Question

1. Write up CMP, CBC, UA-include normal range and what abnormal findings indicate for both HIGH and LOW values. Chest Xray and CT scan uses for these diagnostic tests. 2. As the nurse you are caring for a patient with a Stage 2 wound on their coccyx How as the nurse would you care for this patient? (Include a description of the wound, nursing care nutrition, dressing care for the wound, turning of patient, etc).

Answer 1

1)CMP -Comprehensive metabolic panel this is a blood test which will help in identifing Any metabolic abnormaties .The test consist of all electrolytes,enzymes .it checks your renal and liver functions .The following are the normal and abnormal values of the various test in CMP .

Random Glucose: normal is 120-180mg/do any thing more shows hyperglycemia due to diabetes and low shows hypoglycemia as in case of sepsis .

Electrolyte sodium normal level 135-145 anything above shows hyponatremia and more will be hypernatremia.

Potassium normal is 3.5-5 anything more or less due to abnormal kidney function can cause cardiac arrythemia.

Calcium normal level is 8-10 low levels can cause weak bones and high levels can cause renal calculi .

Creatinine and BUN levels will help us to identify the kidney function.

Liver enzymes like alkaline phosphate,shot,sgpt are assessed anything more of this enzymes shows fatty liver or liver cirrhosis .

Albumin normal 2-3 anything less can lead to impaired skin integrity.

Metabolic panel also checks in the bicarbonate level which help us to understand the acidosis and alkolosis of the body .

PCT Assess the pro calcitonin level which is high in case of any infection.

CBC Is complete blood count which is a blood test which measures the level of blood components .like Hemoglobin normal is between 11-13 anything less is anemia .

Platelets normal is 1.5 lakh-4lakh low platelets indicates risk of bleeding

WBC normal is between 4000-11000 anything less can mean neutropenia or immunocompromised status and more indicates infection or sepsis .

Hematocrit levels shows hemodilution.

CBC also find out the differential cell count like neutrophil,basophil,esinophil which helps us to understand the source of infections bacterial or fungal ,or viral .

Chest XRay and CT scan can be help full in case of any raised WBC Ct scan can be used to identify the source of infections.X Ray can be used to check for pneumonia.In case of deranged liver enzymes CT scan can be used to assess fatty liver or lesion .

In case of lower WBC which indicates immunocompromised status in case of tumour CT scan can be used to assess the presence of any tumours .

2) Stage two pressure ulcer in the cocyx needs extensive nursing intervention to heal the various nursing intervention include .

a)Change of position every 2 hourly

b)use of pressure area care mattresses like air or water mattress

c)Encourage oral fluid it will help in hydration.

d) encourage high protein diet which will help in faster healing

e)Apply hydrocolloid dressing over the wound which will give a moist atmosphere at the same time the exudates can be absorbed on the dressing .

f)elevate the heels of the patient to prevent heel sores.

g) Maintain a normal glucose levels which will aid in healing .

h)Assess for serum albumin level of low correct it it will help in collagen formation and healing of wounds .

I)Handle the wound in a sterile manner to avoid infection.

j)Assess the wound in terms of width,depth,length using the PUSah score of grading to evaluate the progress of healing .

k)In case of slough or dead tissue present on the wound use ointment which will help in self debridement .once the slough is out it aides healing