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REDUCTION OF RISK POTENTIAL: LABORATORY AND DIAGNOSTIC PROCEDURES Mr. Jaime R. Soriano. RN. RM.
OBJECTIVES OF THE SEMINAR ,[object Object],[object Object]
DIAGNOSTIC AND LABORATORY PROCEDURES ,[object Object],[object Object],[object Object],[object Object],[object Object]
NERVOUS SYSTEM Skull and Spinal X-ray Lumbar Puncture CT Scan MRI Electroencephalography
SKULL X-RAY ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],S S S S S
SKULL X-RAY
SPINAL X-RAY ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],A B C D E F
SPINAL X-RAY
SKULL AND SPINAL X-RAY ,[object Object],[object Object],[object Object],[object Object],X R A Y
LUMBAR PUNCTURE
LUMBAR PUNCTURE ,[object Object]
LUMBAR PUNCTURE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
LUMBAR PUNCTURE ,[object Object],[object Object],[object Object],[object Object],[object Object],S I C K
LUMBAR PUNCTURE ,[object Object],[object Object],[object Object],[object Object],[object Object],F F F
LUMBAR PUNCTURE ,[object Object],[object Object],[object Object],[object Object],[object Object],S S S S
LUMBAR PUNCTURE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],F F F F F
LUMBAR PUNCTURE ,[object Object],[object Object],[object Object],[object Object],[object Object],F F F
CT SCAN ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],A B C D E
CT SCAN
CT SCAN ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],A B C D E F G H I
CT SCAN ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],A B C D E F
MRI ,[object Object],[object Object],[object Object],M R I
MRI
MRI ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],M A G N E T I C
MRI ,[object Object],[object Object],[object Object]
MRI ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
EEG
EEG ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],A B C D E
EEG ,[object Object],[object Object],[object Object],[object Object],[object Object],W A S H
EEG ,[object Object],[object Object],[object Object]
EEG ,[object Object]
CARDIOVASCULAR SYSTEM Electrolytes Coagulation Studies Erythrocyte Studies White Blood Cell Count Serum Enzymes and Cardiac Markers Serum Lipids ECG CVP Pericardiocentesis
ELECTROLYTES ,[object Object],[object Object],[object Object],[object Object],[object Object],A S I N
ELECTROLYTES ,[object Object],[object Object],[object Object]
ELECTROLYTES ,[object Object],[object Object],[object Object],[object Object],[object Object],O P T A
ELECTROLYTES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],A B C D
ELECTROLYTES ,[object Object],[object Object],[object Object],[object Object],H C L
ELECTROLYTES ,[object Object],[object Object],[object Object],[object Object],[object Object],D D D
ELECTROLYTES ,[object Object],[object Object],[object Object],[object Object],[object Object],C C C C
ELECTROLYTES ,[object Object],[object Object],[object Object],[object Object],P P
ELECTROLYTES ,[object Object],[object Object],[object Object],[object Object],[object Object],B U T O
ELECTROLYTES ,[object Object],[object Object],[object Object],[object Object]
COAGULATION STUDIES ,[object Object],[object Object],[object Object],[object Object],[object Object],A P T T
COAGULATION STUDIES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],A P T T
COAGULATION STUDIES ,[object Object],[object Object],[object Object],P T
COAGULATION STUDIES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
COAGULATION STUDIES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],A C B D E F
COAGULATION STUDIES ,[object Object],[object Object],[object Object],[object Object],[object Object],C L O T
COAGULATION STUDIES ,[object Object],[object Object],[object Object],[object Object]
COAGULATION STUDIES ,[object Object],[object Object],[object Object]
COAGULATION STUDIES ,[object Object],[object Object],[object Object],[object Object],[object Object]
ERYTHROCYTE STUDIES ,[object Object],[object Object],[object Object],[object Object],E S R
ERYTHROCYTE STUDIES ,[object Object],[object Object],[object Object],[object Object],[object Object],R B C S
ERYTHROCYTE STUDIES ,[object Object],[object Object],[object Object]
ERYTHROCYTE STUDIES ,[object Object],[object Object],[object Object],[object Object],[object Object]
ERYTHROCYTE STUDIES ,[object Object],[object Object],[object Object],[object Object],[object Object]
WHITE BLOOD CELL COUNT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
WHITE BLOOD CELL COUNT ,[object Object],[object Object],[object Object],[object Object]
CARDIAC MARKERS ,[object Object],[object Object],[object Object],[object Object],[object Object]
CARDIAC MARKERS ,[object Object],[object Object],[object Object],[object Object]
CARDIAC MARKERS ,[object Object],[object Object],[object Object],[object Object],[object Object]
CARDIAC MARKERS ,[object Object],[object Object],[object Object],[object Object]
CARDIAC MARKERS ,[object Object],[object Object],[object Object],[object Object]
CARDIAC MARKERS ,[object Object],[object Object],[object Object],[object Object],T R O
CARDIAC MARKERS ,[object Object],[object Object],[object Object],[object Object]
CARDIAC MARKERS ,[object Object],[object Object],[object Object],[object Object]
CARDIAC MARKERS ,[object Object],[object Object],[object Object],[object Object]
CARDIAC MARKERS ,[object Object],[object Object],[object Object]
CARDIAC MARKERS ,[object Object],[object Object],[object Object],[object Object],[object Object]
SERUM LIPIDS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SERUM LIPIDS ,[object Object],[object Object],[object Object],[object Object],[object Object],N N N N
ECG ,[object Object],[object Object],[object Object],E C G
ECG ,[object Object],[object Object],[object Object],[object Object],E C G
BASIC ECG INTERPRETATION Normal Sinus Rhythym Sinus Tachycardia Sinus Bradycardia Atrial Tachycardia Atrial Fibrillation Atrial Flutter Ventricular Tachycardia Ventricular Fibrillation Asystole
STANDARD LEAD PLACEMENT ,[object Object],White:  Right Arm Black:  Left Arm Green:  Right Leg Red:  Left Leg
STANDARD LEAD PLACEMENT ,[object Object]
BASIC ECG INTERPRETATION
BASIC ECG INTERPRETATION ,[object Object],[object Object],[object Object],[object Object],[object Object]
NORMAL CARDIAC RHYTHM PARAMETERS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
FIGURING HEART RATE ,[object Object],[object Object],[object Object]
FIGURING HEART RATE ,[object Object]
FIGURING HEART RATE ,[object Object]
FIGURING HEART RATE ,[object Object]
NORMAL SINUS RHYTHM Rate Rhythm P Waves P-R QRS 60 to 100 Regular Present 0.12 to 0.20 secs 0.08 tp 0.12 secs
SINUS TACHYCARDIA Rate Rhythm P Waves P-R QRS >100 BPM Regular Present 0.12 to 0.20 secs 0.08 to 0.12 secs
SINUS BRADYCARDIA Rate Rhythm P Waves P-R QRS <60 BPM Regular Present 0.12 to 0.20 secs 0.08 to 0.12 secs
ATRIAL TACHYCARDIA Rate Rhythm P Waves P-R QRS 150 to 250 bpm Regular Present Short <0.12  0.08 to 0.12 secs
ATRIAL FIBRILLATION Rate Rhythm P Waves P-R QRS Variable Irregularly- Irregular Absent Non- discernible Narrow
ATRIAL FLUTTER Rate Rhythm P Waves P-R QRS 250 to 350 bpm Usually regular Sawtooth pattern Non- discernible Usually narrow
VENTRICULAR TACHYCARDIA Rate Rhythm P Waves P-R QRS 100 TO 220 BPM Usually regular Absent NA Wide >0.12 sec
VENTRICULAR FIBRILLATION Rate Rhythm P Waves P-R QRS 350 TO 450BPM Completely chaotic and disorganized Absent NA Absent
ASYSTOLE Rate Rhythm P Waves P-R QRS No Rate No Rhythm Absent NA Absent
CVP ,[object Object],[object Object],[object Object],C V P
CVP ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CVP
1. Maintain zero point of manometer always at level of right atrium (intersection between midaxillary line and 4 th  ICS, also referred to as the phlebostatic axis) 2. Determine patency of catheter by opening IV infusion line
3. Turn stopcock to allow IV solution to run into manometer to a level of 10-20cm above expected pressure reading 4. Turn stopcock to allow IV solution to flow from manometer into catheter; fluid level in manometer fluctuates with respiration
5. Stop ventilatory assistance during measurement of CVP 6. After CVP reading, return stopcock to IV infusion position 7. Record CVP reading and position of client (angle of recline)
PERICARDIOCENTESIS ,[object Object],[object Object],[object Object],[object Object],P P P P
PERICARDIOCENTESIS ,[object Object],[object Object],[object Object],[object Object],[object Object],P E R I
PERICARDIOCENTESIS ,[object Object],[object Object],[object Object],[object Object],[object Object],A B C D
PERICARDIOCENTESIS ,[object Object],[object Object],[object Object],[object Object],[object Object],A B C D
RESPIRATORY SYSTEM Chest X-ray Sputum Specimen Bronchoscopy Thoracentesis Lung Biopsy ABG Analysis Incentive Spirometer Peak Flow Meter
CHEST X-RAY ,[object Object],[object Object]
CHEST X-RAY ,[object Object],[object Object],[object Object],[object Object],R A Y
CHEST X-RAY ,[object Object],[object Object]
SPUTUM SPECIMEN ,[object Object],[object Object],[object Object],S S S
SPUTUM SPECIMEN ,[object Object],[object Object],[object Object],[object Object],A B C
SPUTUM SPECIMEN ,[object Object],[object Object],[object Object]
BRONCHOSCOPY ,[object Object],L B T arynx rachea ronchi
BRONCHOSCOPY
BRONCHOSCOPY ,[object Object],[object Object],[object Object],[object Object],[object Object],A B C D
BRONCHOSCOPY ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],B O N C H U S R
BRONCHOSCOPY ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],G A G R E F L E X
THORACENTESIS ,[object Object],[object Object],[object Object],[object Object]
THORACENTESIS
THORACENTESIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],T H O R A X
THORACENTESIS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
LUNG BIOPSY ,[object Object],[object Object],[object Object],[object Object]
LUNG BIOPSY ,[object Object],[object Object],[object Object],[object Object],[object Object],L U N G
LUNG BIOPSY ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],B I O P S Y
ABG ANALYSIS ,[object Object],[object Object],[object Object],[object Object],[object Object]
ABG ANALYSIS ,[object Object],[object Object],[object Object],[object Object],A B G
ABG ANALYSIS ,[object Object],[object Object],[object Object],[object Object]
ABG ANALYSIS ,[object Object],[object Object],[object Object]
ABG ANALYSIS ,[object Object],pH 7.35 to 7.45 PCO2 35 to 45 mmHg HCO3 22 to 26 mmHg PO2 80 to 100 mmHg O2 sat 96%  to 100 %
ABG ANALYSIS ,[object Object],[object Object],[object Object],[object Object]
INCENTIVE SPIROMETER ,[object Object],[object Object],[object Object]
INCENTIVE SPIROMETER
INCENTIVE SPIROMETER ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
INCENTIVE SPIROMETER ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],A B C D E
INCENTIVE SPIROMETER ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PEAK FLOW METER ,[object Object]
PEAK FLOW METER ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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Laboratory and diagnostic procedures part1

  • 1. REDUCTION OF RISK POTENTIAL: LABORATORY AND DIAGNOSTIC PROCEDURES Mr. Jaime R. Soriano. RN. RM.
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  • 4. NERVOUS SYSTEM Skull and Spinal X-ray Lumbar Puncture CT Scan MRI Electroencephalography
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  • 32. CARDIOVASCULAR SYSTEM Electrolytes Coagulation Studies Erythrocyte Studies White Blood Cell Count Serum Enzymes and Cardiac Markers Serum Lipids ECG CVP Pericardiocentesis
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  • 74. BASIC ECG INTERPRETATION Normal Sinus Rhythym Sinus Tachycardia Sinus Bradycardia Atrial Tachycardia Atrial Fibrillation Atrial Flutter Ventricular Tachycardia Ventricular Fibrillation Asystole
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  • 84. NORMAL SINUS RHYTHM Rate Rhythm P Waves P-R QRS 60 to 100 Regular Present 0.12 to 0.20 secs 0.08 tp 0.12 secs
  • 85. SINUS TACHYCARDIA Rate Rhythm P Waves P-R QRS >100 BPM Regular Present 0.12 to 0.20 secs 0.08 to 0.12 secs
  • 86. SINUS BRADYCARDIA Rate Rhythm P Waves P-R QRS <60 BPM Regular Present 0.12 to 0.20 secs 0.08 to 0.12 secs
  • 87. ATRIAL TACHYCARDIA Rate Rhythm P Waves P-R QRS 150 to 250 bpm Regular Present Short <0.12 0.08 to 0.12 secs
  • 88. ATRIAL FIBRILLATION Rate Rhythm P Waves P-R QRS Variable Irregularly- Irregular Absent Non- discernible Narrow
  • 89. ATRIAL FLUTTER Rate Rhythm P Waves P-R QRS 250 to 350 bpm Usually regular Sawtooth pattern Non- discernible Usually narrow
  • 90. VENTRICULAR TACHYCARDIA Rate Rhythm P Waves P-R QRS 100 TO 220 BPM Usually regular Absent NA Wide >0.12 sec
  • 91. VENTRICULAR FIBRILLATION Rate Rhythm P Waves P-R QRS 350 TO 450BPM Completely chaotic and disorganized Absent NA Absent
  • 92. ASYSTOLE Rate Rhythm P Waves P-R QRS No Rate No Rhythm Absent NA Absent
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  • 95. CVP
  • 96. 1. Maintain zero point of manometer always at level of right atrium (intersection between midaxillary line and 4 th ICS, also referred to as the phlebostatic axis) 2. Determine patency of catheter by opening IV infusion line
  • 97. 3. Turn stopcock to allow IV solution to run into manometer to a level of 10-20cm above expected pressure reading 4. Turn stopcock to allow IV solution to flow from manometer into catheter; fluid level in manometer fluctuates with respiration
  • 98. 5. Stop ventilatory assistance during measurement of CVP 6. After CVP reading, return stopcock to IV infusion position 7. Record CVP reading and position of client (angle of recline)
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  • 103. RESPIRATORY SYSTEM Chest X-ray Sputum Specimen Bronchoscopy Thoracentesis Lung Biopsy ABG Analysis Incentive Spirometer Peak Flow Meter
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Editor's Notes

  1. echocardiogram and basic blood analysis. No special dietary restrictions are required for pericardiocentesis. The patient will receive an IV line for sedation Read more:
  2. echocardiogram and basic blood analysis. No special dietary restrictions are required for pericardiocentesis. The patient will receive an IV line for sedation Read more:
  3. echocardiogram and basic blood analysis. No special dietary restrictions are required for pericardiocentesis. The patient will receive an IV line for sedation Read more:
  4. http://www.rcjournal.com/cpgs/ispircpg.html
  5. http://www.rcjournal.com/cpgs/ispircpg.html
  6. http://www.rcjournal.com/cpgs/ispircpg.html