Laboratory

Reference: Labtest.pdf

9| P a g e
Procedure Result Normal Values Clinical Significance
HGB 108 140-180 g/L A Low hemoglobin level indicates
anemia. Estimates of Hgb in each
RBC are moderately important
when determining the total
blood Hgb. However,
hemoglobin findings are even
more dependent upon the total
number of RBC's. In other words,
for the diagnosis of anemia, the
number of RBC's is as important
as the hemoglobin level.
HCT 0.323 0.400-0.540 If the Hct is abnormal, then the
RBC count is possibly abnormal.
If the RBC count turns out to be
normal, then the average size of
the RBC is probably too small.
Shock, hemorrhage, dehydration,
or excessive IV fluid
administration can reduce the
Hct.
Nursing Implications
1. Explain test procedure.
Explain that slight
discomfort may be felt
when the skin is punctured.
2. Encourage to avoid stress if
possible because altered
physiologic status
influences and changes
normal hematologic values.
3. Explain that fasting is not
necessary. However, fatty
meals may alter some test
results as a result of
lipidemia.
4. Apply manual pressure and
dressings over puncture site
on removal of dinner.
5. Monitor the puncture site
for oozing or hematoma
formation.
6. Instruct to resume normal
activities and diet.
RBC count 3.21 4.60-6.00 X 1 This test can also give an indirect
esti-mate of the hemoglobin
levels in the blood. RBC's are
actually "Red Blood Corpuscles,"
(non-nucleated cells). The term
corpuscle indicates that it is a
mature Red Blood Cell. Once the
immature cell has matured, it is
then, and only then, capable of
carrying oxygen. It is then also
not "technically" a cell anymore.
Once it has matured, it loses its
nucleus and can no longer be
properly termed a cell. It would
be called a corpuscle. However,
everyone still refers to them as
RBC's (cells). The source of the
specimen is whole blood,
capillary, or venous blood.
WBC Count 4.08 4.3-10.0 x 10 9/ As we all know, WBC's are our
body's first line of defense
against invading bacteria and
most other harmful organisms.
This test (WBC), measures the
total number of all types of
WBC's. Further examination of
the different types and numbers
of cells present, could tell much
about the state of the body's
defense system. WBC count will
normally vary as much as 2,000
on any given day.
1. Explain test procedure.
Explain that slight
discomfort may be felt
when the skin is
punctured.
2. Encourage to avoid stress if
possible because altered
physiologic status
influences and changes
normal hematologic values.
3. Explain that fasting is not
necessary. However, fatty
meals may alter some test
results as a result of
lipidemia.
4. Apply manual pressure and
dressings over puncture site
on removal of dinner.
5. Monitor the puncture site
for oozing or hematoma
formation.
6. Instruct to resume normal
activities and diet.
Neutrophils 81.0 50.0-70.0% Increased by: Infection;
gonorrhea, osteomyelitis, otitis
media, chickenpox, herpes,
others Ischemic necrosis due to
MI, burns, carcinoma Metabolic
Disorders; diabetic acidosis,
eclampsia, uremia, thyrotoxicosis
Stress Response; due to acute
hemorrhage, surgery, emotional
distress, others Inflammatory
disease; rheumatic fever, acute
gout, vasculitis, myositis
Decreased by: Bone marrow
depression; due to radiation or
cytotoxic drugs Infections; such
as typhoid, hepatitis, influenza,
measles, mumps, rubella
hypersplenism; hepatic disease,
storage disease Collagen vascular
disease; systemic lupus
erythematosus Deficiency of;
folic acid or vitamin B12
Lymphocytes 11.0 20.0-40.0% Increased by: Infections;
pertussis, syphilis, tuberculosis,
hepatitis, mumps, others Others;
thyrotoxicosis, hypoadrenalism,
ulcerative colitis, immune
diseases Decreased by: Severe
debilitating illness; congestive
heart failure, renal failure,
advanced tuberculosis Others;
Defective lymphatic circulation,
high levels of adrenal
Corticosteriods, others
1. Explain test procedure.
Explain that slight
discomfort may be felt
when the skin is
punctured.
2. Encourage to avoid stress if
possible because altered
physiologic status
influences and changes
normal hematologic values.
3. Explain that fasting is not
necessary. However, fatty
meals may alter some test
results as a result of
lipidemia.
4. Apply manual pressure and
dressings over puncture site
on removal of dinner.
5. Monitor the puncture site
for oozing or hematoma
formation.
6. Instruct to resume normal
activities and diet.
Urinalysis: Microscopic exam of This will detect the presence of
the urine RBC's in the urine. Normal is 0-3
RBC's. Gross bleeding into the
(RBC) 150-160 0-3 urine is usually obvious. On lab
exam of the urine, numerou-s,
many, and gross are terms used
to describe the amount of blood
in gross bleeding. However, all
bleeding is not that obvious. In
order to detect slower bleeding
and inflam-mation in the urinary
tract, the microscopic exam is
needed. In some normal condi-
tions, a very few RBC's may get
into the urine. When a level of
more than 3 RBC's are found, a
disease condition is often
present. One of the most
common causes of RBC's in the
urine, is infec-tion or inflamma-
tion of the urinary tract itself
(i.e., cystitis). Trauma and several
other conditions may also cause
bleeding into the urine. Of
course, the nurse will carefully
observe the patient with gross
bleeding. However, do not forget
the patient with only very slight
bleeding as well. This patient can
just as easily develop a severe
hemor-rhage from only a "min-
or" condition
1. Instruct the patient to void
directly into a clean, dry
container. Sterile, disposable
containers are
recommended. Women
should always have a clean-
catch specimen if a
microscopic examination is
ordered. Feces, discharges,
vaginal secretions and
menstrual blood will
contaminate the urine
specimen.
2. Collect specimens form
infants and young children
into a disposable collection
apparatus consisting of a
plastic bag with an adhesive
backing around the opening
that can be fastened to the
perineal area or around the
penis to permit voiding
directly to the bag.
Depending on hospital
policy, the collected urine
can be transferred to an
appropriate specimen
container.
3. Cover all specimens tightly,
label properly and send
immediately to the
laboratory.
4. If a urine sample is obtained
from an indwelling catheter,
 it may be necessary to clamp
the catheter for about 15-30
minutes before obtaining
the sample. Clean the
specimen port with
antiseptic before aspirating
the urine sample with a
needle and a syringe.
5. Observe standard
precautions when handling
urine specimens.
6. If the specimen cannot be
delivered to the laboratory
or tested within an hour, it
should be refrigerated or
have an appropriate
preservative added.