It has been observed and painfully too that the greater majority of our nurses are not conversant with specimen bottles and the specimen to be put in each bottle. This chapter, therefore, attempts to teach them some common laboratory investigations and specimen bottles. practice. It helps the medical practitioner to make a definitive diagnosis. Mr Gbenga Shobowale a seasoned laboratory scientist practising in the Olodi Apapa area of Lagos State once told me that an accurately performed laboratory test is one of the tools a medical doctor need to save the life of a patient.
He said that quack laboratory personnel are the bane of medical practice. I agree with him. The common laboratory investigations in medical practice include”
URINALYSIS: This is a very important test as it detects many diseases in the body. It is a simple test done by using combi-9. It is very necessary that all the nurses know how to do it.
The Parameters include
- Ascorbic acid
The appearance and colour of the urine are seen with the naked eye. If one wants to find out about the Pus cells, Crystals, Cast, Yeast cells, Epithelial cells; Schistosoma haematobium and Trichomonas Vaginalis in the urine, specimen 1 is sent to the laboratory for the scientist to analyze.
The doctor or matron is advised to explain the parameters to the new nurses vis-à-vis their relevance to the test. done when the infection is suspected. If properly done, it will
isolate the organisms implicated and the drugs that can be Urine Microscopy Culture and sensitivity (m/c/s): This test is used to treat such organisms.
HAEMOGRAM: a. Full blood count (FBC): This test gives a picture of the red blood cell (Haemoglobin level) Hb and the white blood cell (WBC) in the blood. The haemoglobin level, Hb denotes the level of blood in the body. The normal level is male 12.5- 18.5mg% and female 11.5-mg%. If the level is lower than the normal, one is said to have anaemia: If the level is a too high one
The white blood cell WBC (4000-11,000mm) is subdivided has poly cypher mia rubra vera. into five called differentials
- b. Blood film
SEROLOGY: The test, is done with serum. It is based usually on antigen and antibody reaction (Ag/Ab reaction) Widal Test: Tests for typhoid infections in the body. The bacteria causing it is salmonella
- S. Typhi
- S. ParatyhiA
- S. Paratyphi B
- S. Paratyphic
- HIV Test
VDRL (Veneral Disease Research Laboratory): This text is for syphilis. d. Hepatitis e.Liver function test LFT f.VDRLea and creatine (E/U/Cr:) This is a test for kidney function
- h. Rheumatoid factor
- i. Fasting blood sugar FBS
- j. profile
CHEMISTRY Serum is used to do most of the chemistry tests
- Blood Sugar
- Fasting blood sugar
- Oral glucose tolerance test
f. Lipid profile + Total Cholesterol
- Other common blood tests
- Hb Genotype
- Blood group and cross-matching
Erythrocyte sedimentation rate ESR. This is a marker of infection. It is the non -specific test. A high level is seen in cases such as cancer, Human Immunodeficiency Virus infection, tuberculosis and arthritis.
These are tests to isolate parasites
- Stool-a “analysis and stool culture
- Spur orm/c/s
- Sputum for AFB (Acid Fast Bacilli)
- Stool for occult blood
- Blood cultures
- Urethral swab form/c/s
- High vaginal swab for m/c/s
One of the most important aspects of laboratory investigations is the method. collection of the sample and the specimen bottle into which the sample is put.
There are four main specimen bottles in us. These are:
1. EDTA bottle: This specimen bottle is identified by its green coloured cover.
2. Heparin bottle: This specimen bottle has a blue coloured cover
3. Flouric’e bottle: This specimen bottle has a yellow coloured cover
4 . Universal bottle: This fairly bigger specimen bottle usually has a red coloured cover. The doctor or matron in charge is advised to show the junior nurses these specimen bottles.