Laboratory Tests and Diagnostic Procedures with Nursing Diagnoses

737 Pages·2012·2.606 MB·English

by  Jane Vincent Corbett, Angela D. Banks

8th
LABORATORY TESTS
Edition
AND DIAGNOSTIC
PROCEDURES

NURSING DIAGNOSES
with
Jane Vincent Corbett, RN, EdD
Professor Emerita
School of Nursing and
Health Professions
University of San Francisco
San Francisco, California
Angela Denise Banks, RN, PhD
Associate Professor
School of Nursing and
Health Professions
University of San Francisco
San Francisco, California
Boston Columbus Indianapolis New York San Francisco Upper Saddle River
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Library of Congress Cataloging-in-Publication Data
Corbett, Jane Vincent.
Laboratory tests and diagnostic procedures : with nursing diagnoses / Jane Vincent Corbett, Angela
Denise Banks. —8th ed.
p. cm.
Includes bibliographical references and index.
ISBN-13: 978-0-13-237332-6
ISBN-10: 0-13-237332-7
1. Diagnosis, Laboratory. 2. Diagnosis. 3. Nursing diagnosis. I. Banks, Angela Denise. II. Title.
RT48.5.C67 2012
616.07'5—dc23
2012000722
Notice: Care has been taken to confirm the accuracy of information presented in this book. The
authors, editors, and the publisher, however, cannot accept any responsibility for errors or omissions
or for consequences from application of the information in this book and make no warranty, express or
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forth in this text are in accord with current recommendations and practice at the time of publication.
However, in view of ongoing research, changes in government regulations, and the constant flow of
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all drugs for any change in indications or dosage and for added warning and precautions. This is par-
ticularly important when the recommended agent is a new and/or infrequently employed drug.
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10 9 8 7 6 5 4 3 2
ISBN-10: 0-13-237332-7
ISBN-13: 978-0-13-237332-6
Dedication
To Rod Corbett, who gave me the space
and time to make this book a reality
and whose contributions were invaluable.
And to our daughter Rhonda Jane
and her husband, Jorge Luis Eyzaguirre,
and my two grandchildren,
Mateo Rodney Eyzaguirre
Raquel Grace Eyzaguirre.
Each of you is such a joy for me! (JVC)

To my husband, Rev. Beryl Banks,
and my son, Caleb Joshua Banks.
Thank you both for your unwavering love
and support during the preparation
and completion of this book. (ADB)
Contents
Preface vi
Acknowledgments viii
Reviewers x
PART I Laboratory Tests 1
Chapter 1 Using Laboratory Data 2
Chapter 2 Hematology Tests 22
Chapter 3 Routine Urinalysis and Other Urine Tests 59
Chapter 4 Renal Function Tests 82
Chapter 5 Four Commonly Measured Electrolytes 102
Chapter 6 Arterial Blood Gases and Related Tests 127
Chapter 7 Three Less Commonly Measured Electrolytes and Vitamin D 157
Chapter 8 Tests to Measure the Metabolism of Glucose and Other Sugars 1 80
Chapter 9 Tests to Measure Lipid Metabolism and Other Cardiac Risk Factors 2 09
Chapter 10 Tests Related to Serum Protein Levels, Tumor Markers, and Cancer Genomics 2 28
Chapter 11 Tests to Measure the Metabolism of Bilirubin 257
Chapter 12 Tests to Measure Enzymes and Cardiac Markers 273
Chapter 13 Coagulation Tests and Tests to Detect Occult Blood 297
Chapter 14 Serologic Tests: Immunohematology Microbiology and Immunology 3 32
Chapter 15 Endocrine Tests 373
Chapter 16 Culture and Sensitivity Tests and Rapid Tests for Infections 414
Chapter 17 Therapeutic Drug Monitoring and Toxicology Screens 447
Chapter 18 Tests Performed in Pregnancy, the Newborn Period, and for Genetic Screening 473
Contents v
PART II Case Studies 495
Chapter 19 Practice Interpretation of Laboratory Data 496
PART III Diagnostic Procedures 505
Chapter 20 Diagnostic Radiologic Tests 506
Chapter 21 Body Scans: CT, DXA, MRI, PET, and SPECT 537
Chapter 22 Nuclear Scans: Diagnostic Tests with Radionuclides or Radioisotopes 558
Chapter 23 Diagnostic Ultrasonography 580
Chapter 24 Common Noninvasive Diagnostic Tests 599
Chapter 25 Common Invasive Tests 622
Chapter 26 Stress Tests, Cardiac Catheterizations, Electrophysiologic Studies, and Syncope Tests 648
Chapter 27 Endoscopic Procedures 665
Chapter 28 Diagnostic Procedures Related to Childbearing Years 681
Appendix A Reference Values for Newborns and Children Compared with Adult Values 700
Appendix B Possible Alterations in Reference Values for the Aged 7 02
Appendix C Altered Reference Values for Common Laboratory Tests in Normal Pregnancies 7 04
Appendix D Units of Measure 706
Appendix E SI Conversion Factors 708
Appendix F Diagrams of Laboratory Results 714
Index 715
Preface
This eighth edition continues to focus on how nurses can use data from laboratory
tests and diagnostic procedures to plan nursing care. The extensive reference list
for each chapter supports the best-practice approach based on current literature in
the field. To further strengthen this evidence-based approach, over 100 websites for
many practice guidelines are included. Although much has changed in health care
since the first edition of this book in 1982, many tests remain the same and many
now have expanded use. These new uses are discussed and compared with the past
to provide the reader with a historical perspective. Additionally, for this edition,
a few tests were deleted and several new tests added with even more emphasis on
genetic testing. Of particular interest are the many rapid tests now available for
point-of-care testing by the nurse and wide range of tests available to the consumer
for home use. The use of picture archiving and communication system (PACS) and
of electronic health records (EHR) is another technological advance discussed in
this edition. As before, examples abound with clinical significance and reference
values over the entire life span from newborns to aged. Two chapters (Chapters 18
and 28) are devoted to the pregnant client.
Related tests or procedures are grouped so that common nursing diagnoses can
be highlighted. The nursing diagnoses presented in this book are not meant to
be used in cookbook form. The nurse can read about the test and possible nurs-
ing diagnoses, but then must evaluate the actual clinical situation and apply what
seems appropriate. The purpose of this book is to make nurses think more, not less.
The case studies in Part II give the reader an opportunity to practice interpreting lab
data to formulate nursing diagnoses.
As health care becomes more and more technical, the multitude of diagnostic
procedures and laboratory tests continue to grow. Nurses can become dazzled by
the technical details and discouraged about keeping pace with these advances. This
book is based on the belief that the nurse’s role in relation to diagnostic testing
should continue to focus on the human element. Professional nurses are involved
on health teaching, client preparation, and assessment for adverse reactions to
diagnostic procedures. The pathophysiologic conditions that cause altered labora-
tory values are explained in an easy-to-understand format. A discussion of usual
medical intervention for a particular set of circumstances is included to show how
nursing use is related to and yet different from medical use of laboratory data. The
independent role of the nurse is emphasized throughout.
Each chapter of this book is organized as an independent study unit complete
with objectives, an organizing theme with background information (called an
expository organizer), and test questions. The organization and content of the
chapters are based on research conducted by the primary author (Corbett, 1985,
1997; Corbett & LaBorde, 1994). This book, meant to be both scholarly and practi-
cal, is intended for use in both the academic and the clinical setting. Following are
some examples:
1. Undergraduate and graduate nursing students can use the book as a textbook in
theory classes that integrate laboratory data as one aspect of nursing care.
Preface vii
2. Practicing nurses can use the book to update themselves in specifi c areas. The
content in this book has been used extensively in continuing education courses
for RNs.
3. Nurses in clinical settings can use the book as a quick reference. By consulting
the index or the listing for each chapter, the nurse can retrieve information
about one specifi c test.
It is intellectually challenging to broaden one’s knowledge in a fi eld, and in nurs-
ing we often have the added benefi t of seeing that our increased knowledge is of
direct benefi t to the client. Our enthusiasm and sense of purpose in writing this
book stem from our belief that students and practicing nurses will be able to use the
information in this book to improve the care of many clients. We hope the reader
fi nds the book informative and useful in the practice of nursing. We welcome writ-
ten comments, which can be sent to me or my co-author at the following addresses:
Dr. Jane Vincent Corbett, RN, EdD
Professor Emerita, School of Nursing and Health Professions
University of San Francisco
2130 Fulton Street
San Francisco, CA 94117
Email: [email protected]
Dr. Angela Denise Banks, RN, PhD
Associate Professor, School of Nursing and Health Professions
University of San Francisco
2130 Fulton Street
San Francisco, CA 94117
Email: [email protected]
Corbett, J. V. (1985). T he effects of two types of preinstructional strategies on two levels of cognitive learning from a written
study unit . Dissertation for School of Education, University of San Francisco. Reprints available from University Micro-
fi lms International, Ann Arbor, MI.
Corbett, J. V. (1997). An exploration of the independent use of laboratory data to make nursing diagnoses [Abstract].
In: M. J. Rantz and P. Lemone (Eds.), Classifi cations of nursing diagnoses: Proceedings of the twelfth conference (p. 3 80) .
Glendale, CA: Cinahl Information Systems.
Corbett, J. V., & LaBorde, A. (1994). Nurses’ perceptions of usefulness of laboratory data for nursing practice. J ournal of
Continuing Education in Nursing, 25 (4), 175–180.
Acknowledgments
For the eighth edition, I am pleased to have Dr. Angela Denise Banks, a co-author
for the fi rst time. It has been wonderful to fi nd a colleague who brings new ideas
and enthusiasm to this project. I am grateful to the University of San Francisco
(USF) for granting me my fi rst sabbatical in 1978 to do the research that culmi-
nated in the fi rst edition of this book. During my 35-year tenure at USF, I had three
more sabbaticals that gave me time to do the research needed for updating each
edition. One sabbatical gave me the opportunity to interview nurses in Israel, and
my fourth sabbatical was spent interacting with students and faculty at St. Bar-
tholomew’s School of Nursing in London. Now as Professor Emerita at USF, I con-
tinue to learn from my colleagues and students.
A large number of nurses from various clinical settings continue to participate
in my continuing education courses. Their questions and discussions about cases
in their own practice have helped me update content for this edition. I am particu-
larly grateful to the Hospital Consortium Education Network of Northern Califor-
nia, who sponsored my classes for nearly 20 years. Other providers of continuing
education such as Stanford University Hospital and the University of California at
San Francisco Medical Center have also sponsored me for many years. A newer pro-
vider, American Health Education, has given me another avenue for teaching and
learning about laboratory tests from practicing nurses.
The format for this book was based on work completed for my doctoral disserta-
tion. I am grateful to S. Alan Cohen, EdD; Joan Hyman, EdD; and William Schwartz,
EdD, who helped me gain an in-depth knowledge about how written strategies such
as behavioral objectives and expository organizers can infl uence cognitive learning
from study units. Eleanor Hein, RN, EdD; Jean Nicholson, RN, MS; Mae Timmons,
RN, EdD; and Ginny Jones, RN, BS, also helped a great deal with their careful cri-
tiques of Chapter 13 , which was used as the prototype chapter.
Carol Bailey, RN, MS (formerly of Kaiser Hospital, San Francisco), has been most
helpful in obtaining information for each edition. Other people at Kaiser, such as
Sunny Holland, RN, Cardiac Catheterization Lab, and Elaine Vaughn, Director of
Diagnostic Imaging Services, have also been helpful in answering many of my ques-
tions and allowing me to observe numerous types of diagnostic procedures. The
University of California at San Francisco (UCSF) provided me with excellent library
resources and the opportunity to observe clinical tests and consult with various
experts. (JVC)
First and foremost, I am grateful to Dr. Jane Vincent Corbett for giving me the
opportunity to co-author this wonderful book. However, this privilege would not
have been possible without the love and support of my wonderful husband, Rev.
Beryl Banks. Beryl, there are no words to describe my gratitude and appreciation for
your understanding during the writing and revising of this book. I thank you for
believing in me and allowing me to pursue my dream of becoming an author.
Caleb Banks, my wonderful son. Thank you for supporting me and believing
that your Mom could do just about anything. You are a tremendous inspiration
and blessing to me.
Acknowledgments ix
Dr. Anna Kwong, my dear friend. You have always been there for me through-
out my journey during the revisions of this book, and I sincerely thank you for
your kindness, consideration, and encouragement. You have been a gift to my fam-
ily and me from the moment we met, and you have changed the way I view life
because it is so much more meaningful since you have become a part of it. (ADB)