1. ANCILLARY PROCEDURES

2. Done in the patient CBC Na, K Creatinine SGOT, SGPT 12-L ECG

3. CBC

4. Complete Blood Count 11/23/0911/28/09 UnitNV Hgb 96118 g/L120-170 RBC 2.933.73 X10^12/L4.0-6.0 Hct 0.280.35 0.37-0.54 MCV 94.394.60 U^387 + -5 MCH 32.631.50 pg29 + -2 MCHC 34.633.30 g/dL34 + -2 RDW 13.4014.10 11.6 – 14.6 Platelet 481830 X10^9/L150-450

5. Complete Blood Count Anemia – Low RBC, Hgb, Hct – Due to insufficient production of EPO by the diseased kidneys (CKD stage 3) Thrombocytosis – Occurs as an acute phase response to infection

6. Complete Blood Count 11/23/0911/28/09 UnitNV WBC 17.7015.39 X10^9/L4.5-10.0 Diff ct Neutrophils 0.75 0.50-0.70 Segmenters 0.740.72 0.50-0.70 Bands 0.01 0-0.05 Metamyelocytes 0.01 Lymphocytes 0.240.23 0.20-0.40 Monocytes0.00-0.07 Eosinophils 0.010.02 0.00-0.05 Basophils Myelocytes

7. Complete Blood Count Leukocytosis – With predominance of neutrophils connotes active bacterial infection

8. BLOOD CHEMISTRY

9. Biochemical Blood Tests Liver Function test – AST/ ALT Kidney Profile test – Creatinine – Electrolytes ( Na, K, Ca, PO) – BUN – Uric Acid Lipid Profile test – TG – Total Cholesterol – LDL, HDL, VLDL

10. Biochemical Blood Tests Liver Function test – AST/ ALT Kidney Profile test – Creatinine – Electrolytes ( Na, K, Ca, PO) – BUN – Uric Acid Lipid Profile test – TG – Total Cholesterol – LDL, HDL, VLDL

11. Biochemical Blood Tests Liver Function test – AST/ ALT Kidney Profile test – Creatinine – Electrolytes ( Na, K, Ca, PO) – BUN – Uric Acid Lipid Profile test – TG – Total Cholesterol – LDL, HDL, VLDL

12. Biochemical Blood Tests AST / ALT – Active liver insult probably drug induced (aspirin). 11/23/0911/28/09UnitN.V. SGPT-ALT37.8U/L0-31 SGOT-AST55.3U/L0-38

13. Biochemical Blood Tests Liver Function test – AST/ ALT Kidney Profile test – Creatinine – Electrolytes ( Na, K, Ca, PO) – BUN – Uric Acid Lipid Profile test – TG – Total Cholesterol – LDL, HDL, VLDL

14. Biochemical Blood Tests Creatinine – Impaired Filtering Capacity of the kidneys due to CKD 11/23/0911/28/09UnitN.V. Creatinine5.23.5mgl/dL0.5-1.2

15. Biochemical Blood Tests Liver Function test – AST/ ALT Kidney Profile test – Creatinine – Electrolytes ( Na, K, Ca, PO) – BUN – Uric Acid Lipid Profile test – TG – Total Cholesterol – LDL, HDL, VLDL

16. Hyponatremia Sodium Most probably due to impaired kidney function 11/23/09 UnitN.V. Sodium130mmol/L137-147

17. Biochemical Blood Tests Liver Function test – AST/ ALT Kidney Profile test – Creatinine – Electrolytes ( Na, K, Ca, PO) – BUN – Uric Acid Lipid Profile test – TG – Total Cholesterol – LDL, HDL, VLDL

18. Hyperkalemia Potassium Most probably due to impaired kidney function 11/23/09 UnitN.V. Potassium5.4mmol/L3.8 - 5

19. OTHER ANCILLARY PROCEDURE

20. ECG Sinus rhythm Left ventricular hypertrophy – pathological reaction to cardiovascular disease, or high blood pressure – increase afterload that the heart has to contract against – causes of increased afterload that can cause LVH include aortic stenosis, aortic insufficiency, and hypertension Peak T-waves – Due to hyperkalemia

21. Requested but not done TestRationale for requestingExpected result iCa Asses for Kidney injury Decreased iPOIncreased BUNIncreased Uric acidIncreased LipId ProfileAsses risk of Heart disease ABGdetermination of pH, partial pressure of carbon dioxide and oxygen, and the bicarbonate level Metabolic acidosis U/S of KUBPAssess the size, location, and shape of the kidneys and related structures, such as the ureters bladder, and prostate Sputum GS, culture Identify certain pathogens by their characteristic appearance Sputum AFBScreening for TB

22. Arterial Blood Gas Expected result: – Metabolic acidosis Normal ValueExpected results pH7.35 – 7.45 pCO235 – 45 mmHg HCO322-26 meq/L