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