N5400 Labs_Images_2024.pptx

LABORATORY & IMAGING STUDIES Week 7: 7/16/24 Dr. Ashley Graham-Perel. EdD, RN, NPD-BC, MEDSURG-BC, CNE Dr. Kiera Hirayama, DNP, MSN, RN Learning Objectives After today’s lecture you will be able to: ✔ Describe commonly ordered laboratory and imaging studies. ✔ Identify normal, or re...

LABORATORY & IMAGING STUDIES Week 7: 7/16/24 Dr. Ashley Graham-Perel. EdD, RN, NPD-BC, MEDSURG-BC, CNE Dr. Kiera Hirayama, DNP, MSN, RN Learning Objectives After today’s lecture you will be able to: ✔ Describe commonly ordered laboratory and imaging studies. ✔ Identify normal, or reference, values for laboratory and imaging studies. ✔ Define critical test results and why they should be immediately reported to a provider. 2 Role of the Nurse I. Specimen Collection i. Verify the order ii. Patient identification and education iii. Hand hygiene iv. Collect the sample v. Label the sample at the bedside (avoid errors) vi. Transport the sample to the lab II. Imaging Studies i. Verify the order ii. Patient identification and education iii. Prep as needed for the ordered test iv. Monitor the patient as needed post test 3 LABORATORY STUDIES  Component Reference Units Range WBC Count (WBC) 5,000-10,000 mm3 Hemoglobin (Hgb) 12-18 g/dL Blood Hematocrit (Hct) 40-50 % RBC Count (RBC) 4.2-5.9 million mm3 Studies Mean Corpuscular Volume (MCV) 80-94 fl Mean Corpuscular Hgb (MCH) 27-32 pg Complete Blood Mean Corpuscular Hgb Conc (MCHC) 33-38 % Red Cell Distribution Width (RDW) 11.5-15.0 % Count (CBC) Platelet Count 100, 000-400,000 mm3 Component Reference Range Units Differential Neutrophils 36-71 % Lymphocytes 20-50 % Monocytes 6-13 % Eosinophils 0-6 % Basophils 0-1 % Band forms 0-1 % 5  Component Reference Units Range Sodium 135-145 mEq/L More Blood Potassium 3.5-5.0 mEq/L Studies Calcium 4.5-5.1 mg/dL Chemistry Chloride 97-107 mEq/L Basic metabolic panel CO2 22-34 mmol/L (BMP) Glucose 60-100 mg/dL - 8 components Blood Urea Nitrogen (BUN) 8.0-20 mg/dL Creatinine 0.7-1.4 mg/dL Complete Metabolic panel (CMP) - 14 components Critical values - Require immediate action 6 7 Even More Blood Studies Coagulation studies Prothrombin Time (PT) - Ref range: 10-13.1 seconds International Normalized Ratio (INR) - Ref range: 0.88-1.16 - 2.0-3.0 for anticoagulant therapy - 2.5-3.5 for mechanical heart valves Partial Thromboplastin Time/Activated Partial Thromboplastin Time (PTT/aPTT) - Ref range: 27.5-37.4 seconds - Heparin therapy monitoring ref range: 58- 99 seconds Blood Cultures Draw 1st 15 min apart 9 Blood Tubes 10 IMAGING STUDIES Radiography X-rays Obstructions, strictures, fractures, etc. No contrast used Emits radiation Normal = negative CT Scans Cross-sectional images of bone and tissue May use oral or IV contrast to illuminate images Emits radiation Normal = negative 12 Radiography MRIs Detailed anatomic views No radiation emitted May use IV contrast to illuminate images Normal = negative Ultrasound Visualizes organs, soft tissue, blood flow through vessels, etc. - e.g., Kidneys, carotid arteries, legs for DVT No contrast used, no radiation Normal = negative 13