Diagnostic Procedure

Diagnostic Procedure

1. is a procedure performed to confirm, or determine the presence of disease in an individual suspected of having the disease, usually following the report of symptoms, or based on the results of other medical tests

   • RBC (Red Blood Cell Count)
     • to carry oxygen to the tissues and to transfer carbon dioxide to the lungs. RBC count or erythrocyte count is a part of complete blood count which is used to determine the number of RBCs in a microliter or mm3 of whole blood. The RBC count cannot provide complete information about the size, shape or concentrations of RBC. An elevated count may be a manifestation of overproduction of RBC while a decreased RBC count may indicate anemia or hemorrhage.
     • Normal Adult Male Range: 4.5 -5.5 mill/uL Normal Adult Female Range: 4- 5. mill/uL Lower ranges are found in children, newborns, and infants Full –term neonates: 4.4. – 5.8 mill/uL at birth, decreasing to 3-3.8 mill/uLat age 2 months and increasing slowly thereafter. Children: 4.6- 4.8 mill/Ul
       • GLUCOSE
         • Glucosuria or glucose in the urine results when blood glucose exceeds the resorptive capacity of the kidney: >180 mg/dl
         • Glucose: negative
           • SHAPE
             • Normal Abnormal 1. Round 1. no shape 2. Cylindrical 2. flat 3. pencil shape
             • COMPONENTS
               • Normal Abnormal 1. undigested fiber 1. worms 2. unabsorbed food residue 2. blood 3. water, stool normally contains 75% water 3. pus 4. mucus
   • SPECIFIC GRAVITY
     • indicates the concentration of urine and hydration status of the patient
     • • 1.010-1.025 • Increase- dehydration, increase Aldosterone • Decrease- DI, excessive hydration, and renal tubular acidosis, diuretics
       • Leukocyte esterase indicates white blood cells in the urine
         • Leukocyte esterase : negative
           • Nitrites strongly suggest bacteriuria.
             • Nitrites : negative
           • ODOR
             • Normal -aromatic, due to indole and scatole which are the products of fermentation in the large intestine Abnormal -foul
               • CONSISTENCY
                 • Normal 1. soft, due to the water content 2. formed, it should have a definite shape Abnormal 1. soft but bulky, a person normally defecates 150-300 grams feces a day 2. hard and dry, this might mean you have a constipation 3. watery, the feces stayed only for a very brief period of time in the large intestine, thus the large intestine was not able to absorb the water content of the stool 4. paste-like, the same with some watery feces
         • SIGNIFY RENAL DISEASE WHEN FOUND IN THE URINE.
           • • Red blood cell casts- indicate glomerulitis or vasculitis • White blood cell casts- bacterial infection • Granular casts- disintegrated epithelial cells, leukocytes, or protein associated in small numbers: renal tubular disease • Hyaline cast – mixture of mucus and globulin from tubules
           • Red blood cell casts- indicate glomerulitis or vasculitis White blood cell casts- bacterial infection Granular casts- renal tubular disease Hyaline cast – mixture of mucus and globulin from tubules

2. ASSESSMENT OF THE LIMITATION IN PHYSICAL CONDITION, SENSORY ABILITY, PYSCHOLOGICAL STATUS, SELF-CARE ABILITY, NUTRITIONAL STATUS AND MOBILITY MUST BE CONSIDERED.

3. NON-INVASIVE

   • invasive when no break in the skin is created and there is no contact with the mucosa, or skin break, or internal body cavity beyond a natural or artificial body orifice. Non-invasive tests don’t involve inserting needles, instruments or fluids into the body.
     • WBC (White Blood Cell Count)
       • Granulocytes Nongranulocytes Neutrophils Eosinophils Basophils Lymphocytes Monocytes
       • WBC count: 10,000/Ul N:54%-75% E:1-4% B:0-1% M:2-85 L:25-40%
   • RED CELL INDICES
     • With the use of RBC count, HCT and Hb results, red cell or erythrocyte indices can be determine (the size, Hb concentration and Hb weight of an average RBC). MCV -size MCH –concentration of hemoglobin per RBC MCHC –concentration of hemoglobin per volume of RBC
       • pH
         • a measure of free hydrogen ion in the urine and indicates the renal tubules’ ability to maintain normal hydrogen concentration in the plasm
         • • 5.5-6-5( 4 to 8) ➢ 7.5: UTI • < 5.5 –metabolic/ respiratory acidosis
     • 84-99 um3 26-32 pg/cell 30-36 g/dl

4. INVASIVE

   • include a simple needle prick for a blood test or shot, insertion of a tube, device or scope.

5. COMPLETE BLOOD COUNT

   • HEMATOCRIT (HCT)
     • measurement of the percentage of red blood cells in whole blood. Hematocrit may be done separately or part of a complete blood count. It is an important determinant of anemia (decreased), dehydration (elevated), increased R.B.C. breakdown in the spleen (decreased), or possible overhydration (decreased).
       • PROTEIN
         • Proteinuria or persistent elevation of protein in the urine.
         • Protein: negative
           • COLOR
             • Normal 1. golden brown, due to the bile pigment derivative known as sterkobilin Abnormal 1. black, clay colored (tan), pale- due to the absence of sterkobilin 2. bright red, aka hematochezia, due to lower gastro intestinal bleeding
             • 3. green, depends on the food you eat, try eating a blue colored ice cream… observe your stool's color 4. black, aka melena, due to upper gastro intestinal bleeding
     • Adult males: 42% - 52% Adult females: 36%- 48 % Neonates: 55%-68% Neonates 1 week: 47%-65% Infants age 1 month: 37% - 49 % Infants age 3 months: 30%-36% Age 1 year: 29%-41% Age 10 years: 36%-40%

6. HEMOGLOBIN (HGB)

   • main transport of oxygen and carbon dioxide in the blood. It is composed of globin a group of amino acids that form a protein and heme which contains iron atoms and imparts the red color to hemoglobin. Hemoglobin count is used to measure the amount of hemoglobin found in a deciliter or 100 ml of a complete blood. As with Hematocrit, it is an important determinant of anemia and hemorrhage (decreased), dehydration (increased), poor diet/nutrition, or possibly a malabsorption problem.
     • BACTERIA
       • Negative results usually reflect the fact that the stool culture was checked for pathogens at several intervals and none were found (not isolated).
         • NEWBORN SCREENING
           • Description: Newborn screening is the process of testing newborn babies for treatable genetic, endocrinology, metabolic and hematologic diseases. The test is done through a blood test when a baby is between 12 hours and 6 days of age. It is usually done while your baby is still in the hospital. The blood sample from the heel of the baby is sent to a State-approved lab for testing.
             • Indication: To detect presence of treatable genetic, endocrinologic, metabolic and hematologic diseases. It can detect 6 conditions: 1.) CH (Congenital hypothyroidism), 2.) CAH (Congenital adrenal hyperplasia), 3.) GAL (Galactosemia), 4.) PKU (Phenylketonuria), 5.) Maple syrup disorder, and 6.) G6PD Deficiency. Detection of other congenital problems can be done through the Expanded Newborn Screening. This test can identify up to 28 other congenital problems
               • Normal Results: A negative screen means that the result of the test is normal and the baby is not suffering from any of the disorders being screened. Newborn screening results are available within three weeks after the NBS Lab receives and tests the samples sent by the institutions
     • CHEST X-RAY
       • Description: Chest x-ray produces an image of a negative of a photographic film produced through exposure to x-rays that have passes the body.
         • Indication: Chest X-ray studies may be ordered as a part of routine screening procedure or general check-up, when pulmonary diseases are suspected and/ or to monitor status of respiratory disorders and abnormalities like tuberculosis and pleural effusion , after chest trauma or to confirm tracheostomy placement.
         • Normal Results: Absence of radiopaque are which may indicate tumor , pneumonia or pulmonary edema. Normal contour of bones and absence of enlargement of organs.
   • Adult male: 14-17.4g/dl Adult female: 12-16 mg/dl Normal Newborn Range: 14 - 20 %
     • PLATELET COUNT
       • are the smallest formed elements of the blood. They are vital to coagulation of the blood to prevent excessive bleeding. Elevated levels suggest stimulation of the bone marrow where the cells are produce and decreased levels may indicate an immune system failure, drug reactions, DHF, B12, or folic acid deficiency.
         • KETONES
           • Ketonuria or ketones in the urine- results when body fat is metabolized for energy, as in cases of diabetic ketoacidosis, fasting, pregnancy, vomiting and diarrhea
           • Ketones: negative
             • Urobilinogen is the end product of conjugated bilirubin metabolism, and a small amount, 1 to 4 mg daily is excreted in the urine.
               • Urobilinogen: trace Increase-hepatocellular dse, hemolysis Absence-obstruction of biliary tree
                 • ELECTROCARDIOGRAPHY (ECG)
                   • Description: This is a non-invasive graphic test used to determine the electrical activity of the heart. This evaluates the heart’s rhythm.
                     • MAMMOGRAPHY
                       • Description: A mammogram is an X-ray test that produces an image of the inner breast tissue on film. This technique, called mammography, is used to visualize normal and abnormal structures within the breasts.
                       • Indication: The American Cancer Society recommends mammogram screening every year for all women age 40 and older to detect presence of abnormal growths on the breasts like calcification, cysts and tumors. The American Cancer Society recommends that a woman obtain her first baseline mammogram between the ages of 35 to 40. After the age of 40, she should receive a yearly mammogram. Women who are at high risk for developing breast cancer may need to obtain mammograms earlier than these recommendations and at more frequent intervals.
                       • Normal Results: Absence of abnormal growths, calcification, cysts or tumors.
                   • Indication: This is a part of routine exams or general check –ups. It is a recommended procedure for clients older than 40 years old before surgery to determine presence of unknown heart disease and for patients with any suspected heart disease.
                     • Normal Results: Normal Sinus rhythm
         • Direct Bilirubin- made in the hepatocyte and appears in the urine as an early manifestations of extrahepatic biliary tract obstruction or intrinsic hepatic disease.
           • Bilirubin: negative
           • SPUTUM EXAM
             • Sputum is a thick fluid produced in the lungs and in the airways leading to the lungs. Sputum Exam is done on a sample of sputum that is usually collected by coughing.
             • test to detect and identify bacteria or fungi (plural of fungus) that are infecting the lungs or breathing passages
               • Normal: Sputum that has passed through the mouth normally contains several types of harmless bacteria. The culture should not show any harmful bacteria or fungi. Abnormal: bacteria or fungi are present.
       • Normal Adult Range: 130 - 400 thous/uL