LABORATORY PROCED URE RBS (ramdom blood sugar) DATE 09-1111 09-1611 09-1711 09-1811 09-1911 09-2011 PROCEDURE

DATE / RESULT 09- 11- 09- 1611 11 ABG (arterial blood gas) 7.495 7. 693 pH NORMS TIME 6pm 6am 6pm 6am 6pm 6am 6pm 6pm 6am NORMS 70 150 mg/dl RESULT 113 mg/dl 134 mg/dl 174 mg/dl 97 mg/dl 216 mg/dl 39 mg/dl 116 mg/dl 148 mg/ dl 110 mg/dl INTERPRETATION and ANALYSIS INTERPRETATION: the blood sugar of the patient is unconstant. There are times that it is normal, high, or low. It depends if the patient eats before the RBS, or not. ANALYSIS: ramdom blood sugar measures the amount of a type of sugar, glucose, in the blood. Increased sugar level indicates diabetes. Low sugar level indicates hypoglycemia. (Introduction to the Human Body, Gerard Tortora; 7th Edition; pg.521)

INTERPRETATION and ANALYSIS

7.35 7.45

PCO

47.9

16.5

35-45 mmHg

PO HCO

78.3 36.1

104.4 19.6

80-100 mmHg 22-26 mmHg

INTERPRETATION:ph is above beyond normal for six days. This indicates alkalosis ANALYSIS: increase:alkalosis; decrease:acidosis INTERPRETATION: PCO is high at the first day and lowered at the sixth day. At the first day, it is acidosis and at the sixth day, it became alkalosis ANALYSIS: increase:acidosis; decrease:alkalosis INTERPRETATION: PO is low at the first day, which is alkalosis. And at the sixth day, it became high, which is acidosis. INTERPRETATION: HCO is high at the first day, which is alkalosis. And at the sixth day, it became low, which is acidosis. ANALYSIS: increase:alkalosis; decrease:acidosis INTERPRETATION and ANALYSIS

PROCEDU RE HEMATOL OGY Hemoglobin

DATE / RESULT 09- 1111 81 9- 1611 87

NORMS

140-180

INTERPRETATION: hemoglobin level is below beyond normal for six days. This is due to decreased percentage of RBC count. Which means, it carries less oxygen and removes less CO in the blood.

hematocrit

0.27

0.29

0.40-0.50

WBC count

4.86x10 /L

5.74x10 /L

5.0-10.0x/L

Neutrophils

0.81

0.87

0.30-0.70

Lymphocyt e

0.19

0.13

0.20-0.40

ANALYSIS: Hgb is the main intracellular protein of erythrocytes. It carries oxygen to and removes CO from the RBC. Hgb is related to the RBC count. (Fundamentals of Nursing, Kozier & Erbs; Vol.II pg. 799-801) INTERPRETATION: Hct level is below beyond normal for six days. This is due to decreased percentage of RBC count. It also indicates abnormal states of hydration. ANALYSIS: Hct measures the percentage of RBC in the total blood volume. Abnormal values also indicates an abnormal states of hydration. (Fundamentals of Nursing, Kozier & Erbs; Vol.II pg. 799-801) INTERPRETATION: the WBC count at the first day is below beyond normal. Then, after six days, the count is at normal count. This is because the patient is having his medications that increases his immunity. ANALYSIS: WBC combats pathogens and other foreign substances that capable of invading deeper tissues and causing disease. Decreased WBC count indicates decrease in disease-fighting cells circulating in the blood. (Introduction to the Human Body, Gerard Tortora; 7th Edition; pg.353) INTERPRETATION: Neutrophils is above beyond normal for six days. This is due to diabetic ketoacidosis. ANALYSIS: neutrophils respond first to bacterial invasion, carrying on phagocytosis and releasing enzymes. Sudden kidney failure can cause a high neutrophil count. The kidneys filter (remove) wastes from the blood. A condition known as ketoacidosis can also cause a high neutrophil count. Ketoacidosis is a condition in which acids and poisonous chemical substances known as ketones are produced by the body. Ketones are produced when the body has a difficult time breaking down fats. (Introduction to the Human Body, Gerard Tortora; 7th Edition; pg.353) INTERPRETATION: lyphocytes is below beyond normal for six days. This is a result of prolonged severe illness. ANALYSIS: lymphocytes is the major combatant in immune responses. Low lymphocyte counts may occur as a result of prolonged severe illness, hiugh steroid levels, and immunosuppression. (Introduction to the Human Body, Gerard Tortora; 7th Edition; pg.353)

Platelet

300x10/ L

251x10/ L

150350x10/L

normal

PROCEDURE MCH (mean corpuscular hgb.) MCV (mean corpuscular volume) RDW (red blood cell distribution width)

DATE 09- 1111

NORMS 28 32 pg 82 98 fl 0.115 0.145

RESULT S 29.1 97.2 0.169

INTERPRETATION and ANALYSIS normal normal INTERPRETATION: the RDW is above beyond normal. This is due to low RBC count. ANALYSIS:RDW is a measurement of the amount that RBC cells vary in size. Increased RDW can be caused by the beginning stages of a decrease in Vitamin B12 or Folic Acid in the body. (Introduction to the Human Body, Gerard Tortora; 7th Edition; pg.800) INTERPRETATION: the MCHC is below beyond normal. This is due to low level of Hgb. ANALYSIS: MCHC is a measure of the concentration of Hgb in a given volume on a PRBC. Low MCHC indicates decreased amount of Hgb. (Introduction to the Human Body, Gerard Tortora; 7th Edition; pg.802) INTERPRETATION and ANALYSIS

MCHC (mean corpuscular hemoglobin conc. )

32 38%

29.7%

PROCEDU RE BUN (blood urea nitrogen)

DATE / RESULT 09- 1111 10.53 09- 1611 12.54

NORMS

1.7-8.3 mmOl/L

creatinine

108

150

35.4-123 mmOl/ L

INTERPRETATION: the BUN level is above beyond normal for six days. This is due to Chronic Kidney Dse. ANALYSIS: BUN is one of the kidney function test. It is a test to measure the amount of urea nitrogen in the blood. Increased BUN may indicate impared kidney function. This may be due to acute or chronic kidney disease, damage, or failure. It may also be due to a condition that results in decreased blood flow to the kidneys, such as congestive heart failure. (Introduction to the Human Body, Gerard Tortora; 6th Edition; pg.1132) INTERPRETATION: serum creatinine is above beyond normal on the sixth day. This is due to CKD. ANALYSIS: Serum creatinine has been found to be a fairly reliable indicator of kidney

Na K

137 3.0

137 3.9

135-145 mmOl/ L 3.5-5.5 mmOl/ L RESU LTS 5.31 26

function. high levels of creatinine thus warn of possible malfunction or failure of the kidneys. (Introduction to the Human Body, Gerard Tortora; 6th Edition; pg.1138) normal normal

PROCEDU RE Urine crea Creatinine clearance

DATE 09- 1411

NORMS 5.3 22.1 mmOl/ 24 hr 75 150 ml/ min

INTERPRETATION and ANALYSIS normal INTERPRETATION: the creatinine clearance is lower-than-normal. This is due to CKD. ANALYSIS: The creatinine clearance test compares the level of creatinine in urine with the creatinine level in the blood. The test helps provide information on kidney function. The creatinine clearance test is used to estimate the glomerular filtration rate (GFR). Lower-thannormal creatinine clearance may indicate CKD. (Introduction to the Human Body, Gerard Tortora; 6th Edition; pg.1140) INTERPRETATION: the urine protein is greaterthan-normal. This is due to diabetic nephropathy. ANALYSIS: A protein urine test measures the amount of proteins, such as albumin, found in a urine sample. This test is most often performed when kidney disease is suspected. It may be used as a screening test. If the kidney is diseased, protein will appear in the urine even if blood levels are normal. Greater-than-normal is due to diabetic nephropathy. (Introduction to the Human Body, Gerard Tortora; 6th Edition; pg.1142) INTERPRETATION and ANALYSIS normal normal INTERPRETATION: HDL is lower-than-normal. This is due to CHF. ANALYSIS: HDL removes excess cholesterol in the blood. Low levels of HDL may place you at risk of getting Coronary Heart Dse. Especially if other lipids in your blood are high, such as LDL cholesterol and triglycerides.

Urine total protein

420 2250 mg/ 24 hr

4830

PROCEDU RE Cholestero l Triglycerid es HDL (high density lipoprotein )

DATE 09- 1411

NORMS 3.1 5.6 mmOl/ L 0.34 2.28 mmOl/ L 1.42 6.42 mmOl/ L

RESULT S 3.98 1.19 0.43

LDL (low density lipoprotein )

3.09suspicious 4.9elevated

3.01

(Introduction to the Human Body, Gerard Tortora; 6th Edition; pg.1151) INTERPRETATION: LDL is higher-than-normal. This is due to CHF. ANALYSIS: optimal: persons with a heart dse. (Introduction to the Human Body, Gerard Tortora; 6th Edition; pg.1155) INTERPRETATION and ANALYSIS INTERPRETATION: the protein is below beyond normal. This is due to CKD. ANALYSIS: total protein measurements can reflect nutritional status and may be used to screen for and help diagnose kidney disease. It provides information to investigate the cause of abnormal pooling of fluid in tissue (edema). Low total protein levels may indicate kidney disorder. (Introduction to the Human Body, Gerard Tortora; 6th Edition; pg.126) INTERPRETATION: albumin is below beyond normal. This is due to ascites. ANALYSIS: albumin is essential for maintaining the oncotic pressure in the vascular system. A decrease in oncotic pressure due to a low albumin level allows fluid to leak out from the interstitial spaces into the peritoneal cavity, producing ascites. (Introduction to the Human Body, Gerard Tortora; 6th Edition; pg.129) INTERPRETATION: globulin is above beyond normal. This is due ANALYSIS: Globulins help fight infection, enhance the process of blood clotting and serve as carrier proteins for hormones. High globulin level indicates kidney dse. (Introduction to the Human Body, Gerard Tortora; 6th Edition; pg.131) INTERPRETATION and ANALYSIS INTERPRETATION: his urine color is dark yellow, which indicates concentrated urine. ANALYSIS: The color of urine can vary from almost colorless to black. Normal urine may show color variation ranging from pale yellow to deep amber. Dak yellow urine indicates some diseases related to kidney. These can cause blood to enter your urine as well as infected materials.

PROCEDU RE Total protein

DATE 09- 1211

NORMS 66 87 g/ dl

RESULT S 60.66

albumin

38 51 g/ dl

18.18

globulin

2.3 3.5 g/ dl

42.48

PROCEDURE URINALYSIS color

DATE 09- 1111

NORMS Pale yellow to deep amber

RESULT S Dark yellow

transparency Specific gravity reaction protein

Clear to turbid (cloudy) 1.001 1.035 acidic +1

turbid 1.030 acidic +3

(Introduction to the Human Body, Gerard Tortora; 6th Edition; pg.519) normal normal normal INTERPRETATION: protein is +3 on Multistix strip. It indicates positive reaction. ANALYSIS: at a constant ph, the development of any green color is due to the presence of protein. Colors range from yellow for negative through yellow- green and green to green blue for positive reactions. (Introduction to the Human Body, Gerard Tortora; 6th Edition; pg.520) INTERPRETATION: pt. Is positive for having glucose in urine. ANALYSIS: glucosuria, the presence of gluycose in the urine, usually indicates DM. (Introduction to the Human Body, Gerard Tortora; 6th Edition; pg.520) INTERPRETATION and ANALYSIS normal normal

glucose

positive

positive

PROCEDURE SEROLOGY -IMMUNOLOGY HCV Ab HBS Ag

DATE 09- 12 11

NORMS

RESULTS

nonreactiv e nonreactiv e DATE 09- 1211 NORMS 105 mm

nonreactive nonreactive

PROCEDURE ABDOMEN UTZ Liver (size)

RESULTS 123 mm

INTERPRETATION and ANALYSIS INTERPRETATION: the liver size is greater-than-normal. This indicates CHF. ANALYSIS: enlarged liver includes CHF. normal normal normal

Kidney (size) Urinary bladder gallbladder PROCEDURE ECHOCARDIO GRAPHIC REPORT DATE 09- 11 -11

90-130x50130 mm normal normal NORMS

98.7x55.1 mm normal normal

RESULT

INTERPRETATION and ANALYSIS

Left ventricle Aortic valve Mitral valve Tricuspid valve Pulmonic valve DATE INPUT 9/11 TIM ORAL E and OUTPUT 77am 720 7pm 750 7am 7300 7pm 7100 7am 7100 7pm 7200 7am 7300 7pm 7150 7am 7NPO 7pm 7220 7am 7300 7pm

thickene d thickene d thickene d thickene d thickene d IVF 80 120 120 120 120 120 120 110 120 150 120 120

Thickened walls Thickened walls thickened thickened thickened

normal normal normal normal normal

BM 2 2 2 1 1 1 -

UO 200 150 550 600 350 500 500 400 1500 2200 1500 1500

Interpretation Decrease input, Increase output Decrease input, Increase output Decrease input, Increase output Decrease input, Increase output Decrease input, Increase output Decrease input, Increase output Decrease input, Increase output Decrease input, Increase output Decrease input, Increase output Decrease input, Increase output Decrease input, Increase output Decrease input, Increase output

9/12

9/13

9/14

9/15

9/16

ANALYSIS Patients with Congestive Heart Failure and fluid volume excess, fluid intake is restricted. Patient with ESRD and fluid volume excess, they are advised to have diuretics to increase water excretion. (Introduction to the Human Body, Gerard Tortora; 6th Edition; pg.112)