The first department that I completed my check offs in was Hematology. I work
in Hematology on a regular basis, but there were still things I learned by going through
my check off sheet with the hematology supervisor. One of the first things I learned was
the proper way to count a fluid on a hemacytometer. Recently our lab purchased two new
Beckman DXH Hematology analyzers that believe it or not will do the cell count on a
fluid for you. You can check the count on a hemacytometer if you want, but no one does
that anymore. The DXH will count the cells in the fluid and give you a red cell and white
cell count. All you have to do is the differential if there are more than 5 white cells in the
WBC count.
I also learned how platelets can aggregate towards the end of the slide and that
sometimes a slide will show no platelets when in fact there are plenty of platelets, they
are just located at the end of the slide. A specimen showing low a low platelet count
should be checked for a clot and then examined on a slide to verify the low platelet count.
If a pregnant female came into the ER and had a CBC ran showing a low platelets count,
and the result was released incorrectly without checking a slide, this could indicate the
patient is going into DIC when in fact she is not. By checking a slide to verify the platelet
count, a tech can stop a tragedy before it gets started. In the case of seeing clumped
platelets on a slide, you would need to have the specimen recollected because of a clot, or
run a blue top and base your platelet count off of that tube instead of the purple. The
patient may have an EDTA deficiency.
Another thing I learned in Hematolog...
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...lt time in Micro because all I do is set ups. I also complete gram
stains on sputum’s and body fluids, and have completed a few AFB cultures. Apart from
this I only run Flu’s, Strep’s and RSV’s. That is the extent of my Micro career, which is
probably why I don’t know a whole lot. I have a very difficult time reading something in
a book, and then just understanding how to perform it manually. I have to go through the
process myself from A to Z a few times to get a routine, kind of like Blood bank, and
then for the most part, I got it. The problem with Micro where I work is that there a few
older ladies who do most of the Micro and they have no desire to show anyone how to do
anything. No one can learn if the department head and the employees and not willing to
share the information they know to help others understand.
a) Urinalysis with significantly increased amounts of blood (via dipstick and sediment), protein, and leukocytes as well as slightly increased bilirubin and slightly decreased pH;
Platelets like the plasma and red blood cells are collected from whole blood by centrifuging. But the major way that platelets are collected is by apheresis where as the blood is being drawn it is centrifuged and the platelets are collected into bags and the rest of the blood is then transfused back to the donor. The process may take up to an hour but these donations can be performed at 2-4 week intervals because the red blood cells are returned to the donor.
The patient has noted that over the past several weeks that he discovered more bruises or even ecchymosis all over his body. The patient has found small red marks around his eyes, the next morning. The patient was self-diagnosing himself, however due to the doctors, the patient has thrombocytopenia that he diagnoses with recently. Thrombocytopenia is a blood disorder that has insufficient platelets in the blood stream. The disease is one of the most common results that are in hospital patients who tend to bleed, then it will stop bleeding and clump up the blood vessels. If any reason an individual platelet falls below normal, then the condition will develop called Thrombocytopenia. The cause of this disorder, (Thrombocytopenia, n.d.) “thrombocytopenia can be inherited or it can be caused by numerous conditions or even drugs”. Thrombocytopenia symptoms are from; bruising, an enlarged spleen. Excessive bleeding on the menstrual cycle, nose bleeds, and jaundice. The enlarged spleen has too many platelets causing it to decrease. The disease also consists of leukemia or a viral infection. The increased breakdown that is caused by some things with the condition. Also serve options lead to a transfusion or finding an underlying. Nevertheless, thrombocytopenia cannot be prevented although, at the same time some conditions of thrombocytopenia can be avoided. By avoiding alcohol and if a person
Patient.co.uk - Trusted medical information and support. (2013, January 1). Patient.co.uk. Retrieved February 15, 2014, from http://www.patient.co.uk/doctor/Thrombocytosis.htm
The purpose of this clinical journal entry is to elaborate on the details of lab day three. On lab day three, we had check-off for blood pressure and apical pulse. In addition, we took a safety test, and learned about mobility, immobility, how to use ambulatory devices, and reposition (C#4, C#6).
The doctor might also conduct a physical examination to confirm the diagnosis. This is carried out by listening...
Depending on the time of surgery, the nurse may admit and discharge the same patient within the timeframe of his or her shift. The nurse obtains a history and physical (H&P) along with the progress notes from the operating surgeon or another licensed personnel written within the last twenty-four hours. The nurse sets the patient up with a peripheral intravenous line before surgery. He or she will interview the patient regarding the last time they ate and/or drank, what medications they take, and when the last medication dose was taken. The nurse also assesses the patient to see if he or she understands the procedure they are there for and asks if they have any questions or concerns. Depending on the health of the patient and what surgical procedure they will be subjected to, either a focused or full health assessment is performed. The nurse also makes sure that all labs pertinent to the patient have been obtained. These labs include a negative pregnancy test (or proof of a negative test within the last seven days) for any patient that could possibly be pregnant, even if the patient is currently menstruating, a finger-stick blood sugar test for all diabetic patients, a blood test for potassium levels for patients with end stage renal disease, and a prothrombin time or international normalized ratio test for patients on Coumadin. The nurse also makes sure that
..., it is necessary to describe them in detail to the patient and to give a prognosis, as far as available medical knowledge will allow, regarding the outcome of pregnancy and postnatal development. To assist the patient in making a decision on the disposition of the pregnancy, prognostication should include medically documented risk figures. Ethically, pregnancy termination should not be recommended made to the patient and her family and significant others. This option should be discussed, but the ultimate decision of whether to continue the pregnancy should be left to the patient and her family and significant others. Furthermore, I think, it is better to refer her to the teratogen or genetic counselor to help her by providing the patient with as much information as possible and encourage her to make her own decision regarding whether to continue the pregnancy.
There has been a dramatic rise in the rate of caesarean section (CS) in the last two decade making it the most commonly performed procedure worldwide. 1Surveys (2, 3) have indicated that 3-5% of total red cells transfusion is related to obstetrics with higher rate in CS patients compared to those having vaginal delivery (1-7% versus 1%) (4, 5).
administered to prevent clots and perhaps continues post-op. If such a patient is not given
A 17 year old boy was admitted to the medicine unit with sickle cell anemia with complaints of vomiting and weakness. I was on my Monday evening shift and I was assigned to eight patients where seven of them were older and this teen named Mr.Govanni was with sickle cell anemia. When I took the handover from the dayshift nurse, I particularly noticed this patient from my assignment list because of his age and condition and at the same time the nurse who handed over the duty specifically told me that the teen boy was non-cooperative. I also saw from the chart that the patient was getting the normal saline at 75cc/hr, CBC result morning( 6 am) showed HB-82g/dl, WBC 10.6.
Red blood cell indices:(mean corpuscular volume [MCV], mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration [MCHC]
Through catheter contrast agent is injected and a series of X-rays will be taken. This will allow a map of the arteries to be created.
They were often administered at night when his room would be dark and he could not see the bag of packed red blood cells hanging from his intravenous (IV) infusion pump pole. He was receiving narcotic pain medicine resulting in very mild sedation and causing him to sleep more. Jose was also persistently febrile and overall did not feel well so his wakefulness and alertness were decreased. If he questioned what was hanging from his IV pole or why his vital signs needed to be checked again, he was told it was a different type of IV fluid or a different type of medication he needed to
Today, there are more advanced lab tests to help doctors classify ALL so they no longer have to rely on just the cell’s characteristics. These new lab tests aid in the grouping of ALL based on the type of lymphocyte the leukemia stems from (B cell or T cell) and how mature the cancer cells are (American Cancer Society, 2013)54.... ... middle of paper ... ... Diseases & Conditions - Medscape Reference.