Davis’s Comprehensive Handbook of Laboratory and Diagnostic Tests With Nursing Implications
Laboratory and diagnostic testing. The words themselves often conjure up cold and impersonal images of needles, specimens lined up in collection containers, and high-tech electronic equipment. But they do not stand alone. They are tied to, bound with, and tell of health or disease in the blood and tissue of a person. Laboratory and diagnostic studies augment the health-care provider’s assessment of the quality of an individual’s physical being. Test results guide the plans and interventions geared toward strengthening life’s quality and endurance. Beyond the pounding noise of the MRI, the cold steel of the x-ray table, the sting of the needle, the invasive collection of fluids and tissue, and the probing and inspection is the gathering of evidence that supports the healthcare provider’s ability to discern the course of a disease and the progression of its treatment. Laboratory and diagnostic data must be viewed with thought and compassion, however, as well as with microscopes and machines. We must remember that behind the specimen and test result is the person from whomit came, a person who is someone’s son, daughter, mother, father, husband, wife, or friend.
This book is written to help health-care providers in their understanding and interpretation of laboratory and diagnostic procedures and their outcomes. Just as important, it is dedicated to all health-care professionals who experience the wonders in the science of laboratory and diagnostic testing, performed and interpreted in a caring and efficient manner. The authors have continued to enhance four areas in this new edition: pathophysiology that affects test results, patient safety, patient education, and integration of related laboratory and diagnostic testing.
First, the Potential Diagnosis section includes an explanation of increased or decreased values, as many of you requested. We have added age-specific reference values for the neonatal, pediatric, and geriatric populations at the request of some of our readers. It should be mentioned that standardized information for the complexity of a geriatric population is difficult to document. Values may be increased or decreased in older adults due to the sole or combined effects of malnutrition, alcohol use, medications, and the presence of multiple chronic or acute diseases with or without muted symptoms.
Second, the authors appreciate that nurses are the strongest patient advocates with a huge responsibility to protect the safety of their patients, and wehave observed student nurses in clinical settings being interviewed by facility accreditation inspectors, so we have updated safety reminders, particularly with respect to positive patient identification, communication of critical information,
proper timing of diagnostic procedures, rescheduling of specimen collection for therapeutic drug monitoring, use of evidence-based practices for prevention of surgical site infections, information regarding the move to track or limit exposure to radiation from CT studies for adults, and the Image Gently campaign for pediatric patients who undergo diagnostic studies that utilize radiation. The pretest section reminds the nurse to positively identify the patient before providing care, treatment, or services. The pretest section also addresses hand-off communication of critical information.
The third area of emphasis coaches the student to focus on patient education and prepares the nurse to anticipate and respond to a patient’s questions or concerns: describing the purpose of the procedure, addressing concernsabout pain, understanding the implications of the test results, and describing post-procedural care. Various related Websites for patient education are included throughout the book.
And fourth, laboratory and diagnostic tests do not stand on their own—allthe pieces fit together to form a picture. The section at the end of each monograph integrates both laboratory and diagnostic tests, providing a more complete
picture of the studies that may be encountered in a patient’s health-care experience. The authors thought it useful for a nurse to know what other tests might be ordered together—and all the related tests are listed alphabetically for ease of use.
Laboratory and diagnostic studies are essential components of a complete patient assessment. Examined in conjunction with an individual’s history and physical examination, laboratory studies and diagnostic data provide clues about health status. Nurses are increasingly expected to integrate an understanding of laboratory and diagnostic procedures and expected outcomes in assessment, planning, implementation, and evaluation of nursing care. The data help develop and support nursing diagnoses, interventions, and outcomes. Nurses may interface with laboratory and diagnostic testing on several levels, including:
••Interacting with patients and families of patients undergoing diagnostic tests or procedures, and providing pretest, intratest, and posttest information and support
••Maintaining quality control to prevent or eliminate problems that may interfere with the accuracy and reliability of test results
••Providing education and emotional support at the point of care
••Ensuring completion of testing in a timely and accurate manner
••Collaborating with other health-care professionals in interpreting findings as they relate to planning and implementing total patient care
••Communicating significant alterations in test outcomes to appropriate healthcare team members
••Coordinating interdisciplinary efforts
Whether the nurse’s role at each level is direct or indirect, the underlying responsibility to the patient, family, and community remains the same. The authors hope that the changes and additions made to the book and its Web-based ancillaries will reward users with an expanded understanding of and appreciation for the place laboratory and diagnostic testing holds in the provision of high-quality nursing care and will make it easy for instructors to integrate this important content in their curricula. The authors would like to thank all the users of the previous editions for helping us identify what they like about this book as well as what might improve its value to them. We want to continue this dialogue. As writers, it is our desire to capture the interest of our readers, to provide essential information, and to continue to improve the presentation of the material in the book and ancillary products. We encourage our readers to provide feedback to the Website and to the publisher’s sales professionals. Your feedback helps us modify the material—to change with your changing needs.
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