diagnosting testing help to determine / monitoring the patient condition and find out disease, and evaluate progress of patient.

1. Diagnosting testing
IN NURSING FOUNDATION
(as per new syllabus bsc nursing
2nd sem)
Mrs. Ritu prajapati
Assistant professor

2. content
• Introduction
• Definition
• Phases of diagnostic testing
• Complete blood count
• Serum electrolyte
• Liver function test
• Serum glucose-AC,PC,HbA1c
• Monitoring capillary blood glucose
(glucometer random blood sugar )

3. • Stool routine examination
• Urine testing – albumin, acetone, pH, specific
gravity
• Urine culture, routine timed urine specimen
• Sputum culture
• Overview of radiological & endoscopic
procedure

4. Introduction
A diagnostic test is designed to investigate or diagnose and monitor the
disease, interventions and the multifactor that could affect the normal
individual profile.
It helps the physician in understanding the status of the
patient and help him in preparing treatment outline or the interventional
therapy according to patient condition of the patient.

5. Definition
• A diagnostic test is the test which helps in locating and identifying the
abnormality, deficiency or deviation from the normal in different
organs or parts of body.

7. Pretest phase
• First phase in the laboratory process.
• This includes the collection of specimen, transporting and processing of sample.
• this phase also includes the issues regarding the handling and collection of the
specimen.
• During the pretesting phase, which is also known as the preanalytic phase, there
are chances of errors while handling the specimen and processing the specimen.
• Therefore, the preanalytical phase should have rigorous control measures to avoid
any unnecessary hindrances or errors.

8. Intra-test phases
• The second phase is also known as the analytic phase.
•This phase is usually considered as the ‘actual’ phase of the diagnostic
testing or laboratory testing and the ultimate results of the diagnostic
test.

9. Post test phases
• The post-analytic phase is the final phase of the laboratory process.
• This phase culminates in the production of a final value, result, or the
case of histology, a diagnostic pathology report.
• The testing results in transmission detection, interpretation by doctor
and treatment, follow-up and retesting to evaluate the outcome of the
condition.

10. Complete blood
count

11. Complete blood test
This is the process of collecting or withdrawing blood samples through
Venepuncture for routine lab investigation to measure the various
components of blood which includes the red blood cells, white blood
cells, hemoglobin, hematocrit and platelets.

12. • To evaluate any abnormality in the blood profile.
• To supplement the diagnosis and treatment related to a specific
condition.
• To monitor variation in the blood.
Purpose

13. Various component of blood measured under complete blood
count
Red blood cell( that carry the oxygen in blood)

14. • WBC ( WHITE BLLOD CELL)
• HEMOGLOBIN
• PLATELATE

15. Equipment
• Alcohol swab
• Purple vial
• Needle
• Syringe and vacutainer
• Tourniquet
TECHNIQUES-
• Label the test tube
• Identify the client
• Collect 1ml -5ml of sample of blood depending on the test
• Gently shake the tube
• Deliver the tube to the lab

16. CBC Normal range

17. SERUM
ELECTROLYTE
vial USED FOR SERUM ELECTROLYTE

18. Serum electrolytes
• Electrolytes are involved in many essential processes in the body.
• They play a vital role in conducting nerve impulses, contracting
muscles, keeping body hydrated and regulating the pH levels.
it is a blood test that measures the levels
of the body’s means electrolyte

21. Vial used of liver function test
LIVER
FUNCTION
TEST

22. Liver function test
Liver function test also known as a liver panel are blood tests that
measure different enzymes, proteins, and other substances made by
liver.
liver function test helps to monitor
liver disease or liver damage

23. 1. ASPIRATE TRANSMINASE test (AST):-
Aspirate transaminase test is an enzyme that found in liver, heart,
muscles. It helps to metabolize amino acids like ALS, AST is normally found in
blood at low levels. If increase in AST levels may indicate liver damage.
NORMAL VALUE 29 TO 33 UNITS PER LITER
2. Alanine TRANSMINASE test (AST):-
Alanine Transaminase test is enzyme found in the liver
that helps convert protein in to energy for the liver cells
NORMAL VALUE 7 TO 55 UNITS PER LITER
3. ALKALINE PHOSPHATES TEST:-
Alkaline phosphates is an enzyme found in the bones, liver, bile
ducts. High level of ALP may indicate liver inflammation, blockage of bile ducts, or
bone disease.
NORMAL VALUE :- 40 TO 129 U/L

24. 4. ALBUMIN TEST:-
Albumin is the main protein made by liver. That fight against
infections. Lower than normal levels may indicate liver damage.
Normal value 3.5 to 5.0 gm/ deciliter
5. Bilirubin test :-
Bilirubin is the waste of product from the breakdown of red
blood cells. Elevated levels indicate liver damage.
Normal value- 0.1 to 1.2mg/dl

25. Purpose:
• To diagnose liver diseases, such as hepatitis.
• To monitor treatment of liver disease. These tests can
• show how well the treatment is working.
• To check how badly a liver has been damaged or scarred
• by disease, such as cirrhosis.
• To monitor side effects of certain medicines.
• For any symptoms of any liver problems or liver disease
such as:
• - Jaundice fever – skin and eyes turn yellowish
• - Swelling and pain of the abdominal
• - Swelling of legs and ankles
• - Itching of the skin
• - Dark color Urine
• - Stool is either bloody, tar- coloured or pale
• - Fatigue

27. Lipid /lipid
protein
Vial use for lip profile

28. Lipid /lipid protein
Lipid profile (or lipid panel) is a blood test that measures the
concentrations of fats and cholesterol in the blood, and can be
used to assess ‘good cholesterol’ versus ‘bad cholesterol’ levels

30. Serum glucose-AC,PC,HbA1c
Monitoring capillary blood glucose
(glucometer random blood sugar )

31. Serum glucose –AC, PC, HbA1c
• Hemoglobin A1c is a measure of the degree to which hemoglobin is
glycosylated in erythrocytes and is expressed as a percentage of total
hemoglobin concentration.
• HbA1c levels provide an indication of the average blood glucose
concentration during the preceding 2–3 months, including both pre-and
postprandial glycemia.

33. Monitoring capillary blood glucose
(glucometer random blood sugar)
Monitoring of the blood glucose level of the patient, who is at risk of
hyperglycemia or hypoglycemia, using a portable glucometer by putting
the drop of blood on the glucometer strip using the needle or lancet.
PURPOSE
•To monitor the blood glucose level of the patient.
•To educate the patient regarding diet management and medication.
•To encourage the patient about compliance with the treatment regimen.

34. Article
• Clean tray containing
• Glucometer
• Testing strips
• Sterile lancet or 26FG sterile needle
• Dry cotton swab and alcohol swab
• Clean gloves
• Hand rub

35. procedure
• Collect the article at the bedside and check physician order.
• doctor can prescribe random blood sugar, fasting blood sugar, postprandial
blood sugar, and also check confirm the frequency of testing.
• Before using the glucometer check the details on how to use this.
• Explain the procedure.
• Assess the patient for nil per oral for fasting blood sugar and also asked
about the meal for postprandial blood sugar.
• Check the hands of patient for cleanliness.
• Wash hands and wear gloves.
• Turn the glucometer on.
• Adjust the gluco-strip in to the glucometer.

36. • For puncturing the finger of the patient use the sterile lancet or needle and also
select appropriate site.
• Clean the site of finger with 70% alcohol swab in circulatory motion from central
to peripheral.
• Let the finger dry.
• Hold the lancet or needle in perpendicular way to the skin and prick the finger.
• Take the drop of blood on the strip. Squeeze the finger to from the complete blood
drop.
• After this apply the dry cotton swab on the puncture site.
• Read the results of blood sugar on the monitor of glucometer.
• Turn off the glucometer.
• Dispose of article.
• Remove gloves and discard them
• Wash hand
• Record the sugar level.

37. FASTING BLOOD SUGAR
• This is a test that helps in determining the amount of glucose (sugar)
in a blood sample after an overnight fast.
• The fasting blood glucose test is commonly used to detect diabetes
mellitus.
The normal range for blood glucose is 70–100 mg/dL.
• A blood sample can be taken in a lab, physician’s office, or the
hospital.
• The test is done in the morning, before the person has taken breakfast.

38. Random blood sugar
A random blood sugar (RBS) test is the testing of the blood sugar level
at any time or random time of the day.
According to American Diabetes Association:
➢The RBS test is done within 1 or 2 hours of eating then the RBS
normal value should be 180 mg/dL.
➢The RBS normal range should be anywhere between 80 and 130
mg/dL prior to eating for healthy blood sugar levels in the body.

41. Stool
examination

42. Stool examination
Definition:
It is a method of obtaining stool specimen from the patient.
Purpose:
• To check the stool for the presence of specific material (blood, ova,
parasite or bacteria like Salmonella and Shigella, etc.)

43. Article :-
• A clean specimen container (routine examination), Sterile specimen
container (culture)
• A spatula/sterile swab stick for stool culture
• Dry bedpan
• Clean gloves
• Disposable mask
• Tissue paper
• Laboratory requisition forms

44. procedure
• Check the physician order and identify the patient.
• Explain the patient to defecate into clean, dry bedpan and instruct
not to contaminate specimen with urine.
• Wear gloves and with help of spatula collect the freshly defecated
sample in a clean/ sterile wide mouth container.
• For fecal or rectal swab, a small amount of stool is collected by
inserting the sterile cotton swab into the stool and rotating it.
• Collect the sample and send laboratory.
• Wrap spa

46. Physical analysis
Analysis of the quantity, colour, consistency,
odour and shape of the stool, also parasites if
found

50. Culturing stool
• The stool can be cultured for disease-causing bacteria.
• A stool sample is placed in an incubator for at least 48–72 hours and any disease-causing
bacteria are identified and isolated.
• Not all bacteria in the stool cause problems; in fact, about half of stool is bacteria, most of
which live there normally and are necessary for digestion. For a stool culture, the lab will need
a fresh or refrigerated sample of stool.
• The best samples are of loose, fresh stool; well-formed stool is rarely positive for disease-
causing bacteria. Sometimes, more than one stool will be collected for a culture.
• Culture is then tested for the presence of microorganisms (gram-positive/ negative or virus or
bacteria). Stool culture
• After identification of the organism, culture is then tested for antibiotics, that are effective to
kill the grown microorganism. Based on the results antibiotics are added to the treatment.

51. URINE
TESTING –
ALBUMIN,
ACETONE,
PH, SPECIFIC
GRAVITY

52. Collection urine specimen and urine testing
For detecting the presence and growth of microorganisms in the urine
sample, a small amount (30–60 mL) of urine is collected.
Purposes
• To identify the antibiotic sensitivity of the pathogen in the urine
sample.
• Culture pathogenic microorganisms are present in the urine.

53. Articles
• Sterile container
• Sterile needle if required in case of catheterized
client
• Soap and water
• Bedpan
• Laboratory form Procedure

54. • Procedure
• Assemble all the article and explain the procedure to the patient about the
collection of specimen.
• Provide privacy of patient
• Wash hand and wear gloves.
• Give bedpan to the bedridden patient.
• Instruct the patient to direct the first and last part of urine stream into the toilet or
bed pan, collect the middle part of stream into container.
• Remove the specimen container after collecting the required amount of specimen.
• Remove the bed pan and make patient comfortable.
• Label the specimen and send laboratory.
• Remove gloves and wash hand

55. Urine testing- albumin, acetone

60. Test urine ph

65. purpose
• To determine the concentration level of the urine.
• To measure the specific gravity of urine.

67. Specific gravity

68. Procedure
• Explain the complete procedure of patient.
• Give the container to the patient and instruct the patient to collect the urine.
• Wear gloves
• Fill 3/4th of glass jar with urine.
• Keep urinometer inside the jar.
• Urinometer should not touch the bottom and the side of jar and should float
freely in the jar.
• When the urinometer sets the jar read the specific gravity directly from the
scale marked on the calibration scale.
• Ensure reading at the eye level.
• Read at the lowest point of the meniscus for an accurate reading.

69. After the procedure
• Discard the urine and rinse jar, urinometer under running water.
• Replace the article after washing.
• Complete the documentation procedure.

72. Test for albumin in urine
This test (hot and cold test) used to find out the presence of albumin in the urine.
Procedure:-(cold method)
• Explain the procedure to the patient and provide the container to the patient and
ask the patient to collect urine the container.
• Take 2ml of the nitric acid in the dry clean test tube.
• Pour same amount of the urine in the dropper from the side of the tube.
• Presence of the white ring on the junction of urine and acid shows the presence of
albumin.
• Discard the collected material and rinse off the articles.
• Replace the articles after the proper washing of article.
• Documents the finding.

73. Albumin hot test procedure
• Explain the whole procedure to the patient and provide instructions
regarding the collection of urine.
• Fill the test tube with 3/4th part with urine. Check paper.
• If alkaline add one drop of acetic acid to make it acidic.
• Light the sprit lamp and boil the top 1/3rd of the urine. Keep the mouth
of test tube away from the face.
• Observe the tube for cloudy appearance, if the urine becomes cloudy,
this indicate presence of albumin.
• Add 5 drops of 2% of acetic acid and look for the appearance.
• If the urine become clear then it indicates presence of phosphates, and
if the cloudy persists then it confirm the presence of albumin.

74. • Normal urine has no albumin present, after the whole process, discard the urine
and rinse the jar and urinometer
• Replace articles.
• Documents the finding.

75. Test for acetone in urine
Testing of the urine specimen for identifying the presence of acetone.
procedure:-
• Explain the whole procedure to the patient and provide the labeled container to the
patient.
• In a clean and dry tube keep 2cm of ammonium sulfate crystals.
• Pour 5ml of urine into the tube and shake till it gets dissolved in to each other.
• Add1-2 crystals of sodium nitroprusside and shake it
• Pour 2ml of concentrated liquor ammonia from the side of tube to from a layer.
• A purple ring is formed at the junction of urine indicates the presence of acetone in
the urine.
• Discard the urine and rinse the article.
• Document the finding.

76. Sputum
culture

77. Sputum culture
Sputum culture is the test that checks for bacteria or another type of
organism that may be causing an infection in lungs or the airways
leading to the lungs.
Sputum also known as phlegm, is thick type of mucus made in the lung.
Indication
• Detect the etiology of respiratory infection.
• Confirmatory diagnosis of tuberculosis.
• Monitoring the response to therapy for respiratory infection.

78. Collection of sputum for culture
Collection of coughed out sputum for culture to identify respiratory
pathogens (acid-fast bacillus, streptococci, pneumococci, diphtheria
bacilli).
Purposes
• Identify respiratory pathogens.
• Look for the color of sputum like hemoptysis, greenish color in
bronchitis, rusty color in pneumonia.

79. Article.
• Sterile specimen container
• Tissue paper
• Sputum mug with disinfectant
• Sterile gloves
• Disposable mask

80. procedure
• Check the physician orders.
• Explain the procedure to the patient .
• Explain the patient that he has expectorate the sputum into the sterile
labeled container, without disinfecting it.
• Ask the patient to sit erect in bed.
• Wash the hand and put on gloves.
• Ask the patient to rinse the mouth with plain water in the morning.
• Keep a sterile specimen container ready for sample and take a tissue paper
in hand.
• Remove the lid of container and place with inner side facing upward.
• instruct the patient to take deep breath and then cough out yin to container.

81. Cont….
• The specimen should be at least 5 ml.
• Assess the sputum specimen to ensure it is sputum and not saliva. Sputum
appears thick and opaque, whereas saliva appears thin, clear and watery.
• If a patient unable to expectorate a sputum sample, interventions may include
nebulizer, deep breathing exercises, chest percussion, postural drainage.
• If the intervention are not successfully a sputum sample may be obtained via
oropharyngeal or endotracheal suction.
• Mouth should be rinsed with plain water and not with antiseptic mouth wash.
• Close the container without touching inside of the lid.
• Provide tissue paper to the patient.
• Replace the articles and discard the waste and rinse the article.
• Document the finding related to specimen.

83. Radiological procedure
Radiology is a branch of medicine that uses imaging technology to
diagnose and treat disease. Radiology Diagnostic Interventional.
Diagnostic radiology
This branch helps in visualizing the structures inside the body and helps
the physician in identifying certain medical conditions. Using these
diagnostic procedures doctors can monitor the progression of the disease
and the way how the body responds to the treatment received.

84. Radiological studies

86. Endoscopic procedure
An endoscopy procedure involves inserting a long, flexible tube
(endoscope) down the throat and into the esophagus to visualize the
gastrointestinal system.
There are several types of endoscopy like those using natural body
opening including esophago gasro duodenoscopy which is often called
upper endoscopy, gastroscopy and entercopy.