Laboratory and Diagnostic Examinations

A. SEROLOGY-IMMUNOLOGY

TEST RESULT REF. VALUES-MTD/CUT- INTERPRETATION

OFF index
HBsAg Non-reactive SD/QIA (Rapid Test) The client has not
been exposed to the
hepatitis virus.
Syphilis Non-reactive SD/QIA (Rapid Test) The client has not
been exposed to the
bacteria Treponema
pallidum.

B. Microscopic Examination

Examination Result Reference Interpretation

Value

Color D/Yellow ----- Urine’s color may vary

with the client’s diet and
drugs taken.
Transparency S/Cloudy Clear Turbidity shows that
there is presence of large
diameter molecules that
is not seen in normal
urine. This turbidity is
caused by the presence
of large amounts of
WBCs.
Specific Gravity 1.030 1.001 – 1.035 Client’s urine’s specific
gravity is within normal
range.
Reaction Acidic(5.0 ----- Urine’s pH is usually
) acidic to maintain an
environment that is not
conducive for bacterial
growth, client’s urine pH
is normal.
Protein +1 Negative Proteinuria shows that
there is damage to the
filtering capacity of the
 kidneys that allows large
molecules to flow.
Ketone -------
Others -------

C. Microscopic Examination

Examination Result Reference Interpretation

Value
WBC 5-8/hpf (0-2/hpf) WBC is greatly elevated
that shows a recent
immunologic response
from an infection.
RBC 1-3 (0-1/hpf) RBC is slightly elevate.
Epithelial cells Few Epithelial cells should not
be seen in a normal urine
but urine samples are
usually contaminated
since the client doesn’t
follow the mid-stream
clean catch.
Pus cells 16-20 (0-1/hpf)
A Urates/ ----------
Phosphates
Bacteria +1 Bacteria are present in
large amount showing
the infection was caused
by a bacterium.
Mucus threads +4
Crystal ---------

D. Hematology

Examination Result Reference Interpretation

Value
Blood type “B” Rh(+)
Hgb 106 F: 120-150 Hemoglobin count is
below the normal range
and the client is already
taking iron supplements
to correct the condition.
Hct 0.32 F:0.30-0.40 Hematocrit is within
 normal range showing no
signs of dehydration or
congestion.
WBC Count 20.39 x 5.0-10.0x109/L WBC is greatly elevated
109/L showing that there is an
infection.
Neutrophils 0.88 0.30-0.70 Neutrophils are the first
line of defense and is
greatly elevated until the
immunologic response is
finished.
Lymphocytes 0.12 0.20-0.40 Lymphocytes are lower
than the normal range
showing no signs of viral
infection.
Eosinophils --------
Monocyte 320x 150-350x109/L
Platelet 109/L

Reticulocyte count ---------- 28-32 pg

MCH ---------- 82-98 fl
MCV ----------

E. Clinical Chemistry

Examination Result Reference Interpretation

Value
BUN 1.55mmol/ 1.7-8.3 Client’s BUN has a slight
L lowering beyond the
normal range showing
that the kidney is still
functioning well in
cleansing the blood.
Creatinine 42 umol/L 35.4-123.8 Creatinine level is within
normal range
Discharge Plan

Discharge Plan Rationale

Medications
• Advice patient to continue taking • To prevent the aggravation of the
medications needed (noting on condition.
medication that should not be • If you don’t continue the
able to discontinue abruptly) to medication the bacteria has
maintain a normal functioning of already acquired resistance from
the body and maintain generation 1 to 3 anti-biotics.
homeostasis. The treatment
regimen ordered by the doctors
must be followed strictly and
should not be stopped. The full
course of antibiotics should be
followed. (At least 7 days.)
• Advice the patient to observe any
reaction towards the given
medications and signs that needs
to call the attention of the
physician.
Exercise
• Discuss to the client importance
or help client develop a program Promote adequate rest to reduce fatigue.
of exercise and relaxation
techniques as tolerated.

Teaching
• Moreover, a teaching plan that Health teaching is the most effective teaching
affect client’s holistic wellness
should be done in order to
maintain an environment that is
conducive for health promotion.

Home Medications
• Always instruct the client the To prevent Drug toxicity
proper dosage of the drug to be
given, frequency, and route of
administration. Proper emphasis
on important parts is best to
remember the teachings.
• Also instruct relatives on some
drug’s precautions before
administration to prevent adverse
reactions of the drug.

OPD Schedule
• Proper referral is best for the
health care provider to evaluate
condition of the client, whether it
is improving or not. Also, for early
diagnosis of any other underlying
conditions.

Diet
• Proper execution of client’s diet is
very important so informing and
instructing client about proper
meals to be given to the client
and increasing oral fluid intake is
important.
Antimicrobial Agents Used in the Treatment of Acute Pyelonephritis
Dosing Oral dose
Agent schedule (mg) IV dose Comments
Penicillins
Amoxicillin Every 8 to 12 500 — None
hours
Amoxicillin-clavulanate Every 8 to 12 500/125 — GI side effects*
potassium (Augmentin) hours
Ampicillin-sulbactam Every 4 to 6 — 150 to 200 mg GI side effects*
(Unasyn) hours per kg per day
Aztreonam (Azactam) Every 6 to 8 — 1 to 2 g Phlebitis; GI side effects*
hours
Imipenem (Primaxin I.V.) Every 6 hours — 0.5 g None
Piperacillin (Pipracil) Every 6 hours — 3g GI side effects*; phlebitis
Piperacillin-tazobactam Every 6 to 8 — 3.375 g/4.5 g GI side effects*; rash;
(Zosyn) hours headaches; insomnia
Ticarcillin-clavulanate Every 4 to 6 — 3.1 g GI side effects*; rash; phlebitis
(Timentin) hours
Cephalosporins
Cefotaxime (Claforan) Every 8 to 12 — 1 to 2 g Thrombophlebitis
hours
Ceftriaxone (Rocephin) Once in 24 — 1 to 2 g Leukopenia; elevated BUN and
 Dosing Oral dose
Agent schedule (mg) IV dose Comments
hours liver enzyme levels
Cephalexin (Keflex) Every 6 hours 500 — GI side effects*
Fluoroquinolones
Ciprofloxacin (Cipro) Every 12 500 400 mg Nausea; headache;
hours photosensitivity; pregnancy
category C
Enoxacin (Penetrex) Every 24 400 — Pregnancy category C
hours
Gatifloxacin (Tequin) Every 24 — 400 mg Pregnancy category C
hours
Levofloxacin (Levaquin) Every 24 250 to 750 250 to 750 mg ECG QT prolongation; pregnancy
hours category C
Lomefloxacin (Maxaquin) Every 24 400 — Pregnancy category C
hours
Norfloxacin (Noroxin) Every 12 400 — Pregnancy category C
hours
Ofloxacin (Floxin) Every 12 200 to 400 400 mg Pregnancy category C
hours
Aminoglycosides
Amikacin (Amikin) Every 12 — 7.5 mg per kg Ototoxicity; nephrotoxicity
hours
Gentamicin (Garamycin) Every 24 — 5 to 7 mg per Ototoxicity; nephrotoxicity
hours kg