Acid Fast Bacilli Stain is also known as Ziehl-Neelsen Technique). It is use to find for the presence of Acid Fast Bacillus bacteria. The most common infection is Tuberculosis also known as Koch disease. Another infections cause by the mycobacteria is diseases with symptoms of TB such as patients with Leprosy and HIV/ AIDS.
A smear is not an accurate test to diagnose Tuberculosis because it produces false-positive results. The confirming diagnosis is Acid Fast Culture and Chest X-Ray.
Prepare the smear using the specimen. Place the specimen on a clean labelled slide. Pass smear on a flame of a Bunsen burner carefully. Apply Carbol Fuchsin on the whole slide and pass over in low flame for 3-5 minutes gently. Wash with tap water. Apply 3% Acid-Alcohol and wash with tap water. Apply Methylene for 30 seconds, wash with tap water and blot to dry. Observe slide on the microscope under oil immersion.
Arterial Blood Gas also known as ABG. ABG is used to assess the heart and lungs dysfunctions, acid-base imbalance in the body, if the oxygen is enough for the body. ABG are taken from patients that has abnormal acid-base imbalances, cardiopulmonary disorders, such as acute respiratory disorder, diabetic ketoacidosis, hypoxia, congenital heart defects, asthma, alkali ingestion, salicylate intoxication, emphysema, pneumonia, sepsis and shock.
Newborns: 60-70 mm Hg
Adults: 75-100 mm Hg
pCO2: 35-45 mm Hg
Newborns: 20-26 mEq/L
Adults: 22-26 mEq/L
O2 saturation: 96%-100%
Base excess: +1 to -2
pH: <7.2 or >7.6
Infants: <37 mm Hg or >92 mm g
Adults: <40 mm Hg
pCO2: <20 mm Hg or >70 mm g
HCO3: <10 mEq/L or >40 mEq/L
O2 saturation: <60%
If the patient has extreme abnormal results from the ABG, administer nursing intervention and also report to attending physician right away, they need immediate critical care management.
Identify correct patient's name. Explain procedure to patient and assess his understanding. Inform patient that they will draw specimen on radial site and might cause pain if a local anesthetic is not available.
Before the test, take patient's temperature. Assess patient's circulation to the wrist and hand before the radial part (area below the thumb) of the hand. Place patient's hand facing up on a pillow, and instruct patient to spread fingers downward. The nurse or pathologist can choose to put an anesthesia if it is available.
SPECIMEN REQUIRED: 2-3 ml
Apply pressure on puncture site with sterile gauze to stop bleeding. Keep pressure for 5 minutes. Label test tube with patient's name, time the specimen is collected, temperature of the patient and if patient is breathing room air, oxygen or is connected to ventilation. Fever, oxygen, and breathing can affect the results of the test.
After test, Watch out for bleeding on puncture 5-10 minutes on the first 30 minutes and check for signs of nerve impairment directly above the puncture site.
Take note of patient's history of recent administration, intravenous infusion, transfusion of blood products, dextran, or Intravenous fluids that could cause cellular aggregation, agglutination. Also consider patient's history of previous transfusion, transfusion reactions, and previous pregnancies.
Identify right patient's name, patient hospital number, and blood type. Label specimen test tube with patient's name, patient hospital number, blood type and place a blood bank wrist band on the patient with the same information. Monitor for signs of infection and inform patient of blood type as soon known.
Chest X-Ray is performed as a routine during hospital admission. It is use to diagnose pulmonary diseases and assess the status of the heart, gastrointestinal tract, thyroid gland, bones of the thorax, and diaphragm. It also helps in monitoring osteoarthritis and heart enlargement.
Some doctors use it to identify placement of the central lines, pulmonary artery catheters, endotracheal tubes, nasogastric and nasoenteric tubes, pacemaker wires and other invasive devices.
Chest X-Ray result may show different diseases such as pneumonia, lung abscess, pneumothorax, and pericardial and pleural effusions in the lungs, thorax, gastrointestinal tract, heart, diaphragm, and other systems. It also evaluates trauma to thorax, detect incorrectly placed monitoring devices, and notes invasive lines. If patient can't be moved, a portable X-ray machine can be brought to the patient's room or nursing unit.
Obesity, lack of full inspiration, and inability to remain still might interfere the results of the test.
Identify correct patient's name. Before test, explain procedure to the patient and assess patient's understanding. Instruct patient to remove prosthesis, jewelries, eye glasses, and other metals. Assure patient that exposure to radiation is minimal. Provide privacy to change patient gown.
For pregnant women, provide shield to protect the fetus if test is needed during pregnancy. For infants and children, they need to be sedated. Place on blanket for comfort. Be considerate and have patience with older people, they might experience difficulty in staying still in positions during the test, so test might take longer.
Clinical Chemistry also known as chemical pathology, clinical bio chemistry or medical biochemistry is the analysis of different enzyme levels in the blood, urine, and other body fludis that shows significant potential pathology that may need immediate treatment.
It is use to identify and evaluate the different system of the body mainly monitoring electrolytes (Sodium, Potassium, Chloride, and Bicarbonate) kidney function (Creatinine, BUN), liver function (Total protein, Bilirubin, Aspartate Transaminase, Alanine Transaminase, Gamma-glutamyl transpeptidase, and Alkaline Phosphatase), cardiac markers (Troponin, Myoglobin, CK-MB, B-Type natriuretic peptide), minerals (Calcium, Phosphate, Potassium, and Magnesium), blood disorders (Iron, Transferrin, TIBC, Vitamin B12, and Folic Acid), and other miscellaneous (Glucose, C-Reactive Protein, Glycosylated Hemoglobin, Uric Acid, Arterial Blood Gases, Adrenocorticotropic Hormone, Toxicology Screening or Forensic Toxicology, Neuron-specific enolase, and Fecal Occult Blood Test) tests that plays integral parts in the body.
Identify patient's name. Label test tube and the test to be done. Explain procedure to the patient and assess patient's understanding.
Disseminated Intravascular Coagulation Screen is a panel of tests to identify blood clotthing and bleeding disorder called Disseminated Intravascular Coagulation.
Disseminated Instravascular Coagulation (DIC, hemorrhage) is a life-threatening condition. Once symptoms of bleeding appear, it must be reported to the physician right away of the patient to start immediate treatment.
Disseminated Intravascular Coagulation is a life-threatening condition. Once symptoms of bleeding appears, it must be reported to the physician right away of the patient to start immediate treatment.
Take note of the client's age, gender, blood pressure, height, weight, symptoms, and if he's taking medications.
Some irregular ECG readings are fatal and might need immediate treatment.
Identify correct patient's name. Explain procedure and purpose of the test to the patient and assess patient's understanding. Place patient in supine position or lying down.
Attach the 6 leads in the chest after applying gel or alcohol in cotton balls, and then attach 4 remaining leads in arms and legs. After test, clean site where leads were attached. With infants and children, call for assistance to keep them still.
Fecalysis or stool exam is examination of the feces through chemical, microbiological, and microscopic view to detect gastrointestinal diseases and bacterias such Escherichia coli, Staphylococcus aureus and other parasites. It also helps in identifying bowel disorders, pancreatitis, malabsorption syndrome and distinguish diarrhea from unknown origin.
Antibiotics, contaminated toilet paper, diet, laxatives and urine can interfere the results of the test.
The Complete Blood Count measures the cellular elements of the blood: hematocrit, hemoglobin, red cell count, red blood cell indices, white cell count, and differential white blood cell count. It identifies the quantity, percentage, concentration and quality of the blood cells.
It is commonly use as a routine blood screen and diagnostic tool to provide information indicating the hematological system and the other systems.
The main diagnostic tool used in routine physical examination to diagnose wide range of diseases in children and adults.
Mammography is done to identify abnormalities on breast tissues. It is required for women to do the test annually combining it with self-breast examination after they're monthyly period. It helps identify mass, cyst, abscess, fibrocystic disease, papilloma of the breasts, cancer, mastitis, and Paget's disease of the breast. It is also use in monitoring the patient's condition after treatment.
Before test, explain procedure to patient and assess patient's understanding of the test. Assure patient that exposure to radiation is minimal. Provide privacy to change patient gown. Advice patient to try to stay still as possible during the test, because the positioning for the test is uncomfortable.
During test, give instructions to take a deep breath and hold it or exhale but don't breath when the film is being taken. After test, advice patient that test should be done every other year if over the age of 40, and if 50, test is done annually.
For pregnant women, provide shield to protect the fetus if test is needed during pregnancy. Be considerate and have patience with older people, they might experience difficulty in staying still in positions during the test, so test might take longer.
It is use to identify a Gram Stain positive from a Gram Stain negative bacteria. It identifies presence of White Blood Cells and Squamous epithial cells that indicates presence of infection or abnormal cell growth. Microbiology Gram Stain is a valuable diagnostic tool of Bacterial Meningitis.
Prepare for a bacterial smear by swiping a cotton bud on the skin you want to check for presence of infection or abnormal cell growth. Place a drop of distilled water on a labelled slide if you are using a nutrient agar. (Skip this if you are using a liquid or broth medium)
Using a sterile wire loop, touch the bacteria and apply it on the agar or liquid medium. Pass smear on a flame of a Bunsen burner carefully. Apply crystal violet on smear for 1 minute and wash with tap water. Apply iodine solution for 1 minute and wash with tap water. Apply ethyl or acetone alcohol for one minute and wash with tap water. (Remember to apply more in thick bacteria compared to thin ones.) Apply safranin in smear then wash with water. Use to blot the smear with tissue paper and air dry. Observe smear on microscope under oil immersion.
Papanicolaou Smear shortened to Pap Smear is a screening test for precancerous and cancerous cells in the women's reproductive organ. It is required for women to take the test yearly when they reach the age of 18 years old or when they become sexually active until they 60-65. The age range may change depending on the risk factor, the individual possesses and especially if she has a family history. The results can also identify fungal infections, venereal disease, and presence of inflammation. Doctors also use it to monitor therapy for cancer and infection.
Biopsy is done if the results revealed existence of abnormal cells or non-abnormal cells but patient is showing signs of illness.
Digitalis and Tetracycline can affect the results, including vaginal medications and contraceptives take 48 hours before the test.
The test cannot be done if the patient is menstruating and had sexual intercourse in the last 24 hours.
Urinalysis or routine urine sample analysis is use to screen for kidney and urinary tract infections and to detect other conditions that are not related to the kidney. Doctors also use the test to monitor progression of disease and the treatment prognosis.
Factors that could interfere the results are heavy bleeding or menstruation, intake of vitamin C, dehydration, vaginal secretion contamination, urine with feces, excessive time lapse from collection to testing, and inadequate cleaning of the urinary meatus.