Diagnostic tests and investigations – Nursing is a profession within the healthcare sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other healthcare providers by their approach to patient care, training, and scope of practice. Nurses practice in many specialisms with differing levels of prescriber authority.
Many nurses provide care within the ordering scope of physicians, and this traditional role has shaped the public image of nurses as care providers. However, nurses are permitted by most jurisdictions to practice independently in a variety of settings depending on training level. In the postwar period, nurse education has undergone a process of diversification towards advanced and specialized credentials, and many of the traditional regulations and provider roles are changing.
Nurses develop a plan of care, working collaboratively with physicians, therapists, the patient, the patient’s family, and other team members, that focus on treating illness to improve quality of life. Nurses may help coordinate the patient care performed by other members of an interdisciplinary healthcare team such as therapists, medical practitioners, and dietitians. Nurses provide care both interdependently, for example, with physicians, and independently as nursing professionals.
Diagnostic tests and investigations
A diagnostic procedure is an examination to identify an individual’s specific areas of weakness and strength in order determine a condition, disease or illness. For example, in order to diagnose a herniated disc, physicians may employ Magnetic Resonance Imaging (MRI), Computer Assisted Tomography (CAT scan), and/or Electromyography (EMG) to determine if the herniated disc is impinging on a nerve root.
or
A diagnostic test is a test used to identify a condition or its cause. It is used to diagnose. A diagnostic test performed as a part of a medical exam may be used to identify the cause of symptoms or identify a disease. When used for other purposes, a diagnostic test may be used to identify specific strengths and weaknesses.
Normal values
The following are normal complete blood count results for adults:
Red blood cell count –
➤ Male: 4.35-5.65 trillion cells/L (4.35-5.65 million cells/mcL**)
➤ Female: 3.92-5.13 trillion cells/L (3.92-5.13 million cells/mcL)
Hemoglobin
➤Male: 13.2-16.6 grams/dL*** (132-166 grams/L)
➤ Female: 11.6-15 grams/dL (116-150 grams/L)
Hematocrit
➤ Male: 38.3-48.6 percent
➤ Female: 35.5-44.9 percent
White blood cell count
➤ 3.4-9.6 billion cells/L (3,400 to 9,600 cells/mcL)
Platelet count
➤ Male: 135-317 billion/L (135,000 to 317,000/mcL)
➤ Female: 157-371 billion/L (157,000 to 371,000/mcL)
- * L = liter
- ** mcL = microliter
- *** dL = deciliter
HEMATOLOGY- Red Blood Cells.
It is the measurement of the normal range of red blood cell count of a person.
- RBC (Male) 4.2-5.6 10^6/ µL [Scientific Notation: 10^6 = 1,000,000
- RBC (Female) 3.8-5.1 10^6/µL
- RBC (Child) 3.5-5.0 10^6/µL
HEMATOLOGY – White Blood Cells.
It is the measurement of the white blood cell count in the body.
- WBC (Male) 3.8-11.0 10^3/mm3 [Scientific Notation: 10^3 = 1,000]
- WBC (Female) 3.8-11.0 10^3/mm3
- WBC (Child) 5.0-10.0 10^3/mm3
HEMOGLOBIN
Diseases that affect red blood cells or the amount of hemoglobin in the blood may be
- Hgb (Male) 14-18 g/dL
- Hgb (Female) 11-16 g/dL
- Hgb (Child) 10-14 g/dL
- Hgb (Newborn) 15-25 g/dL
HEMATOCRIT
Determines the proportion of blood that is made up of red blood cells and may be used to determine the severity of anemia.
- Hct (Male) 39-54%
- Hct (Female) 34-47%
- Hct (Child) 30-42%
- MCV 78-98 fL
- MCH 27-35 pg
- MCHC 31-37%
- neutrophils 50-81%
- bands 1-5%
- lymphocytes 14-44%
- monocytes 2-6%
- eosinophils 1-5%
- basophils 0-1%
CARDIAC MARKERS
Used to diagnose patients with chest discomfort suspected with acute coronary syndrome (ACS).
- troponin 10-0.1 ng/ml (onset: 4-6 hrs, peak: 12-24 hrs, return to normal: 4-7 days)
- troponin T 0-0.2 ng/ml (onset: 3-4 hrs, peak: 10-24 hrs, return to normal: 10-14 days)
- myoglobin (Male) 10-95 ng/ml (onset: 1-3 hrs, peak: 6-10 hrs, return to normal: 12-24 hrs)
- myoglobin (Female) 10-65 ng/ml (onset: 1-3 hrs, peak: 6-10 hrs, return to normal: 12- 24 hrs)
GENERAL CHEMISTRY
The general chemistry panel evaluates a number of the body’s components.
- acetone 0.3-2.0 mg%
- alkaline phosphatase 32 -110 U/L
- anion gap 5-16 mEq/L
- ammonia 11 -35 µmol/L
- amylase 50-150 U/dL
- AST,SGOT (Male) 7-21 U/L
- AST,SGOT (Female) 6-18 U/L
- bilirubin, direct 0.0-0.4 mg/dL
- bilirubin, indirect total minus direct
- bilirubin, total 0.2-1.4 mg/dL
- BUN 6-23 mg/dL
- calcium (total) 8-11 mg/dL
- carbon dioxide 21-34 mEq/L
- roma in Nursing Science & Midwifery
- carbon monoxide symptoms at greater than or equal to 10% saturation
- chloride 96-112 mEq/L
- creatine (Male) 0.2-0.6 mg/dL
- creatine (Female) 0.6-1.0 mg/dL
- creatinine 0.6-1.5 mg/dL
- ethanol 0 mg%; Coma:
- greater than or equal to 400-500 mg%
- folic acid 2.0-21 ng/mL
- glucose 65-99 mg/dL
- (diuresis greater than or equal to 180 mg/dL)
- HDL (Male) 25-65 mg/dL
- HDL (Female) 38-94 mg/dL
- iron 52 – 169 µg/dL
- iron binding capacity 246-455 µg/dL
- lactic acid 0.4-2.3 mEq/L
- lactate 0.3-2.3 mEq/L
- lipase 10-140 U/L
- magnesium 1.5-2.5 mg/dL
- osmolarity 276-295 mOsm/kg
- parathyroid hormone 12-68 pg/mL phosphorus 2.2-4.8 mg/dL
- potassium 3.5-5.5 mEq/L
- SGPT 8-32 U/L
- sodium 135-145 mEq/L
- T3 0.8-1.1 µg/dL
- thyroglobulin less than 55 ng/mL
- thyroxine (T4) (total) 5 – 13 µg/dL
- total protein 5-9 gm/dL
- TSH Less than 9 µU/mL
- urea nitrogen 8-25 mg/dL uric acid (Male) 3.5-7.7 mg/dL
- uric acid (Female) 2.5-6.6 mg/dL
- LIPID PANEL (Adult)
- cholesterol (total) Less than 200 mg/dL desirable
- cholesterol (HDL) 30-75 mg/dL
- cholesterol (LDL) Less than 130 mg/dL desirable
- triglycerides (Male) Greater than 40-170 mg/dL
- triglycerides (Female) Greater than 35-135 mg/dL
URINE
Urine tests are used to diagnose different metabolic and kidney disorders.
- color Straw
- specific gravity 1.003 – 1.040
- pH 4.6-8.0
- Na 10-40 mEq/L1
- K Less than 8 mEq/L
- C1 Less than 8 mEq/L
- protein 1 – 15 mg/dL
- osmolality 80-1300 mOsm/L
- 24 HOUR URINE
- amylase 250-1100 IU/24 hr
- calcium 100-250 mg/24 hr
- chloride 110-250 mEq/24 hr
- creatinine 1-2g/24 hr
- creatine clearance (Male) 100-140 mL/min
- creatine clearance (Male) 16-26 mg/kg/24 hr
- creatine clearance (Female) 80-130 mL/min
- creatine clearance (Female) 10-20 mg/kg/24h
- magnesium 6-9 mEq/24 hr
- osmolality 450-900 mOsm/kg
- phosphorus 0.9-1.3 g/24 hr
- potassium 35-85 mEq/24 hr
- protein 0-150 mg/24 hr
- sodium 30-280 mEq/24 hr
- urea nitrogen 10-22 gm/24 hr
- uric acid 240-755 mg/24 hr
COAGULATION
Coagulation factor tests calculate the role of proteins necessary for blood clot formation.
- ACT 90-130 seconds
- APTT 21-35 seconds
- platelets 140,000-450,000/ml
- plasminogen 62-130%
- PT 10-14 seconds
- PTT 32-45 seconds
- FSP Less than 10 µg/dL
- fibrinogen 160-450 mg/dL
- bleeding time 3-7 minutes
- thrombin time 11-15 seconds
CEREBRAL SPINAL FLUID
It is a series of tests that assess substances present in the cerebral spinal fluid in order to be able to diagnose circumstances affecting the central nervous system.
- appearance clear
- glucose 40-85 mg/dL
- osmolality 290-298 mOsm/L
- pressure 70-180 mm/H2O
- protein 15-45 mg/dL
- total cell count 0-5 cells
- WBCs 0-6/µL
HEMODYNAMIC PARAMETERS
The examination of hemodynamic parameters over time, such as blood pressure and heart rate in order to gauge blood flow and circulation.
- cardiac index 2.5-4.2 L/min/m2
- cardiac output 4-8 LPM
- left ventricular stroke work index 40-70 g/m2/beat
- right ventricular stroke work index 7-12 g/m2/beat
- mean arterial pressure 70-105 mm Hg
- pulmonary vascular resistance 155-255 dynes/sec/cm to the negative 5
- pulmonary vascular resistance index 255-285 dynes/sec/cm to the negative 5
- stroke volume 60-100 mL/beat
- stroke volume index 40-85 mL/m2/beat
- systemic vascular resistance 900-1600 dynes/sec/cm to the negative 5
- systemic vascular resistance index 1970-2390 dynes/sec/cm to the negative 5
- systolic arterial pressure 90 – 140 mm Hg
- diastolic arterial pressure 60-90 mm Hg
- central venous pressure 2-6 mm Hg; 2.5-12 cm H2O
- ejection fraction 60-75%
- left arterial pressure 4 – 12 mm Hg
- right atrial pressure 4-6 mm Hg
- pulmonary artery systolic 15-30 mm Hg
- pulmonary artery diastolic 5-15 mm Hg
- pulmonary artery pressure 10-20 mm Hg
- pulmonary artery wedge pressure 4 – 12 mm Hg pulmonary artery end diastolic pressure 8-10 mm Hg
- right ventricular end diastolic pressure 0-8 mm Hg
