A daughter goes to visit her elderly mother, who lives alone. The mother wants to remain as independent as possible, but her ability to prepare meals has recently declined. As a result, her nutritional status and health have declined. When the daughter arrives at her mother's house, she finds her mother still in bed and incoherent, clammy, and hot to the touch. She calls 911, and her mother is rushed to the emergency department (ED). In the ED, her mother is found to have a fever, and she is unable to answer questions about how she has been feeling lately. The care team consults with the daughter about ordering laboratory analysis, and she gives her consent for the blood draw. Additionally, the daughter consents to the placement of a urinary catheter because the mother is not able to collect a urine specimen independently. CBC results Reference Range Reference Range WBC 16.6 × 103/uL 4.8–10.8 × 103/uL Neutrophils 88% *25% bands 60%–70% RBC 5.3 ×109/L 4.7–6.1 × 109/L Lymphocytes 10% 20%–30% Hgb 15.2 g/dL 14–18 g/dL Monocytes 2% 5%–10% Hct 45% 42%–52% Eosinophils 0 0%–5% MCV 90 fL 80–100 fL Basophils 0 0%–2% MCH 29 pg 27–31 pg Absolute neutrophils 14.6 1.4–6.5 × 103/uL MCHC 35% 32–36% Absolute lymphocytes 1.6 1.2–3.4 × 103/uL RDW 13.6% 11.5–14.5% Absolute monocytes 0.3 0.1–0.6 × 103/uL Plt 172 × 109/L 150–450 × 109/L Absolute eosinophils 0 0–0.5 × 103/uL MPV 8.6 fL 7.4–10.4 fL Absolute basophils 0 0–0.2 × 103/uL Electrolyte and liver analysis results Electrolytes Reference Range Liver analysis Reference Range Na+ 142 mEq/L 135–147 mEq/L ALT 55 U/L 7–55 U/L K+ 4.9 mEq/L 3.5–5.2 mEq/L ALP 201 U/L 45–115 U/L Cl– 101 mEq/L 95–107 mEq/L AST 49 U/L 8–48 U/L Phosphate 4.2 mg/dL 2.4–4.5 mg/dL Bilirubin 7 mg/dL 0.1–1.2 mg/dL BUN 12 mg/dl 8–25 mg/dl Albumin 1.9 g/dL 3.5–5 g/dL Cr 0.1 mg/dl 0.5–1.5 mg/dl GGT 61 U/L 9–48 U/L Glucose 105 mg/dl 60–110 mg/dl Ca2+ 9.2 mg/dL 8.8–10.3 mg/dL Urinalysis, urine culture, and blood culture results Urinalysis Reference Range Urine culture Color Dark yellow Light–dark yellow Gram stain: gram-negative rods Clarity Cloudy Clear 24 hour: positive growth, ID = Escherichia coli Specific gravity 1.032 1.015–1.025 pH 8.2 4.5–8.0 Blood culture Protein Neg Neg Gram stain: gram-negative rods Glucose Neg Neg 24 hour: positive growth, ID = Escherichia coli Ketones Neg Neg Blood Neg Neg Bilirubin Neg Neg Urobilinogen Neg Neg Nitrite Pos Neg Leukocyte esterase Pos Neg Question: What do these laboratory findings suggest? Which of the following factors most likely affected the patient's immune response and contributed to the development of sepsis? E coli is a gram-negative bacterium that can enter the urinary tract by attaching to the epithelial cells lining the urethra. Neutrophils are early and abundant cells that migrate to infected areas, such as the urinary system. Neutrophils are very efficient at phagocytizing bacteria. This is part of the innate immune response. Which types of molecules that recognize the bacteria are part of the innate immune response

A daughter goes to visit her elderly mother, who lives alone. The mother wants to remain as independent as possible, but her ability to prepare meals has recently declined. As a result, her nutritional status and health have declined. When the daughter arrives at her mother's house, she finds her mother still in bed and incoherent, clammy, and hot to the touch. She calls 911, and her mother is rushed to the emergency department (ED). In the ED, her mother is found to have a fever, and she is unable to answer questions about how she has been feeling lately. The care team consults with the daughter about ordering laboratory analysis, and she gives her consent for the blood draw. Additionally, the daughter consents to the placement of a urinary catheter because the mother is not able to collect a urine specimen independently. CBC results Reference Range Reference Range WBC 16.6 × 103/uL 4.8–10.8 × 103/uL Neutrophils 88% *25% bands 60%–70% RBC 5.3 ×109/L 4.7–6.1 × 109/L Lymphocytes 10% 20%–30% Hgb 15.2 g/dL 14–18 g/dL Monocytes 2% 5%–10% Hct 45% 42%–52% Eosinophils 0 0%–5% MCV 90 fL 80–100 fL Basophils 0 0%–2% MCH 29 pg 27–31 pg Absolute neutrophils 14.6 1.4–6.5 × 103/uL MCHC 35% 32–36% Absolute lymphocytes 1.6 1.2–3.4 × 103/uL RDW 13.6% 11.5–14.5% Absolute monocytes 0.3 0.1–0.6 × 103/uL Plt 172 × 109/L 150–450 × 109/L Absolute eosinophils 0 0–0.5 × 103/uL MPV 8.6 fL 7.4–10.4 fL Absolute basophils 0 0–0.2 × 103/uL Electrolyte and liver analysis results Electrolytes Reference Range Liver analysis Reference Range Na+ 142 mEq/L 135–147 mEq/L ALT 55 U/L 7–55 U/L K+ 4.9 mEq/L 3.5–5.2 mEq/L ALP 201 U/L 45–115 U/L Cl– 101 mEq/L 95–107 mEq/L AST 49 U/L 8–48 U/L Phosphate 4.2 mg/dL 2.4–4.5 mg/dL Bilirubin 7 mg/dL 0.1–1.2 mg/dL BUN 12 mg/dl 8–25 mg/dl Albumin 1.9 g/dL 3.5–5 g/dL Cr 0.1 mg/dl 0.5–1.5 mg/dl GGT 61 U/L 9–48 U/L Glucose 105 mg/dl 60–110 mg/dl Ca2+ 9.2 mg/dL 8.8–10.3 mg/dL Urinalysis, urine culture, and blood culture results Urinalysis Reference Range Urine culture Color Dark yellow Light–dark yellow Gram stain: gram-negative rods Clarity Cloudy Clear 24 hour: positive growth, ID = Escherichia coli Specific gravity 1.032 1.015–1.025 pH 8.2 4.5–8.0 Blood culture Protein Neg Neg Gram stain: gram-negative rods Glucose Neg Neg 24 hour: positive growth, ID = Escherichia coli Ketones Neg Neg Blood Neg Neg Bilirubin Neg Neg Urobilinogen Neg Neg Nitrite Pos Neg Leukocyte esterase Pos Neg Question: What do these laboratory findings suggest? Which of the following factors most likely affected the patient's immune response and contributed to the development of sepsis? E coli is a gram-negative bacterium that can enter the urinary tract by attaching to the epithelial cells lining the urethra. Neutrophils are early and abundant cells that migrate to infected areas, such as the urinary system. Neutrophils are very efficient at phagocytizing bacteria. This is part of the innate immune response. Which types of molecules that recognize the bacteria are part of the innate immune response

Phlebotomy Essentials

6th Edition

ISBN:9781451194524

Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Chapter1: Phlebotomy: Past And Present And The Healthcare Setting

Section: Chapter Questions

Problem 1SRQ

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Case scenario

CBC results

		Reference Range			Reference Range
WBC	16.6 × 10³/uL	4.8–10.8 × 10³/uL	Neutrophils	88% *25% bands	60%–70%
RBC	5.3 ×10⁹/L	4.7–6.1 × 10⁹/L	Lymphocytes	10%	20%–30%
Hgb	15.2 g/dL	14–18 g/dL	Monocytes	2%	5%–10%
Hct	45%	42%–52%	Eosinophils	0	0%–5%
MCV	90 fL	80–100 fL	Basophils	0	0%–2%
MCH	29 pg	27–31 pg	Absolute neutrophils	14.6	1.4–6.5 × 10³/uL
MCHC	35%	32–36%	Absolute lymphocytes	1.6	1.2–3.4 × 10³/uL
RDW	13.6%	11.5–14.5%	Absolute monocytes	0.3	0.1–0.6 × 10³/uL
Plt	172 × 10⁹/L	150–450 × 10⁹/L	Absolute eosinophils	0	0–0.5 × 10³/uL
MPV	8.6 fL	7.4–10.4 fL	Absolute basophils	0	0–0.2 × 10³/uL

Electrolyte and liver analysis results

Electrolytes	Reference Range	Liver analysis	Reference Range
Na⁺	142 mEq/L	135–147 mEq/L	ALT	55 U/L	7–55 U/L
K⁺	4.9 mEq/L	3.5–5.2 mEq/L	ALP	201 U/L	45–115 U/L
Cl^–	101 mEq/L	95–107 mEq/L	AST	49 U/L	8–48 U/L
Phosphate	4.2 mg/dL	2.4–4.5 mg/dL	Bilirubin	7 mg/dL	0.1–1.2 mg/dL
BUN	12 mg/dl	8–25 mg/dl	Albumin	1.9 g/dL	3.5–5 g/dL
Cr	0.1 mg/dl	0.5–1.5 mg/dl	GGT	61 U/L	9–48 U/L
Glucose	105 mg/dl	60–110 mg/dl
Ca²⁺	9.2 mg/dL	8.8–10.3 mg/dL

Urinalysis, urine culture, and blood culture results

Urinalysis	Reference Range	Urine culture
Color	Dark yellow	Light–dark yellow	Gram stain: gram-negative rods
Clarity	Cloudy	Clear	24 hour: positive growth, ID = Escherichia coli
Specific gravity	1.032	1.015–1.025
pH	8.2	4.5–8.0	Blood culture
Protein	Neg	Neg	Gram stain: gram-negative rods
Glucose	Neg	Neg	24 hour: positive growth, ID = Escherichia coli
Ketones	Neg	Neg
Blood	Neg	Neg
Bilirubin	Neg	Neg
Urobilinogen	Neg	Neg
Nitrite	Pos	Neg
Leukocyte esterase	Pos	Neg

Question:

What do these laboratory findings suggest?
Which of the following factors most likely affected the patient's immune response and contributed to the development of sepsis?
E coli is a gram-negative bacterium that can enter the urinary tract by attaching to the epithelial cells lining the urethra. Neutrophils are early and abundant cells that migrate to infected areas, such as the urinary system. Neutrophils are very efficient at phagocytizing bacteria. This is part of the innate immune response. Which types of molecules that recognize the bacteria are part of the innate immune response?

Definition Definition Organic compounds that have a carbonyl group, C = O, as their functional group. The carbonyl group in ketones is placed somewhere in the middle of the molecular structure, which means, the C=O is attached to two alkyl groups or benzene rings. Just like all other homologous series, the naming of ketones is done using a common suffix “-one”. The general molecular formula is C n H 2n O. Functional group of a ketone

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