DIAGNOSTIC AND LABORATORY PROCEDURES:
ELECTROLYTES, KIDNEY AND LIVER FUNCTION TESTS
Diagnostic and
Laboratory procedure(s
)
Date orderedDate result(s)
in
Indication(s) or Purpose(s)
Results (1st, 2nd, 3rd)
Normal Values
Analysis and Interpretation (book-based)
Alkaline Phosphate
SGOT/AST
SGPT/ALT
SERUM K LEVELS
D.O:
D.O.
D.O.
Measures liver function and diagnoses liver disease.
Determines the extent of liver damage.
Determines the extent of liver damage.
To help diagnose and monitor acute or chronic
661 IU/L
46 IU/L
74.4 IU/L
3.0 mmol/L
64-306 IU/L
10-40 IU/L
0-39 IU/L
3.5-5.0 mmol/L
Results show elevated levels of Alkaline Phosphatase that suggest evidence of liver disease.
Results show elevated SGOT levels, which indicate possible damage in the liver.
Results show elevated SGPT levels, which indicate alteration in the liver function.
The result of the serum potassium level is decreased.
Calcium
Sodium
pancreatitis and other disorders that may involve the pancreas.
To evaluate fluid and electrolyte status.
To evaluate fluid and electrolyte status.
1.96 mmol/L
139 mmol/L
2.02-2.60 mmol/L
136-145 mmol/L
The result of the calcium level of the calcium is below the normal range.
Results are within normal range.
ULTRASOUND
Diagnostic and
Laboratory procedure(s
)
Date orderedDate result(s)
in
Indication(s) or Purpose(s)
Results(1st,2nd,3rd
)Normal Findings
Analysis and Interpretation
Ultrasound D.O:04-26-07
D.R:04-26-07
It is a non- invasive test performed which provides images of the interior of the hepatobiliary tract on a monitor. To detect foreign bodies and to distinguish between cystic and solid masses (tumors).
04-26-07The liver is enlarged. There is an ovoid mass in the quadrate lobe of the liver. Mass is complex, mainly cystic and measures 89x86x69mm Biliary ducts, both intrahepatic and extrahepatic are in normal caliber. CBD measures 5 mm in diameter. The gall bladder is normal size and wall thickness and does not contain
The liver is the largest internal organ in the body, weighing about 1.3 kg (3lbs.) in the adult. It should be within normal size and echotexture.
Complex mass, quadrate lobe of the liver liver abcess possibly amebic is considered.
stones nor sludge.
HEMATOLOGIC TESTS
Diagnostic and
Laboratory procedure(s
)
Date orderedDate result(s)
in
Indication(s) or Purpose(s)
Results(1st,2nd,3rd
)Normal Values
Analysis and Interpretation (book-based)
Hemoglobin (Hgb)
Hematocrit (Hct)
D.O:04-28-07
D.R:04-28-07
D.O:04-28-07
D.R:04-28-07
To evaluate iron status and oxygen carrying capacity of RBC. Aids in the determination of anemia or polycythemia.
Evaluates anemia and fluid balance and measures concentration of RBC in the blood volume.
110gm/L
0.33
125-175gm/L
0.40-0.52 L/L
Below normal range. The patient has decrease number of hemoglobin content and may be unable to carry adequate amount of O2 in a RBC to tissues.
The patient’s hematocrit is below the normal range. There is decrease percentage of RBC in a whole blood.
White Blood Cells
Neutrophils
Lymphocytes
Platelet Count
D.O:04-28-07
D.R:04-28-07
D.O:04-28-07
D.R:04-28-07
D.O:04-28-07
D.R:04-28-07
D.O:04-28-07
D.R:04-28-07
The WBC counts measures the number of WBC’s in a cubic millimeter of blood. It is used to detect infection or inflammation.
It is used to detect infection or inflammation.
Indicates the amount of lymphocytes participating with macrophages at a site of a local injury.
16.2
0.75
0.24
192
5-10 x 109/L
0.45-0.65
0.20-0.35
150-400 x 109/L
Patient may have alterations in hydration status.
Patient’s WBC count is above normal range. This indicates possible infection and inflammation.
The result of the neutrophils is above the normal range. This indicates that the patient has an infection or inflammation.
The result is within the normal range.
The result is within the normal range.
PARTIALPROTHROMBIN TIME (PTT)
D.O:04-28-07
D.R:04-28-07
Complex method for testing the normalcy of intrinsic coagulation process.
29.4 seconds 35-45 seconds
The result is within the normal range.
Diagnostic Procedures
Diagnostic/ Laboratory Procedures
Date Ordered Date Result(s) In
Indication(s) or Purpose(s)
Results (1st, 2nd, 3rd…)
Normal Values (Units used in the Hospital)
Analysis and Interpretation of
Results
Nursing Responsibility
CBC DO:09-26-03DRI:09-26-03
To determine blood components for comparison.
RBS = 5.6 mmol/lBUN = 4.7 mmol/lCrea = 67.6 mmol/lT.Bili = 17.1 mmol/lD.Bili = 10.26 mmol/lT. CHON = 57.4 gm/lAlbumin = 25.6 gm/lGlob. = 31.8
3.85-9 mmol/l
1.7-8.3 mmol/l
58-100 mmol/l
0.25-25.65 mmol/l0-8.55 mmol/l
63-85 gm/l
34-50 gm/l
18-32 gm/l
Normal
Normal
Normal
Normal
Normal
Normal
Normal
Normal
-Explain procedure-evaluate patient’s understanding.
gm/lA/G ratio = 8.05Alk. Phos. = 1032 IU/lSGOT = 42.4 IU/lSGPT = 36.1 IU/l
15-2464-306 IU/l
10-40 IU/l
0-39 IU/l
LowHigh(possible fibrosis)High(hepatic disease)Normal
HbsAg DO:09-026-03DRI:09-26-03
To determine if the patient is infected with Hepa B.
Non-reactive Non-reactive Normal -Explain procedure-evaluate patient’s understanding.
Serum NA, K DO:09-26-03DRI:09-26-03
To determine if the patient is suffering from hypokalemia.
Na = 123 mmol/l
K = 3.03 mmol/l
135-155 mmol/l
3.4-5.3 mmol/l
Low(Due to vomiting)Low(due to loss of body fluids)
UA DO:09-26-03DRI:09-29-03
To determine if the content of patient’s urine.
Color: Dark YellowTrans: Turbid
Sugar: (-)Alb.: (-)Rxn: acidicSp.Gr.: 1.015
Pus: 8-10 HPFCrystals:Amor. Urates: moderate
Color:Straw
Trans: clear
Sugar:noneAlb.:noneRxn: acidicSp.Gr.: 1.005-1.020Pus: 0-4/HPF
Amor.Urates:Few
Normal
Due to componentNormalNormalNormalNormal
High
High
-Explain or clarify test purpose and procedure.-evaluate patient understanding.
Epithelial cells: moderateBacteria: 5
Epi. Cells: few
Bacteria: noneHighHigh(infection)
CXR DO:09-26-03DRI:
To determine if patient may have PTB.
NA -Make sure all jewelry and dentures are removed.-Explain procedure to patient.
Fecalysis with occult blood
DO:09-29-03DRI:
To determine if there is any internal bleeding.
NA -Explain or clarify test purpose and procedure.-evaluate patient understanding.-Make sure the specimen is given to the lad asap.
Peritoneal Fluid Analysis
DO:09-26-03DRI:09-30-03
To determine components in the peritoneal fluid and determine cause of ascites.
Color: light yellowTrans: sl-turbidT. Cell count: 10Diff. Count: all lymphocytesProtein: .28g/l
Glucose: 60
Color: clear to pale yellowTrans: clear
Protein: 0.3 – 4.1 g/dlGlu: 70-100
Normal
Due to peritonitis
-Explain procedure-get signed consent-apply pressure dressing-measure abdominal girth-monitor urine
Microorganisms: Gram Stain: no micro foundAFB stain: (-)Remarks: RBC crenated (+)
mg/dlMicroorganisms:None
output for at least 24 hours.
IV. Diagnostic and laboratory procedures
Diagnostic/
Laboratory
Procedure
Indications or
Purpose
Date ordered/ date
results were
released
Results Normal values Analysis and
Interpretation of
Results
1st
COMPLETE BLOOD COUNT
The complete blood count is the calculation of the cellular (formed elements) of blood. This is to detect hematologic disorders neoplasm, or immunological abnormality like known or suspected anemia; monitor
July 29, 2007 HCT % 0.22 F – 0.38 - 0.48 The result is below
normal.
A low hematocrit is referred to as being anemic. Some of the most common reasons are loss of blood (bleeding) or nutritional deficiency (iron, vitamin B12,
blood loss; determine the oxygen carrying capacity of the blood; and evaluates the hemoglobin content.
WBC Count(x1 8/l)
10.6
Lymphocytes 0.25
HGB (g/dl) 74
5-10 X 109
0.20 - 0.35
115-155
folate).
The result is above
normal.
Increased WBC (leukocytosis) indicates a sign of infection.
It is within the
normal range.
It is below normal.
Low hemoglobin measurement is an indication of anemia, which is either a reduced number of red blood cells or a reduced amount of hemoglobin (oxygen carrying pigment) in each red
blood cell, that are carried to the tissues.
2nd
Aug. 05,2007 HCT (%) 0.21
WBC 10.1
Lymphocytes 0.22
HGB (g/dl) 70
Neutrophils 0.73
0.38 - 0.48
5-10X109
0.20-0.35
115 - 155
0.45 - 0.65
The result is below normal.
It is slightly below the normal range.
The result is within the normal range.
It is below normal.
It is above normal.
Neutrophils that exceed in normal is usually cause by an acute infection such as appendicitis, smallpox or rheumatic fever.
3rd Aug. 06, 2007 HCT % .35
HGB (g/dl) 117
F .38-.48
115-155
The result is below normal.
It is within the normal range.
NURSING RESPONSIBILITIES IN GETTING CBC:
Before:
Verify the doctor’s order. Explain the procedure and purpose of the test. Tell the patient that a blood sample will be taken. Inform the patient that she may feel some discomfort from the needle puncture and tourniquet.
During:
Collect a venous sample according to the protocol of the laboratory. Transport time for culture specimen must be minimized. Handle specimen carefully.
After:
Apply pressure on the venipuncture site Monitor for signs of infection. Assess for bleeding.
Diagnostic/ Indications or Date ordered/ date Results Normal values Analysis and
Laboratory
Procedure
Purpose results were
released
Interpretation of
Results
URINALYSIS The urinalysis is used as a screening and/or diagnostic tool because it can help detect substances or cellular material in the urine associated with different metabolic and kidney disorders. Often, substances such as protein or glucose will begin to appear in the urine before patients are aware that they may have a problem. It is used to detect urinary tract infections (UTI) and other disorders of the urinary tract. In patients with acute
July 30, 2007 MACROSCOPICColor Yellow
S.G 1. 010
Sugar Negative
Appearance Clear
Reaction pH6.5
Albumin Negative
MICROSCOPICPus Cells : 0-1 HPF
Straw
1.005 – 1.030
Negative
Clear
pH 4.6 – 8.0
Negative
It is within the normal range.
It is within the normal range.
It is normal.
It is normal.
It is within the normal range.
It is normal.
or chronic conditions, the urinalysis may be ordered at intervals as a rapid method to help monitor organ function, status, and response to treatment.
Red Cells: 2-4 HPF
NURSING RESPONSIBILITIES FOR URINALYSIS:
Before: Verify the doctor’s order. Explain to the patient the importance of the procedure. The first morning sample is the most valuable because it is more concentrated and more likely to yield abnormal results Assist the patient.
During: Provide privacy. Advise the patient to catch the midstream of the urine. Transport time for culture specimen must be minimized. Handle specimen carefully.
After: Relay the results to the attending physician.
Diagnostic/
Laboratory
Indications or Date ordered/ date
results were
Results Normal values Analysis and
Interpretation of
Procedure Purpose released Results
COAGULATION
TESTThese tests measure how quickly your blood clots. An abnormality could result in excessive bleeding or excessive clotting (which is difficult to measure).
Aug.05,2007 Bleeding Time1’30”
Clotting Time3’00
MCV74.8
MCH27.8
MCHC35.8
1-3 min.
2-5 min.
82-92
27-33
31-36
It is within the normal range.
It is within the normal range.
It is below normal range.In some types of anemia the MCV is abnormally small and in others abnormally large. MCV is therefore help in characterizing an anemia.
It is within the normal range.
It is within the
normal range.
NURSING RESPONSIBILITIES ON COAGULATION TESTING:
Identify client / order. Correct lab slip. Labels for tube(s) Wash hands. Make sure you have the right tube to collect the specimen in. If in doubt, call the lab. Double check label before affixing to tube. Double check correct lab identified. Dispose of used materials appropriately. Wash hands
Transport to lab according to unit protocol
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