Evaluate outcomes using the following steps:
Learn the normal or reference values and expected outcomes of the test. The patient or their significant others should be able to describe the purpose of the test and the testing process and should properly perform expected activities associated with testing. Offer assistance if necessary. If test outcomes are abnormal, the patient should be encouraged to comply with repeat testing and to introduce appropriate lifestyle changes realistically. Deal with anxiety and fears in a timely manner. Refer the patient to appropriate counseling resources if indicated. Above all, do not dismiss the patient’s feelings and concerns casually.
Compare normal values with abnormal results and apply these comparisons to the patient’s situation. Sometimes, desired outcomes cannot be achieved. For example, the patient cannot, for various reasons, fully participate in the teaching and learning process or the actual testing. Recommendations for follow-up care and lifestyle changes may not be able to be followed. Verbal and nonverbal cues can sometimes provide reasons (e.g., Alzheimer disease, physical limitations) for this inability. In another instance, the patient might be noncompliant with pretest preparations and posttest activities. Denial of the situation is frequently a reason, although there are many other causes for noncompliance. Patients may refuse diagnostic testing because they feel the results may confirm their worst suspicions and fears.
Numerous and varied responses can be related to lack of appropriate problem-solving behaviors, inappropriate behaviors, fears or denial, concern about potential complications, inability to cope with or take control of the situation, depression or abnormal emotional patterns of response, and lack of support from significant others and family. Perceptions of having experienced uncaring acts can lead to frustration, despair, and hopelessness on the patient’s part.
Adverse events (e.g., perforation, anaphylaxis, death) and health hazards may occur as a result of diagnostic procedures or problems with a medical device or product (e.g., reactions to latex gloves or other latex-containing medical devices). Health professionals are asked to monitor and voluntarily report faulty medical devices to the FDA so that action can be taken to protect the public. Reporting does not necessarily constitute an admission that medical personnel or the product caused or contributed to the adverse event.
Prompt action is necessary when results are abnormally high or low and are indicative of a serious situation (e.g., positive blood culture, abnormally elevated potassium level).
Modify, report, and collaborate with other healthcare providers when unexpected or abnormal values occur and when changes in medical care may be necessary as a result of test outcomes.
Examples of expected and unexpected test outcomes appear in Table 1.10.