Diagnostics and

Laboratoy
 Date Ordered Date Normal Values Results Analysis and
Indication(s) or
Diagnostic Procedure Result IN (1st, 2nd) (1st, 2nd) Interpretation
Purpose(s)

Hematology
Hemoglob in is th e
p rotein molecu le
Result shows that
in red b lood cells
patient has a low level
th at carries oxygen
of hemoglobin in the
Hemoglobin March 28, 2015 from the lungs to 137-170 g/L 98 g/L
blood. This indicates
th e b od y's tissu es
that there is a low
an d retu rn s carb on
exchange of oxygen in
d ioxid e from th e
the cells.
tissu es b ack to th e
lu n gs.
The second result also
indicates that the
90 g/L patient has below
March 29, 2015
normal amount of
oxygen in his blood.
 Th e h ematocrit is a Results show that the
test th at measu res patient has a low level
th e p ercen tage of of hematocrit. This may
Hematocrit March 28, 2015 b lood th at is 0.41 – 0.51 0.31 indicate that the
comp rised of red volume of blood is less
b lood cells. than the normal
volume. Suspected of
having anemia.
A much lower level of
hematrocrit was
obtained for the
0.27
March 29, 2015 second result. This may
also indicate fluid
overload.
 Red b lood cell
in d ices h elp
classify typ es of
an emia, a d ecrease
in th e oxygen
carryin g cap acity
of th e b lood .
Results show that the
Health y p eop le
level of RBC of patient
have an adequate
is low. It indicates
n u mb er of
significant decrease in
correctly sized red
level of circulating
b lood cells
RBC March 28, 2015 4.6 – 6.2 x 10/L 3.59 erythrocytes which
con tain in g en ou gh
may be probable for a
h emoglob in to
decrease oxygen
carry su fficien t
carrying capacity of
oxygen to all th e
blood in the body.
b od y's tissu es.
Anemia is
d iagn osed wh en
eith er th e
h emoglob in or
h ematocrit of a
b lood samp le is
too low.
This also indicates lack
of oxygen carried by
3.15
March 29, 2015 the blood though out
the body.
 White blood cells are
responsible for
Result shows a slightly
recognition and
increase of WBC. It
March 28, 2015 neutralization of alien 4.5-11.0 x 10 /L 11.44
White Blood Cells signifies sign of slight
components of the
infection.
immune defense
against viruses and
bacteria.

Second result shows a

high level WBC. It
indicates that the
March 29, 2015 16.0
infection multiples
compared to the first
result which indicates a
slight infection.
 Result shows an
A type of immune cell
increase of Neutrophils
Neutrophils March 28, 2015 that is one of the first 56-66 % 74 %
which indicates a sign
cell types to the site of
of infection.
an infection.
A higher level of
March 29, 2015 85 % neutrophils indicates
an acute infection.
 Lymphocytes indicates Result shows a lower
and evaluates T-Cells level of Lymphocytes It
and B-Cells and to indicates that the
monitor for signs of body's resistance to
Lymphocytes March 28, 2015 infection 24-40 % 20 % fight infection is
substantially reduced,
and one may become
more susceptible to
certain types of
infection.
A much lower level of
Lymphocytes for the
March 29, 2015 11 %
second result indicates
the spread of infection.
 Result shows a higher
The primary functions level of platelet count
Platelet Count March 28, 2015 of Platelet Count is to 140-440 x10/L 468 in the blood which
assist in the diagnosis indicates an increase
of bleeding disorders. viscosity of the blood.
Second results show a
slight increase of
March 29, 2015 448
platelet count from the
normal value.
Complete Blood Count (CBC)

A complete blood count (CBC), also known as full blood count (FBC) or full blood exam (FBE) or blood panel, is a test
panel requested by a doctor or other medical professional that gives information about the cells in a patient's
blood. A scientist or lab technician performs the requested testing and provides the requesting medical
professional with the results of the CBC.

Nursing Responsibilities:

Before:
• Monitor vital signs, report any abnormal
• Provide necessary patient education with regard to specimen collection

During:
• Observe aseptic technique

After:
• Determine the abnormal findings
• Document properly
• Inform the physician for any abnormal findings.
 Date Ordered Date
Indication(s) or
Diagnostic Procedure Result IN
Purpose(s)
Blood Chemistry
Glucose test measures
the amount of glucose
in the blood. Screen for
Glucose March 28, 2015 4.10 - 5.90 mmol/L
diabetes in people who
are at risk before signs
and symptoms are
apparent.
This measures the
amount of ALT/SGPT
enzyme in the blood. It
ALT/SGPT March 28, 2015
is measured to see if
the liver is damaged or
diseased.
Creatinine is a waste
product that forms
when creatine breaks
March 28, 2015 53 - 115 umol/L
Serum Creatinine down. Creatinine levels
help determine how
well your kidneys
function.
March 29, 2015
Normal Values Results Analysis and
(1st, 2nd, 3rd) (1st, 2nd, 3rd) Interpretation
The result is above the
normal range. This
indicates that there is
11.97
too much glucose
within the blood and
indicates
hyperglycemia.
The result is within
normal range. It
indicates normal level
12 - 78 U/L 16
of alt/sgpt in the blood.
This signifies that there
is no problem with the
liver.
The result is within
normal range. It
indicates normal serum
112.07
creatinine level which
indicates that the
kidneys are well
functioning.
A second result shows a
normal level. It signifies
that there are no
114.36
problems with the
functions of the
kidneys.
 Uric acid is a chemical
when the body breaks
down substances called
purines. Purines are
found in some foods The result is within
and drinks. Most uric normal range. It
Uric Acid March 28, 2015 acid dissolves in the 155 - 428 umol/L 286.12 indicates normal uric
blood and travels to acid level which
kidneys. This test is signifies good
done to see the level of functional kidneys.
uric acid in the blood.
High levels can cause
kidney disease.

Indicates the total The result is within the

amount of cholesterol normal range. It
Cholesterol March 28, 2015 <5.20 mmol/L 3.14
in the blood. indicates a normal level
of cholesterol in the
blood.

A type of fat the body The result is within the

uses to store energy normal range. It
Triglycerides March 28, 2015 and give energy to <1.70 mmol/L 1.23 indicates a normal level
muscles. Only small of triglycerides in the
amount is found in the blood.
blood.
 High-density
lipoprotein cholesterol
The result is slightly
is referred to as “good
HDL March 28, 2015 1.04 - 1.55 mmol/L 0.56 below the normal
cholesterol” because it
range.
helps remove LDL
cholesterol from the
blood.

The result is within the

Low-density lipoprotein
normal range. It
cholesterol is referred
indicates a normal level
LDL March 28, 2015 to as “bad cholesterol”. 0.00 – 3.4 mmol/L 2.0
of low-density
Too much of LDL can
lipoprotein in the
lead to cardio-vascular
blood.
problems.
 Date Ordered Date Normal Values Results Analysis and
Indication(s) or
Diagnostic Procedure Result IN (1st, 2nd, 3rd) (1st,2nd, 3rd) Interpretation
Purpose(s)

PSA test is used

primarily to screen for
prostate cancer. It
Patient is 84 years old.
measures the amount
Age > 69 Result is within normal
of prostate-specific
Low Limit: range. It indicates
antigen in the blood.
PSA March 28, 2015 0.21 4.38 ng/mL normal level of
PSA is a protein
High Limit: prostate specific
produced in the
6.77 antigen which signifies
prostate, a small gland
negative result for
that sits below a man’s
prostate cancer.
bladder. Small amounts
of PSA ordinarily
circulate in the blood.

Hepatitis B surface The result signifies that

Less than 0.13 (< 0.13) < 0.13
HBsAg March 28, 2015 antigen or HBsAG there is no presence of
Non Reactive Non Reactive
indicates the presence virus within the
of a virus. patient’s body.
Result is within the
Hypothyriod:
Thyroid stimulating normal range. It
> 7 uUl/ml
hormone test is used to indicates a normal level
Nomal:
March 28, 2015 evaluate the thyroid 1.00 uUl/ml of thyroid stimulating
TSH 0.25 – 5 uUl/ml
function and/or hormone which means
Hyperthyroid:
symptoms of a thyroid the thyroid is
< 0.15 uUl/ml
disorder. functioning very well.
 Date Ordered Date Normal Values Results Analysis and
Indication(s) or
Diagnostic Procedure Result IN (1st, 2nd, 3rd) (1st,2nd, 3rd) Interpretation
Purpose(s)

Blood sodium testing is

used to detect
abnormal
concentration of of It is within normal
Sodium March 29, 2015 136 – 145 mmol/L 137
sodium, termed as range. It indicates
hyponatremia (low normal sodium level.
sodium) and
hypernatremia (high
sodium).

Blood potassium It shows a slight

testing determines the decrease of potassium
concentration of in the blood. This
Potassium March 29, 2015 potassium in the blood 3.5 – 5.1 mmol/L 3.3 affects the proper
that are too high functioning of nerve
(hyperkalemia) or too and muscle cells,
low (hypokalemia). particularly heart
muscle cells.

It is within normal
4.4
April 1, 2015 range. It indicates
normal potassium level.
Capillary Blood Glucose
Analysis and
Diagnostic Purpose/ Indication Normal Values CBG result
Date/Time Interpretation
Procedure

Capillary Blood Glucose Capillary Blood Glucose

(CBG) Monitoring measures the glucose
(sugar) content in the blood It shows an increase in
which is done on a regular March 28, 2015 CBG. It indicates that
70-110mg/dL 320 mg/dl
basis in diabetic patients to 8:00 PM patient is having a
determine their glucose hyperglycemia.
level and to find out the
doses of medicine to be
administered to the patient.
March 28, 2015 It shows an increase in
70-110mg/dL 347 mg/dl
10:00 PM CBG after 2 hours.

It shows a decrease in
March 29, 2015
70-110mg/dL 172 mg/dl CBG for the past 2
12:00 AM
hours. It indicates that
patient is improving.

It shows an increase in
March 29, 2015
70-110mg/dL 275 mg/dl CBG. It indicates that
11:00 AM
patient is having a
hyperglycemia.
After an hour, the CBG
result lowered down
March 29, 2015 but still considered
246 mg/dl
12:10 PM hyperglycemia since it
is above the normal
range.
It shows a decrease in
March 29, 2015 CBG for the past 6
104 mg/dl
6:00 PM hours. Result is within
 Result shows an
March 30, 2015
227 mg/dl increase in CGB for the
12:00 AM
past 6 hours.

Result is within the

March 30, 2015
82 mg/dl normal range for the
6:00 AM
past 6 hours.

March 30, 2015

153 mg/dl It shows an increase in
11:30 AM
CBG.

March 30, 2015 It shows an increase in

265 mg/dl
6:00 PM CBG.

March 30, 2015 It shows an increase in

214 mg/dl
10:00 PM CBG.
March 31, 2015 It shows an increase in
187 mg/dl
12:00 AM CBG.

Result is within the

March 31, 2015
76 mg/dl normal range. It
6:00 AM
indicates a normal CBG.

March 31, 2015 It shows a slightly

121 mg/dl
7:30 AM increase in CBG.

March 31, 2015 It shows an increase in

189 mg/dl
12:00 PM CBG.

March 31, 2015 It shows an increase in

287 mg/dl
6:30 PM CBG.
April 1, 2015 It shows an increase in
191 mg/dl
5:00 AM CBG.

Result is within the

April 1, 2015
93 mg/dl normal range. It
12:00 PM
indicates a normal CBG.

April 1, 2015 It shows an increase in

173 mg/dl
6:00 PM CBG.

April 2, 2015 It shows an increase in

196 mg/dl
5:00 AM CBG.

April 2, 2015 It shows an increase in

154 mg/dl
12:00 PM CBG.

April 2, 2015 It shows an increase in

175 mg/dl
6:00 PM CBG.
April 3, 2015 It shows an increase in
198 mg/dl
5:00 AM CBG.

April 3, 2015 It shows an increase in

214 mg/dl
4:00 PM CBG.

April 3, 2015 It shows an increase in

210 mg/dl
9:00 PM CBG.

Result is below the

April 4, 2015 normal range. It
56 mg/dl
1:00 AM indicates a lower level
of CBG.

Result is within the

April 4, 2015
71 mg/dl normal range. It
1:30 AM
indicates a normal CBG.

Result is below the

April 4, 2015 normal range. It
64 mg/dl
5:00 AM indicates a lower level
of CBG.
 Result is below the
April 4, 2015 normal range. It
61 mg/dl
6:30 AM indicates a lower level
of CBG.

April 4, 2015 It shows an increase in

194 mg/dl
7:00 AM CBG.

April 4, 2015 It shows a slightly

123 mg/dl
8:30 AM increase in CBG.
DIAGNOSTIC INDICATIONS / ANALYSIS AND
DATE REQUESTED RESULTS NORMAL VALUES
PROCEDURE PURPOSES INTERPRETATION

URINALYSIS

The urine color is

the result of a
pigment called
urochrome and how
diluted or
concentrated the
The urine color is
Color urine is. Pigments March 27, 2015 Yellow Pale yellow to Amber
normal.
and other
compounds in
certain foods and
medications may
change the urine
color.
Urine is usually
clear. Haziness
could mean mucus, Indicates presence of
Transparency phosphates, March 27, 2015 Slightly turbid Clear to slightly turbid blood cells, yeast, and
bacteria, pus, or bacteria.
fats are spilling into
the urine.
This measures how
acidic of alkaline
(basic) the urine is.
It indicates that the
Reaction This may sometimes March 27, 2015 6.0 6.5 – 7.0
urine is acidic.
be affected by
certain treatments
or medications.
 DIAGNOSTIC INDICATIONS / ANALYSIS AND
DATE REQUESTED RESULTS NORMAL VALUES
PROCEDURE PURPOSES INTERPRETATION
Urine specific
gravity is a
laboratory test that
measures the
A high specific gravity
concentration of all
usually indicates
chemical particles in March 27, 2015 1.030 1.015-1.025
Specific Gravity dehydration, high salt
the urine. This test
diet, or infection.
helps evaluate your
body's water
balance and urine
concentration.
Glucose is the type
of sugar found in
blood. Normally
there is very little
or no glucose in
A trace of glucose was
urine. When the
found in the urine.
blood sugar level is
Signifies that a certain
very high, as in
amount of glucose
Glucose uncontrolled March 27, 2015 Trace Negative
already passed out the
diabetes, the sugar
kidneys. Patient is
spills over into the
having a
urine. Glucose can
hyperglycemia.
also be found in
urine when the
kidneys are
damaged or
diseased.
Urinalysis

Nursing Responsibilities

Before
• Explain to the patient what test to be done, its purpose and how it is
done.
• Inform the patient that the test will require a urine specimen.
• Instruct the patient how is the proper way to collect urine specimen.
• Provide a clean container for the specimen.

After
• Labels properly together with the laboratory slip.
• Send the specimen to the laboratory.
• Chart time of collection and attach results to chart as soon as they are
available.
DIAGNOSTIC INDICATIONS / ANALYSIS AND
DATE REQUESTED RESULTS NORMAL VALUES
PROCEDURE PURPOSES INTERPRETATION

This is used as a
rapid test to detect The result shows that
Negative for Acid Fast Negative for Acid Fast
AFB Smear mycobacteria that March 30, 2015 the patient is free from
Bacilli Bacilli
may be causing an the infection of
infection such as mycobacteria.
tuberculosis

DIAGNOSTIC PROCEDURE INDICATIONS / PURPOSES
Sputum Gram stain is often
used to isolate the cause of
pneumonia.
Pneumonia is an infection of
the lower respiratory tract,
Culture and Sentitivity with
often caused by
Gram Stain
microorganism invasion.
There are many kinds of
microorganisms (bacteria,
fungi, and viruses) that can
cause pneumonia.
ANALYSIS AND
DATE REQUESTED RESULTS INTERPRETATION
Gram Stain
Polymorphonuclear Cells:
>25/lpf
Epithelial Cells: <10/lpf
Gram Poss (+) Cocci in Pairs:
+
Gram Poss (+) Cocci in
Clusters: +
Gram Poss (+) Cocci Bacilli: +
Culture:
Organism: Klebsiella
Pneumoniae ssp Patient is resistant to
Pneumoniae Ampicillin therefore he
Colony Count: Light Growth cannot take this medication
March 30, 2015 Susceptibilty Report: to prevent any adverse
Susceptible to: reaction. While he is
 Amoxicilline/Clavulani susceptible to the other
c Acid listed medications.
 Ceftazidine
 Ciprofloxacin
 Ceftriaxone
 Cefuroxime
 Gentamicin
 Levofloxacin
 Trimethropin/Sulfame
thazole
 Piperacillin/Tazobacta
m
Resistant to:
 Ampicillin
 Chest PA
RADIOGRAPHIC REPORT

Date: March 27, 2015

Findings:
• There is abnormal opacity in the right upper lobe with prominent right oaratracheal region
deviating the tracheal column towards the left
• The heart is not enlarged
• The aorta is tortuous and calcified
• Diaphragm and sulci are intact
• Degenerative osseous of the thoracic spine are noted

Impression:
• Mass versus consolidation in the right upper lobe with possible paratracheal
• Enlarged lymph nodes
 Ultrasound of whole abdomen and
prostate
SONOGRAPHIC REPORT

Date: March 28, 2015

Findings:
• The liver is not enlarged with a span of 14 cm.
• The hepatic parenchyma in the right lobe is inhomogenous
• There are multiple masses in the right hepatic lobe at segment VI, VII and VIII
• The intra hepatic ducts are dilated
• The portal vein is not dilated
•
• The gallbladder is well distended
•
• The spleen is unremarkable measuring 9.5 x 3.7 cm
•
• The pancreas appears grossly nomal
•
• The right kidney has cortical thickness of 1.1 cm while the left has a cortical thickness of 1.0 cm
• The renal parenchyma is intact with well demonstrated corticomedullary junction
• There is no lithiasis and hydronephrosis
•
• The urinary bladder is poorly distended without intravesical abnormal echogenicity
•
• The prostate gland is normal in size

Impression
• Hepatic masses. Suggest further evaluation with dynamic/triphasic CT Scan of the liver with CT of the lower abdomen
• Sonographically unremarkable Gallblladder, Pancreas, Spleen, Kidneys, Urinary bladder and Prostate Gland.
 CT Scan of the chest with Intravenous
Contrast
Date: March 30, 2015

Findings

• There is large lobulated mass located peripherally in the anterior and apical segment of the right upper lobe adherent to the adjacent pleura. It
measures 8.8 x 3.9 x 5.8 cm (CC x T x AP).
• There is heterogenous enhancement of themass upon contrast administration.
• Spiculations and fibrosis are noted in the surrounding lung parenchyma
• Firbrotic changes are also noted in the middle lobe and both lower lobes
•
• Heterogeneous enhancing confluent soft issue densities with hypodense areas inlovling middle mediastanum particularly the right and left
paratracheal regions are noted
• There is extension of this lesion to the right helium measuring 3.7 x 1.9 x 2.7 cm,.
• The trachea and proximal brochi are patent
• There is a secondary extrinsic compression of the superior vena cava
•
• The heart is normal in size and configuration
• There is a minimal pericardial effusion seen
• Segmental calcifications are noted in the aorta and coronaries.
•
• There is no enlarged axillary lymph node
•
• Degenerative changes of the thoracic and visualized lumbar spine noted
•
• No focal lesion visualized at the adrenal glands
•
• There are hypoenhancing masses in the segment V and VI of the visualized liver parenchyma
•
• Incidental finding of the hypodense nodule in the left thyroid lobe and multiple bilateral renal cortical cysts
 CT Scan of the chest with Intravenous
Contrast
Impression

• Right upper lobe pulmonary mass with probable metastatic mediastinal and right hilar lymphadenophaties and
liver masses
• Minimal pericardial effusion
• Atherosclerosis aorta and coronaries
• Thoracolumbar spondylosis
• Hypodense thyroid nodule, left lobe.