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Test Definition Result Normal Range Interpretation/Sig Nursing

nificance Responsibilities
02/20/2017 Hematology is Hemoglobin: Hemoglobin: Within normal 1. Explain test
Hematology the branch of 131 g/L 120-160 g/L range. If above procedure.
Explain that
medicine concer normal-
slight
ned with the dehydration, renal discomfort
study, diagnosis, problems, may be felt
when the
treatment, and pulmonary disease,
skin is
prevention of congenital heart punctured.
diseases related disease,
2. Encourage to
to the blood. polycythemia vera
avoid stress
if possible
Below normal- because
indicates anemia, altered
physiologic
hemorrhage, bone status
marrow failure and influences
renal disease. and changes
normal
hematologic
values.
RBC: RBC: Within normal
3. Explain that
4.19x1012/L 4.0-5.0 1012/L range. If above
fasting is not
normal- necessary.
dehydration, renal However,
problems, fatty meals
pulmonary disease, may alter
some test
congenital heart
results as a
disease, result of
polycythemia vera lipidemia.

4. Apply
Below Normal- manual
indicates anemia, pressure and
dressings
hemorrhage, bone
over
marrow failure, puncture site
renal disease. on removal
of dinner.
5. Monitor the
MCH: MCH: Within normal puncture site
31.2pg 28-33pg range. If above for oozing or
normal- vitamin hematoma
formation.
B12 or Folate
Deficiency 6. Instruct to
resume
normal
Below Normal-
activities and
because of blood diet.
loss over time, too
little iron in the
body, or microcytic
anemia

MCV: MCV: Within normal


94.5fl 82-98 fl range. If above
normal- vitamin
B12 or Folate
Deficiency

Below Normal- one


reason is because
of lead poisoning.
Long-lasting kidney
failure can also
cause the MCV
level to be too low.
A long-term
decrease of iron in
the body can cause
low MCV levels
MCHC: MCHC: Within normal
33g/L 33-36g/L range. If above
normal- sickle cell
disease, hereditary
spherocytosis

Below Normal-
because of blood
loss over time, too
little iron in the
body, or
hypochromic
anemia.

WBC: WBC: Within normal


10.2 x10^9/L 4.8-10.8 range. If above
x10^9/L normal- seen in
response to
infection, stress,
inflammatory
disorders, or
abnormal
production as in
leukemia.
If below normal-
there is an
increased risk of
infection

Neutrophil: Within normal


69% Neutrophil: range. If above
40-70% normal- infection,
inflammation,
leukemia, instense
exercise,
corticosteroids,
stress
If below normal- an
increased risk of
infection
Lymphocyte: Within normal
22% Lymphocyte: range. If above
19-48% normal- in response
to allergies or when
exposed to certain
types of bacteria or
parasites.
If below normal-
immunosuppressio
n, HIV/AIDS, bone
marrow failure
chemotherapy

Monocyte: Within normal


6% Monocyte: range
3-9% If Above normal-
when there is
sudden infection
from bacteria,
damage or
inflammation of
tissues.
If below normal-
immunosuppressio
n, HIV/AIDS, bone
marrow failure
chemotherapy

Eosinophil: Within normal


2% Eosinophil: range. If above
2-8% normal- are the flu
and the
chickenpox. Other
causes include
tuberculosis,
mumps, rubella,
varicella, whooping
cough, brucellosis,
and herpes simplex
Below normal-
generally not a
concern
Basophils: Within normal
1% Basophils: range. If above
0-0.5% normal- active
allergic response.
If below normal-
generally not a
concern

Hematocrit: Within normal


0.40% Hematocrit: range. If above
0.37-0.45% normal-
dehydration, renal
problems,
pulmonary disease,
congenital heart
disease,
polycythemia vera

Below normal-
indicates anemia,
hemorrhage, bone
marrow failure and
renal disease.

Platelet Within the normal


count: Platelet count: range. If above
381x109/ 150-400x109/L normal- leukemia,
myeloproliferative
disorders,
inflammatory
conditions.
If below normal-
Bone marrow
failure,
chemotherapy, viral
infections, lupus,
pernicious anemia
(due to vitamin B12
deficiency),
leukemia or
lymphoma,
sequestration in the
spleen, certain
medications

Test Definition Result Normal Interpretation/ Nursing


Range Significance Responsibilities
02/20/17 Often, blood tests Sodium: Within the normal 1. Define and explain
Blood check electrolytes, 141 136-145 range. If above normal- the test.
mmol/L 2. State the specific
Chemistry the minerals that mmol/L dehydration, severe
purpose of the test.
help keep the vomiting & diarrhea,
3. Explain the
body's fluid levels CHF, Cushing's
procedure.
in balance, and are disease, hepatic failure, 4. Discuss test
necessary to help high-sodium diet, and preparation,
the muscles, heart, others procedure, and
and other organs If below normal- posttest care.
work properly. consumption of too
many fluids, kidney
Tests for failure, heart failure,
electrolytes cirrhosis, and use of
measure levels of diuretics.
sodium, potassium,
chloride, and Below normal- can be
magnesium in the caused by decreased
body. Potassium: 3.5-5.1 intake, protracted
3.3 mmol/L mmol/L vomiting, renal loss,
cirrhosis, renal failure
and others. Another
possible cause is heavy
alcohol or drug use.

Within the normal


range. If above normal-
high levels of PTH, or
Calcium: 2.12-2.52 by too much calcium
2.27 mmol/L getting into the body
mmol/L because of treatment
with calcium and
vitamin D tablets.
If below normal-
kidney failure when
there is insufficient
Vitamin D available, or
in people who have
already had surgery to
remove their
parathyroid glands.

Within the normal


range. If above normal-
usually develops only

Magnesiu 0.74- when people with kidney

m: 0.99mmol/ failure are given


magnesium salts or take
0.78 L
drugs that contain
mmol/L
magnesium (such as
some antacids or
laxatives).
If below normal-
alcoholism, burns that
affect a large area of
the body, chronic
diarrhea, polyuria, such
as in uncontrolled
diabetes and during
recovery from acute
kidney failure,
hypercalcemia,
hyperaldosteronism.

Within the normal


range. If above normal-
kidney damage or
Creatinine: 53-115 chronic kidney disease
59.4umol/L umol/L If below normal- diet
very low in protein,
severe liver disease, a
low muscle mass due to
a disease or aging, or
pregnancy, may also
indicate liver or heart
disease.

Test Definition Result Normal Significance/Interpretati Nursing


on Responsibilities
Urinalysi A urinalysis is a Color: light Color: Urine gets its yellow color 1. Collect specimens
s group of chemical yellow Pale from a pigment called from infants and
02/20/17 and microscopic yellow - urochrome. That color young children into
tests. They detect the yellow normally varies from pale a disposable
byproducts of normal yellow to deep amber, collection
and depending on the apparatus
abnormal metabolism concentration of the urine. consisting of a
, cells, cellular Darker urine is usually a plastic bag with an
fragments, sign that you're not adhesive backing
and bacteria in urine. drinking enough fluid. around the opening
that can be
fastened to the
Clarity: Clarity: If Cloudy urine may be perineal area or
Clear Clear caused by either normal around the penis to
or abnormal processes. permit voiding
Normal conditions giving directly to the bag.
2. Depending on
rise to turbid urine include
hospital policy, the
precipitation of crystals,
collected urine can
mucus, or vaginal
be transferred to an
discharge. Abnormal
appropriate
causes of turbidity include
specimen
the presence of blood
container.
cells, yeast, and bacteria.
3. Cover all
specimens tightly,
label properly and
Specific Specific Within normal range. send immediately
Gravity: Gravity: Above normal- may be to the laboratory.
4. Observe standard
1.010 1.005- associated with
precautions when
1.030 dehydration, diarrhea,
handling urine
emesis, excessive
specimens.
sweating, urinary
5. If the specimen
tract/bladder infection and
cannot be delivered
others. Below normal-
to the laboratory or
may be associated with
tested within an
renal failure,
hour, it should be
pyelonephritis, diabetes
refrigerated or have
insipidus, acute tubular
an appropriate
necrosis, interstitial
preservative
nephritis, and excessive
added.
fluid intake

Albumin: Albumin: If Trace- simply means


Negative Negative that the amount
of albumin is quite low and
just above the upper limit
of detection ability.
Having trace albumin in
your urine means that
your kidneys are
abnormally spilling a tiny
amount of protein into
the urine from the blood.

Sugar: Sugar: Sugar can be found


Negative Negative in urine when the kidneys
are damaged or diseased.

pH: 7.0 pH: Within normal range. A


4.6-8.0 high pH can be caused by
severe vomiting, a kidney
disease, some urinary
tract infections,
and asthma.
A low pH may be caused
by, uncontrolled diabetes,
aspirin overdose, severe
diarrhea, dehydration,
starvation, or drinking too
much alcohol.

WBC: 0-17/ UL Within normal range.


2/HPF High WBC is a sign of
infection
Low WBC is not a concern

RBC: 18/HPF 0-11/UL


Above normal- maybe due
to: -kidney and other
urinary tract problems,
such as infection, tumor,
or stones, kidney injury,
prostate problems or
bladder/kidney cancer.

Epithelial cells: Epithelia


Within normal range. High
4/HPF l cells:
epithelial cells, the cells in
0-17/ UL
the lining of the bladder or
urethra, may suggest
inflammation within
the bladder, but they also
may originate from the
skin and could be
contamination. Low result
is not a concern

Mucus Mucus Presence or absence of


Threads: Threads: mucus threads is not an
0/HPF 0-1/UL issue because it is usually
found in the urine.

Bacteria: Bacteria: Within normal range. If


5/ UL 0-278/ high- indicates infection.
UL

Test Definition Result Normal Interpretation/ Nursing


Value Significance Responsibilities
Clinical A glucose test is Within normal range.
Chemistry a type of blood Glucose: 4.4- If above normal- happens Pre-Procedure:
02/21/17 test used to 4.8mmol/L 6.4mmol/L when the body has too
determine the little insulin or when the Explain procedure to
amount of body can't use insulin the client.
glucose in the properly
blood. It is If below normal- Drinking Post-Procedure:
mainly used in alcohol, insulinoma,
screening for which is a rare tumor in Apply pressure to the
prediabetes or the pancreas that venipuncture site
diabetes produces too much
insulin, lack of a
hormone, such as
cortisol, growth hormone,
or thyroid hormone,
severe heart, kidney, or
liver failure, infection that
affects the whole body

Radiologic Findings

It is a result where you may know what you have after your physical examination using imaging techniques that
"reads" the images and produces a report of their findings and impression or diagnosis.

DATE COMPONENTS NORMAL ACTUAL RATIONALE Nursing Responsibilities


RESULT
RESULT
02/20/17 Chest PA Clear Clear Lung fields are clear. 1. Nurses may need to

Heart is not enlarged. reduce anxiety in some


patients, particularly in
Diaphragm ad
costophrenic sulci are those who are very young
intact. or confused.
2. Simple, loose clothing is
The rest of the included
important to gain access to
structures are
unremarkable. that part of the body under
examination. This may
mean a loose fitting gown
for hospital patients
3. Some specialized X-ray
IMP: Normal investigations may require
Chest Findings
nothing by mouth for a few
hours before the test, or a
particular bowel
preparation. Often, the
radiography department
will issue specific
instructions when the
appointment is made.
Nurses should ensure
these instructions are
carried out for all hospital
patients
4. Check to see if a female
patient is, or could be
pregnant. Exposure of the
unborn fetus to X-rays can
be damaging to the child
5. After the test, the patient
should be returned to their
normal activities if these
have been disturbed, i.e.
eating and drinking, as
quickly as possible

Test Definition Result Normal Interpretation/ Nursing


Value Significance Responsibilities
Immunolog These tests may Thyroid Within normal range. 1. Explain test
y (Thyroid be ordered to Stimulating If above normal- procedure.
Explain that
Antibodies) help investigate Hormone Hypothyroidism, Pituitary
slight discomfort
01/11/2017 the cause of an (TSH): Adenoma, Thyroid may be felt when
enlarged thyroid 0.424 ul U/ 0.4-4.0 ul Hormone Resistance the skin is
punctured.
(goiter) or other mL U/ mL If below normal- low level
signs and of TSH means that your 2. Encourage to
avoid stress if
symptoms thyroid gland is possible
associated with overactive and is making because altered
physiologic
low or high too much thyroxine
status influences
thyroid hormone and changes
levels. Testing normal
hematologic
may be Total T3 81-178 ng/ Within normal range.
values.
performed as a (TT3): 86.7 dL If above normal-
follow-up when ng/ dL Abnormally high levels of 3. Explain that
fasting is not
other thyroid test TT3 are common in
necessary.
results such as pregnant women and However, fatty
total or free T3, those with liver disease. meals may alter
free T4, and/or If below normal- some test results
as a result of
TSH indicate Euthyroid Sick lipidemia.
thyroid Syndrome, Inflammation
dysfunction. and Oxidative Stress, 4. Apply manual
pressure and
Hypothyroidism involves
dressings over
high levels of thyroid puncture site on
stimulating hormone removal of
dinner.
(TSH) and low levels of
5. Monitor the
the thyroid hormones T4 puncture site for
and TT3. oozing or
hematoma
formation.
Free T4 0.89-1.76 Within normal range. 6. Instruct to
resume normal
(FT4): 1.26 ng/ dL If above normal- Elevated
activities and
ng/ dL FT4 levels may indicate diet.
hyperthyroidism. They
may also indicate other
thyroid problems, such as
thyroiditis or toxic
multinodular goiter
If below normal-
Hypothyroidism involves
high levels of thyroid
stimulating hormone
(TSH) and low levels of
the thyroid hormones FT4
and TT3.

ULTRASOUND OF THE THYROID (01/12/2017)


Thyroid Sonogram: Nursing Responsibilities:
Right thyroid lobe is slightly enlarged and measure 5.1x
1.8x 1.2cm. The normal sized left lobe measures 4.2x 1.8x Answer any questions about the procedure.

1.3cm. Both have inhomogenous and nodular echotextures.


Assess patients health, including allergies and
The largest nodule is noted in the right superior pole and
measures 2.2x 1.4cm. It has mixed but predominantly solid
other health issues.
hypoechoic portions with thin, well-defined hypoechoic rim.
There is mild-mod color flow within and its periphery on Doppler
Monitor blood pressure and temperature.
evaluation. A small 0.21cm oral hypoechoic nodule is also noted
in the midpole of the left lobe. Inform that there is no necessary preparation
There are no mass lesions in the immediate vicinity of the before the test.
thyroid, bilaterally. No enlarged cervical lymph nodes are seen
bilaterally. Monitor recovery and discharge after the
procedure.
Impression:
NODULAR THYROID LOBES WITH A MIXED NODULE IN THE
SUPERIOR POLE OF THE RIGHT

FINE NEEDLE ASPIRATION BIOPSY (02/07/2017)


Specimen: Thyroid Complex Mass FNA
Pathologic Diagnosis: Nursing Responsibilities:
THYROID COMPLEX MASS, RIGHT FNAB
CYTOMORPHOLOGIC FINDINGS CONSISTENT WITH Answer any questions about the procedure.

PAPILLARY THYROID CARCINOMA


Secure consent

Gross and Microscopic Description:


Assess patients health and other health
Received are 13 slides with smears stated to be from an FNAB of
issues.
the right thyroid complex mass
Monitor vital signs.

Inform that there is no necessary preparation


before the test.

Monitor recovery and discharge after the


procedure.

Possible Diagnostic Tests:

Thyroid Scan - or nuclear medicine scan, tests the gland's function. After a radioactive tracer is injected, a special
camera captures images of the thyroid gland and measures the amount of dye the gland (nodules) absorbs.

Laryngoscopy -depending on your tumor's characteristics, and the close proximity of your thyroid gland to your voice box
(larynx), your doctor may recommend laryngoscopy. A laryngoscope is a lighted and flexible tube with magnification used
to examine your larynx.

Computed tomography (CT) scan -an x-ray test that produces detailed cross-sectional images of your body. It can help
determine the location and size of thyroid cancers and whether they have spread to nearby areas, although ultrasound is
usually the test of choice. A CT scan can also be used to look for spread into distant organs such as the lungs.

Magnetic resonance imaging (MRI) scan -like CT scans, MRI scans can be used to look for cancer in the thyroid, or
cancer that has spread to nearby or distant parts of the body. But ultrasound is usually the first choice for looking at the
thyroid. MRI can provide very detailed images of soft tissues such as the thyroid gland. MRI scans are also very helpful in
looking at the brain and spinal cord.
Positron emission tomography (PET) scan- this test can be very useful if your thyroid cancer is one that doesnt take
up radioactive iodine. In this situation, the PET scan may be able to tell whether the cancer has spread.