SPECIMEN COLLECTION &

DIAGNOSTIC PROCEDURES
Andrew Isiah P. Bonifacio, RN
DIAGNOSTIC AND LABORATORY TESTS

tools that provide information

about clients.

may be used for basic screening

as part of a wellness check.
 PURPOSES

confirm a diagnosis

monitor an illness

evaluate client’s response to

treatment.
 DIAGNOSTIC TESTING PHASES

PRE-TEST

INTRA-TEST

POST-TEST
BLOOD TESTS
 TERMINOLOGIES

VENIPUNCTURE

PHLEBOTOMIST
 COMPLETE BLOOD COUNT

hemoglobin hematocrit erythrocyte

a differential
leukocyte white cell
count
 ERYTHROCYTE (RED BLOOD CELL)
COUNT

NORMAL •4.6–6.0
VALUES: million/mm3
 HEMOGLOBIN (HGB)

•M: 13.5–18 g/dL

NORMAL
VALUES:
•F: 12–15 g/dL
 HEMATOCRIT (HCT/PCV)

•M: 40–54%
NORMAL
VALUES:
•F: 36–46%
 LEUKOCYTE (WBC) COUNT

NORMAL •4,500–
VALUES: 11,000/mm3
 NEUTROPHIL COUNT

NORMAL
VALUES: •50-70%
 LYMPHOCYTE COUNT

NORMAL
VALUES: •25-35%
 MONOCYTE COUNT

NORMAL
VALUES: •4-6%
THROMBOCYTE (PLATELET) COUNT

NORMAL •150,000–
VALUES:
400,000/mm3
SERUM ELECTROLYTES
 SERUM CREATININE & BUN
SERUM
CREATININE
NORMAL •0.6-1.2 mg/dL
VALUES:

BUN NORMAL
VALUES •8-20 mg/dL
 BLOOD CHEMISTRY

liver function cardiac

tests markers

lipid profile
 LIVER FUNCTION TESTS

ALT •Men: 10–55 unit/L

NORMAL
VALUES: •Women: 7–30 unit/L

AST •Men: 10–40 unit/L

NORMAL
VALUES •Women: 9–25 unit/L
 LIVER FUNCTION TESTS

AMMONIA
NORMAL
VALUES:
•15–45 mcg/dL

PROTHROMBIN
NORMAL
VALUES
•11–13 seconds
 CARDIAC MARKERS

CREATINE KINASE • Men: 38–174 unit/L

NORMAL VALUES: • Women: 26–140 unit/L

TROPONIN • Troponin I: <0.35 ng/mL

NORMAL VALUES • Troponin T: <0.2 ng/Ml

MYOGLOBIN
NORMAL VALUES
• 5–70 ng/mL
 LIPID PROFILE

CHOLESTEROL
NORMAL VALUES:
• <200 mg/dL

HDL NORMAL • Men: 35–65 mg/dL

VALUES • Women: 35–80 mg/dL

LDL NORMAL
VALUES
• <130 mg/dL
NURSING CONSIDERATIONS
SPECIMEN COLLECTION
STOOL COLLECTION
 NURSING CONSIDERATIONS
Defecate in a clean bedpan or bedside
commode.
Void before the specimen collection.

Do not place toilet tissue in the bedpan

after defecation.
Notify the nurse as for specimens that
need to be sent to the laboratory
immediately.
 TYPES OF URINE COLLECTION

CLEAN VOIDED

CLEAN CATCH (MIDSTREAM)

TIMED URINE (24 HOUR URINE)

URINE COLLECTION
URINE COLLECTION
 NURSING CONSIDERATIONS
Urine must be kept separate from feces.

Female clients should discard the toilet

tissue in the toilet or in a waste bag
Put the lid tightly on the container

If the outside of the container has been

contaminated by urine, clean it with a
disinfectant.
SPUTUM SPECIMEN
 NURSING CONSIDERATIONS
Offer mouth care.

Ask the client to breathe deeply and then cough up 1 to 2

teaspoons (5 to 10 mL) of sputum.
Wear gloves and personal protective equipment.

Follow special precautions if necessary.

Label and transport the specimen to the laboratory.

VISUALIZATION PROCEDURES
 CLIENTS WITH GASTROINTESTINAL
ALTERATIONS
Anoscopy

Proctoscopy

Proctosigmoidoscopy

Colonoscopy
BARIUM EXAMS
CLIENTS WITH URINARY ALTERATIONS

KUB

Intravenous pyelography (IVP)

Retrograde pyelography

Renal ultrasonography

Cystoscopy
CLIENTS WITH CARDIOPULMONARY
ALTERATIONS
Electrocardiography

Stress electrocardiography

Angiography

Lung scan (V/Q Scan)

BRONCHOSCOPY
MRI
ASPIRATION PROCEDURES
LUMBAR PUNCTURE
THORACENTESIS
PARACENTESIS
LIVER BIOPSY