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A.) Hematology Hematology is concerned with the study of blood, the blood-forming organs, and blood diseases. Hematology includes the study of etiology, diagnosis, treatment, prognosis, and prevention of blood diseases.

Before the procedure: 1. Tell the mother that the test requires a blood sample. 2. Explain to the mother that the patient will experience slight discomfort from the tourniquet and the needle puncture.

During the procedure: 1. Hold the patient in place for the procedure to be well administered. 2. Support the patient emotionally as she cries during extraction.

After the procedure: 1. Apply direct pressure to the venipuncture site until bleeding stops. 2. Instruct the watcher not to let the patient play or scratch the newly puncture site.

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07/12/11 Hemoglobin The oxygen-carrying pigment of erythrocytes, formed by developing erythrocytes in the bone marrow. The hemoglobin determination evaluates the hemoglobin content of erythrocyte by measuring the number of grams of hemoglobin per 100ml of blood

Normal Range: 120-160 g/dL Result: 122 g/dL (Normal)

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7/12/11 Erythrocyte A cell that contains hemoglobin and can carry oxygen to the body. Also called a red blood cell (RBC). Normal Range: 4.00-5.00 10^12/L Result: 4.78 10^12/L (Normal)

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7/12/11 Mean Corpuscular Hemoglobin The mean corpuscular hemoglobin, or "mean cell hemoglobin" (MCH), is the average mass of hemoglobin per red blood cell in a sample of blood. Normal Range: 27-33 pg

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Result: 25.5 ( LOW ) Significance: Microcytic Anemias

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7/12/11 Mean Corpuscular Volume Mean corpuscular volume (MCV) is a measurement of the average size of your RBCs (red blood cells). Normal Range: 85-96 fL

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Result: 78 fL ( LOW ) Significance: Microcytic RBC, Iron deficiency anemia, chronic blood loss, beta thalasemia

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7/12/11 Mean Corpuscular Hemoglobin Concentration Mean corpuscular hemoglobin concentration (abbreviated as MCHC) is the measurement of the average concentration of hemoglobin in a red blood cell. Normal Range: 32-36 g/dL Result: 32.6 g/dL (Normal)

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7/12/11 Leukocyte A white blood cell protects the body against infection and fight infection when it occurs. Normal Range: 5.0-10.0 10^9/L Result: 15.3 10^9/L ( HIGH )

Significance: Elevated in acute infectious disease, and in the lymphocytic and monocytic infections in viral disease, allergy, chronic inflammation

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7/12/11 Neutrophils Neutrophils are one of the first-responders of inflammatory cells to migrate towards the site of inflammation Normal Range: 0.55-0.65% Result: 0.55 (Normal)

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7/12/11 Lymphocyte Determines if the bodys first line of defense is present, which combat foreign invader Normal Range: 0.25-0.40% Result: 0.38% (Normal)

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7/12/11 Monocytes Monocytes are precursors of macrophages and functions when infections are present. Thus, they play an important role in non-specific immunity and inflammatory response. Normal Range: 0.02-0.05% Result: 0.04% (Normal)

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7/12/11 Eosinophils A type of white blood cell containing granules that can be stained by eosin (a chemical that produces a red stain). Normal Range: 0.01-0.05% Result: 0.02% (Normal)

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7/12/11 Basophils White blood cell that increases in response to parasitic infections and allergic reactions. Normal Range: 0.000-0.005% Result: 0.01(High) Clinical Significance: High in response to an infection from a virus

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7/12/11 Hematocrit The hematocrit measures how much space in the blood is occupied by red blood cells. The hematocrit is used to screen for anemia, or is measured on a person to determine the extent of anemia.

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Normal Range: 0.37-0.45 Result: 0.37 (Normal)

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7/12/11 Thrombocytes An irregularly shaped cell-like particle in the blood that is an important part of blood clotting. They are important in blood clotting. When bleeding occurs, the platelets swell, clump together, and form a sticky plug that helps stop the bleeding.

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Normal Range: 150-300 10^9/L Result: 538 10^9/L ( High ) Significance: High platelet occurs as a symptom of another disease or condition, such as anemia, infection or cancer. May be caused by bleeding

B.) Urinalysis Urine analysis is an array of tests performed on urine and one of the most common methods of medical diagnosis. A part of a urinalysis can be performed by using urine dipsticks, in which the test results can be read as color changes.

Nursing Responsibilities: 1.) Explain the procedure. 2.) Give clean vial and instruct to void directly into the specimen bottle. 3.) Instruct to wash and dry genitalia/perineum with soap and genitalia/perineum with soap and water. 4.) Cap and label, prompt delivery and document.

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7/12/11 Significance: Deep yellow- presence of riboflavin Smokey- Presence of red blood cells Orange-Bilirubin, pyridium, santonin Pink/red-presence of hemoglobin, myoglobin Black- presence of melanin

Result: Light Yellow (Normal)

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7/12/11 Significance: Clear- normal Cloudy-presence of pus, glucose or albumin Result: Clear (Normal)

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7/12/11 Normal Range: 1.003-1.030 Result: 1.020 (Normal)

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7/12/11 This test detects the ion concentration of urine. Small amounts of protein or ketoacidosistend to elevate the urine's specific gravity Normal Result: Negative Result: Negative (Normal)

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7/12/11 Although glucose is easily filtered in the glomerulus, it is not present in the urine because all of the glucose that is filtered is normally reabsorbed from the renal tubules back into the blood. Normal Result: Negative Result: Negative (Normal)

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7/12/11 Normal Result: 0-2/ HPF Result: 6/ HPF (High) Significance: WBC in urine are a marker of infection if present for greater than 5 wbc per high power field

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7/12/11 Normal Result: Negative Result: Positive The presence of bacteria in urine is referred to as bacteriuria. When the number of bacteria found in urine is significantly large, that is, more than 100,000 pathogenic bacteria per milliliter of urine, then it is generally indicative of a urinary tract infection.

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C. Stool Analysis Determining the cause of symptoms affecting the digestive tract, including prolonged diarrhea, bloody diarrhea, an increased amount of gas, nausea, vomiting, loss of appetite, bloating, abdominal pain and cramping, and fever.

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Nursing Responsibilities Before the exam: Instruct the patient to defecate into a clean bedpan or a large-mouthed container Instruct patient not to put the toilet paper in the bed pan or collection container

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During the exam: Instruction should be rendered that feces should be collected in a dry container free of urine Instruct the patient that a freshly passed stool is the specimen of choice. Stool should be transferred to a container with tongue blades. The specimen should be labeled and sent immediately to the laboratory

After the exam: Make the patient comfortable Instruct mother or watcher to ensure proper hygiene after exam, especially when the exam is done again

7/12/11 The color of the feces should be noted, since it can provide information on pathologic conditions and organic dysfunction Result: Yellow

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Interpretation: Yellow to green-severe diarrhea Black-bleeding of upper GI tract Red-bleeding from lower GI tract

7/12/11 Normally evacuated feces reflect the shape and caliber of the colonic lumen as well as the colonic motility. Significance: Stool is mostly liquid with no solid pieces. Passed quickly through the colon; is indicative of severe diarrhea possibly as a result of a viral or bacterial infection. Result: Watery

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7/12/11 Done in the evaluation of gastrointestinal bleeding, and obstruction, parasitic disease and increased absorption. Normal Findings: No Ova Result: No Ova

D.) Radiologic Findings Chest X-ray is used to detect abnormalities in the lungs, but can also detect abnormalities in the heart, aorta, and the bones of the thoracic area.

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7/12/11 and 7/14/11 Result/Findings: Bronchopneumonia with consolidation in the lingula. Hazy infiltrates seen in inner lungs with confluence in the lingula. Interpretation: Impression - Bronchopneumonia

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E.) HIV Testing HIV tests are used to detect the presence of the human immunodeficiency virus (HIV), the virus that causes acquired immunodeficiency syndrome (AIDS), in serum, saliva, or urine. Such tests may detect antibodies, antigens, or RNA.

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7/24/11 Result: Non-Reactive

Possible Diagnostics and Laboratory Tests

A sputum fungal smear is a laboratory test that looks for fungus in a sputum sample. Sputum is the material that comes up from air passages when you cough very deeply. A sputum sample is needed. You will be asked to cough deeply and spit any material that comes up from your lung into a special container. The sample is sent to a lab. A small amount is lightly smeared onto a microscope slide and mixed with potassium hydroxide (KOH). The slide is examined under the microscope and checked for fungus parts.

Routine sputum culture is a test of secretions from the lungs and bronchi (tubes that carry air to the lung) to look for bacteria that cause infection. You will cough deeply and spit any sputum into a sterile cup. The sputum is then taken to the laboratory. There, it is placed in a special substance (medium) under conditions that allow the bacteria or fungi to grow.

It is a test done to measure how much oxygen and carbon dioxide is in your blood. It also looks at the acidity (pH) of the blood. Usually, blood gases look at blood from an artery. In rarer cases, blood from a vein may be used.

It is a test that looks at a sample of fluid from the space around the lungs to find and identify disease-causing organisms.