Nursing Care

for Patients

Undergoing

Diagnostic

ProceduresBlood Extraction

Diagnostic Examination

•It may be performed by a physician at the patient’s bedside or in a specially equipped room for therapeutic or diagnostic purposes.

•The nurse’s knowledge and organization of the diagnostic procedure can be the keys to success.

Diagnostic Testing Phases• Pretest

Focus: Client PreparationTeaching and communicating with the patient

What type of sample is neededHow will it be collectedWhat Equipment to useDoes it need fasting prior to the procedureDoes it involve administration of dyeAre medications given withheldAre fluids restricted or forcedIs consent requiredHow long is the test

• IntratestFocus: Specimen Collection and performing, or

assisting with certain diagnostic testingThe Nurse..

Uses standard precaution/Sterile technique as appropriateProvides emotional and physical support

Monitors patient (VS, Pulse oximetry, ECG, etc.)Ensures correct labeling, storage and transportation of specimen

• Post-TestFocus: Nursing care and follow up

activities for the clientCompares previous and current test results

Nursing Diagnoses• Anxiety or Fear related to possible diagnosis of

acute or chronic illness pending conclusion of diagnostic testing

• Impaired Physical mobility related to prescribed bed rest and restricted movement of involve extremity after testing

• Deficient knowledge related to misperceptions received from others regarding process for test

BLOOD TESTS• Most commonly used diagnostic

test• Provide valuable information

about the hematologic system and many other systems as well• Venipuncture is performed

Blood Tests that do not require fasting

• CBC• Serum Electrolytes (BMP- basic metabolic panel or

Chem 7)Na, K, Cl, Ca, bicarb•Creatinine•Direct/Indirect Bilirubin•PT, PTT, APTT•Drug Monitoring •Arterial Blood Gas/ CO2 levels•CK-MB, Trop T and I, Homocysteine, C-Reactive

Protein•Ferritin

Blood Tests that require fasting

• CBG/HGT• Blood Chemistry

FBS, BUNLipid Profile : LDL, HDL, Triglycerides, Total CholeLiver Enzymes : AST, ALT, ALP, GGT, AlbuminCalcium Tests: PTH, Vitamin D, PhosphorusIron Tests: Iron levels, Transferrin saturationCardiac Blood Tests: Apolipoproteins

Nursing Care after the Extraction of Blood

• Immediately after blood is drawn, pressure is applied (with cotton or gauze) to the puncture site.

• Resume your normal activities and any medications withheld before the test.

• Blood may collect and clot under the skin (hematoma) at the puncture site; this is harmless and will resolve on its own. For a large hematoma that causes swelling and discomfort, apply ice initially; after 24 hours, use warm, moist compresses to help dissolve the clotted blood.

Lifespan ConsiderationsSite of Puncture: Neonates – use outer aspect of the heel Children – use side of fingertips for 2 years and

above-allow the child to choose the puncture site-praise and assure the child that it is not punishment.

Elders – may need assistance- warm the hands by wrapping with a warm washcloth for 3-5 mins