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Commonly Asked Emergency Drugs
Emergency Drug
Adenosine
Atropine sulfate
Epinephrine
Lasix
Lidocaine
Magnesium sulfate
Morphine Sulfate
Narcan
Nitroglycerine
Vasopressin

Initial Dose
6 mg
0.5 – 1 mg.q 3-5 min
1 mg.q 3-5 min
0.5-1 mg/kg
1-1.5 mg/kg
1-2 g
1-3 mg
0.02-2mg
0.4 mg SL
40 units

Indications
Bradycardia
Cardiac arrest
Pulmonary edema
Ventricular fibrillation, Ventricular tachycardia
Ventricular tachycardia r/t hypomagnesemia
Chest pain, pulmonary edema
Narcotic – respiratory depression
Chest pain, pulmonary edema
Cardiac arrest

Antidotes
Agents
Acetaminophen
Anticholinesterase
Anticholinergics
Benzodiazepines
Coumadine
Cyanide
Digoxin
Dopamine
Heparin
Iron
Lead
Magnesium Sulfate
Narcotics

Antidotes
Acetylcysteine (Mucomyst)
Atropine So4
Physostigmine
Flumazenil
Vitamin K
Sodium nitrate
Digoxin immune fab (Digibind)
Phentolamine
Protamine sulfate
Deferoxamine
Dimercaprol, edentate disodium and succimer
Calcium gluconate
Naloxone
Drug Name Endings: What they can suggest you!!!

Endings
*cain
*cillin
*dine
*done
*ide
*lam/
*pam
*micin/
*mycin
*mine/
*zide
*olol
*pril
*sone

class
Local anesthetics
Antibiotics
Antiulcer agent
Opiod analgesics
Oral hypoglycemics
Antianxiety
Antibiotics
Diuretics
Beta blockers
ACE inhibitors
Steroids
Drugs Trade /(generics)
1

Aminophylline
(theophylline)

2

4

Amphogel
(aluminum hydroxide)
Antabuse
(disulfiram)
Aspirin (ASA)

5

Atropine SO4

6

Bacterium
(cotrimoxazole)

7

Benadryl
(diphenhydramine hcl)

3

8

FREQUENTLY ASKED MEDICATIONS
Desired Effects
Best Time to be
Taken
Bronchodilator
To case breathing
AM / empty stomach
Classification

Antacid

phosphate level

Between meals and HS

Antialcoholic agent

Avoidance of alcohol

Anti-inflammatory
Anti-pyretic
Analgesic
Anticholinergic and
Vagolytic
Antibiotic

 temperature
 pain and
inflammation
 heart rate and
decrease secretion s
(-) infection

After 12 hrs. stoppage
from alcohol
Full stomach

Antihistamine
Anti – EPS

Antineoplastic

(-) allergy
(-) movement
syndrome
respiratory distress
in newborn
size of tumor

Antidiabetic agent

Normal glucose range AM

Other
•
•
•
•
•
•

No s
No c
Che
Give
Rep
No a

Best taken with food

• Che
• Syru
over
• Obs
• Avo
• Red
• Rash
• Asse
neph
• Avo

Best taken with food

• Mon

AM

• Incr
• Mon
• Mon

30 PC
PC

Celestone
(betamethazone)
9 Cytoxan
(cyclophosphamide)
10 Diabinase
(chlorpropaminde)
11 Diamox
(acetazolamide)
12 Digoxin (lanoxin)

Steroids

Antiglaucoma
antidiuretics
Cardiac glycoside

 urine output
 vertigo
Normal heart rate

AM with meals

• Pho

AM

13 Dilantin (phenytoin)
14 Diuril (chlorothiazide)

Anti-convulsant
Diuretics

(-) seizure
 urine output

Best taken with food
Best taken with food

•
•
•
•

AM

•
•

15 Epinephrine

Bronchodilator

 heart rate

16 Flagyl (metronidazole)

Antihelmintic

(-) helminth

Best taken with food

17 Haldol (haloperidol)

Antipsychotic

 (+) symptoms of
psychosis

AC

•
•
•
•
•
•

Asse
Mon
Tap
Rep
extr
Incr
Don
driv
Asse
Avo
Not
Tetr
Asse
Pho
18 Kayexalate

 serum K

19 Lasix (furosemide)

Promote excretions
of K
Diuretic

 urine output

AM

20 Lithane (LiCO3)

Antimanic

 hyperactivity

PC

21 Lovenox (mevacor)

Antithrombotic

(-) thrombosis

22 Magnesium SO4

Anticonvulsant

(-) convulsion

23 Mastinon
(pyridostigmine)
24 Mathergine
(methylergonovine
maleate)
25 Monoamine oxidase
inhibitor

Cholinesterase
inhibitor
Oxytocic for post
partum atony

 muscle strength

Antidepressant

Improved sleeping
pattern

PC

26 Nitroglycerin

Antiangina

(-) chest pain

27 Pancrease (pancreatin)

Pancreatic enzyme

(-) fat in the stool

Best taken before any
strenuous activity
Between meal and
snacks

28 Phenergan
(promethazine
hyrochloride)
29 Reserpine (serpasil)

Antihistamine

(-) allergy

Empty stomach

Antihypertensive

 BP

Best taken with meals

30 Ritalin
(methylphenidate)
31 Robaxin
(methocarbamol)
32 Synthroid
(levothyroxine sodium)
33 Tagamet (cimetidine)
34 Thorazine
(chlorpromazine hcl)
35 Valium (diazepam)
36 Xylocaine (lidocaine)

Stimulant

 hyperactivity

AM / PC

Skeletal muscle
relaxant
Thyroid hormone
supplement
Antiacidity
Antipsychotic

(-) muscle spasm

AM

Normal T4 level

AM
Best taken with food
PC

Antianxiety
Antiarrythmic

(-) heartburn
(-) positive signs of
psychosis
(-) anxiety
Normal heart rate

37 Zyloprim (allopurinol)

Antigout

 uric acid

Best taken with food

PC

Firmly contracted
uterus

AC

• May
• Mon
• Incr
K
• Mon
• Dec
• Soft
• No r
• Kee
• Asse
• Anti
• Mon
• Anti
• Mon
• Rep
•
•
•
•
•
•

No t
Asse
Mon
Tak
Kee
Prep
don’
• Obs
• Anti

• No s
• Mon
• Mon
deve
• No a
• Anti
• Mon
•
•
•
•
•

Avo
Pho
Mon
No a
Mon
conv
• S/E
• Incr
vit.
Common Tubes

Table or Apparatus
Miller-Abbott tube

Purpose
Longer than Levin
tube; has mercury of
air in bags so tube can
be used to decompress
the lower intestinal
tract

Examples of Use
1. Small-bowel
obstructions
2. Intussusception
3. Volvulus

Cantor Tube

To drain bile from the
common bile duct
until edema has
subscribed

Cholecystectomy
when a common duct
exploration (CDE) or
choledochostomy was
also done

T-tube

A type of closedwound drainage
connected to suctionused to drain, a large
amount of
serosa`nguineous
drainage from under
an incision

1. Mastectomy
2. Total hip
procedure
3. Total knee
procedure

Hemovac

A method of closed
wound suction
drainage indicate
when tissue
displacement and
tissue trauma may

1.
2.
3.
4.

Neurosurgery
Neck surgery
Mastectomy
Total knee and hip
replacement
5. Abdominal surgery

Key points
1. Care similar to that
Levin NG tube
irrigated.
2. connected to
suction, not sterile
technique
3. orders will be
written on how to
advance the tube
gently pushing
tube a few inches
each hour, patient
position may affect
advancement of
tube
4. X-rays determine
the desired
location of tube
1. Bile drainage is
influenced by
position of the
drainage bag.
2. Clamp tubes as
ordered to see if
bile will flow into
duodenum,
normally.
1. May compress
unit, and have
portable vacuum or
connect to wall
suction.
2. Small drainage
tube may get
clogged physician
may irrigate these
at times
Empty reservoir when
full, to prevent loss of
wound drainage and
back contamination
Jackson-Pratt
Three-way Foley

Suprapubic catheter

Ureteral catheter

occur with rigid drain
tubes (e.g Hemovac)
See Hemovac
To provide avenues
for constant irrigation
and constant drainage
of urinary bladder

6. Urological
procedure
See Hemovac
1. Transurethral
resection (TUR)
2. Bladder infection

To drain bladder via
an opening through the
abdominal wall above
the pubic bone
To drain urine feom
the pelvis of one
kidney, or for splinting
ureter

Suprapubic
prostatectomy
1. Cystoscopy for
diagnostic
workups
2. Ureteral surgery
3. Pyelotomy

See Hemovac
Watch for blocking by
clots causes bladder
spasms
Irrigant solution often
has antibiotic added to
normal salin or sterile
water
Sterile water rather
than normal saline
may be used for lysis
of clots
May have orders to
irrigate prn or
continuously
Never clamp the tubepelvis of kidney only
holds 4-8 mL
Use only 5 mL sterile
normal saline if
ordered to irrigate

Common Diagnostics Procedures
Noninvasive Diagnostic Procedures
Characteristics:
1. it provides an indirect assessment of organ size, shape, and / or function
2. it is safe
3. it is easily reproducible
4. it requires less complex equipment for recording
5. it does not require the written consent of patient or guardian
General Nursing Tasks:
1. Decrease patients anxieties and offer support by
a. Explain purpose and procedure of test
b. Acknowledge questions regarding safety of the procedure
c. Remain with the patient while the procedure is going on
2. Use procedure in the collection of specimens that avoids contamination
A. Graphic studies of Heart and brain
1. Electrocardiogram (ECG) – graphic record of electrical activity generated by the heart
during depolarization and repolarazation.
- diagnose abnormal cardiac rhythms and coronary heart disease
2. Echocardiography (ultrasound cadiography) – graphic record of motions produced by
cardiac structure as high-frequency sound vibrations are echoed though chest wall into the
heart.
- used to demonstrate valvular or other structural deformities, detect pericardial
effudion, diagnose tumors and cardiomegaly, evaluate prosthetic valve function.
3. Electroencephalogram (ECG) – graphic record of the electrical potentials generated by the
physiological activity of the brain
- used to detect surface lesions or tumors of the brain and presence of epilepsy.
4. Echoencephalogram – beam of ultrasound is passed though the head, and returning echoes
are graphically recorded.
- used to detect subdural hematomas, intracerebral hemorrhage, or tumors.
B. Roentgenological studies (X-ray)
1. Chest – used to determine size, contour of the heart; size, location, and nature of pulmonary
lesions: pleural thickening and effusions: pulmonary vasculature: disorder of thoracic ones
and soft tissues.
- used lead shield to protect pregnant woman
2. Kidney, Ureter, and Bladder (KUB) – used to determine size, shape, and position of
kidney, ureter and bladder
- No special consideration
3. Breast (Mammography) – examination of the breast with or without the injection of the
radiopaque substance into the duct of mammary gland.
- used to determined the presence of tumor or cyst (best done a week after
menstruation)
- no deodorant, perfume, powder, or ointment in underarm area on the day of X-ray
(contains Calcium oxalate)
- May be uncomfortable due to the pressure on the breast. (uses two x-ray plates)
C. Roentgenological studies (FLUOROSCOPY) – requires the ingestion or injection of a
contrast medium to visualize the target organ.
Additional Nursing Task:
a. Administration of enemies or cathartics before the procedure and laxative after.
b. Keeping the patient NPO 6-12 hours before examination
c. Ascertain patient’s allergy and allergic reactions
d. Observing for allergic reactions to contrast medium
e. Providing fluid and food after procedure to prevent dehydration
f. Observe stool for color and consistency until barium passes
1. Upper GI (Barium swallow) – ingestion of barium sulfate or meglumine diatrizoate
(Gastrografin [white and chalky substance], followed by fluoroscopic and x-ray
examination)
-

used to determine patency and caliber of the esophagus and to detect esophageal
varices, mobility of gastric wall, presence of ulcer, filling defects due to tumor,
patency of pyloric valve and presence of structural abnormalities
2. Lower GI (Barium Enema) – rectal instillation of barium sulfate followed by
glouroscopic and x-ray examination
- used to determine contour and mobility of colon and presence of any spaceoccupying tumors. Perform before upper GI
Patients preparations:
- no food after evening meal the evening before the test
- stool softener laxatives and enema suppositories to cleanse the bowel before the test
- NPO after midnight before the test
After care:
-

increased fluid intake, food and rest
laxatives for at least two days or until stools are normal in color and consistency

3. Cholecystogram – ingestion of organic iodine contrast medium (Telepaque) followed in
12 hour by x-ray visualization
- gallbladder disease is indicated with poor or no visualization of the bladder
- accurate only if GI and liver function is intact
- perform before barium swallow and barium enema
Patients preparations:
- administer large amount of water with contrast capsule
- low-fat meal before evening before x-ray
- oral laxative of stool softener after meal
- no food allowed after contrast capsule
After care:
-

increased fluid intake, food and rest
observe for any untoward reactions

4. Intravenous Pyelography (IVP) – injection of a radiopaque contrast medium in the vein
of the client to visualize ureter, bladder and kidney
Patients preparations:
- Laxative in the evening before the examination
- NPO for 12 hours
- Cleaning enema morning of the procedure
After care:
-

increased fluid intake, food and rest;
observe for any untoward reactions
D. Computed Tomography (CT) – an x-ray beam sweeps around the body, allowing measuring
of various tissue densities. Provides clear radiographic deficition of structures that are not
visible by other techniques.
- initial scan may be followed by “contrast enhancement” using an injection of
contrast agent iodine via vein, followed by a repeat scan.
Patients preparations:
- instructions for eating before test vary
- clear liquids up to 2 hours before the procedure are permitted
E. Magnetic resonance imaging (MRI) – noninvasive technique that produces cross sectional
images by exposure to magnetic energy sources. It uses no contrast medium; takes 30-0
minutes to complete. Patient may still for periods of 5-20 minutes at a time.
Patients preparations:
- patient can take food and medications except for low abdominal and pelvic studies
(food and fluid withheld) 4-6 hr to decrease peristalsis)
- Restrictions
a. those who have metal implants
b. those with permanent pacemakers
c. those who are pregnant
F. Ultrasound (sonogram) – uses sound waves to diagnose disorders of the thyroid, kidney,
liver, uterus, gallbladder, fetus and intracranial structures of the neonate.
Patients preparations:
- advise client not to chew gum or smoke before the procedure
- no x-ray
- for gallbladder studies; NPO for 8 hours
- for lower abdomen and uterus ; 32 ounces of water PO 30 minutes before the
procedure
G. Pulmonary function studies
• Ventilatory studies – use of incentive spirometer to determine how well the lung is
ventilating.
1. Vital capacity (VC) – largest amount of air that can be expelled after maximal
inspiration
Normal = 4000 – 5000 mL.
Decrease = indicate lung disease
Increase or decrease = indicate chronic obstructive lung disease
2. Forced expiratory volume (FEV) – percentage of vital capacity that can be forcibly
expired in 1, 2, or 3 seconds.
Normal =

80 – 83% in 1 sec
90 – 94% in 2 sec
95 – 97% in 3 sec
decrease = indicate expiratory airway obstruction
H. Sputum Studies
1. Gross sputum evaluations – collection of sputum samples to ascertain quantity,
consistency, color and odor
2. Sputum smear – sputum is smeared thinly on a slide so that it can be studied
microscopically.
- used to determine cytological changes or presence of pathogenic microorganism
3. Sputum culture – sputum samples are implanted or inoculated into special media.
- used to diagnosed pulmonary infection
I. Examination of the gastric contents
1. Gastric analysis – aspiration of the contents of the fasting stomach analysis of free and total
acid
Gastric acidity increase :
Gastric acidity decrease :

duodenal ulcer
pernicious anemia an cancer of the stomach

J. Doppler ultrasound – measures blood flow in the major veins and arteries. The
transducer of the test instrument is placed on the skin, sending ultra-high-frequency
sound.
- sound varies with respiration and valsalva maneuver
- no discomfort to the patient.
K. Glucose Testing – to detect disorder of glucose metabolism, such as diabetes.
1. Fasting blood sugar (FBS) – blood sample is drawn after a 12 fast (usually midnight).
Water is allowed.
Normal blood glucose ; 60 – 120 mg/dL
Diabetic patient = 126 mg/dL
2. 2 hr postprandial (PPBS) – blood is taken after meal
Patients preparations:
- offer a high-carbohydrate diet for 2-4 days before testing
- patient fast overnight
- eats a high-carbohydrate breakfast
- blood sample is drawn 2 hr interval
- no cigarette smoking and caffeine for these may increase glucose level
Common Diagnostics Procedures
Invasive Diagnostics Procedures
Characteristics:
1. it directly records the size, shape and function of an organ;
2. it requires the written consent of the patient or guardian;
3. it may result in morbidity and occasionally death.
General Nursing Task:
1. Before procedure:
a. have patient sing permit to procedure
b. ascertain and repot any patient history of allergy or allergic reaction
c. explain procedure briefly and accurately
d. explain that contrast medium might cause flushing or warm feeling
e. keep patient NPO 6-12 hour before procedure if anesthesia is to be used
f. allow patient to verbalize concerns
g. administer preprocedure sedatives, as ordered
h. if procedure done at bed side:
- remain with patient and offer reassurance
- assist with optimal positioning of patient
- observe for indication of complications – shock, pain and dyspnea
2. After procedure:
a. observe and record vital signs
b. check injection or biopsy sites for bleeding, infection, tenderness, or thrombosis
• report untoward reaction to the physician
• apply warm compress to ease discomfort, as ordered
c. if tropical anesthesia is used during procedure, do not give food or fluid until gag
reflex returns
d. encourage relaxation by allowing patient to discuss experience and verbalize
feelings.
A. Procedures to evaluate the cardiovascular system
1. Angiography – intravenous injection of radiopaque solution or contrast for the purpose
of studying its circulation through the patient’s heart, lungs and great vessels.
- Used to check the competency of the heart valves, diagnose congenital septal
defects, study heart function and structure before cardiac surgery, detect occlusions
of coronary arteries.
2. Cardiac catheterization – insertion of a radiopaque catheter into a vein to study the
heart great vessels.
- Used to confirm diagnosis of heart disease and determine extent of disease,
measure pressures in the heart chamber and great vessels, obtain estimate of cardiac
output, and obtain blood samples to measure oxygen content.
a. Right heart catheterization – catheter is inserted through a cut-down in the
antecubital vein into the superior vena cava, through the right atrium and
ventricle and into the pulmonary activity.
b. Left-heart catheterization- catheter maybe passed retrograde to the left
ventricle through the brachial and femoral artery, it can be passed through
the left atrium after right-heart catherization by means of a special needle
that punctures the septa; or it may be passed directly into the left ventricle
by means of a posterior puncture.
Specific nursing considerations:
1. Preprocedure patient teaching:
a. Fatigue is a common complaint due to lying still for 3 hr
b. Feeling of fluttery sensation while the catheter is passed back into the left
ventricle
c. Flushed, warm feeling may occur when contrast medium is injected.
2. Postprocedure observations:
a. monitor ECG pattern for arrhythmias
b. check extremities for color and temperature, peripheral pulses for quality.
3. Angiography (Arteriography) – injection of a contrast medium in to the arteries to
study the vascular tree.
- Used to determine obstructions or narrowing of peripheral arteries.
B. Procedure to evaluate the respiratory system
1. Lung scan – injection of radioactive isotope into the body, followed by lung scintiscan,
which produces a graphic record of gamma rays emitted by the isotopes in the tissues.
- used to determine lung perfusion when pulmonary emboli and infarctions are
suspected.
2. Pulmonary angioghraphy – x – ray visualization of the pulmonary vasculature after the
injection of a radiopaque contrast medium.
- used to evaluate pulmonary disorders such as pulmonary embolism, lung tumor and
aneurysms, and changes in the pulmonary vasculature due to such conditions as
emphysema.
3. Bronchoscopy – introduction of a fiberoptic scope into the trachea and bronchi
- used to inspect tracheobronchial tree for pathological changes, remove foreign
bodies or mucous plugs causing airway obstruction, and apply chemotherapeutic
agents.
a. Prebronchoscopy interventions:
• oral hygiene
• postural drainage as indicated
b. Postbronchoscopy interventions:
• Instruct patient not to swallow oral secretions
• Save expectorated sputum for laboratory analysis
• NPO till gag reflex returns
• Observe for subcutaneous emphysema and dyspnea
•

Apply ice collar to reduce throat discomfort

4. Thoracentesis – needle puncture through the chest wall and into the pleura
- used to remove fluid and occasionally air from the pleural space
- nursing considerations
a. position : high fowler’s position or sitting upon edge of the bed, with feet
supported on the chair.
b. If the patient is unable to sit up – turn unto unaffected side

a. Position: high fowler’s position or sitting upon edge of the bed, with feet supported on
the chair.
b. If the patient’ is unable to sit up-turn unto unaffected side
C. Procedures to evaluate the renal system
1.
Renal angiogram – small catheter is inserted into the femoral artery and passed into
the aorta or renal artery, radiopaque fluid is in stilled, and serial films are taken.
- Used to diagnose renal hypertension and pheochromocytoma and differentiate renal
cyst from tumors.
Postangiogram nursing actions:
1. Check pedal pulse for signs of decreased circulation.
2. Cystoscopy – Visualization of bladder, urethra, and prostatic urethra by insertion of a
tubular, lighted, telescopic lens (cystoscope) through the urinary meatus.
- Used to directly inspect the bladder; collect urine from the renal pelvis; obtain biopsy
specimens from bladder and urethra; remove calculi; and treat lesions in the bladder,
urethra, and prostate.
Nursing actions following procedure:
• Observe for urinary retention
• Warm sitz baths to relieve discomfort
3. Renal biopsy – needle aspiration of tissue from the kidney for the purpose of
microscopic examination.
Procedures to evaluate the digestive system:
1. Esophagoscopy and gastroscopy – visualization of the esophagus, the stomach,
and sometimes the duodenum by means of a lighted tube inserted through the
mouth.
2. Proctoscopy – visualization of rectum and colon by means of a lighted tube
inserted through the anus.
3. Peritoneoscopy – direct visualization of the liver and peritoneum by means of a
peritoneoscope inserted through an abdominal stab wound.
4. Liver biospsy – needle aspiration of tissue for the purpose of microscopic
examination; used to determine tissue changes, facilitate diagnosis, and provide
information regarding a disease course.
Nursing action:
1. Place patient on right side and position pillow for pressure, to prevent bleeding.
5. Paracentesis – needle aspiration of fluid from the peritoneal cavity used to relieve
excess fluid accumulation or for diagnostic studies.
a. Specific nursing actions before paracentesis:
a. Have patient void - to prevent possible injury to bladder during
procedure
b. Position – sitting up on side of bed, with feet supported by
chair.
c. Check vital signs and peripheral circulation frequently
throughout procedure
d. Observe for signs of hypovolemic shock – may occur due to
fluid shift from vascular compartment following removal of
protein – rich ascitic fluid.
b. Specific nursing actions following paracentesis:
a. Apply pressure to injection site and cover with sterile dressing.
b. Measure and record amount and color of ascitic fluid; send
specimens to lab for diagnostic studies.
D. Procedures to evaluate the reproductive system in women
1. Culdoscopy – surgical procedure in which a culdoscope is inserted into the
posterior vaginal cul-de-sac
- Used to visualize uterus, fallopian tube, and peritoneal contents.
2. Breast biopsy – needle aspiration or incisional removal of breast tissue for
microscopic examination.
- used to differentiate among benign tumors, cysts, and malignant tumor in the
breast.
3. Uterotubal insufflation (Rubin’s Test) – injection of carbon dioxide into the
cervical canal.
- Used to determin fallopian tube patency
E. Procedure to evaluate the neuroendocrine system
1. Cerebral angiography – fluoroscopic visualization of the brain vasculature
after injection of a contrast medium into the carotid or vertebral arteries
- used to localize lesions (tumors, abscesses, and occlusions) that are large enough
to distort cerebrovascular blood flow.
2. Myelogram – through a lumbar-puncture needle, a contrast medium is injected into
the subarachnoid space of the spinal column to visualize the spinal cord.
- Used to detect herniated or ruptured intervertebral disks, tumors and cysts that
compress or distort spinal cord.
Nursing consideration:
• Elevate head of bed = with water soluble contrast
• Flat position – with oil contrast
• V/s every 4 hr for 24 hr.
3. Lumbar puncture – puncture of the lumbar subarachnoid space of the spinal
cordwith a needle to withdraw samples of cerebrospinal fluid.
- Used to evaluate CSF for infections and determine presence of hemorrhage.
Note: not done if increased ICP is suspected
Position: Before : fetal position / knee chest position
After : flat or supine

Test
Antigen skin
Benedict’s test
Bentonite Flacculation Test
Beutler’s test
Blanching test
Bronsulpthalein test
Caloric test
CD4 determination
Cerebral perfusion test
Coomb’s test
CPK BB
CPK MB
CPK MM
Dark field illumination test and
kalm test
Dick test
Dull’s eye test
ELISA test
Gram staining and Culture of

Indication
Test to rule-out cancer of the lungs
For glucose monitoring
Test for filariasis
Test for galactosemia
Determines the impairment in circulation
Liver angiography
Test done by placing water in the ear canal causes nystagmus.
A test for inner ear
Checking the immune status to AIDS patient
Test used to check the cerebral function
Determines the production of the antibodies. RhoGAM is
given (1st 72 hours)
Test for brain muscles
Test for cardiac muscles: for MI
Test for muscle injury
Determination for the presence of syphilis
Detect scarlet fever
Determines the presence of blindness. Done in 1st ten days (+)
normal (-) abnormal
Determines presence of HIV
Determination for the presence of gonorrhea
cervical and urethral smear
Gross hearing test
Guthrie test
Heat and Acetic acid test
Immunochromatographic test
Jones Criteria
Lepronin test
Liver enzyme test
Liver profile test
Lumbar puncture
Malaria smear
Mantoux test
Meniere’s test
Methylene blue test
Moloney test
Oxytocin challege test
Pandy’s test
Phenosulpthalein test
Queckkenstedt’s test
Rectal swab
Rinne Test
Romberg’s test
Schick test
Schiller’s test
Schilling test
Schwabach test
Shake test
Skin test
Slit skin smear
Specific gravity test
Sperm count test
Sputum exam
Sulkowitch test
Sweat chloride test
Tensilon (Endophonium) test
Tonometer

Test used by whispering words or spoken voice test
Test for PKU
For protein or albumin detection
A rapid assessment method done for filariasis. The antigen test
that can be done at daytime
One way of diagnosing Rheumatic heart fever
A screening test for leprosy
For SGOT and SGPT
Determines Hepa-b surface antigen
Determines for the presence of meningitis and encephalitis.
Position the patient in side lying position
Test to confirm malaria; specimen is taken at the height or
peak of fever
Determination for TB exposure
Test for vestibular function
For ketone detection
Hypersensitivity test for Diphtheria
Determines if the fetus can tolerate uterine contraction; (+) CS
is necessary
Determines the presence of protein in the CSF
Kidney angiogram
Test that involve the compression of jugular veins
Done in patient with cholera, pinworm detection
Shifted between mastoid bone and two inches from the ear
canal opening
Assess gait and station such as ataxia
Susceptibility test for diphtheria (+) no immunity (-) with
immunity
Staining the cervix with an iodine solution. Healthy tissues will
turn brown, while cancerous tissue resist the stain
Used to patient with severe chilling sensation; for confirmation
of pernicious anemia
Differentiate between conductive and sensorineural deafness,
mastoid of patient and examiner
Determines the amount of surfactant in the lungs.
Purpose it to produce antigen reaction
A confirmatory test for leprosy
For diabetes mellitus and insipidus as well as for dehydration
For male infertility (low sperm count-oversex)
For defection and sensitivity of causative microorganism, for
pneumonia and TB
Urine test detection for calcium deficiency and calcium in the
urine
Used to diagnosed cystic fibrosis
For rapid detection of myasthenia gravis
Test used to measure ocular tension and helping in detecting
early glaucoma N=12-20 mmHg
Done to determine presence of petechiae in Dengue
Hemorrhagic fever
Determination for the presence of herpes simplex
Evaluation of bone conduction. Tuning fork is placed on
patient’s forehead or teeth
For typhoid fever determination
A confirmatory for AIDS

Torniquet test
TZANK test
Weber test
Wedal’s Test
Western blot test

Arterial Blood Gases
Type
Respiratory
Acidosis
pH<7.35;
PaCO2>45
Respiratory
Alkalosis
pH>7.45;
PaCO2<35
Metabolic
Acidosis
pH<7.35;
HCO3,22

Causes
. COPD
. Respiratory
. Overdose
. Atelectasis
. Pulmonary edema
. Aspiration
. Hyperventilation
. Anxiety
. Pain
. Ventilators
. DKA
. Diarrhea
. ASA poisoning
. Renal failure

Metabolic
Alkalosis
PH>7.45;
HCO3>26

. Vomiting
. NGT
. Diuretics and
Antacids

Remember
Facts

Manifestations
. Weakness
. Tachycardia
. Decreased LOC
. Headache

Management
. Assess VS
. Monitor
. ABG
. CPT
. TCDB

. Lightheadedness
. Ringing of the
ears
. Tingling
. Headache
. N/V
. Kussmaul
respiration
. Dysrhythmias
. Tingling
. Dizziness
. Bradypnea

. Slow
breathing
. Paper bag
. Administer sodium
bicarbonate
. Monitor I/O
. Use seizure
precautions
. Monitor VS
. I/O
. ABG

: Respiratory Opposite; Metabolic Equal
: pH = 7.35 – 7.45
PCO2 = 34 – 45 HCO3=22-26

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Commonly asked emergency drugs

  • 1. Commonly Asked Emergency Drugs Emergency Drug Adenosine Atropine sulfate Epinephrine Lasix Lidocaine Magnesium sulfate Morphine Sulfate Narcan Nitroglycerine Vasopressin Initial Dose 6 mg 0.5 – 1 mg.q 3-5 min 1 mg.q 3-5 min 0.5-1 mg/kg 1-1.5 mg/kg 1-2 g 1-3 mg 0.02-2mg 0.4 mg SL 40 units Indications Bradycardia Cardiac arrest Pulmonary edema Ventricular fibrillation, Ventricular tachycardia Ventricular tachycardia r/t hypomagnesemia Chest pain, pulmonary edema Narcotic – respiratory depression Chest pain, pulmonary edema Cardiac arrest Antidotes Agents Acetaminophen Anticholinesterase Anticholinergics Benzodiazepines Coumadine Cyanide Digoxin Dopamine Heparin Iron Lead Magnesium Sulfate Narcotics Antidotes Acetylcysteine (Mucomyst) Atropine So4 Physostigmine Flumazenil Vitamin K Sodium nitrate Digoxin immune fab (Digibind) Phentolamine Protamine sulfate Deferoxamine Dimercaprol, edentate disodium and succimer Calcium gluconate Naloxone Drug Name Endings: What they can suggest you!!! Endings *cain *cillin *dine *done *ide *lam/ *pam *micin/ *mycin *mine/ *zide *olol *pril *sone class Local anesthetics Antibiotics Antiulcer agent Opiod analgesics Oral hypoglycemics Antianxiety Antibiotics Diuretics Beta blockers ACE inhibitors Steroids
  • 2. Drugs Trade /(generics) 1 Aminophylline (theophylline) 2 4 Amphogel (aluminum hydroxide) Antabuse (disulfiram) Aspirin (ASA) 5 Atropine SO4 6 Bacterium (cotrimoxazole) 7 Benadryl (diphenhydramine hcl) 3 8 FREQUENTLY ASKED MEDICATIONS Desired Effects Best Time to be Taken Bronchodilator To case breathing AM / empty stomach Classification Antacid phosphate level Between meals and HS Antialcoholic agent Avoidance of alcohol Anti-inflammatory Anti-pyretic Analgesic Anticholinergic and Vagolytic Antibiotic  temperature  pain and inflammation  heart rate and decrease secretion s (-) infection After 12 hrs. stoppage from alcohol Full stomach Antihistamine Anti – EPS Antineoplastic (-) allergy (-) movement syndrome respiratory distress in newborn size of tumor Antidiabetic agent Normal glucose range AM Other • • • • • • No s No c Che Give Rep No a Best taken with food • Che • Syru over • Obs • Avo • Red • Rash • Asse neph • Avo Best taken with food • Mon AM • Incr • Mon • Mon 30 PC PC Celestone (betamethazone) 9 Cytoxan (cyclophosphamide) 10 Diabinase (chlorpropaminde) 11 Diamox (acetazolamide) 12 Digoxin (lanoxin) Steroids Antiglaucoma antidiuretics Cardiac glycoside  urine output  vertigo Normal heart rate AM with meals • Pho AM 13 Dilantin (phenytoin) 14 Diuril (chlorothiazide) Anti-convulsant Diuretics (-) seizure  urine output Best taken with food Best taken with food • • • • AM • • 15 Epinephrine Bronchodilator  heart rate 16 Flagyl (metronidazole) Antihelmintic (-) helminth Best taken with food 17 Haldol (haloperidol) Antipsychotic  (+) symptoms of psychosis AC • • • • • • Asse Mon Tap Rep extr Incr Don driv Asse Avo Not Tetr Asse Pho
  • 3. 18 Kayexalate  serum K 19 Lasix (furosemide) Promote excretions of K Diuretic  urine output AM 20 Lithane (LiCO3) Antimanic  hyperactivity PC 21 Lovenox (mevacor) Antithrombotic (-) thrombosis 22 Magnesium SO4 Anticonvulsant (-) convulsion 23 Mastinon (pyridostigmine) 24 Mathergine (methylergonovine maleate) 25 Monoamine oxidase inhibitor Cholinesterase inhibitor Oxytocic for post partum atony  muscle strength Antidepressant Improved sleeping pattern PC 26 Nitroglycerin Antiangina (-) chest pain 27 Pancrease (pancreatin) Pancreatic enzyme (-) fat in the stool Best taken before any strenuous activity Between meal and snacks 28 Phenergan (promethazine hyrochloride) 29 Reserpine (serpasil) Antihistamine (-) allergy Empty stomach Antihypertensive  BP Best taken with meals 30 Ritalin (methylphenidate) 31 Robaxin (methocarbamol) 32 Synthroid (levothyroxine sodium) 33 Tagamet (cimetidine) 34 Thorazine (chlorpromazine hcl) 35 Valium (diazepam) 36 Xylocaine (lidocaine) Stimulant  hyperactivity AM / PC Skeletal muscle relaxant Thyroid hormone supplement Antiacidity Antipsychotic (-) muscle spasm AM Normal T4 level AM Best taken with food PC Antianxiety Antiarrythmic (-) heartburn (-) positive signs of psychosis (-) anxiety Normal heart rate 37 Zyloprim (allopurinol) Antigout  uric acid Best taken with food PC Firmly contracted uterus AC • May • Mon • Incr K • Mon • Dec • Soft • No r • Kee • Asse • Anti • Mon • Anti • Mon • Rep • • • • • • No t Asse Mon Tak Kee Prep don’ • Obs • Anti • No s • Mon • Mon deve • No a • Anti • Mon • • • • • Avo Pho Mon No a Mon conv • S/E • Incr
  • 5. Common Tubes Table or Apparatus Miller-Abbott tube Purpose Longer than Levin tube; has mercury of air in bags so tube can be used to decompress the lower intestinal tract Examples of Use 1. Small-bowel obstructions 2. Intussusception 3. Volvulus Cantor Tube To drain bile from the common bile duct until edema has subscribed Cholecystectomy when a common duct exploration (CDE) or choledochostomy was also done T-tube A type of closedwound drainage connected to suctionused to drain, a large amount of serosa`nguineous drainage from under an incision 1. Mastectomy 2. Total hip procedure 3. Total knee procedure Hemovac A method of closed wound suction drainage indicate when tissue displacement and tissue trauma may 1. 2. 3. 4. Neurosurgery Neck surgery Mastectomy Total knee and hip replacement 5. Abdominal surgery Key points 1. Care similar to that Levin NG tube irrigated. 2. connected to suction, not sterile technique 3. orders will be written on how to advance the tube gently pushing tube a few inches each hour, patient position may affect advancement of tube 4. X-rays determine the desired location of tube 1. Bile drainage is influenced by position of the drainage bag. 2. Clamp tubes as ordered to see if bile will flow into duodenum, normally. 1. May compress unit, and have portable vacuum or connect to wall suction. 2. Small drainage tube may get clogged physician may irrigate these at times Empty reservoir when full, to prevent loss of wound drainage and back contamination
  • 6. Jackson-Pratt Three-way Foley Suprapubic catheter Ureteral catheter occur with rigid drain tubes (e.g Hemovac) See Hemovac To provide avenues for constant irrigation and constant drainage of urinary bladder 6. Urological procedure See Hemovac 1. Transurethral resection (TUR) 2. Bladder infection To drain bladder via an opening through the abdominal wall above the pubic bone To drain urine feom the pelvis of one kidney, or for splinting ureter Suprapubic prostatectomy 1. Cystoscopy for diagnostic workups 2. Ureteral surgery 3. Pyelotomy See Hemovac Watch for blocking by clots causes bladder spasms Irrigant solution often has antibiotic added to normal salin or sterile water Sterile water rather than normal saline may be used for lysis of clots May have orders to irrigate prn or continuously Never clamp the tubepelvis of kidney only holds 4-8 mL Use only 5 mL sterile normal saline if ordered to irrigate Common Diagnostics Procedures Noninvasive Diagnostic Procedures Characteristics: 1. it provides an indirect assessment of organ size, shape, and / or function 2. it is safe 3. it is easily reproducible 4. it requires less complex equipment for recording 5. it does not require the written consent of patient or guardian General Nursing Tasks: 1. Decrease patients anxieties and offer support by a. Explain purpose and procedure of test b. Acknowledge questions regarding safety of the procedure c. Remain with the patient while the procedure is going on 2. Use procedure in the collection of specimens that avoids contamination A. Graphic studies of Heart and brain 1. Electrocardiogram (ECG) – graphic record of electrical activity generated by the heart during depolarization and repolarazation. - diagnose abnormal cardiac rhythms and coronary heart disease
  • 7. 2. Echocardiography (ultrasound cadiography) – graphic record of motions produced by cardiac structure as high-frequency sound vibrations are echoed though chest wall into the heart. - used to demonstrate valvular or other structural deformities, detect pericardial effudion, diagnose tumors and cardiomegaly, evaluate prosthetic valve function. 3. Electroencephalogram (ECG) – graphic record of the electrical potentials generated by the physiological activity of the brain - used to detect surface lesions or tumors of the brain and presence of epilepsy. 4. Echoencephalogram – beam of ultrasound is passed though the head, and returning echoes are graphically recorded. - used to detect subdural hematomas, intracerebral hemorrhage, or tumors. B. Roentgenological studies (X-ray) 1. Chest – used to determine size, contour of the heart; size, location, and nature of pulmonary lesions: pleural thickening and effusions: pulmonary vasculature: disorder of thoracic ones and soft tissues. - used lead shield to protect pregnant woman 2. Kidney, Ureter, and Bladder (KUB) – used to determine size, shape, and position of kidney, ureter and bladder - No special consideration 3. Breast (Mammography) – examination of the breast with or without the injection of the radiopaque substance into the duct of mammary gland. - used to determined the presence of tumor or cyst (best done a week after menstruation) - no deodorant, perfume, powder, or ointment in underarm area on the day of X-ray (contains Calcium oxalate) - May be uncomfortable due to the pressure on the breast. (uses two x-ray plates) C. Roentgenological studies (FLUOROSCOPY) – requires the ingestion or injection of a contrast medium to visualize the target organ. Additional Nursing Task: a. Administration of enemies or cathartics before the procedure and laxative after. b. Keeping the patient NPO 6-12 hours before examination c. Ascertain patient’s allergy and allergic reactions d. Observing for allergic reactions to contrast medium e. Providing fluid and food after procedure to prevent dehydration f. Observe stool for color and consistency until barium passes 1. Upper GI (Barium swallow) – ingestion of barium sulfate or meglumine diatrizoate (Gastrografin [white and chalky substance], followed by fluoroscopic and x-ray examination)
  • 8. - used to determine patency and caliber of the esophagus and to detect esophageal varices, mobility of gastric wall, presence of ulcer, filling defects due to tumor, patency of pyloric valve and presence of structural abnormalities 2. Lower GI (Barium Enema) – rectal instillation of barium sulfate followed by glouroscopic and x-ray examination - used to determine contour and mobility of colon and presence of any spaceoccupying tumors. Perform before upper GI Patients preparations: - no food after evening meal the evening before the test - stool softener laxatives and enema suppositories to cleanse the bowel before the test - NPO after midnight before the test After care: - increased fluid intake, food and rest laxatives for at least two days or until stools are normal in color and consistency 3. Cholecystogram – ingestion of organic iodine contrast medium (Telepaque) followed in 12 hour by x-ray visualization - gallbladder disease is indicated with poor or no visualization of the bladder - accurate only if GI and liver function is intact - perform before barium swallow and barium enema Patients preparations: - administer large amount of water with contrast capsule - low-fat meal before evening before x-ray - oral laxative of stool softener after meal - no food allowed after contrast capsule After care: - increased fluid intake, food and rest observe for any untoward reactions 4. Intravenous Pyelography (IVP) – injection of a radiopaque contrast medium in the vein of the client to visualize ureter, bladder and kidney Patients preparations: - Laxative in the evening before the examination - NPO for 12 hours - Cleaning enema morning of the procedure After care: - increased fluid intake, food and rest; observe for any untoward reactions
  • 9. D. Computed Tomography (CT) – an x-ray beam sweeps around the body, allowing measuring of various tissue densities. Provides clear radiographic deficition of structures that are not visible by other techniques. - initial scan may be followed by “contrast enhancement” using an injection of contrast agent iodine via vein, followed by a repeat scan. Patients preparations: - instructions for eating before test vary - clear liquids up to 2 hours before the procedure are permitted E. Magnetic resonance imaging (MRI) – noninvasive technique that produces cross sectional images by exposure to magnetic energy sources. It uses no contrast medium; takes 30-0 minutes to complete. Patient may still for periods of 5-20 minutes at a time. Patients preparations: - patient can take food and medications except for low abdominal and pelvic studies (food and fluid withheld) 4-6 hr to decrease peristalsis) - Restrictions a. those who have metal implants b. those with permanent pacemakers c. those who are pregnant F. Ultrasound (sonogram) – uses sound waves to diagnose disorders of the thyroid, kidney, liver, uterus, gallbladder, fetus and intracranial structures of the neonate. Patients preparations: - advise client not to chew gum or smoke before the procedure - no x-ray - for gallbladder studies; NPO for 8 hours - for lower abdomen and uterus ; 32 ounces of water PO 30 minutes before the procedure G. Pulmonary function studies • Ventilatory studies – use of incentive spirometer to determine how well the lung is ventilating. 1. Vital capacity (VC) – largest amount of air that can be expelled after maximal inspiration Normal = 4000 – 5000 mL. Decrease = indicate lung disease Increase or decrease = indicate chronic obstructive lung disease 2. Forced expiratory volume (FEV) – percentage of vital capacity that can be forcibly expired in 1, 2, or 3 seconds. Normal = 80 – 83% in 1 sec 90 – 94% in 2 sec
  • 10. 95 – 97% in 3 sec decrease = indicate expiratory airway obstruction H. Sputum Studies 1. Gross sputum evaluations – collection of sputum samples to ascertain quantity, consistency, color and odor 2. Sputum smear – sputum is smeared thinly on a slide so that it can be studied microscopically. - used to determine cytological changes or presence of pathogenic microorganism 3. Sputum culture – sputum samples are implanted or inoculated into special media. - used to diagnosed pulmonary infection I. Examination of the gastric contents 1. Gastric analysis – aspiration of the contents of the fasting stomach analysis of free and total acid Gastric acidity increase : Gastric acidity decrease : duodenal ulcer pernicious anemia an cancer of the stomach J. Doppler ultrasound – measures blood flow in the major veins and arteries. The transducer of the test instrument is placed on the skin, sending ultra-high-frequency sound. - sound varies with respiration and valsalva maneuver - no discomfort to the patient. K. Glucose Testing – to detect disorder of glucose metabolism, such as diabetes. 1. Fasting blood sugar (FBS) – blood sample is drawn after a 12 fast (usually midnight). Water is allowed. Normal blood glucose ; 60 – 120 mg/dL Diabetic patient = 126 mg/dL 2. 2 hr postprandial (PPBS) – blood is taken after meal Patients preparations: - offer a high-carbohydrate diet for 2-4 days before testing - patient fast overnight - eats a high-carbohydrate breakfast - blood sample is drawn 2 hr interval - no cigarette smoking and caffeine for these may increase glucose level
  • 11. Common Diagnostics Procedures Invasive Diagnostics Procedures Characteristics: 1. it directly records the size, shape and function of an organ; 2. it requires the written consent of the patient or guardian; 3. it may result in morbidity and occasionally death. General Nursing Task: 1. Before procedure: a. have patient sing permit to procedure b. ascertain and repot any patient history of allergy or allergic reaction c. explain procedure briefly and accurately d. explain that contrast medium might cause flushing or warm feeling e. keep patient NPO 6-12 hour before procedure if anesthesia is to be used f. allow patient to verbalize concerns g. administer preprocedure sedatives, as ordered h. if procedure done at bed side: - remain with patient and offer reassurance - assist with optimal positioning of patient - observe for indication of complications – shock, pain and dyspnea 2. After procedure: a. observe and record vital signs b. check injection or biopsy sites for bleeding, infection, tenderness, or thrombosis • report untoward reaction to the physician • apply warm compress to ease discomfort, as ordered c. if tropical anesthesia is used during procedure, do not give food or fluid until gag reflex returns d. encourage relaxation by allowing patient to discuss experience and verbalize feelings. A. Procedures to evaluate the cardiovascular system 1. Angiography – intravenous injection of radiopaque solution or contrast for the purpose of studying its circulation through the patient’s heart, lungs and great vessels. - Used to check the competency of the heart valves, diagnose congenital septal defects, study heart function and structure before cardiac surgery, detect occlusions of coronary arteries. 2. Cardiac catheterization – insertion of a radiopaque catheter into a vein to study the heart great vessels. - Used to confirm diagnosis of heart disease and determine extent of disease, measure pressures in the heart chamber and great vessels, obtain estimate of cardiac output, and obtain blood samples to measure oxygen content. a. Right heart catheterization – catheter is inserted through a cut-down in the antecubital vein into the superior vena cava, through the right atrium and ventricle and into the pulmonary activity.
  • 12. b. Left-heart catheterization- catheter maybe passed retrograde to the left ventricle through the brachial and femoral artery, it can be passed through the left atrium after right-heart catherization by means of a special needle that punctures the septa; or it may be passed directly into the left ventricle by means of a posterior puncture. Specific nursing considerations: 1. Preprocedure patient teaching: a. Fatigue is a common complaint due to lying still for 3 hr b. Feeling of fluttery sensation while the catheter is passed back into the left ventricle c. Flushed, warm feeling may occur when contrast medium is injected. 2. Postprocedure observations: a. monitor ECG pattern for arrhythmias b. check extremities for color and temperature, peripheral pulses for quality. 3. Angiography (Arteriography) – injection of a contrast medium in to the arteries to study the vascular tree. - Used to determine obstructions or narrowing of peripheral arteries. B. Procedure to evaluate the respiratory system 1. Lung scan – injection of radioactive isotope into the body, followed by lung scintiscan, which produces a graphic record of gamma rays emitted by the isotopes in the tissues. - used to determine lung perfusion when pulmonary emboli and infarctions are suspected. 2. Pulmonary angioghraphy – x – ray visualization of the pulmonary vasculature after the injection of a radiopaque contrast medium. - used to evaluate pulmonary disorders such as pulmonary embolism, lung tumor and aneurysms, and changes in the pulmonary vasculature due to such conditions as emphysema. 3. Bronchoscopy – introduction of a fiberoptic scope into the trachea and bronchi - used to inspect tracheobronchial tree for pathological changes, remove foreign bodies or mucous plugs causing airway obstruction, and apply chemotherapeutic agents. a. Prebronchoscopy interventions: • oral hygiene • postural drainage as indicated b. Postbronchoscopy interventions: • Instruct patient not to swallow oral secretions • Save expectorated sputum for laboratory analysis • NPO till gag reflex returns • Observe for subcutaneous emphysema and dyspnea
  • 13. • Apply ice collar to reduce throat discomfort 4. Thoracentesis – needle puncture through the chest wall and into the pleura - used to remove fluid and occasionally air from the pleural space - nursing considerations a. position : high fowler’s position or sitting upon edge of the bed, with feet supported on the chair. b. If the patient is unable to sit up – turn unto unaffected side a. Position: high fowler’s position or sitting upon edge of the bed, with feet supported on the chair. b. If the patient’ is unable to sit up-turn unto unaffected side C. Procedures to evaluate the renal system 1. Renal angiogram – small catheter is inserted into the femoral artery and passed into the aorta or renal artery, radiopaque fluid is in stilled, and serial films are taken. - Used to diagnose renal hypertension and pheochromocytoma and differentiate renal cyst from tumors. Postangiogram nursing actions: 1. Check pedal pulse for signs of decreased circulation. 2. Cystoscopy – Visualization of bladder, urethra, and prostatic urethra by insertion of a tubular, lighted, telescopic lens (cystoscope) through the urinary meatus. - Used to directly inspect the bladder; collect urine from the renal pelvis; obtain biopsy specimens from bladder and urethra; remove calculi; and treat lesions in the bladder, urethra, and prostate. Nursing actions following procedure: • Observe for urinary retention • Warm sitz baths to relieve discomfort 3. Renal biopsy – needle aspiration of tissue from the kidney for the purpose of microscopic examination. Procedures to evaluate the digestive system: 1. Esophagoscopy and gastroscopy – visualization of the esophagus, the stomach, and sometimes the duodenum by means of a lighted tube inserted through the mouth. 2. Proctoscopy – visualization of rectum and colon by means of a lighted tube inserted through the anus.
  • 14. 3. Peritoneoscopy – direct visualization of the liver and peritoneum by means of a peritoneoscope inserted through an abdominal stab wound. 4. Liver biospsy – needle aspiration of tissue for the purpose of microscopic examination; used to determine tissue changes, facilitate diagnosis, and provide information regarding a disease course. Nursing action: 1. Place patient on right side and position pillow for pressure, to prevent bleeding. 5. Paracentesis – needle aspiration of fluid from the peritoneal cavity used to relieve excess fluid accumulation or for diagnostic studies. a. Specific nursing actions before paracentesis: a. Have patient void - to prevent possible injury to bladder during procedure b. Position – sitting up on side of bed, with feet supported by chair. c. Check vital signs and peripheral circulation frequently throughout procedure d. Observe for signs of hypovolemic shock – may occur due to fluid shift from vascular compartment following removal of protein – rich ascitic fluid. b. Specific nursing actions following paracentesis: a. Apply pressure to injection site and cover with sterile dressing. b. Measure and record amount and color of ascitic fluid; send specimens to lab for diagnostic studies. D. Procedures to evaluate the reproductive system in women 1. Culdoscopy – surgical procedure in which a culdoscope is inserted into the posterior vaginal cul-de-sac - Used to visualize uterus, fallopian tube, and peritoneal contents. 2. Breast biopsy – needle aspiration or incisional removal of breast tissue for microscopic examination. - used to differentiate among benign tumors, cysts, and malignant tumor in the breast. 3. Uterotubal insufflation (Rubin’s Test) – injection of carbon dioxide into the cervical canal. - Used to determin fallopian tube patency E. Procedure to evaluate the neuroendocrine system 1. Cerebral angiography – fluoroscopic visualization of the brain vasculature after injection of a contrast medium into the carotid or vertebral arteries - used to localize lesions (tumors, abscesses, and occlusions) that are large enough to distort cerebrovascular blood flow.
  • 15. 2. Myelogram – through a lumbar-puncture needle, a contrast medium is injected into the subarachnoid space of the spinal column to visualize the spinal cord. - Used to detect herniated or ruptured intervertebral disks, tumors and cysts that compress or distort spinal cord. Nursing consideration: • Elevate head of bed = with water soluble contrast • Flat position – with oil contrast • V/s every 4 hr for 24 hr. 3. Lumbar puncture – puncture of the lumbar subarachnoid space of the spinal cordwith a needle to withdraw samples of cerebrospinal fluid. - Used to evaluate CSF for infections and determine presence of hemorrhage. Note: not done if increased ICP is suspected Position: Before : fetal position / knee chest position After : flat or supine Test Antigen skin Benedict’s test Bentonite Flacculation Test Beutler’s test Blanching test Bronsulpthalein test Caloric test CD4 determination Cerebral perfusion test Coomb’s test CPK BB CPK MB CPK MM Dark field illumination test and kalm test Dick test Dull’s eye test ELISA test Gram staining and Culture of Indication Test to rule-out cancer of the lungs For glucose monitoring Test for filariasis Test for galactosemia Determines the impairment in circulation Liver angiography Test done by placing water in the ear canal causes nystagmus. A test for inner ear Checking the immune status to AIDS patient Test used to check the cerebral function Determines the production of the antibodies. RhoGAM is given (1st 72 hours) Test for brain muscles Test for cardiac muscles: for MI Test for muscle injury Determination for the presence of syphilis Detect scarlet fever Determines the presence of blindness. Done in 1st ten days (+) normal (-) abnormal Determines presence of HIV Determination for the presence of gonorrhea
  • 16. cervical and urethral smear Gross hearing test Guthrie test Heat and Acetic acid test Immunochromatographic test Jones Criteria Lepronin test Liver enzyme test Liver profile test Lumbar puncture Malaria smear Mantoux test Meniere’s test Methylene blue test Moloney test Oxytocin challege test Pandy’s test Phenosulpthalein test Queckkenstedt’s test Rectal swab Rinne Test Romberg’s test Schick test Schiller’s test Schilling test Schwabach test Shake test Skin test Slit skin smear Specific gravity test Sperm count test Sputum exam Sulkowitch test Sweat chloride test Tensilon (Endophonium) test Tonometer Test used by whispering words or spoken voice test Test for PKU For protein or albumin detection A rapid assessment method done for filariasis. The antigen test that can be done at daytime One way of diagnosing Rheumatic heart fever A screening test for leprosy For SGOT and SGPT Determines Hepa-b surface antigen Determines for the presence of meningitis and encephalitis. Position the patient in side lying position Test to confirm malaria; specimen is taken at the height or peak of fever Determination for TB exposure Test for vestibular function For ketone detection Hypersensitivity test for Diphtheria Determines if the fetus can tolerate uterine contraction; (+) CS is necessary Determines the presence of protein in the CSF Kidney angiogram Test that involve the compression of jugular veins Done in patient with cholera, pinworm detection Shifted between mastoid bone and two inches from the ear canal opening Assess gait and station such as ataxia Susceptibility test for diphtheria (+) no immunity (-) with immunity Staining the cervix with an iodine solution. Healthy tissues will turn brown, while cancerous tissue resist the stain Used to patient with severe chilling sensation; for confirmation of pernicious anemia Differentiate between conductive and sensorineural deafness, mastoid of patient and examiner Determines the amount of surfactant in the lungs. Purpose it to produce antigen reaction A confirmatory test for leprosy For diabetes mellitus and insipidus as well as for dehydration For male infertility (low sperm count-oversex) For defection and sensitivity of causative microorganism, for pneumonia and TB Urine test detection for calcium deficiency and calcium in the urine Used to diagnosed cystic fibrosis For rapid detection of myasthenia gravis Test used to measure ocular tension and helping in detecting
  • 17. early glaucoma N=12-20 mmHg Done to determine presence of petechiae in Dengue Hemorrhagic fever Determination for the presence of herpes simplex Evaluation of bone conduction. Tuning fork is placed on patient’s forehead or teeth For typhoid fever determination A confirmatory for AIDS Torniquet test TZANK test Weber test Wedal’s Test Western blot test Arterial Blood Gases Type Respiratory Acidosis pH<7.35; PaCO2>45 Respiratory Alkalosis pH>7.45; PaCO2<35 Metabolic Acidosis pH<7.35; HCO3,22 Causes . COPD . Respiratory . Overdose . Atelectasis . Pulmonary edema . Aspiration . Hyperventilation . Anxiety . Pain . Ventilators . DKA . Diarrhea . ASA poisoning . Renal failure Metabolic Alkalosis PH>7.45; HCO3>26 . Vomiting . NGT . Diuretics and Antacids Remember Facts Manifestations . Weakness . Tachycardia . Decreased LOC . Headache Management . Assess VS . Monitor . ABG . CPT . TCDB . Lightheadedness . Ringing of the ears . Tingling . Headache . N/V . Kussmaul respiration . Dysrhythmias . Tingling . Dizziness . Bradypnea . Slow breathing . Paper bag . Administer sodium bicarbonate . Monitor I/O . Use seizure precautions . Monitor VS . I/O . ABG : Respiratory Opposite; Metabolic Equal : pH = 7.35 – 7.45 PCO2 = 34 – 45 HCO3=22-26