CASE: PULMONARY TUBERCULOSIS

GROUP D: NCM 104 RLE-CD BSN 3Y2-1

SUBMITTED TO: Gerardo Nicolas, RN, MAN

GROUP MEMBERS CONTRIBUTION

Hipple, Lesley S. Question #1: ANATOMY & PHYSIOLOGY
Jagna, Ma. Christina Sirikit N. Question #2: PATHOPHYSIOLOGY
Lascañas, Miafel B. Question #3: DRUG STUDY
Majan, Irica S. Question #4: NCP #2 (Acute Pain)
Mallare, Michelle Gliselle G. Question #4: NCP #1 (Ineffective Breathing Pattern)
Quiambao, Razelle F. Question #5: LABS (CBC)
Rebadavia, Shaira D. Question #5: LABS (Pleural Fluid Analysis & Serum)

I. ANATOMY & PHYSIOLOGY

Respiration is the biochemical process in which the cells of an organism obtain energy by
combining oxygen and glucose, resulting in the release of carbon dioxide, water, and ATP (the
currency of energy in cells).  When you breathe, you are taking in oxygen with each inhale and
releasing carbon dioxide with each exhale. This gas exchange is important for respiration, but
while breathing is a physical process, respiration can be thought of as more of a chemical
process. the human respiratory system consists of the respiratory tract and the lungs. Mechanism
of respiration involves the breathing mechanism and exchange of gases. The gaseous exchange
occurs by diffusion in the alveoli. It depends upon the pressure differences between blood and
tissues, or atmospheric air and blood. The exchange of gases takes place at the surface of the
alveolus.

RESPIRATORY TRACT
The respiratory tract cleans, warms, and moistens air during its trip to the lungs. The tract
can be divided into an upper and lower part. The upper part consists of the nose, nasal cavity,
pharynx (throat), and larynx (voice box). The lower part consists of the trachea (windpipe),
bronchi, and bronchial tree.

The nose has openings to the outside that allow air to enter. Hairs inside the nose trap dirt
and keep it out of the respiratory tract. The external nose leads to a large cavity within the skull,
the nasal cavity. This cavity is lined with mucous membrane and fine hairs called cilia. Mucus
moistens the incoming air and traps dust. The cilia move pieces of the mucus with its trapped
particles to the throat, where it is spit out or swallowed. Blood vessels in the nose and nasal
cavity release heat and warm the entering air.

Air leaves the nasal cavity and enters the pharynx. From there it passes into the larynx,
which is supported by a framework of cartilage (tough, white connective tissue). The larynx is
covered by the epiglottis, a flap of elastic cartilage that moves up and down like a trap door. The
epiglottis stays open during breathing, but closes during swallowing. The valve mechanism
keeps solid particles (food) and liquids out of the trachea. If something other than air enters the
trachea, it is expelled through automatic coughing.

Air enters the trachea in the neck. Mucous membrane lines the trachea and C- shaped
cartilage rings reinforce its walls. Elastic fibers in the trachea walls allow the airways to expand
and contract during breathing, while the cartilage rings prevent them from collapsing. The
trachea divides behind the sternum (breastbone) to form a left and right branch, called bronchi
each entering a lung.

THE LUNGS

The lungs are two cons-shaped organs located in the chest or thoracic cavity. The
heart separates them. The right lung is somewhat larger than the left. The lungs also contain
elastic tissues that allow them to inflate and deflate without losing shape and are covered by a
thin lining called the pleura. The lungs are involved in the important process of breathing. The
oxygen inhaled from the outside environment enters into the blood and the carbon dioxide leaves
the blood. This inhaling and exhaling are facilitated by the lungs
A fluid between the two membrane layers reduces friction and allows smooth movement
of the lungs during breathing. The lungs are divided into lobes, each one of which receives its
own bronchial branch. Inside the lungs, the bronchi subdivide repeatedly into smaller airways.
Eventually they form tiny branches called terminal bronchioles. Terminal bronchioles have a
diameter of about 0.02 inch (0.5 millimeter). This branching network within the lungs is called
the bronchial tree.
The terminal bronchioles enter cup-shaped air sacs called alveoli. The average person has
a total of about 700 million-filled alveoli in the lungs. These provide an enormous surface area
for gas exchange. A network of capillaries (tiny blood vessels) surrounds each alveoli. As blood
passes through these vessels and air fills the alveoli, the exchange of gases takes place: oxygen
passes from the alveoli into the capillaries while carbon dioxide passes from the capillaries into
the alveoli.
This process of external respiration causes the blood to leave the lungs laden with oxygen
and cleared of carbon dioxide. When this blood reaches the cells of the body, internal respiration
takes place. The oxygen diffuses into the tissue fluid and then into the capillaries. The carbon
dioxide-filled blood then returns to the lungs for another cycle.

MECHANICS OF BREATHING

Inhalation and exhalation are how your body brings in oxygen and gets rid of carbon dioxide. The
process gets help from a large dome-shaped muscle under your lungs called the diaphragm. When
you breathe in, the diaphragm moves downward toward the abdomen, and the rib muscles pull
the ribs upward and outward. This makes the chest cavity bigger and pulls air through the nose or
mouth into the lungs. The air which we breathe in and out of the lungs varies in its pressure. So
basically, when there is a fall in air pressure the alveolar spaces fall and the air enters the lungs
(inspiration) and as the pressure of the alveoli within exceeds the atmospheric pressure, the air is
blown from the lungs (expiration). The flow rate of air is in proportion to the magnitude of the
pressure difference

II. PATHOPHYSIOLOGY
 III. DRUG STUDY
MEDICATION/ MECHANISM OF INDICATIONS/ POSSIBLE SIDE NURSING
CONTRAINDICATION
DRUGS ACTION DRUG RATIONALE EFFECTS CONSIDERATIONS

BRAND NAME: Reduces fever by Used for the relieve of  Contraindicated with  Chest pain  Monitor for relief of headache/
AEKNIL acting on the fever, headache and allergy to  Dyspnea if the fever has been reduce.
hypothalamus to mild to moderate pain acetaminophen or any  Maintain/monitor temp if 37.5
 Rash
GENERIC NAME: cause vasodilation
components.  Fever or higher.
PARACETAMOL and sweating
   Use cautiously with  Acute kidney  Instruct the client to report if
CLASSIFICA impaired hepatic failure any of the adverse effect has
TION:  function, chronic  Jaundice reaction.
Non-Steroidal Anti- alcoholism.  Educate client that high doses or
 Hepatic toxicity
Inflammatory
and failure unsupervised long term use of
(NSAID),
Non-Opioid the medicine can cause liver
Analgesics, damage.
Anti-pyretics  Make sure not to exceed the
  recommended dosage.
DOSE/ ROUTE/
FREQUENCY:
30mg TIV q4

BRAND NAME: Works by inhibiting Is used to lower Hypersensitive to  Pain  Assess patients previous
FORGRAM the mucopeptide respiratory tract cephalosporin, penicillins  Induration sensitivity reaction to penicillin
synthesis in the infection. and related abx. or other cephalosphorins.
 Phlebitis
GENERIC NAME: 
bacterial cell wall.  Rash  Assess patient for sign and
CEFTRIAXONE
The beta lactam  Diarrhea symptoms of infection before
CLASSIFICA moiety of  Thrombocytosis and during treatment.
TION:  ceftriaxone binds to  Report signs such as petechiae,
 Leucopenia
3rd Generation carboxypeptides., ecchymotic areas, epixtaxis or
Cephalosporin  Glossitis
endopeptidases and other forms of unexplained
 Respiratory super
transpeptidases in bleeding.
DOSE/ ROUTE/ infection
the bacterial  Assess for possible upper
FREQUENCY:
2g TIV OD cytoplasmic respiratory infection, itching
membrane. and fever.

These enzymes are

involved in cell wall
 synthesis and cell
division. By binding
to these enzymes
ceftriaxone result in
the formation of
defective cell walls
and cell death

BRAND NAME: Inhibits protein Used to treat bacterial Contraindicates  Diarrhea  Inquire about previous
BIAXIN synthesis in infection caused by S. with  Abdominal hypersensitivity to other
  susceptible bacteria, pyogenes, S. hypersensitivity macrolides before treatment.
Discomfort
GENERIC NAME:  causing cell death pneumonia to clarithromycin,  Nausea  Assess patient for infection
CLARITHRO
MYCIN Used to treat lower erythromycin, or  Dyspepsia (Vital Signs, Appearance of
  respiratory infection any macrolide  Headache sputum, urine, and stool;
CLASSIFICA caused by abx. WBC) at beginning of and
 Urticaria
TION:  myocasplasmapneumo Use cautiously throughout therapy.
Anti-Infective; niae s. pneumonia, H. with colitis  Monitor for super infection
Macrolide Antibiotic Influenzae, M. hepatic or renal
 
catarrhalis. impairment.
DOSE/ ROUTE/
FREQUENCY:
50mg tab BID

BRAND NAME: Exhibits anti For pain on Hypersensitivity to  Rash  Ask for history of Allergy to
ASPIRIN pyretic, anti integumentary salicylates, sever anemia,  Gastrointestinal salicylates or NSAIDs;
  inflammatory and structures, myalgia, hx of blood coagulation  Monitor CBC, clotting times,
ulcerations
GENERIC NAME: urinalysis, stool guaiac, LFTs,
analgesics effects. neuralgia, headache. defects, vitamin k  Abdominal pain
ACETYLSAL renal function tests.
YSILIC ACID The antipyretic Used to thin out the deficiency.  Upset stomach  Assess for pain; type, location
(ASA) effect is due to an blood in order to  Heartburn and pattern
  action on the control blood pressure,  Note for asthma
 Drowsiness
CLASSIFICA hypothalamus, also to prevent blood  Monitor renal lft and CBC.
 Headache
TION: resulting in heat loss clotting which can lead  Determine hx of peptic ulcers
NSAIDs,  Cramping
by vasodilation of to occlusions therefore or bleeding tendencies
Non-selective  Nausea
peripheral blood increasing blood
cyclooxygenase  Gastritis
(COX) Inhibitor vessels. Anti pressure
inflammatory  Bleeding
 
DOSE/ROUTE/FRE effects are mediated
QUENCY: by a decrease in
80mg tab OD prostaglandin
synthesis. It also
decreases platelet
aggregation,

BRAND NAME: Binds to mu-opioids It is used to relieve  Hypersensitivity t drug  Nausea  Assess type, location and
ULTRAM receptors. moderately severe pain or opioids  Vomiting intensity of pain 2-3 hours after
  Inhibits reuptake of  Severe renal or hepatic administration.
 Sweating
GENERIC NAME: serotonin and impairment  Drowsiness.  Assess previous analgesic hx.
TRAMADOL
  norepinephrine in  Suicidal patients  Tramadol is not recommended
CLASSIFICA the CNS  Acute intoxication on pt that depends on opioids,
TION: from alcohol, may cause opioids withdrawal
Opioid Analgesics hypnotics, centrally for pt who received more than
  1 week of opioids then
acting analgesics,
DOSE/ ROUTE/
opioids, or suddenly stops.
FREQUENCY:
50mg TIV q6 psychotropic drugs
 GI obstruction
 Concomitant use of
MAOI
 Significant respiratory
depression or acute or
severe bronchial
asthma or hypercapnia
in unmonitored
settings
 Breastfeeding women
BRAND NAME: Inhibits Hypotension,  Hypersensitivity to  Dizziness  Monitor patients BP
COSAAR vasoconstrictive and Nephepatically in type drug  Fatigue  Monitor patients who are also
  aldosterone- 2 diabetic patients, to  Concomitant use with  Headache taking diuretics for
GENERIC NAME:
secreting action of reduce risk for CVA in aliskiren in diabetic  Insomnia symptomatic hypotension
LOSARTAN
  angiotensin II by pt with HPN patients  Chest pain  Assess patients renal function
CLASSIFICA blocking receptor on  Use cautiously in  Tell patient to avoid salt
 Edema
TION:  the surface of patients with renal or substitutes
 Nausea
Angiotensin receptor vascular smooth hepatic dysfunction
blockers (ARBs)  Muscle cramps
muscle and other
   Respiratory cough
DOSE/ ROUTE/ tissue cells.  Nasal congestion
FREQUENCY:
50mg OD

BRAND NAME: Atorvastatin Reduction of risk of  Hypersensitivity to  Headache  Stress that atorvastatin is an
LIPITOR competitively stroke and heart attack drug  Flatulence adjunct to-not substitute for
  inhibits HMG-CoA in type 2 diabetes pts  Active liver disease or low-cholesterol diet
 Diarrhea
GENERIC NAME: 
reductase, the witout evidence of unexplained persistent  Nausea &  Tell patient to take drug at the
ATORVASTATIN
  enzyme that heart disease but with elevations of Vomiting same time each day to maintain
CLASSIFICA catalyses the other CV risk factors. transaminase levels,  Anorexia its effects
TION: conversion of Used to lower porphyria.  Instruct patient to take a
 Chest pain
Dyslipidaemic agent HMG-CoA to cholesterol that could missed dose as soon as
 Rashes
  mevalonic acid. be contributing to possible. If it’s almost time for
DOSE/ ROUTE/  Myalgia
This results in the increased blood his next dose, he should skip
FREQUENCY:  Allergy
induction of the pressure and also taken the missed dose.
40mg tab OD  Infection
LDL receptors, to prevent heart  Advise patient to notify
leading to lowered disease, including prescriber immediately if he
LDL-cholesterol heart attacks and develops unexplained muscle
concentration. strokes pain, tenderness, or weakness,
especially if accompanied by
fatigue or fever.

BRAND NAME: Increase peripheral Used in patients with Contraindicate with  Heartburn  Monitor hx of allergy to the
FORTAMET utilization of type 2 diabetes. allergy to Metformin;  Stomach pain medication.
  glucose, decrease Controlling high blood CHF; Diabetes  Do not discontinue without
 Nausea
GENERIC NAME:
hepatic glucose sugar helps prevent complicated by fever,  Vomiting consulting the physician.
METFORMIN
  production and alter kidney damage, sever infection, severe  Bloating  Monitor ketones and glucose
CLASSIFICA intestinal absorption blindness, nerve trauma, ketosis, acidosis. as prescribed.
 Constipation
TION:  of glucose. problems, loss of  Monitor urine or serum
 Weight loss
Biguanides limbs, and sexual glucose levels frequently to
  function problems. determine effectiveness of drug
DOSE/ ROUTE/
FREQUENCY: and dosage.
500mg tab BID  WARNING: Arrange for
transfer to insulin therapy
during periods of high stress
(infections, surgery, trauma).
 WARNING: Use IV glucose if
 severe hypoglycemia occurs as
a result of overdose.

BRAND NAME: Calcium channel Uses to treat mild to  Hypersensitivity to drug  Swelling  Monitor blood pressure and
NORVASC blocking agent that moderate HPN and  Use cautiously in  Headache heart rate and rhythm to detect
  selectively blocks Angina possible development of
patients receiving other  Fatigue
GENERIC NAME: calcium ion reflux peripheral vasodilators  Dizziness adverse effects.
AMLODIPINE
  across cell  Breastfeeding women  Nausea  Monitor BP with postural
CLASSIFICA membranes of changes. Report postural
 Palpitations
TION: cardiac ad vascular hypotension.
 Flushing
Calcium channel smooth muscle  Monitor more frequently when
blocker without changing additional antihypertensive or
  serum calcium diuretic are added.
DOSE/ ROUTE/
concentrations. It’s  Monitor HR; dose related
FREQUENCY:
10mg OD predominantly acts palpitation.
on peripheral
circulation
decreasing
peripheral vascular
resistance and
increases cardiac
output

BRAND NAME: Elevates the serum Prevention and  Hypersensitivity to drug  Diarrhea  Assess to allergy for sulfite.
FERATAB iron concentration, treatment of iron  Chronic alcoholism  Stomach pain  Confirm that client does have
  and is the converted deficiency anemias  Allergy to any  Chest pain iron def. anemia
GENERIC NAME: 
to Hgb or Trapped Dietary supplemental ingredients:  Dark urine  Administer right doses.
FERROUS
SULFATE in the for iron. hemochromatosis  Educate client that stool may
  reticuloendothelial  Hemosiderosis be dark or green during use.
CLASSIFICA cells for storage and  Hemolytic anemia
TION:  eventual conversion
 Anti-anemic to a usable form of
  iron.
DOSE/ ROUTE/
FREQUENCY:
1 TAB BID

BRAND NAME: Antibacterial Used to treat moderate  Hypersensitivity to drug  Constipation  Obtain hx of hypersensitivity
ZOSYN combination product to severe infections and penicillins,  Diarrhea to penicillins.
  consisting of the caused by bacteria cephalosphorins, or  Difficulty  Monitor client carefully during
GENERIC NAME:  semisynthetic beta-lactamase first 30 mins after initiation of
sleeping
PIPERACILLIN
piperacillin and the inhibitors  Headache the infusion for sign of
TAZOBACTAM
  beta-lactamase  Use cautiously in  Nausea sensitivity.
CLASSIFICA inhibitor tazobactam patients with bleeding  Insomnia  Report loose stool or diarrhea,
TION: component does not tendencies, uremia, rash, itching.
 Rash
Antibiotics decrease the activity hypokalemia
 Pruritus
  od the piperacillin
DOSE/ ROUTE/ component against
FREQUENCY:
susceptible
4.5g TIV q6
organism

BRAND NAME: Is a quaternary Management of Pt with cardiac  Headache  Teach patient proper use of
COMBIVENT cammonium bronchospasm in pt tachyarrythmias,  Dizziness inhaler
  derivative of sufferings from COPD hypertrophic obstructive  Monitor respiratory status,
 Nausea
GENERIC NAME: atropine and is an who requires regular cardiomyophathy and pt  Dry mouth auscultate lungs before and
SALBUTAMOL +
IPRATROPIUM anticholinergic drug treatment with both with a hx to  Tremors after inhalation,
  which has ipratropium and hypersensitivity to any of  Report treatment failure
 Nervousness
bronchodilator drug
CLASSIFICATI salbutamol. its components. (exacerbation of respiratory
 Cough
ON: properties. symptoms) to physicians
Bronchodilators  Sore throat
Salbutamol
  produces
DOSE/ ROUTE/
bronchodilation
FREQUENCY:
1 Neb q8 through stimulation
of bet2-adrenergic
receptors in
bronchial smooth
muscle, thereby
causing relaxation
of muscle fibers.
 IV. NURSING CARE PLANS

NURSING BACKGROUND
CUES PLANNING INTERVENTION RATIONALE EVALUATION
DIAGNOSIS KNOWLEDGE
SUBJECTIVE Ineffective Mycobacterium After 30 INDEPENDENT: After 30 minutes
DATA: breathing pattern tuberculosis minutes of 1. Assess respiratory 1. To detect early warning of rendering
Patient related to retained rendering function noting breath signs of impending appropriate
complained he bronchial appropriate sounds, rate, rhythm, and respiratory difficulties. nursing
was slightly secretions and nursing depth, and use of intervention, the
dyspneic. decreased lung Inhalation intervention the accessory muscles. goal was partially
expansion of the bacteria patient will be met as evidenced
OBJECTIVE secondary to able to 2. Place patient in semi or 2. To maximize lung by the patient
DATA: pleural effusion maintain an high-Fowler’s position. expansion and decreases maintaining an
 Dyspneic as evidenced by effective Assist patient with respiratory effort. This effective
 Decreased dyspnea bacterial invasion breathing coughing and deep- may promote movement breathing pattern
breath sounds in lungs pattern as breathing exercises. of secretions into larger of relaxed
on right lower evidenced by airways for breathing at
lung relaxed expectoration. normal rate and
breathing at depth and absence
Vital Signs: normal rate, 3. Maintain fluid intake of 3. To help thin secretions, of dyspnea; and
 BP: 150/90 infection depth, and at least 2500 mL/day making them easier to indicated verbally
mmHg absence of unless contraindicated. expectorate. and through
 PR: 80 bpm dyspnea and behavior of
 RR: 20 bpm indicates, either 4. Maintain a clear airway 4. To facilitate adequate feeling
activation of the verbally or by encouraging patient to clearance of secretions. comfortable when
inflammatory through mobilize own secretions breathing.
Ultrasound
response behavior, with successful
Report:
(July 27, 2020) feeling coughing.
 Evidence of comfortable
sonolucent free when breathing. 5. Educate patient or 5. To allow patient to
Increased capillary significant other proper participate in
flowing fluid permeability
collection seen breathing and coughing maintaining health status
in right lung methods such as pursed- and improve ventilation.
lip and abdominal
X-Ray Report breathing
Fluid shift to
(July 29, 2020) pleural space 6. Review laboratory data 6. To determine degree of
 Right-side
such as Arterial Blood oxygenation and O2
pleural effusion
Gas retention.
Decreased breath
 sound 7. Monitor O2 saturation 7. To verify maintenance
and pulse rate and improvements in O2
saturation and help
identify earlier when
action must be taken.
Difficulty of
breathing 8. Assist client in the use of 8. To reduce the patient’s
(Dyspnea) relaxation technique anxiety, thereby reducing
oxygen demand.

9. Encourage small 9. To prevent crowding of

Ineffective frequent meals. the diaphragm.
breathing pattern

DEPENDENT:
10. Administer 10. To increase lumen size
bronchodilators of the tracheobronchial
(Salbutamol + tree, thus decreasing
Ipratropium) as ordered resistance to airflow
and improving oxygen
delivery.

11. Humidify inspired air 11. To prevent drying of

and oxygen as mucous membranes and
prescribed. helps thin secretions.

NURSING BACKGROUND
CUES PLANNING INTERVENTION RATIONALE EVALUATION
DIAGNOSIS KNOWLEDGE
SUBJECTIVE Acute pain Exposure to MTB After 30 INDEPENDENT 1. To obtain VS changes After 30 minutes 
DATA: related to pleural bacteria minutes of 1. Monitored VS and pain during onset of pain and of nursing
Patient irritation ↓ nursing scale for future comparison interventions, the
complained of secondary to fluid Bacterial infection intervention , after interventions have
client’s reported
upper back pain accumulation in ↓ the patient will been made. (To establish
with pain scale of the pleural cavity Inflammation and report baseline data) pain was relieved
7/10, radiating to pleural damage d/t improvement in from 7/10 to 3/10
the right lower lesions pain felt from 2. Acknowledged and 2. To facilitate a healthy and no more
back and ↓ 7/10 to 0-3/10 accepted client’s and effective therapeutic facial grimace
shoulder, dull and Irritation of the description of pain. relationship which
stabbing quality pleura + fluid would improve pain GOAL WAS
while coughing accumulation management MET
↓
OBJECTIVE Acute Pain 3. Encouraged patient to do 3. To divert patient’s
DATA: different activities to attention from pain
 (+) Guarding divert his attention from thereby possibly
actions feeling the pain like; lessening the intensity
 (+) facial felt
grimacing a. Listening to music
whenever possible
VITAL b.Watching videos or
SIGNS: shows in mobile or
 BP: 150/90 television if they are
 PR: 80 available
 RR: 20
 O2 sat: 95% 4. Encouraged patient to 4. To help relieve tension
perform deep breathing thus help relieving the
exercise pain

5. Encouraged adequate 5. To decrease stimuli that

rest periods. cause pain on the patient

6. Provided quiet and calm 6. To limit potential

environment environmental factors
that contribute to their
perception of pain and to
promote patient’s
comfort.

DEPENDENT
7. Administered 7. To relive pain by the use
 analgesics of pharmacologic
(Tramadol), as methods
ordered

V. LABORATORY

COMPLETE BLOOD COUNT: AUGUST 25, 2020

EXAMINATIO
RESULT SI UNIT NORMAL VALUES INTERPRETATION
N
WBC 7.5 L 5.0-10.0 Normal -
Neutrophil 52.4 % 37.0 - 72.0 Normal -
Eosinophil 23.6 % 0.0-0.6 Above Normal Indication of Infection
Basophil 1.3 % 1.0-1.0 Normal -

Lymphocytes 14.0 % 20.0-50.0 Below Normal Indication of Infection

Monocytes 8.7 % 0.0-14.0 Normal -

Anemia/ possible mal absorption of

RBC 3.6 % 4.5-5.5 Below Normal nutrients due to decrease of appetite as
evidence by wt loss

Anemia/ possible mal absorption of

Hemoglobin 98 g/L 140-160 Below Normal nutrients due to decrease of appetite as
evidence by wt loss
 Anemia/ possible mal absorption of
Hematocrit 0.303 % 0.400-0.540 Below Normal nutrients due to decrease of appetite as
evidence by wt loss
MCV 85.4 Fl 80.0-94.0 Normal -
MCH 27.6 Pg 27.5-33.2 Normal -
RDW 13.5 % 11.0-15.0 Normal -
MCHC 32 g/dL 32-36 Normal -
Platelet Count 589 Fl 150-440 Above Normal Indication of bacterial infection
MPV 7.7 Fl 7.5- 11.5 Normal -
RBC is coated with sugar ( glycated)
Hemoglobin AIC 7.10% % 4.4- 6.4 Above Normal
possible/ already is DM patient

PLEURAL FLUID ANALYSIS: AUGUST 26, 2020

EXAMINATIO
RESULT SI UNIT NORMAL VALUES INTERPRETATION
N
Sugar 5.50 mmol/L 3.89-5.84 Normal -
Protein 7.5 g/dL < 3.0 Above Normal Indicates fluid is exudative
Indicates presence of inflammation/tissue
LDH 444.0 U/L 207-414 Above Normal
damage, also indicative of exudative fluid
Segmenters 89.8 % 40-80 Above Normal Indicates presence of infection
Lymphocytes 10.2 % 20-40 Below Normal Indicates presence of bacterial infection

SERUM LABORATORY: AUGUST 25, 2020

RESULT
RESULT
EXAMINATION (8/27/2020 SI UNIT NORMAL VALUES INTERPRETATION
(8/25/2020)
)
Above Normal Possible kidney dysfunction
BUN 4.94 7.06 mmol/ L 2.50- 6.50
(8/27/2020) related to medication treatment
Sodium 135 142.60 mmol/ L 136.00- 142.00 Normal -
Potassium 4.36 4.83 mmol/ L 3.80- 5.00 Normal -
Chloride 102.80 107.50 mmol/ L 95.00- 103.00 Normal -
 Above Normal Possible acute kidney
Crea-S 101.3 138.0 mmol/ L 70.0- 115.0 dysfunction related to
(8/27/2020) medication treatment

LIVER ENZYME TEST:

EXAMINATION RESULT SI UNIT NORMAL VALUES INTERPRETATION

ALT/SGPT 14.0 U/L 1.0- 45.0 Normal -
AST/SGOT 11.5 U/L 1.0- 40.0 Normal -

EXAMINATIO
RESULT SI UNIT NORMAL VALUES INTERPRETATION
N
Glucose 7.26 mmol/L 3.85- 6.40 Above Normal Indicates patient having Diabetes Mellitus
TC 4.72 mmol/L 1.0- 5.20 Normal -
TG 1.99 mmol/L 0.40- 2.30 Normal -
LDL 2.65 mmol/L 1.70- 4.60 Normal -
HDL-C 1.17 mmol/L 0.90- 1.56 Normal -
VLDL 1 mmol/L 0.1 – 1.7 Normal -
TP 67.7 g/L 62.0- 85.0 Normal -
Albumin 41.7 g/L 35.0- 53.0 Normal -
Globulin 26.00 g/L 27.00- 32.00 Normal -
A/G 1.60 g/L 1.50- 2.50 Normal -
Indicates presence of inflammation/ tissue
LDH 298.5 U/L 1.0-248.0 Above Normal
damage