Diagnostics
A. PRE-OP
Diagnostic
Description of the Procedure
Procedure
TLSV X-ray A lumbosacral spine x-ray is a
picture of the small bones
(vertebrae) in the lower part of the
spine. This area includes the lumbar
region and the sacrum, the area that
connects the spine to the pelvis.
HIP/PELVIS X-RAY A pelvis x-ray is a picture of the
bones around both the hips. The
pelvis connects the legs to the body.
KNEE A knee X-ray is a safe and painless
BILATERAL X- test that uses a small amount of
RAY radiation to take a picture of a
person's knee. This image shows
parts of the bones of the knee,
including the femur (the bone above
the knee), the tibia and fibula (the
lower leg bones), the patella
Significance/Purpose of the
Procedure
A lumbosacral spine X-ray, or
lumbar spine X-ray, is an imaging test
that helps your doctor view the
anatomy of your lower back.
A pelvic X-ray can help find the
cause of symptoms such as pain,
swelling, or deformity in the pelvic,
hip, or upper leg regions, and can
detect broken bones after an injury.
X-rays of the knee joint are
requested frequently, particularly at
the Emergency Assistance
department. They are used primarily
to confirm/exclude a fracture, or to
assess the level of osteoarthritis in the
knee joints.
Date of
Findings & Implications
Procedure
January 17, - Thoracic kyphosis and lumber lordosis are maintained
2020 with no fracture or listhesis.
- No evident scoliosis.
- Bone density is osteopenic.
- No disc space narrowing.
- Marginal spurs and end plate sclerosis are seen in the
visualized spine.
- Intersegmental line is normal.
- The pedicles, larninae, and facet joints are intact.
- Lumber gravity line falls anterior to the sacral
promontory messuring 2.6 cm.
- Sacroiliac joints are preserved.
- Incidental note of bowel ileus.
January 17, - No radiographic evidence of fracture or dislocation.
2020 - Both femoral heads are well in place within the ace-
tabular fossa.
- Both hip joint spaces appear narrowed with sclerotic
margins.
- Rest of visualized osseous and soft tissue structure are
unremarkable.
January 17, - Medial tibiofemoral and patellofemoral joint spaces
2020 are narrowed.
- Sclerosis of articular surfaces.
- Juxtaarticular and patellofemoral spurs are noted in
both knees.
- No definite radiographic evidence of fracture nor
dislocation seen in the projection taken.
 (kneecap), and the soft tissues.
ABO AND RH ABO/RH testing entails putting a
TYPING sample of the cell suspension in
various reagents, centrifuging at a
specific speed for a specific period
of time, and then gently shaking the
tube. If there is any clumping of
blood cells, known as agglutination,
the result for that reagent is positive.
Diagnostic procedure Description of procedure
and date done
Complete Blood Count A CBC may be ordered when a
January 17, 2020 person has any number of signs and
5:08 pm symptoms that may be related to
disorders that affect blood cells.
During a CBC, A lab technician will
draw blood from a vein, typically
from the inside of the elbow. A
tourniquet will be placed around the
arm to help the vein swell with
blood. The medical technologist will
insert the needle, collect the blood
sample, remove the elastic band, and
submit the blood sample to the
 DEGENERATIVE OSTEOARTHRITIS OF THE
KNEE, BILATERAL.
ABO- to determine by what kind of January 17, ABO Blood typing: B
antigens your red blood cells have on 2020
the surface. Antigens are substances 5:20 pm
that help your body differentiate
between its own cells and foreign, Rh Typing: POSITIVE
potentially dangerous ones. If your
body thinks a cell is foreign, it will set
out to destroy it.
Rh- is an inherited protein found on
the surface of red blood cells. If your
blood has the protein,
you're Rh positive. If your blood lacks
the protein, you're Rh negative. Your
pregnancy needs special care if
you're Rh negative and your baby
is Rh positive (Rh incompatibility).
Significance/ Purpose of the Significant findings Nursing Implications
procedure
CBC is used to determine general Hemoglobin Normal A low Hemoglobin indicates anemia.
health status, screen, diagnose, or Range: 120-160g/L
monitor any one of a variety of diseases
and conditions that affect blood cells, Result: 109-
such as anemia, infection, Low
inflammation, bleeding disorder or Hematocrit Normal A low Hematocrit
cancer. Range: 0.37-0.47 means the percentage
When an individual has an infection, L/L of red blood cells is
inflammation, bruising or bleeding a below the lower limits
doctor may order a CBC to help Result: of normal.
diagnose the cause and/or determine its 0.34 - Low
severity WBC COUNT A WBC count indicate that the
Normal Range: 5.0- immune system is working to destroy
laboratory testing. 10.0 an infection.
Result:
16.33- High
Neutrophils Normal A high Neutrophils indicate
Range: 50-70% neutrophilia. this is a sign of infection.
Result:
90- High
Lymphocytes Lymphocyte counts below the
Normal Range: 20- normal range can also be temporary.
40% They can occur after a cold or another
Result: infection, or be caused by intense
6- Low physical exercise, severe stress, or
malnutrition. A low level can also be a
sign of a condition known as
lymphocytopenia or lymphopenia.

Monocytes Within the normal range.

Normal Range:
0-10%
Result:
4-Normal
Eosinophil Within the normal range.
Normal Range:
0-7%
Result:
0- Normal
Basophil Within the normal range.
Normal Range:
0-1 %
Result:
0- Normal
Red Blood Cells A low red blood cell count indicates
Normal Range: hemorrhage and anemia.
4.04- 5.48 10^12/L

Erythrocyte Sedimentation The ESR test measures the rate at
Rate which the red blood cells,
January 17, 2020 or erythrocytes, in a sample of blood
5:10pm settle at the bottom. This process of
settling is called sedimentation. A
doctor will draw a small amount of
blood from the individual's vein and
.send it to a laboratory
Cell count and differential A synovial fluid analysis, a doctor
count will extract and analyze a sample
January 17, 2020 of synovial fluid from the joint.
7:56pm Doctors may refer to the collection
of synovial fluid as arthrocentesis.
Numb the area around the
affected joint using a local anesthetic
injection or a numbing spray.
ROUTINE CHEMISTRY Routine Chemistry is applied to
Result:
3.43- Low
Platelet COUNT A high platelet count can happen when
Normal Range: something causes the bone marrow to
150- 400 10^9/L make too many platelets. When the
Result: reason is unknown, it is called primary,
512- High or essential, thrombocytosis. When
excess platelets are due to an infection
or other condition, it is called
secondary thrombocytosis.
Erythrocyte sedimentation rate (ESR), is A very high ESR usually has an
a blood test that can reveal inflammatory :Normal Range obvious cause, such as a severe
activity in your body. mm/hr 0-10 infection, marked by an increase in
:Result globulins, polymyalgia rheumatica or
High -131.00 .temporal arteritis
Synovial fluid analysis is :Specimen type There are crystals, excess WBC, or
a procedure that doctors use to help them Synovial Fluid .microorganism in the fluid
diagnose several joint-related conditions,
including RA, osteoarthritis, and gout. It :Physical exam
also allows them to rule out infection as Color: Yellow
.the cause of symptoms Appearance: Turbid
Volume: 21.90 ml
:Microscopic Examination
:No. of WBC
Too numerous to count / cumm (82%
.segmenters 18% Lymphocytes)
:No. of RBC
cumm (100% Crenated 0% non- 116
.crenated)
Routine chemistry is done to learn Sodium
 January 17, 2020 assays of physiologically important information about general health, check Normal Range: 135- Within the normal range.
6:02pm substances found in blood, urine, the body’s electrolyte balance, help 145 mmol/L Result:
tissues and other biological fluids diagnose diseases and conditions, and 136.95- Normal
for the purpose of aiding the check how a treatment is affecting Creatinine A high levels of Creatinine warn of
physicians in making a diagnosis or certain organs. Normal Range: 49-90 possible malfunction or failure of the
following therapy. Before having umol/L kidneys.
blood chemistry, instructions will be Result:
given such as stopping the intake of 42.70- Low
medications that may alter the test as Potassium
per physician’s instructions. Normal Range: 3.5- Within the normal range.
A sample of blood is drawn from a 5.1
vein, usually inner elbow and sent Result:
to a laboratory analysis. 3.70- Normal
Chloride A low chloride level indicates
Normal Range: 98- hypochloremia.
107 mmol/L
Result:
96.37- Low
Blood Urea Nitrogen
Normal Range: 2.8- Within the normal range.
72mmol/L
Result:
4.62- Normal
C-Reactive Protein A high level of CRP in the blood is a
Normal Range: < 1 marker of inflammation.
mg/L
Result:
41.33- High

.B. POST-OP

Diagnostic procedure Description of procedure Significance/ Purpose of the Significant findings Nursing Implications
and date done
Gram-stain A Gram stain is a laboratory
January17, 2020 procedure used to detect the presence
10:31 pm of bacteria and sometimes fungi in a
sample taken from the site of a
suspected infection. Color — typically
bacteria may be either "Gram positive"
(purple) or "Gram negative" (pink).
Bacteriology A synovial fluid analysis, a doctor
January 17, 2020 will extract and analyze a sample
10:31 pm of synovial fluid from the joint.
Doctors may refer to the collection
of synovial fluid as arthrocentesis.
Numb the area around the
affected joint using a local anesthetic
injection or a numbing spray.
AFB Acid- Fast Bacilli (AFB) smear and
January 17, 2020 culture are two separate tests always
11:09 pm performed together at the MSPHL,
Tuberculosis (TB) Unit. AFB smear
refers to the microscopic examination
of a fluorochrome stain of a clinical
specimen.
Gram-stain A Gram stain is a laboratory
January18, 2020 procedure used to detect the presence
12:03 am of bacteria and sometimes fungi in a
sample taken from the site of a
suspected infection. Color — typically
bacteria may be either "Gram positive"
(purple) or "Gram negative" (pink).
Bacteriology A synovial fluid analysis, a doctor
January 18, 2020 will extract and analyze a sample
12:13 pm of synovial fluid from the joint.
procedure
Gram staining is a common Specimen type: Positive gram-stain means bacteria
technique used to differentiate two Synovial Fluid are present. Because of
large groups of bacteria based on the staining technique used, gram-
their different cell wall constituents. Pus Cell: positive bacteria will appear purple
The Gram stain procedure Positive two under a microscope and gram-
distinguishes between Gram negative bacteria will appear pink.
positive and Gram negative groups by No microorganism seen
coloring these cells red or violet.
Synovial fluid analysis is Specimen type: Normal
a procedure that doctors use to help them Synovial Fluid
diagnose several joint-related conditions,
including RA, osteoarthritis, and gout. It Culture Result:
also allows them to rule out infection as No growth after 72 hours of infection
.the cause of symptoms
An acid-fast bacteria (AFB) culture is Specimen type: Negative AFB indicates no infection
done to find out if you have tuberculosis Synovial Fluid is present.
(TB) or another mycobacterial infection.
Besides TB, the other main mycobacterial Result:
infections are leprosy and a TB-like Negative for Acid Bacilli
disease that affects people with
.HIV/AIDS
Gram staining is a common Specimen type: Positive gram-stain means bacteria
technique used to differentiate two Synovial Fluid are present. Because of
large groups of bacteria based on the staining technique used, gram-
their different cell wall constituents. Pus Cell: positive bacteria will appear purple
The Gram stain procedure Positive two under a microscope and gram-
distinguishes between Gram negative bacteria will appear pink.
positive and Gram negative groups by No microorganism seen
coloring these cells red or violet.
Synovial fluid analysis is Specimen type: Normal
a procedure that doctors use to help them Synovial Fluid
diagnose several joint-related conditions,
 Doctors may refer to the collection
of synovial fluid as arthrocentesis.
Numb the area around the
affected joint using a local anesthetic
injection or a numbing spray.
Cell count and differential A synovial fluid analysis, a doctor
count will extract and analyze a sample
January 17, 2020 of synovial fluid from the joint.
7:56pm Doctors may refer to the collection
of synovial fluid as arthrocentesis.
Numb the area around the
affected joint using a local anesthetic
injection or a numbing spray.
Complete Blood Count A CBC may be ordered when a
January 18, 2020 person has any number of signs and
1:37 am symptoms that may be related to
disorders that affect blood cells.
During a CBC, A lab technician will
draw blood from a vein, typically
from the inside of the elbow. A
tourniquet will be placed around the
arm to help the vein swell with
blood. The medical technologist will
insert the needle, collect the blood
sample, remove the elastic band, and
submit the blood sample to the
laboratory testing.
including RA, osteoarthritis, and gout. It Culture Result:
also allows them to rule out infection as No growth after 72 hours of infection
.the cause of symptoms
Synovial fluid analysis is :Specimen type There are crystals, excess WBC, or
a procedure that doctors use to help them Synovial Fluid microorganism in the fluid.
diagnose several joint-related conditions,
including RA, osteoarthritis, and gout. It :Physical exam
also allows them to rule out infection as Color: Yellow
.the cause of symptoms Appearance: Turbid
Volume: 7 ml
:Microscopic Examination
:No. of WBC
Too numerous to count / cumm (90%
.segmenters 10% Lymphocytes)
:No. of RBC
260 cumm (60% Crenated 40% non-
crenated).
CBC is used to determine general Hemoglobin Normal A low Hemoglobin indicates anemia.
health status, screen, diagnose, or Range:
monitor any one of a variety of diseases 120-160g/L
and conditions that affect blood cells,
such as anemia, infection, Result:
inflammation, bleeding disorder or 95- Low
cancer. Hematocrit A low Hematocrit
When an individual has an infection, Normal Range: means the percentage
inflammation, bruising or bleeding a 0.37-0.47 L/L of red blood cells is
doctor may order a CBC to help below the lower limits
diagnose the cause and/or determine its Result: of normal.
severity 0.30 - Low
WBC COUNT A WBC count indicate that the
Normal Range: immune system is working to destroy
5.0-10.0 an infection.
Result:
11.16- High
Neutrophils A high Neutrophils indicate
Normal Range: neutrophilia. this is a sign of infection.
50-70%
Result:
86- High
Lymphocytes Lymphocyte counts below the
Normal Range: normal range can be temporary. They
20-40% can occur after a cold or another
Result: infection, or be caused by intense
9- Low physical exercise, severe stress, or
malnutrition. A low level can also be a
sign of a condition known as
lymphocytopenia or lymphopenia.

Monocytes Within the normal range.

Normal Range:
0-10%
Result:
5-Normal
Eosinophil Within the normal range.
Normal Range:
0-7%
Result:
0- Normal
Basophil Within the normal range.
Normal Range:
0-1 %
Result:
0- Normal
Red Blood Cells A low red blood cell count indicates
Normal Range: hemorrhage and anemia.
 4.04- 5.48 10^12/L
Result:
3.12- Low
Platelet COUNT A high platelet count can happen
Normal Range: when something causes the bone
150- 400 10^9/L marrow to make too many platelets.
Result: When the reason is unknown, it is
452- High called primary, or essential,
thrombocytosis. When
excess platelets are due to an infection
or other condition, it is called
secondary thrombocytosis.
URINALYSIS A urinalysis is done in order to To screen for, help diagnose and/or Color Within the normal range
January 18, 2019 analyze urine. Patient will be given a monitor several diseases and conditions, Normal range:
3:53 pm plastic cup, and go to the bathroom such as kidney disorders or urinary tract Lt. Yellow – Amber
and urinate. Clean catch urine is infections including chronic kidney Result:
advised to prevent bacteria from disease, diabetes, bladder infections and Yellow
getting into sample. The cup is kidney stones (UTIs). And is done to Specific Gravity: Within the normal range
covered and will be brought to the look for abnormalities such as an excess Normal range:
doctor or nurse, and will be sent to amount of protein. 1.00- 1.005
the laboratory room for testing. Blood, pus, bacteria, or sugar. Result:
Urinalysis is also needed to determine 1.003
positivity or negativity of pregnancy. ph Within the normal range
Normal range:
5.0 – 6.5
Result:
5.5
Leuko Esterase: Within the normal range
Normal range:
Negative
Result:
Negative
Nitrite Within the normal range
Normal range:
Negative
Result:
Negative
Urine protein Within the normal range
Normal range:
Negative
Result:
Negative
Ascorbic Acid Within the normal range
Normal range:
0 mmol/L
Result:
0
Creatinine
Normal range:
4.4 – 17.7 mmol/L
Result:
0.9 - Low
Transparency (clarity) Within the normal range
Result:
Clear
Glucose Within the normal range
Normal range:
Negative
Result:
Negative
Ketone Within the normal range
Normal range:
Negative
Result:
Negative
Urobilinogen Within the normal range
Normal range:
Normal
Result:
Negative
 Bilirubin Within the normal range
Normal range:
Negative
Result:
Negative
Erythrocyte Within the normal range
Normal range:
Negative
Result:
Negative
MicroAlbumin Within the normal range
Normal range:
0 – 10 mg/L
Result:
10
Calcium Within the normal range
Normal range:
0 – 10 mmol/L
Result:
1.0
ROUTINE CHEMISTRY Routine Chemistry is applied to Routine chemistry is done to learn Glucose, FBS Within the normal range
January 19, 2020 assays of physiologically important information about general health, check Normal Range:
8:05 am substances found in blood, urine, the body’s electrolyte balance, help 4.1 – 5.9 mmol/L
tissues and other biological fluids diagnose diseases and conditions, and
Result:
for the purpose of aiding the check how a treatment is affecting
5.17- Normal
physicians in making a diagnosis or certain organs. HDL, Cholesterol A low HDL, Cholesterol indicates a
following therapy. Before having Normal Range: positive effect on your heart health
blood chemistry, instructions will be 1.03 – 1.55 mmol/L
given such as stopping the intake of Result:
medications that may alter the test as
0.77- Low
per physician’s instructions.
LDI, Cholesterol A high LDI, Cholesterol indicates
A sample of blood is drawn from a
Normal Range: hypoxia
vein, usually inner elbow and sent
< 2.6 mmol/L
to a laboratory analysis.
Result:
 3.29 - High
Traiglycendes Within the normal range
Normal Range:
< 1.70 mmol/L
Result:
1.32 - Normal
Total Cholesterol Within the normal range
Normal Range:
< 5.2 mmol/L
Result:
4.94 - Normal
Complete Blood Count A CBC may be ordered when a CBC is used to determine general Hemoglobin Normal A low Hemoglobin indicates anemia
January 22, 2020 person has any number of signs and health status, screen, diagnose, or Range:
11:48 am. symptoms that may be related to monitor any one of a variety of diseases 120-160g/L
disorders that affect blood cells. and conditions that affect blood cells,
During a CBC, A lab technician will such as anemia, infection, Result:
draw blood from a vein, typically inflammation, bleeding disorder or 99- Low
from the inside of the elbow. A cancer. Hematocrit A low Hematocrit
tourniquet will be placed around the When an individual has an infection, Normal Range: means the percentage
arm to help the vein swell with inflammation, bruising or bleeding a 0.37-0.47 L/L of red blood cells is
blood. The medical technologist will doctor may order a CBC to help below the lower limits
insert the needle, collect the blood diagnose the cause and/or determine its Result: of normal.
sample, remove the elastic band, and severity 0.33 - Low
submit the blood sample to the WBC COUNT A WBC count indicate that the
laboratory testing. Normal Range: immune system is working to destroy
5.0-10.0 an infection.
Result:
10.44 - High
Neutrophils A high Neutrophils indicate
Normal Range: neutrophilia. this is a sign of infection.
50-70%
Result:
86- High
Lymphocytes Lymphocyte counts below the
Normal Range: normal range can be temporary. They
20-40% can occur after a cold or another
Result: infection, or be caused by intense
9- Low physical exercise, severe stress, or
malnutrition. A low level can also be a
sign of a condition known as
lymphocytopenia or lymphopenia.

Monocytes Within the normal range

Normal Range:
0-10%
Result:
5 - Normal
Eosinophil Within the normal range
Normal Range:
0-7%
Result:
0- Normal
Basophil Within the normal range
Normal Range:
0-1 %
Result:
0- Normal
Red Blood Cells A low red blood cell count indicates
Normal Range: hemorrhage and anemia.
4.04- 5.48 10^12/L
Result:
3.30 - Low
Platelet COUNT A high platelet count can happen
Normal Range: when something causes the bone
150- 400 10^9/L marrow to make too many platelets.
Result: When the reason is unknown, it is
423- High called primary, or essential,
thrombocytosis. When
 excess platelets are due to an infection
or other condition, it is called
secondary thrombocytosis.
ROUTINE CHEMISTRY Routine Chemistry is applied to Routine chemistry is done to learn Creatinine A high levels of Creatinine  warn of
January 22, 2020 assays of physiologically important information about general health, check Normal Range: possible malfunction or failure of the
11:37 am substances found in blood, urine, the body’s electrolyte balance, help 49-90 umol/L kidneys.
tissues and other biological fluids diagnose diseases and conditions, and Result:
for the purpose of aiding the check how a treatment is affecting 42.70- Low
physicians in making a diagnosis or certain organs.
following therapy. Before having
blood chemistry, instructions will be
given such as stopping the intake of
medications that may alter the test as
per physician’s instructions.
A sample of blood is drawn from a
vein, usually inner elbow and sent
to a laboratory analysis.
Complete Blood Count A CBC may be ordered when a CBC is used to determine general Hemoglobin Normal A low Hemoglobin indicates anemia.
January 29, 2020 person has any number of signs and health status, screen, diagnose, or Range:
11:53 am symptoms that may be related to monitor any one of a variety of diseases 120-160g/L
disorders that affect blood cells. and conditions that affect blood cells, Result:
During a CBC, A lab technician will such as anemia, infection, 103 - Low
draw blood from a vein, typically inflammation, bleeding disorder or Hematocrit A low Hematocrit means the
from the inside of the elbow. A cancer. Normal Range: percentage of red blood cells is
tourniquet will be placed around the When an individual has an infection, 0.37-0.47 L/L below the lower limits of normal.
arm to help the vein swell with inflammation, bruising or bleeding a Result:
blood. The medical technologist will doctor may order a CBC to help 0.33 - Low
insert the needle, collect the blood diagnose the cause and/or determine its WBC COUNT Within the normal range
sample, remove the elastic band, and severity Normal Range:
submit the blood sample to the 5.0-10.0
laboratory testing. Result:
9.74 – High
Neutrophils A high Neutrophils indicate
Normal Range: neutrophilia. this is a sign of infection.
50-70%
Result:
80- High
Lymphocytes Lymphocyte counts below the
Normal Range: normal range can be temporary. They
20-40% can occur after a cold or another
Result: infection, or be caused by intense
13- Low physical exercise, severe stress, or
malnutrition. A low level can also be a
sign of a condition known as
lymphocytopenia or lymphopenia.

Monocytes Within the normal range

Normal Range:
0-10%
Result:
6 - Normal
Eosinophil Within the normal range
Normal Range:
0-7%
Result:
1 - Normal
Basophil Within the normal range
Normal Range:
0-1 %
Result:
0- Normal
Red Blood Cells A low red blood cell count indicates
Normal Range: hemorrhage and anemia.
4.04- 5.48 10^12/L
Result:
3.29 - Low
Platelet COUNT A high platelet count can happen
Normal Range: when something causes the bone
150- 400 10^9/L marrow to make too many platelets.
 Result: When the reason is unknown, it is
579 High called primary, or essential,
thrombocytosis. When
excess platelets are due to an infection
or other condition, it is called
secondary thrombocytosis.
ROUTINE CHEMISTRY Routine Chemistry is applied to Routine chemistry is done to learn Creatinine A high levels of Creatinine  warn of
January 29, 2020 assays of physiologically important information about general health, check Normal Range: possible malfunction or failure of the
11:42 am substances found in blood, urine, the body’s electrolyte balance, help 49-90 umol/L kidneys.
tissues and other biological fluids diagnose diseases and conditions, and Result:
for the purpose of aiding the check how a treatment is affecting 35.85 - Low
physicians in making a diagnosis or certain organs. SGOT/AST Within normal range
following therapy. Before having Normal Range:
blood chemistry, instructions will be < 35 U/L
given such as stopping the intake of Result:
medications that may alter the test as 20.30- Normal
per physician’s instructions. SGPT/ALT Within normal range
A sample of blood is drawn from a Normal Range:
vein, usually inner elbow and sent < 35 U/L
to a laboratory analysis. Result:
22.43 - Normal