Lipase
13.18 What is lipase?
Lipase is an enzyme in the pancreas.
13.19 What might cause a high level of lipase in the blood stream?
Levels of lipase in the blood increase when the pancreatic duct is blocked or there is damage to the pancreas.
13.20 Is a high lipase level used to diagnose pancreatic disorders?
The lipase test does not diagnose pancreatic disorder. A high level of lipase in blood requires additional testing.
13.21 Why is a patient administered the lipase test?
The test screens for pancreatic disease, pancreatitis, and cystic fibrosis. The test assesses treatment for pancreatitis and cystic fibrosis.
13.22 What should be assessed before administering the lipase test?
Assess if the patient has:
• Eaten or drunk anything except water 12 hours before the test is administered
• High cholesterol, varicose veins, kidney disease, diabetes, or high blood pressure
• Taken narcotics, anticoagulants, or cholinergics 13.23 What might a high level of lipase indicate?
A high lipase level may indicate pancreatic cancer, pancreatitis, pancreatic disease, cholecystitis, gallstones, bowel obstruction, infarction, chronic kidney disease, inflammation, infection, drug abuse, or peptic ulcer disease.
13.24 What is the function of cholesterol?
Cholesterol is produced in the liver and used for cell growth and hormone production.
13.25 What is the VLDL test?
Very low-density lipoprotein (VLDL) distributes triglyceride that is produced in the liver. High levels of VLDL increase the risk of cardiovascular disorders.
CHAPTER 13 Pancreas and Lipid Metabolism Tests 142
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C H A P T E R 1 4
Diagnostic Radiologic Tests
14.1 Definition
Radiologic tests provide a view inside the body. Radiologic tests use X-rays to view inside the body without opening the skin. An X-ray remains a cost-effective way to identify many common disorders, although primi- tive when compared with computed tomography (CT), computed axial tomography (CAT) scans, and magnetic resonance imaging (MRI). The X-ray is absorbed by dense objects and passes through less dense objects. Dense objects such as bone appear white on the X-ray file. Less dense objects, such as air, appear black, while fluid and fat appear as a lighter shade of gray.
14.2 How an X-ray Is Taken
The patient is positioned between the X-ray machine and photographic film. The X-ray machine focuses the X-ray beam at the area of the patient’s body that is being examined. A portion of the X-ray beam passes through the patient’s body, striking the photographic film and leaving a black area on the photographic film. Another por- tion of the X-ray beam is absorbed by bone and other dense tissue in the patient’s body, which appear as shades of grey on the photographic film, depending on the density of the tissue. Areas that are not X-rayed are protected by a lead apron, when possible, to prevent X-rays from reaching those areas. An X-ray does not provide a good image of cartilage, ligaments, tendons, and other soft tissues. The healthcare provider is likely to order a CT scan or MRI to examine soft tissue.
Teach the Patient
Explain that an X-ray may not be taken if the patient is pregnant, the level of radiation will not have any long- term effects for the patient, and the healthcare provider may require specific preparation depending on the part of the body being X-rayed. Explain that any jewelry in the vicinity of the X-ray site must be removed, a radiol- ogist is usually the healthcare professional who reads the X-ray, and that the patient may be required to remove clothing and wear a gown during the X-ray. Explain that the patient will be asked to lie still and hold his or her breath when the X-ray is taken, that the X-ray room is cool, and that the patient may feel uncomfortable while positioning for the X-ray. Assess if the patient has signed a consent form.
14.3 Abdominal X-ray
An abdominal X-ray shows the position, size, and shape of the:
• Stomach
• Diaphragm
• Liver
• Spleen
CHAPTER 14 Diagnostic Radiologic Tests 144
• Large intestines
• Small intestines
Ovaries are not protected with a lead apron during the X-ray because it is located at the site of the X-ray.
An abdominal X-ray cannot detect ulcers or bleeding.
The healthcare provider may also order a CT scan, ultrasound, or IV pyelograph.
A KUB X-ray is an abdominal X-ray that examines the kidneys, uterus, and bladder.
Why the Test Is Performed
The test assesses the underlying cause of abdominal or flank pain, confirms the position of nasogastric tube, nephrostomy tube, V-P shunt, dialysis catheter, locates an ingested foreign body, assesses the underlying cause of vomiting and nausea, assesses for intestinal blockage, and assesses for perforation in the intestine or stomach.
Before Administering the Test
Assess if the patient:• Is pregnant. An ultrasound is ordered instead of an X-ray if the patient is pregnant, to protect the fetus from radiation exposure.
• Has taken Pepto-Bismol (bismuth) or barium four days prior to the test. Bismuth and barium might obstruct the X-ray beam.
• Has an empty bladder
How the Test Is Performed
• The patient may be asked to stand between the X-ray machine and the photographic film or lie on his or her back or side on the X-ray table.
• The patient lies on his or her back:
• A lead apron is placed over the lower pelvic area to protect the area from X-rays.
• The X-ray machine is positioned over the abdomen.
• The patient is asked to lie still and hold his or her breath when the X-ray is taken.
• An X-ray is taken.
• The patient is asked to stand between the X-ray machine and the photographic film:
• The patient is asked to stand still and hold his or her breath when the X-ray is taken.
• An X-ray is taken.
• See How an X-ray Is Taken.
Teach the Patient
Explain why the X-ray is being taken, what the patient can expect in the X-ray room, that the patient should not take Pepto-Bismol (bismuth) or barium four days prior to the test, and that the patient will need to empty his or her bladder before the test.
Understanding the Test Results
The test takes 10 minutes. The results are ready within 15 minutes or two days, depending on the patient’s condition.
• Normal:
• Normal position, size, and shape of the stomach, diaphragm, liver, spleen, large and small intestines
• No growths
• Normal amounts of air, fluid, or stool
• Abnormal:
• Abnormal position, size, and shape of the stomach, diaphragm, liver, spleen, large and small intestines
• Blockage
• Perforation in the intestine or stomach (Conn syndrome)