DIAGNOSTIC AND LABORATORY PROCEDURES:

ELECTROLYTES, KIDNEY AND LIVER FUNCTION TESTS

Diagnostic and Analysis and

Date ordered Indication(s) or Results (1st, 2nd,
Laboratory Normal Values Interpretation (book-
Date result(s) in Purpose(s) 3rd)
procedure(s) based)

Alkaline D.O: Measures liver 661 IU/L 64-306 IU/L Results show elevated
Phosphate function and levels of Alkaline
diagnoses liver Phosphatase that suggest
disease. evidence of liver disease.

Results show elevated

SGOT/AST D.O. Determines the extent 46 IU/L 10-40 IU/L SGOT levels, which
of liver damage. indicate possible damage in
the liver.

Determines the extent Results show elevated

SGPT/ALT D.O. of liver damage. 74.4 IU/L 0-39 IU/L SGPT levels, which
indicate alteration in the
liver function.

To help diagnose and

monitor acute or The result of the serum
SERUM K chronic pancreatitis 3.0 mmol/L 3.5-5.0 mmol/L potassium level is
LEVELS and other disorders decreased.
that may involve the
pancreas.
 To evaluate fluid and
electrolyte status.
The result of the calcium
Calcium 1.96 mmol/L 2.02-2.60 mmol/L level of the calcium is
below the normal range.

To evaluate fluid and

electrolyte status.
Results are within normal
136-145 mmol/L range.
Sodium 139 mmol/L
 ULTRASOUND

Diagnostic and
Date ordered Indication(s) or Analysis and
Laboratory Results(1st,2nd,3rd) Normal Findings
Date result(s) in Purpose(s) Interpretation
procedure(s)

Ultrasound D.O: It is a non- invasive 04-26-07 The liver is the largest Complex mass,
04-26-07 test performed which The liver is enlarged. internal organ in the quadrate lobe of the
provides images of There is an ovoid mass body, weighing about liver liver abcess
D.R: the interior of the in the quadrate lobe of 1.3 kg (3lbs.) in the possibly amebic is
04-26-07 hepatobiliary tract on the liver. Mass is adult. It should be considered.
a monitor. To detect complex, mainly cystic within normal size and
foreign bodies and to and measures echotexture.
distinguish between 89x86x69mm Biliary
cystic and solid ducts, both intrahepatic
masses (tumors). 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 stones
nor sludge.
 HEMATOLOGIC TESTS

Diagnostic and Analysis and

Date ordered Indication(s) or
Laboratory Results(1st,2nd,3rd) Normal Values Interpretation (book-
Date result(s) in Purpose(s)
procedure(s) based)
Hemoglobin D.O: To evaluate iron 110gm/L 125-175gm/L Below normal range.
(Hgb) 04-28-07 status and oxygen The patient has
carrying capacity of decrease number of
D.R: RBC. Aids in the hemoglobin content and
04-28-07 determination of may be unable to carry
anemia or adequate amount of O2
polycythemia. in a RBC to tissues.

The patient’s
hematocrit is below the
Evaluates anemia and normal range.
Hematocrit D.O: fluid balance and 0.33 0.40-0.52 L/L There is decrease
(Hct) 04-28-07 measures percentage of RBC in a
concentration of RBC whole blood. Patient
D.R: in the blood volume. may have alterations in
04-28-07 hydration status.

Patient’s WBC count is

above normal range.
The WBC counts This indicates possible
measures the number infection and
White Blood D.O: of WBC’s in a cubic 16.2 5-10 x 109/L inflammation.
Cells 04-28-07 millimeter of blood.
It is used to detect
D.R: infection or
04-28-07 inflammation. The result of the
neutrophils is above the
 It is used to detect normal range. This
infection or indicates that the
inflammation. patient has an infection
Neutrophils D.O: 0.75 0.45-0.65 or inflammation.
04-28-07
The result is within the
D.R: normal range.
04-28-07
Indicates the amount
of lymphocytes
participating with
Lymphocytes D.O: macrophages at a site 0.24 0.20-0.35
04-28-07 of a local injury.
The result is within the
D.R: normal range.
04-28-07

Platelet Count D.O: 192 150-400 x 109/L

04-28-07 The result is within the
Complex method for normal range.
D.R: testing the normalcy
04-28-07 of intrinsic
coagulation process.

PARTIAL D.O: 29.4 seconds 35-45 seconds

PROTHROMBI 04-28-07
N TIME (PTT)
D.R:
04-28-07
Diagnostic Procedures

Diagnostic/ Date Ordered Indication(s) or Results (1st, 2nd, Normal Values Analysis and Nursing
Laboratory Date Result(s) In Purpose(s) 3rd…) (Units used in Interpretation of Responsibility
Procedures the Hospital) Results
CBC DO:09-26-03 To determine RBS = 5.6 3.85-9 mmol/l Normal -Explain
DRI:09-26-03 blood mmol/l procedure
components for BUN = 4.7 1.7-8.3 mmol/l Normal -evaluate
comparison. mmol/l patient’s
Crea = 67.6 58-100 mmol/l Normal understanding.
mmol/l
T.Bili = 17.1 0.25-25.65 Normal
mmol/l mmol/l
D.Bili = 10.26 0-8.55 mmol/l Normal
mmol/l
T. CHON = 57.4 63-85 gm/l Normal
gm/l
Albumin = 25.6 34-50 gm/l Normal
gm/l
Glob. = 31.8 18-32 gm/l Normal
gm/l
A/G ratio = 8.05 15-24 Low
Alk. Phos. = 64-306 IU/l High(possible
1032 IU/l fibrosis)
SGOT = 42.4 10-40 IU/l High(hepatic
IU/l disease)
SGPT = 36.1 0-39 IU/l Normal
IU/l

HbsAg DO:09-026-03 To determine if Non-reactive Non-reactive Normal -Explain

 DRI:09-26-03 the patient is procedure
infected with -evaluate
Hepa B. patient’s
understanding.
Serum NA, K DO:09-26-03 To determine if Na = 123 mmol/l 135-155 mmol/l Low(Due to
DRI:09-26-03 the patient is vomiting)
suffering from K = 3.03 mmol/l 3.4-5.3 mmol/l Low(due to loss
hypokalemia. of body fluids)
UA DO:09-26-03 To determine if Color: Dark Color:Straw Normal -Explain or
DRI:09-29-03 the content of Yellow clarify test
patient’s urine. Trans: Turbid Trans: clear Due to purpose and
component procedure.
Sugar: (-) Sugar:none Normal -evaluate patient
Alb.: (-) Alb.:none Normal understanding.
Rxn: acidic Rxn: acidic Normal
Sp.Gr.: 1.015 Sp.Gr.: 1.005- Normal
1.020
Pus: 8-10 HPF Pus: 0-4/HPF High
Crystals:
Amor. Urates: Amor.Urates:
moderate Few High
Epithelial cells: Epi. Cells: few
moderate High
Bacteria: 5 Bacteria: none High(infection)
CXR DO:09-26-03 To determine if NA -Make sure all
DRI: patient may have jewelry and
PTB. dentures are
removed.
-Explain
procedure to
patient.
Fecalysis with DO:09-29-03 To determine if NA -Explain or
occult blood DRI: there is any clarify test
internal purpose and
bleeding. procedure.
-evaluate patient
understanding.
-Make sure the
specimen is
given to the lad
asap.

Peritoneal Fluid DO:09-26-03 To determine Color: light Color: clear to Normal -Explain
Analysis DRI:09-30-03 components in yellow pale yellow procedure
the peritoneal Trans: sl-turbid Trans: clear Due to -get signed
fluid and T. Cell count: 10 peritonitis consent
determine cause Diff. Count: all -apply pressure
of ascites. lymphocytes dressing
Protein: .28g/l Protein: 0.3 – 4.1 -measure
g/dl abdominal girth
Glucose: 60 Glu: 70-100 -monitor urine
mg/dl output for at
Microorganisms: Microorganisms: least 24 hours.
Gram Stain: no None
micro found
AFB stain: (-)
Remarks: RBC
crenated (+)
 IV. Diagnostic and laboratory procedures
Diagnostic/ Indications or Date ordered/ date Results Normal values Analysis and
Laboratory Purpose results were Interpretation of
Procedure released Results

1st The complete blood July 29, 2007 HCT % 0.22 F – 0.38 - 0.48 The result is below
count is the
normal.
calculation of the
COMPLETE cellular (formed A low hematocrit is
BLOOD COUNT elements) of blood. referred to as being
This is to detect anemic. Some of the
hematologic most common
disorders neoplasm, reasons are loss of
or immunological blood (bleeding) or
abnormality like nutritional
known or suspected deficiency (iron,
anemia; monitor vitamin B12,
blood loss; folate).
determine the
oxygen carrying WBC Count(x1 8/l)
capacity of the
blood; and evaluates 10.6 5-10 X 109 The result is above
the hemoglobin
normal.
content.
Increased WBC
(leukocytosis)
indicates a sign of
infection.
 Lymphocytes 0.25 0.20 - 0.35 It is within the
normal range.

HGB (g/dl) 74 115-155 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 0.38 - 0.48 The result is below
normal.

WBC 10.1 5-10X109 It is slightly below

the normal range.
 Lymphocytes
0.22 0.20-0.35 The result is within
the normal range.

HGB (g/dl) 70 115 - 155 It is below normal.

Neutrophils 0.73 0.45 - 0.65 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 F .38-.48 The result is below
normal.

HGB (g/dl) 117 115-155 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 Purpose results were Interpretation of
Procedure released Results

URINALYSIS The urinalysis is July 30, 2007 MACROSCOPIC

used as a screening Color Yellow Straw It is within the
and/or diagnostic normal range.
tool because it can
help detect
 substances or S.G 1. 010 1.005 – 1.030 It is within the
cellular material in normal range.
the urine associated
with different Sugar
metabolic and Negative Negative It is normal.
kidney disorders.
Often, substances
such as protein or Appearance
glucose will begin to Clear Clear It is normal.
appear in the urine
before patients are
aware that they may Reaction pH6.5 pH 4.6 – 8.0 It is within the
have a problem. It is normal range.
used to detect
urinary tract Albumin
infections (UTI) and Negative Negative It is normal.
other disorders of
the urinary tract. In MICROSCOPIC
patients with acute Pus Cells : 0-1 HPF
or chronic
conditions, the Red Cells: 2-4 HPF
urinalysis may be
ordered at intervals
as a rapid method to
help monitor organ
function, status, and
response to
treatment.

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/ Indications or Date ordered/ date Results Normal values Analysis and
Laboratory Purpose results were Interpretation of
Procedure released Results

COAGULATION These tests measure Aug.05,2007 Bleeding Time

TEST how quickly your 1’30” 1-3 min. It is within the
blood clots.  An normal range.
abnormality could
result in excessive Clotting Time
bleeding or 3’00 2-5 min. It is within the
excessive clotting normal range.
(which is difficult to
 measure).    MCV
74.8 82-92 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.

MCH
27.8 27-33 It is within the
normal range.

MCHC
35.8 31-36 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