Labs and Dx Vmmc Sepsis

7/21/2019 Labs and Dx Vmmc Sepsis

1/21

DIAGNOSTIC PROCEDURES

Cytologicand

Hystologic Studies

Cytological studies indicate superficial soft tissue masses/inflammatory lesions, Intra-abdominal masses, Peripheral andmesenteric lymph nodes, Internal organs, Body cavity effusions. Histology Indicates firm lesions, iagnoses !here architecture

is needed to ma"e the diagnosis #e.g. small cell lymphoma, inflammation in hemodiluted samples$

Date Done Name of Test/Pocedue

Indication fo t!etest / Pocedue

Nomal"indings

Actual Results Inte#etation andAnalysis

NusingRes#onsi$ilities

%ctober&', &'(&

%AmangRodigue&

'edicalCente(

Biopsy

)ppendectomy

A##endi)

) diagnosticprocedure used to

investigatesuperficial lumps or

masses. It is a

method of obtainingdiagnostic materialfor cytologic #cell$

and histologic#tissue$ study thatcauses a minimal

amount of trauma tothe patient. (Manual

of Laboratory &Diagnostic Tests by

Fischbach, 7thEdition, page 763

Benign ornegative* no

abnormalcells or

abnormal

tissuepresent

+opathogenicorganisms

he specimenconsists ofvermiform

appendi . '.0 '.1 cm.

he serosa isdar" bro!n andcovered !ithcream-yello!

purulenteudates.2ectioning

reveals a '.( cmthic" !all bearing

a '. cm in

diameter point ofrupture at itsdistal third

segment. helumen averages

'.3 cm indiameter andcontains dar"bro!n fecal

Inte#etation*

)n abnormal result ofthe biopsy may be due

to

Analysis*

(Manual of Laboratory& Diagnostic Tests byFischbach, 7th Edition,

page76!

Petest Patient Cae

4plain the purpose and

procedure, benefits, andris"s of the test. 4venthough a local

anesthetic is used, theprocedure causes somediscomfort, and thisshould not beminimi5ed. If theapproach involvespassing near a rib, thepain may be greaterbecause of thesensitivity of the bone6

this is not a cause foralarm.

7nepected pain may

induce a vasovagal orother undesirableresponse. %ther ris"sinclude infection andhematoma or


2/21

material. Bloc" 8

)cute2uppurative

appendicitis,ruptured, !ithperiappendicitis

hemorrhage, dependingon the site aspirated.

Pocedue

7se local anesthesia in

most cases. )spiratesuperficial or palpablelesions !ithoutradiologic aid, butaspirate nonpalpablelesions usingradiographic imaging asan aid for needleplacement. 7se sterile

techni9ue. Position the needle

properly, then retractthe plunger of thesyringe to createnegative pressure.:ove the needle up anddo!n, and sometimesat several differentangles. ;elease the

plunger of the syringeand remove the needle.

4press material

obtained onto glassslides, !hich musteither be fiedimmediately in 0ro!th* =ightgro!th

Inte#etation*)n abnormal result ofthe pathology may be

due to the

Analysis*(Medical and "urgical

#ursing by$gnata%icius and

or'an, )th Edition,page *+7

+ovember&, &'(8 ,ounddisc!age It is a method ofobtaining diagnosticmaterial for cytologic#cell$ and histologic#tissue$ study thatcauses a minimal

amount of trauma tothe patient. (Manual


Fischbach, 7thEdition, page 763

Benign ornegative* noabnormalcells or

abnormaltissue

present

+opathogenic

organisms

Clinicalimpression*2urgical siteimpression

?inal reading*Candida)lbicans

;emar"s* >erm

tube result

Inte#etation*)n abnormal result ofthe pathology may be

due to the

Analysis*(Medical and "urgical

#ursing by$gnata%icius and

or'an, )th Edition,

page *+7


4/21

:onitor for signs of

inflammation and usesite care infectioncontrol measures. reat

pain, !hich may becommon in sensitiveareas such as thebreast, nipple, prostate,and scrotum.

:onitor for specific

problems, !hich varydepending on the siteaspirated #eg,hemoptysis after a lung

aspiration$. Counsel about follo!-up

procedures forinfections and malignantconditions.


5/21

He#atitis -Seology

Test

his test is an indication of previous infection, as !ell as current infection, and gives an indication of immunity #antibodies$ tofuture eposure, in the case of Hepatitis B.


Indication fo t!etest / Pocedue Cut off +alue Patient +alue Inte#etation andAnalysis Nusing es#onsi$ilities

%ctober &,&'(8

Hepatitis Bsurfaceantigen

#HBs )g$

o screen for anddetect HB@

infections6 earliestindicator of acutehepatitis B and

fre9uently identifies

infected peoplebefore symptomsappear

(Manual ofLaboratory &

Diagnostic Tests byFischbach, 7th

Edition, page ))+

+on-reactive +on-reactive Nomal Pre-test*

)ssess patientAs social

and clinical history and"no!ledge of test.4plain test purposeand procedure.

Procedure*

Collect a 1-m= blood

serum sample in a red-topped tube or t!olavender-toppedethylenediaminetetraacetic acid #4)$ tubes, m= each, for plasma.%bserve standard

precautions. Centrifugepromptly andaseptically. Placespecimen in abioha5ard bag fortransport to thelaboratory. 2endspecimens fro5en on

%ctober &,&'(8 Hepatitis Bantibody#)nti-Hbs$

his test indicatesthat a person hassuccessfully

responded to thehepatitis B vaccineor has recovered

from an acutehepatitis B

infection. (Manual

C.%.@.('.''' 0.81;eactive +ormal


6/21


Fischbach, 7thEdition, page )-*

dry ice. Chec" !ithyour laboratory forprotocols and !hetherplasma or serum is

needed. Be a!are that some

specimens need to besplit into t!o plasticvials before free5ingand sent fro5en on dryice. Chec" !ith yourlaboratory.

Post-test*

4plain significance oftest results andcounsel appropriatelyregarding presence ofinfection, recovery, andimmunity. Counselhealth care !or"ersand family regardingprotective andpreventive measures

necessary to avoidtransmission. Instructpatient to alert healthcare !or"ers andothers regarding theirhepatitis history insituations in !hicheposure to body fluidsand !astes may occur.

%ctober &,&'(8

Hepatitis Cantibody

#)nti-HC@$

his test detects thepresence of

antibodies to thevirus, indicating

eposure tohepatitis c virus.


Diagnostic Tests by

Fischbach, 7thEdition, page ).3

C.%.@. '.&' '.3+on-reactive

+ormal


7/21

.A-ORATOR STUDIES

Com#lete-lood Count

his test is used to evaluate anemia, leu"emia, reaction to inflammation and infections, peripheral bloodcellular characters,2tate of hydration and dehydration.


Indication fo t!etest / Pocedue

Nomal"indings

ActualResults

Inte#etation andAnalysis

NusingRes#onsi$ilities

%ctober 8(,&'(8

Hemoglobin It is used todetermine the

concentration ofhemoglobin in !holeblood. It also serves

as an important

buffer in theetracellular fluid.(Manual of

Laboratory &Diagnostic Tests by

Fischbach, 7thEdition, page 7!

(8-(' g/= 0 g/= Inte#etation*

ecreased hemoglobinmay be due to the clients

Analysis*

(Medical and "urgical#ursing by $gnata%icius

and or'an, )th Edition,page .7

Petest*

4plain test

procedure. 4plainthat slight discomfortmay be felt !hen s"in

is punctured.

)void stress if

possible becausealtered physiologicstatus influences andchanges normalhemogram values.

2elect hemogram

components orderedat regular intervals#eg, daily, every otherday$. hese shouldbe dra!n consistentlyat the same time ofday for reasons ofaccurate comparison6

+ovember ,&'(8

Hemoglobin It is used todetermine the

concentration ofhemoglobin in !holeblood. It also serves

as an importantbuffer in the

etracellular fluid.(Manual of


(8-(' g/= g/= Inte#etation*

ecreased hemoglobinmay be due to the clients

Analysis*




8/21


9/21

Edition, page 7! needle.

:onitor the

puncture site for

oo5ing or hematomaformation. :aintainpressure dressingson the site ifnecessary. +otifyphysician of unusualproblems !ithbleeding.

;esume normal

activities and diet.

Bruising at the

puncture site is notuncommon. 2igns ofinflammation areunusual and shouldbe reported if theinflamed areaappears larger, if red

strea"s develop, or ifdrainage occurs.

+ovember ,&'(8

Hematocrit his test indirectlymeasures the ;BC

mass. he resultsare epressed asthe percentage byvolume of pac"ed

;BCs in !holeblood #PC@$. It is an

importantmeasurement in the

determination ofanemia or

polycythemia.(Manual ofLaboratory &


Edition, page 7!

'.'-'. '.&3 Inte#etation*

ecreased hematocritmay be due to the clients

Analysis*



+ovember ,&'(8

Hematocrit his test indirectlymeasures the ;BCmass. he results

are epressed asthe percentage byvolume of pac"ed

;BCs in !holeblood #PC@$. It is an

importantmeasurement in the

determination ofanemia or

'.'-'. '.&( Inte#etation*

ecreased hematocrit

may be due to the clients

Analysis*




10/21

polycythemia.(Manual of


Fischbach, 7thEdition, page 7!

%ctober 8(,

&'(8

Dhite blood cell It helps diagnosean

infection

orinflammatory

process6 it also maybe used to

determine thepresence of other

diseases that affectDBCs(Manual of


Fischbach, 7thEdition, page !-

.' ('E0/=-

('.'('E0/=

&(.(0('E0/=

Inte#etation*

Increased !hite blood cellmay be due to the clients

Analysis*



+ovember ,

&'(8

Dhite blood cell It helps diagnoseaninfectionor

inflammatoryprocess6 it also maybe used to


diseases that affectDBCs


.' ('E0/=-

('.'('E0/=

(1.0('E0/=

Inte#etation*


Analysis*


http://labtestsonline.org/glossary/infection/http://labtestsonline.org/glossary/inflammation/http://labtestsonline.org/glossary/inflammation/http://labtestsonline.org/glossary/infection/http://labtestsonline.org/glossary/inflammation/http://labtestsonline.org/glossary/inflammation/http://labtestsonline.org/glossary/inflammation/http://labtestsonline.org/glossary/inflammation/http://labtestsonline.org/glossary/infection/http://labtestsonline.org/glossary/inflammation/http://labtestsonline.org/glossary/inflammation/http://labtestsonline.org/glossary/infection/


11/21


Edition, page !-

+ovember ,&'(8

Dhite blood cell It helps diagnoseaninfectionorinflammatory

process6 it also maybe used to


diseases that affectDBCs

(Manual of

Laboratory &Diagnostic Tests byFischbach, 7th

Edition, page !-

.' ('E0/=-('.'

('E0/=

&'.(8('E0/= Inte#etation*


Analysis*


and or'an, )th Edition,

page .7

%ctober 8(,&'(8

=ymphocytes his test measuresthe number of

lymphocytes in theperipheral blood. It

operates in the

immune defenses ofthe body.(Manual of


Fischbach, 7thEdition, page 6*

'.&' F '.' '.'0 Inte#etation*

ecreased lymphocytesmay be due to the clients

Analysis*


http://labtestsonline.org/glossary/infection/http://labtestsonline.org/glossary/inflammation/http://labtestsonline.org/glossary/inflammation/http://labtestsonline.org/glossary/infection/http://labtestsonline.org/glossary/inflammation/http://labtestsonline.org/glossary/inflammation/


12/21

+ovember ,&'(&

=ymphocytes his test measuresthe number of

lymphocytes in theperipheral blood. It

operates in theimmune defenses ofthe body.



Edition, page 6*

'.&' F '.' '.( Inte#etation*


Analysis*



+ovember ,

&'(&

=ymphocytes his test measures

the number oflymphocytes in theperipheral blood. It

operates in theimmune defenses of

the body.(Manual of


Fischbach, 7thEdition, page 6*

'.&' F '.' '.(& Inte#etation*


Analysis*



%ctober 8(,&'(8

2egmentedneutrophils

his test determinesthe presence ofneutrophilia orneutropenia.(Manual of


'.3'-'.1' '.08 Inte#etation*

Increased segmentersmay be due to

Analysis*


13/21

Fischbach, 7thEdition, page )


and or'an, )th Edition,page ..-

+ovember ,&'(&





'.3'-'.1' '.( Inte#etation*


Analysis*



+ovember ,&'(&





'.3'-'.1' '.3 Inte#etation*


Analysis*




14/21

Clinical

C!emisty

Blood c!emisty testing identifies many chemical blood constituents. It is often necessary to measure several blood

chemicals to establish a pattern of abnormalities. ) !ide range of tests can be grouped under the headings of en5ymes,

electrolytes, blood sugars, lipids, hormones, proteins, vitamins, minerals, and drug investigation.

Date done Name of Test/Pocedue

Indication fo t!eTest/ Pocedue

Nomal"indings

ActualResult/

"indings

Inte#etation andAnalysis

NusingRes#onsi$iliti

%ctober 8(,

&'(8

Potassium It evaluates changesin body potassium

levels and diagnosesacid-base and !ater

imbalances.(Manual of Laboratory& Diagnostic Tests by

Fischbach, 7thEdition, page .6*

8.-.(

umol/=

.' umol/= NomalPe0test*

4plain purpos

procedure.

4ncouragerelaation.

Be a!are that

tourni9uet

application sho

be as brief as

possible !hendra!ing to pre

venous stasis

hemolysis.

4nsure that

supplements a

ta"en !ithin t

+ovember &,

&'(8



imbalances.(Manual of Laboratory& Diagnostic Tests by


8.-.(

umol/=

8.& umol/= Inte#etation*

ecreased potassium may

be due to the clients

Analysis*

(Medical and "urgical

#ursing by $gnata%icius


page .7

+ovember ,

&'(8


8.-.(

umol/=

&. umol/= Inte#etation*


15/21


imbalances.(Manual of Laboratory

& Diagnostic Tests byFischbach, 7thEdition, page .6*

ecreased potassium may

be due to the clients

Analysis*

(Medical and "urgical

#ursing by $gnata%icius


page .7

hours before th

blood sample i

dra!n.

Post0Test*

Interpret test re

monitor chang

body potassiu

intervene as

appropriate.

Be a!are that

recogni5ing sig

and symptoms

hypo"alemia a

hyper"alemia i

important. :an

these originate

nervous and

muscular syste

and are usually

nonspecific an

similar.

+ovember ,

&'(8


levels and diagnoses

acid-base and !aterimbalances.

(Manual of Laboratory& Diagnostic Tests by


8.-.(

umol/=

8. umol/= Nomal

%ctober 8(,

&'(8

2odium It is used to determineelectrolytes, acid-

base balance, !ater

balance, !aterintoication, and

dehydration. (Manualof Laboratory &


Edition, page .6!

(8-(3

m49/=

(3 m49/= Nomal

+ovember , 2odium It is used to determine (8-(3 (8 m49/= Nomal


16/21

&'(8 electrolytes, acid-base balance, !ater

balance, !aterintoication, and

dehydration. (Manualof Laboratory &Diagnostic Tests by

Fischbach, 7thEdition, page .6!

m49/=

;emember tha

potassium bloolevel rises '.3

#'.3 mmol/=$ fo

every '.( decr

in blood pH.%ctober 8(,

&'(&

Creatinine Itdiagnoses impairedrenal function. It is amore specific and

sensitive indicator of"idney disease than

B7+.



1(-((

umol/=

8& umol/= Inte#etation*

Increased creatinine may

be due to

Analysis*



+ovember &,

&'(8

Creatinine Itdiagnoses impairedrenal function. It is amore specific and


B7+.


Fischbach, 7th

1(-((

umol/=

&18 umol/= Inte#etation*


be due to

Analysis*



17/21

Edition, page .6* and or'an, )th Edition,page ..-

+ovember ,

&'(8

Creatinine Itdiagnoses impaired

renal function. It is amore specific andsensitive indicator of"idney disease than

B7+.



1(-((

umol/=

&&& umol/= Inte#etation*


be due to

Analysis*



+ovember ,

&'(8

Creatinine It

diagnoses impairedrenal function. It is amore specific and


B7+.



1(-((

umol/=

(0 umol/= Inte#etation*


be due to

Analysis*




18/21


19/21

the ability of the lungsto oygenate the bloodand is used to assessthe effectiveness of

oygen therapy.(Manual of Laboratory& Diagnostic Tests byFischbach, 7th Edition,

page .37

Perform the

modified )llenAs testto assess collateral

circulation beforeperforming a radialpuncture, as follo!s*

4levate the

patientAs !rist !ith asmall pillo!, and as"the patient to etendthe fingers do!n!ard#this flees the !rist

and positions theradial artery closer tothe surface$.

:ean!hile,

ensure that all airbubbles in the bloodsample are epelledas 9uic"ly as

possible. )ir in thesample changes )B>values. Cap thesyringe and gentlyrotate to mi heparin!ith the blood.

=abel the sample

%ctober 8(,&'(8

Partialpressure of

carbon dioide#PC%&$

his test measures thepressure or tensioneerted by dissolved

C%&in the blood #('

Documents

Labs and Dx Vmmc Sepsis