guaiac test, 808hematocrit, 799hemoglobin, 799hemoglobin A1C (HbA1), 802hemoptysis, 816intravenous pyelography (IVP),

817kidneys/ureters/bladder (KUB),

817leukocyte, 801lumbar puncture, 819lung scan, 818magnetic resonance imaging

(MRI), 818manometer, 820midstream urine specimen, 810occult blood, 808peak level, 802phlebotomist, 799polycythemia, 801positron emission tomography

(PET), 819

proctoscopy, 817proctosigmoidoscopy, 817radiopharmaceutical, 819reagent, 809red blood cell (RBC) count, 801red blood cell (RBC) indices, 801retrograde pyelography, 817saliva, 815serum osmolality, 802specific gravity, 815sputum, 815steatorrhea, 808stress electrocardiography, 818thoracentesis, 821trocar, 821trough level, 802ultrasonography, 817urine osmolality, 815venipuncture, 799white blood cell (WBC), 801

abdominal paracentesis, 821angiography, 818anoscopy, 817arterial blood gases, 802ascites, 821aspiration, 819biopsy, 819blood chemistry, 802blood urea nitrogen (BUN), 802cannula, 821clean-catch urine specimen, 810clean voided urine specimen, 810colonoscopy, 817complete blood count (CBC), 799computed tomography (CT), 818creatinine, 802cystoscope, 817cystoscopy, 817echocardiogram, 818electrocardiogram (ECG), 817electrocardiography, 817expectorate, 816

KEY TERMS

Diagnostic and laboratory tests (commonly called lab tests) aretools that provide information about the client. Tests may beused as basic screening as part of a wellness check. Frequentlytests are used to help confirm a diagnosis, monitor an illness,and provide valuable information about the client’s response totreatment. Nurses require knowledge of the most common laband diagnostic tests because one primary role of the nurse is toteach the client and family or significant other how to preparefor the test and the care that may be required following the test.Nurses must also know the implications of the test results in or-der to provide the most appropriate nursing care for the client.

DIAGNOSTIC TESTING PHASESDiagnostic testing occurs in many environments. The tradi-tional sites include hospitals, clinics, and the primary careprovider’s office. Many test sites, however, are moving to thecommunity. Examples include the home, workplace, shoppingmalls, and mobile units. The more complex diagnostic tests areperformed at diagnostic centers specifically built for those tests.

Diagnostic testing involves three phases: pretest, intratest,and post-test.

PretestThe major focus of the pretest phase is client preparation. Athorough assessment and data collection (e.g., biologic, psycho-logic, sociologic, cultural, and spiritual) assist the nurse in de-termining communication and teaching strategies. Prior toradiologic studies it is important to ask female clients if preg-nancy is possible. Special precautions may be necessary or thetest may need to be postponed.

The nurse also needs to know what equipment and supplies areneeded for the specific test. Common questions include the fol-lowing: What type of sample will be needed and how will it be col-lected? Does the client need to stop oral intake for a certainnumber of hours prior to the test? Does the test include adminis-tration of dye (contrast media) and, if so, is it injected or swal-lowed? Are fluids restricted or forced? Are medications given orwithheld? How long is the test? Is a consent form required? An-swers to these type of questions can help avoid costly mistakes andreduce inconvenience to all involved. Most facilities have infor-mation about the tests available to the health care team. The labo-ratory at the facility can also act as a resource for information.

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CULTURALLY COMPETENT CAREDrawing Blood Samples

In Asian traditional medicine, blood is not drawn for medical pur-poses (Salimbene, 2000, p. 23). An Asian client practicing tradi-tional medicine views blood as a source of life and believes that thebody cannot replace lost blood (Spector, 2004). As a result, Asianclients may be upset by venipuncture or the drawing of blood fortesting, especially if there are numerous tests. They may view thisas upsetting the body’s normal balance and weakening the body.Also, blood represents a person’s essence and they may fear thattheir essence is being given away. Therefore, Asian clients may alsoneed to be informed that their blood will not be given to anyoneelse.

Note: From What Language Does Your Patient Hurt In? A Practical Guide to Cul-turally Competent Patient Care by S. Salimbene, 2000, EMCParadigm; andCultural Diversity in Health & Illness by R. E. Spector, 2004, Prentice Hall. Adaptedwith permission.

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