Diagnostic and Laboratory Procedures

1. Complete Blood Count (CBC)

- It is the basic screening test and is one of the most frequently ordered laboratory
procedures
- The findings in CBC give valuable diagnostic information about the hematologic and
other body systems; prognosis, response to treatment and recovery.
- The CBC consists a series of tests that determine the number, variety, percentage,
concentration and quality of blood cells.
- It is done to evaluate the number of circulating red cells in the blood toward
diagnosing disease and monitoring therapeutic treatment. Variations in the number of
cells is most often seen in anemias, cancer and hemorrhage.
Nursing Responsibilities:
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 tests results as
a result of lipidemia.
4. Apple 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.

Normal Values
Hgb: 120.0 150.0 mg/L

Complete Blood Count

Date: 7-5-16
Values Obtained
95.0

Hct: 0.37 0.47 g/dL

0.27

RBC count: 4.0-5.40

WBC: 4.50-11.00
Platelet Count: 200-400
MCV: 83-101

3.5
8.5
314
77.1

MCHC: 315-345 g/L

352

Differential Leukocyte Count

Segmenters: .55-.65
Eukocytes: .25-.35

.83
.17

Clinical Interpretation
A low hemoglobin level
indicates your body
produces fewer RBC than
usual.
Reduced hematocrit level
may be due to shock,
hemorrhage, dehydration
or excessive IV fluid
administration
May indicate anemia
Normal
Normal
May indicate microcytic
anemia
May indicate autoimmune
hemolytic anemia
May be due to infection
Indicates low in infection
resistance.

Normal Values
Hgb: 120.0 150.0 mg/L

Complete Blood Count

Date: 6-30-16
Values Obtained
71

Hct: 0.37 0.47 g/dL

0.29

RBC count: 4.0-5.40

WBC: 4.50-11.00
Platelet Count: 200-400

2.85
15.7
473

MCV: 83-101
MCHC: 315-345 g/L
Differential Leukocyte Count
Segmenters: .55-.65
Eukocytes: .25-.35

69
29.9
.96
.04

Clinical Interpretation
A low hemoglobin level
indicates your body
produces fewer RBC than
usual.
Reduced hematocrit level
may be due to shock,
hemorrhage, dehydration
or excessive IV fluid
administration
May indicate anemia
Indicates infection
The body may destroy its
own platelets due to
autoimmune diseases,
infection that causes too
much bleeding.
May indicate microcytic
anemia
Normal
May be due to infection
Indicates low in infection
resistance.

2. Compatibility Test

1.
2.
3.
4.
5.
6.

refers to the test that is performed prior to a blood transfusion in order to determine if
the donor's blood is compatible with the blood of an intended recipient.
is also used to determine compatibility between a donor and recipient, in organ
transplantation or blood transfusion.
is done by a certified laboratory technologist, in a laboratory.

Nursing Responsibilities
Explain test procedure. Explain that slight discomfort may be felt when the skin is
punctured.
Encourage to avoid stress if possible because altered physiologic status influences and
changes normal hematologic values.
Explain that fasting is not necessary. However, fatty meals may alter some tests results as
a result of lipidemia.
Apple manual pressure and dressings over puncture site on removal of dinner.
Monitor the puncture site for oozing or hematoma formation.
Instruct to resume normal activities and diet.

Compatibility Test
Patient Blood Type: O
Forward Typing:
(Tube method)
Anti A: (-)
Anti B: (-)
Anti O: (-)
Blood Type: O+

Values Obtained
Rh type: (+)
Reverse Typing
A1 Cells:
A2 Cells:
B Cells:
O Cells:
CROSS MATCHING RESULT

Major: Compatible
Minor: Compatible
Thermophase: No agglutination for hemolysis
Protein Phase: No agglutination for hemolysis
Protein Phase: No agglutination for hemolysis
Secreening Test
HIV: Nonreactive
HBSAg: Nonreactive
RPR: Negative
Malaria: Negative
Anti-HCW: Nonreactive
3. Arterial Blood Gas
- An arterial blood gas (ABG) test measures the acidity (pH) and the levels of oxygen
and carbon dioxide in the blood from an artery.
- This test is used to check how well your lungs are able to move oxygen into the blood
and remove carbon dioxide from the blood.
-

An arterial blood gas (ABG) test is done to:

1. Check for severe breathing problems and lung diseases, such asasthma, cystic
fibrosis, or chronic obstructive pulmonary disease (COPD).
2. See how well treatment for lung diseases is working.
3. Find out if you need extra oxygen or help with breathing (mechanical ventilation).
4. Find out if you are receiving the right amount of oxygen when you are using
oxygen in the hospital.

5. Measure the acid-base level in the blood of people who have heart failure, kidney
failure, uncontrolled diabetes, sleep disorders, severe infections, or after a drug
overdose.

Nursing Responsibilities
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. Apple manual pressure and dressings over puncture site on removal of dinner.
4. Monitor the puncture site for oozing or hematoma formation.
5. Instruct to resume normal activities and diet.
Arterial Blood Gas
Date: 6-30-16
Parameters
Ph: 7.35 -7.45

Values Obtained
7.27

PCO2: 35-45 mmHg

12

PO2: 80-100 mmHg

124

HCO3: 22-26 mEgL

5.5

Clinical Interpretation
Respiratory change is
acid - therefore
contributing to the
acidosis.
Indicates severe metabolic
acidosis.
May indicate Increased
oxygen levels in the
inhaled air or Polycythemia
Indicates
metabolic
problem. If not, it indicates
compensatory changes.
Normal

O2 Sat: 95-100%
98%
4. Blood Chemistry Testing
- Is identifying the numerous chemical substances found in the blood.
- The analysis of these substances will provide clues to the functioning of the major
body systems.
- To provide general information about how your body is functioning

To screen for a wide range of problems, including kidney, liver, heart, adrenal,
gastrointestinal, endocrine, and neuromuscular disorders
- To monitor people who have hypertension (high blood pressure) or hypokalemia (low
levels of potassium)
- To detect problems with the way your body is working
- To measure chemical substances in the blood
Nursing Responsibilities:
1. Report to the doctor any medications, herbs, or supplements that patient are taking.
They may be advised to discontinue certain of these agents before the test.
2. Instruct patient to avoid a diet rich in meats before a blood urea nitrogen test.
3. No special precautions are needed before testing for sodium, potassium, chloride,
carbon dioxide, or creatinine.
4. Instruct client to not drink alcohol before this test.
Normal Values
Urea Nitrogen
7.98-20.17 mg/dL

Values
Obtained
(7-6-16)
54.71

Creatinine 0.500.90 mg/dL

3.71

Potassium 3.505.10 mEq/L

3.30

Uric acid
2.30-6.10 mg/dL
Sodium
136-145

Normal Values
Fasting Glucose 70-115 mg/dL
Total Cholesterol <200 mg/dL

Blood Chemistry Testing

Values
Values
Values
Clinical
Obtained
Obtained Obtained Interpretation
(7-7-16)
(7-1-16)
(6-30-16)
25.83
Indicates
impaired kidney
function
1.29
Signifies
impaired kidney
function or
kidney disease
3.20
2.70
3.60
Indicates
impared kidney
function
2.53
Normal
137

Values
Obtained
335.82
154.23

126

101

Indicates
hyponatremia.
Kidney failure
as well as
vomiting or
diarrhea may
lead to
abnormal levels.

Clinical Interpretation
Elevated in diabetic patients
Normal

Triglycerides 50-150 mg/dL

HDL cholesterol 32.69-75 mg/dL

96.36
27.31

LDL cholesterol
65.40-130

108.42

Normal
Decreased in patients with type II
diabetes, overweight, obesity, and
a lack of physical activity
Normal

5. Electrocardiogram
- An electrocardiogram (EKG or ECG) is a test that checks for problems with
the electrical activity of your heart. An EKG shows the heart's electrical activity as
line tracings on paper.
- Check the heart's electrical activity.
- Find the cause of symptoms of heart disease. Symptoms include shortness of
breath, dizziness, fainting, and heartbeats that are rapid and irregular (palpitations).
- Find out if the walls of the heart chambers are too thick.
- Check how well medicines are working and see if they are causing side effects that
affect the heart.
- Check how well mechanical devices that are implanted in the heart, such
as pacemakers, are working. These devices help to control the heartbeat.
- Check the health of the heart when other diseases or conditions are present. These
include high blood pressure, high cholesterol, cigarette smoking, diabetes, and a
family history of early heart disease.
Nursing Responsibilities:
1. Explain the procedure to the patient. He needs to lie still, relax and breath normally
during the procedure.
2. Note current cardiac drug therapy.
3. Explain that test is painless and takes only 5-10 minutes.
Electrocardiogram
Rate: 97
Rhythm: Sinus
Interval: PR: 0.18
QRS: .10
QT: 0.40
Interpretation:
Sinus Rhythm, Poor R wave
Progression: Nonspecific ST-T wave

Values Obtained
Axis Device: +45 degrees

Date: 6-30-16