Rbc, hgh, hct - lab help

[Student2001]

I have a patient who has osteomyelitis, bmi of 38, acute renal failure, taking unicyn, amputation several days ago on his right toes, has diabetes, left side weakness, prostate cancer (in remission), knee abrasion with no feeling in foot, HTN, high cholesterol, DVT, Fasciotomy, new a fib, osteoporosis

Why did the physician have RBC, HGH, HCT drawn? I think it could be because he had an amputation, so he could be weak and fatigued. His was low probably because of malnutrition and renal failure.. is there any other reason why this could be low?

also his WBC was done because....?? i thought that was just done because he has a bacterial infection (osteomyelitis), and cancer. his are normal now though.. they were normal the last few days he had it drawn and only were a little off before amputation and now i`m supposing that his infection is under control. Is there any other reason why doctor would order this test specifically for him and why they are normal now?

any help would be greatly appreciated, I'm having a lot of problems figuring labs out and the rationale behind why they are done in each case..

[Pneumothorax, BSN, RN]

fasciotomy?..did he have compartment syndrome?

[Al.ginger]

is he in the hospital???

It just a routine to have one more piece for bigger picture. Hct hgb can show blood loss during surgery, also gives you idea about his systemic circulation - if his body getting enough nutrients and O2. WBC - yep, if there is infection... or... if its low, physician will think - why?

[DennRN]

fasciotomy?..did he have compartment syndrome?

He had a bone marrow infection, part of the natural immune response would be the inflammatory process (swelling).

So yeah, it would be a fair assumption that he needed to have the pressure relieved before ischemia caused necrosis.

[Pneumothorax, BSN, RN]

He had a bone marrow infection, part of the natural immune response would be the inflammatory process (swelling).

So yeah, it would be a fair assumption that he needed to have the pressure relieved before ischemia caused necrosis.

i saw the osteomyelitis..i just didnt want to make the assumption...

ive learned some things are done for not textbook reasons as of late... :)

[Cortisol]

My guess is that the attending physician just wants to be sure that there are no signs of anemia or leukopenia. These are rare side effects of penicillin, but with multiple medical dx, your patient is at higher risk for such complications.

Also, chronic diseases may lead to microcytic anemia, and he may be wanting to check for that as well.

[Al.ginger]

If there is bone problemsm they assessing for bone marrow depression then

[nurseprnRN, BSN, RN]

renal failure also depresses rbc production, because somewhere along the line of evolution the kidneys drew the short straw for the job of paying attention to blood oxygen-carrying capacity since they see so much blood flow in the course of their workday. besides making urine and working on regulating acid-base and electrolyte balance, they make erythropoietin in response to low oxygen-carrying capacity. but hey....renal failure means that job goes undone, too.

he also has bad arteries and won't heal unless his blood oxygen-carrying capacity isn't optimal (and maybe not even then since he has such lousy capillary flow from his dm). remember, a person with a spo2 of 100% and a hematocrit of 16 carries only half as much oxygen to cells as someone with a spo2 of 100% and a hematocrit of 32. spo2 isn't all the story.