Diagnostic Procedures

Complete Blood Count

The CBC is used as a broad screening test to check for such disorders as anemia, infection, and
many other diseases. It is actually a panel of tests that examines different parts of the blood and
includes the following:
• White blood cell (WBC) count is a count of the actual number of white blood cells per
volume of blood. Both increases and decreases can be significant.
• White blood cell differential looks at the types of white blood cells present. There are five
different types of white blood cells, each with its own function in protecting us from
infection. The differential classifies a person's white blood cells into each
type: neutrophils (also known as segs, PMNs, granulocytes,
grans), lymphocytes, monocytes, eosinophils, and basophils.
• Red blood cell (RBC) count is a count of the actual number of red blood cells per volume of
blood. Both increases and decreases can point to abnormal conditions.
• Hemoglobin measures the amount of oxygen-carrying protein in the blood.
• Hematocrit measures the percentage of red blood cells in a given volume of whole blood.
• The platelet count is the number of platelets in a given volume of blood. Both increases and
decreases can point to abnormal conditions of excess bleeding or clotting. Mean platelet
volume (MPV) is a machine-calculated measurement of the average size of your platelets.
New platelets are larger, and an increased MPV occurs when increased numbers of platelets
are being produced. MPV gives your doctor information about platelet production in your
bone marrow.
• Mean corpuscular volume (MCV) is a measurement of the average size of your RBCs. The
MCV is elevated when your RBCs are larger than normal (macrocytic), for example in
anemia caused by vitamin B12 deficiency. When the MCV is decreased, your RBCs are
smaller than normal (microcytic) as is seen in iron deficiency anemia or thalassemias.

Nursing Responsibilities

• Explain the procedure to the client

• Emphasize that the procedure would be slightly painful
• Monitor puncture site for hematoma formation
• Notify physician of unusual problem or bleeding occurs
• Send the specimen directly to the laboratory
• Interpret test outcomes

Name of Procedure Normal Values Values Obtained Clinical

Interpretation
C BC CBC : 14-17 GMS % 15.0 GMS% The result in the
patient’s CBC was
HgB: 42- 51 VOL% 45.0 VOL% in normal condition
RBC COUNT: 5000- 9,200 but there is
10000 increased blood
2% count that may be
BASOPHILS: 2% caused by infection.
1%
METAMYELOCYTES:
 3-5%

STABS: 70%

SEGMENTS:27% 70%

27%

Urinalysis

The urinalysis is used as a screening and/or diagnostic tool because it can help detect substances
or cellular material in the urine associated with different metabolic and kidney disorders. It is
ordered widely and routinely to detect any abnormalities that require follow up. Often,
substances such as protein or glucose will begin to appear in the urine before patients are aware
that they may have a problem. It is used to detect urinary tract infections (UTI) and other
disorders of the urinary tract. In patients with acute or chronic conditions, such as kidney disease,
the urinalysis may be ordered at intervals as a rapid method to help monitor organ function,
status, and response to treatment.

Nursing Responsibilities

• Instruct the client to urinate in the toilet when he/she gets up early in the morning
• Instruct to collect all urine in the special container
• Cap the container, keep it in a refrigerator
• Instruct to label the container with complete name, date, time of completion and return it
as instructed
• Instruct to deliver it to the laboratory of your health care provider as soon as possible
upon completion.

Name of Procedure Normal Values Values Obtained Clinical interpretation

URINALYSIS COLOR: YELLOW YELLOW The result is normal
AMBER and clear but it is rare
when the epithelial
cells are viewed.
TRANSPARENCY:
CLEAR CLEAR

REACTION: 4.8 –
7.8 5.0

SPECIFIC
GRAVITY: 1.028 –
1.026 1.005

SUGAR: NEGATIVE
 PROTIEN: NEGATIVE
NEGATIVE

NEGATIVE
MICROSCOPIC:

RBC: 0-1/HPF

0-1/HPF
PUS CELLS: 0-
2/HPF

BACTERIA: FEW 0-2/HPF

EPITHELIAL
CELLS: FEW FEW

RARE

BLOOD GLUCOSE TEST

is a way of testing the concentration of glucose in the blood (glycemia). Particularly important in the care
of diabetes mellitus, a blood glucose test is performed by piercing the skin (typically, on the finger) to
draw blood, then applying the blood to a chemically active disposable 'test-strip'. Different manufacturers
use different technology, but most systems measure an electrical characteristic, and use this to determine
the glucose level in the blood.

Blood Glucose Test

GLUCOSE LEVEL INDICATION

From 70 to 99 mg/dL (3.9 to 5.5 mmol/L) Normal fasting glucose

From 100 to 125 mg/dL (5.6 to 6.9 mmol/L) Impaired fasting glucose (pre-
diabetes)

126 mg/dL (7.0 mmol/L) and above on more than one testing Diabetes
occasion

CT scanning
sometimes called CAT scanning—is a noninvasive medical test that helps physicians
diagnose and treat medical conditions.
CT scanning combines special x-ray equipment with sophisticated computers to produce
multiple images or pictures of the inside of the body. These cross-sectional images of the
area being studied can then be examined on a computer monitor, printed or transferred
to a CD.
CT scans of internal organs, bones, soft tissue and blood vessels provide greater clarity
and reveal more details than regular x-ray exams.
Using specialized equipment and expertise to create and interpret CT scans of the
body, radiologists can more easily diagnose problems such as cancers, cardiovascular
disease, infectious disease, appendicitis, trauma and musculoskeletaldisorders.

Magnetic resonance imaging (MRI)

is a noninvasive medical test that helps physicians diagnose and treat medical conditions.
MR imaging 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