Alaine aminotransferase Procedure Preparation o o o o o Explain to the patient that this test assesses liver function.

Tell the patient that the test requires a blood sample. Explain who will perform the venipuncture and when. Explain to the patient that he may experience slight discomfort from the tourniquet and the needle puncture Inform the patient that he may need not restrict food and fluids. Notify the laboratory and physician of drugs the patient is taking that may affect test result; It may be necessary to restrict them.

Implementation o o o Perform a venipuncture and collect the sample in a 4-ml tube without additives Handle the sample gently to prevent hemolysis ALT activity is a stable in serum for up to 3 days at room temperature.

Patient care o o Apply direct pressure to the venipuncture site until bleeding stop. Instruct the patient that he may resume medications stopped before the test.

Aspartate aminotransferase Procedure Preparation o o o o o Explain to the patient that this test assesses heart and liver function. Inform the patient that the test usually requires three venipunctures ( one on the admission and one each day for the next three days ). Tell the patient that he may need not restrict food and fluids. Explain to the patient that he may experience slight discomfort from the tourniquet and the needle puncture. Notify the laboratory and physician of drugs the patient is taking that may affect test result; It may be necessary to restrict them.

Implementation o o o Perform a venipuncture and collect the sample in a 4-ml tube without additives. To avoid missing peak AST levels, draw serum samples at the same time each day. Handle the sample gently to prevent hemolysis and send it to the laboratory immediately.

Patient care o o Apply direct pressure to the vinipuncture site until bleeding stop. Instruct the patient that he may resume medications stopped before the test.

Computed Tomograhpy of the liver and bilary tract Procedure Preparation o o o Explain to the patient that computed tomography (CT) scanning helps detect biliary tract and liver disease. Check the patient history for hypersensitivity iodine, seafood , or the contrast media used in other diagnostic tests. If ordered, gives the patient the oral contrast medium supplied by the radiology department .Tell the patient that hell drink a contrast medium and then fast until after the examination. It I.V. contrast medium isnt ordered, fasting isnt necessary. If the patient will receive I.V contrast, hell need to fast from food fluids for 4-hours before the test Tell the patient to immediately report nausea, vomiting, dizziness, headache and hives. If the test will involve an I,V, contrast medium , tell the patient he may experience discomfort from the needle puncture and a localized feeling of warmth on injection, as a salty or metallic taste. Inform the patient that hell lie on an adjustable table inside a scanning gantry. Tell the patient that hell need to remain still during the test and periodically hold his breath. Stress the importance of remaining still during the test because movement can cause artifacts, thereby prolonging the test and limiting its accuracy.

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Implementation o o o o o The patient is placed in the supine position on an X-ray table, and the table is position within the opening in the scanning gantry. A series of transverse X-rays is taken and recorded on magnetic tape. This information is reconstructed by a computer and appears as a images on a television screen. When the first series of X-ray is completed, the images are reviewed. If contrast enhancement is ordered, the contrast medium is injected. A second series of X-rays is taken. The patient is observed carefully for an allergic reaction.

Patient care o Monitor the patient for adverse effects to the contrast medium.

Lipase Procedure Preparation o o o o o Explain to the patient that this test evaluates pancreatic function. Tell the patient that the test require a blood sample. Explain who will perform the venipuncture and when. Inform the patient that he may experience slight discomfort from the tourniquet and the needle puncture. Instruct the patient to fast overnight before the test. Notify the laboratory of drugs the patient is taking that may affect test result; it may be necessary to restrict them.

Implementation o o Perform a venipuncture and collect the sample a in a 4-ml clot-activator tube. Handle the sample gently to prevent hemolysis.

Patient care o o Apply direct pressure to the vinipuncture site until bleeding stop. Instruct the patient that he may resume his usual diet and medications stopped before the test.