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Lab Value InterpretationA.rtf

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Dalhousie University
NURS 2090
Heather Helpard

Lab Value Interpretation **don’t memorize ranges, they will be given **1 blood test does not equal a diagnosis!! Complete Blood Count (CBC): Total cell count in a person’s blood 1. WBC: 4,000-10,000/ mm 3  2. RBC: 4.2- 5.9 million/ mm 3  This value represents the TOTAL RBC count  ↓ values expected with: hemorrhage, anemia (which also indicates low 0 2 perfusion to cells)  **When RBC, Hemoglobin, Hematocrit are low = hemorrhage. 3. Hemoglobin: Males 14-18g/ dL; Females 12-16 g/dL  Will never see elevated levels, but is of concern when low  Be careful with low values b/c this could be misleading. Patient may not be breathing, but if you look at the pulse ox, it could give you a reading of 100% b/c the hemoglobin is full of 2 4. Hematocrit: Males 40-54%; Females: 37-47% 3 5. MCV: 86-98 µm /cell 6. MCH: 27-32 µµg/ RBC  ↓ values expected with dehydration and high altitudes 7. RDW: Red cell distribution width- 11.5- 14.5 8. Platelet Count: 150,000-400,000 mm 3  Platelets are located in the bone marrow and the liver. If you have a major trauma to the liver/cirrhosis you will see ↓ platelets  ↓ platelets = hemorrhage, bleeding, bruising  ↑ platelets = clotting, DVT, autoimmune 9. WBC Differential: ↑ value = infection/ blood cancer; ↓ value= chemo/ HIV (isolate pt)  Neutrophils: 40-75%  Are the first responders to infection (bacterial, some viral, inflammation)  Lymphocytes: 15-45%  If the value is higher than neutrophils it may indicate B/T cells problems  Viral infection/ leukemia  Monocytes: 1-10%  Bacterial infections (TB, malaria)  Eosinophils: 1-6%  Parasites/ allergic response/ asthma  Basophils: 0-2%  Bone marrow/ leukemia/ lymphoma Glycemic Index: ranks carbs on a scale of 0-100 (rates based on how the affect blood sugar) 1-55 = low Glycemic Index (wont make the blood sugar rise too quickly) 55-69 = medium 70-100 = high ** Any time you add fat or acid to a food, you will lower the glycemic index. That is why a cookie has lower GI than oatmeal. It will be absorbed much slower. Glycemic load: blood sugar raising POWER. Formula: Glycemic Index x g of carbs 100 This will give you a score from 0- 20+. A GI of less than 120 per day is what you are aiming for. Less than 10 = low 11-19 = medium 20 + = high Urinalysis (including normal ranges) 1. pH: 5- 6.5, Is no normal pH expected; however, would want to see it after prostate surgery to kill bacteria (recommends to drink cranberry juice for acidity and OJ for a more alkaline urine) 2. Specific gravity: 1.016- 1.022, Shows how concentrated the urine is 3. WBC: 0-5 4. RBC: 0-5, Seeing this in urine would indicate some sort of trauma 5. Ketones: Negative, we don’t want to see ketones, that indicates DKA, muscle break down 6. Glucose: less than .05, if in urine = diabetes 7. Osmolality: 100-900 8. Protein: less than 165 mg/ 24 hr, don’t want to see this in urine, if we do it could indicate: anorexia, kidney disease, cancer, kidney stones 9. Leukocyte Esterase: negative, Leukocytes = UTI 10. Nitrates: Negative, associated with UTIs (not not all) 11. Blood: Negative, may reveal menstruation or catheter irritation 12. Casts: Negative, if it was positive = kidney stones Case Study One  22 year old female; multiple stab wounds to the chest and abdomen  Vital signs: o P128: reflex compensation for blood loss o BP80/55: immediately think hypovolemic shock o RR 37 and labored: has a punctured and compromised/collapsed lung  Collapsed R lung: means collapsed alveoli, decreased oxygen/perfusion  Severe abdominal and chest pain  Awake and slightly confused: will progress to coma due to lack of oxygen  Pedal Pulse (PP) absent; Radial pulses weak; carotid pulses palpable  Skin cool and clammy: also shows shock Case Study One: CBC a.Abnormal Findings on the CBC:  Hgb: 8g/dL(normal 12-16g/dL) Critical  Hct: 25% (normal 3low7%) b.Bonus: Arterial Blood Gases  PaC02: 52mmHg: acidic  pH 7.31: acidic  HCO3 25mEq/L: normal  Uncompensated respiratory acidosis: knew that b/c of depressed respiratory rate ** We will put in a chest tube, intebate, transfuse and give IV fluids Case Study Two:  84 year old woman; one week history of upper respiratory symptoms; two day history of increased malaise and weakness; three days ago developed a cough and now she has difficulty cat
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