubin is a substance produced during the normal breakdown of red blood
cells.
• Bilirubin passes through the liver and is excreted in the stool. Elevated levels
of bilirubin (jaundice) might indicate liver damage or disease or certain types
of anemia.
6.Gamma-glutamyltransferase (GGT).
• GGT is an enzyme in the blood. Higher-than-normal levels may indicate liver
or bile duct damage.
7.Lactate dehydrogenase (LD).
• LD is an enzyme found in the liver.
• Elevated levels may indicate liver damage but can be elevated in many other
disorders.
8.Prothrombin time (PT).
• PT is a blood test that measures how long it takes blood to clot.
• Increased PT may indicate liver damage but can also be
elevated if you're taking certain blood-thinning drugs, such as
warfarin.
 Normal blood test values include:
• ALT: Up to 40 U/L
• AST: UP to 40 U/L
• ALP: 40 to 130 U/L
• Albumin: 3.5 to 5.0 grams per decilitre (g/dL)
• Total protein: 6 to 8 g/dL
• Bilirubin: 0.1 to 1.2 mg/dL
• GGT: 8 to 61 U/L
• LD: 122 to 222 U/L
• PT: 11 to 13 seconds).
• Lipid/ Lipoprotein Profile
• Cholesterol is a form of fat we need. It helps make the outer membranes of our bodies'
cells stable. But for decades, it was known that people with high total cholesterol levels
are more likely to get heart disease.
• It was found that the different forms of cholesterol ("good" and "bad") play a role.
• For example, low-density lipoprotein (LDL), or "bad" cholesterol, can stick to blood
vessel walls. Over time, it can play a role in clogging arteries in a process called
atherosclerosis. Narrowed arteries in the heart can then develop sudden blood clots,
causing heart attacks.
• Triglycerides are another fat that is measured with cholesterol testing. High levels can
raise the chances of having a heart attack or stroke. This is especially true when the
person has low levels of "good" cholesterol, called high-density lipoprotein (HDL).
High triglyceride levels also make him more likely to develop diabetes.
• HDL is "good" because it removes harmful substances from the blood and helps the
liver break them down into waste.
• LDL is "bad" because it can cause plaque to develop in the arteries, increasing the risk
of heart disease.
 LIPID PROFILE
DESIRABLE BORDERLINE HIGH RISK
CHOLESTEROL Less than 200 mg/dl 200-239 mg/dl 240 mg/dl

TRIGLYCERIDES Less than 150 mg/dl 150-199 mg/dl 200-499 mg/dl

HDL 60 mg/dl 35-45 mg/dl More than 35 mg/dl

CHOLESTEROL
HDL 60-130 mg/dl 130-159 mg/dl 160-189 mg/dl
CHOLESTEROL

CHOLESTEROL /HDL 4.0 5.0 6.0

Ratio
 Renal Function Test
• Healthy kidneys remove wastes and excess fluid
from the blood. Blood and urine tests show how
well the kidneys are doing their job and how
quickly body wastes are being removed.
 Serum Creatinine-
• Creatinine is a waste product that comes from the
normal wear and tear on the muscles of the body.
The typical range for serum creatinine is:--
• For adult men, 0.74 to 1.35 mg/dL.
• For adult women, 0.59 to 1.04 mg/dL.
• A creatinine level of greater than 1.2 for women
and greater than 1.4 for men may be an early sign
that the kidneys are not working properly. As
kidney disease progresses,
 Blood Urea Nitrogen (BUN)
• Urea nitrogen comes from the breakdown of
protein in the foods a person eats.
• A normal BUN level is between 7 and 20 mg/dl.
As kidney function decreases, the BUN level
rises.
 • . Serum Glucose Testing - AC, PC, HbA1c,
GRBS-
 INTRODUCTION-
• Blood glucose testing, also known as blood glucose
monitoring, is one of the main tools involved in
controlling diabetes.
• A blood glucose test is a blood test that screens for
diabetes by measuring the level of glucose (sugar) in a
person's blood.
• AC – (Ante cibum) Meaning before meal
• PC- (Post cibum) Meaning after meal.
• HbA1c- (Glycated hemoglobin) Measures average Hb
level 2-3 months.
 • AC – (Ante Cibum) Meaning before meal
Fasting blood glucose level.
 Indications-
To screen for and diagnose prediabetes and diabetes
To detect high blood glucose (hyperglycemia) or low blood
glucose (hypoglycemia)
 Preparation for fasting blood glucose test
Screening and diagnosis: In general, it is recommended that the person fast
(nothing to eat or drink except water) for at least 8 hours (usually
overnight) before having a blood glucose test.
For people with diabetes, glucose levels are often checked both while fasting
and after meals to provide the best control of diabetes.
• If the blood glucose level is 70 to 99 mg/dL (3.9 to 5.5 mmol/L). It means
the glucose level is within the normal range
• If the blood glucose level is 100 to 125 mg/dL (5.6 to 6.9 mmol/L). It
means there is an impaired fasting glucose level (pre-diabetes).
• If the blood glucose level is 126 mg/dl (7.0 mmol/L) or higher on more
than one testing occasion. It means the person is diabetic.
 Post-Prandial Blood Sugar Testing--
• The word "postprandial" means after a meal. So,
postprandial blood sugar or PPBS refers to the
level of plasma glucose in the blood after a meal.
Carbohydrate foods contain glucose and they
provide energy to our body.
• After an hour of having a meal, the blood sugar
level reaches its peak point
 • MONITORING CAPILLARY BLOOD
GLUCOSE (Glucometer Random Blood Sugar
- GRBS)
• Capillary blood glucose testing is a quick and
convenient tool for measuring a patient's blood
glucose level.
• A clinical test that takes place next to the patient
rather than being processed in a laboratory can aid
diagnosis and closely monitor blood glucose
levels to support blood glucose control.
• Steps to be followed when using a blood sugar meter or
Glucometer
1. Thoroughly wash the hands and disinfect the glucometer.
2. Gather the glucometer, a test strip, a lancet, and an alcohol wipe.
3. Rub the hands together to encourage blood flow to the fingertips.
4. Turn the meter on and insert the test strip
5. Wipe the fingertip with the alcohol pad and let the alcohol
evaporate.
6. Prick the finger with the lancet.
7. Gently squeeze at the base of the finger until a drop of blood forms
on the fingertip.
8. Place the blood droplet on the test strip.
9. Wait for the glucometer. to display the blood sugar measurement.
10. Record the result, adding notes about anything that may have
contributed to an abnormal reading, such as food or physical
activity.
11. Properly dispose of the wipe, lancet, and test strip.
Disadvantages of blood glucose testing by using Glucometer
• Pain when pricking fingers
• Cost of blood glucose testing supplies.
• Anxiety if no education has been provided on how to interpret and
act on the glucose results.
What is HbAlc and how is it related to postprandial blood sugar?
• HbAlc or hemoglobin Alc mean glycated hemoglobin.
• In other words, the hemoglobin in the blood attaches itself to
glucose and can be a matter of concern in the long run.
• A higher level of HbAlc can cause diabetes and other complications
in the body.
HbA1c blood sugar tests
• The HbA1c test measures the percentage of glucose-bound
hemoglobin in a person's blood. According to The National Institutes
of Health (NIH), this gives a general picture of a person's blood
glucose levels over the past 2-3 months.
• HbA1c values

HbA1c mmol/mol %
Normal Below 42 mmol/mol Below 6.0%

Prediabetes 42 to 47 mmol/mol 6.0% to 6.4%

Diabetes 6.5% or over 48 mmol/mol 6.5% or over

 • How Can a Person Lower Their HbA1c
Levels?
• Following type 1 or type 2, a diabetes
management plan can help lower a client's HbAlc
level.
• This May Consist Of Dietary Modifications,
• Physical Activity,
• Medications,
 • STOOL ROUTINE EXAMINATION-
• Stool tests are a widespread practice that may be
performed due to various reasons.
• They are presented on children as well as in adults
if there are any changes in your stool or if you
have any gastrointestinal problems, problems like
severe diarrhea, allergy, and inflammation in the
body, or any digestive issues like malabsorption
or even bleeding affects the internal organs.
 -Characteristics of normal Stool-
 Volume - Variable
 Colour --
 Infant: Yellow
 Adult: Brown
 Odour
• Aromatic, may be affected by foods ingested.
 Consistency
• Soft, semi-solid, and formed.
 Shape
• The formed stool is usually about 1 inch (2.5 cm) in diameter and has the
tubular shape of the colon, but may be larger 'or' smaller, depending on
the condition of the colon.
 Composition
• Waste residues of indigestion: bile, intestinal secretions, shredded
epithelial cells, bacteria, and inorganic material (chiefly calcium and
phosphates), seeds, meat fibers, and fat may be present in small amounts.
 Indications for testing stool.
1. Diarrhea that may last for more than a few days.
2. Blood in the feces.
3. Severe stomach pain and cramps on a recurrent
basis.
4. Fever and nausea.
5. Problems in the gastrointestinal tract.
6. Food poisoning.
7. Lactose intolerance.
8. Colorectal Cancer.
 • URINE TESTING
• Observation and collection of urine specimens
• The nurse is responsible for collecting urine
specimens.
• The nurse collects clean voided specimens for
routine urine analysis, clean catch or midstream
urine specimens for urine culture, and timed urine
specimens for a variety of tests that depends on
the client's specific health problems.
 • Characteristics of normal urine
• The nurse inspects the clients' urine for colour,
clarity, and odour.
 Color: Normal colour of urine ranges from pale, straw to amber
depending on its concentration.
 Clarity: Normal urine appears transparent when freshly voided but
becomes turbid (cloudy) upon standing for several minutes in a
container.
 Odour: Urine has a characteristic odour. The more concentrated the
urine the stronger the odour. Bacteria in the urine cause an ammonia
odour. Fruity or sweet odour occurs from acetone in patients with
diabetes or starvation, due to the breakdown of fat.
 Volume: The volume of urine varies from one to two liters in 24 hours.
The urine output depends upon the water intake.
 PH: 4.6 to 8.0. Average 6.0 and is slightly acidic. (7 is neutral less than
7 is acidic and greater than 7 is alkaline).
 Specific gravity: 1.001 to 1.025.
• Assessment and collection of urine specimens
 Objectives-
1. To make the diagnosis and prescribe proper treatment.
2. To observe the effect of special treatment and drugs.
3. To ascertain the general health of the patient before surgery.
A. Clean voided Urine Specimen-
• It is collected for routine examination..
• Male clients generally can void directly into the specimen
containers, and female clients usually sit or squat over the
toilet holding the container between their legs during
voiding.
• It is better to take the first voided specimen in the morning
because it tends to have a higher, more uniform
concentration and is more acidic P H.
• 10 ml of urine is sufficient for a routine urine analysis.
 B. Clean Catch or Midstream Urine Specimen for
Culture-
• Clean catch or midstream urine specimens are
collected when a urine culture is ordered to identify
microorganisms causing urinary tract infection.
• Clean catch specimens are collected into a sterile
container with a lid.
• Disposable clean catch kits are also available.
 Purpose
• To determine the presence of microorganisms, the
type of organisms, and the antibiotics to which the
organisms are sensitive.
(C)Timed urine specimen or 24 hours urine specimen
• Some urine examinations require the collection of all urine
produced and voided over a specific time ranging from 1
hour to 24 hours
 Purposes
1.To assess the ability of the kidney to concentrate and dilute
urine.
2. To determine disorders of glucose metabolism eg. diabetes
mellitus.
3. To determine the level of specific constituents eg. Albumin,
Creatinine, Hormone like Corticosteroids.
(D)Collecting sterile specimen from an indwelling catheter
• Sterile urine specimens can be obtained from closed
drainage systems by inserting a sterile needle.
 • COMMON URINE TESTS-
1.Test for specific gravity
• Before testing urine for specific gravity. Allow the
urinometer to float in urine in a jar freely and read the
specific gravity at eye level. Read measurement at the
base of the meniscus at the level of the urine. An elevated
specific gravity can indicate dehydration.
 • Test for albumin, sugar and acetone
 Articles required-----
• A tray containing Test tube:
• Test tube holder
• Acetic acid
• Nitric acid or sulphosalicylic acid, 3%Benedict's Solution
• Ammonium sulphate, crystals Sodium Nitroprusside crystals Liquor Ammonia
• Spirit lamp,Match box,Kidney tray,Urine in a container,Dropper

 Test for albumin

(a) Hot test
• Fill three-fourths of a test tube with urine. Heat the upper third of the
urine and allow it to boil over the spirit lamp flames. Keep the mouth
of the test tube away from your face to prevent scalding.
• Add one or two drops of acetic acid into the test tube of urine. If the
urine remains cloudy it indicates the presence of albumin and if it
becomes clear it indicates that the cloudy appearance was due to
phosphates
(b)Cold test
• Pour a small quantity of nitric acid or sulfosalicylic
acid 3% into a clean test tube. Allow an equal quantity
of urine to trickle steadily down through the sides of
the test tube. If albumin is present a white precipitate
will be seen where the two fluids meet.
 Test for sugar .
1.Benedict's test:
• Take benedict's solution 5cc in a test tube, boil over the spirit lamp
to check the purity of a solution if no colour change, the solution is
pure. Add & drops of urine with a dropper into the test tube and
shake well. Boil it again for 2 minutes and allow it to cool The
result may be recorded according
2.Urine test for sugar using dipstick/ strips
• It is a quick and simple way to check for abnormally high levels of
glucose in the urine. The urine glucose test involves taking a
sample of urine. A small cardboard device known as a dipstick will
measure glucose levels. The dipstick will change color depending
on the amount of glucose
 .Test for acetone
• Rothera's test:
• Take Ammonium sulfate crystals 2cm depth in a
test tube and add an equal volume of urine and
one crystal of sodium Nitroprusside. and shake
well. Add liquor ammonia to the urine through the
sides.
• If acetone is present a permanganate purple
colour ring is formed at the junction of urine and
ammonia.
• Discard the urine, clean, and replace articles.
 Test for Bile Salts (Hey's Test)
• Take three fourth of urine in a test tube and
sprinkle sulphur power over half-inch height on
the surface of urine.
• If sulphur powder sinks into the test tube, it
indicates the presence of bile salts. Bile salts
present in the urine reduces the surface tension
of the urine and allows the sulphur powder to
sinks down.
• In normal urine, sulphur particles will float.
 Test for Bile Pigments (Smith's Test)
• Fill three fourth of a test tube with urine.
• Add iodine drops along the sides of the test tube to form
a layer on the surface of the urine.
• A green colour at the junction of the two liquids indicates
the presence of bile pigments.
Test for PH
• A urine pH level test is a test that analyzes the acidity or
alkalinity of a urine sample.
• It is a simple and painless test. Many diseases, diet, and
the medicines an individual takes can affect how acidic
or basic his / her urine
 Why does the patient need a urine pH level test?
• Kidney stones are small masses of minerals that can
collect in the kidneys and cause pain as they prevent
urine from passing through the kidneys and urinary
system. Since these stones tend to form in a highly
acidic or basic/alkaline environment, the doctor may test
the client's urine to determine the likelihood of forming
kidney stones.
 How is the urine pH level test performed?
• Before testing, the doctor may ask the patient to stop
taking certain medications known to affect the urine
pH.
• Examples of these drugs include:
• Acetazolamide used to treat glaucoma, epilepsy, and
other disorders
• Ammonium chloride, used in some cough medicines
• Methenamine mandelate used to treat urinary tract
infections
• Potassium citrate used to treat gout and kidney stones
• Sodium bicarbonate used to treat heartburn and acid
indigestion
 PH Values----
• A neutral pH is 7.0. The higher the number, the
more basic (alkaline) it is. The lower the number,
the more acidic the urine is.
• The average urine sample test is about 6.0
• Observation and collection of Sputum
• Sputum is the mucous secretion from the lungs,
bronchi, and trachea.
• It is important to differentiate it from saliva, the clear
liquid secreted by the salivary glands in the mouth.
• Thirty ounces of mucus produced/day.
• Healthy Individuals do not produce sputum.
• Clients need to cough to bring sputum up from the
lungs, bronchi, and trachea into the mouth to
expectorate into a collecting container.. Document
amount of sputum collected, color, odour, consistency
(thick, tenacious, watery), and presence of blood.
 Collection of sputum specimen-
• Purposes
• For culture and sensitivity to identify a specific
microorganism and its drug sensitivities.
• For cytology to identify the origin, structure, and
pathology of cells.
• For acid-fast bacillus (AFB)- Requires serial collection
for three consecutive days to identify the organism.
• Sputum specimens are collected in the morning. Upon
awakening, the client can cough up the secretions that
have accumulated during the night.
• When a client cannot cough the nurse must use
pharyngeal suctioning to obtain the specimen.
  Steps of procedure
• Explain client the method and purposes of sputum
collection.
• Instruct client to rinse mouth with plain water and not
with antiseptic mouthwashes.
• Ask the client to breathe deeply and then cough up 15 to
30ml of sputum.
• Wear gloves and a mask to avoid direct contact with the
sputum.
• Ask the client to expectorate or spit out the sputum into
the specimen container.
• Make sure that sputum does not contact the outside of
the container
• Include the amount, colour, consistency, odour
and presence of blood,
• Following sputum collection, offer mouth wash
to remove any unpleasant taste.
• Label and transport the specimen to the
laboratory with requisition immediately.
• Document the collection of sputum specimens
on the clients' chart. Include the amount, colour,
consistency, odour and presence of blood,
  Nasal Swab Collection and test for Corona
Virus
• The swab test is the process for the common
diagnosis for COVID-19 among the suspected
COVID-19 positive. The swab test is the use of a
swab of almost 6 inches and inserting it in a
person's nasal cavity. It is done on both nostrils to
collect enough samples for conducting a swab
test for coronavirus. The swab test's importance is
very high in the health care department compared
to other forms of tests, as it offers enough sample
quantity for ease of testing.
 • Procedure
• The people taking the COVID-19 test have to follow a
specific process for the swab test. The swab testing time is
just 30 seconds, with the swab stick twirling for 15 seconds
for each nostril. The nasal swab test procedure involves the
following process
1. The health care worker has to wear the essential protection
kit.
2. Then relax the patient and tilt their head a little.
3. Take a flexible plastic swab with artificial cotton and insert
it in the nostril for almost 6 inches.
4. Twirl it 2-3 times and take it out.
5. Repeat the process for the other nostril.
6. Put the swab with specimens into an airtight packet and
send it for testing.
7.Swab test guidelines for the health care workers conducting
the test:
8.Health care workers need to maintain complete infection
control measures when collecting specimens. It is crucial to
use personal protective equipment (PPE), N95 or higher-
level respirator, eye protection, gloves, and a gown etc.
9.They should only use synthetic fiber swabs with plastic or
wire shafts
10.After testing, the specimens can be kept at 2-8°C for up to
72 hours.
 Results-
• The swab test for COVID-19 tests is done by using the RT-
PCR technique, With the method, the swab test report time
is considerably less. On an average, the lab requires a period
of six to eight hours for the diagnosis.
  Diagnostic Radiology Procedures
• There are several different methods of obtaining images
to help screen for, diagnose, or monitor medical
conditions. These include:
• X-Rays
• X-rays or plain radiographs are often done to look at
bones, the chest, or the abdomen. With X-rays, denser
structures, such as bones, appear white (opaque) whereas
air-filled areas (such as the lungs) appear black. Most
structures of the body are in shades of gray between these
two.X-rays may be used alone to diagnose conditions
such as fractures, pneumonia, or bowel obstruction. But
often additional imaging studies are needed. eg., chest X-
rays may sometimes identify lung cancer.
 PURPOSES –
• To identify or detect any structural
irregularity /abnormality
• To rule out disease condition
 INDICATION-
• Injury
• Disease
• Physical Abnormality.
 CONTRAINDICATIO-
• Pregnancy.
 Computed Tomography (CT)
• Computed axial tomography (CAT scans or CT
scans) uses a series of X-rays plus a computer to
produce a cross-sectional image of the inside of
the body.
• CT provides more detail than an X-ray, and can
better define areas where tissues overlap. CT
scans can detect smaller abnormalities than can
be found with a conventional X-ray.
• The use of contrast dyes for CT scans can further
improve visualization in some areas, such as the
digestive tract.
 PURPOSE –
• To Detect Neoplasm.
• To Show Detail Image Of An Organ
 INDICATION –
• Bone Lesions
• Tumors
• Brain And Spinal Disease
 CONTRAINDICATIO-
• Renal Failure
• Pregnancy
• Claustrophobia
 Magnetic Resonance Imaging (MRI)
• Magnetic resonance imaging uses strong magnetic
fields and radio waves to produce images of the
inside of the body. While CT is often a better
method for evaluating bones and blood vessels,
MRI is frequently a better test for evaluating soft
tissue, such as the brain, spinal cord, nerves,
muscles, tendons, and breast tissue.
 PURPOSES-
• To visualize internal organ and tissues.
• To detect various pathological conditions.
• To rule out stages of malignancy.
 CONTRAINDICATIONS-
• Pacemaker
• Cochlear Implant
• Insulin Pump
 COMPLICATION-
• Allergy to contrast medium.
 • ULTRASOUND (SONOGRAPHY)
 DEFINITION
• Ultrasonography is a diagnostic procedure that
uses sound waves to produce images on screen
which allows medical providers to view internal
structures of the body
 PURPOSES –
• To confirm accurate diagnosis.
• To determine gestational age.
• For early detection of various disease.
 INDICATION
• Pain
• Swelling
• Routine Procedure In Pregnancy.
 • ENDOSCOPY
 DEFINITION- Endoscopy is a visual examination of
esophagus ,stomach and first part of small intestine
(duodenum) by the use of special instrument called
Endoscope
 PURPOSES-
• To Obtain Specimen
• To Treat Upper G.I. Condition
 INDICATION-
• Chronic GI Bleeding
• Gastric Ulcer
• Neoplasm
 CONTRAINDICATION-
• Possible Perforation
• Medically Unstable Patient
• Head And Neck Surgery
  BRONCHOSCOPY-
• In a bronchoscopy, a tube is inserted through the
mouth and passed down through the trachea into
the bronchial tubes.
• Bronchoscopy can be used to visualize tumors
and do biopsies. By adding ultrasound, it can
also be used to biopsy lung tumors that are near
but not within the airways. It may be used for
treatment as well, to stop bleeding from a tumor,
or to dilate the airway if a tumor is causing
narrowing.
 • COLONOSCOPY-
• INTRODUUCTION-
• A colonoscopy is an examination use to detect changes or
abnormalities in the large intestine (colon) and rectum.
 PURPOSES-
• To Detect Colon Problems.
• To Reduce Your Risk Of Death From Colorectal Cancer
 INDICATION-
• Acute And Chronic Diarrhea
• Polyps
• Screen For Colorectal Cancer
 CONTRAINDICATION-
• Severe Toxic Mega Colon
• Colitis Resent
• Myocardial Infarction
  CYSTOSCOPY-
 INTRODUCTION-
Cystoscopy is the procedure of viewing a patient’
urinary passage and bladder through an instrument
introduced through their urinary passage.
The instrument is called CYSTOSCOPE.
 PURPOSES-
• To visualize urinary passage and bladder
• To detect various disorder of urinary tract and bladder.
 INDICATION-
• Hematuria
• repeated attacks of urinary tract infection
 • ERCP (ENDOSCOPIC RETROGRADE
CHOLANGIO PANCREATOGRAPHY)
• ERCP (Endoscopic Retrograde Cholangio
Pancreatography)
• In an ERCP, a tube is inserted down through
the mouth and stomach and into the bile and
pancreatic ducts which lead into the small
intestine from the liver and pancreas. This
method can be used to retrieve gallstones that
have lodged in these ducts, as well as to
visualize the ducts as well as visualize the
pancreatic duct to evaluate pancreatic lesions.
• EGD (Esophageal Gastro Duodenoscopy)
• In an EGD, a doctor inserts a narrow tube in
through the mouth and down sequentially through
the esophagus, the stomach, and into the
duodenum.
• EGD has been very effective in diagnosing
conditions that were once hard to diagnose,
including problems with the esophagus, ulcers in
the stomach and duodenum, inflammation,
cancers, etc.
• Laparoscopy-
• In a laparoscopy, small incisions are made in the belly
button and over the abdomen allowing scope to be
introduced into the peritoneal cavity. It can be done both
for diagnosis and as a method of treatment.
 • Laryngoscopy-
• A laryngoscopy is a procedure in which a tube is inserted
through the mouth to visualize the larynx. This method
can detect abnormalities in the voice box, ranging from
polyps to laryngeal cancer.
  Mediastinoscopy-
• A mediastinoscopy is a procedure in which a scope is
inserted through the chest wall into the space between
the lungs. It may be used to diagnose conditions such
as lymphomas.
 Proctoscopy-
• A proctoscopy is a scope that can be inserted through
the anus to evaluate the rectum. It is done most often to
evaluate rectal bleeding.
 Thoracoscopy-
• A thoracoscopy is a procedure in which small incisions
are made in the chest wall to gain access to the lungs.
In addition to being used to do lung biopsies.
 • Nurses Role in Diagnostic testing-
• Nurses provide a vital service to patients and other health
care providers.
• They specialize in patient care, prepare patients for
testing and evaluate health progress. Diagnostic testing
refers to any test that may provide a diagnosis for a
condition, disease, or syndrome.
1.Preparing equipment-
• Gathering and preparing equipment is often done by
nurses.
• Their responsibilities include checking the equipment, to
assure it is working properly and is ready for use on
patients. Cleaning equipment before and after each use
to prevent the spread of infection
2.Preparing patients-
• Preparing a patient for diagnostic testing is a nurse's
responsibility. Drawing blood or administering
medication before testing is one-way nurses help prepare
patients. They also help in diagnostic testing by collecting
specimens, such as sputum or urine samples, and sending
them to the lab.
3.Assist with testing
• Assisting both patients and other health care providers
during diagnostic testing is done by nurses. They provide
patient care during the test which may include
administering medicines when needed. Nurses must help
position patients properly to complete the necessary
diagnostic testing. Transporting patients to and from the
test can be part of their job
4. Monitor patients during testing-
• Patients are monitored by nurses during
diagnostic testing.
• This includes monitoring their current medical
condition, especially in those patients deemed
unstable.
• They must check a patient's vital signs (blood
pressure, pulse, breathing rate), assess the
physical condition, and keep an eye on any
monitors that the patient needs to remain hooked
up to during the tests, such as a heart monitor or
ventilator.
5. Reporting results-
• Test results are reported to the patient's doctor,
specialists, and others in need of the information
by nurses. Results may be phoned in, faxed, or
sent electronically via a computer. It may be the
nurse's responsibility to check for the results of
the tests as well.
• They may be in charge of entering the results into
the patient's medical record.