most commonly asked procedures
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MOST COMMONLY ASKED
PROCEDURES
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ABDOMINAL ASSESSMENT
Detects abnormalities in the abd area e.g.
mass; abn bowel sounds
Order: IAPP
Palpation: last (?)
C.I. w/ wilms tumor & abd aortic
aneurysm
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ALPHA-FETO CHON
Assess presence of neural tube defects &
down syndrome
High AFP = neural tube defects
Low AFP = down syndrome
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AMNIOCENTESIS
Assess fetal growth & maturity; det. geneticD/O & sex of the fetus
14-16 wksassess for chromosomalaberration
After 35 wksassess fetal lung maturity
2:1 fetal lung maturity* Report fetal hyper/hypoactivity, vag
bleeding, chills, fever, fluid leakage
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APGAR SCORING
1st minute
5 minute
5 Criteria:
0-3 poor
4-6 fair7- 10 good
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ABG ANALYSIS
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ARTERIOGRAPHY
Evaluation tool before coronary artery
surgery to detect suspected congenital
anomalies
Assess for allergy to iodine or seafood,
shellfish
Epinephrine at B.S.
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BARIUM ENEMA
Assess large colon
Laxative before:
Laxative after:
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BARIUM SWALLOW
Assess esophagus & stomach
NPO 6-8 H
Laxative after
Increase OFI
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Blood coagulation test
Det presence of bleeding D/O
N PTT: 60-70 secs
Critical level: 175 secs
*N PT: 11-12 secs
Critical level : 24 secs*Clotting Time: 9 mins
Critical level: 12 mins
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Blood coagulation test
When pt.s blood value is above critical
value, w/hold the next dose of
anticoagulant
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BRAIN SCAN
Detects neoplasms, brain abscess & subdural
Hematoma
Consent, inc OFI after test
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BRONCHOSCOPY
Exam of bronchial tree
Consent, NPO before & after, Semi F,
Suction at B.S.
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CALORIC STIMULATION
TEST Detects D/O of inner ear like meneires
dse, use of alternating warm & cold H2O.
Warm H2O: N 8th C.N. = horizontal
nystagmus
Cold H2O: N brainstem = horizontal
nystagmus
N inner ear = severe nystagmus
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CALORIC STIMULATION
TEST
Cold H2O: menieres dse = moderate
nystagmus
: acoustic neuroma = no
nystagmus
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CARDIAC
CATHETERIZATION Measure O2 sat, conc, det need for cardiac
surgery
Assess for allergy, NPO 6H before test
Check peripheral & apical pulses Q 15
minutes for 2-4 H. check for bleeding.
Keep a 20 lb sandbag for P. keep extextended for 4-6 H
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CXR
Detects abn of organs in the thoracia area
Px women: lead shield
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CHOLANGIOGRAM
Visualization of the bile ducts
Check for allergy to iodine
Epinephrine at B.S.
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CHOLECYSTOGRAM
Assess gallstones
NPO p midnoc, low fat diet
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COLONOSCOPY
Visualization of L.I.
Informed consent, clear liq diet 48H prior
to the test
Laxative evening before the test
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CRANIAL NERVE
ASSESSMENT Detects abnormality in brainstem activity
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CT SCAN
Photograph of tissue densities w/ the use of
radiation
Check allergies, NPO 4 H if dye is used
C.I: claustrophobic pts., allergy to dye, Px
women, obesity (>300 lbs)
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CVP
Ind of P at RA 4th ICS- 0 level at
manometer
Tip SVC
N CVP= 212 mmHg
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CYSTOSCOPY
Inspect bladder & urethra
Informed consent, NPO if gen anesthesia;
liq diet if local anesthesia
After: force fluids
Sitz bath for abd pain
N: pink tinged or tea-colored urine
Notify Dr if bright red urine or clots
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DOPPLER UTZ
Evaluates patency of veins & arteries in the
lower ext
PAINLESS
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ECG
Records electrical waves of the heart
Tell pt to lie still, breath N,
ST elevation or T wave inversion = MI
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EEG
Records the electrical activity of the brain,
detects intracranial he & tumors
Shampoo pt.s hair, avoid caffeine beforethe test, w/hold stimulants,
antidepressants,tranquilizers,
anticonvulsants for 24-48 H prior the test
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EMG
Monitor electrical activity of the mm
Avoid stimulants & sedatives before the
procedure
Ask the Pt. to contract mm slowly &
progressively
Inform Pt that a needle will be inserted into
the mm
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ENDOSCOPIC
RETROGRADE CHOLANGIO
PANCREATOGRAPHY Radiographic visualization of the bile &
pancreatic ducts
C.I.: in pancreatitis, NPO before & afterthe procedure
Narcan at B.S.
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ENDOSCOPY
(GASTROSCOPY,
ESOPHAGOSCOPY) Assess esophagus & stomach
Consent, remove dentures, NPO 6-8H
before the procedure
Resume feeding after gag reflex returns
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FBS LEVEL
Detects DM
N: 70-110 or 80120 mg/dl
> 140 mg/dl = DM
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GASTRIC ANALYSIS
Assess ulcers or to R/O pernicious anemia,
to analyze acidity, appearance & vol of
gastric secretions Refrigerate gastric samples if NOT tested
w/in 4H
Gastric ulcerHcl N
Doudenal ulcerHcl elevated
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GTT
Confirms presence of sugar in the blood
High CHO given 24-48 H before the test
Blood drawn after an overnight fast
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GUTHRIE CAPILLARY
BLOOD TEST Screen test for PKU
N level: 2mg/dl
Give high CHON diet 24-48 H before the
test
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HYSTEROSALPINGOGRAPH
Y Det patency of F.T. & to detect pathology
in the uterine cavity.
X-ray exam administration of aradiopaque dye into the uterine cavity
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INCENTIVE SPIROMETRY
Used in prevention & txt of atelectasis
Semi F, take slow, easy deep breath fr the
mouthpiece
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IVP
Visualization of the urinary tract
Obtain consent, NPO 8 -10H before the
procedure. Laxative to clear the bowelsounds. Check allergy to iodine
Epinephrine
Salty taste during the test
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LAPAROSCOPY
Evaluates pelvic pain & infertility & treats
endometriosis lesions
NPO before the procedure
Enema before the procedure
Shoulder or abd discomfort after procedure
due to use of CO2
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LIVER BIOPSY
R/O liver D/O
Consent, bleeding most common
complicationPosition: L side or supine
Instruct to inhale, exhale, & hold breath
during procedureAfter: position on R side for 2H to prevent
Hge
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LP
W/draw CSF to determine abnormalities
Before: empty bladder & bowel
Position: C-position
Needle bt L3-L4 or L4-L5. S.C ends at L2.
After: position flat to prevent(?)
Inc fluid intake
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LUNG SCAN
Det lung perfusion when pulmo emboli &
infarction are suspected
Consent. Check allergy. Remove jewelriesfr the chest area. Sedatives as ordered.
Gloves w/in 24 H
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MAMMOGRAPHY
Det presence of tumors
Avoid deodorants, talcum powder, lotion,
perfume, ung.
Breast will be placed bet 2 Xray plates
Best done a wk after menses
Position: lying down w/ pillow under the
shoulder of the breast being examined
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MANTOUX TEST
(+) induration 10 mm or more
(+) induration of 5 mm or more in HIV;
healed TB
(+) rxn = exposure TB bacilli
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MRI
Provides C-sectional images of brain
tissues, more detailed than a CT scan
C.I.: Px women, claustrophobic Pts,Pts w/metal implants like pacemaker, hip
replacements & jewelries
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MULTIPLE GATED
ACQUISITION SCAN Detects valvular abn of the heart, coronary
artery dse, determines effects of CV drug
therapy Consent, PAINLESS, use of gloves if
contact w/ urine
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MYELOGRAM
Detects herniated intervertebral discs,
visualization of the S.C.
HOB elevated if H2O based dye(amipaque)
Flat on Bed if Oil based dye (pantopaque)
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NEEDLE BIOPSY OF THE
KIDNEY Obtain specimen/tissue sample fr the
kidney
NPO 6-8 H, check bleeding
Position on prone w/ pillow under the abd
P to puncture site
Inc fluid intake to 3000ml
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PARACENTESIS
Examine contents of the peritoneal fluid & to
relieve SOB when ventilation is impaired
Consent.
Sitting position feet on footstool. Void
immediately before the test
Check: Wt
Abd girth
RR
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PERICARDIOCENTESIS
Aspirate fluid from the pericardial sac
Monitor dysrrhythmias, puncture of lungs,
stomach, liver & laceration. Listen fordecrease intensity of heart sounds or
muffled heart sounds = CARDIAC
TAMPONADE
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RAIU TEST
Detects hyperthyroidism &
hypothyroidism
Increase iodine uptake=
Decrease iodine uptake =
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RINNE TEST
Differentiate bet conductive &
sensorineural hearing losses
Vibrating tuning fork 2 positions:
Mastoid bone (bone conduction)
Ear canal (air conduction)
CONDUCTIVE HEARING LOSS=bone
conduction longer than air conduction
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SCHILLINGS TEST
Detects Vit B12 absorption
Requires 24 H urine specimen
NPO except for H2O 8-12 H before the test
N= 8-40%; >40%=anemia
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SIGMOIDOSCOPY
Assess sigmoid colon
Consent, Full liq diet evening before the
test
Enema before the procedure(?)
Bleedingmost common complication
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SWAN-GANZ
CATHETERIZATION Monitor pulmonary artery P & PCWP
Catheter 4 lumens
1. CVP2. For fluid infusion
3. Monitor PAP & PCWP
4. Deflation of balloonN PAP= 20-30mmHg
NPCWP= 8-13 mmHg
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SWEAT CHLORIDE TEST
Detects cystic fibrosis
N Cl level= 90-110 mg/dl (serum)
= 10-35 meq/L (sweat)
Pilocarpine- to induce sweating
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SUCTIONING
Obtain sputum sample, relieve congestion
hyperO2 before & after
Intermittent suction on withdrawal of the
catheter (10-15 secs)
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THORACENTESIS
Aspiration of fluid & or air from pleural
space
Consent. Orthopneic position.
After: position on the unaffected side
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TONOMETRY
Measures IOP
N reading 12-21 mmHg
Increase = glaucoma
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WEBER TEST
Detects presence of unilateral hearing loss
Tuning fork set into vibration & placed on
the pts forehead or teeth.