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Laboratory Test

Date: Mar. 1, 2015


Patient Name: Lina, Teresa M.
Age/ Sex: 89 F
Time: 8:20 PM
COMPLETE BLOOD COUNT
S.I
HEMOGLOBIN
HEMATOCRIT
RBC COUNT

95.0
0.28
2.87

MCH
RDW

33.1
56.2

Reference Range
120.00 150.00 gm/L
0.37 0.47
4.00 5.40
RED BLOOD CELLS INDICES
27.00 31.00 pg
39.00 46.00 fL

DIFFERENTIAL COUNT
SEGMENTERS
0.77
LYMPHOCYTES 0.20

0.55 0.65
0.25 0.35

Definition:
- A complete blood count (CBC) is a blood test used to evaluate your overall health and detect a wide range of disorders, including
anemia, infection and leukemia. A complete blood count test measures several components and features of your blood, including:
Red blood cells, which carry oxygen.
- The WBC differential evaluates the distribution and morphology of white blood cells. Therefore, it provides more specific
information about a patient's immune system than the WBC count alone. In the differential test, the lab classifies 100 or more white
cells in a stained film of peripheral blood according to two major types of leukocytes. They are: (Granulocytes (neutrophils,
eosinophils, and basophils); non-Granulocytes (lymphocytes, monocytes). The percentage of each type is then determined.

Interpretation:
There is a decrease in Hemoglobin and Hematocrit count which is 95.0 (Hgb) and 0.28 (Hct) and this suggest that there is a possible
Iron, vitamin B12, or folate deficiency; bone marrow damage; leukemia or lymphoma; acute or chronic blood loss; red blood cell
hemolysis. In Red blood cell indices there is low Mean Corpuscular Hemoglobin (MCH) which is the amount of hemoglobin per red
blood cells, 33.1 pg is the result and it suggest that there is a possible iron deficiency. There is an increase of Red cell distribution
width, which is a measurement of the variation in the red blood cell size. The result is 56.2 fL, this suggest that there is a possible
Iron deficiency, vitamin B12 or folate deficiency, recent blood loss. In Differential count there is a decrease in lymphocytes. The result
(0.20) may suggest that there is a possible congestive heart failure, renal failure, advanced tuberculosis and others; Defective
lymphatic circulation, high levels of adrenal Corticosteroids. There is an increase in segementers. The result is 0.77, which suggest
that there is a possible inflammation or infection.
Nursing Responsibilities:
> Explain the test procedure. Explain that slight discomfort may be felt when the skin is punctured.
> Encourage avoiding stress if possible because altered physiologic status influences and changes normal hematologic values.
> Apply normal pressure and dressings over puncture site on removal of syringe needle.
> Monitor the puncture site for oozing or hematoma formation.
> Instruct to resume normal activities and diet.

Laboratory Test
Date: Feb. 24, 2015
Patient Name: Lina, Teresa M.
Age/Sex: 89/f
Time: 3:46 PM
Arterial Blood Gas
Parameters

Results

Normal Range

Ph

41

35 45 mmHg

PCO2

93

80 100 mmHg

HCO3

43.1

22 26 m EgL

Definition:
- Arterial blood gas analysis is a common investigation in emergency departments and intensive care units for monitoring patients
with acute respiratory failure. It also has some application in general practice, such as assessing the need for domiciliary oxygen
therapy in patients with chronic obstructive pulmonary disease. An arterial blood gas result can help in the assessment of a patient's
gas exchange, ventilator control and acidbase balance.
Interpretation:
- Metabolic Alkalosis is the interpretation of the result of the test. Because the Ph remains normal, which is in normal compensated
range. Then there is an increase in PCO2 (partial carbon dioxide) and HCO3 (Bicarbonate) result is 93 mmHg and 43.1 m EgL This
is usually caused by Vomiting, prolonged therapy with potassium wasting diuretics or steroids, Cushing's disease, ingestion/
overdose of sodium bicarbonate (e.g. antacids)
Nursing Responsibilities:
> After applying pressure to the puncture site for 3 to 5 minutes and when bleeding has stopped, tape a gauze pad firmly over it.
> If the puncture site is on the arm, dont tape the entire circumference because this may restrict circulation.

> If the patient is receiving anticoagulants or has a coagulonopathy, apply pressure to the puncture site longer than 5 minutes if
necessary.
> Monitor vital signs and observe for signs of circulatory impairment.
Precautions
> Wait at least 20 minutes before drawing arterial blood when starting, changing, or discontinuing oxygen therapy. After initiating or
changing settings of mechanical ventilation or other extubation.
> Before sending the sample to the laboratory, note on the laboratory request whether the patient was breathing room air or
receiving oxygen therapy when the sample is collected.

Laboratory Test:
Date: March 2, 2015
Patient name: Lina, Teresa M.
Age/sex: 89/f

Pleural Fluids Analysis


MACROSCOPIC EXAMINATION

RESULT

NORMAL VALUE

CHEMICAL TEST

RESULT

NORMAL VALUE

VOLUME
COLOR
TRANSPARENCY
SPECIFIC GRAVITY
REACTION
MACROSCOPIC EXAMINATION

App. 850 cc
Yellowish
Hazy
1.010
8.0
RESULT

cc
Colorless

GLUCOSE
PROTEIN

**131.69
280.0

45 80mg/dL
8-43 mg/dL

WBC COUNT
LYMPHOCYTES
SEGMENTERS

200 cells

Clear
1.006 1.008
7.31
NORMAL VALUE
0-10 cumm

Definition:
- To assess and categorize fluid obtained from within the pleural space for infection, cancer, and blood as well as identify the cause
of its accumulation. Pleural fluid (5 mL) collected in a green-top (heparin) tube for amylase, cholesterol, glucose, lactate
dehydrogenase (LDH), pH, protein, and triglycerides; lavender-top (EDTA) tube for cell count; sterile containers for microbiology
specimens; 200 to 500 mL of fluid in a clear container with anticoagulant for cytology. Ensure that there is an equal amount of fixative
and fluid in the container for cytology.

Interpretation:
- There is the changes in color and transparency in the macroscopic examination, which may indicate there is an infection. There is a
very high increase in WBC count can be also a sign of infection.
Nursing responsibilities:
> Explain the test procedure. Explain that slight discomfort may be felt when the skin is punctured.
> Encourage avoiding stress if possible because altered physiologic status influences and changes normal hematologic values.
> Apply normal pressure and dressings over puncture site on removal of syringe needle.
> Monitor the puncture site for oozing or hematoma formation.
> Instruct to resume normal activities and diet.

Laboratory Test:

Electrocardiograph (ECG)
Definition:
- This is a definitive diagnostic procedure measuring electrical activity from a three dimensional perspective
Rate: 55 bpm
Rhythm: Junctional
Interval PR: none
QRS duration: 0.08 sec
QT: 0.44
Interpretation:
- Junctional Rhythm, Interdeterminate axis, anterior wall ischemia
Nursing Responsibilitites:
> The patient should be nursed in a high observation area. ECG monitoring can cause anxiety for the patient or their relatives,
especially if alarms sound.
> Alarms should be set appropriately and explained to the patient and their family, and the rationale for ECG monitoring should be
discussed. Patients and relatives are likely to monitor watch so informing them of acceptable values can reduce unnecessary
panic. > > Patients should also be advised that activities, such as brushing teeth, are likely to cause emergency alarms to sound.
Electrode repositioning and configuration can reduce the inci- dence of this.

> Once ECG monitoring has started, it is important that certain details of the procedure are documented. Following immediate
assessment, any changes in ECG rate or rhythm should be reported as appropriate. If rhythm or waveform morphology changes, a
diagnostic 12-lead ECG is usually indicated.