Đang tải... (xem toàn văn)
(BQ) Part 1 book Mosby''s manual of diagnostic and laboratory tests presents the following contents: Guidelines for proper test preparation and performance, blood studies.
i Pagana: Mosby’s Manual of Diagnostic and Laboratory Tests, ed 5, Case Studies Realistic Scenarios with related questions to help you develop skills in critical thinking Pagana manual Kathleen Deska Pagana, PhD, RN Timothy J Pagana, MD, FACS Professor Emeritus Department of Nursing Lycoming College President, Pagana Keynotes & Presentations http://www.KathleenPagana.com Williamsport, Pennsylvania Medical Director, Emeritus The Kathryn Candor Lundy Breast Health Center and The SurgiCenter Susquehanna Health System Williamsport, Pennsylvania 3251 Riverport Lane St Louis, Missouri 63043 MOSBY’S MANUAL OF DIAGNOSTIC AND LABORATORY TESTS, FIFTH EDITION Copyright © 2014 by Mosby, an imprint of Elsevier Inc Copyright © 2010, 2006, 2002, 1998 by Mosby, Inc., an affiliate of Elsevier Inc ISBN: 978-0-323-08949-4 No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein) Notices Knowledge and best practice in this field are constantly changing As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein International Standard Book Number 978-0-323-08949-4 Senior Content Strategist: Tamara Myers Content Manager: Jean Sims Fornango Publishing Services Manager: Deborah L Vogel Senior Project Manager: Jodi M Willard Design Direction: Margaret Reid Printed in Canada Last digit is the print number: 9 8 7 6 5 4 3 2 1 We lovingly dedicate this book to our delightful grandchildren: Ella Marie Gaul Jocelyn Elizabeth Gaul Timothy William Gaul Justin Aquinas Gaul Juliana Kathleen Pericci Luke Michael Pericci Reviewers Michael Andary, MD, MS Professor College of Osteopathic Medicine Michigan State University East Lansing, Michigan Stephen Krau, PhD, RN, CNE Associate Professor School of Nursing Vanderbilt University Nashville, Tennessee Valerie Bush, PhD, FACB Clinical Laboratory Director Bassett Medical Center Cooperstown, New York Geralyn López-de-Victoria, PhD, MS Science Department Chair Midlands Technical College West Columbia, South Carolina Karmen A Grant, MS, RN, CNDR Nursing Instructor Rogers State University Claremore, Oklahoma Carla R Lynch, MS, RN Nursing Instructor Rogers State University Claremore, Oklahoma Joseph Hawkins, MS Ed., CNMT Associate Professor and Program Director Nuclear Medicine Technology Florida Hospital College of Health Sciences Orlando, Florida Naser Nejadi, BS, MSc Tehran University of Medical Sciences Tehran, Iran Michael Horner, DO Department of Michigan State University Lansing, Michigan Mary Anne Jessee, MSN, RN Assistant Professor School of Nursing Vanderbilt University Nashville, Tennessee vi Sandra Rome, RN, MN, AOCN Clinical Nurse Specialist Cedars-Sinai Medical Center Los Angeles, California Bonnie L Welniak, MSN, RN Assistant Professor of Nursing Monroe County Community College Monroe, Michigan Preface This book provides the user with an up-to-date, extensive manual that allows rapid access to clinically relevant laboratory and diagnostic tests A unique feature of this manual is its consistent format, which provides a comprehensive approach to laboratory and diagnostic tests Tests are categorized according to either the method of testing (e.g., x-ray, ultrasound, nuclear scan) or the type of specimen (e.g., blood, urine, stool) used for testing Every chapter of this book is based on this categorization Each chapter begins with an alphabetical listing of all tests in the chapter to aid the user in locating discussions quickly An overview follows the list and contains general information concerning test methods and related patient care Chapter includes a discussion of guidelines for proper test preparation and performance New coding requirements for ordering tests have been added along with a description of common laboratory methods Standard Precautions and other clinically important information for the health care provider are included to ensure accurate diagnostic and laboratory testing This information is essential for health care economics so that tests are performed in a timely fashion and not need to be repeated because of problems in patient preparation, test procedure, or specimen handling Communication and collaboration with other health care providers are emphasized The privacy rules resulting from the Health Insurance Portability and Accountability Act (HIPAA) are explained in relationship to diagnostic and laboratory test results Throughout the book, information is explained in a comprehensive manner to enhance full understanding of each particular test Every feature of test discussion is geared to provide complete information in a sequence that best simulates priorities in clinical practice The following information is provided, whenever possible, for a thorough understanding of each diagnostic test: • Name of test Tests are listed by their complete name A complete list of abbreviations and alternative test names follows each main entry • Normal findings Normal values are listed, when applicable, for the infant, child, adult, and elderly person Also, where appropriate, values are separated into categories of male and female We realize that normal ranges for laboratory tests vary significantly depending on the method of testing and the particular laboratory For this reason, we strongly encourage the user to check the normal values at the institution where the test is performed This should be relatively easy because most laboratory reports indicate normal values • Critical values These values give an indication of results that are well outside the usual range for normal These results generally require immediate intervention • Indications This section describes the main uses for each test Emphasis is placed on the type of patient signs and symptoms that lead to the indications for each test • Test explanation This section provides a comprehensive description of each test The explanation includes fundamental information about basic pathophysiology related to the test methods, what diseases the test results may indicate, and the location where the test is generally performed Also, in this section, patient sensation, test duration, and the type of health care professional involved in the testing are described vii viii Preface • C ontraindications This information alerts the user to patients who should not have the test performed As in other segments of the book, each contraindication is fully explained with an in-depth rationale Patients frequently highlighted in this section include those who are pregnant, who are allergic to iodinated or contrast dye, or who have bleeding disorders • Potential complications This section alerts the user to potential problems that will necessitate astute posttesting assessments and interventions Not only is each complication fully explained in detail, but also patient symptoms and appropriate interventions are described For example, a potential complication of an intravenous pyelogram is renal failure, especially in the elderly patient An appropriate intervention may be to hydrate the patient before the test and force fluids afterward • Interfering factors This section includes a thorough discussion of factors that can invalidate or alter the test results An important feature of this section is the inclusion of drugs that can interfere with test results Drugs that increase or decrease test values are indicated by a drug icon ( ) for quick a ccess • Procedure and patient care This section emphasizes the role of nurses and other health care providers in diagnostic and laboratory testing by addressing psychosocial and physiologic interventions Patient teaching priorities are noted with a special icon ( ) to highlight information to be communicated to patients For quick location of essential information concerning the testing procedure, this section is divided into before, during, and after time sequences • Before This section addresses the need to explain the procedure and to allay patient concerns or anxieties Dietary restrictions, bowel preparations, baseline pretest assessment, and the need for informed consent are discussed • During This section provides a complete and thorough description of the testing procedure, alternative procedures, and methods of testing In most instances, a step-by-step description of testing procedures is provided This information is important because all health care providers involved in the particular test should have a good understanding of what the procedure entails so they can assist more completely in the testing process • After This section includes vital information that the nurse or other health care provider should know concerning postprocedure care of the patient This includes information on specific posttest assessment, medication administration, recognition of posttest complications (with suggestions for interventions), home care, and follow-up • Test results and clinical significance As the name implies, this section describes the significance of the test findings A unique feature of this manual, compared with other books on diagnostic and laboratory tests, is an extensive discussion of the pathophysiology of the disease process and how it relates to the test result This provides enhanced understanding of the diagnostic test and better understanding of many disease processes • Related tests This section, another unique feature of the text, includes a list of tests that are related to the main test under discussion This includes tests that provide similar information, tests that provide confirmatory information, and other tests used to evaluate the same organ, disease process, or symptom complex A short description and page numbers for all related tests are included for ease in cross-referencing This aids the reader to develop a broader understanding of diagnostic testing and indicates where the reader may go to obtain more information on the topic of interest This logical format emphasizes clinically relevant information The clarity of the format facilitates a full understanding of content essential to both students and health care providers, and its uniformity allows the user to quickly recognize where information of interest may be found Multiple colors have been used to help locate tests, highlight critical information, and generally improve the readability of the text Another key feature is the use of color photographs and illustrations throughout the book Many tables are also included to simplify or summarize complex material regarding clinical care, test categories, or disease processes Preface ix Feature boxes are used throughout the book to highlight and summarize important clinical data They allow the reader to assimilate important information at a glance There are three types of feature boxes: Clinical Priorities, Age-Related Concerns, and Home Care Responsibilities Clinical Priorities boxes emphasize pertinent information specific to understanding and performing a particular test For example, coagulation studies must be assessed before invasive studies (e.g., liver biopsy) that may cause bleeding Chest x-ray examinations should be performed after procedures (e.g., pleural biopsy) that may cause a pneumothorax Age-Related Concerns boxes primarily address pediatric and geriatric priorities For example, the risk for dye-induced renal failure is emphasized in the dehydrated elderly patient scheduled for an intravenous pyelogram The bowel preparation for children of different ages is described in the barium enema study Home Care Responsibilities boxes focus on factors that need to be addressed after a test is performed With an increasing number of procedures being performed on an outpatient basis, the patient has the responsibility for detecting problems and knowing what to when they occur Often, the patient returns home with instructions or guidelines for recognizing problems such as infection, bleeding, or urinary retention New to this edition is a comprehensive listing of diagnostic and laboratory tests used when evaluating a patient with a common disease or condition These are based on the International Classification of Disease (ICD) codes (see p xi) This alphabetical list should be invaluable to readers who want to know the testing possibilities for common problems such as adrenal abnormalities, AIDS, Alzheimer’s disease, bowel obstruction, breast cancer, and others For emphasis, this material is placed before Chapter Also new is a description of commonly performed laboratory methods, which is placed in Chapter This section explains methods used to evaluate blood, urine, spinal fluid, and other specimens Methods such as latex agglutination, agglutination inhibition, hemagglutination, electrophoresis, immunoassay, polymerase chain reaction, and FISH techniques are examples Appendix A, Alphabetical List of Tests, helps the user locate specific tests at a glance Appendix B, List of Tests by Body System, familiarizes the user with other related studies the patient or client may need or the user may want to review This information should be especially useful for students and health care providers working in specialized areas For example, all tests related to infertility are listed in the Reproductive System section Appendix C provides a list of Panel Tests such as cardiac enzymes, lipid profile, liver profile, and thyroid studies Appendix D contains a list of Abbreviations for Diagnostic and Laboratory Tests Finally, a comprehensive Index includes the names of all tests and their synonyms and other relevant terms found within the tests Typical Abbreviations and Units of Measurement are located on the inside cover Many new studies such as anti-glycan antibodies, laboratory genetics, neuron-specific enolase, galectin-3, and ProstaScint scan have been added All other studies have been revised and updated Outdated tests have been eliminated Illustrations and photographs have been extensively updated, and many new ones have been added We sincerely thank Mosby/Elsevier for invaluable assistance and dedication to our books over 30 years We also thank our editors—Jean Sims Fornango, Brandi Flagg, and Jodi Willard—for their enthusiasm and support We invite comments from users of this book so that we may improve our goal of providing useful and relevant diagnostic and laboratory test information to users of future editions Kathleen D Pagana Timothy J Pagana ... Alphabetical List of Tests, 11 36 B List of Tests by Body System, 11 45 C Panel Testing, 11 52 D Abbreviations for Diagnostic and Laboratory Tests, 11 54 x Testing for Common Diseases and Conditions This... Tests, 847 10 Ultrasound Studies, 8 61 11 Urine Studies, 903 12 X-Ray Studies, 9 81 13 Miscellaneous Studies, 10 79 Bibliography, 11 32 Illustration Credits, 11 35 Appendixes A Alphabetical List of. .. lipid profile, liver profile, and thyroid studies Appendix D contains a list of Abbreviations for Diagnostic and Laboratory Tests Finally, a comprehensive Index includes the names of all tests and