For each case analyze the lab
results. What interventions will you
institute?
1. Melba
Jones, age 40, had a total knee replacement due to arthritis and chronic end-stage renal
failure. The following labs were obtained:
| pH 7.33 |
Na 132 |
RBC 3.18
|
WBC 20.2 |
| PaCO2 32 |
K 3.8 |
Hbg
8.4 |
segs 78% |
| PaO2 86 |
Cl 94 |
Hct 27.2 |
bands 7% |
| B.E. 5 |
CO2 39 |
MCV 57 |
lymph
7% |
|
Creat 5 |
MCH 30 |
mono
7% |
| Anion gap 2 |
AST 45 |
MCHC 33
|
eos 1% |
| Alk phos 238 |
Ca 7.8 |
RDW 30 |
baso
4% |
| ESR 135 |
PO4 3.1 |
Plt 532 |
myelo slt |
| ANA positive |
|
|
|
2. Mary Frank,
age 40, sees her health care provider for the flu. She complains of fever, fatigue, sore
throat, enlarged lymph nodes in neck and axilla, headache, and generalized aches and
pains. Physical exam reveals enlarged liver
and spleen.
Lab results:
| RBC 3.9 |
WBC 17 |
EBV titer
1:360 |
| Hgb 11.8 |
Neut 45 |
Heterophil
antibody pos |
| Hct
35.2 |
Lymph 45 |
ANA agglutination neg |
| Plat 300 |
Mono 10 |
Rheumatoid factor neg |
|
atypical lymphs |
ESR
120 |
|
|
CRP
32 |
3. Joyce
Bridges, age 40, sees her health care provider for flu-like symptoms that come and go. She
complains of joint pain, fatigue, and a skin rash. Physical
exam reveals swelling of both wrists with tenderness, nonpainful lesions in mouth, and
rash on face and extremities. Ms. Bridges states that rash gets worse when exposed to
sunlight.
Lab results:
| RBC 2.6 |
WBC 4200 |
Plat 85 |
Anti-RNP pos |
| Hg
7.8 |
Segs
85 |
retic 5% |
Anti-Sm
pos |
| Hct
23.6 |
Lymphs 9 |
ESR 1: 500 |
anti-ds-DNA pos |
| MCV 84 |
Monos
3 |
|
ANA
pos |
| MCH 34 |
Baso
2 |
|
Coombs
pos |
| MCHC 33 |
Eos 1 |
|
|
|