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1.

Complete Blood Count (CBC)  It is a basic screening test and is one of the most frequently ordered
laboratory procedures.

The findings in the CBC give valuable diagnostic information about the hematologic and other body systems, prognosis, response to treatment, and recovery.

The CBC consists of a series of tests that determine the number, variety, percentage, concentration and quality of blood cells.

Tests
         White blood cell count (WBC): presence of infection Differential white blood cell count: specific patterns of WBC Red blood cell count (RBC): carries oxygen and carbon dioxide from lungs to tissue and vice versa Hematocrit (Hct): measures RBC mass Hemoglobin (Hgb): main component of RBC Red blood cell indices: calculated values of size and hemoglobin content of RBCs, important in anemia evaluation Platelet count: necessary for clotting and control of bleeding Red blood cell distribution width (RDW): indicates degree variability and abnormal cell size Mean platelet volume (MPV): index of platelet production

Normal Values in Adults

WBC: 5.0 10.0 x 103/mm3 RBC: 4.0 5.5 x 106/mm3 Hgb: 12.0 17.4 g/dL Hct: 36 52% Platelet: 140 400 x 103/mm3 RDW: 11.5 14.5% MPV: 7.4 10.4 fL
Nursing Considerations       Explain test procedure. Explain that slight discomfort may be felt when the skin is punctured. Encourage to avoid stress if possible because altered physiologic status influences and changes normal hematologic values. Explain that fasting is not necessary. However, fatty meals may alter some test results as a result of lipidemia. Apply manual pressure and dressings over puncture site on removal of dinner. Monitor the puncture site for oozing or hematoma formation. Instruct to resume normal activities and diet.

2. Lipid Profile
The lipid profile is a group of tests that are often ordered together to determine risk of coronary heart disease. They are tests that have been shown to be good indicators of whether someone is likely to have a heart attack or stroke caused by blockage of blood vessels or hardening of the arteries (atherosclerosis). The lipid profile typically includes:

y y y y

Total cholesterol High density lipoprotein cholesterol (HDL) often called good cholesterol Low density lipoprotein cholesterol (LDL) often called bad cholesterol Triglycerides

An extended profile may also include:

y y

Very low density lipoprotein cholesterol (VLDL-C) Non-HDL-C

How is the sample collected for testing? A blood sample is obtained by inserting a needle into a vein in the arm. Sometimes a drop of blood is collected by puncturing the skin on a fingertip. You need to fast for 9-12 hours before having your blood drawn; only water is permitted.

How is a lipid profile used? The lipid profile is used to help determine your risk of heart disease and to help guide you and your health care provider in deciding what treatment may be best for you if you have borderline or high risk.

When is it ordered? It is recommended that healthy adults with no other risk factors for heart disease be tested with a fasting lipid profile once every five years. You may be screened using only a cholesterol test and not a full lipid profile. However, if the cholesterol test result is high, you may have follow-up testing with a lipid profile.

What are risk factors (in addition to high LDL-C) for coronary heart disease? Risk factors include:

 

Cigarette smoking Age (if you are a male 45 years or older or a female 55 years or older)

 

Low HDL cholesterol (less than 40 mg/dL (1.04 mmol/L)) Hypertension (Blood Pressure of 140/90 or higher or taking high blood pressure medications)

Family history of premature heart disease (heart disease in a first degree male relative under age 55 or a first degree female relative under age 65)

Diabetes

LDL Cholesterol Optimal: Less than 100 mg/dL (2.59 mmol/L) Near/above optimal: 100-129 mg/dL (2.59-3.34 mmol/L) Borderline high: 130-159 mg/dL (3.37-4.12 mmol/L) High: 160-189 mg/dL (4.15-4.90 mmol/L) Very high: Greater than 190 mg/dL (4.90 mmol/L) Total Cholesterol Desirable: Less than 200 mg/dL (5.18 mmol/L) Borderline high: 200-239 mg/dL (5.18 to 6.18 mmol/L) High: 240 mg/dL (6.22 mmol/L) or higher HDL Cholesterol Low level, increased risk: Less than 40 mg/dL (1.0 mmol/L) for men and less than 50 mg/dL (1.3 mmol/L) for women Average level, average risk: 40-50 mg/dL (1.0-1.3 mmol/L) for men and between 50-59 mg/dl (1.3-1.5 mmol/L) for women High level, less than average risk: 60 mg/dL (1.55 mmol/L) or higher for both men and women Fasting Triglycerides Desirable: Less than 150 mg/dL (1.70 mmol/L) Borderline high: 150-199 mg/dL(1.7-2.2 mmol/L) High: 200-499 mg/dL (2.3-5.6 mmol/L) Very high: Greater than 500 mg/dL (5.6 mmol/L) 3. BLOOD SUGAR
Diabetes is a condition where success of treatment depends on how well you keep your blood sugar controlled. Monitor your reading on a chart. Over a period of time you will have the power to manage the condition yourself and will understand why your sugar level goes up or down.

Increase in concentration of glucose in the blood leads to a condition called "diabeticcoma" or hyperglycemia.

Fasting blood sugar (FBS) level is one of the tests used


to diagnose diabetes mellitus and an elevated fasting blood sugar level, the diagnosis of diabetes mellitus is usually made.

The fasting blood sugar is determined by taking a sample of venous blood after an overnight fasting. The sugar level is then evaluated in the blood sample.

In t erp ret i n g y our F ast i n g B lo od S ug ar ( FB S)

y y y

FBS < 100 mg/dl (5.6 mmol/l) = normal fasting blood sugar; FBS 100 125 mg/dl (5.6 6.9 mmol/l) = IFG (impaired fasting glucose); FBS 126 mg/dl (7.0 mmol/l) = provisional diagnosis of diabetes
Rat i on a le for usi n g fa st i n g b l oo d s ug ar The blood glucose level is usually maintained in a range of

2.2-3.9

mmol/L (40-70 mg/dl). Between meals, and even during an overnight


fast, that level is still maintained, even in the absence of food intake. The body does this by converting glycogen to glucose and, when necessary, fats to glucose). These two methods of producing glucose maintain a normal glucose level during fasting.

Random blood glucose test is also called a


simple glucose test.

You use to do it by yourself when you want to measure your blood sugar levels at any time during the day. Its very easy to perform it, thats why called simple (random) blood glucose test. You can use any glucose meters that can be found in the market. Basically, this is a test that you perform to get to know what the levels of your blood glucose are at any time of the day to better monitor your diabetes. So, the normal results you should get are between

70 to 100 mg/dl.

But if youre a diabetic, your acceptable figures could be till 130 mg/dl.

Its very important to get always steady results from this test. Even in case youre not a diabetic, you can perform this test to get to know if you have diabetes or not. Especially if you:

y y y

Are older than 50 years old. Have a family history of diabetes. Being part of high risk population.

In the above cases you can do this test. If you get results higher than 120 mg/dl but lower than 150 mg/dl, you may consider yourself a prediabetic. That means that you dont have diabetes yet, but youve high risk of having it in the future. But if you watch your diet strategy and what lifestyle changes you may do, you may consider yourself safe of diabetes. If you get results higher than 180 mg/dl, than you should repeat the test again and perform other tests to fully diagnose youre a diabetic.

Glycosylated Hemoglobin Test, or Hemoglobin A1c (HbA1c) is a test used to give you and your doctor the most
accurate picture of your overall diabetes control.

Sugar that is not used for energy is left in the blood, where it attaches itself to the hemoglobin, which is the part of the red blood cell that carries oxygen, in a process called glycosylation. The more glucose there is in the bloodstream, the more glucose builds up in the cells. This binding of sugar to molecules in cells is one way diabetes causes physical damage and health problems. The HbA1c test measures the amount of sugar that is attached to the hemoglobin in red blood cells, with results given as a percentage. Although different laboratories may use different testing methods, the percentage that occurs in people without diabetes is usually about six percent. Because red blood cells live in the bloodstream for about four months, the HbA1c test shows the average blood sugar for the past several months, similar to the way the batting average of a baseball player is calculated over a period of time. Unlike your regular blood sugar test, the HbA1c test is not affected by short-term changes. So even though you may have had high blood sugar on occasion, a good glycosylated hemoglobin result can show that, overall, you are doing a good job of controlling your diabetesThe chart below shows the average daily blood glucose levels for four different HbA1c values.

HbA1c Value Average daily blood glucose level over past three months 6% 120 mg/dl (pretty good) 8% 180 mg/dl (not too bad) 10% 240 mg/dl (not good) 13% 330 mg/dl (dangerous)
The HbA1c test should be done every three to six months, depending on your treatment program and level of control. Its a good idea to discuss the HbA1c test with your doctor or diabetes educator, and ask what the normal range for the test is at the laboratory your doctor uses. Then, when you find out your HbA1c value, youll know whether you are on target, or whether you need to work with your physician or diabetes educator on better control of your diabetes.

4. Electrolytes
Electrolytes are substances that become ions in solution and acquire the capacity to conduct electricity. Electrolytes are present in the human body, and the balance of the electrolytes in our bodies is essential for normal function of our cells and our organs. Common electrolytes that are measured by doctors with blood testing include sodium, potassium, chloride, and bicarbonate. The functions and normal range values for these electrolytes are described below. Sodium Sodium is the major positive ion (cation) in fluid outside of cells. The chemical notation for sodium is Na+. When combined with chloride, the resulting substance is table salt. Excess sodium (such as that obtained from dietary sources) is excreted in the urine. Sodium regulates the total amount of water in the body and the transmission of sodium into and out of individual cells also plays a role in critical body functions. Potassium (K) Potassium is most concentrated inside the cells of the body. The gradient, or the difference in concentration from within the cell compared to the plasma, is essential in the generation of the electricial impulses in the body that allow muscles and the brain to function.

Calcium (Ca) The bones are a dynamic store of the calcium in the body. They are constantly under the influence of the hormone calcitonin, which promotes bone growth and decreases calcium levels in the blood, and parathyroid hormone, which does the opposite. Calcium is bound to the proteins in the bloodstream, so the level of calcium is related to the patient's nutrition as well as the calcium intake in the diet. Calcium metabolism in the body is closely linked to magnesium levels. Often, the body's magnesium status needs to be optimized before the calcium levels can be treated.

Normal Values: Calcium 8.8 - 10.3 mg/dL Potassium 3.5 - 5.2 mEq/L Sodium 135 - 147 mEq/L 5. X-ray
An x ray is a procedure used to evaluate organs and structures for symptoms of disease. X rays are a form of radiation that can penetrate the body and produce an image on an x-ray film. Another name for the film produced by X rays is radiograph.

Types of XRay Exam


There is a wide range of xray tests, each of which is targeted at different body parts and conditions. Some of the specialized tests that you may come across as an x-ray technologist are:  Angiography  Arthrography  Barium x-rays  Bone Density Scan  Bone X-Ray  Chest X-Ray  Cystogram  Discography  Fluoroscopy  Intravenous Pyelography (IVP)  Mammography  Myelography  Skull Radiography  Virtual Colonoscopy (VC)

Preparation: There is no advance preparation necessary for x rays. Once the patient arrives in the exam area, a hospital gown will replace all clothing on the upper body and all jewelry must be removed. Aftercare: No aftercare is required by patients who
have x rays.

Risks: The only risk associated with X ray is minimal exposure to


radiation, particularly for pregnant women and children. Those patients should use protective lead aprons during the procedure. Technologists are cautioned to check carefully possible dislodging of any tubes or monitors in the chest area from the patient's placement during the exam.

Normal Results: A radiologist, or physician specially trained in the


technique and interpretation of X rays, will evaluate the results. A normal x ray will show normal structures for the age and medical history of the patient. Findings, whether normal or abnormal, will be provided to the referring physician in the form of a written report.

Abnormal findings on x rays are used in conjunction with a


physician's physical exam findings, patient medical history, and other diagnostic tests including laboratory tests to reach a final diagnosis.

6. Computed tomography (CT) scans


Computed tomography (CT) scans are completed with the use of a 360degree x-ray beam and computer production of images. These scans allow for cross-sectional views of body organs and tissues. Computed tomography is also known as computerized axial tomography or CAT scan. Because the computerized image is so sharp, focused, and threedimensional, many tissues can be better differentiated than on standard x rays. Common CT indications include:

y y y y y

Sinus studies Brain studies Body scans Aorta scans Chest scans

Aftercare: No aftercare is generally required following a CT scan.


Immediately following the exam, the technologist will continue to watch the patient for possible adverse contrast reactions. Patients are instructed to advise the technologist of any symptoms, particularly respiratory difficulty. The site of contrast injection will be bandaged and may feel tender following the exam. Hives may develop later and usually do not require treatment.

Risks: Radiation exposure from a CT scan is similar to, though higher than, that of a conventional x ray. Although this is a risk to pregnant women, the exposure to other adults is minimal and should produce no effects. Although severe contrast reactions are rare, they are a risk of many CT procedures. There is also a small risk of renal failure in high-risk patients.

Normal findings on a CT exam show bone, the densest tissue, as


white areas. Tissues and fluid will show as various shades of gray and fat will be dark gray or black. Air will also look black and darker than fat tissue. Intravenous, oral, and rectal contrasts appear as white areas. The radiologist can determine if tissues and organs appear normal by the different gradations of the gray scale. In CT, the images that can cut through a section of tissue or organ provide threedimensional viewing for the radiologist and referring physician.

Abnormal results may show different characteristics of tissues


within organs. Accumulations of blood or other fluids where they do not belong may be detected. Radiologists can differentiate among types of tumors throughout the body by viewing details of their makeup.

7. Magnetic resonance imaging (MRI)


Magnetic resonance imaging (MRI) is a noninvasive medical test that helps physicians diagnose and treat medical conditions. MRI uses a powerful magnetic field, radio frequency pulses and a computer to produce detailed pictures of organs, soft tissues, bone and virtually all other internal body structures. The images can then be examined on a computer monitor, transmitted electronically, printed or copied to a CD. MRI does not use ionizing radiation (x-rays).

Normal Values
Normal results mean there are no new growths, or problems or changes in the size or position of organs in the chest cavity.

What do Abnormal Results Mean?


Results depend on the part of the body being examined and the nature of the problem. Different types of tissues send back different MRI signals. For example, healthy tissue sends back a slightly different signal than cancerous tissue.

An abnormal chest MRI can be due to: y y y y y y y y y y


Abnormal blood vessels in the lungs Abnormal growth of cells in the esophagus Abnormal lymph nodes Aortic dissection Aortic stenosis Atrial myxoma Atrial septal defect Bacterial pericarditis Bronchial abnormalities Bronchiectasis

y y y y y y y y y y

Cardiac tamponade Chronic obstructive pulmonary disease (COPD) Coarctation of the aorta Constrictive pericarditis Cystic lung lesions Ischemic cardiomyopathy Lung tumors Mitral regurgitation - acute Mitral regurgitation - chronic Mitral valve prolapse

y y y y y

Other masses or tumors of the chest Pericardial effusion Pericarditis after heart attack Pleural abnormalities Restrictive cardiomyopathy

y y y y y

Skin lesion of histoplasmosis Swollen glands and enlarged lymph nodes in the chest SVC obstruction Thoracic aortic aneurysm Thymus tumor

Guidelines:
 Guidelines about eating and drinking before an MRI exam vary with the specific exam and also with the facility. For some types of exams, you will be asked to fast for 8-12 hours. Unless you are told otherwise, you may follow your regular daily routine and take medications as usual.  Some MRI examinations may require the patient to swallow contrast material or receive an injection of contrast into the bloodstream. The radiologist or technologist may ask if you have allergies of any kind, such as allergy to iodine or x-ray contrast material, drugs, food, the environment, or asthma. However, the contrast material most commonly used for an MRI exam, called gadolinium, does not contain iodine and is less likely to cause side effects or an allergic reaction.  The radiologist should also know if you have any serious health problems or if you have recently had surgery. Some conditions, such as severe kidney disease may prevent you from being given contrast material for an MRI. If there is a history of kidney disease, it may be necessary to perform a blood test to determine whether the kidneys are functioning adequately.  Women should always inform their physician or technologist if there is any possibility that they are pregnant. MRI has been used for scanning patients since the 1980s with no reports of any ill effects on pregnant women or their babies. However, because the baby will be in a strong magnetic field, pregnant women should not have this exam unless the potential benefit from the MRI exam is assumed to outweigh the potential risks.  If you have claustrophobia (fear of enclosed spaces) or anxiety, you may want to ask your physician for a prescription for a mild sedative prior to the scheduled examination.  Jewelry and other accessories should be left at home if possible, or removed prior to the MRI scan. Because they can interfere with the magnetic field of the MRI unit, metal and electronic objects are not allowed in the exam room. These items include:

y y y y y


Jewelry, watches, credit cards and hearing aids, all of which can be damaged. Pins, hairpins, metal zippers and similar metallic items, which can distort MRI images. Removable dental work. Pens, pocketknives and eyeglasses. Body piercings.

In most cases, an MRI exam is safe for patients with metal implants, except for a few types. People with the following implants cannot be scanned and should not enter the MRI scanning area unless explicitly instructed to do so by a radiologist or technologist who is aware of the presence of any of the following: internal (implanted) defibrillator or pacemaker cochlear (ear) implant some types of clips used on brain aneurysms

y y y


You should tell the technologist if you have medical or electronic devices in your body, because they may interfere with the exam or potentially pose a risk, depending on their nature and the strength of the MRI magnet. Examples include but are not limited to: artificial heart valves implanted drug infusion ports implanted electronic device, including a cardiac pacemaker artificial limbs or metallic joint prostheses implanted nerve stimulators metal pins, screws, plates, stents or surgical staples

y y y y y y


In general, metal objects used in orthopedic surgery pose no risk during MRI. However, a recently placed artificial joint may require the use of another imaging procedure. If there is any question of their presence, an x-ray may be taken to detect the presence of and identify any metal objects.

Patients who might have metal objects in certain parts of their bodies may also require an x-ray prior to an MRI. You should notify the technologist or radiologist of any shrapnel, bullets, or other pieces of metal which may be present in your body due to accidents. Dyes used in tattoos may contain iron and could heat up during MRI, but this is rarely a problem. Tooth fillings and braces usually are not affected by the magnetic field but they may distort images of the facial area or brain, so the radiologist should be aware of them.

Infants and young children usually require sedation to complete an MRI exam without moving. Moderate and conscious sedation can be provided at most facilities. A physician or nurse specializing in the administration of sedation to children will be available during the exam to ensure your child's safety while under the effects of sedation.

8. Ultrasound
Ultrasound uses high-frequency sound waves to look at organs and structures inside the body. Health care professionals use them to view the heart, blood vessels, kidneys, liver and other organs. During pregnancy, doctors use ultrasound tests to examine the fetus. Unlike xrays, ultrasound does not involve exposure to radiation. During an ultrasound test, a clear, water-based conducting gel is applied to the skin over the area being examined to help with the transmission of the sound waves. A special technician or doctor moves a device called a transducer over part of your body. The transducer sends out sound waves, which bounce off the tissues inside your body. The transducer also captures the waves that bounce back. Images are created from these sound waves.

There is generally little discomfort with ultrasound procedures. The conducting gel may feel slightly cold and wet.

Normal Values
The organs examined are normal in appearance.

What do Abnormal Results Mean?


The significance of abnormal results depends on the organ being examined and the nature of the problem. You should consult your health care provider with any questions and concerns. Many possible conditions could be revealed by an abdominal ultrasound. Some of these include:

y y y y y y y

Abdominal aortic aneurysm Cholecystitis Gallstones Hydronephrosis Kidney stones Spleen enlargement (splenomegaly) Pancreatitis

Contentment is not the fulfillment of what you want, but the realization of how much you already have. -Unknown