DIAGNOSTICS AND LABORATORY PROCEDURES

This chapter presents and discusses the purposes and results of the diagnostics and laboratory
procedures ordered by the physician, vital to the process of discerning and understanding the condition
of the patient, as well as to assess the patient’s present condition after numerous collaborative
interventions.

Date and Time Description and Purpose Result of the Test

Procedure
March 4, On her routine prenatal Intrauterine Fetal Demise at 22
Pelvic Ultrasound Report check-up at Bambang, it weeks and 5 days by femur length
was found out that her singleton, in breech presentation
Bambang Hospital, Nueva baby has no heart beat as Oligohydramnios (AFI=3.14 cm)
Vizcaya what was shown in the < 3rd percentile for AOG
results of the ultrasound. Posterior placenta, Grade 0, No
Pelvic Ultrasound may previa.
visualize fibroid tumors,
ovarian growths, cysts,
and problems with the
fallopian tubes.

The results show that patient Mary has Intrauterine Fetal Demise at 22 weeks and 5 days by
femur length singleton and is in breech presentation.

Date and Time Description and Purpose Result of the Test

Procedure
March 4, 7:31pm Urinalysis is a test that Physical Examination
Urinalysis evaluates a urine sample. It  Color
includes remarks about the  Light yellow
urine color, appearance, and  Appearance
odor. The pH is determined.  Slightly Turbid
The urine is tested for the Chemical Examination
presence of proteins, glucose,  Specific Gravity( 1.000 to 1.030)
ketones, blood, and leukocyte  1.025
esterase.  pH (4.6-8.0)
 6.0
 Leukocyte Esterase and
Also, it used to assess bladder Erythrocyte
or kidney infections, diabetes,  Positive One
dehydration and preeclampsia  Nitrates, Glucose, Ketones,
 by screening for high levels of Urobilinogen, and Bilirubin
sugars, proteins, ketones and  Negative
bacteria.  Protein (<3+)
 Positive Three

Microscopic Examination
 Pus cells (5-10/hpf)
 3-5/ hpf
 RBC (≤2 RBCs/hpf)
 1-3/ hpf
 Yeast cells
 None/lpf
 Bacteria
 Moderate / hpf
 Epithelial cells
 Loaded/lpf
 Mucous threads
 None/ lpf
 Amorphous urates
 Few/lpf

The results of the test indicates that the client has an increased amount of protein in the
blood, which may be an indicative of Pre-eclampsia, if found in the later stages of pregnancy,
which is true for the patient. Also, it shows that there is presence of Urinary Tract Infection
(UTI) as patient Mary has a slightly increased Pus cell, with moderate amount of bacteria, and
has numerous amounts of epithelial cells in the urine. Also, the RBC has slightly increase due to
bleeding leading that may support the diagnosis of preeclampsia.

Date and Time Description and Purpose Result of the Test

Procedure
March 4, 10:16 PM Alanine Transaminase (ALT)tests  14-63 U/L
ROUTINE CHEMISTRY: checks for and measures damage to  23 U/L
1. SGPT/ALT the liver. This test is also done to
check for medical treatments that
may affect the liver.
2. SGOT/AST Aspartate Aminotransferase (AST) is  15-37u/L
often included in blood tests as a  43 U/L
measurement of liver health. High
levels of AST may be an indicative of
renal disease, while ALT is most often
associated with liver disease or
disorder.

3. BLOOD UREA Blood Urea Nitrogen (BUN) test is  2.5-6.4 mmol/L

NITROGEN(BUN ordered as a diagnostic tool used in  4.41 mmol/L
 ) examining liver and or kidney function.  7-18 mg/dL
Normal levels of BUN indicate a  12.35 mg/dL
normal liver and kidney function.
Overproduction in the liver or under-
excretion by the kidneys will cause
BUN levels to rise above normal.
Meanwhile, if the liver is not
producing enough BUN, results will
show a lower than normal value.

4. CREATININE Creatinine blood test measures the  53-115.0mmol/L

level of creatinine in the blood,  74.23mmol/L
which is done to check for kidney  0.6-1.3mg/ dL
function.  0.84

With the results of the routine chemistry specifically the Amino Transferase (AST) shows that
there is an increase in the amounts of AST, this may either indicate kidney damage, which results to an
additional release of AST in the bloodstream.High values of ASTmay associated with pre-eclampsia.

Date and Time Description and Purpose Result of the Test

Procedure
March 4, 10:26pm
Complete Blood Count
Complete Blood Count (CBC) is a  Hemoglobin Mass Conc.
blood test used to evaluate for 120-160 g/L:
presence of blood-related  150 g/L: Normal
disorders such as anemia,  Hematocrit: 0.37-0.47
infection and leukemia.  0.45: Normal
 WBC: 5-10 x 109/L:
This test is done to detect  11.58
additional signs of preeclampsia. Neutrophil: 0.50-0.70
 0.58: Normal
Lymphocyte: 0.20-0.40:
 0.37: Normal
Monocyte:0.0-0.10
 0.03:normal
Eosinophil: 0.0-0.07
 0.01:Normal
Basophils: 0.0-0.01
 0.01: normal
 RBC Count:4.04-5.48
 4.80: Normal
 Platelet Count: 150-400
 230:Normal
 The test shows that there is an increase in the WBC levels, which implies that there is infection.

Date and Time Description and Purpose Result of the Test

Procedure
March 4, 10:26 PM
ABO AND RH TYPING
The patient is expected to ABO = “B”
undergo Dilation and RH TYPE = POSITIVE
Curettage procedure, thus
this is done in preparation for
possible blood transfusions.

Patient M’s blood type is B positive.

Date and Time Description and Purpose Result of the Test

Procedure
March 5, 10:21PM Magnesium testing is done to  0.74-0.99mmol/l
ROUTINE CHEMESTRY: evaluate for increased or low levels  1.44mmol/l
MAGNESIUM of Magnesium in the blood.  1.8-2.4 mg/dL
Magnesium levels tend to be  3.50 mg/dL
decreased in the second and third
trimesters of pregnancy and could
be very low on pre-eclamptic clients.

The test shows that patient M has increased Magnesium serum levels.An increase in Magnesium
serum levels may indicate damage function of the kidneys. Patient M has been receiving Magnesium
Sulfate at March 5, 2016 via side drip. Excess of magnesium is excreted in the urine.

Date and Time Description and Purpose Result of the Test

Procedure
March 6, 6:08 am 24-hour urine collection is
24-Hour Urine collection used to assess for kidney Urine Creatinine: 5300-22300 umol/L
function and helps diagnose  13226.79
for kidney problems. Also, this
test measures the creatinine Urine Protein: 0-11.90 mg/dl
and protein levels, and other  21.23 mg/dL
chemical compounds.

Test results show that creatinine within the normal range; however the protein is above normal.
Increased protein level in the urine is an indicative of Pre-eclampsia.
 Date and Time Description and Purpose Result of the Test
Procedure
March 7, 8:12 AM A second 24-hour urine
24-hour Urine collection collection was ordered for 24 Hour urine protein: <119mg/day
comparisonand  5,270. 85
confirmation with the first
24-hour urine test Urine Protein: 0-11.90mg/dl
 117.13
conducted.

The result shows that there is an increase in protein levels in the urine.It shows that
there is an increase in the severity of preeclampsia. The more severe the condition becomes,
the greater the risk that complication will develop.