Question

I need list of 5 labs or diagnostic tests that i can apply to this case study as a nurse (choose five labs or diagnostic tests that might be ordered for your case study client. Note normal results, expected abnormal values, and what that would signify for your client?

Ms. Mae is a 75 year old Japanese American who speaks Japanese as a primary language but is proficient in reading/writing English. She recently moved to a long-term care facility as she was unable to adequately take care of herself at home. Ms. Mae is divorced and was a housewife. Her two daughters live nearby and visit each week. Her past medical history includes colon CA, colostomy, depression, hypertension, and osteoporosis. She wears glasses for reading.

Orders include:

Regular diet

Ambulate with gaitbelt and 1 standby assist

PT/OT daily

Change ostomy appliance PRN

Psychiatry consult

Sertraline 50 mg PO daily

Alendronate 10 mg PO daily

Cholecalciferol 1 capsule (5,000 IU) daily

Metoprolol ER 100 mg PO daily

Clonidine 0.1 mg PO TID

Full resuscitation

Answer 1

Ms. Mae

Past medical history:

CA colon: Cancer of Colon

Colostomy: An incision into the colon to allow for drainage.  

Depression: It is mental health condition characterised by depressive mood and depressive cognitions such as hopelessness, helplessness and worthlessness and sometimes suicidal ideations.

Osteoporosis: A disease occuring especially in women, following menopause , in which the bones become extremely porous and are subject to fracture.

Hypertension: Abnormally high blood pressure.  

Lab tests or Diagnostic tests:

1. DEXA ( Dual energy X ray absorptiometry) :

In patients with osteoporosis, severe bone losd wiil be visible, Osteopenia present

Normal: No osteopnia

X ray of Ms. Mae ( humerous bone / femur bone): osteopnia present.

2. BMD test ( Bone mineral Density test) :

T score : +1 to -1 ( Normal value)

T score : - 2.5 SD or more ( Osteoporosis)

Lab value T Score : -2.5 ( expected value)

  

3. Blood test for Clonidine overdose:

Toxicity data: TDLO

> 126micro gram/ kg in women indicates overdose and the symptoms of overdose are hypotension, hypothermia, bradicardia, respiratory depression etc.

Lab value : 100 microgram / kg ( expected result) - Normal

* Sertraline Blood level:

Normal reference range: 50 - 200 ng / mL

Lab value: 100 ng/ mL ( normal value)

4. Cholesterol level:

Normal values:

Total Cholesterol : 200 mg / dL

HDL: 60 to 100 mg/ dL

LDL : <100 mg

Lab values :

Total Cholesterol : 180mg/ dL

HDL: 38 mg/ dL

LDL: 80 mg/ dL ( expected abnormal values).

Inference: HDL below 40 mg/ dL is indicating the risk for heart disease.  

5. Electrolyte level:

Sodium level: 135 to 145 mEq/ L ( normal level)

lab value : 140 m Eq / L ( expected value)

Normal Sodium level.