laboratory and diagnostic test results
In this course project assignment, you are presented with laboratory and diagnostic test results for two different patients. Laboratory tests include results from blood and urine tests, along with testing of other body fluids such as feces, secretions, throat swabs, etc. Diagnostic testing includes procedures such as x-ray, MRI, CT scans, ultrasounds, echocardiograms, electrocardiograms, etc. These types of diagnostic procedures often require interpretation by a physician. In this case, you may find a separate document with the physician’s conclusions from the test results.
You will be exploring the medical terminology used in these test results and will be asked to interpret the meanings of various words and abbreviations.
To complete this assignment, do the following:
Download the test results for the two patients:
Brenda Jastik Test Results
Steve Nguyen Test Results
Download, complete, and submit the document below. This document contains questions you will answer regarding the test results for each patient.
Module 04 Course Project Assignment Template
please write answers on separate Microsoft Word Document
Chief complaint
SOB, malaise, chest px
Vendor Order 1704PEQQ added on 04/06/17 Other
Imaging Order 1704PELA added on 04/06/17 Other
PATIENT Brenda Jastik DOB 07/15/1951 AGE 65 yrs SEX Female PRN BO958186
FACILITY Northstar Physicians Center T (999) 999-9999 1234 Sunshine Way 100 Minneapolis, MN 99999
ENCOUNTER
NOTE TYPE SOAP Note SEEN BY Nazir Ashaad DATE 02/05/2017 AGE AT DOS
65 yrs
Not signed
Orders
LAB ORDERS
3638 – CBC W Auto Differential panel – Blood
759 – Streptococcus pneumoniae Ag
IMAGING ORDERS
1769 – Chest X-ray 2 views
Free cloud based EHR
Encounter – Office Visit Date of service: 02/05/17 Patient: Bren… https://static.practicefusion.com/apps/ehr/?c=1385407302#/PF/…
1 of 1 4/6/17, 4:21 PM
Northstar Laboratory
3456 Sunshine Way #300
Minneapolis, MN 99999
Phone: (555) 555-5555
Patient: Brenda Jastik
DOB: 07/15/1951
Lab Results
Component Your Value Standard Range Units
WBC Count 18.0 4.5-11.0 K/UL
RBC Count 5.0 3.5-5.5 MIL/UL
Hgb 12.3 12.0-15.0 G/DL
Hematocrit 38.3 36.0-48.0 %
MCV 93.4 79.0-101.0 FL
MCH 29.6 25.0-35.0 PG
MCHC 33.4 31.0-37.0 %
RDW-CV 14.1 11.0-16.0 FL
Platelet Count 356 150-420 K/UL
Component Your Value Standard Range
Strep. Pneumon. Ag Positive NEG
Comments CBC shows elevated WBC count, indicating infection. RBC and remaining components are WNL. Strep. Pneumon. Ag test is positive, indicating a diagnosis of bacterial infection. Follow-up and treatment is necessary.
Interpretation by: Pamela Yost, MD
Northstar Imaging Center
2345 Sunshine Way #200
Minneapolis, MN 99999
Phone: (555) 555-5555
Patient: Brenda Jastik
DOB: 07/15/1951
Indication SOB, Chest pain, Malaise, Fever Clinical History Symptoms have persisted and progressed for 2 weeks. Unresponsive to prior antibiotic tx. Procedure
1. PA chest radiograph 2. Lateral chest radiograph
Findings
Comparison Exam is dated 11/01/06. Cardiomediastinal silhouette is normal. There is a right lower lobe opacity with an air bronchogram; the remaining lung fields are clear. There are no effusions. The bony thorax appears normal. The right lower lobe opacity is new since the comparison exam. Impression
1. Probable right lower lobe pneumonia. 2. Follow-up treatment is necessary.
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