Urinalysis

-This test evaluates physical characteristics of urine. Determine the specific gravity and Ph and
detects and measures protein, glucose and ketone bodies. Use to detect or measure urine
components include the evaluation of physical characteristics, such as color, odor and opacity
and microscopic inspection of centrifuged sediment for cells, cast, and crystals.

PURPOSE:
 To assess overall health. Urinalysis as part of a routine medical exam, or on
hospital admission to screen for a variety of disorders
 To help detect metabolic or systemic disease
 To determine disorders of glucose metabolism, for example, diabetes mellitus

Procedure:

1 .By the laboratory technician, patient will be asked to collect a urine sample in a specimen
cup.

2. The connection technique is different from woman and men.

 For men, the opening of the urethra (tip of the penis) should be wiped clean with a
cleansing wipe before collection is begun.
 In woman, the area around the urethra also needs to be wiped clean with a cleansing
wipe. The woman then spreads the labia of the external genitalia and wipes from front to back.

***Alcohol wipes should be avoided as these may irritate the area.

3. After the urethra is properly cleaned, the collection may begin by discarding the initial stream
of urine into the toilet. Patient should do “clean-catch mid-stream”.

4. Then, 10-15 milliliters (ml) of urine may be collected in the provided sterile specimen cup by
directly urinating into the cup.

5. Once an adequate amount is collected, then the remaining urine should be voided in the toilet.

Nursing Responsibilities:

1. Check the doctor’s order

2. Confirm the patient's identity.

3. Explain the procedure and its rationale.

4. Instruct the patient to void directly into a clean dry container.

5. Use aseptic technique by cleaning the urinary opening.

6. Instruct the patient to get a sample in the midstream of urination.

7. Instruct the patient to cover the specimen bottle when done.

DATE ORDERED: July 29, 2014

July 31, 2014

PHYSICAL NORMAL RESULT ANALYSIS

EXAMINATION VALUES
Color Amber Yellow Normal
Transparency Clear Slightly turbid Normal
Ph/Reaction 4.5-8 6.8 Normal
Specific gravity 1.010 – 1.025 1.010 Normal
CHEMICAL
EXAMINATION
Protein Negative Negative Normal
Sugar Negative Negative Normal

Chest X-ray (Posteroanterior)

-The most commonly requested X-Ray in medicine and accounts for 50% of all X-Rays
performed.
-It evaluates the lungs, heart and chest wall and can detect medical conditions such as
pneumonia, heart failure, emphysema, lung malignancy, (cancer) and
tuberculosis.
-Chest X-ray (CXR) is performed by a radiographer in X-ray room.

PURPOSE:
 To determine cause of symptoms such as dyspnea, and chest pain

Procedure:
 The patient is typically instructed to wear a gown and remove all metal
containing objects around the upper body as these will interfere with the
visualization of the tissues.
 The patient is then asked by the technician to stand in front of surface adjacent to
the film that records the images. The front of the chest is closest to the surface.
Another part of the machine that releases the radiation is then placed about 6 feet
away, behind the patient.
 The technician may advise the patient to take a deep breath and hold it and then
takes the image by activating the device.
 The image is then captured on the film within a few seconds
 The film can be developed within a few minutes to be reviewed by he doctor

Nursing Responsibilities:

 Check the doctor’s order

 Inform the patient about the procedure
 Assess patient comfort
 Assess vital signs and client stability
 Record and report data
RESULT:

Chest is homogenous density noted in the left upper lung field exhibiting concave inferior
border. Consider hidden neoplastic process and Kock’s pneumonia. Chest CT scan is suggested.
 Heart is normal in size
 Hemi diaphragm, costa phrenic sulci and visualized lower area intact

Clinical Chemistry
-Also known as chemical pathology, clinical biochemistry or medical biochemistry.

-Uses chemical processes to measure levels of chemical components in body fluids.

-The most common specimens used in clinical chemistry are blood and urine.
-Components may include blood glucose, electrolytes, enzymes, hormones lipids (fat),
other metabolic substances, and proteins.

 Random blood sugar (RBS) measures blood glucose regardless of when you last ate.

PURPOSE:
 To check for prediabetes and diabetes

PROCEDURE:

1. Blood is usually taken from a vein in the arm.

2. A tourniquet or elastic band is wrapped around the upper arm to apply pressure to the
area and make the vein swell.
3. The person may be asked to open and close the fist to make the veins to stand out more.
4. The skin is cleaned and disinfected.
5. A needle is inserted into the vein and a small amount of blood is removed. The person
will feel a prick or stinging sensation.
6. The sample is collected in a tube and labeled with the person’s name and other
identifying information.
7. The tourniquet is removed and the needle is withdrawn. Mild discomfort may be felt
when the needle is withdrawn.
8. Pressure is applied to the area where the needle was inserted until bleeding stops.
9. The sample is sent to a laboratory to be analyzed by special machines, examined under a
microscope or both.
Date ordered: July 29, 2014

July 31, 2014

Examination Normal values Result Analysis
Random blood sugar 2.5-7.3 mmol/L 9.44 Due to ?
45-130 mg/dL 170
HbAlc 4.0%-5.5% Negative Negative
Creatinine Adult: 53-106 umol/L 73 Normal
<2yrs: 27-54 umol/L
SGOT/AST Men: 10-40 U/L 56.0 Due to hepatotoxic
Women: 9-25 U/L drugs.
SGPT/ALT Men: 10-55 U/L 39.1 Normal
Women: 7-30 U/L
Sodium 135-145 meq/L 137 Normal
Potasium 3.5-5.0 meq/L 3.4 Normal

ECG
-Electrocardiography is a transthoracic (across the thorax or chest) interpretation of the
electrical activity of the heart over a period of time, as detected by electrodes attached to the
outer surface of the skin and recorded by a device external to the body.

PURPOSE:
To assess symptoms such as dyspnea, chest pain, palpitations and abnormal breathing patterns

PROCEDURE:

 The individual lies on a bed or couch while electrodes are placed on the skin at the wrists,
ankles, and several locations across the chest. The electrodes are connected by wires to a
control unit that selects different combinations of heart signals to record. The resulting
electrical signals are amplified and recorded on paper or displayed on a monitor. The test
takes only a few minutes and is painless.

NURSING RESPONSIBILITIES:

 Explain to the patient the need to lie still, relax and breath normally during procedure
 Explain that the test is painless and takes 5-10 minutesss
 Place the patient in supine or semi fowler’s position
 Place electrodes on the chest
 All recording and other nearby electrical equipment should be properly grounded
BLOOD TYPING AND CROSS MATCHING
DESCRIPTION:
-Blood typing is a method to determine what specific type of blood you have.
Cross matching refers to the testing that is performed prior to a blood transfusion in order to
determine if the donor’s blood is compatible with the blood of an intended recipient.

PURPOSE:
 To determine the blood type of the patient
 To check compatibility of the donor and the patient before blood transfusion

PROCEDURE:
 Blood is drawn from a vein, usually from the inside of the elbow or the antecubital area
 The puncture site is cleaned with an aseptic solution
 An elastic bond is placed around the upper arm to apply pressure, which causes the vein
to swell with blood
 A needle is inserted into the vein, and the blood is collected into a tube
 During the procedure, the elastic band is removed to restore circulation
 Once the blood has been collected, the needle is removed, and a band-aid or gauze is
applied

NURSING RESPONSIBILITIES:
 Check the doctor’s order
 Explain the procedure to the patient and its rationale
 Use aseptic technique by cleansing the venipuncture site with cotton alcohol
 Evaluate the venipuncture site and pressure if there is continuous bleeding
 Report any result to the requesting HCP, who will discuss the results with the patient

RESULT:
DATE TEST: July 29, 2014

RESULT

- O

Blood Transfusion
PACKED RBC

Date ordered: August 1, 2014

 Date and time Serial number

8 - 1 – 14 14-1948
9:30 pm

PURPOSE:
 To raise the hemoglobin level of the patient secondary to anemia

NURSING MANAGEMENT:
-Check the doctor’s order

- Cross matching should be done prior to the procedure

-Verify the patient identity

-Packed RBC must be prepared 30 minutes prior to transfusion. It should be

maintained on a room temperature

-Check the requisition form, the blood bag, and the serial number

-Two nurses must be present in checking prior to transfusion

-Check for the patients initial vital signs

-Ensure the doctor’s counter check on the order and sign thereafter

-Monitor patient for signs and symptoms of adverse reactions such as hemolytic reactions
(chills, fever, headache, cyanosis, chest pain, tachycardia, and hypotension), febrile reaction,
mild or severe allergic reaction, circulatory overload, or sepsis.