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DIAGNOSTIC TEST

In document Case Study (Goiter) (Page 22-38)

HEMATOLOGY Result Range Interpretation

Hemoglobin L 63.0 115.0 – 155.0 g/L A low hemoglobin count is a commonly seen blood test result.

Hemoglobin (Hb or Hgb) is a protein in red blood cells that carries oxygen throughout the body.

In many cases, a low

hemoglobin count is only slightly lower than normal and doesn't affect how you feel. If it gets more severe and causes

symptoms, your low hemoglobin count may indicate you have anemia.

Hematocrit L 0.23 0.36 – 0.48 Causes of low hematocrit, or anemia, include: Bleeding (ulcers, trauma, colon cancer, internal bleeding) Destruction of red blood cells (sickle cell anemia, enlarged spleen) Decreased production of red blood cells (bone marrow supression, cancer, drugs) RBC L 3.86 4.20 – 6.10 x10^6/uL When the hemoglobin count is

low, the body is not able to get as much oxygen to go

throughout the body.

WBC H 10.42 5.0 – 10.0 x10^3/uL An increased production of white blood cells to fight an infection MCV L 58.80 79.40 – 94.80 fl Mean corpuscular volume (MCV)

is the average volume of red cells in a specimen. MCV is elevated or decreased in

accordance with average red cell size; ie, low MCV indicates microcytic (small average RBC size), normal MCV indicates normocytic (normal average RBC size), and high MCV indicates macrocytic (large average RBC size).

MCHC L 27.8 32.20 – 35.50 g/dL The mean corpuscular hemoglobin concentration, a measure of the concentration of hemoglobin in a given volume of packed red blood cells. It is reported as part of a standard complete blood count.

Differential count

The blood differential test measures the percentage of each type of white blood cell (WBC) that you have in your blood. It also reveals if there are any abnormal or immature cells.

Neutrophil H 79 55.00 – 75.00 % It is important to realize that an abnormal increase in one type of white blood cell can cause a decrease in the percentage of other types of white blood cells.

An increased percentage of neutrophils may be due to: Acute infection. Acute stress.

Lymphocyte L 16 20 – 35% Lymphocytopenia is an

abnormally low number of lymphocytes (a type of white blood cell) in the blood. Many disorders can decrease the number of lymphocytes in the blood, but viral infections (including AIDS) and

undernutrition are the most common.

Monocyte 4 2 – 10 % A blood differential test, also

called a white blood cell count differential, measures the

number of each of the five types of white blood cells present in your blood: neutrophils.

lymphocytes. monocytes.

Eosinophil 1.000 1 – 8 % Eosinophils have two distinct functions in your immune system. They destroy invading germs like viruses, bacteria, or parasites such as Giardia and pinworm. Eosinophils also create an inflammatory response, especially if an allergy is

involved.

Basophil Basophils are produced in your

bone marrow, circulate in the blood and are the least abundant of all leukocytes. They are classified as immune cells and categorized a granulocytes.

Therefore, the basic function of this white blood cell is release of its substances in response to a foreign invasion.

Platelet Count 319 150 – 400 x10^3/uL A platelet count is a lab test to measure how many platelets you have in your blood. Platelets are parts of the blood that help the blood clot. They are smaller than red or white blood cells.

Urinalysis Result Range Interpretation

Chemical Analysis

pH 6.5 A urine pH test can tell

your doctor how acidic or basic (alkaline) your urine is using a simple, painless urine test.

Many diseases, your diet, and the medicines you take can affect how acidic or basic your urine is. For instance, results that are either too high or low can indicate the likelihood that your body will form kidney stones. If your urine is at an extreme on either the low or high end of pH levels, you can adjust your diet to reduce the likelihood painful kidney stones will form. In short, your urine pH is an indicator

of your overall health and gives your doctor important clues as to what is going on in your body.

Glucose Negative The glucose urine test

measures the amount of sugar (glucose) in a urine sample. The presence of glucose in the urine is called glycosuria or glucosuria.

Protein Negative Urine protein testing is

used to detect protein in the urine, to help evaluate and monitor kidney function, and to help detect and

diagnose early kidney damage and disease.

Urine Flowcytometry

WBC 8.0 0 – 27 /uL Leukocyte esterase is

an enzyme present in most white blood cells (WBCs). Normally, a few white blood cells (see microscopic examination) are present in urine and this test is negative.

When the number of WBCs in urine

increases significantly, this screening test will become positive.

When the WBC count in urine is high, it means that there is inflammation in the urinary tract or kidneys.

The most common cause for WBCs in urine (leukocyturia) is a

bacterial urinary tract infection (UTI), such as a bladder or kidney infection.

RBC H 40 0 – 28 /uL This test is used to

detect hemoglobin in the urine

(hemoglobinuria).

Hemoglobin is an oxygen-transporting protein found inside red blood cells (RBCs).

Its presence in the urine indicates blood in the urine (known as hematuria). The small number of RBCs normally present in urine usually result in a

"negative" test.

However, when the number of RBCs increases, they are detected as a "positive"

test result.

Epithelial Cells H 14 0 – 7/uL Epithelial cells in urine may be a cause for concern if the numbers are higher than normal.

The sloughing of epithelia is quite a normal process of the body sheddingdead cells and creating new ones. If epithelial cells are high in your urine it could signal a problem with your kidneys or an infection in your urinary system. This article will examine some

possible causes of epithelial cells in urine and what urinalysis means.

Cast Urinary casts are

formed only in the distal convoluted tubule (DCT) or the collecting duct (distal nephron). The proximal convoluted tubule (PCT) and loop of Henle are not locations for cast formation.

Hyaline casts are composed primarily of a mucoprotein (Tamm-Horsfall protein) secreted by tubule cells.

Bacteria 4 Urine is normally

sterile, which means that it contains no bacteria. A small number of bacteria may be found in the urine of many healthy people. This is usually considered to be harmless. However, a certain level of bacteria can mean that the bladder, urethra, or kidneys are infected.

NCP

Assessment Diagnosis Planning Intervention evaluation

Objective:

Risk for infection r/t surgical incision

secondary to total abdominal

hysterectomy

After 8 hours of nursing intervention, the patient will be able to:

 Establish rapport Rationale: To gain patient’s trust and cooperation

 Monitor V.S.

Rationale: To obtain baseline data

 Observe and report signs of infection such as redness, warmth, discharge, and increased body temperature.

Rationale: With the onset of infection the immune system is activated and signs of infection appear.

 Note and report laboratory values (e.g., white blood cell count) rationale:

Laboratory values provide a global view of the client's immune function

 Use proper hand washing techniques before and after giving care to client.

Rationale: Hand washing significantly decreases the

number of microorganisms

 Provide wound healing such as cleaning of wound Rationale: To reduce risk for infection

Goal met as evidenced by normal vital signs and patient showed no signs and symptoms of infection

 Provide care, change dressing as needed To promote healing to the incision

Assessment Diagnosis Planning Intervention evaluation

Risk for infection r/t surgical incision

secondary to total abdominal

hysterectomy

After 8 hours of nursing intervention, the patient will be able to:

 Establish rapport Rationale: To gain patient’s trust and cooperation

 Monitor V.S.

Rationale: To obtain baseline data

 Observe and report signs of infection such as redness, warmth, discharge, and increased body temperature.

Rationale: With the onset of infection the immune system is activated and signs of infection appear.

 Note and report laboratory values (e.g., white blood cell count) rationale:

Laboratory values provide a global view of the client's immune function

 Use proper hand washing techniques before and after giving care to client.

Rationale: Hand washing significantly decreases the

number of microorganisms

 Provide wound healing such as cleaning of wound Rationale: To reduce

Goal met as evidenced by normal vital signs and patient showed no signs and symptoms of infection

risk for infection

 Provide care, change dressing as needed To promote healing to the incision

Assessment Diagnosis Planning Intervention evaluation

Risk for infection r/t surgical incision

secondary to total abdominal

hysterectomy

After 8 hours of nursing intervention, the patient will be able to:

 Establish rapport Rationale: To gain patient’s trust and cooperation

 Monitor V.S.

Rationale: To obtain baseline data

 Observe and report signs of infection such as redness, warmth, discharge, and increased body temperature.

Rationale: With the onset of infection the immune system is activated and signs of infection appear.

 Note and report laboratory values (e.g., white blood cell count) rationale:

Laboratory values provide a global view of the client's immune function

 Use proper hand washing techniques before and after giving care to client.

Rationale: Hand washing significantly decreases the

number of microorganisms

 Provide wound healing such as cleaning of wound

Goal met as evidenced by normal vital signs and patient showed no signs and symptoms of infection

Rationale: To reduce risk for infection

 Provide care, change dressing as needed To promote healing to the incision

Assessment Diagnosis Planning Intervention evaluation

Risk for infection r/t surgical incision

secondary to total abdominal

hysterectomy

After 8 hours of nursing intervention, the patient will be able to:

 Establish rapport Rationale: To gain patient’s trust and cooperation

 Monitor V.S.

Rationale: To obtain baseline data

 Observe and report signs of infection such as redness, warmth, discharge, and increased body temperature.

Rationale: With the onset of infection the immune system is activated and signs of infection appear.

 Note and report laboratory values (e.g., white blood cell count) rationale:

Laboratory values provide a global view of the client's immune function

 Use proper hand washing techniques before and after giving care to client.

Rationale: Hand washing significantly decreases the

number of microorganisms

 Provide wound healing such as cleaning of wound Rationale: To reduce

Goal met as evidenced by normal vital signs and patient showed no signs and symptoms of infection

risk for infection

 Provide care, change dressing as needed To promote healing to the incision

Assessment Diagnosis Planning Intervention evaluation

Risk for infection r/t surgical incision

secondary to total abdominal

hysterectomy

After 8 hours of nursing intervention, the patient will be able to:

 Establish rapport Rationale: To gain patient’s trust and cooperation

 Monitor V.S.

Rationale: To obtain baseline data

 Observe and report signs of infection such as redness, warmth, discharge, and increased body temperature.

Rationale: With the onset of infection the immune system is activated and signs of infection appear.

 Note and report laboratory values (e.g., white blood cell count) rationale:

Laboratory values provide a global view of the client's immune function

 Use proper hand washing techniques before and after giving care to client.

Rationale: Hand washing significantly decreases the

number of microorganisms

 Provide wound healing such as cleaning of wound Rationale: To reduce

Goal met as evidenced by normal vital signs and patient showed no signs and symptoms of infection

risk for infection

 Provide care, change dressing as needed To promote healing to the incision

In document Case Study (Goiter) (Page 22-38)

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