NSG 550 Diagnostics Study Guide Quiz 1 LATEST GUIDE
Diagnostic Reasoning Study Guide - Quiz 1
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Clinical Reasoning
o Knowledge + cognition = metacognition
o Collect H&P, complete physical exam, interpret diagnostic studies
o Clinical decision making is multifaceted and encompasses the patient, clinical
problem, and the practitioner’s perspectives.
o Critical thinking involves application of analysis, evaluation, and inference
o Accuracy: does the test measure what it was designed to measure; proportion of
all tests (positive and negative) that are correct.
o Precision: does the test reproduce the same results when repeated on the same
patient or a sample; a test can be precise but not necessarily accurate if the results
differ from reference range.
o Sensitivity: among people who have the disease, how often is the test right?
o Specificity: among people who do not have the disease, how often is the test
right?
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Patient follow-up with results
o Do not give over the phone, or on answering machine
o Do not give to family/friends unless written consent is given
o Provide education on meaning of results, disease process, home care, next visit,
and treatment options
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American College of Radiology (ACR) Appropriateness Criteria
o Evidence-based guidelines to assist referring physicians and other providers
in making the most appropriate imaging or treatment decision for a specific
clinical condition
o Starting January 2020 the ACR Appropriateness Criteria used by health care
providers for determining imaging studies for patient management will
become the standard of care for reporting on Medicare patients.
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ACR Practice Guidelines for Communication of Diagnostic Imaging Findings
o Effective communication should 1) promote optimal patient care and support
the referring physician/health care provider in this endeavor, 2) be tailored to
satisfy the need for timeliness, and 3) minimize the risk of communication
errors.
Examples of Various Diagnostic Studies
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Blood studies
o Used to establish Dx, r/o clinical problem, monitor therapy, establish prognosis,
screen for disease
o Venous – most common
o Arterial – causes more discomfort, used for blood gasses, higher risk of hematoma
– hold pressure longer
o skin puncture – often used in pediatrics, mix of venous and arterial. Earlobe can
be used for arterial if needed. Do not milk d/t hemolysis
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Electrodiagnostic studies
o Tests electrical impulses
