Test Definition Result Normal Range Interpretation/

Significance

Nursing

Responsibilities

11/08/15

HbA1C

(Glycosycated

Hemoglobin)

The HbA1c

level represents

the average of

your blood

sugar levels

over the past 2

to 3 months. It

allows you

evaluate your

overall diabetic

control and to

make changes

if necessary.

6.7% 4.3-6.1%

Above Normal.

The higher the

HbA1c, the

greater the risk

of developing

diabetes-

related

complications.

Pre-Procedure:

Explain

procedure to the

client.

Post-Procedure:

Apply pressure

to the

venipuncture site

Test Definition Result Normal Range Interpretation/

Significance

Nursing

Responsibilities

11/05/15 &

11/09/15

Hematology

Hematology is

the branch of

medicine concer

Hemoglobin:

90 g/L @

11/05/15 Hemoglobin:

Below normal-

indicates anemia,

hemorrhage, bone

1. Explain test procedure. Explain that slight

ned with the

study, diagnosis,

treatment, and

prevention of

diseases related

to the blood.

109g/L @

11/09/15

RBC:

3.8x1012/L @

11/05/15

4.1x1012/L @

11/09/15

MCH:

24pg @

11/05/15

26.6pg @

11/09/15

120-160 g/L

RBC:

4.5-5.0 1012/L

MCH:

28-33pg

marrow failure and

renal disease.

Below Normal-

indicates anemia,

hemorrhage, bone

marrow failure,

renal disease.

Below Normal-

because of blood

loss over time, too

little iron in the

body, or microcytic

anemia

discomfort may be felt when the skin is punctured.

2. Encourage to avoid stress if possible because altered physiologic status influences and changes normal hematologic values.

3. Explain that fasting is not necessary. However, fatty meals may alter some test results as a result of lipidemia.

4. Apply manual pressure and

MCV:

76.8fl @

11/05/15

81.4fl @

11/09/15

MCHC:

31.1g/L @

11/05/15

32.7g/L @

11/09/15

MCV:

82-98 fl

MCHC:

33-36g/L

Below Normal- one

reason is because

of lead poisoning.

Long-lasting kidney

failure can also

cause the MCV

level to be too low.

A long-term

decrease of iron in

the body can cause

low MCV levels

Below Normal-

because of blood

loss over time, too

little iron in the

body, or

hypochromic

anemia.

dressings over puncture site on removal of dinner.

5. Monitor the puncture site for oozing or hematoma formation.

6. Instruct to resume normal activities and diet.

WBC:

9 g/L @

11/05/15

10.6 g/L @

11/09/15

Neutrophil:

70% @

11/05/15

WBC:

4.8-10.8 g/L

Neutrophil:

Within normal

range. If above

normal- seen in

response to

infection, stress,

inflammatory

disorders, or

abnormal

production as in

leukemia. If below

normal- there is an

increased risk of

infection

Within normal

range. If below

normal- an

increased risk of

infection

76% @

11/09/15

Lymphocyte:

19% @

11/05/15

40-70%

Lymphocyte:

19-48%

Above normal-

when there is

sudden infection

from bacteria,

damage or

inflammation of

tissues.

Within normal

range. If above

normal- are the flu

and the

chickenpox. Other

causes include

tuberculosis,

mumps, rubella,

varicella, whooping

cough, brucellosis,

and herpes simplex

16% @

11/09/15

Monocyte:

7% @

11/05/15

6% @

11/09/15

Monocyte:

3-9%

Below normal- If

not enough bone

marrow is produced

or the activity of the

bone marrow

decreases

Within normal

range. If above

normal- when

someone has an

infection, because

more of these cells

are needed to fight

it. If below normal-

Any illness or

chemical that

affects the bone

marrow

Eosinophil:

3% @

11/05/15

1% @

11/09/15

Basophils:

1% @

11/05/15

1% @

Eosinophil:

2-8%

Within normal

range. If above

normal- in response

to allergies or when

exposed to certain

types of bacteria or

parasites.

Below normal- can

be caused by

intoxication from

alcohol or

excessive

production of

cortisol.

Within the normal

range. If above

normal- in response

to an infection from

a virus and removal

11/09/15

Hematocrit:

0.29% @

11/05/15

0.33% @

11/09/15

Platelet

count:

325x109/L @

11/05/15

Basophils:

0-0.5%

Hematocrit:

0.37-0.45%

Platelet count:

of the spleen. If

below normal-

people who have

severe allergies

and also in

pregnant women

and people under

stress.

Below normal- is

referred to as being

anemic.

Within normal

range. If below

normal- indicates

thrombocytopenia

235 x109/L

150-400x109/L and is high risk for

bleeding

tendencies. If

above normal-

thrombocytosis.

Test Definition Result Normal Value Significance /

Interpretation

Nursing

Responsibilities

11/06/15

Coagulation

Test

Coagulation tests

measure your

blood’s ability to

clot, as well as

how long it takes.

Testing can help

your doctor

assess your risk

of excessive

bleeding or

developing clots

(thrombosis)

Control: 13.4

seconds

Test: 12.8

seconds

11-13.5

seconds

Within normal

range.

If above

normal- means

it takes blood

longer than

usual to clot. If

below normal-

means blood

clots more

quickly than

expected.

Pre-Procedure:

Explain

procedure to the

client.

Post-Procedure:

Apply pressure

to the

venipuncture site

somewhere in

your blood

vessels.

Test Definition Result Normal

Range

Interpretation/

Significance

Nursing

Responsibilities

11/06/15

Blood

Chemistry

Often, blood tests

check electrolytes,

the minerals that

help keep the

body's fluid levels

in balance, and are

necessary to help

the muscles, heart,

and other organs

work properly.

Tests for

electrolytes

measure levels of

sodium, potassium,

chloride, and

Sodium:

145.8

mmol/L

Potassium:

3.64

mmol/L

136-145

mmol/L

3.5-5.1

mmol/L

Above normal-

dehydration, severe

vomiting & diarrhea,

CHF, Cushing's

disease, hepatic failure,

high-sodium diet, and

others.

Within normal range. If

below normal- can be

caused by decreased

intake, protracted

vomiting, renal loss,

cirrhosis, renal failure

and others. The most

1. Define and explain

the test.

2. State the specific

purpose of the test.

3. Explain the

procedure.

4. Discuss test

preparation,

procedure, and

posttest care.

magnesium in the

body.

Calcium:

2.34

mmol/L

2.12-2.52

mmol/L

common cause of high

potassium is kidney

failure. Another

possible cause is heavy

alcohol or drug use.

Within normal range.

Low calcium levels in

the blood can occur in

kidney failure when

there is insufficient

Vitamin D available, or

in people who have

already had surgery to

remove their

parathyroid glands.

High calcium levels in

the blood can be

caused by high levels of

PTH, or by too much

calcium getting into the

body because of

treatment with calcium

and vitamin D tablets.

Test Definition Result Normal

Value

Interpretation/ Significance Nursing Responsibilities

Clinical

Chemistry

11/05/15

A serum

creatinine test

measures the

level of

creatinine in

your blood and

gives you an

estimate of how

well your

kidneys filter

(glomerular

filtration rate).

Creatinine:

163.2umol/L

53-115

umol/L

Above normal- Any condition

that impairs the function of

the kidneys.

1. Define and explain the

test.

2. State the specific

purpose of the test.

3. Explain the

procedure.

Discuss test preparation,

procedure, and posttest

care.

Test Definition Result Normal

Value

Interpretation/

Significance

Nursing

Responsibilities

Clinical

Chemistry

11/06/15

A glucose test is

a type of blood

test used to

determine the

amount of

glucose in the

blood. It is

mainly used in

screening for

prediabetes or

diabetes

A cholesterol

test can help

determine your

risk of the

buildup of

plaques in your

arteries that can

lead to narrowed

or blocked

arteries

Glucose:

7.0mmol/L

Cholestero

l:

5.30

mmol/L

4.4-

6.4mmol/L

0-5.2

mmol/L

Above normal- happens

when the body has too

little insulin or when the

body can't use insulin

properly

Above normal- often are

a significant risk factor for

heart disease.

Pre-Procedure:

Explain procedure to

the client.

Post-Procedure:

Apply pressure to the

venipuncture site

throughout your

body

Triglycerides are

a type of fat

(lipid) found in

your blood.

When you eat,

your body

converts any

calories it

doesn't need to

use right away

into triglycerides.

The triglycerides

are stored in

your fat cells.

High Density

Lipoproteins

Triglycerid

e:

1.02mmol/

L

HDL

1.31mmol/

0-1.68

mmol/L

1.03-1.55

mmol/L

Within normal range.

High levels

of triglycerides may raise

the risk of coronary artery

disease, especially in

women. Low levels of

triglyceride can be

perfectly healthy and

normal.

Within normal range. If

above normal- the lower

transport

cholesterol from

the tissues of

the body to the

liver, so the

cholesterol can

be eliminated in

the bile. HDL

cholesterol is

therefore

considered the

'good'

cholesterol.

Low-Density

Lipoprotein

cholesterol is

usually referred

L

LDL:

3.53

mmol/L

0-3.4

mmol/L

the risk of coronary artery

disease. If below normal-

includes a variety of

conditions, ranging from

mild to severe, in which

concentrations of alpha

lipoproteins or high-

density lipoprotein (HDL)

are reduced. The etiology

of HDL deficiencies

ranges from secondary

causes, such as smoking,

to specific genetic

mutations, such as

Tangier disease and fish-

eye disease.

Above normal- put you at

greater risk for a heart

attack from a

sudden blood clot in

to as “bad”

cholesterol

because it

deposits its

cholesterol on

the walls of

arteries. LDL is

also the type of

cholesterol that

becomes

oxidized and

damages the

lining of your

arteries, setting

the stage for

mineral and fat

deposits.

an artery narrowed

by atherosclerosis.

Test Definition Result Normal Significance/

Interpretation

Nursing

Responsibilities

Urinalysi

s

A urinalysis is a

group of chemical

Colour: dark

yellow

Colour:

Pale

Urine gets its yellow color

from a pigment called

1. Collect specimens

from infants and

11/05/15 and microscopic

tests. They detect the

byproducts of normal

and

abnormal metabolis

m, cells, cellular

fragments,

and bacteria in urine.

Clarity:

Cloudy

yellow -

yellow

Clarity:

Clear

urochrome. That color

normally varies from pale

yellow to deep amber,

depending on the

concentration of the urine.

Darker urine is usually a

sign that you're not

drinking enough fluid.

Cloudy urine may be

caused by either normal

or abnormal processes.

Normal conditions giving

rise to turbid urine include

precipitation of crystals,

mucus, or vaginal

discharge. Abnormal

causes of turbidity include

the presence of blood

cells, yeast, and bacteria.

young children into

a disposable

collection

apparatus

consisting of a

plastic bag with an

adhesive backing

around the opening

that can be

fastened to the

perineal area or

around the penis to

permit voiding

directly to the bag.

2. Depending on

hospital policy, the

collected urine can

be transferred to an

appropriate

specimen

container.

3. Cover all

Specific

Gravity:

1.010

Albumin:

Trace

Specific

Gravity:

1.005-

1.030

Albumin:

Negative

Within normal range.

Above normal- may be

associated with

dehydration, diarrhea,

emesis, excessive

sweating, urinary

tract/bladder infection and

others. Below normal-

may be associated with

renal failure,

pyelonephritis, diabetes

insipidus, acute tubular

necrosis, interstitial

nephritis, and excessive

fluid intake

Trace simply means that

the amount of albumin is

quite low and just above

the upper limit of detection

specimens tightly,

label properly and

send immediately

to the laboratory.

4. Observe standard

precautions when

handling urine

specimens.

5. If the specimen

cannot be delivered

to the laboratory or

tested within an

hour, it should be

refrigerated or have

an appropriate

preservative

added.

Sugar:

Trace

pH: 6.0

Sugar:

Negative

pH:

4.6-8.0

ability. Having trace

albumin in your urine

means that your kidneys

are abnormally spilling a

tiny amount of protein into

the urine from the blood.

Sugar can be found

in urine when the kidneys

are damaged or diseased.

Within normal range. A

high pH can be caused by

severe vomiting, a kidney

disease, some urinary

tract infections,

and asthma. A low pH

may be caused by,

uncontrolled diabetes,

WBC:

11/HPF

RBC: 3/HPF

Epithelial cells:

3/HPF

0-3/

HPF

RBC:

0-2/HPF

Epithelia

l cells:

0-3/HPF

aspirin overdose, severe

diarrhea, dehydration,

starvation, or drinking too

much alcohol.

High WBC is a sign of

infection

Above normal- maybe due

to: -kidney and other

urinary tract problems,

such as infection, tumor,

or stones, kidney injury,

prostate problems or

bladder/kidney cancer.

Presence of epithelial

cells, the cells in the lining

of the bladder or urethra,

Mucus

Threads:

0/HPF

Bacteria:

125

Mucus

Threads:

0-3/HPF

Bacteria:

0-30/

HPF

may suggest inflammation

within the bladder, but

they also may originate

from the skin and could be

contamination.

Presence or absence of

mucus threads is not an

issue because it is usually

found in the urine.

Indicates infection.

Radiologic Findings

It is a result where you may know what you have after your physical examination using imaging techniques that "reads" the images and produces a report of their findings and impression or diagnosis.

DATE COMPONENTS NORMAL ACTUAL RATIONALE Nursing Responsibilities

RESULT RESULT

11/05/15 Chest PA Clear Clear

IMP: Normal Chest Findings

There was no apparent problem or any unusualities during the imaging study.

1. Nurses may need to

reduce anxiety in some

patients, particularly in

those who are very young

or confused.

2. Simple, loose clothing is

important to gain access to

that part of the body under

examination. This may

mean a loose fitting gown

for hospital patients

3. Some specialized X-ray

investigations may require

nothing by mouth for a few

hours before the test, or a

particular bowel

preparation. Often, the

radiography department

will issue specific

instructions when the

appointment is made.

Nurses should ensure

these instructions are

carried out for all hospital

patients

4. Check to see if a female

patient is, or could be

pregnant. Exposure of the

unborn fetus to X-rays can

be damaging to the child

5. After the test, the patient

should be returned to their

normal activities if these

have been disturbed, i.e.

eating and drinking, as

quickly as possible

Possible Diagnostic Tests

Colonoscopy- Colonoscopy is the most accurate and versatile diagnostic test for Rectosigmoid Adenocrcinoma, since it

can localize and biopsy lesions throughout the large bowel, detect synchronous neoplasms, and remove polyps

Barium enema- Barium enema is widely available and may be used to investigate patients with symptoms suggesting of

rectosigmoid adenocarcinoma. However, the diagnostic yield of both double-contrast barium enema (DCBE) alone and

the combination of DCBE plus flexible sigmoidoscopy is less than that of colonoscopy or CT colonography for the

evaluation of lower tract symptom

CT colonography- CT colonography (also called virtual colonoscopy or CT colography) provides a computer-simulated

endoluminal perspective of the air-filled distended colon. The technique uses conventional spiral or helical CT scan or

magnetic resonance images acquired as an uninterrupted volume of data, and employs sophisticated postprocessing

software to generate images that allow the operator to fly-through and navigate a cleansed colon in any chosen direction.

CT colonography requires a mechanical bowel prep that is similar to that needed for barium enema, since stool can

simulate polyps.

Digital rectal examination (DRE)- may be used as an initial screening examination; however, tumors located more than

7 centimeters from the anal verge may be missed during this examination. Additional studies include barium enema,

usually with flexible sigmoidoscopy and/or colonoscopy used as a complementary procedure. The average finger can

reach approximately 8 cm above the dentate line; rectal tumors can be assessed for size, ulceration, and presence of any

pararectal lymph nodes, as well as fixation to surrounding structures (eg, sphincters, prostate, vagina, coccyx and

sacrum); sphincter function can be assessed

Rigid proctoscopy- This examination helps to identify the exact location of the tumor in relation to the sphincter

mechanism

Fecal immunochemical test may also be done using monoclonal antibodies to identify hemoglobin present in rectal

lesions, indicating bleeding. A complete blood count (CBC) is done to rule out anemia; the presence of hypochromic,

microcytic anemia suggests iron deficiency. Additional blood tests, including measurement of a molecule that is

associated with cancer cells (carcinoembryonic antigen, or CEA test), a cancer antigen (CA) 19-9 assay, and liver function

tests, may indicate possible metastasis of the rectal cancer to other organs. Stool DNA screening may be done to

evaluate genetic changes that may have led to cancer development.

CA125 Testing is a blood test that can be performed to help the physician to determine the risk of ovarian cancer.

However, an elevated CA125 is nonspecific and can be elevated in the face of many common benign findings, such as

pregnancy, uterine fibroids, menses, and endometriosis. It can also be elevated by non-ovarian malignancies such as

stomach cancer, colon cancer, and cancer of the liver.

In postmenopausal patients, however, the accuracy of predicting ovarian malignancy increases considerably. The higher

the level of CA125, the more it is likely that an ovarian mass is malignant. A note of caution, however: CA125 is elevated

above normal in only 50% of patients with Stage 1 ovarian cancer and may miss half of the patients with a localized

tumor. In other words, when the CA125 is elevated, it raises your concern; but if the CA125 is normal, it is not a guarantee

of normal findings.

MRI Some patients may benefit from further imagining studies. The elderly, the sick, or patients who simply refuse surgery

may benefit from an MRI. An MRI of the ovary is not diagnostic for cancer; however, it is very sensitive for benign ovarian

masses such as dermoids or uterine fibroids that can be confused with ovarian masses. Thus, MRI’s should be reserved

for patients with indeterminate ultrasound findings who cannot have surgery because of the costs, the need for

intravenous dye, and claustrophobia of the machine.