Can someone help me with this assignment??

[SugarNSpiceX2]

I have limited information on 3 different patients and I have to take this info and do the following:

1. Identify abnormal lab values and specify whether it is low or high, slightly or critically.

2. Give specific names for deficiency or excess of the values.

3. Which ones are reportable or not and to whom?

4. List possible reasons for abnormalities.

5. What further data is needed? (Pt. assessment, head-to-toe, subjective and objective data, Hx, questions to ask, etc)

And here is the 3 patients and the info I have on them.

Patient #1 -

67 y.o. Male

Hx of colon cancer and diverticulitis

WBC 20.55

Neutrophils 75%

Monocytes 12%

RBC 4.93

Hgb 8

Hct 34%

Platelet 100

Bleeding time 11 sec

Patient #2 -

Dx Urosepsis, anorexia x2 days

WBC 16.98

Neutrophils 60%

RBC 4.6

Hgb 18

Hct 52%

Platelet 300

Bleeding Time 9 sec

Patient #3 -

71 y.o. Female

Hx of glomerulonephritis

Sodium 126

Potassium 6.9

Chloride 92

BUN 28

Creatinine 1.2

I am just kind of stuck and not sure what to even look for....can anyone help?

[Daytonite, BSN, RN]

1. identify abnormal lab values and specify whether it is low or high, slightly or critically.

2. give specific names for deficiency or excess of the values.

not all will have specific medical terms for a deficiency or excess of a value.

3. which ones are reportable or not and to whom?

report panic values to the physician who ordered the test

4. list possible reasons for abnormalities.

many times this may be a disease.

5. what further data is needed? (pt. assessment, head-to-toe, subjective and objective data, hx, questions to ask, etc)

patient #3

71 y.o. female

hx of glomerulonephritis

sodium 126 - this is below normal; elevated sodium is called hypernatremia; decreased sodium is called hyponatremia

• normal adult:
  
  • 135-145 meq/liter
    

  [*]panic (critical) values:

  • below120 meq/liter
    
  • above 160 meq/liter

potassium 6.9 - this is a panic value; elevated potassium is called hyperkalemia; decreased potassium is called hypokalemia

• normal adult:
  
  • 3.5-5.0 meq/liter
    

  [*]panic (critical) values:

  • below 2.5 meq/liter
    
  • above 6.5 meq/liter

chloride 92 - this is below normal; elevated chloride is called hyperchloremia; decreased chloride is called hypochloremia

• normal adult:
  • 90-110 meq/liter

  [*]panic (critical) value:

  • below 80 meq/liter
    
  • above 115 meq/liter

bun 28 - this is above normal; elevated blood urea is referred to as azotemia; there is no term for decreased levels of urea

• normal adult:
  • 10-20 mg/dl

  [*]panic (critical) value:

  • above 100 mg/dl

creatinine 1.2 - this is above normal; there are no medical terms that i know of for deficiency or excess of the values

• normal adult female:
  • 0.5 - 1.1 mg/dl

  [*]panic (critical) value:

  • above 4 mg/dl (indicates serious renal function impairment)

this patient has a very high potassium (hyperkalemia). here are the symptoms of hyperkalemia. you want to, at a minimum, assess for these. hyperkalemia causes heart block and slowing of the heart rate. note the very last one which is why this is a panic value and the doctor needs to be notified of this immediately:

• tachycardia that changes to bradycardia
  
• ventricular arrhythmias
  
• on ekg: peaked t waves, widened qrs complex, depressed st segment
  
• hypotension
  
• nausea/vomiting
  
• diarrhea
  
• abdominal cramps
  
• decreased gastric motility
  
• muscle weakness
  
• muscle cramps
  
• flaccid muscle paralysis first in the legs and then in the arms and trunk
  
• paresthesias of the face, tongue, feet and hands
  
• drowsiness
  
• oliguria
  
• cardiac arrest due to hypopolarization and alterations in repolarization
  

here are 3 websites where you can get lab test information:

• medicine net procedures & tests a to z index http://www.medicinenet.com/procedures_and_tests/article.htm
  
• web md index list of tests http://www.webmd.com/a_to_z_guide/medical_tests.htm
  
• lab tests online http://www.labtestsonline.org/

you will not find information on bleeding time on these websites because i already checked them. i answered your other post on bleeding tome from information from my lab reference here at my home. you need to look up information about each of the lab tests for the other patient scenarios just as i did for the 3rd one from the web links listed.

[RN2B73]

Wow, all I can say is holy crap...I start my program in January and I can't even wrap my brain around all the knowledge you spewed...pretty impressive I must say:)