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Interpreting Lab Values

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Hello everyone!

I have a pediatric rotation at the moment, and I'm doing a Kardex careplan on him, and it includes evaluating 5 diagnostic lab results. I chose the abnormal ones from the chart and am having a hard time interpreting them.

MCHC: 30.2 gm/dl ref. range 32-35 gm/dl

RDW-CV: 18.1% ref. range 11.5-15.4 %

RDW-SD: 50.4 ref. range 35.1-46.3

These are the ones I'm having the most difficulty with. MCHC is the average concentration of hemoglobin wihtin a single RBC (Pagana & Pagana, 2009). His decreased level means he has a type of hypochromic anemia. I get that. What is the difference between the RDW-CV and RDW-SD? SD stands for standard deviation, which is derived from the number of RBC on the smear, so what's the CV? Does this mean he has a macrocytic, hypochromic anemia or what? HELP! so confuzzled :confused:

His other lab that I'm having trouble interpreting is his ABS Basophil. I don't have a reference, and the hospital's lab didn't provide one on the report. The client's level is 0.114. So what does that mean? The reference range in my book, which doesn't specify peds, is 25-100 per mm^3. It doesn't match up at all. The reference for the % is 0.5-1, which is closer to my client's 0.114 result, but the test was ABS basophil, not basophil %. :eek:

Any help would be appreciated! :bow:

Did you talk to your instructor and find out what they are looking for? I feel like these are not the kind of lab tests they would want you to look up. It's not typical to use these specific tests, is the only reason I ask. Do you know this kid really has amenia? The hypochromic anemia you speak of, did this kid have greenish skin? Did he have a b6 deficiency, ulcers, take some asprin, lead poisoning? Maybe he has an infection. Basophils are r/t allergic response so was this kid having an allergic reaction? Did he have inflammation somewhere, maybe there was dust, maybe pollen, maybe he has a mosquito bite or a slight reaction to the smell of the lab techs perfume. See where I am going with this, these don't really tell you much unless you are looking for something very specific. These values could be off if the fluid balance is off and really don't help you see the big picture of this person. I am not sure what the assignment is supposed to be for that you are doing...

If I were picking 5 lab tests I would not pick ANY of the ones that you did. I might look at the RBC, WBC, CRP, ALT, AST, BUN, CR, PLT, things like that. These more common tests would be better indicators for the general things you would assess as a nurse...infection, liver function, kidney function, hemorrhage, etc. A good way to show your professor that you are thinking and relating the information is to pick tests that are relavent to the diagnosis of the patient. If the patient had a heart issue, pick 5 tests ralated to heart function. Liver issue, liver function tests, and so forth. That is what my professors would want anyway. Hope I helped a little!

As far as there not being reference ranges, ABS basophils are the absolute count of basophils in the blood, there is no reference range, the number is dependant on the other counts (hence the percentage, so say they are sb 1% well if the total count or wbc's were 1000 in this patient and the basophils were 10 then that would be 1% if there were 5, then 0.5% of 1000 but some other person might have 10,000 wbc so is the absolute count was 100 for basophils that would be normal (1%) does that make sense? Basically you cant have a reference range because it is dependant on the total count, I just can't seem to explain it, sorry!

Hello everyone!

I have a pediatric rotation at the moment, and I'm doing a Kardex careplan on him, and it includes evaluating 5 diagnostic lab results. I chose the abnormal ones from the chart and am having a hard time interpreting them.

MCHC: 30.2 gm/dl ref. range 32-35 gm/dl

RDW-CV: 18.1% ref. range 11.5-15.4 %

RDW-SD: 50.4 ref. range 35.1-46.3

These are the ones I'm having the most difficulty with. MCHC is the average concentration of hemoglobin wihtin a single RBC (Pagana & Pagana, 2009). His decreased level means he has a type of hypochromic anemia. I get that. What is the difference between the RDW-CV and RDW-SD? SD stands for standard deviation, which is derived from the number of RBC on the smear, so what's the CV? Does this mean he has a macrocytic, hypochromic anemia or what? HELP! so confuzzled :confused:

His other lab that I'm having trouble interpreting is his ABS Basophil. I don't have a reference, and the hospital's lab didn't provide one on the report. The client's level is 0.114. So what does that mean? The reference range in my book, which doesn't specify peds, is 25-100 per mm^3. It doesn't match up at all. The reference for the % is 0.5-1, which is closer to my client's 0.114 result, but the test was ABS basophil, not basophil %. :eek:

Any help would be appreciated! :bow:

Edited by * RN *