Saint Mary’s University

SCHOOL OF HEALTH and NATURAL SCIENCES

Nursing Department
Bayombong, Nueva Vizcaya

Chapter IV. Laboratory Results and Diagnostic Studies

According to the Journal of Laboratory and Precision Medicine, Pregnancy causes

profound physiological changes, and, during this period, women's bodies undergo an adaptation
process to accommodate fetus growth. Laboratory medicine covers an essential role in the
monitoring of these physiological changes. Indeed, laboratory tests are universally recognized
as a meaningful tool for detecting pathological conditions during pregnancy. Interpretation of
laboratory tests should be carefully accounted for by physicians for the management of the
pregnant mother. Moreover, tests that are generally conducted for all pregnant women include
urinalysis and blood studies. The urine is analyzed for albumin, glucose, ketones, and bacteria
casts. Blood studies usually include a complete blood count (hemoglobin, hematocrit, red and
white blood cell counts, and platelets), blood typing and Rh factor, a rubella titer, hepatitis B
surface antibody-antigen, HIV, VDRL, and RPR tests, and cervical smears to detect STIs. In
addition, most offices and clinics have ultrasound equipment available to validate an intrauterine
pregnancy and assess early fetal growth. Indeed, nursing considerations are also vital before,
during, and after every laboratory/diagnostic procedure.
The table presented below is the common laboratory and diagnostic including the
definition, how it is done, and the nursing considerations before, during, and after the procedure:

Test Definition Procedure Nursing

Considerations
Complete blood cell Evaluates hemoglobin A member of the Before:
count (CBC) (12–14 g) and health care team Explain the test
hematocrit (42% +/− draws a sample of procedure. Explain
5) levels and red blood for a complete that slight discomfort
blood cell count (4.2– blood count by putting may be felt when the
5.4 million/mm3) to a needle into a vein in skin is punctured.
detect the presence of the arm, generally
anemia; identifies around the bend of Encourage them to
WBC (5,000– the elbow. A blood avoid stress if
10,000/mm3), which if sample is submitted possible because
elevated may indicate to a laboratory for altered physiologic
an infection; testing status influences and
determines platelet changes normal
count (150,000– hematologic values.
450,000 cubic mL) to
assess clotting ability. Explain that fasting is
not necessary.
However, fatty meals
may alter some test
results as a result of
lipidemia.

During:
Apply manual
pressure and
dressings over the
puncture site on

1st Floor, Constant Jurgens (UB) Building

Saint Mary’s University, Ponce St., Bayombong, Nueva Vizcaya, 3700 Philippines
Telephone: (078) 321-2221 ext. 122; Telefax: (078) 321-2117; Mobile No.: 0936-286-7269
 Saint Mary’s University
SCHOOL OF HEALTH and NATURAL SCIENCES
Nursing Department
Bayombong, Nueva Vizcaya

removal of dinner.

Monitor the puncture

site for oozing or
hematoma formation.

After
Instruct to resume
normal activities and
diet.
Blood typing Determines woman’s The skin will be Before:
blood type and Rh cleaned before the Verify doctor's order.
status to rule out any test with an antiseptic Inform the client and
blood incompatibility to help prevent explain the purpose of
issues early; Rh- infection. A nurse will the procedure.
negative mother wrap a band around
would likely receive the arm to make veins During:
RhoGAM (at 28 more visible. They will Check for cross-
weeks) if she is Rh use a needle to draw matching and typing.
sensitive via indirect several samples of To ensure
Coombs test. blood from the arm or compatibility.
hand. After the draw,
gauze and a bandage Obtain and record
will be placed over the baseline vital signs.
puncture site.
After:
Practice strict
asepsis. At least 2
licensed nurses check
the label of the blood
transfusion. Check
the following:
 Serial number
 Blood
component
 Blood type
 Rh factor
 Expiration
date
 Screening test
(VDRL,
HBsAg,
malarial
smear) – this
is to ensure
that the blood
is free from
blood-carried

1st Floor, Constant Jurgens (UB) Building

Saint Mary’s University, Ponce St., Bayombong, Nueva Vizcaya, 3700 Philippines
Telephone: (078) 321-2221 ext. 122; Telefax: (078) 321-2117; Mobile No.: 0936-286-7269
 Saint Mary’s University
SCHOOL OF HEALTH and NATURAL SCIENCES
Nursing Department
Bayombong, Nueva Vizcaya

diseases and
therefore, safe
from
transfusion.

Warm blood at room

temperature before
transfusion to prevent
chills.

Identify clients
properly. Two nurses
check the client’s
identification.

Monitor vital signs.

Altered vital signs
indicate adverse
reaction (increase in
temp, increase in
respiratory rate)

Do not mix
medications with
blood transfusion to
prevent adverse
effects.

After:
Observe potential
complications. Notify
the physician.

Rubella titer Detects antibodies for A blood sample is Before:

the virus that causes drawn from a vein in Pregnant women who
German measles; if the arm of an adult or are exposed to rubella
titer is 1:8 or less, the from a heel prick or and who do not have
woman is not the umbilical cord of a documented proof of
immune, requires newborn. immunity should be
immunization after tested for rubella-
birth, and is advised specific IgM
to avoid people with antibodies to identify
undiagnosed rashes. recent infection.

During:
Recommend
restricting activities to
avoid exposure while

1st Floor, Constant Jurgens (UB) Building

Saint Mary’s University, Ponce St., Bayombong, Nueva Vizcaya, 3700 Philippines
Telephone: (078) 321-2221 ext. 122; Telefax: (078) 321-2117; Mobile No.: 0936-286-7269
 Saint Mary’s University
SCHOOL OF HEALTH and NATURAL SCIENCES
Nursing Department
Bayombong, Nueva Vizcaya

waiting for serologic

test results.

Evaluate exposed
pregnant women with
positive IgG titers and
negative IgM to
determine if they
acquired immunity
before pregnancy or
infection during
pregnancy.

Evaluate pregnant
women with
confirmed rubella to
assess risk to the
fetus.

After:
Any pregnant woman
with documented
immunity and rubella-
like symptoms should
be immediately
evaluated by a
physician to diagnose
the symptoms and
ensure the health of
the mother and fetus

Hepatitis B Determines if mother Taking a hepatitis B Before, During, &

has hepatitis B by test requires a blood After Additional doses
detecting presence of sample, which can be may be required for
hepatitis antibody collected by a individuals with a
surface antigen healthcare suppressed immune
(HbsAg) in her blood. professional. For system.
laboratory-based
testing, blood is Correct cold chain
drawn from a patient's vaccine storage
vein. After blood is should be ensured.
collected, the sample
is sent to a laboratory The injection site
for analysis. batch number and
expiry date should be
recorded in the
patient record
HIV testing Detects HIV HIV tests are typically Before:

1st Floor, Constant Jurgens (UB) Building

Saint Mary’s University, Ponce St., Bayombong, Nueva Vizcaya, 3700 Philippines
Telephone: (078) 321-2221 ext. 122; Telefax: (078) 321-2117; Mobile No.: 0936-286-7269
 Saint Mary’s University
SCHOOL OF HEALTH and NATURAL SCIENCES
Nursing Department
Bayombong, Nueva Vizcaya

antibodies and if performed on blood or Ensure understanding

positive requires more oral fluid. They may of the patient.
specific testing, also be performed on Respecting the
counseling, and urine. A NAT looks for individual’s right to
treatment during the actual virus in the decide if they want to
pregnancy with blood and involves be tested or not.
antiretroviral drawing blood from a
medications to vein. During:
prevent transmission Providing pre-test
to the fetus. information on the
purpose of testing,
and on the treatment
and support available
once the result is
known. After:
Confidentiality must
be protected.

Cervical smears Detects abnormalities A Pap smear involves

such as cervical collecting cells from
cancer (Pap test) or the cervix — the
infections such as lower, narrow end of
gonorrhea, chlamydia, the uterus that's at the
or group B top of the vagina.
streptococcus so that
treatment can be
initiated if positive.

1st Floor, Constant Jurgens (UB) Building

Saint Mary’s University, Ponce St., Bayombong, Nueva Vizcaya, 3700 Philippines
Telephone: (078) 321-2221 ext. 122; Telefax: (078) 321-2117; Mobile No.: 0936-286-7269