WORLD CITI COLLEGES ANTIPOLO CITY

WORLD CITI’S COLLEGE OF NURSING

Case Study on
TYPHOID FEVER
Station Unit (QMHCH)

Prepared by:
III-A Group A2

ETRATA, SHEENAH MELISSA G.

BSN 04-00466

Prepared to:
Mr. DANILO CASTILLO
Clinical Instructor

Date submitted: August 14, 2006

INTRODUCTION

BACKGROUND

Typhoid fever, also known as enteric fever, is a systemic infection by Salmonella

typhi or by the related but less virulent Salmonella paratyphi. Since ancient times, these
bacteria have thrived during wartime and during the breakdown of basic sanitation.
Archeologists have found S typhi in Athenian mass graves from the era of the
Peloponnesian Wars, implicating it as the cause of the Great Plague of Athens. S typhi
persists mostly in developing nations where sanitation is generally poor. Although
sporadic outbreaks occur in developed nations, most individuals with typhoid fever in
such areas have recently returned from travel to an endemic region.

Of all Salmonella serotypes, only S typhi and S paratyphi are pathogenic

exclusively in humans. Typhoid fever is a severe multisystemic illness characterized by
the classic prolonged fever, sustained bacteremia without endothelial or endocardial
involvement, and bacterial invasion of and multiplication within the mononuclear
phagocytic cells of the liver, spleen, lymph nodes, and Peyer patches. Typhoid fever is
potentially fatal if untreated.

People are typically infected with S typhi and S paratyphi through food and
beverages contaminated by a chronic stool carrier. Less commonly, carriers may shed the
bacteria in urine. Individuals may also be infected by drinking sewage-contaminated
water or by eating contaminated shellfish or faultily canned meat.

Salmonella is a genus in the family Enterobacteriaceae that has more than 2300
serotypes previously described in the Kauffman-White schema. Salmonellae are gram-
negative, flagellate, nonsporulating, facultative anaerobic bacilli that ferment glucose,
reduce nitrate to nitrite, and synthesize peritrichous flagella when motile. All but S typhi
produce gas upon sugar fermentation.
Salmonellae are grouped based on the somatic O antigen and further divided into
serotypes based on flagellar H and surface virulence (Vi) antigens. In particular, S typhi,
the cause of typhoid fever, has O and H antigens, an envelope (K) antigen, and a
lipopolysaccharide macromolecular complex called endotoxin that forms the outer
portion of the cell wall. S typhi, S paratyphi C, and Salmonella Dublinare the only
Salmonella serotypes that carry Vi antigen. Based on DNA studies, all salmonellae are
now considered one of two species: Salmonella enterica (formerly called Salmonella
choleraesuis) and Salmonella bongori. S enterica has 6 subspecies (I, II, IIIa, IIIb, IV,
VI); S bongori has one (V). S typhi and S paratyphi are S enterica I subspecies, serotypes
typhi and paratyphi

DEFINITION

Is a genital infection caused by Salmonella Typhi, involving primarily the lymphoid

tissues (Peyer’s Patches) of the small intestine, is a bacteria infection transmitted by
contaminated water, milk, shellfish or other foods.

CAUSATIVE AGENT: Salmonella Typhi, S. Typhi

SYNONYM: Enteric Fever, Typhus Abdominali

MODE OF TRANSMISSION: Direct or indirect contact with patient or carrier.

Principal vehicles are food and water. Contamination is usually by hands of carrier. Flies
are vector.

SYSTEM AFFECTED: (Typhoid Fever) Gastrointestinal, Pulmonary, Skin/exocrine

INCUBATION PERIOD: 5-40 days (mean: 10-20 days) Varies: average 2 weeks, usual
range 1 to 3 weeks.
PERIOD OF COMMUNICABILITY: As long as typhoid bacilli appear in excreta:
usually from appearance of prodromal symptoms from first week throughout
convalescence.

ETIOLOGY AND EPIDEMIOLOGY: Caused by Salmonella Typhi/Typhosa;

Salmonellosis - which is harbored in human excreta.
- the causative agent is a gram negative motile and nonperforming
bacillus
- the organism is pathogenic only for man
- it is identified by biochemical reactions and serological groupings ad
typing of its antigen O (sematic), H ( flagellar) and Vi (carbohydrate
envelop)
- it is a hardy organism and easily survives in natural habitat like water
or in organic material.
- SOURCES OF INFECTION
- a. Spread chiefly by carrier, patient’s who have recovered from the
fever but whose stools; urine may spread these bacilli for years.
- b. The ingestion of infected oysters or shellfish taken from waters
contaminated by offshore sewage disposal depots.
- c. Certain drugs substance of animal origin may be contaminated; a
potential danger.
- MODE OF TRANSMISSION
- Fecal oral route
- a. Contracted from contaminated foods, milk, products, seafood and
shellfish and by drinking contaminated water.
- b. Files- may be a vector in transmission of the disease
- c. Asymptomatic carriers, especially food handlers0 are responsible for
infecting a large number of cases.
- INCIDENCE
- a. World-wide distribution
- b. Endemic particularly in areas of low sanitation levels like urban
deprived communities.
- c. It occurs anytime of the year but especially from May-August
- d. The infection is generally milder in the young.
- e. Commonly seen in the individual between 16 and 30 years of age,
but all ages may be affected including the very young.
- f. There is increase incidence during foreign travel (certain areas of the
developing world) and in microbiology laboratories.
OBJECTIVES

GENERAL OBJECTIVES:

Gain knowledge and understanding about Typhoid Fever

SPECIFIC OBJECTIVES:

a. To determine the possible causes of Typhoid Fever

b. To understand the disease process.

c. To determine the proper nursing interventions and proper treatment for the

disease.
THEORETICAL FRAMEWORK

Myra Levine

She advocated that nursing is a human interaction and put forth 4 conservation
principles of nursing which are concerned with the unity and integrity of the individual.

1. Conservation Of Energy

In order for our body to function accordingly it must utilize energy.

Energy inputs such as food, oxygen and fluids are essential for the human body to
produce energy output.

→ Conservation of energy must be considered important in dealing with

adult undergoing typhoid fever. Proper oxygenation, fluids and
nourishment should be provided to facilitate maintenance of health.

2. Conservation Of Structural Integrity

The human body is composed boundaries (skin, mucous membranes) that

must be sustained to facilitate health and prevent harmful agents from entering the
body.
→ It is important to emphasize that when dealing with adults, aseptic
technique be strictly followed. This is protect adult form further
contamination of microorganism.

3. Conservation of Personal Integrity

The nursing intervention is based on conservation of individual clients

personality
 → Every individual has a sense of identity, self worth and self-esteem,
which must be preserved and enhanced by nurse.
→ Our duty as nurse not only focuses on the physical needs of our
patients but also its psychological, emotional and spiritual needs as
well. Whether we are giving service to and infant or an adult we must
never forget to minister to their needs with the outmost respect.

4. Conservation of Social Integrity

Social integrity of the client reflects to the community in which he

functions.

→ Family plays a big role in rendering effective care on the patient. Or

duty is to educate and explain to the family the condition of the patient
and at the time help them be involved in rendering care.

`
 Conservation of energy

Conservation of Conservation of
Personal integrity ADULT Structural Integrity

Conservation of
Social Integrity

NURSING ASSESSMENT

PATIENT’S PROFILE

Demographic data of patient

Name of the Hospital: Queen Mary Help of Christian Hospital

Hospital Code: *******

Hospital No: ******

Patient’s Name: Mrs. E. R

Sex: Female

Birthday: May 4 1974

Age: 32 years old

Birthplace: Binangonan Rizal

Father’s Name: Mr. R. R.

 Mother’s Name: Mrs. P. R.

Nationality: Filipino

Religion: Roman Catholic

Admitting Physician: Dr. J. M.,MD

Admitting Clerk: Mr. T.M.A

Admission Date: July 30, 2006

Type of Admission: Old

Admission Diagnosis: Typhoid Fever

Chief Complaint

Fever and Vomiting

History of Past Illness

During my shift. I interviewed my patient and report that she don’t have

any disease in the family

 History of Present Illness

Two days prior to admission the patient experienced high grade fever, weakness,

discomfort, easy fatigability, severe headache vomiting due to these condition she

was advised to consult to a doctor to prevent further complications.

PSYCHOSOCIAL HISTORY

Mrs. E.R has good relationship with her family and friends. She used to go out
with her friends, watch movie, shopping, roam at the mall, eat together and chat. She
likes going out after work and meet her friends frequently. She work 8 hours a day and
able to have good working relationship with her co-workers and her boss as well. When
she is in high school she was voted as the class PRO because she can interact with
different kinds of people and when she stepped on college she was again voted as PRO.
During my shift I noticed that she used to talk a lot with her friends through her cell
phone.
PHYSICAL ASSESSMENT
Mc CAIN 13 Areas
I. SOCIAL STATUS

During my shift at Queen Mary Help of Christian Hospital I was

assigned in room 222, my patient’s name is Mrs. E. R. 32 years old. Married and
permanently living at Binangonan Rizal. She finishes college and now working as an
employee to a government agency. Her attending physician is Dr. J. M.,MD. She likes
going out with her friends, chatting. She is also fond of watching TV, collecting CD’s
DVD’s. At the hospital, she is approachable and easy to talk with. In spite of her
condition she always asks questions to every nurse who delivered her care. We had a
good client-nurse interaction with our patient.

II. MENTAL STATUS

Level of consciousness:
The patient is conscious and coherent; the client is oriented
to person, place and time. She’s aware of what is happening to her surroundings. She can
take actions and can respond to her environment/stimuli.
 III. EMOTIONAL STATUS

. Patient reports concerns about existing condition, but is generally

calm.

IV. SENSORY STATUS

The patient’s senses are in its proper functioning.

Vision : His vision is clear, sclera is white, pupils dilated, iris is

Black.
Hearing : Can hear sounds audibly.
Taste : Can recognize the palate of his food well.
Touch : Can respond to stimuli, able to differentiate hot,
cold, and warm..
Smell : Can distinguish scents, smell and odor.

V. BODY TEMPERATURE

During the first interaction with the patient, she was

febrile. Her body temperature was 37.8◦C within
the normal range of 36.5-37.2◦C taken through axilla.

VI. MOTOR ABILITY

The patient is mobile; she can move her upper and lower
extremities in moderation. Cannot tolerate prolong, lengthy and
intense activities. Can walk at slower pace.

VII. RESPIRATORY STATUS

 Patient has a normal RR of 20 and not using any respiratory aids.

VIII. CIRCULATORY STATUS

Patient has normal BP of 120/80 mmhg and a pulse rate of 92.

IX NUTRITIONAL STATUS

Prior to admission patient’s regular meal is more on

meat and vegetables (lutong ulam na nabibili sa palengke). Upon
admission, the patient was advised DAT as her diet.

X. ELIMINATION STATUS

The patient is able to excrete waste products from her

Digestive tract consciously. Is able to maturate.
Stool: Urine:
Consistency: Semi-solid Consistency: concentrated
& scanty.
Color: yellow Color: amber
Frequency: 1-2 times a day Frequency: 4-6 times.
10cc/hr

XI. REPRODUCTION

The patient has 2 children, the youngest is 19 years old and the
eldest is 21. She was married when he was 22 years of age and blessed her
having a child right away.

XII. STATE OF PHYSICAL REST AND COMFORT

 Patient declared have an average sleep of 4-5 hours every night. She can’t
take a nap every afternoon because she has work. Restless and irritable due to his present
conditions suffered and not comfortable in lying position. She’s more comfortable
lying on bed on a high fowler’s position.

XIII. STATE OF SKIN AND APPENDAGES

The skin appears pale, cold and clammy. Has rashes, no pallor, no
edema. Has good skin turgor and integrity. Hair is fairly
distributed.

USUAL PATTERN OF DAILY LIVING

Before Hospitalization

Mrs. E. R. is a hardworking person and working on a government agency,

Her activities are, she used to cook at home, love to eat, she washed clothes and
clean the house during weekend and attend mass every Sunday. She also attends
her prayer meeting every Wednesday night after work. She used to go out with
her friends every night after work. She used to have vacation every summer, holy
week and Christmas season. She like to play badminton, volleyball, play cards ,
play archery with her high school peers, swimming with her husband and family.

During Hospitalization

During my Shift at Queen Mary under my CI Mr. Danillo Castillo, I was

assigned to room 222 my patient is Mrs. E. R.Mrs E. T is somehow quiet and
 irritable especially with her existing condition but she is cooperative. She’s not
feeling well and fell tired easily. She wants to go home and wants to go back to
work.

ANATOMY AND PHYSIOLOGY

GASTROINTESTINAL TRACT
GI TRACT

Your gastrointestinal, or "GI" tract, runs from your mouth all the way to your
anus. It is essentially a very long and windy tube through which food is broken apart,
digested, and the nutrients absorbed into your system. To get a good understanding of
the process which turns your lunch into a BM (Bowel Movement), lets follow the course
of a turkey sandwich with mayo and lettuce through your GI tract.

You start off by taking a bite out of the sandwich and your teeth chew it up.
Saliva (water and enzymes) from your salivary glands (parotid, sublingual, and sub
maxillary) moistens the food and begin to digest the starch in the bread. A chewed up
ball of sandwich (bolus) in your mouth then is swallowed and travels down your
ESOPHAGUS. The ESOPHAGUS is a muscular tube about 22-30 cm long that passes
through the middle of your chest, through your diaphragm, and attaches to
your STOMACH. A SPHINCTER - a muscle that works like the drawstring of a purse -
relaxes to let the food into your stomach, and then tightens to keep food from going back
up the esophagus. Your stomach makes hydrochloric acid and enzymes which break
down the protein - in this case, the turkey. If the sphincter isn't working just right, one
gets the acidic stomach contents refluxing back into the esophagus. This is Gastro-
Esophageal Reflux Disease, or GERD. This is also known as heartburn. The stomach is
very muscular and also acts to grind up the food by squeezing and relaxing. Okay, our
turkey sandwich is now essentially mincemeat. What next?

The stomach is connected to the SMALL INTESTINE, and another sphincter

opens to let the food through. The small intestine is another hollow tube. If fully
stretched out, it would measure between 15 and 34 feet. It's divided into three sections.
You can't tell where one section starts and the other stops with the naked eye - only under
a microscope. The three sections, in order, are: the DUODENUM, the JEJUNUM, and
the ILEUM.

Our chewed-up sandwich now enters the DUODENUM. The LIVER makes bile,
which is green and helps the digestion of fats. Bile is stored in the GALL BLADDER,
and conveniently squirted into the DUODENUM when food enters. PANCREATIC juice
also enters the duodenum. The PANCREAS makes strong enzymes which help break
down the fats, carbohydrates, and proteins in the mayonnaise, bread, and turkey,
respectively. This is where most of our sandwich is fully broken down! The pancreatic
juice also contains bicarbonate, which neutralizes the strong hydrochloric acid the
stomach has contributed to the mixture.

The tail end of the DUODENUM, the JEJUNUM and the ILEUM absorb the
nutrients from the broken down food. They also reabsorb water from the food mixture,
and from all the saliva and other secretions that were used to break down the food. The
small intestine also contains helpful bacteria which aid the digestion of certain vitamins.
It may take 2-4 hours for food to pass from one end of the small intestine to the other
PATHOPHYSILOGY/SYMPAHTOLOGY

Predisposing Factor:
- Contaminated water, food or drink.

Ingestion of Salmonella Typhosa / typhi

Contaminated food/ water, feces. Fingers, fomites and flies.

GIT invading small intestinal mucosa

Transverse the intestinal lymphatics,Mesenteric

Peyers Patches (lower ileum)

Lymph flow
 Thorasic duct

Blood stream

Etiologic agent in the blood circulation.

Bacteremia- secondary to the infection of liver, spleen bone marrow and lymph nodes

In the liver and kidneys, the focal necrosis of parecheymal cells at the site colonization
lyphoid tissue hypertrophy abd hyperplasia.

signs and symptoms:

Sever headache
fever
Loss of appetite
General discomfort
Rash (rose spots)
Abdominal pain with distention
hepatomegaly
Constipation with diarrhea
Stools bloody
Slow, sluggish lethargic.
Assessment Nursing Diagnosis Planning Intervention Rationale Evaluation
Subjective Cues: Activity Intolerance After 8 hours of 1. Identify 1. Serves as After 8 hours of
 “Nang-hihina related to generalized nursing intervention, presence of baseline data. nursing intervention,
talaga ako” as weakness as the patient will factors 2. Provides patient is slightly
verbalized by manifested by report participate desired contributing comparative participating in
the patient. of fatigue or activities and report to fatigue baseline activities and reports
weakness. measurable increase 2. Evaluate 3. To identify increase in activity.
Objective Cues: in activity tolerance.. current degree of
 vital signs limitations of weakness,
 Temp.- 37.2 deficit in light fatigue and
 RR- 20 cpm of usual status pain.
3. Note patient 4. To facilitate
 PR-92 bpm
reports of the needs and
 BP- 120/80
weakness desires of
mm hg
fatigue, pain patient and
 Irritable difficulty lessen
 Weakness accomplishin irritability
 Fatigue g tasks. and
 Discomfort 4. Identify discomfort.
activity needs 5. Stress and
versus depression
desires. may be
5. Assess increasing the
emotional effects of an
/psychologica illness or
l factors depression
affecting old might be the
current result of
situation. being forced
6. Monitor vital into
signgs, inactivity.
watching for 6. To assess
changes in changes that
blood may affect
pressure, patient health
heart and condition.
respiratory 7. To prevent
rate, note skin overexertion.
pallor/cyanosi 8. It provides to
s and conserve
presence of energy.
confusion. 9. T reduce
7. Adjust fatigue
activity 10. Helps to
reduce minimize
intensity level frustration,
or discontinue rechannel
activity that energy.
 Drug Name Action Indication Contraindication Adverse Reactions Nursing
Responsibilities
Generic name: Inhibits protein Typhoid fever Trivial infection: GI intolerance: neurologic  If patient has
Chloramphenicol synthesis; nay be and other anemia esp. reaction: more that a
bacteristatic or infectious caused aplastic anemia, hypersensitivity,superinfection; superficial
Brand name: bactericidal by history o gray baby syndrome,reversible infection
Chloromycetin depending on chlorampericol hypersensitivity or bone marrow depression, anticipates
concentration. sensitive toxic reactions, aplastic anemia. using systemic
Classification: . organism. concurrent therapy therapy as
Cloramphenicol with other bone well.
Dosage: marrow depressing
Adult and Children drugs. Pregnancy
50-100 mg/kg in 4 and lactation.
divided doses.

Drug Name Action Indication Contraindication Adverse Nursing

Reactions Responsibilities
Generic name: An aminopenicillin Respiratory tract, Hypersensitivity to Diarrhoea,  If large doses
Amoxicilin that inhibits cell skin and soft penicillin indigestion, urtical are given or if
wall synthesis tissue , veneral or erythemtous therapy is
Brand name: during bacterial pelvic severe rash, hepatitis. prolonged,
Trimox,Amoxil,biomox multiplication. systemic bacterial or
Bacteria resist infections, UTI,
Classification: amoxicillin by dental adscess. fungal super
Penicillin-anti infective producing infection may
penicillinanses- occur,
Dosage: enzymes that especially in
Adult Oral/IM 250-500 hydrolite elderly,
mg 5-8 hrly. amoxicillin. debilitated, or
immuno
suppressed
patients.
Drug Name Action Indication Contraindication Adverse Nursing
Reactions Responsibilities
Generic name: Inhibits bacterial Treatment of Hypersensitivity to Nausea, diarrhea,  Long term
Ciprofloxacin DNA synthesis, infections of the ciprofloxacin otr vomiting, theraphy may
mainly by blocking respi tract, othe quinoles. dyspepsia, result in over
Brand name: DNA gyrase; sinuses, abdominal pain, growth of
Xipro bactericidal. eyes,kidneys and anorexia, organism
UTI, genital dizziness resistant to
Classification: organ,abdomen, headache and ciprofloxacin..
quinoles skin and soft tiredness,.
tissue, bones and
Dosage: joints.
Tab 125-750 mg orally
bid

THE DO’s

→ Take the antibiotics as ordered and until finished.

→ Increase fluid intake and stay on liquid diet until
the diarrhea stops.
→ Advance to high-calorie diet after diarrhea stops
 → Isolate the patient or have him use a separate
bathroom
→ Scrub the bathroom with a bleach solution after
use
→ Wash hands thoroughly and frequently
→ Use tepid sponge baths to reduce fever.
→ Rest in bed until symptoms subside.

THE DON’Ts

→ Don’t skip doses or stop antibiotic until finished

→ Don’t use aspirin or aspirin derivatives for fever because these medications irritate the intestinal tract.
→ IF the water suplly is of questionable safety, don’t eat rwas fruits or vegetables unless you peel them yourself.
EVALUATION

PROGNOSIS

The mortality rate in typhoid fever is low provided early diagnosis

and management are made and no complication will occur.

DISCHARGE PLANNING
Prevention:

1. Isolation of patients
2. Care of exposed persons
3. Prevention
-Typhoid vaccine, 1 subcutaneously injection followed by 2nd injection $
or more weeks later; booster injection every 3 years for selected individuals.
- Vaccination should be under taken in individuals with risk of exposure
- Immunization- reduces the risk active disease.
4. Maintain Environmental Hygiene and Public Health Measures- are important
in the prevention of the disease.
a. Protect and purify water supplies.
b. Employs sanitary waste disposal techniques.
c. Pasteurize milk and dairy products; refrigerate while transporting.
d. Avoid eating fresh, uncooked vegetable and unpeel fruits (in endemic
areas) that have not been washed in iodinated or chlorinated water.
e. Ensure that food handlers use hand washing facilities.
5. The patient must followed with routine stool culture after recovery detect the
development of the carrier state- approximately 2%-5% of typhoid patients
become permanent carriers, harboring the organism and excreting it their urine
and stools.
a. carriers may be given ampicillin or amoxicillin to attempt to abolish
carrier state ( There is evidence that treating certain patients with salmonella in
their stools may prolong the carrier state)
b. Positive chronic carrier state – documented evidence of S. typhi in stool
or urine for 1 year or more.
c. Carriers must not become food or milk handlers.

HEALTH TEACHINGS

NURSING INTERVENTIONS:

1. Give supportive care- typhoid fever is a nursing challenge.

a. Maintain or restore fluid and electrolyte balance especially in infants.
b. Support the patient during period of toxemia- the patient may be
drowsy partially in continent or delirious.
c. Position the patient to prevent aspiration.
d. Watch for bladder distention – the patient may be lose of urge to void
during toxic state. Keep I and O record.
e. Encourage a high fluid intake- the patient may become dehydrated
from high insensible water loss, vomiting and/ or diarrhea and poor
oral intake.
f. Take rectal temperature every 2-4 hours- give fever sponge for
temperature of 40 degrees Celsius or higher.
g. Observe for retention of feces.
1. Enemas are given under low pressure to diminish change of
intestinal perforation.
2. Relieve ditention with rectal tube, inserted for a short time.
 h. Give a high calorie, low residue diet during febrile stage.
i. Give non-gastric forming foods or non-irritating foods and vitamin B
complex.
2. Watch for complication which can occur after an apparent clinical cure.
a. Perforation of intestine- from erosion of one the ulcers;most common
during the 3rd week.
1. Symptoms: sharp abdominal pain- may stop suddenly,
abdominal rigidity and shock.
2. Treatment: Prepare for intestinal decompression procedures.
Intravenous fluids and surgical intervention if conservative
measures do not produce clinical improvement.

b. Intestinal Hemorrhage- from crosion of blood vessels in ulcerated and

small intestine ( occurs in 10% of patients)
1. Clinical manifestation: apprehensions,sewating; pallor,weak
rapid pulse, narrowing pulse rate:hypotension; bloody or taryy
stools.
2. Treatment: withhold food and give blood transfusion.

c. Other complications: thrombophlebitis, urinary infections, cholecystitis,

meningitis, osteomyelitis

3. Practice proper hand washing.

4. Employ sanitary waste disposal.
5. Protect and Purity Water supplies.
6. Pasteurize milk.
7. Proper food handling and preparation.
 LABORATORY EXAMINATION

A. Hematology Test

Laboratory Normal Values Results Clinical Significance

exam
Hemoglobin 170-220g/l 161g/l As the number of RBC
decreases, so does the Hgb
concentration decreases due
to insufficient oxygenation
because of prolong labor. It
may also indicate iron
deficiency anemia.
Hematocrit 0.55-0.68% 0.39% The lower the percentage of
the hematocrit in the cells
the lower the RBC contents.

RBC 4.7-6.1mil/mm3 4.2 Decreased in RBC may

indicate insufficient
circulation of oxygen and
carbon dioxide in the body
WBC 4.800-10,800/mm 11,200/mm Elevated WBC
indicatesinfection
Neutrophils 40-74% 58
Lymphocytes 19-48% 42
Basophils 0-0.01 0.01
Eosinophils 0-7% 2
Platelets 130,000- 234,000
500,000/mm3
B. Urinaysis (UA)

Color Amber
Specific gravity 1.005-1.030
pH 5.0-8.0
Glucose (+)
Sodium 10-40
Potasiium < 8 mEq/l
Chloride < 8 mEq/l
Protein Negative –trace
Osmolarity 500-800