An a Pa Tho Lab
Transcript of An a Pa Tho Lab
8/9/2019 An a Pa Tho Lab
http://slidepdf.com/reader/full/an-a-pa-tho-lab 1/16
8/9/2019 An a Pa Tho Lab
http://slidepdf.com/reader/full/an-a-pa-tho-lab 2/16
The heart is a hallow, cone-shaped
organ about the size of the fist. It is
located in the mediastinum,
between the lungs and underlying
the sternum. It is enclosed by a
double layer of fibroserous
membrane known as pericardium.
The parietal, or outermost,
pericardium serves to protect the
heart and anchor it to surrounding
structures. The visceral pericardium
adheres to the surface of the heart
forming the hearts outermost layer,
the epicardium. The heart wall
contains two additional layers: the
myocardium which is the middle
and thickest muscular layer of the
heart and is responsible for the
contraction of the heart and the
endocardium which is the
innermost layer of the heart that
lines the chambers and valve.
8/9/2019 An a Pa Tho Lab
http://slidepdf.com/reader/full/an-a-pa-tho-lab 3/16
y The heart also has four chambers, two atria (left atrium and the right atrium)and two ventricles (left ventricle and the right ventricle). The two atria andtwo ventricles are separated longitudinally by the interventricular septum,
forming two parallel pumps. The atria and ventricles are separated from oneanother by the atrioventricular(AV) valves, the tricuspid valve on the rightand the bicuspid or mitral valve on the left. The ventricles in return, areseparated by the great vessels (the pulmonary arteries and aorta) by thesemilunar valves: the pulmonic valve on the right and aortic valve on the left.
The valves serves to direct the flow of blood, allowing it to move from theatria to the ventricles, and then ventricles to the great vessels, but preventingbackflow. The heart has four one-way valves, the aortic, mitral valve,pulmonary valve and tricuspid valve. The blood supply of the heart comesfrom the left and right coronary arteries.
y Deoxygenated blood from the veins enters the right side of the heart throughthe superior and inferior vena cavae. From here, it flows into the right ventricle, which pumps it through the pulmonary artery into the lungs for gasexchange at the alveolar/capillary membrane. Freshly oxygenated bloodreturns to the left atrium via the pulmonary veins. From here, the blood
enters the left ventricle to be pumped out to the systemic circulation through
8/9/2019 An a Pa Tho Lab
http://slidepdf.com/reader/full/an-a-pa-tho-lab 4/16
y W ith each heart beat, the myocardium goes through a cycleof contraction (systole) and relaxation (diastole). Systole is when the heart ejects ( propels) the blood into the
pulmonary and systolic circulations. Diastole is when the ventricles fill with blood. The diastolic phase of the cardiaccycle is twice as long as the systolic phase. This isimportant because diastole is largely a passive process. Thelonger the diastolic phase allows this filling to occur. S1 isthe first sound, beginning of ventricular systole and caused
by closure of the atrioventricular valves-the tricuspid andthe mitral. S2 is the second sound and the beginning of the ventricular systole, the sound is caused by closure of thesemilunar vales, the aortic and the pulmonic.
y The main functions of cardiovascular system are totransport oxygen, hormones and nutrients to the tissues,also, the transport of waste products to the lungs andkidneys for excretion. The conducting system of the heartconsist if the SA node, the AV nod, Bundle of His and thePurkinje fibers
8/9/2019 An a Pa Tho Lab
http://slidepdf.com/reader/full/an-a-pa-tho-lab 5/16
y The amount of blood the heart pumps out in each beatis called the stroke volume. W hen this volume is
multiplied by the number of the heart beat in oneminute, it becomes the cardiac output. W hen thecardiac output is multiplied by the total peripheralresistance, it becomes the blood pressure. The preloadis the degree of stretching of the heart muscle when itis filled up with blood. The after load is the resistanceto which the heart must pump to eject the blood.
y The vascular system is consists of the arteries, veinsand capillaries. The arteries are the vessels that carry
blood away from the heart to the periphery. The veinsare the vessels that carry blood to the heart. Thecapillaries are lined with squamous cells and connectthe veins and arteries.
8/9/2019 An a Pa Tho Lab
http://slidepdf.com/reader/full/an-a-pa-tho-lab 6/16
The pancreas is a
glandular organ that
secretes digestive enzymes
(internal secretions) and
hormones (external
secretions). In humans,
the pancreas is a yellowish
organ about 7 inches (17.8
cm) long and 1.5 inches
(3.8 cm) wide.
The pancreas lies beneath
the stomach and is
connected to the small
intestine at the duodenum
(first section of small
intestine).
THE PACREAS
8/9/2019 An a Pa Tho Lab
http://slidepdf.com/reader/full/an-a-pa-tho-lab 7/16
y The pancreas contains enzyme producing cells that secretetwo hormones. The two hormones are insulin and glucagon.Insulin and glucagon are secreted directly into thebloodstream, and together, they regulate the level of glucosein the blood. Insulin lowers the blood sugar level andincreases the amount of glucagon that is stored carbohydratein the liver. Glucagon slowly increases the blood sugar level if it falls too low. If the insulin secreting cells do not work
properly, diabetes occurs.y The pancreas produces the body's most important enzymes.
The enzymes are designed to digest foods and break downstarches.
y The pancreas also helps neutralize chyme and helps break
down proteins, fats and starch. Chyme is a thick semifluidmass of partly digested food that is passed from the stomachto the duodenum. If the pancreas is not working properly toneutralize chyme and break down proteins, fats and starch,starvation may occur.
8/9/2019 An a Pa Tho Lab
http://slidepdf.com/reader/full/an-a-pa-tho-lab 8/16
Modifiable FactorsObesity BMI: 34Sedentary Lifestyle
Modifiable FactorsObesity BMI: 34Sedentary Lifestyle
Non-Modifiable Factors Age 72yoFamily History Hx HypertensionHx DM
Non-Modifiable Factors Age 72yoFamily History Hx HypertensionHx DM
Normoglycemic StateNormoglycemic State
Increased level of plasmatriglyceridesLow levels of high-density lipoproteins
Increased level of plasmatriglyceridesLow levels of high-density lipoproteins
Abnormal fibrinolysisCoronary Artery DiseaseHypertension
Abnormal fibrinolysisCoronary Artery DiseaseHypertension
Pumping ability of the heart becomes
impaired
Pumping ability of the heart becomes
impaired
HASCVDHASCVD
Congestion of body tissues fromsystemic venous congestionCongestion of body tissues fromsystemic venous congestion
V entricular Gallop S3 V entricular Gallop S3
CHFCHF
Right Side of the heart is affectedRight Side of the heart is affected
Peripheral EdemaPeripheral Edema Pulmonary CongestionPulmonary Congestion
PneumoniaPneumonia
CoughCough DOBDOB CracklesCrackles
8/9/2019 An a Pa Tho Lab
http://slidepdf.com/reader/full/an-a-pa-tho-lab 9/16
Modifiable FactorsObesity BMI: 34Sedentary Lifestyle
Non-Modifiable Factors Age 72yoFamily History Hx HypertensionHx DM
Impaired Insulin ProductionImpaired Insulin Production
Fasting HyperglycemiaFasting Hyperglycemia
Normoglycemic StateNormoglycemic State
Increased resistance to the action of insulinIncreased resistance to the action of insulin
Increased visceral (intra-abdominal) fatIncreased visceral (intra-abdominal) fat
Peripheral Tissues inhibit glucose uptakePeripheral Tissues inhibit glucose uptake
Increased in Blood Glucose LevelsIncreased in Blood Glucose Levels
Amount of glucose filtered by the glomeruli of the kidney exceedsthe amount that can be reabsorbed by the renal tubules Amount of glucose filtered by the glomeruli of the kidney exceedsthe amount that can be reabsorbed by the renal tubules
GLYCOSURIA GLYCOSURIA
+ Large doses of water in the urine+ Large doses of water in the urineCKDCKD + HYPERGLYCEMIA + HYPERGLYCEMIA
Tea-colored urineOutput: 250cc/voidTea-colored urineOutput: 250cc/void POLYURIA POLYURIA
Intracellular dehydrationIntracellular dehydration
Water is pulled out of the body cellsincluding in the thirst center Water is pulled out of the body cellsincluding in the thirst center
POLYDIPSIA POLYDIPSIA
Favor the growth of microorganismsFavor the growth of microorganisms
Impaired wound healingImpaired wound healing
Skin InfectionsSkin Infections
CELLULITISCELLULITIS
Necrotic tissuesNecrotic tissues
LICHENIFICATIONon right leg
LICHENIFICATIONon right leg
8/9/2019 An a Pa Tho Lab
http://slidepdf.com/reader/full/an-a-pa-tho-lab 10/16
DIAGNOSTIC/LABORATORY STUDIES
NAME OF TEST
OR
PROCEDURE
DATE
DONE
INDICATION FOR
THE TEST
NORMAL VALUES ACTUAL
RESULTS/
FINDINGS
SIGNIFICANCE OF THE
RESULTS/FINDINGS
HEMATOLOGY` 2/8/10 Complete Blood
Count (CBC) is to
check the specimen of
venous blood;
includes hemoglobin,
hematocrit
measurements, RBC
count and indices,
WBC count and a
differential white cell
count.
WBC 5-10x109/L 12.6 (increased) Increase in WBC indicates an
infection.
(Fundamentals of Nursing, p
800)
Used of Antiinfective drugs
such as Metronidazole
interferes in WBC count.
(Diagnostic Tests, p 497)
SEG 0.6-0.7% 0.85 (increased) Increase in segmenter indicates
Viral or Bacterial Infection
(Fundamentals of Nursing, p
800)
8/9/2019 An a Pa Tho Lab
http://slidepdf.com/reader/full/an-a-pa-tho-lab 11/16
NAME OF TEST
OR
PROCEDURE
DATE
DONE
INDICATION FOR
THE TEST
NORMAL VALUES ACTUAL
RESULTS/
FINDINGS
SIGNIFICANCE OF THE
RESULTS/FINDINGS
HEMATOLOGY` 2/8/10 Complete BloodCount (CBC) is to
check the specimen of
venous blood;
includes hemoglobin,
hematocrit
measurements, RBC
count and indices,
WBC count and a
differential white cell
count.
LYM 0.2-0.4% 0.12 (increased) An increase in lymphocyteindicates Viral or Bacterial
Infection (Fundamentals of
Nursing, p 800)
EOSI 0.01-0.05% 0.03 (increased) Low in eosinophils indicates
Tissue injury (Fundamentals of
Nursing, p 800)
HGB F:120-160
G/L
93 (decreased) Low in hemoglobin implies
Anemia (Fundamentals of
Nursing, p 800)
HCT 0.42-0.52% 0.29 (decreased) Decrease in hematocrit
signifies anemia
(Fundamentals of Nursing, p
800)
8/9/2019 An a Pa Tho Lab
http://slidepdf.com/reader/full/an-a-pa-tho-lab 12/16
NAME OF TEST
OR
PROCEDURE
DATE
DONE
INDICATION FOR
THE TEST
NORMAL VALUES ACTUAL
RESULTS/
FINDINGS
SIGNIFICANCE OF THE
RESULTS/FINDINGS
URINALYSIS 1/30/10 Urinalysis is to
determine urine
composition and possible abnormal
components (e.g.
protein or glucose) or
infection.
Physical
Color
Transparency
Specific
Gravity
Amber
SlightlyTurbid
1.010-1.025
Amber
Slightly Turbid1.015
NORMAL
Chemical
Albumin
Sugar
Negative
Negative
Positive (3)
Negative
Presence of Albumin indicates
diabetes
mellitus.(http://en.wikipedia.or
g/wiki/Protenuria)
Indicates renal failure.
(Diagnostic Test, p 353)
NORMAL
Chemical
Albumin
Sugar
Negative
Negative
Positive (3)
Negative
Presence of Albumin indicates
diabetes
mellitus.(http://en.wikipedia.or
g/wiki/Protenuria)
Indicates renal failure.
(Diagnostic Test, p 353)
NORMAL
8/9/2019 An a Pa Tho Lab
http://slidepdf.com/reader/full/an-a-pa-tho-lab 13/16
NAME OF TEST
OR
PROCEDURE
DATE
DONE
INDICATION FOR
THE TEST
NORMAL VALUES ACTUAL
RESULTS/
FINDINGS
SIGNIFICANCE OF THE
RESULTS/FINDINGS
URINALYSIS 1/30/10 Urinalysis is to
determine urine
composition and possible abnormal
components (e.g.
protein or glucose) or
infection.
Cells
RBC
Pus cells
Bacteria
Amorphous
urates
0-3/HPF
absent
absent
absent
2-5/HPF
1-4/HPF
Moderate
Some
Decrease in RBC indicates
anemia (Diagnostic Tests. p378)
Presence of pus cells indicates
infection (http://www.biology-
online.org/dictionary/Pus_cell)
An indication that there may be a presence of (infection
http://www.biology-
online.org/dictionary/Bacteria)
Result of the refrigeration
process of urine
(http://www.irvingcrowley.co
m/cls/urin.htm)
8/9/2019 An a Pa Tho Lab
http://slidepdf.com/reader/full/an-a-pa-tho-lab 14/16
NAME OF TEST
OR
PROCEDURE
DATE
DONE
INDICATION FOR
THE TEST
NORMAL VALUES ACTUAL
RESULTS/
FINDINGS
SIGNIFICANCE OF THE
RESULTS/FINDINGS
BIOCHEMISTRY 2/15/10 Biochemistry is
used to keep the body¶s fluid
levels in balance,
and are necessary
to help the
muscles, heart
work properly.
BUN
Creatinin
e
K
1.9-
9.2mmol/L
53-133
mmol/L
3.6-5.5
mEq/L
9.7 (increased)
171
(increased)
3.3 (decrease)
Increase in BUN
indicates congestiveheart failure and renal
failure. (Diagnostic Test,
p 56)
Increase in Creatinine
signifies heart failureand renal failure.
(Diagnostic Test, p 124)
Decrease in Potassium
can be the side effect of
his diuretics. (Diagnostic
Test, p 340)
8/9/2019 An a Pa Tho Lab
http://slidepdf.com/reader/full/an-a-pa-tho-lab 15/16
NAME OF TEST
OR
PROCEDURE
DATE
DONE
INDICATION FOR
THE TEST
NORMAL VALUES ACTUAL
RESULTS/
FINDINGS
SIGNIFICANCE OF THE
RESULTS/FINDINGS
ARTERIAL
BLOOD
GAS
1/30/10 Arterial blood gas is
used to measure the
partial pressure of
arterial oxygen,
PaCO2,pH, oxygen
Saturation and
bicarbonate.
pH 7.35-7.45 7.467 An increase in pH indicates
alkalosis
(http://en.wikipedia.org/wiki/Ar
terial_blood_gas)
pCO2 35-
45mmHg
40.5 NORMAL
pO2 80-100
mmHg
76.8 (decreased) A decrease in O2 indicates that
the patient is not respiring
properly, and is hypoxemic.
(http://en.wikipedia.org/wiki/Ar
terial_blood_gas)
HCO3a 22-25
mEq/L
29.5 (increased) An increase in HCO3í indicates
kidneys are working to
compensate for a respiratory
issue so as to normalize the
blood pH
(http://en.wikipedia.org/wiki/Ar
terial_blood_gas)
8/9/2019 An a Pa Tho Lab
http://slidepdf.com/reader/full/an-a-pa-tho-lab 16/16
Microbiology 1/30/10 Deals with the study of
microorganisms
including bacteria, v iruses, fungi and
parasiteswhich are of
medical importance
and are capable of
causing diseases in
human beings.
Presence of Enterobacter
aerogenes(hea v y gro wth)
Ultrasound 1/30/10Used to v isualize
muscles, tendons, and
many internal organs, to
capture their size,
structure and any
pathological lesions
with real time
tomographic images.
Ultrasound has been
used by sonographers to
image the human body
for at least 50 years and
has become one of the
most widely used
diagnostic tools in
modern medicine.
Bilateral mild diffuse
renal parenchymal
disease moderately
distended urinary
bladder.