CBC with diff (questions)

Nurses General Nursing

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Specializes in Pre-Op, Med-Surg, Oncology.

I'm just starting in a new trauma/PACU/ICU live-in unit and I am trying to learn and re-learn a few things. I was hoping someone -- or several someone's -- could explain (as in-depth as we can go) the implications of a CBC with differentials and what information I can gain from this? What does each section indicate and what changes should I look for? I realize that I can get this information from wikipedia, but there are a lot of hints and tips that come from experience that I cannot gain from reading those sources. Thanks!

Specializes in Oncology, Medical.

What you might want to do is investigate what a CBC diff includes and then investigate what each type of cell does. From there, you can logically determine what a high or low value indicates. At a very basic level, you certainly want to know white blood cell count, hemoglobin, platelet count, and possibly hematocrit, so start with those. Then you may want to look at the types of white blood cells there are, because each of them has a specific function.

What the patient is going through will also change the perspective of the CBC diff. For example, a patient's white blood cell count is high - does the patient have an infection or have malignant disease (i.e. leukemia)? If the patient has had surgery recently, then it could very well be an infection.

I have an excellent text book that I've kept from school that goes over all diagnostic tests, what they mean, how it can affect the patients, and what it means for nurses. It's an awesome reference book to have!

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I have an excellent text book that I've kept from school that goes over all diagnostic tests, what they mean, how it can affect the patients, and what it means for nurses. It's an awesome reference book to have!

What textbook?

Specializes in Oncology, Medical.
What textbook?

"Mosby's Manual of Diagnostic and Laboratory Tests" by Pagana and Pagana. I have the 3rd edition. I'm not sure if there are others or what they're like.

"Mosby's Manual of Diagnostic and Laboratory Tests" by Pagana and Pagana. I have the 3rd edition. I'm not sure if there are others or what they're like.

I really like that text.

In fact, I was just studying from it today to clarify some things I need to learn better for work.

I would definitely suggest OP get this.

Specializes in Nurse Scientist-Research.

To the OP: What is a live-in unit?

One website I have really admired for its down to earth treatment of everyday situations is maintained by a member of this community, though I'm not positive he is still active here. It is meant to help new MICU nurses but even though I work in the NICU I still gather very useful information from this site. I think he also offers an actual book that can be ordered though I'm not sure if it has information beyond what's on the website.

index

I checked and under the lab section he has a brief section on CBC, pretty much all that I've ever needed to know as a nurse. In the NICU, we used to worry some about "left shifts" but that is falling out of favor as an indication of infection. If we do mention it, the docs dismiss it, if we don't mention it, they exclaim "Why didn't you mention they have a 0.35 shift?"

Please re-read what TiffyRN said.

I have been a nurse in almost every area of acute care nursing for over 30 years. I have rarely needed to know more than the hemoglobin, hematocrit, white blood cell count, and platelet count.

I can think of hundreds of other areas of nursing/medical knowledge you will need to have a good understanding of than CBC with diff!

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