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Chapter 16

Chapter 16. Other Diagnostic Studies. Objectives. Explain the purpose of provided diagnostic procedures. Identify the hospital department that would perform provided procedures. State two purposes of an electroencephalogram.

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Chapter 16

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  1. Chapter 16 Other Diagnostic Studies

  2. Objectives • Explain the purpose of provided diagnostic procedures. • Identify the hospital department that would perform provided procedures. • State two purposes of an electroencephalogram. • State what category of medication should be noted on the requisition when an electroencephalogram is ordered.

  3. Objectives, continued • State the difference between an invasive procedure and a noninvasive procedure. • Name two noninvasive diagnostic studies related to the heart. • Name two invasive diagnostic studies related to the heart. • State what category of medication should be noted on the request when an electrocardiogram is ordered.

  4. Objectives, continued • Name six endoscopies and the parts of the body visualized by each. • Discuss the importance of patient preparation before a sigmoidoscopy or a visual examination of the colon. • List two studies related to the gastrointestinal (GI) system that are performed in the endoscopy department.

  5. Objectives, continued • List four diagnostic tests that are performed by the cardiopulmonary (respiratory care) department. • State what category of medication should be noted on the requisition when arterial blood gases are ordered. • Name two studies performed by the cardiovascular department to diagnose vascular diseases.

  6. Lesson 16.1

  7. Neurodiagnostics (Neurologic and Neuromuscular System Electrodiagnostics) • Neurodiagnostics may include several tests related to the function of the nervous system (brain and spinal cord) • In smaller facilities, the electroencephalography may be the only neurodiagnostic test performed

  8. Neurodiagnostics, continued Neurodiagnostic tests: • Electroencephalogram (EEG) performed to diagnose brain disease or to confirm brain death or cerebral silence • Evoked potentials • Visual evoked potential (VEP) • Auditory evoked response (AER) or • Brainstem auditory evoked response (BAER) • Somatosensory evoked potential (SEP)

  9. Neurodiagnostics, continued Neurodiagnostic tests: • Electronystagmography (ENG) (electro-oculography) • Electromyography (EMG) and nerve conduction studies (NCS) • Caloric study (oculovestibular reflex study)

  10. Electroencephalography (EEG) From Chipps E, Clanin N, Campbell V: Neurologic disorders, St. Louis, 1992, Mosby.

  11. Medications To Note When Ordering Neurodiagnostic Procedures Anticonvulsant medications: • Phenobarbital • Dilantin • Tegretol

  12. Neurology Diagnostic Downtime Requisition

  13. Cardiovascular Diagnostics • The procedures carried out by this department are related to the performance of the heart and the vascular system • The results of these studies aid the physician in making a diagnosis and will affect treatment provided

  14. Cardiovascular Diagnostics, continued • Noninvasive • Electrodiagnostics • Nuclear cardiology • Cardiovascular sonography • Peripheral vascular studies • Invasive • Cardiac cath (catheterization) lab

  15. Cardiovascular Diagnostics - Noninvasive Electrodiagnostics: • Electrocardiogram (EKG or ECG) • Holter or cardiac monitor • Impedance plethysmography (IPG) • Exercise electrocardiogram (treadmill stress test)

  16. Electrode Placement for 12-lead Electrocardiogram (ECG) From Ignatavicius D, Workman L: Medical-Surgical Nursing, 5th ed., Philadelphia, Saunders, 2006.

  17. Patient Wearing a Holter Monitor From Canobbio MM: Cardiovascular disorders, St. Louis, 1990, Mosby.

  18. Patient Taking an Exercise Stress Test From Canobbio MM: Cardiovascular disorders, St. Louis, 1990, Mosby.

  19. Cardiovascular/Nuclear Medicine Studies Cardiovascular/nuclear medicine studies): • Thallium stress test • Sestamibi stress test

  20. Cardiovascular/Ultrasound Studies Cardiovascular sonography (ultrasound/echography): • Echocardiogram • Transesophageal echocardiogram (TEE)

  21. Cardiovascular Catheterization Cardiac cath lab studies (cardiac catheterization): • Coronary angiography (also discussed in special procedures section of Chapter 15) • Coronary angioplasty (therapeutic procedure discussed in Chapter 17) • Electrophysiological studies (EPS) • Swan-Ganz catheter insertion

  22. Cardiovascular Catheterization, continued From Ignatavicius D, Workman L: Medical-Surgical Nursing, 5th ed., Philadelphia, Saunders, 2006.

  23. Cardiovascular Catheterization, continued • Consent form required • Scheduling with department and physician may be required • Some preparation may be required (NPO)

  24. Vascular Plethysmography/Ultrasound Studies Peripheral vascular studies: • Vascular plethysmography • Vascular ultrasound • Duplex scanning • Venous and arterial Doppler flow studies (e.g., carotid Doppler)

  25. Medications To Note When Ordering Cardiac Studies Cardiovascular medications: • Lanoxin (digoxin) • Nitroglycerin (NTG) • Quinidine • Lidocaine • Any other cardiovascular medication

  26. Cardiovascular Diagnostic Downtime Requisition

  27. Lesson 16.2

  28. Endoscopy • The word endoscopy is a general term used to indicate the visual examination of a body cavity or hollow organ • It is a diagnostic procedure performed by a doctor • During some endoscopic procedures, biopsies are performed

  29. Endoscopy, continued • A consent is needed for endoscopy examinations • When a visual examination of the stomach and/or intestines is ordered, the patient would need to be prepared for the procedure • Barium should not be given before a gastrointestinal visual examination

  30. Endoscopy, continued • Organ examined • Anal canal • Bronchi • Esophagus • Stomach • Biliary and pancreatic ducts Types of endoscopies • Anoscopy • Bronchoscopy • Esophagoscopy • Gastroscopy • Endoscopic retrograde cholangio-pancreatography (ERCP)

  31. Endoscopy, continued • Organ examined • Gastrointestinal tract • Large intestine • Sigmoid colon • Rectum Types of endoscopies • Esophagogastro-duodenoscopy (EGD) • Colonoscopy • Sigmoidoscopy • Proctoscopy

  32. Endoscopy Downtime Requisition

  33. Bronchoscopy From Pagana KD, Pagana TJ: Mosby’s manual of diagnostic and laboratory tests, ed 3, St. Louis, 2006, Mosby.

  34. Gastrointestinal Studies (GI Lab) Some gastrointestinal (GI) studies are performed in the endoscopy department, usually on an outpatient basis, while others may be performed at the bedside by the nurse

  35. Gastrointestinal Studies (GI Lab), continued Gastrointestinal (GI) studies that may be performed in the endoscopy department: • Gastric analysis • Esophageal manometry/motility and reflux • Secretin test

  36. Cardiopulmonary (Respiratory Care) • The cardiopulmonary department (also called the respiratory care department) performs diagnostic tests to determine lung function as well as treatments for respiratory disease and conditions • Treatment orders performed by the cardiopulmonary (respiratory care) department will be discussed in Chapter 17

  37. Cardiopulmonary (Respiratory Care) Examples of diagnostic tests performed: • Arterial blood gases (ABG) • Capillary blood gases (CBG) • Pulmonary function tests (PFTs) • Spirometry • Oximetry (pulse oximetry, ear oximetry, oxygen saturation)

  38. Medications To Note When OrderingCardiopulmonary Diagnostic Procedures Anticoagulants: • Heparin • Lovenox • Coumadin • Aspirin (ASA)

  39. Cardiopulmonary (Respiratory Care) Diagnostic Downtime Requisition

  40. Sleep Study The sleep study department performs studies to assess a patient’s sleep patterns to: • Determine nature and severity of insomnia • Reveal presence of obstructive sleep apnea (OSA) and the severity of the condition • Assist in the diagnosis of narcolepsy

  41. Sleep Study, continued Examples of sleep studies performed: • Polysomnography (PSG) • Inductive plethysmography for apnea • Multiple sleep latency tests • Multiple wake tests

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