Laboratory Examination

Exam: CBC- Hematology

Taken: 02- 11- 10

Component Result Normal Values Possible Causes of

Abnormal Findings
Hemoglobin 10 12-15 Decreased
hemoglobin caused
by blood loss,
hemolytic anemia,
bone marrow
suppression or
sickle cell anemia
Hematocrit 0.30 0.37-0.45 Decreased
hematocrit caused
by blood loss,
overhydration,
dietary deficiency
or anemia.
Red Blood Cell 3.99 4.6- 5.2 Decreased number
Count of RBCs per cubic
millimeter caused
by abnormal loss of
erythrocytes,
abnormal
destruction of
erythrocytes, lack
of needed
elements or
hormones for
erythrocyte
production or bone
marrow
suppression.
White Blood Cell 8.18 5- 10 Within normal
Count range of total
number of WBCs in
a cubic millimeter
of blood.
Neutrophils 0.890 0.55- 0.65 Increase
Neutrophils there is
stress, or acute
infection.
Lymphocytes 0.100 0.25- 0.35 Decrease caused
by adrenal
corticosteroids and
other
immunosuppressiv
e drugs or
 autoimmune
diseases
Monocytes 0 0.02-0.1 Caused maybe of
drug therapy.
Eosinophils 0.010 0.02- 0.04 Caused maybe of
corticosteroid
therapy.
Basophils 0 0-0.05 Within normal
range.
Platelet 269 140-340 Within normal
range.
MCV (mean 75.70 86-100 Caused by iron
corpuscular deficiency anemia
volume)- the or lead poisoning.
mean or average
size of the
individual RBC.
MCH (mean 25.10 26-31 Caused maybe of
Corpuscular iron deficiency
hemoglobin)- anemia.
amount of
hemoglobin
present in one
cell.
MCHC (mean 33.10 31- 37 Within normal
corpuscular range
hemoglobin
concentration)-
the proportion of
each cell
occupied by
hemoglobin,

Urinalysis
Taken: 02-11- 10

Color Straw
Transparency Clear
Reaction 8.0
Specific gravity 1.005 Specific gravity is an
indicator of urine
concentration, or the
amount of solutes
(metabolic wastes and
electrolytes) present in
urine. The normal
specific gravity of urine
ranges from 1.010 to
1.025
Albumin Negative Albumin is a protein
 produced by the liver.
Sugar Negative Urine is tested for sugar
to screen clients for
diabetes mellitus and to
assess clients during
pregnancy for abnormal
glucose tolerance.
Wbc 3-5
Rbc 1-2
Amorphous urates Many
Mucous threads Few
Procedure:
Infants
• Clean the perineal area and the urethral opening as you would with an
adult client. Apply a specimen bag that has an adhesive backing that
attaches to the skin. After the infant has voided a desired amount,
gently remove the bag from the skin.
Children
• When collecting a routine urine specimen, explain the procedure in
simple nonmedical terms appropriate to the child and ask the child to
void using a clean collecting receptacle.
• Give the child a clean specimen container to play with.
• Allow a parent to assist if possible. The child may feel comfortable with
a parent present.
• For sterile urine specimens, straight catheterization may be necessary
in which the urinary catheter is inserted using sterile technique, the
specimen is obtained and the catheter is removed.

Blood Chemistry
Taken:02-11-10
Creatinine HIGH 1.5 mg/ dl 0.52-1.04
Sodium LOW 133 mmol/L 137- 145
Potassium LOW 3.2 mmol/L 3.5- 5.1
Creatinine, Sodium, Potassium are serum electrolytes to determine acid-
base imabalances. Creatinine is produced in relatively constant quantities
by the muscles and is excreted by the kidneys. Thus, the amount of
creatinine in the blood relates to renal excretory function. Sodium is major
determinants of serum osmolality that are used primarily to evaluate fluid
balance. An increase in serum osmolality indicates a fluid volume deficit, a
decrease reflects a fluid volume excess. Potassium indicates for
hypocalemia or hypercalamia. That of both extremes have negative effect
on the contraction of the heart.

Examination: Hgt
Sources: blood
Taken: 02-11-10

Result: 152 mg/dl

Procedure:
1. Prior to performing the procedure, introduce self and verify the client’s
identity using agency protocol. Explain to the client what you are going
to do, why it is necessary, and how he or she can cooperate.
2. perform hand hygiene and observe other appropriate infection control
procedures.
3. provide for client’s privacy.
4. prepare the equipment. Calibrate the meter and run a control sample
according to manufacturer’s instructions.
5. select and prepare the vascular puncture site. Choose a vascular site.
Avoid sites beside the bone. Wrap the fingers first in a warm cloth or
hold a finger a dependent position. If the earlobe is used, rub it gently
with a small piece of gauze
Anatomy
 Impaired Tissue Perfusion

Obstruction of coronary arteries

-Myocardial ischemia – resulting to
angina pectoris
Cerebro-vascular accident –
ischemia
Peripheral vascular disease leads to
ischemia
Pulmonary embolism

Nursing Care Plan

Assessment Diagnosis Planning Intervention Rationale Evaluation

S> “Masaki t Acute Pain Will > Provide > to promote > Met,
ang puson R/T cervical report comfort non client
ko.” As stated cancer that the measures like pharmacologic reported
>pain scale, discomfort pain will repositioning. al measures that pain
rated 7 as to be > Encourage was
0-10 pain alleviated use of alleviated.
>(+) facial . relaxation > to distract
grimace techniques like attention
>(+) imaging, or
guarding listening to
behavior music.
> Encourage
deep breathing
exercises. > to reduce
> Advise to tension
have adequate
rest period.
> to reduce
 fatigue
S> “Simula ng Fatigue R/T Will > Encourage to > to reduce Met, client
mag-chemo chemotherap report have adequate fatigue showed
ako lagi na ko y effect sense of rest period. energetic.
nanghihina.”a energy. > Encourage
s stated. forward
O> restless movement. > enhances
> poor commitment to
muscle >Schedule promoting
strength activities for optimal
periods when outcomes
client has the > to maximize
most energy. participation
> Limit
exposure to
temperature
and humidity
extremes.
> Encourage > it can
nutritionally negatively
dense, easy to impact energy
consume foods level
and avoid
caffeine and
high sugar > to promote
foods or drinks. energy
> Provide
diversional
activities like > Participating
watching t.v. in pleasurable
but avoid to activities can
overstimulate refocus energy
or and diminish
understimulate feelings of
. unhappiness,
sluggishness,
and
worthlessness
that can
accompany
fatigue.