Copyright © 2003 F.A Davis Company Nurse’s Manual of Laboratory and Diagnostic Tests EDITION Bonita Morrow Cavanaugh, PhD, RN Clinical Nurse Specialist Nursing Education The Children’s Hospital Denver, Colorado Clinical Faculty University of Colorado Health Sciences Center School of Nursing Denver, Colorado Affiliate Professor University of Northern Colorado School of Nursing Greeley, Colorado F.A Davis Company • Philadelphia Copyright © 2003 F.A Davis Company F A Davis Company 1915 Arch Street Philadelphia, PA 19103 www.fadavis.com Copyright © 2003 by F A Davis Company Copyright © 1999, 1995, 1989 by F A Davis Company All rights reserved This book is protected by copyright No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher Printed in the United States of America Last digit indicates print number: 10 Publisher: Lisa Deitch Developmental Editor: Diane Blodgett Cover Designer: Louis J Forgione As new scientific information becomes available through basic and clinical research, recommended treatments and drug therapies undergo changes The author and publisher have done everything possible to make this book accurate, up to date, and in accord with accepted standards at the time of publication The author, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of the book Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation The reader is advised always to check product information (package inserts) for changes and new information regarding dose and contraindications before administering any drug Caution is especially urged when using new or infrequently ordered drugs Library of Congress Cataloging-in-Publication Data Cavanaugh, Bonita Morrow, 1952– Nurse’s manual of laboratory and diagnostic tests – 4th ed / Bonita Morrow Cavanaugh p cm Rev ed of: Nurse’s manual of laboratory and diagnostic tests / Juanita Watson 3rd ed c1995 Includes bibliographical references and index ISBN 0-8036-1055-6 (pbk.) Diagnosis, Laboratory —Handbooks, manuals, etc Nursing-Handbook, manuals, etc I Watson, Juanita, 1946– Nurse’s manual of laboratory and diagnostic tests II Title [DNLM: Laboratory Techniques and Procedures nurses’ instruction handbooks QY 39 C377n 1999] RT48.5.W38 1999 616.07′5—dc21 DNLM/DLC for Library of Congress 98-50920 CIP Authorization to photocopy items for internal or personal use, or the internal or personal use of specific clients, is granted by F A Davis Company for users registered with the Copyright Clearance Center (CCC) Transactional Reporting Service, provided that the fee of $.10 per copy is paid directly to CCC, 222 Rosewood Drive, Danvers, MA 01923 For those organizations that have been granted a photocopy license by CCC, a separate system of payment has been arranged The fee code for users of the Transactional Reporting Service is: 8036-1055/03 + $.10 Copyright © 2003 F.A Davis Company To Laurie O’Neil Good, the finest nurse I have ever known Love, Bonnie Copyright © 2003 F.A Davis Company This page intentionally left blank Copyright © 2003 F.A Davis Company Preface This book is designed to provide both students and practitioners of nursing with the information they need to care for individuals undergoing laboratory and diagnostic tests and procedures The content is presented as a guiding reference for planning care, providing specific interventions, and evaluating outcomes of nursing care In this edition, the background information and description of the test or procedure are followed directly by the clinical applications data, starting with reference values, for each test or group of tests The introductory sections include the anatomic, physiological, and pathophysiological content necessary for a thorough understanding of the purpose of and indications for specific tests and procedures The inclusion of this information makes this book unlike many other references on this subject matter This feature enhances the integration of basic science knowledge with an understanding of and application to diagnostic testing This is extremely helpful for nursing students in developing critical thinking and clinical judgment For each test or study within the respective sections, reference values, including variations related to age or gender, are provided Critical values, where appropriate, are highlighted Both conventional units and international units are provided Readers are encouraged to be aware of some variation in laboratory values from agency to agency For all tests, interfering factors are noted where appropriate Contraindications and Nursing Alerts are included to provide information crucial to safe and reliable testing and nursing care Other features of this manual that contribute to its practical use are presentation of detailed content in tabular format when appropriate and the use of appendices to provide essential information applicable to most, if not all, tests and procedures Every effort has been made to include tests and procedures currently in use in practice settings It is recognized that newer tests and procedures may have become available after this manuscript was prepared Readers are encouraged to keep abreast of current literature and consult with laboratories and agencies in their area for new developments in the field of diagnostic tests BONITA MORROW CAVANAUGH v Copyright © 2003 F.A Davis Company This page intentionally left blank Copyright © 2003 F.A Davis Company Acknowledgments This book would not have been possible without the help, support, and encouragement of a number of people Special appreciation is due to the staff of the F A Davis Company I am particularly indebted to Lisa Deitch, Publisher, for her major contribution in developing the unique format of this text, for her encouragement, and for always being available for help when I needed it I would also like to acknowledge Robert Martone, Nursing Publisher, who encouraged me to pursue this project, and Robert H Craven, Jr., President, for his support and patience as the book evolved Special thanks are also due to Ruth De George, Editorial Assistant, and Michele Reese, Editorial Aide, for their invaluable assistance Many other individuals at the F A Davis Company contributed to the production of this book, and I wish to extend to all of them my sincere appreciation for their expertise and dedication to the high standards necessary to produce a good book Special recognition in this regard is due to Jessica Howie Martin, Production Editor, and Bob Butler, Director of Production I thank the consultants who served as reviewers of the manuscript for their thoroughness and generosity in sharing their ideas and suggestions Your comments proved invaluable! Finally, a special thanks to those family members, friends, and associates who offered and gave their support, patience, and encouragement B.M.C vii Copyright © 2003 F.A Davis Company This page intentionally left blank Copyright © 2003 F.A Davis Company Consultants Janice Brownlee, BScN, MAEd Dolores Philpot, BSMT, AND, MSN Professor Canadore College of Applied Arts and Technology North Bay, Ontario, Canada Instructor University of Tennessee Knoxville, Tennessee Sylvan L Settle, RN Marie Colucci, BS, MS, EdD Associate Professor Riverside Community College Riverside, California Vocational Teacher Tennessee Technology Center Memphis, Tennessee Joyce Taylor, RN, MSN, DSN, BA Mary Jo Goolsby, MSN, ARNP, EdD Instructor Florida State University Tallahassee, Florida Associate Professor Henderson State University Arkadelphia, Arkansas Shelley M Tiffin, ART (CSMLS), BMLSc Shelby Hawk, RN, MSN Instructor Mid Michigan Community College Harrison, Michigan Priscilla Innocent, RN, MSN Associate Professor Indiana Wesleyan University Marion, Indiana Dr Fran Keen, RN, DNSc Bachelor of Medical Laboratory Science Program Department of Pathology and Laboratory Medicine University of British Columbia Vancouver, British Columbia, Canada Donna Yancey, BSN, MSN, DNS Assistant Professor Purdue University West Lafayette, Indiana Associate Professor University of Miami Coral Gables, Florida ix Copyright © 2003 F.A Davis Company 660 INDEX Erythrocyte(s) (Continued) reference values, 20t in duodenal secretions, 317 in gastric secretions, 313 hematocrit, 21 reference values, 21t hemoglobin, 21–22 reference values, 22t osmotic fragility, 29 causes of alterations in, 29t reference values, 29 in pericardial fluid, 285t production of, 4–5 RBC indices, 22 in anemias, 23t indications for, 24 reference values, 23t stained examination, 24 abnormalities seen on, 24–25t indications for, 25 survival time study, 517–520 nursing care, 520 procedure, 518–519 reference values, 518 in urine, 230–231 Erythropoiesis, 4–5 inadequacy of, iron in, 11 Erythropoietin, causes of tissue hypoxia stimulating release of, 5t Esophageal acid and clearing, 551 Esophageal manometry, 550–552 reference values, 550t Esophageal varices, GI bleeding in, 326t Esophagogastroduodenoscopy (EGD), 372–374 with fiber-optic endoscope, 374f Esophagography See Barium swallow Esophagus, manometric studies of, 550–552 ESR See Erythrocytes, sedimentation rate Estradiol (E2), 182 reference values, 183t Estriol (E3), 182 reference values, 183t Estrogens blood levels, 182–183 reference values, 183t urinary, 255 indications for measuring, 260 reference values, 258t Estrone (E1), 182 reference values, 183t Ethylenediaminetetra-acetic acid (EDTA), as anticoagulant, 40 Euglobulin lysis time, 58–59 Evoked potentials (EP) brain, 571–573 His bundle, 583–585 nursing alert, 584 Excretory urogram (EUG) See Intravenous pyelogram Exercise ECG, 564–565 in cardiac scanning, 495 nursing alert, 497 Exercise pulmonary function studies, 590–591 Extracellular fluid, disorders and drugs associated with altered levels of, 193t Extremities bones of, 408f Doppler ultrasound studies arterial, 477–478 venous, 480–481 lower angiography of, 454–456 arthroscopy of knee, 394f radiologic studies of, 407–408 upper, angiography of, 453–454 Eye(s) color perception tests, 608–609 corneal staining test, 613–614 culture and sensitivity testing, 354 electrophysiologic studies electronystagmography, 573–574 electro-oculography, 575–576 electroretinography, 574–575 fluorescein angiography of, 451–452 plethysmographic studies of, 554–555 radiologic studies of, 401–402 refraction, 610–611 Schirmer tearing test, 612–613 slit-lamp biomicroscopy, 611–612 tonometry, 609–610 ultrasonography of, 463–464 visual acuity tests, 605–607 visual field tests, 607–608 F Factor assays, 55–57 Falling test, 601–602 reference values, 602 Fasting blood sugar (FBS), 113 client preparation for, 101 Fats, quantitative, in feces, 327 indications for testing, 329 reference values, 328t Fatty acids See Free fatty acids; Nonesterfied fatty acids FDP See Fibrinogen degradation products Febrile agglutinin tests, 82–83, 82t Febrile conditions, profile/panel groupings and tests, 647 Feces analysis of, 321–331 for bile, 328 indications for, 329 for carbohydrate utilization, 327–328 indications for, 329 microbiologic, 329–331 indications for, 331 microscopic, 321–322 indications for, 324 for occult blood, 325, 327 indications for, 329 for quantitative fats, 323, 327 indications for, 329 for trypsin, 327 indications for, 329 for urobilinogen, 328 indications for, 329 diarrhea, types of, 330 gross characteristics of, 321–322t reference values, 324t, 328t Ferric ammonium citrate (Geritol), 540 Ferritin, 11 reference values, 12t serum levels, by age and sex, 11f Copyright © 2003 F.A Davis Company INDEX Fertility, semen analysis for, 306–308 Fetoplacental adequacy, manometric studies of, 555–557 ␣-Fetoprotein (AFP) in amniotic fluid, reference values, 302 maternal, conditions associated with increases in, 299t serum test for, 90–92 Fetoscopy, 390 indications for, 391 procedure for, 393 reference values, 390 Fetus Doppler ultrasound imaging of, 459, 475–476 risks of, 460 fetal cell karyotyping, 298 hematopoiesis in, marrow growth sites in, 4f maturity of, tests for, 300–301 creatinine bilirubin, 301–302 L:S ratio, 132, 301 phosphatidyl glycerol, 301 shake test, 301 percutaneous umbilical cord blood sampling, 625 FFAs See Free fatty acids Fibrin split products (FPS), 58 Fibrinogen, 39 in CSF fluid, 275 plasma levels, 57–58 Fibrinogen degradation products (FDP), 39 Fibrinolytic system, 41, 58 Fishberg test, 242, 243 Florinef, 180 Flow rate, conversion factors, 643 Fludrocortisone acetate (Florinef), 180 Fluorescein angiography, 451–452 Fluorescent treponemal antibody (FTA) test, 281 Fluorescent treponemal antibody-absorption test (FTA-ABS), 80t, 83–84 Fluoroscopy, 398 in cardiac films, 409 Folic acid blood, reference values, 13t studies indications for, 13 procedure and nursing care for, 13–14 Follicle-stimulating hormone (FSH), 167–168 challenge tests, 168–169 reference values, 168t Forssman antibody, 86 FPS See Fibrin split products Free fatty acids (FFAs) factors associated with altered levels of, 128t test for, 127–128 FSH See Follicle-stimulating hormone FTA See Fluorescent treponemal antibody test FTA-ABS See Fluorescent treponemal antibody-absorption test Fungal infection antibody tests, 78, 78t reference values in, 79 sputum culture for, 79 G Gadopentetate dimeglumine (Magnevist), 537, 540 Gallbladder See also Hepatobiliary system 661 procedures and tests, profile/panel groups, 646 radionuclide-mediated scanning studies of, 509–510 ultrasonography of, 469–470 Gallium 67 (67Ga) scanning, 485t, 513–514 Gastric acid stimulation test, 315 procedure, 316 Gastric acidity reference values, 316t tests for basal gastric acidity, 315 gastric acid stimulation, 315 Hollander insulin test, 315 Gastric emptying scanning, 502–503 Gastric hormones, 190–191 Gastric inhibitory peptide (GIP), 190 Gastric secretions analysis of, 311–317 indications for, 313–314 macroscopic, 312–313 microscopic, 313 procedure and nursing care for, 314–315 blood in, 313 color of, 312–313 mucus in, 313 pH, 313 reference values, 314t Gastrin, 190–191 Gastritis, GI bleeding in, 326t Gastrointestinal bleeding scanning, 504–505 Gastrointestinal reflux scanning, 503–504 Gastrointestinal system abdominal CT, 535–536 abdominal films, 404–405 acidity, tests for, 315–316 endoscopic studies esophagogastroduodenoscopy, 372–374 proctosigmoidoscopy, 379–381 GI series lower, 416–417 upper, 414–416 profile/panel groupings and tests, 646–647 secretions, analysis of, 311–317 Gated blood pool imaging, 497 Genetic mutation, as tumor marker, clinical associations, 91 Genitalia cultures of, 358 male, 305f Geritol, 540 GH See Growth hormone GIP See Gastric inhibitory peptide Glaucoma, tonometry testing for, 609 Globin, 22 Globulins See also Albumin-to-globulin ratio serum causes of altered levels in, 116t reference values, 117t thyroxine-binding, 175–176 Glucagon, 187, 189–190 metabolic effects, 105t Glucose blood levels, 105–108 causes of alterations in, 106t hormones influencing, 105t reference values, 107t two-hour postprandial test, 108–109 in cerebrospinal fluid, 276 Copyright © 2003 F.A Davis Company 662 INDEX Glucose (Continued) in pericardial fluid, 285t in urine, 225–226; see also Glycosuria Glucose tolerance tests (GTTs), 109 cortisone, 111–112 intravenous, 111 oral, 109–110 nursing alert for, 110 reference values, 110t Glucose-6-phosphate dehydrogenase (G6PD), 30 Glutamic-oxaloacetic transaminase (GOT) See Aspartate aminotransferase Glutamine, in cerebrospinal fluid, 276 ␥-Glutamyl transpeptidase, 145–146 Glycosuria, 226 drugs and disorders causing, 227t drugs producing false-positive results, 227t Glycosylated hemoglobin, 112 Gonadotropin-releasing hormone (GnRH), 160 Gonads, hormones of, 182–187 GOT See Aspartate aminotransferase G6PD See Glucose-6-phosphate dehydrogenase Gram stain of cerebrospinal fluid, 280 of sputum, 269 of synovial fluid, 292 Growth hormone (GH, STH, SH), 161–162 metabolic effects, 105t reference values, 161t stimulation tests, 162–163 nursing alert, 162 reference values, 162t suppression test, 163 reference values, 163t Growth hormone-inhibiting hormone (GHIH), 160 GTT See Glucose tolerance tests “Guidelines for Isolation Precautions in Hospitals” (Centers for Disease Control and Prevention), 634–635 Gynecologic laparoscopy indications for, 391 procedure for, 392–393 H Hallucinogens, urine testing for, 266 Haptoglobin, test for, 118–119 hCG See Human chorionic gonadotropin HCO3-, definition of, 207 HDL See High-density lipoproteins Head and intracranial scanning computed tomography, 531–533 magnetic resonance imaging, 541 Hearing loss studies acoustic admittance tests, 599–601 audiometry, 596–598 tuning fork tests, 598–599 Heart See also Cardiovascular system angiography of, 440–443 arteries and large vessels of, 441f magnetic resonance imaging of, 541–542 positron emission tomography of, 515–516 radiologic studies of, 409–410 radionuclide-mediated scanning studies, 495–498 indications for, 496 procedure and nursing care for, 497–498 reference ECG values, 560t Heart shunt imaging, 497 Heinz bodies, causes of, 26t Helper T cells, 61 balance with suppressor T cells, 61t reference values, 64t Hematocrit, 21 critical values, 21 reference values, 21t in CBC, 15t Hematologic system, profile/panel groupings and tests, 645 Hematology, 3–38 definition of, Hematopoiesis, 4–7 evaluation of, theory of, 5f Hematopoietic function, tests of, 3–38 bone marrow examination, 7–9 complete blood count, 14–16, 19 erythrocyte studies, 19–32 iron studies, 11–13 leukocyte studies, 32–38 reticulocyte count, 9–11 Heme, 22 formation pathway, 248f urinary porphyrins and, 247 Hemoglobin, 21–22 degradation of, 229f developmental changes in, 27f electrophoresis, 26–29 indications for, 27 procedure and nursing care for, 29 reference values, 28t glycosylated, 112 molecular structure, 26 normal vs abnormal formation of, 28f reference values, 22 in CBC, 15t urinary, reference values, 249f in urine, 228 Hemoglobinopathies, 26–27 Hemolytic assays, 71 profile/panel groupings, 645 Hemolytic disease of the newborn, tests for, 299 Hemorrhage See Bleeding Hemorrhoids, GI bleeding in, 327 Hemostasis, 39–59 antagonists to, 41–42 definition of, 39 Hemostatic functions, tests of, 39–59 bleeding time, 44–46 clot retraction, 47–48 coagulation studies, 49 activated partial thromboplastin time, 51–52 euglobulin lysis time, 58–59 factor assays, 55–57 fibrin split products, 58 partial thromboplastin time, 51–52 plasma fibrinogen, 57–58 prothrombin consumption time, 54 prothrombin time, 49–51 thrombin clotting time, 53–54 whole blood clotting time, 52–53 platelet aggregation, 46–47 platelet count, 42–44 profile/panel groupings, 644 Rumple-Leeds capillary fragility, 47–48 Hepatitis tests, 87–88 reference values, 88t Copyright © 2003 F.A Davis Company INDEX Hepatobiliary system angiography of, 447–449 cholangiography operative, 422 percutaneous transhepatic, 422–424 T-tube, 420–422 cholecystography intravenous, 419–420 oral, 417–419 profile/panel groupings and tests, 646 radionuclide-mediated scanning studies of, 509–510 retrograde cholangiopancreatography, 377–379 Hexosaminidase, 156–157 Hiatial hernia, GI bleeding in, 326t High-density lipoproteins (HDL), 133 conditions associated with altered levels of, 134t reference values, 133t His bundle evoked potential study, 583–585 nursing alert, 584 Histology See also Biopsy methods in, 332–333 Histoplasmosis, skin test for, 622–623 HIV See Human immunodeficiency virus HLA See Human leukocyte antigen test Hollander insulin test, 315 procedure for, 316, 317 Holter ECG, 562–563 Homovanillic acid (HMA), urinary, 255 indications for measuring, 260 reference values, 257t Hormones, in blood chemistry adrenal, 177–182 aldosterone, 179–180 cortisol, 179 cortisol/ACTH challenge tests, 179–180 gastric, 190–191 gastrin, 190–191 gonadal, 182–187 estrogens, 182–183 progesterone, 183–184 testosterone, 184–185 hypophyseal, 160–171 adrenocorticotropic hormone, 164–166 antidiuretic hormone, 170–171 follicle-stimulating hormone, 167–168 FSH/LH challenge tests, 168–169 growth hormone, 161–162 growth hormone stimulation tests, 162–163 growth hormone suppression tests, 163 luteinizing hormone, 169–170 prolactin, 163–164 thyroid-stimulating hormone, 165–166 TSH stimulation test, 166–167 pancreatic, 187–190 C-peptide, 189 glucagon, 189–190 insulin, 188–189 parathyroid, 176–177 placental, 185–187 human chorionic gonadotropin, 185–186 human placental lactogen, 186–187 thyroid, 171–176 calcitonin, 176 thyroxine, 172–173 thyroxine-binding globulin, 175–176 triiodothyronine, 173–174 triiodothyronine uptake, 174–175 Household toxins, toxic doses and effects, 218–219t Howell-Jolly bodies, causes of, 26t hPL See Human placental lactogen hPRL See Prolactin Human chorionic gonadotropin (hCG), 185–186 as tumor marker, clinical associations, 91 urinary, 255–256 indications for measuring, 260 reference values, 259t Human immunodeficiency virus (HIV), tests for, 88–89 Human leukocyte antigen (HLA) test, 101–102 diseases associated with, 101t Human placental lactogen (hPL), 186–187 ␣-Hydroxybutyric dehydrogenase, 157 17-Hydroxycorticosteroids (17-OHCS), urinary, 252 indications for measuring, 259 5-Hydroxyindoleacetic acid as tumor marker, clinical associations, 91 urinary, 255 indications for measuring, 260 reference values, 258t Hydroxyproline, urine, 262 reference values, 263t Hyperaldosteronism, 253 Hyperchromia, 24t Hyperglycemia, causes of, 106t Hypersplenism, 42 Hypertension, chronic, profile/panel groups, 648 Hyperthyroidism, 172 Cytomel/perclorate suppression studies in, 523–524 Hypoalbuminemia, causes of, 115t Hypochromia, characteristics and significance of, 24t Hypogammaglobulinemia, 68 Hypoglycemia, causes of, 106t Hypophysis See Pituitary glands, hormones of Hypothyroidism, 172 TSH radionuclide study in, 523 Hypoxia erythropoiesis and, 4–5 tissue, causes of, 5t Hysterosalpingography, 433–434 I IAT See Indirect antiglobulin test Immune complex assays, 73 Immune deficiency diseases abnormal T-cell subsets in, 63t blockage of lymphocyte maturation in, 66f helper–suppressor cell imbalance in, 61t Immune response, categories of, 60 Immune system, profile/panel groupings and tests, 647 Immunoblast transformation test, 66 reference values, 67t Immunodiffusion, for fungal infections, 78t Immunoglobulins B-cell, as tumor marker, clinical associations, 91 IgA, causes of altered levels in, 65t IgD, causes of altered levels in, 65t IgE causes of altered levels in, 66t radioallergosorbent test for, 73–74 IgG assays of, 68–71 causes of altered levels in, 65t in cerebrospinal fluid, 277t conditions causing excessive levels of, 69t 663 Copyright © 2003 F.A Davis Company 664 INDEX Immunoglobulins (Continued) reference values, 70 IgM, causes of altered levels in, 65t Immunohematology, 96 Immunologic antibody tests, 77–78 Immunology, 60–95 Inclusions, in synovial fluid, 293t Indirect antiglobulin test (IAT), 100–101 Indirect fluorescent antibody tests, for fungal and parasitic infections, 78t Indirect immunofluorescent test, 78t Indium 111 (111In), 484t, 489, 492 Industrial toxins, toxic doses and effects, 218–219t Infections and infectious diseases bacterial, antibody tests for, 80–82 isolation procedures, CDC guidelines for, 634–635 nursing goals and interventions, 649 profile/panel groupings and tests, 647 skins tests for, 619 blastomycosis, 622–623 coccidioidomycosis, 622, 623 histoplasmosis, 622, 623 mumps, 621–622 toxoplasmosis, 623, 624 trichinosis, 623–624 tuberculin, 620–621 Infectious mononucleosis tests, 85–87 Inflammatory bowel disease, GI bleeding in, 326t Informed consent, for nuclear studies, 483 INR See International Normalized Ratio Insulin, 187 antibodies to, reference values, 76t metabolic effects, 105t tests for, 188–189 International Normalized Ratio (INR), 49 International Sensitivity Index, 49 International Units, for enzyme activity, 140 Intestinal biopsy, 345–347 Intestinal hormones, 190–191 Intradermal tests, 617–618 See also Skin tests Intravenous cholangiography (IVC), 419 nursing alert, 419 Intravenous pyelogram (IVP), 424, 429–430 Inulin, clearance test, 239 Iodinated contrast media adverse reactions to, 399t in angiography, 438 Iodine physiological function of, 212 as radionuclide, 485 Iron studies, 11 indications for, 11–12 procedure and nursing care for, 12–13 reference values, 12t Isocitrate dehydrogenase, 146 Isolation procedures, CDC guidelines for, 634–635 IVC See Intravenous cholangiography IVP See Intravenous pyelogram Ivy method, of bleeding time, 44, 45 procedure, 45–46 J Jaeger test, 605, 606 Jaundice, urine urobilinogen and bilirubin in, 229t Joints arthrography of, 431–432 radionuclide-mediated studies scanning studies of, 490–492 K Karyotyping, of fetal cells, 298 17-Ketogenic steroids, urinary, 254 indications for measuring, 259–260 reference values, 257t Ketonuria, 224, 226, 228 17-Ketosteroids, urinary, 253–254 indications for measuring, 259 reference values, 257t Kidney(s) angiography of, 449–450 biopsy of, 339–341 indications for, 340 nursing alert, 340 procedure and nursing care for, 340–341 disease, laboratory correlations in, 235–236t function tests, 239–244 radionuclide-mediated scanning studies of, 510–512 tubular function tests, 240–241 ultrasonography of, 470–471 Krebs cycle, isocitrate dehydrogenase in, 146 Krypton 81m, 485t L Lactate dehydrogenase (LD), as tumor marker, clinical associations, 91 Lactic acid, in cerebrospinal fluid, 276 Lactic dehydrogenase, 155–156 in plural fluid, 287t Landau micro method, for ESR determination, 32t LAP See Leukocyte alkaline phosphatase Laparoscopy, 389–394 gastrointestinal indications for, 390–391 procedure for, 392 reference values, 390 gynecological, 389 indications for, 391 procedure for, 392–393 reference values, 390 indications for, 390–391 nursing care for, 391–392, 393–394 Laryngoscopy direct, 365–366 indications for, 365 indirect, 364, 365f nursing alert, 365 procedure and nursing care for, 365–367 Latex agglutination, for fungal and parasitic infections, 78t LDL See Low-density lipoproteins Lecithin-to-sphingomyelin ratio, 132, 300–301, 301 reference values, 302t Lee-White coagulation time, 52–53 reference values, 53t Leptocytosis, characteristics and significance of, 25t Leucine aminopeptidase serum, 144–145 urinary, 250, 251 indications for testing, 251 testing procedure, 252 Leukoagglutinins, 97 Copyright © 2003 F.A Davis Company INDEX Leukocyte alkaline phosphatase (LAP), 37–38 Leukocyte esterase, in urine, 230 Leukocyte studies, 32–38 differential white blood cell count, 34–36 reference values, 35t white blood cell count, 33–34 reference values, 33t white blood cell enzymes leukocyte alkaline phosphatase, 37–38 periodic acid–Schiff stain, 38 reference values, 38t Leukocyte(s), in duodenal secretions, 317 in feces, 322 in gastric secretions, 313 in pericardial fluid, 285t reference values, 15t differential count, 16t in urine, 231 Leukocytosis, causes of, 6t Leukopenia, causes of, 6t Leukopoiesis, 6–7 altered, causes of, 6t LH See Luteinizing hormone LHRH See Gonadotropin-releasing hormone Limulus assay, of cerebrospinal fluid, 280 Lipase, serum, 148–149 Lipids, cardiac, profile/panel groupings, 644 Lipoproteins classification of, 127 composition of, 127t fractionation, 133–135 conditions associated with alterations in, 134t phenotypes clinical significance of, 136t reference values, 137t phenotyping, 135–137 reference values, 133t Liver See also Hepatobiliary system angiography of, 447–449 biopsy of, 342–344 indications for, 342–343 nursing alert, 343 procedure and nursing care for, 343–344 radionuclide-mediated scanning studies of, 507–508 ultrasonography of, 469–470 Low-density lipoproteins (LDL), 133 conditions associated with altered levels of, 134t reference values, 133t Lower gastrointestinal series (LGI) See Barium enema L:S ratio See Lecithin-to-sphingomyelin ratio LTH See Prolactin Lumbar puncture, 278–279 in CSF flow scan, 490 in thoracic CT, 534 Lung(s) See also Chest and thoracic studies angiography of, 446–447 biopsy of, 347–348 nursing alert, 347 positron emission tomography of, 515–516 radionuclide-mediated scanning studies, 498–500 Lupus erythematosus cell preparation, 76t reference values, 76t Luteinizing hormone (LH), 169–170 challenge tests, 168–169 reference values, 170t Luteinizing hormone-releasing hormone (LHRH) See Gonadotropin-releasing hormone 665 Lymph node(s) biopsy of, 344–345 ultrasonography of, 466 Lymphangiography, 451–453 Lymphocyte(s) bone marrow causes of altered levels of, 7t reference values, 8t causes of altered levels of, 36t functions of, 33 tests for, 61–62 maturation, immunodeficiency diseases blocking, 66f reference values, 16t in synovial fluid, 293t Lysozyme, urinary, 250, 251 indications for testing, 251 testing procedure, 252 M Macrocytosis, characteristics and significance of, 24t Macrophages See Monocytes Magnesium (Mg) serum, 204–206 disorders and drugs associated with altered levels of, 205t reference values, 205t urinary, 245–246 Magnetic resonance imaging (MRI), 529, 537 abdominal, 540–541 angiography, 539–540 body, 537–539 head and intracranial, 541 heart and chest, 541–542 musculoskeletal, 542–544 Magnevist, 537 Mallory-Weiss tears, at gastroesophageal junction, GI bleeding in, 326t Mammography, 411–412 American Cancer Society recommendations on, 411 Mammotest, 336 Manganese, blood levels, 212 Manometric studies, 545–557 esophageal, 550–552 fetoplacental adequacy, 555–557 oculoplethysmography, 554–555 plethysmography, 552 arterial, 552–553 body, 553–554 venous, 553 urodynamic, 545–546 cystometry, 546–548 urethral pressure profile, 549–550 uroflowmetry, 548–549 Mantoux test, 618, 620 reference values, 619 Masking level differences, 603t, 604 MCH See Mean corpuscular hemoglobin MCHC See Mean corpuscular hemoglobin concentration MCV See Mean corpuscular volume M:E ration See Myeloid-to-erythroid ratio Mean corpuscular hemoglobin concentration (MCHC), 22 reference values, 15t, 23t Mean corpuscular hemoglobin (MCH), 22 reference values, 15t, 23t Mean corpuscular volume (MCV), 22 reference values, 15t, 23t Copyright © 2003 F.A Davis Company 666 INDEX Measurement, units of, 636–643 Meat fibers, fecal examination for, 323 Meckel’s diverticulum GI bleeding in, 326t nuclear scanning, 505–506 Mediastinoscopy, 371–372 nursing alert, 371 Megakaryocytes, bone marrow, reference values, 8t Meningitis, acute bacterial, 280 Mesenteric angiography, 450–451 Methemoglobinemia, 27 Metyrapone, 178 Microbiologic studies See also Culture and sensitivity tests; Culture(s) of feces, 329–331 indications for, 331 of urine, 264–265 Microcytosis, characteristics and significance of, 24t Minerals trace, blood levels, 212–213 in urine, 264 Mixed lymphocyte culture (MLC), 67 MLC See Mixed lymphocyte culture Molybdenum, physiological function of, 212 Monoclonal gammopathies, 68, 69t Monocytes causes of altered levels of, 36t function of, 32 reference values, 16t in synovial fluid, 293t Monosodium urate (MSU) crystals, in synovial fluid, 292, 293t Mosenthal test, 242, 243–244 MRI See Magnetic resonance imaging Mucus, in gastric secretions, 313 MUGA See Multiple gated acquisition imaging Multiple gated acquisition imaging (MUGA), 495, 497 Mumps, skin test for, 621–622 Muramidase See Lysozyme, urinary Musculoskeletal system magnetic resonance imaging of, 542–544 profile/panel groupings and tests, 646 Myasthenia gravis, Tensilon test in, 595 Mycobacterium tuberculosis acid-fast smear and culture of, 272 in gastric secretions, 313 Mycoplasma pneumoniae infection, 82 Myeloblasts, bone marrow, reference values, 8t Myelography, 434–436 Myeloid-to-erythroid (M:E) ratio, reference values, Myocardial imaging, 497 Myocardial infarction See Acute myocardial infarction Myoglobin in acute myocardial infarction, 152 as cardiac marker, 153t N Narcotics, toxic blood levels, 216t Neck, computed tomography scanning of, 533–534 Neisseria meningitidis, in cerebrospinal fluid, 280 Nephrotomography, 429 Neural tube defects, amniotic fluid analysis for, 298–299 Neurogenic bladder, types and effects of, 546t Neurological system profile/panel groupings and tests, 645 studies of, 594 acoustic admittance tests, 599–601 color perception tests, 608–609 corneal staining test, 613–614 hearing loss audiometry, 596–598 hearing loss tuning fork tests, 598–599 otoneural lesion site tests, 603–604 otoneurological tests, 601–603 refraction, 610–611 Schirmer tearing test, 612–613 slit-lamp biomicroscopy, 611–612 spinal nerve root thermography, 594–595 spondee speech reception threshold test, 604–605 Tensilon test, 595–596 tonometry, 609–610 visual acuity tests, 605–607 visual field tests, 607–608 Neurosyphilis, CSF serologic test for, 281 Neutrophils bone marrow causes of altered levels of, 7t reference values, 8t causes of altered levels of, 34t in CBC, reference values, 16t function of, 32 in synovial fluid, 293t Newborn(s) arterial blood gas values in, 208t blood collection in, 629 for VDRL/RPR tests, 84 hemolytic disease of, tests for, 299 Nonesterfied fatty acids (NEFAs), 127 Nonimmune transformation tests, reference values, 67t Norepinephrine in aldosterone challenge tests, reference values, 181t in urine, reference values, 257t Normoblasts, bone marrow causes of altered levels of, 7t reference values, 8t Nose, culture and sensitivity testing, 355–356 Nuclear scanning, 482–527 positron emission tomography, 485–486, 514–516 radionuclide laboratory studies, 486–487 radionuclide-mediated studies, 487 adrenal scanning, 493–494 bone and joint scanning, 490–492 bone marrow scanning, 492–493 brain scanning, 487–489 cardiac scanning, 495–498 cerebrospinal fluid flow scanning, 489–490 deep vein scanning, 508–509 gallbladder/biliary system scanning, 509–510 Gallium 67 scanning, 513–514 gastric emptying scanning, 502–503 gastrointestinal bleeding scanning, 504–505 gastrointestinal reflux scanning, 503–504 kidney/renography scanning, 510–512 liver scanning, 507–508 lung scanning, 498–500 Meckel’s diverticulum scanning, 505–506 pancreas scanning, 506–507 parathyroid scanning, 501 parotid/salivary gland scanning, 490 pheochromocytoma scanning, 494–495 scrotal scanning, 512–513 spleen scanning, 508 Copyright © 2003 F.A Davis Company INDEX thyroid scanning, 500–501 radionuclides/radiopharmaceuticals used in, 484–485t risks of, 487 single-photon emission computed tomography, 486 5′-Nucleotidase, 144 Null cells, 61 reference values, 64t Nursing care plan, 649–650 O O2 saturation, definition of, 207 Obstetric ultrasonography, 475–476 Occult blood, 325, 327 OCG See Cholecystography, oral Oculoplethysmography, 554–555 Oikilocytosis, 24 Olychromatophilia, 24t Operative cholangiography, 422 Opsonization, 71 Oral cholecystography, 417–419 Orinase See Tolbutamide tolerance test Ornithine carbamoyltransferase, 146–147 Osmolality of serum, 206–207 of urine, 242 Otoneural lesion site tests, 603–604 Otoneurological tests, 601–603 Oxalate as anticoagulant, 40 urinary, 264 reference values, 264t Oximetry, 591–592 Oxytocin challenge test, 556 P Pain, nursing goals and interventions, 649 Pancreas hormones of, 187–190 radionuclide-mediated scanning studies of, 506–507 retrograde cholangiopancreatography, 377–379 tests and procedures, profile/panel groups, 646 ultrasonography of, 468–469 Papanicolaou (Pap) smear, 332–334 procedure and nursing care for, 334–335 Para-aminohippuric acid (PAH), clearance test, 239 Paracentesis, 291 Paranasal sinuses, tomography of, 411 Parasites antibody tests for, 78t in duodenal secretions, 317 fecal, tests for, 323–324 Parathyroid glands hormones, 176–177 radionuclide-mediated scanning studies of, 500–501 tests and procedures, profile/panel groups, 646 ultrasonography of, 464–465 Parathyroid hormone (PTH), 176–177 Parotid gland, radionuclide-mediated scanning study of, 490 Partial thromboplastin time (PTT), 51 reference values, 52t PAS stain See Periodic acid–Schiff stain Past-pointing test, 601–602 reference values, 602 667 Patch test, 617 Paul-Bunnell antibody, 86 pCO2, definition of, 207 PCR See Polymerase chain reaction PCT See Prothrombin consumption time Pelvic floor sphincter electromyography, 566–567 Pelvimetry, 405–406 Pelvis computed tomography of, 536–537 pelvic floor sphincter electromyography, 566–567 ultrasonography of, 474–475 Pelviscopy See Laparoscopy, gynecological Peptic ulcer, GI bleeding in, 326t Perchlorate suppression, 523–525 Percutaneous transhepatic cholangiography (PTHC), 422–424 needle placement in, 423t nursing alert, 423 procedure, 424 Percutaneous transluminal coronary angioplasty (PTCA), 578 Percutaneous umbilical cord blood sampling (PUBS), 625 Perfusion scanning, 498–500 Pericardial fluid analysis of, 284–286 reference values, 285t Pericardiocentesis, 285–286 Perimetric test, 608 reference values, 608 Periodic acid–Schiff stain (PAS), 37t, 38 reference values, 38t Peritoneal fluid analysis of, 289–292 procedure and nursing care for, 291–292 reference values, 290t Persantine, 495 PET See Positron emission tomography pH in arterial blood gas, 208t definition of, 207 of duodenal secretions, 317 effects of CO2 on, 208t of gastric secretions, 313 of plural fluid, 287t scale and selected values, 643 of semen, 309t of sputum, 268 of urine, 224–225 Phenolsulfonphthalein (PSP) test, 240–241 nursing alert on, 241 Phenotyping, lipoproteins, 135–137 clinicopathological significance of, 136t reference values, 137t Phenylketonuria (PKU), 262 urine in, 224 Pheochromocytoma radionuclide-mediated scanning studies of, 494–495 VMA testing and, 254 Phonocardiography, 563–564 Phosphate, serum, 202–204 disorders and drugs associated with altered levels of, 203t reference values, 203t Phosphatidylglycerol, amniotic fluid reference values, 301 test for fetal maturity, 301 Phosphatidylinositol, amniotic fluid, reference values, 301 Copyright © 2003 F.A Davis Company 668 INDEX Phospholipids, 125 reference values for, 132t tests for, 131–133 Phosphorus serum, 202–204 disorders and drugs associated with altered levels of, 203t reference values, 203t urinary, 245 Pilocarpine iontophoresis sweat test See Sweat test Pipyridamole, 497 Pituitary glands hormones of, 160–171; See also Adrenocorticotropic hormone; Follicle-stimulating hormone; Growth hormone; Luteinizing hormone; Prolactin; Thyroid-stimulating hormone tests and procedures, profile/panel groups, 646 PK See Pyruvate kinase Placental hormones, 185–187 Plasma See also Serum composition of, fibrinogen levels, 57–58 volume, radionucleide-mediated study, 517 Plasma cells antibody production in, 62 bone marrow causes of altered levels of, 7t reference values, 8t Platelet antibody tests, 97 Platelets aggregation drugs impairing, 46t tests of, 46–47 causes of altered levels of, 43t count, 42 critical values, 44 procedure and nursing care for, 44 reference values, 43 functions of, 39–40 causes of alterations in, 42t reference values, in CBC, 16t survival time, 521f radionuclide-mediated laboratory studies of, 520–521 Plethysmography, 552 arterial, 552–553 in arterial Doppler extremity studies, 477 body, 553–554 in pulmonary function studies, 588 ocular, 552–553 venous, 553 Pleura, biopsy of, 348–349 nursing alert, 349 Pleural fluid analysis of, 286 procedure and nursing care for, 288–289 profile/panel grouping, 645 indications for, 287–288 reference values, 287t transudates vs exudates, differentiation, 288t Pluripotential stem cells, Pneumonia, bacterial, 271 sputum characteristics in, 269 pO2, definition of, 207 Poikilocytosis, characteristics and significance of, 24t Poisons See Toxins Polychromatophilia, characteristics and significance of, 24t Polyclonal gammopathies, 68, 69t Polymerase chain reaction (PCR), of sputum, 269 Porphobilinogen (PBG), urinary, 247 reference values, 249f Porphyrins, 247 Portal venography, 447, 448 Porter-Silber chromogens, 253 Positron emission tomography (PET), 485–486, 514–516 cardiac nuclear scanning, 498 indications for, 515 procedure and nursing care for, 515–516 Postcoital test, in semen analysis, 309t Postprandial test, of blood glucose levels, 108–109 Potassium (K) serum, 192–196 disorders and drugs associated with altered levels of, 194–195t nursing alert, 195 urinary, 245 PPD See Tuberculin test PR interval, 559, 559f Prebycusis, 597 Pregnancy hCG in detection of, 185–186 tests and procedures in, profile/panel groups, 647 ultrasonography in, 475–476 risks of, 460 Pregnanediol, urinary, 255 indications for measuring, 260 reference values, 259t Pregnanetriol, urinary, 254 indications for measuring, 260 reference values, 257t Presbyopia, 606 Pressure, conversion factors, 642 Proctosigmoidoscopy, 379–381 indications for, 379 nursing alert, 380 procedure and nursing care for, 380–381 Profile/panel groupings, 644–648 Progesterone, 183–184 in evaluation of amenorrhea, 168 Prolactin (hPRL, LTH), 163–164 reference values, 164t Prostate biopsy of, 349–350 ultrasonography of, 472 Prostate acid phosphatase (PAP), clinical associations, 91 Prostate-specific antigen (PSA), 150 clinical associations, 91 Protein(s) in cerebrospinal fluid, 276 in plural fluid, 287t serum, 114–118 protein metabolites, 120–125 reference values, 117t urinary, 225, 261 indications for measuring, 262 reference values, 263t Proteinuria, 225 Prothrombin, 50 Prothrombin consumption time (PCT), 54 Prothrombin time (PT, pro time) critical values, 51 procedure and nursing care for, 51 reference values, 50t Protonormoblasts, bone marrow, reference values, 8t PSA See Prostate-specific antigen Copyright © 2003 F.A Davis Company INDEX Pseudocholinesterase (PCE), 157–158 PSP test See Phenolsulfonphthalein test Psychiatric drugs, toxic blood levels, 217t PT See Prothrombin time Pteroylglutamic acid See Folic acid PTH See Parathyroid hormone PTHC See Percutaneous transhepatic cholangiography PTT See Partial thromboplastin time PUBS See Percutaneous umbilical cord blood sampling Pulmonary angiography, 446–447 Pulmonary artery catheterization, 582–583 nursing alert, 582 Pulmonary function studies, 586–590 exercise, 590–591 reference values, 588t Pulmonary system See Respiratory system Purines, 261 Pyelography, antegrade, 424–426 nursing alert, 425 Pyruvate kinase (PK), deficiency of, 31 Q QRS complex, 559, 559f Queckenstedt’s test, 278–279 R Radioactive iodine uptake (RAIU) study, 521–523 reference values, 522 Radioallergosorbent test (RAST), for IgE, 73–74 Radioimmunoassay studies, 487 for hepatitis virus, 87–88 for PTH, 177 for T3, 173 uptake, 174 for T4, 172 for TBG, 174 for TSH, 166 Radiologic studies, 397–436 See also Angiography abdominal films, 404–405 antegrade pyelography, 424–426 arthrography, 431–432 barium enema, 416–417 barium swallow, 413–414 bronchography, 432–433 cardiac films, 409–410 chest films, 402–404 cineradiography, 398 contrast media, 399, 413 dual energy X-ray absorptiometry, 408–409 extremity films, 407–408 fluoroscopy, 398 hysterosalpingography, 433–434 intravenous pyelogram, 429–430 myelography, 434–436 obstruction series, 405 operative cholangiography, 422 oral cholecystography, 417–419 orbital films, 401–402 pelvimetry, 405–406 percutaneous transhepatic cholangiography, 422–424 plain films, 399–400 radiation exposure risks, 399 retrograde cystography, 427–428 retrograde ureteropyelography, 428–429 669 retrograde urethrography, 426–427 sialography, 430–431 skull films, 400–401 spinal films, 406–407 tomography, 398 chest, 410–411 paranasal sinus, 411 T-tube cholangiography, 420–422 upper gastrointestinal series, 414–416 voiding cystourethrography, 430 xeroradiography, 398–399 mammography, 411–412 Radionuclide-mediated laboratory studies, 516–527 platelet survival time, 520–521 radioactive iodine uptake, 521–523 red blood cell survival time, 517–520 Schilling test, 525–526 thyroid Cytomel/perchlorate suppression, 523–525 thyroid-stimulating hormone, 523 total blood volume, 516–517 Radionuclide-mediated scanning studies, 487 brain, 487–488 Radionuclides, 482, 483 diagnostic scanning uses, 484–485t diagnostic uses, 484–485t as interfering factor in hepatitis tests, 87–88 in PET, 514–515 in SPECT, 486 Radiopharmaceuticals, diagnostic uses, 484–485t Raji cell assay, 73 Rapid plasma reagin (RPR) tests, 84–85 causes of false positive reactions to, 83t RAST See Radioallergosorbent test Raynaud’s syndrome, 585 Red blood cell indices, 22–23 indications for, 24 reference values, 15t, 23t Red blood cell survival time study indications for, 518 procedure and nursing care for, 518–520 reference values, 518 Red blood cells (RBCs) See Erythrocyte(s) Refraction, 610–611 Reiter cells, in synovial fluid, 293 Reiter complement fixation test, 281 Renal-urologic systems, profile/panel groupings and tests, 646 Renin, 158–160 testing indications for, 159 nursing alert for, 159 procedure, 159–160 reference values, 158t Renography, 510–511 nursing care and procedure, 512 Reproductive system, profile/panel groupings and tests, 646–647 Respiratory distress syndrome (RDS), of newborns, 300 Respiratory system See also Chest and thoracic studies; Lung(s) profile/panel groupings and tests, 645 secretions of, 268 studies of, 586 exercise pulmonary function, 590–591 oximetry, 591–592 pulmonary function, 586–590 upper, culture and sensitivity testing, 355–356 Copyright © 2003 F.A Davis Company 670 INDEX Rest cardiac scan, 497 Reticulocyte(s), bone marrow, causes of alterations in, 7t, 8t causes of altered levels of, 7t peripheral blood, count, 9–11 indications for, 10 procedure and nursing care for, 10–11 reference values, 10t reference values, 8t Reticulocytosis, 10 Reticuloendothelial cells, Retina, fluorescein angiography of, 451–452 Retrograde cholangiopancreatography indications for, 377 procedure and nursing care for, 378–379 Retrograde cystography, 427–428 Retrograde ureteropyelography, 428–429 Retrograde urethrography, 426–427 Retroperitoneal ultrasonography, 466 Rh factor, in hemolytic disease of newborn, 299 Rheumatoid factor (RF), 75t reference values, 76t Rib cage, 407f Rice bodies, in synovial fluid, 293 Rickettsial infections, febrile agglutinin tests for, 82t Rinne test, 598, 599 reference values, 599 Romberg test, 601–602 reference values, 602 Rouleaux formation, 31 RPR See Rapid plasma reagin tests Rumple-Leeds capillary fragility test, 48–49 causes of positive results, 48t S Salivary glands, radionuclide-mediated scanning study of, 490 Salmonella infections, febrile agglutinin tests for, 82t Scan studies, non-nuclear, 528–544 See also Nuclear scanning computed tomography, 528–529, 529–532 abdominal scanning, 535–536 body scanning, 530–531 head and intracranial scanning, 531–533 neck and spinal scanning, 533–534 pelvic scanning, 536–537 thoracic scanning, 534–535 magnetic resonance imaging, 529, 537 abdominal, 540–541 angiography, 539–540 body, 537–539 head and intracranial, 541 heart and chest, 541–542 musculoskeletal, 542–544 Schiller test, 337 Schilling test, 525–526 nursing alert, 526 Schiøtz tonometer, 609 Schirmer tearing test, 612–613 Schistocytosis, characteristics and significance of, 25t Schistosoma haematobium, in urine, 232 Schwabach test, 598, 599 reference values, 599 Scientific notation, 636 Scratch test, 616–617 Scrotum radionuclide-mediated scanning studies of, 512–513 ultrasonography of, 473 Secretin test, 319 Selium 75 (75Se), 506 Semen analysis of, 305–310 for fertility, 306–308 procedure and nursing care for, 308–310 formation of, 305–306 gross characteristics of, 306 reference values, 309t sample collection, 309–310 tests for presence of, 308–309 Septicemia after endoscopic retrograde cholangiopancreatography, 379 after percutaneous transhepatic cholangiography, 424 blood culture in, 353 nursing alert, 354 Sequential multiple analyzer (SMA), 644 Serologic tests for bacterial infections, 80t for neurosyphilis, 281 for viral diseases, 86t Serous fluid, 283 gross characteristics of, 284 Serum ferritin levels, by age and sex, 11f iron levels, 11 reference values, 12t protein electrophoretic patterns, 69f vitamin B12, reference values, 13t Serum glutamic-oxaloacetic transaminase (SGOT) See Aspartate aminotransferase Serum glutamic-pyruvic transaminase (SGPT) See Alanine aminotransferase Serum osmolality, 206–207 SGOT See Aspartate aminotransferase SGPT See Alanine aminotransferase SH See Growth hormone Shake test, for fetal maturity, 301 reference values, 302t SI (Système International) units, 636–638 Sialography, 430–431 Sickle cell thalassemia, 27 hemoglobin formation in, 28f Sickledex text, 27 Siderotic granules, causes of, 26 Signal-averaged ECG, 565–566 Sims-Huhner test, 308 Single-photon emission computed tomography (SPECT), 486 in radionuclide-mediated scanning of brain, 489 of liver, 508 Sinuses, paranasal, tomography of, 411 Skin antibodies to, 77t reference values, 76t biopsy of, 335 culture and sensitivity testing, 357–358 Skin tests, 615–624 for allergens, 615–616 intradermal tests, 617–618 patch test, 617 scratch test, 616–617 for immune competence, 618–619 Copyright © 2003 F.A Davis Company INDEX for infectious diseases, 619–620 histoplasmosis/coccidioidomycosis/blastomycosis, 622–623 mumps, 621–622 trichinosis/toxoplasmosis, 623–624 tuberculin, 620–621 for T- and B-cell assays, 62 Skull, radiologic studies of, 400–401 Slit-lamp biomicroscopy, 611–612 Small intestine, biopsy of, 345–347 Smith micro method, for ESR determination, 32t Smooth muscle, antibodies to, reference values, 76t Snellen test, 605–606 Sodium (Na) serum, 191–192 disorders and drugs associated with altered levels of, 193t reference values, 192t urinary, 244–245 Somatostatin, 187 metabolic effects, 105t Specific gravity, of urine, 224 SPECT See Single-photon emission computed tomography Spectrophotometric analysis, of amniotic fluid, 300 Speech reception threshold test, 604–605 Sperm morphology of, 307, 309t abnormalities in, 307f motility of, 309t grades of, 307t Spherocytosis, characteristics and significance of, 25t Sphingomyelin See Lecithin-to-sphingomyelin ratio Spinal nerve root thermography, 594–595 Spine cervical, 400f computed tomography scanning of, 533–534 lumbar puncture, 278–279 radiologic studies of, 406–407 thoracic and lumbosacral, 407f Spleen radionuclide-mediated scanning studies of, 508 ultrasonography of, 468 nursing alert, 468 Spondee speech reception threshold test, 604–605 Sputum analysis of, 268–273 acid-fast bacillus smear and culture, 272 culture and sensitivity, 271 cytologic examination, 271–273 profile/panel groupings, 645 stains, 269–271 production of, 268 Squamous cell carcinoma (SCC) antigen, clinical associations, 91t ST segment, 559, 559f Staining acid-fast, 272 bone marrow, 7–8 Gram of cerebrospinal fluid, 280 of sputum, 269 of synovial fluid, 292 periodic acid–Schiff (PAS), 37t, 38 red blood cell, 24–26 Staphylococcal antibody tests, 80–81 Stem cell(s), in hematopoiesis, STH See Growth hormone Stomatocytosis, characteristics and significance of, 25t Stool cultures, 329–331 Streptococcal antibody tests, 81–82 Streptokinase-streptodornase test, 618 reference values, 619 Stress test See Exercise ECG Striated muscle antibodies to diseases associated with, 77t reference values, 76t biopsy of, 344 Sugars, nonglucose, in urine, 226 Sulfhemoglobin, 27 Sulkowitch’s test, 245, 247 Suppressor T cells, 61 balance with helper T cells, 61t reference values, 64t Suprapubic aspiration, for urinalysis, 332–333 Sweat test, 592–594 nursing alert, 593 Synovial fluid, 283 analysis of, 292–296 indications for, 294–295 reference values, 293 crystals in, 293t gross characteristics of, 284 white blood cells and inclusions seen in, 293t Syphilis tests, 83 fluorescent treponemal antibody, 80t, 281 fluorescent treponemal antibody-absorption, 80t, 83–84 rapid plasma reagin tests, 84–85 causes of false positive reactions to, 83t venereal disease research laboratory, 80t, 84–85 T T lymphocytes abnormal subsets, causes of, 61, 63t antigen response of, 67f assays of, 62–64, 66 causes of altered levels of, 63t function of, 33, 61, 62 reference values, 16t, 64t Tangent screen test, 608 Tartrate-resistant acid phosphatase (TRAP), 38t, 39 Tay-Sachs disease fetal cell karyotyping for, 298 hexosaminidase and, 156–157 TBG See Thyroxine-binding globulin TCT See Thrombin clotting time Technetium 99m (99mTc), 484t, 487 Temperature, conversion factors, 642 Template method, of bleeding time, 44 procedure, 45–46 Tensilon test, 595–596 Testosterone, 184–185 T4 See Thyroxine ␣-Thalassemia, 26–27 hemoglobin formation in, 28f ␤-Thalassemia, 26 hemoglobin formation in, 28f Thalassemias, 26–27 Thallium 201, 485t Thermography, spinal nerve root, 594–595 Thiamine See Vitamin B1 671 Copyright © 2003 F.A Davis Company 672 INDEX Thoracoscopy, 372–374 nursing alert, 373 Throat, culture and sensitivity testing, 355–356 Thrombin, 40 Thrombin clotting time (TCT), 40 Thrombocytes See Platelets Thrombocytopenia causes of, 43t nursing care after venipuncture in, 44 Thrombocytosis causes of, 43t nursing care after venipuncture in, 44 Thrombopathies, 42 Thrombosis, venous, after PT testing, nursing care, 51 Thyrocalcitonin See Calcitonin Thyroglobulin, antibodies to, reference values, 76t Thyroid Cytomel/perchlorate suppression studies, 523–525 Thyroid glands biopsy of, 350–351 hormones of, 171–176 radionuclide-mediated scanning studies of, 500–501 tests and procedures, profile/panel groups, 646 ultrasonography of, 464–465 Thyroid-stimulating hormone (TSH), 165–166 radionuclide-mediated laboratory studies, 523 reference values, 166t stimulation test, 166–167 reference values, 167 Thyroid-stimulating immunoglobulins (TSI, TSIg), 175–176 Thyrotropin-releasing hormone (TRH), 160 Thyroxine (T4), 171–173 metabolic effects, 105t reference values, 172t Thyroxine-binding globulin (TBG), 175–176 TIBC See Total iron-binding capacity Time, conversion factors, 642 Titer, definition of, 78 Tolbutamide tolerance test, 113 nursing alert for, 113 Tomography, 398 chest, 410–411 paranasal sinus, 411 Tone decay test, 604 reference values, 603 Tonometry, 609–610 Total blood volume studies, 516–517 procedure and nursing care, 517 reference values, 516 Total complement (CH50), 71 reference values, 72t Total iron-binding capacity (TIBC), 11 reference values, 12t Tourniquet test, of capillary fragility, 48–49 Toxins, toxic doses and effects, 218–219t Toxoplasmosis, skin test for, 623–624 Tracheal suctioning, for sputum specimen, 270 Transesophageal echocardiography, 463 Transferrin, 11 reference values, 12t Transfusion reactions, nursing care for, 98 Transmission categories, for isolation precautions, 635 Trichinosis, skin test for, 623–624 Triglycerides disorders and drugs associated with altered levels of, 125, 129t in plural fluid, 287t test for, 128–130 Triiodothyronine (T3), 171, 173–174 reference values, 174t uptake test, 174–175 reference values, 174t Troponin serum levels, 154–155 type I, as cardiac marker, 154t type T, as cardiac marker, 153t Trypsin, in feces, 327 indications for testing, 329 reference values, 328t TSH See Thyroid-stimulating hormone T3 See Triiodothyronine T-tube cholangiography, 420–422 nursing alert, 421 tube placement in, 421f Tuberculin test, 618, 620–621 procedure for, 621 Tularemia, febrile agglutinin tests for, 82t Tumor markers, 646 classification of, 90 clinical associations, 91t Tumors See also Cancer(s) profile/panel groupings and tests for, 647 Tuning fork tests, for hearing loss, 598–599 Typanometry, 599–600 reference values, 600 Tyrosyluria, 262 U UA See Urinalysis UGI See Upper gastrointestinal series Ultrasound studies, 458–481 abdominal/aoric ultrasonography, 466–467 bladder ultrasonography, 471–472 breast ultrasonography, 473–474 devise to detect blood flow velocity, 460f Doppler ultrasound technique, 459 arterial extremity studies, 477–478 arterial transcranial, 479–480 carotid artery, 478–479 procedures in, 476 venous extremity studies, 480–481 echocardiography, 460–462 transesophageal, 463 echoencephalography, 462–463 liver/biliary system ultrasonography, 469–470 lymph node/retroperitoneal ultrasonography, 466 obstetric ultrasonography, 475–476 ocular ultrasonography, 463–464 pancreatic ultrasonography, 468–469 pelvic ultrasonography, 474–475 prostate ultrasonography, 472 renal ultrasonography, 470–471 risks of, 459–460 scrotal ultrasonography, 473 spleen ultrasonography, 468 thoracic ultrasonography, 465–466 thyroid/parathyroid ultrasonography, 464–465 Upper gastrointestinal series (UGI), 414–416 procedure, 415 reference values, 414 Urea, clearance test, 239 Urea nitrogen causes of altered levels of, 121t Copyright © 2003 F.A Davis Company INDEX test for, 120–122 Ureteropyelography, retrograde, 428–429 Ureter(s), biopsy of, 338–339 Urethral pressure profile, 549–550 reference values, 549t Urethrography, retrograde, 426–427 Uric acid serum causes of altered levels of, 126t critical values, 125 reference values, 125t test for, 124–125 urinary, 261 indications for measuring, 262 Urinalysis (UA) nursing alert, 237 profile/panel groups, 646 reference values, 237 routine, 222–239 indications for, 234, 237 interfering factors, 232 procedure and nursing care for, 237–238 sample collection for, 238 Urinary sediment, 222 Urinary tract infections (UTIs) nitrite analysis and, 225 urine pH and, 225 Urine appearance, 222 bilirubin in, 228–230 in jaundice, 229t blood in, 228 casts in, 231–232 types and significance of, 233t clearance tests, 239–240 color, 222 factors affecting, 223t concentration and dilution tests, 241–242 indications for, 242–243 procedure and nursing care for, 243–244 crystals in, 232 characteristics and significance of, 234t cytologic examination of, 265 drug screening tests of, 265–266 enzymes in, 250–252 reference values, 251t epithelial cells in, 231 formation of, 221 glucose in, 225–226 drugs and disorders causing, 227t drugs producing false-positive results, 227t hormones in, 252–261 ketones in, 226, 228 leukocyte esterase in, 230 macroscopic analysis, 222–225 microbiologic examination of, 264–265 microscopic analysis, 230–232 nitrite in, 230 odor, 224 pH, 224–225 pigments in, 247–248 reference values, 249t proteins in, 225, 261 indications for measuring, 262 reference values, 263t red blood cells, 230–231 specific gravity, 224, 242 673 specimen collection catheterized specimen, 332 in children, 633 clean-catch specimen, 331–332 double-voided specimen, 631 first morning specimen, 631 pediatric, 333 random specimen, 250, 631 suprapubic aspiration, 332–333 by suprapubic aspiration, 632 twenty-four hour (timed) specimen, 332 urobilinogen in, 228–230 in jaundice, 229t white blood cells in, 231 Urine hydroxyproline, 262 reference values, 263t Urobilinogen in feces, 328 indications for testing, 329 in urine, 228–230 Urodynamic studies, 545–546 Uroflowmetry, 548–549 Uroporphyrin, 247 reference values, 249f V Vaginal samples, for semen presence, 309 Vanillylmandelic acid (VMA), urinary, 254–255 indications for measuring, 260 reference values, 257t Vascular activity, 39–59 Vasoactive intestinal peptide (VIP), as tumor marker, clinical associations, 91 VDRL See Venereal disease research laboratory Veins deep, radionuclide-mediated scanning studies of, 508–509 of hand and wrist, 454f of leg and foot, 455f Venereal disease research laboratory (VDRL), 80t, 83, 84–85 Venipuncture, 626–627 Venous Doppler extremity studies, 480–481 Venous plethysmography, 553 Venous thrombosis, after PT testing, nursing care, 51 Ventilation-perfusion scanning, 498–500 Ventricular puncture, 279 Very-low density lipoproteins (VLDL), 133 conditions associated with altered levels of, 134t reference values, 133t Viral infections antibody tests for, 85 hepatitis, 87–88 HIV, 88–90 infectious mononucleosis, 85–87 serologic tests for, 86t Visual acuity tests, 605–607 Visual field tests, 607–608 confrontation test, 608 perimetric test, 608 tangent screen test, 608 Vitamin A, blood levels, 210–211 reference values, 210t Vitamin B1, urinary, reference values, 264t Vitamin B12 deficiency, Schilling test in, 525–526 serum, reference values, 13t Copyright © 2003 F.A Davis Company 674 INDEX Vitamin B12 (Continued) studies indications for, 13 procedure and nursing care for, 13–14 Vitamin C blood levels, 211 reference values, 211t urinary, reference values, 264t Vitamin D, blood levels, 211 reference values, 212 Vitamins, in urine, 263–264 VLDL See Very-low density lipoproteins VMA See Vanillylmandelic acid Voiding cystourethrography, 430 Volume, conversion factors, 641 von Willebrand’s disease, 44, 45 von Willebrand’s factor, 39 W Wassermann test, 281 WBC count See White blood cell count Weber test, 599 reference values, 599 Weights and measures, 639–640 conversion rules and factors, 640–643 Weil-Felix (OX-19) test, 80t Westergren method, for ESR determination, 32t Western immunoblot (WIB) assay, 89 White blood cell count (WBC) critical values, 34 differential, 34 causes of alterations in, 34–36t reference values, 16t, 35t reference values, 33t in CBC, 15t White blood cell (WBC) count, 33 White blood cells (WBCs) See Leukocyte(s); Lymphocyte(s); specific types Whole blood clotting time, 52–53 WIB See Western immunoblot assay Widal test, 80t Wintrobe method, for ESR determination, 32t Wound(s), culture and sensitivity testing, 356–357 Wright’s stain, of sputum, 269 X Xenon 133, 485t Xeroradiography, 398–399, 411–412 X-rays See Radiologic studies Y Yeasts in gastric secretions, 313 sputum cultures for, 271 in urine, 232 nitrite analysis and, 230 Z Zinc, physiological function of, 212 ... Cavanaugh, Bonita Morrow, 1952– Nurse’s manual of laboratory and diagnostic tests – 4th ed / Bonita Morrow Cavanaugh p cm Rev ed of: Nurse’s manual of laboratory and diagnostic tests / Juanita Watson... references and index ISBN 0-8036-1055-6 (pbk.) Diagnosis, Laboratory —Handbooks, manuals, etc Nursing-Handbook, manuals, etc I Watson, Juanita, 1946– Nurse’s manual of laboratory and diagnostic tests. .. Contents SECTION I • Laboratory Tests, CHAPTER Hematology and Tests of Hematopoietic Function CHAPTER Hemostasis and Tests of Hemostatic Functions 39 CHAPTER Immunology and Immunologic