DIAGNOSTIC TESTS Total Cholesterol NR: <200mg/dL (ROUTINE LABORATORY EXAMINATIONS) Triglycerides NR: 100-200mg/dL HDL good cholesterol COMPLETE BLOOD COUNT (CBC) LDL bad cholesterol o Keep patient on NPO for 12 hours prior to lab Normal Values extraction. o Ideal to do NPO at night when the patient White Blood Cells (WBC) 4,000-10,000/mm3 sleeps to prevent hypoglycemia attacks in the Red Blood Cells (RBC) 4.2-5.9 million/mm3 morning when the patient is actively doing activities. Hemoglobin (Hgb) Males 14-18 g/dL o Specimen collection will be in the morning, Females 12-16 g/dL before breakfast. Hematocrit (Hct) Males 40-54% Signs & Symptoms of Hypoglycemia Females 37-47% Wet (cold sweat) Mean Corpuscular Volume (MCV) 86-98 um3/cell Wild (restless) Weak Mean Corpuscular Hemoglobin (MCH) 27-32 uug/RBC White Red Cell Distribution Width (RDW) 11.5-14.5 Headache/Light-Headedness Tremors Platelet Count 150,000-400,000/mm3 WBC Differential COAGULATION TESTS To check patient’s risk for bleeding especially before o Neutrophils 40-75% surgery. o Lymphocytes 15-45% Prothrombin time (PT or Protime) APTT (Activated Partial Thromboplastin Time) o Monocytes 1-10% Other Blood test to check for risk of bleeding: o Eosinophils 1-6% Bleeding Time Clotting Time o Basophils 0-2% Other Tests Blood Typing (A,B,AB,O) – reflected antigens present in the RBC surface (A & B) RBC/Erythrocytes; Hemoglobin, Hematocrit – reflects Cross-Matching (+,-) – reflects D antigen – oxygen carrying capacity of the blood. Rhesus factor (Rh factor) Rh(+) – has D antigen Platelets/Thrombocytes – blood clotting, control of Rh(-) – has no D antigen bleeding.
WBC’s/Leukocytes – protect the body from bacterial
GLUCOSE TESTS and foreign body invasion. Capillary Blood Glucose (CBG) – NPO 1-2 hours prior for accurate results Neutrophils – phagocytosis; 1st line of defense, (NR: 70-110mg/dL) others: 80-120mg/dL arrive at a given site within 1 hour of inflammatory Random Blood Sugar (RBS) – no fasting reaction, short lived; sensitive to bacterial Fasting Blood Sugar (FBS) – requires NPO for 8 hours; invasion. results may be affected by diet Monocytes – with longer phagocytic action; 2nd Glycosylated Hemoglobin (HBA1C) – most accurate line of defense; effective against bacteria, fungi indicator of patient’s glucose control for the past 3-4 and viruses months; no fasting. Eosinophils – allergic reactions/ phagocytosis of (NR: 6-6.8%) parasites Basophils – allergic reactions; produce and stores LIVER ENZYMES: TRANSAMINASES histamines and other substances involved in Sensitive indicators of live injury/tissue injuries hypersensitivity reactions Based from release of enzymes from damaged liver cells. SERUM ELECTROLYTES Aspartate Aminotransferase (AST or SGOT) - Contraction of skeletal and cardiac muscles Alanine Aminotransferase (ALT or SGPT) Na 135-145 mEq/L K 3.5-5 mEq/L BLOOD CULTURES o ↑ (excitable heart); cardiac arrest Aerobic o ↓ cardiac arrest Anaerobic Ca 4.5-5 mg/dL X2 in 2 different areas 1UE 1LE o Ca ↑ P ↓ (reverse effect) Nursing Responsibilities Cl 97-107 mEq/L o Peak of fever Phosphorus 2.5-4.5 mg/dL o No antipyretics prior to blood extraction Mg 1.3-2.5 mEq/L o Prior to start antibiotics Diagnostic Tests Results Lower GI Endoscopy (LGIE) – Colonoscopy o 24hrs (NPO from midnight), Proctosigmoidoscoy, o 48hrs Anoscopy (place on knee-chest position) o 72hrs final report INDIRECT VISUALIZATION CULTURE AND SENSITIVITY TESTS Culture – determines the specific microorganism Xrays possibly causing the infection. Roentgenography – Xray; visualization of body Sensitivity – determines the specific antibiotics that the parts with the use of roentgen rays; mostly non- microorganism is sensitive, as well as those that make invasive them resistant. Ask if patient is pregnant – exposure of baby to URINALYSIS radiation may cause congenital anomalies. Early morning Clean catch no squamous cells Angiography/Fluoroscopy – invasive, puncture Midstream urine through femoral artery where catheter will be Label properly: name, age, birthday, date, and time of inserted, and injection of dye into affected collection arteries before xray. Check for allergies to Iodine. Send to lab within 30 minutes of collection to prevent Cerebral Angiography bacterial growth. Coronary Angiography
URINE CULTURE AND SENSITIVITY TEST Barium Swallow
Examination of Upper GI tract under fluoroscopy STOOL CULTURE after the patient drinks Barium Sulfate NPO from Midnight OCCULT BLOOD/GUIAC TEST Occult – hidden/not seen by the naked eye. CT Scan To check for presence of occult blood in the stool Hemoglobin free diet for 3 days prior to specimen Magnetic Resonance Imaging (MRI) collection. No metals No red meat, beef, lessen meat, green leafy vegetables, dark-colored foods that may alter stool Ultrasound color. TRANSFORMED VISUALIZATION FECALYSIS Graphic representation of a structure or its function. Collect small amount Graphs are translation of physical energy forms: Label properly electricity, sound, and radiation waves Send to lab within 30 minutes of collection to prevent bacterial growth within specimen Electrocardiogram (ECG)
Direct Visualization Electrodes will be attached to the patient’s Indirect Visualization head. Transformed Visualization EMG with NCS/NCV DIRECT VISUALIZATION Several needles will be injected to the muscles Viewing of internal body cavities with the use of scopes, and projected on the screen. Audiogram/Audiometry Invasive – requires informed and signed consent Measures hearing acuity. form. All possible consequences should be well Pure Tone Audiometry explained by the doctor. Speech Audiometry Decibels – unit of measurement for Fundoscopy – ophthalmoscope; visual acuity loudness/intensity of sound. and eye structures. Otoscopy – examination of internal ear TESTS FOR FUNCTIONS structures with otoscope. Exercise Tolerance/Treadmill Stress Test Bronchoscopy – direct inspection and Basal Metabolic Rate observation of the respiratory tract. Blood Gas Analysis
Cystoscopy – direct visualization of the bladder;
requires full bladder, drink 1-2 glasses of fluid prior to procedure.