Date

Procedure Hematology

Norms Hematocrit (Hct) (31-43g/dL)

Results 31.7

Hemoglobin (Hgb) (11-16 g/dL)

11.2

Interpretation and Analysis Hematocrit is within normal range, low Hct may indicate fluid overload, anemia, and acute massive blood loss. High count may indicate hemoconcentration from loss of fluid, dehydration, and polycythemia. Hemoglobin is within normal range, low count may indicate fluid overload, anemia, or recent hemorrhage. High count may indicate hemoconcentrration from polycythemia or dehydration. RBC is within normal range. Low count results in anemia, fluid overload, leukemia, may be caused also by recent hemorrhage. High count may indicate polycythemia vera, cardiac and pulmonary disorders characterized by cyanosis, dehydration and acute poisoning. WBC is within normal range. Low count may

RBC Count ( 3.9-5.3x10^6/L)

4.04

WBC Count (5-17x10^3/L)

13.22

Platelets (150-450x10^3/L)

293

indicate bone marrow depression. High count may indicate infection, leukemia, and tissue necrosis. Low count may indicate Idiopathic thrombocytopenia purpura, aplastic anemia, hemolytic disorders, chemotherapeutic drugs or radiation, hypersplenism or splenomegaly, infiltrative bone marrow disease, DIC, and Viral Infections. High count may indicate malignancies, polycythemia vera, splenectomy and rebound thrombocytosis. High count indicates Inflammatory disease or response, tissue necrosis, granulocyte leukemia and other malignancies, acute stress response, and bacterial infection. Low count may indicate bone marrow depression, viral diseases, and may be due to the use of chemotherapeutic

Neutrophil (25-43)

75

Lymphocyte (42-50)

19

drugs. Low count is may be due to the Use of corticosteroids or immunosuppressive drugs, High count indicates chronic bacterial infections, tuberculosis, pertussis or lymphocytic anemia. Low count is may be due to drug therapy, or use of prednisone. High count may indicate infections, collagen vascular diseases, and monocytic anemia. 78.5 Low count is maybe due to stress response, or cushings syndrome. High count indicates allergic reactions, parasitic infections, skin diseases. Cancers, pernicious anemia. Low count indicates microcytic anemia, IDA, Hypochromic anemia, Thalassemia, or lead poisoning. High count indicates pernicious anemia, microcytic anemia, foilc acid, or B12 deficiency anemia.

Monocyte (4-5)

03

Eosinophils (2-3)

03

MCV (80-100 fl)

MCH (27-37)

27.7

MCHC (31-37)

35.3

RDW (8.5-15)

12.7

Low count indicate microcytic anemia, high count indicate macrocytic anemia. Low count indicate microcytic anemia, hypochromic anemia, thalassemia, or IDA. High count indicate spherocytosis. Low count

Procedure Chest X-Ray

Findings Bibasal Streaky Infiltrates Heart, Diaphragm, and Bony thorax are unremarkable. IMP: Bibasal Pneumonia

Analysis

Drug Study Drug Cefuroxime Action: A secondgeneration cephalosporin that inhibits cellwall synthesis, promoting osmotic instability; usually Contraindications and cautions Serious Contraindicate infections of the d in patients lower hypersensitive respiratory and to drug or urinary tracts; other skin and skincephalosporin structure s. infections; bone Use cautiously and joint in patients with infections; history of septicemia; sensitivity to meningitis; penicillin and Indications Nursing Consideration CV: phlebitis, Children age 2 Obtain and older: thrombophlebitis. specimen for GI: 250 mg P.O. q culture and pseudomembranous 12 hours. sensitivity tests colitis, nausea, before giving anorexia, vomiting, first dose. diarrhea. Therapy may Hematologic: begin pending transient results. neutropenia, eosinophilia, With large hemolytic anemia, doses or Adverse Reactions Dosages Patient Teaching Tell the significant others to notify prescriber if the patient has loose stools or diarrhea. Inform the significant others to alert the nurse if the

bactericidal.

gonorrhea; and for perioperative prevention of infection. Oral form: Otitis media, pharyngitis, tonsillitis, infections of the urinary and lower respiratory tracts, and skin and skinstructure infections. Mild to moderate pain caused by headache, muscle ache, backache, minor arthritis, common colds, toothache, or menstrual cramps or fever.

in breastfeeding women. Use cautiously and with reduced dosage in patients with impaired renal function. Monitor renal function.

thrombocytopenia.

prolonged therapy, monitor patient for superinfection, especially in high-risk patients.

patient has discomfort at I.V. insertion site. Tell significant others to notify prescriber if rash or signs and symptoms of superinfection occur.

Paracetamol (Acetaminophen) Action: Pain relief may result from inhibition of prostaglandin synthesis in CNS, with subsequent blockage of pain impulses. Fever reduction may result from vasodilatation and increased peripheral blood flow in hypothalamus, which dissipates heat and lowers body temperature

Hypersensitivit y to drug

Hematologic: neutropenia, leucopenia,

Children from 2-3 years: 160 mg q 4 hours.

Observe for acute toxicity and overdose

Tell patients SO(s) not to use drug concurrently with other acetaminophe n- containing products. As appropriate, review all other significant and life threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

Salbutamol Action: Relaxes bronchial, uterine, and vascular smooth muscle by stimulating beta2 receptors.

To prevent or treat bronchospasm in patients with reversible obstructive airway disease--

Contraindicated in patients hypersensitive to drug or its ingredients. Use cautiously in patients with CV disorders (including coronary insufficiency and hypertension), hyperthyroidism, or diabetes mellitus and in those who are unusually responsive to adrenergics. Use extendedrelease tablets cautiously in patients with preexisting GI narrowing.

Adverse reactions CNS: tremor, nervousness, dizziness, insomnia, headache, hyperactivity, weakness, CNS stimulation, malaise. CV: tachycardia, palpitations, hypertension. EENT: dry and irritated nose and throat (with inhaled form), nasal congestion, epistaxis, hoarseness. GI: heartburn, nausea, vomiting, anorexia, bad taste in mouth, increased appetite. Metabolic: hypokalemia. Musculoskel etal: muscle cramps.

children age 3 and older: dosage and frequency vary with dosage form. Aerosol inhalation--1 or 2 inhalations q 4 to 6 hours. More frequent administration or more inhalations aren't recommended.

Hx: Hypersensitivity to albuterol; tachyarrhythmias, tachycardia caused by digitalis intoxication. Physical: Weight, skin color, turgor, orientation, reflexes, adventitious sounds.

Warn patients SO about possibility of paradoxical bronchospa sm. If this occurs, stop drug immediately. If more than 1 inhalation is ordered, advise patient to wait at least 2 minutes before repeating procedure.

Respiratory: BRONCHOS PASM, cough, wheezing, dyspnea, bronchitis, increased sputum. Other: hypersensitiv ity reactions.