University of the Philippines Manila

The Health Sciences Center

COLLEGE OF NURSING
A World Health Organization Collaborating Center
Sotejo Hall, Pedro Gil Street, Ermita, Manila

LABORATORY STUDY

NAME OF STUDENT: Ma. Stefanie P. Reyes DATE OF ASSIGNMENT: August 10-13, 2010
NAME OF PATIENT: Gabriela R. Morante CIVIL STATUS: Single WARD: 9 BED
DIAGNOSIS OR CLINICAL IMPRESSION: Acute Lymphocytic Leukemia, NO.: 18
Cushing Syndrome AGE: 9 SEX: Female

NAME OF INDICATIONS FOR NORMAL SIGNIFICANCE OF THE

DATE/S DONE ACTUAL RESULTS/ FINDINGS
TEST/PROCEDURE THE TEST VALUE RESULTS/FINDINGS
Complete Blood Count (1) (2) (3) (4) (5)
(CBC) (1) July 26, c 4.0-11.0 4.77 3.4 5.6 3.6 3.1 • The client’s RBC counts are all
• WBC 2010 • The client was 9 significantly lower than normal. It
• RBC (2) July 30, diagnosed to 4.0-6.0 2.7 2.1 follows that her hemoglobin and
• Hemoglobin 2010 have Acute 6 3 HCT are also lower than normal.
• HCT (3) August 4, Lymphocytic 120-180 86 67 56 76 73 Her platelet counts are also low.
2010 0.370-0.540 0.2 0.1 0.1 0.2 0.2 These are all indicative of
• MCV Leukemia (ALL).
(4) August 6, Examining her 54 96 7 3 2 Leukemia.
• MCH
2010 blood cells for 80-100 92 92 •In the last 2 tests, the client’s
• MCHC (5) August 9, their number and 27.0-31.0 31. 31. lymphocyte counts are both
• RDW 2010 higher than normal. An increased
cell morphology is 2 5
• Platelets lymphocyte level is a clinical
very important. 320-360 339 342
• Neutrophil manifestation of Lymphocytic
11.0-16.0 14.4 14.2
• Lymphocytes Leukemia.
150-540 25 49 21 225 26
• Monocytes •The client’s eosinophil and basophil
0.500-0.700 0.57 0.56 0.3 0.1
• Eosinophils 6 9 counts are also both higher than
• Basophils 0.200-0.500 0.24 0.43 0.6 0.7 normal—another indication of
• Reactive 1 7 Leukemia.
Lymphocyte 0.020-0.090 0.4 0.1 •The first 2 tests indicated that the
0.000-0.060 0.1 client’s MCH levels are higher
0.000-0.020 0.01 0.1 than normal. This may indicate
Macrocyctic Anemia.
0.03
Blood Chemistry
• BUN July 24, 2010 • Test is used to 5-18 mg/dL 5.88 •The client’s decreased creatinine
• Creatinine measure the 15.3-61 μmol/L 5.2 concentration in her blood is a
• Uric Acid concentration of 0.15-0.5 0.25 manifestation of Leukemia.
• Albumin the different mmol/L • The client’s albumin level is also
• Total Bilirubin substance in 40-55 g/L 32 lower than normal. This may be
• Direct Bilirubin blood. Just like the 5-17 μmol/L 8.79 (0.51) due to her third-space losses.
• Indirect Bilirubin CBC, it is also 1.7-3.7 μmol/L 2.32 (0.14) •The client’s low potassium level and
• Alkaline used to determine 3.4-11.2 6.47 (0.38) high AST and ALT levels may
Phosphatase general health μmol/L possibly indicate hemolysis.
• AST status and to 50-120 UL 98
screen for and 15-30 U/L 47
• ALT monitor a variety 8-35 U/mL 109
• Magnesium of disorders. 0.62-0.95 0.82
• Phosphorus mmol/L
• Sodium 0.8-1.45 1.13
• Potassium mmol/L
• Chloride 135-145 137
mmol/L
3.5-5 mmol/L 2.7
97-107 mmol/L 99

NAME OF INDICATIONS FOR NORMAL SIGNIFICANCE OF THE

DATE/S DONE ACTUAL RESULTS/ FINDINGS
TEST/PROCEDURE THE TEST VALUE RESULTS/FINDINGS
Blood Typing July 30, 2010 • Test is done to O+ • The client occasionally needs to
identify client’s blood undergo blood transfusion
type for possible because of her disease. Therefore,
transfusion. blood typing is very important to
ensure blood compatibility.
Urinalysis (1) (2)
Physical Analysis (1) July 24, • General health • The client’s urine samples might
Color 2010 screening used to Amber yellow Yellow Light yellow have appeared to be turbid and
Transparency (2) July 28, detect renal and Clear Turbid Hazy hazy due to the presence of red
Chemical Analysis 2010 metabolic diseases. blood cells, bacteria and pus.
Blood • It is also used for +3 +3 • The result of the test indicates
Bilirubin the diagnosis of - - - that the client has significantly
Urobilinogen diseases or disorders Normal Normal higher than normal RBC counts in
Ketones of the kidneys or - - Trace her urine sample. Her WBC counts
urinary tract. - - Trace are also high which may indicate
Albumin
- - - infection in the urinary tract.
Nitrite
Trace Trace Trace • The presence of bacteria in her
Glucose
4.6-8.0 7 8.5 urine sample is an indication of
pH urinary tract infection.
Specific Gravity 1.005-1.030 1.022 1.010
Leukocytes - - -
Urine Sediment Analysis
RBC 2 31 1778
RBC morphology Normal Normal
0-4 9 34
WBC
0 0 0
Casts
71 104
Bacteria
Fecalysis (1) (2)
Color (1) July 27, • Test is used to Reddish Yellowish brown • The 2nd test indicated that the
Consistency 2010 detect the ff: Watery Soft client has the ova of Ascaris
Parasites (2) July 29, bacterial, protozoan (+) Ascaris lumbricodes and Blastocystis
2010 or parasitic lumbricodes hominis in her GI tract. This may
enterocolitis. (-) ova
RBC (+) Blastocystis prompt medical treatment.
WBC • Also used to detect hominis
Yeast Cells occult blood which Abundant/ (-)/hpf
Occult Blood may indicate hpf
bleeding in the GI 0-4/hpf (-)/hpf
 tract, - -
- -
Serum Potassium July 29, 2010 3.5-5 mmol/L 4.9 • The client’s potassium level
went back to normal. (compared
to previous)
Serum Cortisol August 4, 2010 5-10 ug/dL 11.2 • The client’s high cortisol level is
a manifestation of Cushing
syndrome.
Serum LDH August 4, 2010 100-190 u/L 392 • Her high LDH level may indicate
lymphoma or hemolysis.
Immunopathology July 30, 2010
Salmonella IgG > 1.1 0.406 (Nonreactive)
> 1.1 1.245 (Reactive)
Salmonella IgM