This document discusses nursing care for patients undergoing diagnostic procedures involving blood extraction. It covers the diagnostic testing phases including pre-test preparation, specimen collection during intratest, and post-test follow up. Common blood tests are outlined, noting which require fasting. Nursing diagnoses related to procedures include anxiety, impaired mobility, and deficient knowledge. The document provides guidance on nursing care after blood extraction, including pressure application and follow up care of hematomas or swelling. Lifespan considerations for puncture sites in neonates, children, and elders are also mentioned.

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