Hematology For a Complete Blood Count (CBC), specimens of venous blood are taken, it includes hemoglobin and hematocrit measurements, erythrocyte (RBC) count, leukocyte (WBC) count, red blood cell (RBC) indices, and a differential white cell count. The CBC is a basic screening test and one of the most frequently ordered blood tests. Possible Causes of Normal Findings Hematology
Result 04.13.07
Result 04.20.07
Normal Values Increased
Decreased
WBC
14.43 x 109/L
16.03 x 109/L
5–10 x 109/L
◊ Infection ◊ Inflammation ◊ Trauma
◊ Autoimmune disease ◊ Drug toxicity ◊ Bone marrow failure
Neutrophil
0.01
0.62
0.550.65
◊ stress ◊ acute infection
◊ aplastic anemia ◊ dietary deficiency
Lymphocytes
0.83
0.31
0.250.35
◊Chronic infection ◊ Viral Infection ◊Mononucleosis
◊ Leukemia ◊ Sepsis ◊Immunodeficiency\ diseases
Eosinophils
0.01
0.03
0.020.07
◊ Parasitic infections ◊ Allergic reactions ◊ Leukemia
◊ Increased Adrenosteroid production
Hemoglobin
101.1 g/L
110.7 g/L
116-140 g/L
◊ Polycythemia ◊ Dehydration ◊ COPD
◊ ◊ ◊ ◊ ◊
Hemorrhage Anemia Cancer Kidney disease Sickle Cell Anemia
Hematocrit
0.32
0.34
0.350.41
◊ Polycythemia ◊ Dehydration ◊ COPD
◊ ◊ ◊ ◊
Hemorrhage Anemia Hyperthyroidism Dietary deficiency
Platelet
365 x 109/L
615 x 109/L
150-350 x 109/L
◊ Malignant disorder ◊ Polycythemia ◊ Rheumatoid Arthritis ◊ Iron Deficiency Anemia
◊ ◊ ◊ ◊ ◊
Hemorrhage Leukemia Pernicious anemia Hemolytic anemia Chemotherapy
RBC
4.76 x 1012/L
5.28
3.0 -5.0x 1012/L
◊ Dehydration ◊ Pulmonary fibrosis
◊ Hemorrhage ◊ Anemia ◊ Dietary deficiency
Urinalysis Urine tests include tests for specific gravity, pH and the presence of abnormal constituents such as glucose, ketones, protein, and occult blood.
Specific gravity is an indicator of urine concentration, or the amounts of solutes present in the urine. The specific gravity of urine normally ranges from 1.010 to 1.025. Low specific gravity readings is a result of excess fluid intake or diseases affecting the ability of the kidneys to concentrate urine. A high specific gravity may indicate fluid deficit or dehydration, or excess solutes such as glucose in the urine.
Urinary pH is measured to determine the relative acidity or alkalinity of urine and assess the client’s acid-base status. Urine is normally acidic with an average pH of 6. Assessment of urine pH is useful in determining whether the kidneys are responding appropriately to acidbase imbalances.
Urine is tested for glucose to screen clients for diabetes mellitus. Normally, the amount of glucose in the urine is neglible. Ketone bodies, a product of the breakdown of fatty acids, normally are not present in the urine. However, they may be present for clients with poorly controlled diabetes.
Protein is normally negative in urine testing. If protein becomes positive in some clients, this may indicate that their glomerular membrane in the kidney has been damaged. Normal urine is free from blood. When blood is present, it may be clearly visisble or not visible (occult).
Microscopic
Result 04.12.07
Result 04.20.07
Normal Values
Color
Light yellow
Dark yellow
Straw/amber
Transparency
Slightly hazy
Clear
Clear
Glucose
Negative
Negative
Negative
Ketone
Ngative
Negative
Negative
Specific Gravity
1.010
1.01
1.005-1.030
pH
6
6
4.6-8.0
WBC
1
3
0-4hpf
RBC
3
3
0-3pf
Epithelial Cells
1
1
0-3
Bacteria
256
341
0-850
Result 04.12 (00:15am)
Result 04.12 (12:43pm)
Normal Values
Serum Electrolyte
Electrolyte
Sodium
129
129
137-145 mEq/L
Potassium
2.4
3.2
3.6-5.0 mEq/L
Chlorine
71
76
98-107 mEq/L
Calcium
2.31
2.26
2.10-2.56 mEq/L
Blood Urea Nitrogen Blood levels of two metabolically produced substances, urea and creatinine, are routinely used to evaluate renal function. The kidneys, through filtration and tubular secretion, normally eliminate both. Urea, the end product of protein metabolism is measured as blood urea nitrogen. BUN
Result
Normal Values
urea
9.8 mmol/L
2.5-6.1
creatinine
57 mmol/L
62-106
Echocardiogram Indication:
Hypertension
Findings:
Left Atrial Enlargement Left Ventricular Enlargement & Hypertrophy No coarctation of aorta Intact IAS/IVS Fair LV Systolic function Mild AI Mild MR Mild PR
Lab Studies • Electrolytes, BUN, and creatinine levels to evaluate for renal impairment • CBC and smear to exclude microangiopathic anemia • Urinalysis (UA) o Dipstick UA to detect hematuria or proteinuria (renal impairment) o Microscopic UA to detect RBCs or RBC casts (renal impairment) • Optional studies o Toxicology screen o Pregnancy test o Endocrine testing Imaging Studies • Chest radiography is indicated in patients with chest pain or shortness of breath. o Cardiac enlargement o Pulmonary edema o Widened mediastinum • Head CT scans are indicated in patients with abnormal neurologic examinations. o Intracranial bleeding o Cerebral edema o Cerebral infarction
• •
Chest CT scan, transesophageal echocardiography, or aortic angiogram is indicated in cases where aortic dissection is suspected.
Other Tests • Electrocardiogram (ECG) to assess for evidence of myocardial ischemia or left ventricular hypertrophy
