DIAGNOSTIC EXAMS

Blood Typing

This test is used to determine the blood type of the patient prior to donating or receiving blood. With blood typing, ABO and
Rh antigens can be detected in the blood of prospective blood donors and potential blood recipients. ABO system is where human
blood is grouped according to the presence or absence of these antigens. The major antigens are A and B where group A RBC
contains A antigen and group B RBC contains B antigen; while group AB RBC have both antigen A and B, which means group O
RBC have neither of the antigen. The Rh factor is to determine the presence or absence of Rh antigens on RBCs that determines the
classification of Rh positive (+) or Rh negative (-). Blood cross matching is a test performed to assure compatibility and guarantee
that no reaction will occur between the donor and the recipient’s blood

Diagnostic Normal
Date Result Clinical Significance Nursing Interventions
Exam Results
A ASO system Blood Type: Blood type B Determines: Pretest:
U A, B, AB and • ABO type >Obtain written consent for
G O - Type A,B AB or O the procedure
U • Rh type >Explain the procedure to the
S - Rh positive (+) or Rh patient
T negative (-) >Tell the patient that no

• Crossmatch Compatibility fasting is required

19, Rh Factor Rh Type: Rh positive (+)
Rh positive During Test:
2010 (+) or Rh >Collect 7 – 14 ml of venous
negative (-) blood in a red – top tube.
A Cross Compatibility Compatible in three Determines:
(may vary among
U Matching in the phases. • ABO type
 G donor’s and Both patient and donor - Type A,B AB or O laboratories)
U the has B cell typing, 1 • Rh type >Avoid hemolysis
S recipient’s serum A cell, negative - Rh positive (+) or Rh >Label the blood tube
T blood typing B cell and -1 Rh negative (-) appropriately before sending
typing. • Crossmatch Compatibility it to the laboratory.
27,
Posttest:
2010 >Apply pressure or a
A ASO system Blood Type: Blood type B Determines:
pressure dressing to the
U A, B, AB and • ABO type venipuncture site
G O - Type A,B AB or O >Assess the venipuncture
U • Rh type site for bleeding
S - Rh positive (+) or Rh
T negative (-)
• Crossmatch Compatibility
28, Rh Factor Rh Type: Rh positive (+)
Rh positive
2010 (+) or Rh
negative (-)
 Complete Blood Count

The CBC is a series of different tests used to evaluate the blood and the cellular components of RBC’s, WBC’s and
platelets. The CBC is used to assess the patient for anemia, infection, inflammation, polycythemia, hemolytic disease, and the effects
of ABO incompatibility, leukemia and dehydration status.

Laboratory Nursing
Date Result Normal Value Clinical Significance
Test Interventions

A Hemoglobin 70 g/L 135 - 175 g/L Increased in: polycythemia, dehydration, acute Pretest:
U (low) thermal injury, COPD >Identify patient
G Decreased in: hemorrhage, bleeding, anemia, and check the
U hemolytic anemia, fluid overload, fluid retention, requisition form
S pregnancy, cirrhosis of the liver, hyperthyroidism with the patient’s
T identification
WBC 9.6x109/L 5.0 - 10.0x109/L Increased in: infection, inflammation, bracelet.
19, (normal) leukocytosis, lymphoma, mumps, cancer (liver, >Inform the
intestine), tissue necrosis (burns, gangrene, patient that
2010 myocardial infarction), varicella, rubeola, blood needs to
leukemoid reaction be drawn from
Decreased in: aplastic anemia, bone marrow the designated
depression, pernicious anemia, some infectious or site. Provide
 parasitic diseases, brucellosis, typhoid fever, viral reassurance to
infections (influenza, rubella, hepatitis), typhus, help limit
dengue fever, malaria, Gaucher’s disease, radiation, anxiety.
antineoplastic drugs, toxic injestion of heavy metals, >The patient
SLE, Felty syndrome may be seated
or in supine
Neutrophils 43 55 – 75 % Increased in: chronic myelogenous leukemia position. The
(low) (CML), bacterial infection, severe burns, patient’s arm is
rheumatic fever, ketoacidosis, cancer, down in extension,
syndrome with easy access
Decreased in: drug reaction, autoimmune to the antecubital
neutropenia, maternal antibody production, aplastic fossa.
anemia, radiation or chemotherapy, megaloblastic
anemia, hypersplenism, cancer of the bone marrow
Posttest:
Lymphocytes 10 20 – 35 % Increased in: infectious mononucleosis, >Instruct patient
(low) infectious hepatitis, cytomegalovirus infection, to continue
pertussis, brucellosis, tuberculosis, syphilis, compression of
lymphocytic leukemia, the puncture site
Decreased in: thoracic duct drainage, right-sided for 2 to 5
heart failure, Hodgkin’s disease, SLE, aplastic minutes or until
anemia, HIV infection, military TB, renal failure, the bleeding
Terminal cancer stops.
>Assess the
 0.47 Increased in: skin diseases, trichinosis, scarlet patient’s arm to
Eosinophils 0.2 - 0.4 %
(high) fever, CML, MPD, Hodgkin’s disease, malignancy, ensure that the
rheumatoid arthritis, sarcoidosis, allergic bleeding has
reaction to drugs, allergies ceased. Apply
Decreased in: pyrogenic infection, shock, adhesive
postsurgical response bandage as
needed.
0.21 Increased in: polycythemia, dehydration, Addison’s >If hematoma
Hematocrit 0.40 - 0.52
(low) disease, acute thermal injury, extreme physical occurs or if there
exertion, COPD is still bleeding,
Decreased in: hemorrhage, anemia, hemolytic ask the patient to
anemia, fluid overload, fluid retention, cirrhosis, continue
leukemia, lymphoma compression of
the site or
elevate the arm
Hemoglobin 52 g/L 135 - 175 g/L Increased in: polycythemia, dehydration, acute
and rest in on
(low) thermal injury, COPD
top of the head.
A Decreased in: hemorrhage, bleeding, anemia,
U hemolytic anemia, fluid overload, fluid retention,
G pregnancy, cirrhosis of the liver, hyperthyroidism
U
S Erythrocytes 2.07x 10^6/uL 4.20 - 6.10 Increased in: polycythemia, renal tumor,
T (low) x10^6/uL dehydration, Addison’s disease, acute thermal
injury, extreme physical exertion, COPD
24, Decreased in: hemorrhage, fluid overload, fluid
 retention, anemia, aplastic anemia, bone marrow
2010 depression, hemolytic anemia, cirrhosis, leukemia,
lymphoma

Leukocytes 6.46 5.0 - 10.0 Increased in: infection, inflammation,

(normal) x10^3/uL leukocytosis, lymphoma, mumps, cancer (liver,
intestine), tissue necrosis (burns, gangrene,
myocardial infarction), varicella, rubeola,
leukemoid reaction
Decreased in: aplastic anemia, bone marrow
depression, pernicious anemia, some infectious or
parasitic diseases, brucellosis, typhoid fever, viral
infections (influenza, rubella, hepatitis), typhus,
dengue fever, malaria, Gaucher’s disease, radiation,
antineoplastic drugs, toxic injestion of heavy metals,
SLE, Felty syndrome

Neutrophils 47 55-75 % Increased in: chronic myelogenous leukemia

(low) (CML), bacterial infection, severe burns,
rheumatic fever, ketoacidosis, cancer, down
syndrome
Decreased in: drug reaction, autoimmune
neutropenia, maternal antibody production, aplastic
anemia, radiation or chemotherapy, megaloblastic
 anemia, hypersplenism, cancer of the bone marrow

Lymphocytes 17 20-35 % Increased in: infectious mononucleosis,

(low) infectious hepatitis, cytomegalovirus infection,
pertussis, brucellosis, tuberculosis, syphilis,
lymphocytic leukemia,
Decreased in: thoracic duct drainage, right-sided
heart failure, Hodgkin’s disease, SLE, aplastic
anemia, HIV infection, military TB, renal failure,
Terminal cancer

Monocytes 7 2-10 % Increased in: acute infection, tuberculosis,

(normal) syphilis, brucellosis, sarcoidosis, ulcerative
colitis, CML, myeloproliferative disease (MPD),
multiple myeloma, Hodgkin’s disease, non-
Hodgkin’s lymphoma, acute monocytic leukemia,
SLE, polyarteritis nodosa, rheumatoid arthritis
Decreased in: hairy cell leukemia, bone marrow
failure, aplastic anemia

Eosinophils 29 1-8 % Increased in: skin diseases, trichinosis, scarlet

(high) fever, CML, MPD, Hodgkin’s disease, malignancy,
rheumatoid arthritis, sarcoidosis, allergic
reaction to drugs, allergies
 Decreased in: pyrogenic infection, shock,
postsurgical response

Hematocrit 0.16 0.36- 0.52 Increased in: polycythemia, dehydration,

(low) Addison’s disease, acute thermal injury, extreme
physical exertion, COPD
Decreased in: hemorrhage, anemia, hemolytic
anemia, fluid overload, fluid retention, cirrhosis,
leukemia, lymphoma

Platelet 206 150 – 400 Increased in: bone marrow disorder or may
x10^3/uL accompany an apparently unrelated process
such as iron deficiency; chronic inflammatory
conditions, hemolytic anemias, malignancy, and
hemorrhage
Decreased in: congenital disorders, Fanconi’s
anemia, aplastic anemias, neoplasms, alcohol,
Thiazide Diuretics, Viral infections, radiotherapy,
Gram-negative sepsis, long-term bleeding problems

MCV 76.9 fl 79.00-94.80 fl Low: microcytosis-small RBC

(low) High: macrocytosis—large RBC

MCH 25.1 pg 25.60-32.20 pg High: uncomplicated macrocytic anemia- folic

 acid deficiency, hypothyroidism
(low) Decrease: iron deficiency anemia

Decrease: iron deficiency anemia, hypochromic- low

32.7 g/dL hemoglobin concentration
MCHC 32.20-36.50g/dL
(normal) Normal: normochromic- acute blood loss,
aplastic anemias, acquired hemolytic anemia
A Hemoglobin 100 g/L 135 - 175 g/L Increased in: polycythemia, dehydration, acute
U (low) thermal injury, COPD
G Decreased in: hemorrhage, bleeding, anemia,
U hemolytic anemia, fluid overload, fluid retention,
S pregnancy, cirrhosis of the liver, hyperthyroidism
T
Erythrocytes 2.75x 10^6/uL 4.20 - 6.10 Increased in: polycythemia, renal tumor,
30, (low) x10^6/uL dehydration, Addison’s disease, acute thermal
injury, extreme physical exertion, COPD
2010 Decreased in: hemorrhage, fluid overload, fluid
retention, anemia, aplastic anemia, bone marrow
depression, hemolytic anemia, cirrhosis, leukemia,
lymphoma

Leukocytes 7.07 5.0 - 10.0 Increased in: infection, inflammation,

(normal) x10^3/uL leukocytosis, lymphoma, mumps, cancer (liver,
intestine), tissue necrosis (burns, gangrene,
myocardial infarction), varicella, rubeola,
 leukemoid reaction
Decreased in: aplastic anemia, bone marrow
depression, pernicious anemia, some infectious or
parasitic diseases, brucellosis, typhoid fever, viral
infections (influenza, rubella, hepatitis), typhus,
dengue fever, malaria, Gaucher’s disease, radiation,
antineoplastic drugs, toxic injestion of heavy metals,
SLE, Felty syndrome

Neutrophils 52 55-75 % Increased in: chronic myelogenous leukemia

(low) (CML), bacterial infection, severe burns,
rheumatic fever, ketoacidosis, cancer, down
syndrome
Decreased in: drug reaction, autoimmune
neutropenia, maternal antibody production, aplastic
anemia, radiation or chemotherapy, megaloblastic
anemia, hypersplenism, cancer of the bone marrow

Lymphocytes 20 20-35 % Increased in: infectious mononucleosis,

(normal) infectious hepatitis, cytomegalovirus infection,
pertussis, brucellosis, tuberculosis, syphilis,
lymphocytic leukemia,
Decreased in: thoracic duct drainage, right-sided
 heart failure, Hodgkin’s disease, SLE, aplastic
anemia, HIV infection, military TB, renal failure,
Terminal cancer

Monocytes 11 2-10 Increased in: acute infection, tuberculosis,

(high) syphilis, brucellosis, sarcoidosis, ulcerative
colitis, CML, myeloproliferative disease (MPD),
multiple myeloma, Hodgkin’s disease, non-
Hodgkin’s lymphoma, acute monocytic leukemia,
SLE, polyarteritis nodosa, rheumatoid arthritis
Decreased in: hairy cell leukemia, bone marrow
failure, aplastic anemia

Eosinophils 16 1-8 Increased in: skin diseases, trichinosis, scarlet

(high) fever, CML, MPD, Hodgkin’s disease, malignancy,
rheumatoid arthritis, sarcoidosis, allergic
reaction to drugs, allergies
Decreased in: pyrogenic infection, shock,
postsurgical response

Basophil 0 0 -1 Increased in: hypersensitivity reactions,

(normal) ulcerative colitis, chronic hemolytic anemia,
Hodgkin’s disease, myxedema, CML,
polycythemia
 Decreased in: hyperthyroidism, pregnancy, stress,
Cushing syndrome

Hematocrit 0.29 0.36- 0.52 Increased in: polycythemia, dehydration,

(low) Addison’s disease, acute thermal injury, extreme
physical exertion, COPD
Decreased in: hemorrhage, anemia, hemolytic
anemia, fluid overload, fluid retention, cirrhosis,
leukemia, lymphoma

Platelet 144 150 – 400 Increased in: bone marrow disorder or may
x10^3/uL accompany an apparently unrelated process
such as iron deficiency; chronic inflammatory
conditions, hemolytic anemias, malignancy, and
hemorrhage
Decreased in: congenital disorders, Fanconi’s
anemia, aplastic anemias, neoplasms, alcohol,
Thiazide Diuretics, Viral infections, radiotherapy,
Gram-negative sepsis, long-term bleeding problems

MCV 77.1 fl 79.00-94.80 fl Low: microcytosis-small RBC

(low) High: macrocytosis—large RBC

MCH 25.7 pg 25.60-32.20 pg High: uncomplicated macrocytic anemia- folic

 acid deficiency, hypothyroidism
(low) Decrease: iron deficiency anemia

Decrease: iron deficiency anemia, hypochromic- low

34.5 g/dL hemoglobin concentration
MCHC 32.20-36.50g/dL
(normal) Normal: normochromic- acute blood loss,
aplastic anemias, acquired hemolytic anemia
S Hemoglobin 89 g/L 135 - 175 g/L Increased in: polycythemia, dehydration, acute
E (low) thermal injury, COPD
P Decreased in: hemorrhage, bleeding, anemia,
T hemolytic anemia, fluid overload, fluid retention,
E pregnancy, cirrhosis of the liver, hyperthyroidism
M
B Erythrocytes 2.39x 10^6/uL 4.20 - 6.10 Increased in: polycythemia, renal tumor,
E (low) x10^6/uL dehydration, Addison’s disease, acute thermal
R injury, extreme physical exertion, COPD
Decreased in: hemorrhage, fluid overload, fluid
02, retention, anemia, aplastic anemia, bone marrow
depression, hemolytic anemia, cirrhosis, leukemia,
2010 lymphoma

Leukocytes 6.07 5.0 - 10.0 Increased in: infection, inflammation,

(normal) x10^3/uL leukocytosis, lymphoma, mumps, cancer (liver,
intestine), tissue necrosis (burns, gangrene,
myocardial infarction), varicella, rubeola,
 leukemoid reaction
Decreased in: aplastic anemia, bone marrow
depression, pernicious anemia, some infectious or
parasitic diseases, brucellosis, typhoid fever, viral
infections (influenza, rubella, hepatitis), typhus,
dengue fever, malaria, Gaucher’s disease, radiation,
antineoplastic drugs, toxic injestion of heavy metals,
SLE, Felty syndrome

Neutrophils 62 55-75 % Increased in: chronic myelogenous leukemia

(low) (CML), bacterial infection, severe burns,
rheumatic fever, ketoacidosis, cancer, down
syndrome
Decreased in: drug reaction, autoimmune
neutropenia, maternal antibody production, aplastic
anemia, radiation or chemotherapy, megaloblastic
anemia, hypersplenism, cancer of the bone marrow

Lymphocytes 14 20-35 % Increased in: infectious mononucleosis,

(normal) infectious hepatitis, cytomegalovirus infection,
pertussis, brucellosis, tuberculosis, syphilis,
lymphocytic leukemia,
Decreased in: thoracic duct drainage, right-sided
 heart failure, Hodgkin’s disease, SLE, aplastic
anemia, HIV infection, military TB, renal failure,
Terminal cancer

Monocytes 10 2-10 Increased in: acute infection, tuberculosis,

(high) syphilis, brucellosis, sarcoidosis, ulcerative
colitis, CML, myeloproliferative disease (MPD),
multiple myeloma, Hodgkin’s disease, non-
Hodgkin’s lymphoma, acute monocytic leukemia,
SLE, polyarteritis nodosa, rheumatoid arthritis
Decreased in: hairy cell leukemia, bone marrow
failure, aplastic anemia

Eosinophils 14 1-8 Increased in: skin diseases, trichinosis, scarlet

(high) fever, CML, MPD, Hodgkin’s disease, malignancy,
rheumatoid arthritis, sarcoidosis, allergic
reaction to drugs, allergies
Decreased in: pyrogenic infection, shock,
postsurgical response

Hematocrit 0.27 0.36- 0.52 Increased in: polycythemia, dehydration,

(low) Addison’s disease, acute thermal injury, extreme
physical exertion, COPD
Decreased in: hemorrhage, anemia, hemolytic
 anemia, fluid overload, fluid retention, cirrhosis,
leukemia, lymphoma

Increased in: bone marrow disorder or may

150 accompany an apparently unrelated process
Platelet 150 – 400
such as iron deficiency; chronic inflammatory
x10^3/uL
conditions, hemolytic anemias, malignancy, and
hemorrhage
Decreased in: congenital disorders, Fanconi’s
anemia, aplastic anemias, neoplasms, alcohol,
Thiazide Diuretics, Viral infections, radiotherapy,
Gram-negative sepsis, long-term bleeding problems

Low: microcytosis-small RBC

78.8 fl High: macrocytosis—large RBC
MCV 79.00-94.80 fl
(low)
High: uncomplicated macrocytic anemia- folic
25.3 pg acid deficiency, hypothyroidism
MCH 25.60-32.20 pg
(low) Decrease: iron deficiency anemia

Decrease: iron deficiency anemia, hypochromic- low

33.3 g/dL hemoglobin concentration
MCHC 32.20-36.50g/dL
(normal) Normal: normochromic- acute blood loss,
aplastic anemias, acquired hemolytic anemia
Ultrasonography

It is a very safe technique, using high frequency sound waves which are transmitted through a part of the body and reflected
by the internal organs and structures which form the picture or image which can be analyzed. Information gained through this test
includes measurement of size, determination of shape and location, and actual movement of certain structures.
Diagnostic Normal Clinical Nursing
Date Result
Exam Results Significance Interventions
A Whole No anatomic Findings: Abnormal in: cyst, Pretest:
U ultrasound of or functional  The liver is normal in size with coarsened tumor, hypertrophy, >Obtain written
G the abdomen abnormalities parenchyma. No focal or diffuse lesions. obstruction or consent, particularly
U exist. The There are no dilated intrahepatic biliary ducts stricture, calculus, for any ultrasound
S organs are and vessels. The gallbladder is adequately aneurysm, foreign procedure that
T normal in deistended with non-thickened galls. No body, vascular involves insertion of
size, shape, intraluminal echoes seen. The widest occlusion, venous transducer into a
19, contour and antroposterior diameter of the common duct thrombosis, body cavity or blood
position. The measures 4 mm. atherosclerotic vessel
2010 internal plaque, abscess, >The nurse
structures of  The pancreas and spleen are obscured congenital schedules the
the organs by overlying bowel gas. anomaly, ultrasound
and nearby hematoma, examination before
tissues are  Right kidney measures 71 mm x 28 mm bleeding, or several days after
within normal (LW) with cortical thickness of 9 mm. Left pregnancy, fetal any barium studies;
limits. kidney measures 73 mm x 26 mm (LW) with development residual barium
 cortical thickness of 9 mm. No focal lesions blocks the
seen on both sides. Both presents transmission of
hyperechoic parenchyma relative to the liver ultrasound impulses
and spleen. No dilated collecting system >Abdominal
noted. ultrasound, requires
fasting from food for
 A 6.2 cm long dilated segment is noted in 12 hours
the infra-renal aorta having a maximal >Inform the patient
diameter 4.3 cm. A 1.8 cm intraluminal that the examination
thickening noted. is safe and painless
>instruct the patient
 Urinary bladder is partially filled. No not to void until after
intraluminal echoes noted. the test is completed
>Remove clothes,

 The prostate gland is enlarged having an jewelry and metallic

approximate weight of 31 gms. objects; wear a

hospital gown

Impression: Posttest:

 Liver Parenchymal Disease >remove conduction

gel from the skin
 Infrarenal Aortic Aneurysm with Mural
>assist patient to a
Thrombosis
comfortable position
 Grade II Prostatic Enlargement
and getting dressed,
 Bilateral Small Sized Kidneys with
as needed
Parenchymal Disease
Blood Studies

SERUM CREATININE
Creatinine is used to diagnose impaired renal function. This test measures the amount of creatinine in the blood. Creatinine is
a catabolic product of creatinine phosphate, which is used in skeletal muscle comntraction. Creatinine, as blood urea nitrogen (BUN),
is excreted entirely by the kidneys and therefore is directly proportional to renal excretory function.

SODIUM
This test is automatically performed when “serum electrolyte” is requested. It is used to evaluate and monitor fluid and
electrolyte balance and therapy. Sodium content in the blood is a result of balance between dietary sodium intake and renal
excretion.

POTASSIUM
This test is routinely performed in most patients investigated for any type of serious illness. Furthermore, because this
electrolyte is so important to cardiac function, it is a part of all complete routine evaluations, especially in patients who take diuretics
or hearts medication.

CALCIUM
This serum calcium test is used to elevate parathyroid function and calcium metabolism by directly measuring the total
amount of calcium in the blood. Serum calcium levels are used to monitor patients with renal failure, renal transplantation,
hyperparathyroidism, and various malignancies. They are also to monitor calcium levels during and after large – volume blood
transfusions.
 Diagnostic
Date Results Normal Value Clinical Significance Nursing Interventions
Exam
A Creatinine 202.20 53.00 – 115.00 umol/L Increased in: diseases affecting renal Pretest:
U umol/L Female: 44 – 97 umol/L function, such as glomerulonephritis, >Explain the procedure
G (high) Male: 53 – 106 umo/L pyelonephritis, acute tubular to the patient
U Adolescent: 0.5 – 1.0 necrosis, urinary tract obstruction, >Tell the patient that no
S mg/dL reduced renal blood flow (e.g. shock, fasting is required
T Child: 0.3 – 0.7 mg/dL dehydration, congestive heart failure
Infant: 0.2 – 0.4 mg/dL [CHF], atherosclerosis), diabetic During Test:
24, Newborn: 0.3 – 1.2 nephropathy, nephritis >For creatinine:
mg/dL Decreased in: debilitation, decreased  Collect
2010 muscle mass (e.g. muscular dystrophy, approximately 5
myasthenia gravis [MG]) mL of blood in a
red-top tube
Sodium 130 mmol/L Adult: 136 - 155 mmol/L Increased in: increased sodium  For pediatric
(low) Child: 136 – 145 mmol/L intake (increased dietary intake, patient, blood can
Infant: 134 – 150 mmol/L excessive sodium in IV fluids), is usually drawn
Newborn: 134 – 144 decreased sodium loss (Cushing from a heel stick
mmol/L syndrome, hyperaldosteronism), >For sodium:
excessive free body water loss  Collect 5 to 10 mL
(gastrointestinal loss with without of venous blood
rehydration, excessive sweating, in a red- or green-
extensive thermal burns, diabetes top tube
insipidus, osmotic dieresis)
 If the patient is
Decreased in: decreased sodium intake
 ( deficient dietary intake, deficient receiving an IV
sodium in the IV fluids), increased infusion, obtain
sodium loss (Addison disease, the blood from the
diarrhea, vomiting, or nasogastric opposite arm
aspiration, intraluminal bowel loss,  List on the
diuretic administration, chronis renal laboratory slip
insufficiency, large – volume aspiration any drug that may
of pleural or peritoneal fluid), increased affect test results
free body water (excessive oral water >For potassium:
intake, hyperglycemia, excessive IV • Instruct the
water intake, CHF, peripheral edema, patient to avoid
ascites, pleural effusion, syndrome of opening and
inappropriate or ectopic secretion of closing the hand
ADH after a tourniquet
is applied
Potassium 4.67 mmol/L Adult: 3.5 – 5.5 mmol/L Increased in: excessive dietary • Collect 5 to 7 mL
Child: 3.4 – 4.7 mmol/L intake, excessive IV intake, acute or of venous blood
Infant: 4.1 – 5.3 mmol/L chronic renal failure, Addison in a red- or green-
Newborn: 3.9 – 5.9 disease, hypoaldosteronism, top tube
mmol/L aldosterone –inhibiting diuretics, • Avoid hemolysis
crush injury to tissues, hemolysis,
• Indicate on the
transfusion of hemolyzed blood,
laboratory slip
infection, acidosis, dehydration
any drugs that
Decreased in: deficient dietary intake,
 deficient IV intake, burns, may affect the
gastrointestinal disorders, diuretics, test results
hyperaldosteronism, Cushing >For Calcium
syndrome, renal tubular acidosis, • Collect
licorice ingestion, alkalosis, insulin approximately 7
administration, glucose administration, mL of venous
ascites, renal artery stenosis, cystic blood in a red-top
fibrosis, trauma/surgery/burns tube
• Avoid prolonged
Calcium 1.93 mmol/L 1.75 – 3. 93 mmol/L Increased in: hyperparathyroidism, tourniquet use
non-parathyroid PTH-producing • List on the
tumor (e.g. lung or renal carcinoma), laboratory slip
metastatic tumor to bone, Paget any drug that may
disease of bone , prolonged affect the test
immobilization, milk-alkali syndrome, results
vitamin D intoxication, lymphoma,
granulomatous infections such as Posttest:
sarcoidosis and tuberculosis >Apply pressure or a
Addison disease, acromegaly. pressure dressing to the
hyperthyroidism venipuncture site
Decreased in: hypoparathyroidism, >Observe the
renal failure, hyperphosphatemia venipuncture site for
secondary to renal failue, Rickts. bleeding
Vitamin D deficiency, osteomalacia,
 malabsorption, pancreatitis, fat >For potassium:
embolism, alkalosis • Evaluate patient
with increased or
S Creatinine 203.10 53.00 – 115.00 umol/L Increased in: diseases affecting renal
decreased
E umol/L Female: 44 – 97 umol/L function, such as glomerulonephritis,
potassium levels
P Male: 53 – 106 umo/L pyelonephritis, acute tubular
for cardiac
T Adolescent: 0.5 – 1.0 necrosis, urinary tract obstruction,
arrhythmias
E mg/dL reduced renal blood flow (e.g. shock,
• Monitor patients
M Child: 0.3 – 0.7 mg/dL dehydration, congestive heart failure
taking digoxin and
B Infant: 0.2 – 0.4 mg/dL [CHF], atherosclerosis), diabetic
diuretics for
E Newborn: 0.3 – 1.2 nephropathy, nephritis
hypokalemia
R mg/dL Decreased in: debilitation, decreased
• If indicated,
01, muscle mass (e.g. muscular dystrophy,
administer resin
2010 myasthenia gravis [MG])
exchange (e.g.
Kayexalate
enema) to correct
hyperkalemia.

Creatinine 199.10 53.00 – 115.00 umol/L Increased in: diseases affecting renal Pretest:
S umol/L Female: 44 – 97 umol/L function, such as glomerulonephritis, >Explain the procedure
E (high) Male: 53 – 106 umo/L pyelonephritis, acute tubular to the patient
P Adolescent: 0.5 – 1.0 necrosis, urinary tract obstruction, >Tell the patient that no
T mg/dL reduced renal blood flow (e.g. shock, fasting is required
E Child: 0.3 – 0.7 mg/dL dehydration, congestive heart failure
M Infant: 0.2 – 0.4 mg/dL [CHF], atherosclerosis), diabetic During Test:
 B Newborn: 0.3 – 1.2 nephropathy, nephritis >For creatinine:
E mg/dL Decreased in: debilitation, decreased  Collect
R muscle mass (e.g. muscular dystrophy, approximately 5
myasthenia gravis [MG]) mL of blood in a
02, red-top tube
Sodium 129.70 Adult: 136 - 155 mmol/L Increased in: increased sodium  For pediatric
2010 mmol/L Child: 136 – 145 mmol/L intake (increased dietary intake, patient, blood can
(low) Infant: 134 – 150 mmol/L excessive sodium in IV fluids), is usually drawn
Newborn: 134 – 144 decreased sodium loss (Cushing from a heel stick
mmol/L syndrome, hyperaldosteronism), >For sodium:
excessive free body water loss  Collect 5 to 10 mL
(gastrointestinal loss with without of venous blood
rehydration, excessive sweating, in a red- or green-
extensive thermal burns, diabetes top tube
insipidus, osmotic dieresis)  If the patient is
Decreased in: decreased sodium intake receiving an IV
( deficient dietary intake, deficient infusion, obtain
sodium in the IV fluids), increased the blood from the
sodium loss (Addison disease, opposite arm
diarrhea, vomiting, or nasogastric  List on the
aspiration, intraluminal bowel loss, laboratory slip
diuretic administration, chronis renal any drug that may
insufficiency, large – volume aspiration affect test results
of pleural or peritoneal fluid), increased >For potassium:
 free body water (excessive oral water • Instruct the
intake, hyperglycemia, excessive IV patient to avoid
water intake, CHF, peripheral edema, opening and
ascites, pleural effusion, syndrome of closing the hand
inappropriate or ectopic secretion of after a tourniquet
ADH is applied
• Collect 5 to 7 mL
Potassium 3.64 mmol/L Adult: 3.5 – 5.5 mmol/L Increased in: excessive dietary of venous blood
Child: 3.4 – 4.7 mmol/L intake, excessive IV intake, acute or in a red- or green-
Infant: 4.1 – 5.3 mmol/L chronic renal failure, Addison top tube
Newborn: 3.9 – 5.9 disease, hypoaldosteronism, • Avoid hemolysis
mmol/L aldosterone –inhibiting diuretics, • Indicate on the
crush injury to tissues, hemolysis, laboratory slip
transfusion of hemolyzed blood, any drugs that
infection, acidosis, dehydration may affect the
Decreased in: deficient dietary intake, test results
deficient IV intake, burns, >For Calcium
gastrointestinal disorders, diuretics,
• Collect
hyperaldosteronism, Cushing
approximately 7
syndrome, renal tubular acidosis,
mL of venous
licorice ingestion, alkalosis, insulin
blood in a red-top
administration, glucose administration,
tube
ascites, renal artery stenosis, cystic
• Avoid prolonged
fibrosis, trauma/surgery/burns
tourniquet use
 • List on the
laboratory slip
any drug that may
affect the test
results

Posttest:
>Apply pressure or a
pressure dressing to the
venipuncture site
>Observe the
venipuncture site for
bleeding
>For potassium:
• Evaluate patient
with increased or
decreased
potassium levels
for cardiac
arrhythmias
• Monitor patients
taking digoxin and
diuretics for
hypokalemia
• If indicated,
administer resin
exchange ( e.g.
Kayexalate
enema) to correct
hyperkalemia.
Chest X – Ray

This is the most commonly obtained x-ray study because it can indicate so much information about the heart, lungs, bony
thorax, mediasternum and great vessels. Chest radiography is important in the complete evaluation of the pulmonary and cardiac
systems.

Diagnostic Normal
Date Result Clinical Significance Nursing Interventions
Exam Results
A Chest PA No anatomic Findings: Abnormal in: lung tumors Pretest:
U or functional  Hazy infiltrates are seen in both (primary or metastatic), >Explain the procedure
G abnormalities upper lungs. The rest of the lungs pneumonia, pulmonary to the patient
U exist. The are clear. Tracheal air column is at edema, pleural effusion, >Tell the patient the no
S organs are the midline. The heart is not pneumothorax, atelectasis, fasting is required
T normal in enlarged. Calcified density is seen in COPD, TB, lung abscess, >Inform the patient that
size, shape, aortic knob. Both hemidiaphragms congenital lung diseases, the examination is safe
24, contour and and costophrenic sulci are intact. pleuritis, foreign body in and painless
position. The The rest of the included structures the chest, bronchus, or >Instruct the patient tp
2010 internal are unremarkable. esophagus, cardiac remove clothing to the
structures of Impression: enlargement, pericarditis, waist and to put on an
the organs  Bilateral Upper Lung pericardial effusion, soft- x-ray gown
and nearby Pnuemonia Koch’s etiology tissue sarcoma, >Remove all metal
tissues are Considered. Sputum AFB osteogenic sarcoma, objects so they do not
within normal Correlation Suggested. fracture of ribs or thoracic block visualization of
limits.  Atherosclerotic Aorta spine, thoracic scoliosis, the part of the chest
metastatic tumor to bony >Tell the patient that he
 thorax, diaphragmatic or or she will be asked to
hiatal hernia, aortic take a deep breath and
calcinosis, enlarged lymph hold it while the x-ray
nodes, dilated aorta, films are obtained
thymoma, lymphoma, Inform the patient that
substernal thyroid, no discomfort is
widened sternum associated with chest
radiography

During test:
>After the patient is
correctly positioned, tell
him or her to take a
deep breath and hold it
until the x-ray films are
obtained

Posttest:
>Inform the patient that
the results will be
available after a few
minutes

Urinalysis
 This is part of routine diagnostic and screening evaluations. It can reveal a significant amount of preliminary information about
the kidneys and other metabolic processes. It is done diagnostically in patients with abdominal or back pain, dysuria, hematuria and
urinary frequency. It is part of routine monitoring in patients with chronic renal disease and some metabolic disease.

Diagnostic Nursing
Date Normal Results Result Clinical Significance
Exam Interventions
S Urine Test Color: Amber yellow Color: light yellow infection, hematuria, drug Pretest:
E Appearance: clear Appearance: clear therapy, overhydration, >Explain the
P Specific Gravity: 1.005- Specific Gravity: 1.005 diabetes, diuretic therapy, procedure to the
T 1.030 Albumin: negative jaundice, dehydration, UTI, patient
E Albumin: negative Sugar: negative nephritic syndrome,
M Sugar: negative Pus cells: 0-2/hpf glumerolonephritis, SLE, During test:
B Pus cells: 0/hpf Red blood cells: 0-3/hpf heavy metal poisoning , >Collect a fresh urine
E Red blood cells: ≤ 2/hpf Mucous threads: positive trauma, orthostatic specimen in a urine
R Mucous threads: positive proteinuria, stress, renal container
diseases, renal stones, >Obtain a clean-catch
06, cystitis, etc. or midstream
specimen, especially
2010 when there is bleeding
or discharges. Obtain
the midstream urine as
follows
 Have the
patient begin to
urinate, then after
 a few moment let
the patient void in
the containing
until the container
is almost full
 Cap the
container
 Let the patient
finish voiding

Posttest:
>Transport the urine
specimen to the
laboratory promptly
>If the specimen
cannot be processed
immediately,
refrigerate it