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Examination: Laboratory and Diagnostic Testing: A Perioperative Update
Examination Laboratory and Diagnostic Testing: A Perioperative Update PURPOSE/GOAL To educate perioperative nurses about the perioperative implications of three laboratory and diagnostic tests.
BEHAVIORAL OBJECTIVES After reading and studying the article on laboratory and diagnostic testing, nurses will be able to 1.
discuss the brain natriuretic peptide test,
2.
compare conventional colonoscopy to virtual colonoscopy, and
3.
discuss the implications of the microalbumin test.
QUESTIONS 1. Serum concentrations of brain natriuretic peptide (BNP) and N-terminal portion BNP (NT-proBNP) are good markers for congestive heart failure because they correlate well with left ventricular pressures. a. true b. false 2. The BNP test helps 1. classify the severity of the patient’s congestive heart failure. 2. determine whether a patient’s shortness of breath has a noncardiac cause. 3. preserve heart function. 4. rule out heart failure. 5. save patients from undergoing additional invasive and uncomfortable test procedures. a. 1 and 3 b. 2 and 4 c. 1, 2, 4, and 5 d. 1, 2, 3, 4, and 5 3. The BNP test is being used more widely because it © AORN, Inc, 2007
1. correlates well with the New York Heart Association classification system. 2. is a helpful prognosticator of mortality risk. 3. is an efficient and cost-effective screening technique for identifying patients who might be at risk for cardiac problems. a. 1 b. 1 and 3 c. 2 and 3 d. 1, 2, and 3 4. Symptoms of possible complications (eg, colon perforation, hemorrhage) after conventional colonoscopy include 1. abdominal discomfort and tenderness. 2. decreased blood pressure. 3. fever and chills. 4. hematuria or decreased urine output. 5. increased pulse rate. 6. nausea and vomiting. a. 1, 3, and 5
1.8 AORN is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. AORN is providerapproved by the California Board of Registered Nursing, Provider Number CEP 13019. Check with your state board of nursing for acceptance of this activity for relicensure. This program meets criteria for CNOR and CRNFA recertification, as well as other continuing education requirements.
APRIL 2007, VOL 85, NO 4 • AORN JOURNAL • 763
APRIL 2007, VOL 85, NO 4
b. 2, 4, and 6 c. 1, 2, 3, and 5 d. 1, 2, 3, 4, 5, and 6 5. Advantages of virtual colonoscopy over conventional colonoscopy include 1. no risk of colonic perforation. 2. no need for sedation. 3. that it allows for immediate biopsy of suspected tissue. 4. no postanesthesia recovery is required. 5. that normal activities can be resumed in 24 to 48 hours. a. 1 and 5 b. 1, 2, and 4 c. 2, 3, and 5 d. 1, 2, 3, 4, and 5 6. Appropriate candidates for virtual colonoscopy include those who 1. are asymptomatic and at average risk for colorectal cancer. 2. are on warfarin therapy. 3. have a previous history of polyps or colon cancer. 4. require antibiotic prophylaxis before an invasive procedure. 5. weigh more than 300 lbs. a. 1 and 3 b. 1, 2, and 4 c. 2, 4, and 5 d. 1, 2, 3, 4, and 5 7.
Virtual colonoscopy is only a fraction of the cost of regular colon-
Examination
oscopy; however, because it is relatively new, not all insurance carriers will cover it. a. true b. false 8. The term microalbuminuria refers to a. a small amount of albumin. b. an albumin concentration in the urine that is greater than normal. c. a small molecule of albumin. d. albumin in the urine that is detectable with conventional dipstick methodology. 9. For patients with diabetes, testing for microalbumin in the urine 1. helps determine the duration of the disease and the degree of glycemic control. 2. is an early indicator of the development of diabetic complications. 3. may indicate ischemic events related to atherosclerosis. a. 1 b. 2 c. 2 and 3 d. 1, 2, and 3 10. Increased microalbumin levels may help identify surgical patients at risk for systemic inflammatory response syndrome and organ failure. a. true b. false
The behavioral objectives and examination for this program were prepared by Rebecca Holm, RN, MSN, CNOR, clinical editor, with consultation from Susan Bakewell, RN, MS, BC, director, Center for Perioperative Education.
764 • AORN JOURNAL
Answer Sheet Laboratory and Diagnostic Testing: A Perioperative Update
P
Event #07028 Session #8391
lease fill out the application and answer form on this page and the evaluation form on the back of this page. Tear the page out of the Journal or make photocopies and mail with appropriate fee to:
Continuing education contact hours: 1.8
AORN Customer Service c/o AORN Journal Continuing Education 2170 S Parker Rd, Suite 300 Denver, CO 80231-5711 or fax with credit card information to (303) 750-3212.
Fee: Members $9 Nonmembers $18
Additionally, please verify by signature that you have reviewed the objectives and read the article, or you will not receive credit.
Program offered April 2007
Signature ________________________ 1. Record your AORN member identification number in the appropriate section below. (See your member card.) 2. Completely darken the spaces that indicate your answers to examination questions one through 10. Use blue or black ink only. 3. Our accrediting body requires that we verify the time you needed to complete this 1.8 continuing education contact hour (108-minute) program.________minutes 4. Enclose fee if information is mailed.
The deadline for this program is April 30, 2010 A score of 70% correct on the examination is required for credit.
AORN (ID) # _______________________________ Name _____________________________________ Address ___________________________________ City_______________________________________ State __________ Zip ____________ Phone number______________________________ RN license #________________________________ State __________________________ Fee enclosed _______________________________ or bill the credit card indicated Q MC Q Visa Q American Express Q Discover Card # ____________________________________ Expiration date Signature _________________________________________________ © AORN, Inc, 2007
1.8
Participants receive feedback on incorrect answers. Each applicant who successfully completes this program will receive a certificate of completion.
(for credit card authorization)
APRIL 2007, VOL 85, NO 4 • AORN JOURNAL • 765
Learner Evaluation Laboratory and Diagnostic Testing: A Perioperative Update
1.8
Objectives
This evaluation is used to determine the extent to which this continuing education program met your learning needs. Rate these items on a scale of 1 to 5.
To what extent were the following objectives of this continuing education program achieved? 1. Discuss the brain natriuretic peptide test. 2. Compare conventional colonoscopy to virtual colonoscopy. 3. Discuss the implications of the microalbumin test.
Content To what extent 4. did this article increase your knowledge of the subject matter? 5. was the content clear and organized? 6. did this article facilitate learning? 7. were your individual objectives met? 8. did the objectives relate to the overall purpose/goal?
Test Questions/Answers To what extent 9. were they reflective of the content? 10. were they easy to understand? 11. did they address important points?
Learner Input 12. Will you be able to use the information from this article in your work setting? a. yes b. no 13. I learned of this article via a. the Journal I receive as an AORN member. b. a Journal I obtained elsewhere. c. the AORN Journal web site. 14. What factor most affects whether you take an AORN Journal continuing education examination? a. need for continuing education contact hours b. price c. subject matter relevant to cur-
766 • AORN JOURNAL • APRIL 2007, VOL 85, NO 4
rent position d. number of continuing education contact hours offered
Purpose/Goal: To educate perioperative nurses the perioperative implications of three laboratory and diagnostic tests.
What other topics would you like to see addressed in a future continuing education article? Would you be interested or do you know someone who would be interested in writing an article on this topic? Topic(s): ___________________________ ___________________________________ ___________________________________ ___________________________________ Author names and addresses: ________ ___________________________________ ___________________________________ ___________________________________ © AORN, Inc, 2007
BEHAVIORAL OBJECTIVES After reading and studying the article on laboratory and diagnostic testing, nurses will be able to 1.
discuss the brain natriuretic peptide test,
2.
compare conventional colonoscopy to virtual colonoscopy, and
3.
discuss the implications of the microalbumin test.
QUESTIONS 1. Serum concentrations of brain natriuretic peptide (BNP) and N-terminal portion BNP (NT-proBNP) are good markers for congestive heart failure because they correlate well with left ventricular pressures. a. true b. false 2. The BNP test helps 1. classify the severity of the patient’s congestive heart failure. 2. determine whether a patient’s shortness of breath has a noncardiac cause. 3. preserve heart function. 4. rule out heart failure. 5. save patients from undergoing additional invasive and uncomfortable test procedures. a. 1 and 3 b. 2 and 4 c. 1, 2, 4, and 5 d. 1, 2, 3, 4, and 5 3. The BNP test is being used more widely because it © AORN, Inc, 2007
1. correlates well with the New York Heart Association classification system. 2. is a helpful prognosticator of mortality risk. 3. is an efficient and cost-effective screening technique for identifying patients who might be at risk for cardiac problems. a. 1 b. 1 and 3 c. 2 and 3 d. 1, 2, and 3 4. Symptoms of possible complications (eg, colon perforation, hemorrhage) after conventional colonoscopy include 1. abdominal discomfort and tenderness. 2. decreased blood pressure. 3. fever and chills. 4. hematuria or decreased urine output. 5. increased pulse rate. 6. nausea and vomiting. a. 1, 3, and 5
1.8 AORN is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. AORN is providerapproved by the California Board of Registered Nursing, Provider Number CEP 13019. Check with your state board of nursing for acceptance of this activity for relicensure. This program meets criteria for CNOR and CRNFA recertification, as well as other continuing education requirements.
APRIL 2007, VOL 85, NO 4 • AORN JOURNAL • 763
APRIL 2007, VOL 85, NO 4
b. 2, 4, and 6 c. 1, 2, 3, and 5 d. 1, 2, 3, 4, 5, and 6 5. Advantages of virtual colonoscopy over conventional colonoscopy include 1. no risk of colonic perforation. 2. no need for sedation. 3. that it allows for immediate biopsy of suspected tissue. 4. no postanesthesia recovery is required. 5. that normal activities can be resumed in 24 to 48 hours. a. 1 and 5 b. 1, 2, and 4 c. 2, 3, and 5 d. 1, 2, 3, 4, and 5 6. Appropriate candidates for virtual colonoscopy include those who 1. are asymptomatic and at average risk for colorectal cancer. 2. are on warfarin therapy. 3. have a previous history of polyps or colon cancer. 4. require antibiotic prophylaxis before an invasive procedure. 5. weigh more than 300 lbs. a. 1 and 3 b. 1, 2, and 4 c. 2, 4, and 5 d. 1, 2, 3, 4, and 5 7.
Virtual colonoscopy is only a fraction of the cost of regular colon-
Examination
oscopy; however, because it is relatively new, not all insurance carriers will cover it. a. true b. false 8. The term microalbuminuria refers to a. a small amount of albumin. b. an albumin concentration in the urine that is greater than normal. c. a small molecule of albumin. d. albumin in the urine that is detectable with conventional dipstick methodology. 9. For patients with diabetes, testing for microalbumin in the urine 1. helps determine the duration of the disease and the degree of glycemic control. 2. is an early indicator of the development of diabetic complications. 3. may indicate ischemic events related to atherosclerosis. a. 1 b. 2 c. 2 and 3 d. 1, 2, and 3 10. Increased microalbumin levels may help identify surgical patients at risk for systemic inflammatory response syndrome and organ failure. a. true b. false
The behavioral objectives and examination for this program were prepared by Rebecca Holm, RN, MSN, CNOR, clinical editor, with consultation from Susan Bakewell, RN, MS, BC, director, Center for Perioperative Education.
764 • AORN JOURNAL
Answer Sheet Laboratory and Diagnostic Testing: A Perioperative Update
P
Event #07028 Session #8391
lease fill out the application and answer form on this page and the evaluation form on the back of this page. Tear the page out of the Journal or make photocopies and mail with appropriate fee to:
Continuing education contact hours: 1.8
AORN Customer Service c/o AORN Journal Continuing Education 2170 S Parker Rd, Suite 300 Denver, CO 80231-5711 or fax with credit card information to (303) 750-3212.
Fee: Members $9 Nonmembers $18
Additionally, please verify by signature that you have reviewed the objectives and read the article, or you will not receive credit.
Program offered April 2007
Signature ________________________ 1. Record your AORN member identification number in the appropriate section below. (See your member card.) 2. Completely darken the spaces that indicate your answers to examination questions one through 10. Use blue or black ink only. 3. Our accrediting body requires that we verify the time you needed to complete this 1.8 continuing education contact hour (108-minute) program.________minutes 4. Enclose fee if information is mailed.
The deadline for this program is April 30, 2010 A score of 70% correct on the examination is required for credit.
AORN (ID) # _______________________________ Name _____________________________________ Address ___________________________________ City_______________________________________ State __________ Zip ____________ Phone number______________________________ RN license #________________________________ State __________________________ Fee enclosed _______________________________ or bill the credit card indicated Q MC Q Visa Q American Express Q Discover Card # ____________________________________ Expiration date Signature _________________________________________________ © AORN, Inc, 2007
1.8
Participants receive feedback on incorrect answers. Each applicant who successfully completes this program will receive a certificate of completion.
(for credit card authorization)
APRIL 2007, VOL 85, NO 4 • AORN JOURNAL • 765
Learner Evaluation Laboratory and Diagnostic Testing: A Perioperative Update
1.8
Objectives
This evaluation is used to determine the extent to which this continuing education program met your learning needs. Rate these items on a scale of 1 to 5.
To what extent were the following objectives of this continuing education program achieved? 1. Discuss the brain natriuretic peptide test. 2. Compare conventional colonoscopy to virtual colonoscopy. 3. Discuss the implications of the microalbumin test.
Content To what extent 4. did this article increase your knowledge of the subject matter? 5. was the content clear and organized? 6. did this article facilitate learning? 7. were your individual objectives met? 8. did the objectives relate to the overall purpose/goal?
Test Questions/Answers To what extent 9. were they reflective of the content? 10. were they easy to understand? 11. did they address important points?
Learner Input 12. Will you be able to use the information from this article in your work setting? a. yes b. no 13. I learned of this article via a. the Journal I receive as an AORN member. b. a Journal I obtained elsewhere. c. the AORN Journal web site. 14. What factor most affects whether you take an AORN Journal continuing education examination? a. need for continuing education contact hours b. price c. subject matter relevant to cur-
766 • AORN JOURNAL • APRIL 2007, VOL 85, NO 4
rent position d. number of continuing education contact hours offered
Purpose/Goal: To educate perioperative nurses the perioperative implications of three laboratory and diagnostic tests.
What other topics would you like to see addressed in a future continuing education article? Would you be interested or do you know someone who would be interested in writing an article on this topic? Topic(s): ___________________________ ___________________________________ ___________________________________ ___________________________________ Author names and addresses: ________ ___________________________________ ___________________________________ ___________________________________ © AORN, Inc, 2007