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Lecture notes Acute Care (SHN2004)

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Interpreting results

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SHN2004 – Interpreting results


Interpreting Results – Blood & Urine
What is blood?
 A form of connective tissue.
 Responsible for transport of nutrients, gases, chemical messengers, waste products,
maintenance of body temperature, clot formation.
 The various cell types typically found in blood are known collectively as the formed
elements
- Erythrocytes (red blood cells)
- Leucocytes (white blood cells)
- Platelets (thrombocytes)


Blood Analysis
 Physical and chemical analysis of blood provides a valuable insight into the functioning
of the human body.
 Blood samples taken by nurse, phlebotomist, or doctor.
 Through physical and chemical analysis, we can measure absence, presence, and
concentration of a range of factors.
- General health
- Health of specific organs such as the liver and kidneys
- Indicate the presence of an infection and its likely target
- Monitor the progression of an existing condition
- Screen for certain genetic abnormalities
 The following aspects of blood biochemistry are typically measured:
 RBC measurements–RBC count, haemoglobin (Hb), sedimentation rates, haematocrit
(Hct), mean cell volume, mean cell haemoglobin.
 WBC measurements–WBC count, lymphocytes, monocytes, neutrophils, eosinophils,
basophils, blasts.
 Clotting measurements–Platelets, fibrinogen, international normalised ratio, partial
thromboplastin time, prothrombin time.

RBC measurements and normal adult ranges WBC measurements and normal adult ranges




Clotting measurements and normal adult ranges

, SHN2004 – Interpreting results




Interpretation of RBC measurement >/< normal range

 RBC count
- High values can be caused by kidney problems, dehydration, or certain heart
conditions. Also, indicator of fatty liver disease.
- Low values can also indicate kidney impairment but also anaemia and nutritional
deficiencies.
 Haemoglobin (Hb)
- High values linked with smoking, dehydration, hypoxia, carbon monoxide poisoning.
Also, diseases of the lungs.
- Low values can indicate anaemia and seen during pregnancy.
 Erythrocyte sedimentation rate (ESR)
- High levels can indicate widespread inflammatory disorders as a result of a current
infection. High levels can also indicate pregnancy.
- Low levels are often seen alongside low plasma protein concentrations. Low levels
are also seen with sickle cell anaemia.
 Haematocrit (Hct)
- High values can indicate dehydration, also liver or heart disease.
- Low values are indicative of anaemia, a nutritional deficiency or recent blood loss.
 Mean cell volume (MCV)
- High values have been linked to chronic fatigue syndrome.
- Low values can be an indicator of anaemia.
 Mean cell haemoglobin (MCH)
- High values are often associated with anaemia.
- Low values are typically associated with a nutritional deficiency.

Interpretation of WBC measurement >/< normal range

 Monocytes
- High values often seen with malaria and tuberculosis. Also, leukaemia.
- Low values typically associated with immune suppressants. Also chemotherapy and
radiotherapy.
 Neutrophils
- High values can signify a current or recent bacterial infection. Also elevated with
many STIs or osteomyelitis.
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