midterms HA LEC

• Diagnostic Procedures


  an examination to identify an individual's specific areas of weakness and strength in order determine a condition, disease or illness
• TYPES of DIAGNOSTIC PROCEDURES

  INVASIVE and NON-INVASIVE
• NON-INVASIVE

  • not entering or penetrating the body or disturbing body tissue, especially in a diagnostic procedure.
  • To assess body function in health and disease (physical examination and inspection), such as pulse-taking, the auscultation of heart sounds and lung sounds
• COMPUTED TOMOGRAPHY


  medical imaging procedure that uses computer-processed combinations of many X-ray measurements taken from different angles to produce cross-sectional (tomographic) images of

  specific areas of a scanned object, allowing the user to see inside the object without cutting
• MAGNETIC RESONANCE IMAGING (MRI)


  is a medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes of the body mostly used in radiology and nuclear medicine in order to investigate the anatomy

  and physiology of the body
• RADIOGRAPHY


  an imaging technique using X-rays, gamma rays, or similar ionizing radiation and non-ionizing radiation to view the internal form of

  an object
• INVASIVE

  • involving the introduction of instruments or other objects into the body or body cavities
  • characterized by or involving invasion
  • Medicine/Medical. requiring the entry of a needle, catheter, or other instrument into a part of the body, especially in a diagnostic procedure, as a biopsy
• graphy = to record

  gram = an image

  scopy = to see

  scope = examination instrument

  centesis = to puncture

  metry = to measure

  meter = instrument for measurement
• DIAGNOSTIC TOOLS

  FECALYSIS and URINALYSIS
• FECALYSIS


  Stool analysis / Stool examination
• DEFECATION


  the process of expulsion of feces from the rectum
• Loose Bowel Movement (LBM) - Liquid stool
• CONSTIPATION – Hard and dry stool
• MACROSPIC EXAMINATION FOR FECALYIS


  ▪ Volume <200gms/day

  ▪ Color

  ▪ Consistency

  ▪ Odor

  ▪ Blood, Mucous

  ▪ Parts of parasite and Adult Parasite
• COMPOSITION OF FECES


  ▪ 3⁄4 Water, 1⁄4 Solid

  ▪ Undigested and Unabsorbed foo

  ▪ Intestinal secretions, Mucous

  ▪ Bile pigments and Salts

  ▪ Bacteria and Inorganic material

  ▪ Epithelial cells, Leukocytes
• COLOUR OF STOOL

  Human fecal matter is normally yellowish brown in colour which results from a combination of bile and bilirubin
• MACROSCOPIC EXAMINATION FOR URINALYSIS


  ▪ Volume

  ▪ Color

  ▪ Odor

  ▪ Reaction or urinary pH

  ▪ Specific gravity

  ▪ Osmolality
• URINARY VOLUME

  ▪ NORMAL = 600-2000 mL with night urine not in excess of 400 mL

  ▪ POLYURIA - >2000mL/24 hrs

  ▪ OLIGURIA - <500mL/24 hrs

  ▪ ANURIA – complete cessation of urine (<200mL)

  ▪ NOCTURIA – excretion of urine by adult of >500 mL with a specific gravity of <1.018 at night (characteristic of chronic glomerulonephritis)
• CAUSES OF POLYURIA

  ▪ Diabetes mellitues

  ▪ Diabetes insipidus

  ▪ Polycystic kidney

  ▪ Chronic renal failure

  ▪ Diuretics

  ▪ Intravenous saline/glucose
• COLORS OF URINE

  COLOURLESS - dilution, diabetes mellitus, diabetes insipidus, diuretics

  MILKY -purulent genitourinary tract infection, chyluria

  ORANGE – urobilinogen

  RED - beetroot ingestion, hematuria, hemoglobinuria

  BROWN/BLACK- alkaptonuria, melanin
• ODOUR OF URINE

  ▪ NORMAL - aromatic due to the volatile fatty acids

  ▪ AMMONICAL - bacterial action (E. coli)

  ▪ FRUITY - ketonuria, starvation

  ▪ MUSTY - Phenylketonuria

  ▪ FISHY - UTI with Proteus

  ▪ RANCID-Tyrosinemia Intravenous saline/glucose
• CHEMICAL EXAMINATION

  ▪ Proteins

  ▪ Sugars

  ▪ Ketone bodies

  ▪ Bilirubin

  ▪ Bile salts

  ▪ Urobilinogen

  ▪ Blood
• 1.NOCTURIA

  → increased frequency at night

  2. DYSURIA

  → painful or difficulty of urination

  3. HESITANCY

  → difficult of initiating

  4.ENURESIS

  → involuntary voiding
• SODIUM (Na)


  • Normally 125-145 mmol/l

  • Collect in red top tube

  INCREASED

  → Diabetes insipidus

  → Excessive sweating

  → Cushing’s syndrome
• Chloride (Cl)


  • Normally 197-107 mEq/L

  • Collect in tiger top tube

  INCREASED

  → Diarrhea

  → Hyperalimentation
• Potassium (K)

  • Normally 3.5-5 mEq/L

  • Collect in red or tiger top tube

  INCREASED

  → Renal failure

  → Addison’s disease

  → Dehydration

  → ACE inhibitors

  → Spironolactone
• Blood Urea Nitrogen (BUN)


  • Normally 5-20 mg/dl

  • Collect in tiger top tube

  INCREASED

  → Renal failure

  → CHF

  → aminoglycosides
• Creatinine

  • Normally <1.1 mg/dl

  • Collect in tiger or red top tube

  • Measures blood flow through kidneys

  INCREASED

  → Renal failure
• Glucose


  • Normally 80-140 mg/dl

  • Collect in red or tiger top tube

  INCREASED

  → DM

  → Cushing’s syndrome

  → Pancreatitis

  → Thiazide diuretics
• Albumin


  • Normally 3.5-5 g/dl

  • Collect in tiger top tube

  • Best lab test for MEASURING PROTEIN

  DECREASED

  • Malnutrition

  • Nephrotic syndrome

  • Alcoholic cirrhosis

  • Inflammatory bowel disease

  • Metastatic cancer

  • Leukemia

  • Hodgkin’s disease
• Bilirubin


  • Normally 0.3-1 mg/dl

  • Collect in tiger top tube

  INCREASED

  → Liver damage

  → Hemolysis

  → Billary obstruction
• Complete Blood Count


  • WBC, H&H, Platelets most important

  • Collect in purple top tube

  • Capillary sample will decrease

  hematocrit

  • Platelets normally 150,000-450,000 uL
• White Blood Count


  • Normally 4500-11,000

  • Differential provides more clues to cause than overall count does

  INCREASED

  → Infection

  → Inflammation

  → Leukemia

  DECREASED

  • Bone marrow failure

  • Vitamin B12 deficiency
• CAUSES OF INCREASED

  DIFFERENTIALS

  • BASOPHILS: Leukemia, s/p splenectomy

  • EOSNOPHILS: Allergies, asthma, parasites

  • LYMPHOCYTES: Viral infections, leukemia

  • MONOCYTES: Bacterial infections, protozoan infections, ulcerative colitis

  • NEUTOPHILS: Bacterial infection, noninfectious tissue damage, metabolic disorders
• CAUSES OF POSITIVE VALUES ON UA

  • BILIRUBIN: Jaundice, hepatitis, fecal contamination of sample

  • BLOOD: Stones, BPH, infection, Foley cath

  • GLUCOSE: DM, pancreatitis, steroids

  • KETONES: Starvation, high fat diet, diabetic ketoacidosis, vomiting, diarrhea, asprin overdose

  • LEUKOESTERASE: UTI

  → Leukoesterase plus nitrates: 75% of UTI

  → Neither LE or nitrates: 92% not UTI

  • PROTEIN: Renal failure, CHF
• DOCUMENT

  is a collection of data, regardless of the medium on which it is recorded. include both paper and electronic.

  from Latin "documentum'’ and “doceo” literally refers to teach, both for giving instructions and for warning purposes
• DOCUMENTATION


  Any printed or written record of activities.

  Recording and reporting are the major ways health care providers communicate.

  The client's medical record is a legal document of all activities regarding client care
• THE LEGAL ASPECTS OF DOCUMENTATION REQUIRE:

  • Writing legible and neat
  • Spelling and grammar properly used
  • Authorized abbreviations used
  • Time-sequenced factual and descriptive entries
• SYSTEMS OF DOCUMENTATION

  a)Narrative charting

  b) Source-oriented charting

  c) Problem-oriented charting

  d) PIE charting

  e) Focus charting

  f) Charting by exception

  g) Computerized documentation

  h) Critical pathways
• SOURCE-ORIENTED CHARTING


  Narrative recording by each member of the health care team on separate documents.