Hematology. Possible Causes of Normal Findings. Result Normal Values Autoimmune disease Drug toxicity Bone marrow failure.

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Bertina Preston
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1 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. Hematology Normal Values Increased Possible Causes of Normal Findings Decreased WBC x x 5 10 x Infection Inflammation Trauma Autoimmune disease Drug toxicity Bone marrow failure Neutrophil stress acute infection aplastic anemia dietary deficiency Lymphocytes Chronic infection Viral Infection Mononucleosis Sepsis Immunodeficiency\ diseases Eosinophils Parasitic infections Allergic reactions Increased Adrenosteroid production Hemoglobin g/l g/l g/l COPD Cancer Kidney disease Sickle Cell Anemia

2 Hematocrit COPD Hyperthyroidism Dietary deficiency Platelet 365 x 615 x x Malignant disorder Rheumatoid Arthritis Iron Deficiency Anemia Pernicious anemia Hemolytic anemia Chemotherapy RBC 4.76 x /L x /L Pulmonary fibrosis 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 to 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.

3 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 Normal Values Color Light yellow Dark yellow Straw/amber Transparency Slightly hazy Clear Clear Glucose Negative Negative Negative Ketone Ngative Negative Negative Specific Gravity ph WBC hpf RBC pf Epithelial Cells Bacteria Serum Electrolyte Electrolyte (00:15am) (12:43pm) Normal Values Sodium meq/l Potassium meq/l Chlorine meq/l Calcium meq/l

4 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 Normal Values urea 9.8 mmol/l creatinine 57 mmol/l Echocardiogram Indication: Findings: Hypertension 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

5 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

Interpretation of Laboratory Values

Interpretation of Laboratory Values Konrad J. Dias PT, DPT, CCS Overview Electrolyte imbalances Renal Function Tests Complete Blood Count Coagulation Profile Fluid imbalance Sodium Electrolyte Imbalances