1. Nursing Care
for
Patients
Undergoing
Diagnostic
Procedures
Blood Extraction

2. 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.

3. Diagnostic Testing Phases
• Pretest
Focus: Client Preparation
Teaching and communicating with the patient
What type of sample is needed
How will it be collected
What Equipment to use
Does it need fasting prior to the procedure
Does it involve administration of dye
Are medications given withheld
Are fluids restricted or forced
Is consent required
How long is the test

4. • Intratest
Focus: Specimen Collection and performing, or
assisting with certain diagnostic testing
The Nurse..
Uses standard precaution/Sterile technique as
appropriate
Provides emotional and physical support
Monitors patient (VS, Pulse oximetry, ECG, etc.)
Ensures correct labeling, storage and transportation
of specimen

5. • Post-Test
Focus: Nursing care and follow up
activities for the client
Compares previous and current
test results

6. 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

7. BLOOD TESTS
• Most commonly used diagnostic
test
• Provide valuable information
about the hematologic system
and many other systems as well
• Venipuncture is performed

8. 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

9. Blood Tests that require fasting
• CBG/HGT
• Blood Chemistry
FBS, BUN
Lipid Profile : LDL, HDL, Triglycerides, Total Chole
Liver Enzymes : AST, ALT, ALP, GGT, Albumin
Calcium Tests: PTH, Vitamin D, Phosphorus
Iron Tests: Iron levels, Transferrin saturation
Cardiac Blood Tests: Apolipoproteins

10. 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.

11. Lifespan Considerations
Site 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