Complete Blood Count

Complete Blood CountA complete blood count (CBC) gives important information about the kinds and numbers of cells in the blood, especially red blood cells camera, white blood cells camera, and platelets. A CBC helps your doctor check any symptoms, such as weakness, fatigue, or bruising, you may have. A CBC also helps him or her diagnose conditions, such as anemia, infection, and many other disorders.

Contains the ff:White blood cell (WBC, leukocyte) Red blood cell (RBC) Hematocrit (HCT, packed cell volume, PCV). Hemoglobin (Hgb) Platelet (thrombocyte) count Mean platelet volume (MPV)Red blood cell indices - There are three red blood cell indices: mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC)

Indications of CBCFind the cause of symptoms such as fatigue, weakness, fever, bruising, or weight loss.Find anemia.See how much blood has been lost if there is bleeding.Diagnose polycythemia.Find an infection.Diagnose diseases of the blood, such as leukemia.Check how the body is dealing with some types of drug or radiation treatment.Check how abnormal bleeding is affecting the blood cells and counts.Screen for high and low values before a surgery.See if there are too many or too few of certain types of cells. This may help find other conditions, such as too many eosinophils may mean an allergy or asthma is present.May be done as part of a regular physical examination. A blood count can give valuable information about the general state of your health.

ProcedureNot much blood is drawn in a CBC. A health professional will usually draw the blood from a vein. For an infant, the blood may be obtained by puncturing the heel with a small needle (lancet). If the blood is being drawn from a vein, the skin surface is cleaned with antiseptic, and an elastic band (tourniquet) is placed around the upper arm to apply pressure and cause the veins to swell with blood. A needle is inserted into a vein (usually in the arm inside of the elbow or on the back of the hand) and blood is withdrawn and collected in a vial or syringe.After the procedure, the elastic band is removed. Once the blood has been collected, the needle is removed and the area is covered with cotton or a bandage to stop the bleeding. Collecting blood for this test will only take a few minutes

Nursing Considerations and ResponsibilitiesBefore the Test:Inform the patient this test can assist in evaluating the amount of hemoglobin in the blood to assist in diagnosis and monitor therapy.Obtain a history of the patient's complaints, including a list of known allergens, especially allergies or sensitivities to latex.Obtain a history of the patient's cardiovascular, gastrointestinal, hematopoietic, hepatobiliary, immune, and respiratory systems; symptoms; and results of previously performed laboratory tests and diagnostic and surgical procedures.Note any recent procedures that can interfere with test results.Obtain a list of the patient's current medications, including herbs, nutritional supplements, and nutraceuticalsReview the procedure with the patient. Inform the patient that specimen collection takes approximately 5 to 10 min. Address concerns about pain and explain that there may be some discomfort during the venipuncture.Sensitivity to social and cultural issues, as well as concern for modesty, is important in providing psychological support before, during, and after the procedure.There are no food, fluid, or medication restrictions unless by medical direction.

During the test:If the patient has a history of allergic reaction to latex, avoid the use of equipment containing latex.Instruct the patient to cooperate fully and to follow directions. Direct the patient to breathe normally and to avoid unnecessary movement.Observe standard precautions, and follow the general guidelines. Positively identify the patient, and label the appropriate tubes with the corresponding patient demographics, date, and time of collection. Perform a venipuncture; collect the specimen in a 5-mL lavender-top (EDTA) tube. An EDTA Microtainer sample may be obtained from infants, children, and adults for whom venipuncture may not be feasible. The specimen should be mixed gently by inverting the tube 10 times. The specimen should be analyzed within 24 hr when stored at room temperature or within 48 hr if stored at refrigerated temperature. If it is anticipated the specimen will not be analyzed within 24 hr, two blood smears should be made immediately after the venipuncture and submitted with the blood sample. Smears made from specimens older than 24 hr may contain an unacceptable number of misleading artifactual abnormalities of the RBCs.Remove the needle and apply direct pressure with dry gauze to stop bleeding. Observe/assess venipuncture site for bleeding or hematoma formation and secure gauze with adhesive bandage.Promptly transport the specimen to the laboratory for processing and analysis.

After the test:A report of the results will be sent to the requesting HCP, who will discuss the results with the patient.Depending on the results of this procedure, additional testing may be performed to evaluate or monitor progression of the disease process and determine the need for a change in therapy. Evaluate test results in relation to the patient's symptoms and other tests performed.

Radiography (X-ray)

X-rayIt is a safe and painless test that uses a small amount of radiation to take a picture of a person's chest. During the examination, an X-ray machine sends a beam of radiation through the chest, and an image is recorded on special film or a computer. The X-ray image is black and white. Dense body parts that block the passage of the X-ray beam through the body, such as the heart and bones, appear white on the X-ray image. Hollow body parts, such as the lungs, allow X-ray beams to pass through them and appear black. An X-ray technician takes the X-rays. Usually, two are taken: one from the back of the chest if the child is old enough to stand up for the X-ray, and one from the side. In younger children a picture from the front of the chest is taken as well as from the side. In some cases, special views of the chest are taken.

Indications of X-rayA chest X-ray is used to help find the cause of symptoms such as cough, shortness of breath, or chest pain. It can detect signs of asthma, pneumonia, a collapsed lung, heart problems (such as an enlarged heart), and broken ribs or lung damage after an injury. Chest X-rays can reveal small metal objects (such as coins) that might have been swallowed. They can also help confirm that medical tubes have been placed in.Fractures and broken bones

ProcedureThe client will be asked to enter a special room that will most likely contain a table and a large X-ray machine hanging from the ceiling. Parents are usually able to accompany their child to provide reassurance and support.A chest X-ray may be performed in a standing, sitting, or lying position. This will depend on the condition of your child and the reason for the X-ray. The technician will position your child, then step behind a wall or to an adjoining room to operate the machine. Older kids will be asked to hold their breath and remain still for 2-3 seconds while the X-ray is taken; infants may require gentle restraint. Keeping the chest still is important to prevent blurring of the X-ray image. Two X-rays are usually taken, one from the back and one from the side.If the client is in the hospital and cannot easily be brought to the radiology department, a portable X-ray machine can be brought to your child's bedside. Portable X-rays are often used in emergency departments, intensive care units, or operating rooms. In this case, only one X-ray might be taken, usually from the front.

Nursing Considerations and ResponsibilitiesBefore the test:Obtain the health history of the patientExplain the procedure to the clientTell the patient to remove any accessories and metal objects that are on his bodyHelp reduce anxiety to patient, particularly in those who are very young or confused. Some may be anxious about the exposure to radiation, and need to be given as much information as possible about the test, and to be reassured that the benefits of having the test far out way the very small risk involved.Simple, loose clothing is important to gain access to that part of the body under examination. This may mean a loose fitting gown for hospital patients. The patient may need a dressing gown and footwear for privacy and warmth while away from bed.

During the test:Instruct the patient to remain still. If the patient is an infant, put restraint and tell the guardian to assist in holding the infant as to prevent blurring of the image.Tell the guardian of the patient to not disrupt or distract the medical team

After the test:The patients X-ray will be sent to the doctor who ordered it, usually within 48 hours. If the results are urgent, the referring doctor will be contacted immediately.The patient should be returned to their normal activities if these have been disturbed, i.e. eating and drinking, as quickly as possible.Document and record the findings. The results should be kept safe for further observations and future use.