| A | B |
|---|
| WBC count | 4,500–10,000/μL (mm3)Provides more specific information about infections and disease processes |
| Neutrophils | 50%–70% (2,500– 7,000/μL) Rapid responders to infection and tissue damage . Increase in acute infection and inflammation |
| Eosinophils | 1%–3% (100-300/μL) Increase during allergic and parasitic conditions |
| Basophils | 0.4%–1.0% (40–100/μL) Increase during healing; decrease in stress and allergic reactions |
| Lymphocytes | 25%–35% (1,700– 3,500/μL) Play a major role in immune response with B lymphocytes and T lymphocytes |
| Monocytes | 4%–6% (200–600/μL) Second line of defense against bacterial infection and foreign substances |
| Platelets | 150,000– 400,000/μL (mm3) The number of circulating platelets in the blood Low platelet count associated with bleeding; increased count may increase risk for abnormal clotting No client preparation is required. Observe for manifestations of bleeding.Monitor count in clients undergoing |
| Bleeding time | 3–7 minutes Used to screen for disorders caused by platelet dysfunction Bleeding time is prolonged by ingestion of aspirin and anti- inflammato |
| Prothrombin time (PT or protime) | 10–13 seconds (varies by laboratory) Evaluates the extrinsic clotting pathway; prolonged in warfarin (Coumadin) therapy No food or fluid restrictions are necessary. |
| INR (International Normalized Ratio) | 2–3.0 Used to evaluate Coumadin therapy (see Chapter 18 for therapeutic values)The INR provides a more standardized measure of Coumadi |
| Partial thromboplastin time (PTT) 60–70 Activated partial thromboplastin time (APTT, PTT) 20–35 seconds | Used to evaluate clotting pathways and monitor heparin therapy No food or fluid restriction is required. Values are increased in clotting factor deficiencies, heparin ther- apy, and aspirin ingestion. More sensitive than PTT;evaluates the intrinsic clotting pathway; prolonged in heparin therapy |
| Coombs’ test | Negative Performed to diagnose hemolytic anemias and evaluate transfusion reactions.The expected results are no detected antibod- ies to RBCs (indirect Coombs’) or no detected RBC antigen–antibody com- plexes (direct Coombs’). No food or fluid restriction is required. Ask about previous transfusions or transfusion reactions. Report manifestations of transfusion reaction |
| Hemoglobin electrophoresis | a Hb A1 95%–98% a Hb A2 1.5%–4% a Hb F less than 2% a Hb C 0% a Hb D 0% a Hb S 0% Performed to detect abnormal forms of hemoglobin associated with genetic hemolytic anemias (e.g., sickle cell anemia, thalassemia) No food or fluid restrictions are required. Assess for and report manifestations of hemolytic anemias. Encourage the client to obtain genetic counseling. |
| Iron | 50–150 mcg/dL (10–27 mol/L) Serum iron and body iron stores are measured to evaluate iron deficiency anemia. Antibiotics, estrogen and testosterone, oral contraceptives, aspirin, and ethanol affect results. Total iron-binding capacity 250–450 μg/dL Measures the maximum amount of iron that can bind to transferrin, the protein that transports it |
| Ferritin | Men: 15–445 ng/mL (15–445 μg/L) Women: 10–310 ng/mL (10–310 μg/L) A measure of the amount of iron stored in body tissues No food or fluid restrictions are required. Results in women are affected by age and use of o |
| Transferrin | 200–430 mg/dL (2.0–4.3 g/L)Measures the protein that transports iron to the bone marrow for use in synthesizing hemoglobin Avoid iron supplements for 12 hours before testing. Results are affecte |
| D-dimer | Negative D-dimer is a fragment produced when fibrinolysis occurs. It is used primarily to diagnose disseminated intravascular coagulation. No food or fluid restriction is required. Report manifestations such as unexplained bleeding. Monitor vital sign |
| Schilling test | 10%–40% of vitamin B12 excretion in 24 hr Primarily used to diagnose pernicious anemia.This timed test evaluates the body’s ability to absorb vitamin B12 from the GI tract. An oral dose of radioactively tagged vitamin B12 and an intramuscular vita- min B12 injection are administered, followed by collection of a 24-hour urine specimen. Verify that client has given informed consent. Instruct the client to: a Withhold food and fluids for 8–12 hours before the test. a Avoid taking vitamin B supple- ments for 3 days before the test. May eat and drink after vitamin B12 injection is given. Observe for manifestations of anaphylaxis for at least 1 hour after administration of radioac- tive vitamin B12. Collect a 24-hour urine sample (see Box 28-3 ), using rub- ber gloves to h |
