JMJ Marist Brothers

Notre Dame of Marbel University

College of Arts and Sciences – Nursing Department
Koronadal City, South Cotabato

Chapter III

MEDICAL AND NURSING MANAGEMENT

A. Laboratory Results

1. Electrolytes

- Electrolytes are minerals that carry an electric charge when they are

dissolved in a liquid such as blood. The blood electrolytes—sodium,

potassium, chloride, and bicarbonate—help regulate nerve and muscle

function and maintain acid-base balance and water balance. Careful

management of fluid and electrolyte balance is important in the treatment

of meningitis. Over or under hydration are associated with adverse

outcomes.

2. Hematology

- A complete blood count with differential is a general index of health. It

checks the number of red and white blood cells in your blood. White blood

cells fight infection. The count is usually elevated in meningitis. Blood tests

may show signs of infection such as elevated white blood cells. If your

meningitis is complicated with sepsis (infection of the blood), your blood

tests may show the bacteria as well. Viral meningitis does not typically

involve the blood and is not associated with sepsis.

3. Clinical Chemistry
 JMJ Marist Brothers
Notre Dame of Marbel University
College of Arts and Sciences – Nursing Department
Koronadal City, South Cotabato

- It uses chemical reactions to determine the levels of

various chemical compounds in bodily fluids. Several simple chemical

tests are used to detect and quantify different compounds in blood and

urine, the most commonly tested specimens in clinical chemistry. This is

done to evaluate the health of your kidneys as a protocol before doing a

CT Scan.

4. Radiological Report

- A chest X-ray can identify an infection in the chest or lungs, which may be

a sign that an infectious bacteria or virus is affecting other areas of the

body.

5. CT Scan Section

- Brain imaging with contrast injection can detect inflammation of meningitis.

While inflammation of the meninges does not always appear on brain

imaging studies, these studies can also identify other neurological

conditions such as brain tumors, stroke, bleeding in the brain and

abscesses, and encephalitis that may present with similar symptoms to

those of meningitis.

6. Cerebrospinal fluid (CSF) analysis

- It is a way of looking for conditions that affect your brain and spine. It’s a

series of laboratory tests performed on a sample of CSF. CSF is the clear

 JMJ Marist Brothers
Notre Dame of Marbel University
College of Arts and Sciences – Nursing Department
Koronadal City, South Cotabato

fluid that cushions and delivers nutrients to your central nervous system

(CNS).
 JMJ Marist Brothers
Notre Dame of Marbel University
College of Arts and Sciences – Nursing Department
Koronadal City, South Cotabato

HEMATOLOGY

Date: 15-Nov-18

TEST RESULT UNIT NORMAL INTERPRETATION

RANGE
Hemoglobin 150 g/L 123-153 Within the normal

range
White Blood Cell Count 29.80 x109/L 4.4-11.30 Higher than the

normal range. A

high white blood

cell count usually

indicates an

increased

production of white

blood cells to fight

an infection
DIFFERENTIAL COUNT
Segmenters 0.95 % 0.54-0.64 Higher than the

normal range.

Increased

segmenters is a

sign of an infection.

Neutrophilia can

point to a number
 JMJ Marist Brothers
Notre Dame of Marbel University
College of Arts and Sciences – Nursing Department
Koronadal City, South Cotabato

of underlying

conditions and

factors, including

infection, most

likely bacterial.
Lymphocytes 0.02 % 0.29-0.39 Lower than the

normal range.

Lymphocytopenia

causes abnormality

in the immune

system, including

protection against

bacteria.
Monocytes 0.03 % 0.04-0.09 Lower than the

normal range.

Severe infection

can be associated

with leukopenia.
Hematocrit 0.46 % 0.35-0.44 Higher than the

normal range.

Indication of

dehydration or low

availability of
 JMJ Marist Brothers
Notre Dame of Marbel University
College of Arts and Sciences – Nursing Department
Koronadal City, South Cotabato

oxygen.
9
Platelet Count 320 x10 /L 150-450 Within the normal

range

ELECTROLYTES

Date: 15-Nov-18

NORMAL
TEST RESULT UNIT INTERPRETATION
RANGE
Sodium 135.60 mmol/L 136-145 Lower than the normal

range.

Bacterial meningitis can

cause overhydration by

preventing the body from

eliminating fluids the way

it should. This can lead

to hyponatremia, an
 JMJ Marist Brothers
Notre Dame of Marbel University
College of Arts and Sciences – Nursing Department
Koronadal City, South Cotabato

electrolyte disturbance in

which

the sodium concentratio

n in the blood plasma is

lower than normal.

Potassium 4.15 mmol/L 3.5 – 5.1 Within the normal range
Calcium, 1.11 mmol/L 1.15-1.33 Lower than the normal

ionized levels. Low levels of free

calcium can cause your

heart rate to slow down

or speed up, cause

muscle spasms, and

even result in a coma.

RADIOLOGIC REPORT

Date: 15-Nov-18

CHEST PA

There are hazy densities seen in both parahilar areas. The heart is not enlarged.

The rest of the included structures are unremarkable.

IMPRESSION: PARAHILAR PNEUMONITIS

CLINICAL CHEMISTRY

Test Date: 16-Nov-18

 JMJ Marist Brothers
Notre Dame of Marbel University
College of Arts and Sciences – Nursing Department
Koronadal City, South Cotabato

ANALYSIS METHOD RESULT (Result RANGE (Range Interpretation

2nd unit) 2nd unit)

Creatinine Jaffe 88.36 (1.00 53.00- (0.599- Within the

Centronic umol/L mg/dl) 97.00 1.096) normal range

CT SCAN SECTION

(Cranial with Contrast)

Date: 17-Nov-18

Multiple plain and IV contrast enhanced axial CT images of the head were obtained. No

adverse reactions were observed.

No abnormal density changes appreciated in the brain and brainstem parenchyma.

No pathologic intra and extra-axial fluid collections demonstrated.

Gyri, sulci, fissures and cisterns are intact.

Prominent enhancement noted in the leptomeninges.

The ventricles are normal in size.

Midline structures are not displaced.

Vascular opacification does not appear unusual.

Sella, orbits, paranasal sinuses and petromastoids are unremarkable.

Calvarium and visualized facial bones are intact.

 JMJ Marist Brothers
Notre Dame of Marbel University
College of Arts and Sciences – Nursing Department
Koronadal City, South Cotabato

Extracalvarial soft tissues are unremarkable.

No other significant findings.

IMPRESSION

- PROMINENT ENHANCEMENT OF THE LEPTOMENINGES.

SUGGESTIVE OF MENINGITIS.

CLINICAL CORRELATION SUGGESTED.

ELECTROLYTES

Date: 19-Nov-18

TEST RESULT UNIT NORMAL RANGE INTERPRETATION

Potassium 4.15 mmol/L 3.5 – 5.1 mmol/L Within the normal range

HEMATOLOGY

Date: 19-Nov-18

TEST RESULT UNIT NORMAL INTERPRETATION

RANGE
Hemoglobin 128 g/L 123-153 Within the normal

range
9
White Blood Cell Count 11.30 x10 /L 4.4-11.30 Within the normal
 JMJ Marist Brothers
Notre Dame of Marbel University
College of Arts and Sciences – Nursing Department
Koronadal City, South Cotabato

range
DIFFERENTIAL COUNT
Segmenters 0.84 % 0.54-0.64 Higher than the

normal range.

Increased segmenters

is a sign of an

infection. Neutrophilia

can point to a number

of underlying

conditions and

factors, including

infection, most likely

bacterial
Lymphocytes 0.11 % 0.29-0.39 Lower than the

normal range.

Lymphocytopenia

causes abnormality in

the immune system,

including protection

against bacteria.
Monocytes 0.05 % 0.04-0.09 Within the normal

range
Hematocrit 0.39 % 0.35-0.44 Within the normal

range
 JMJ Marist Brothers
Notre Dame of Marbel University
College of Arts and Sciences – Nursing Department
Koronadal City, South Cotabato

Platelet Count 320 x109/L 150-450 Within the normal

range

CEREBROSPINAL FLUID

Date: 22-Nov-18

Volume:1ml

CELL COUNT

TEST RESULT NORMAL INTERPRETATION

RANGE
Color Straw Colorless Xanthochromia indicates

the presence of bilirubin,

hemoglobin, red blood

cells, or increased

protein
Transparency Clear Clear Normal
Cell Count 1.1 ×10/L 0 - 0.05 Within the normal range
MICROSCOPIC

EXAMINATION
Segmenters 10 20–70 Lower than the normal

range. Outside a certain

range has a possibility

that the patient has a

serious bacterial

infection, including the

 JMJ Marist Brothers
Notre Dame of Marbel University
College of Arts and Sciences – Nursing Department
Koronadal City, South Cotabato

possibility of

meningococcal disease.
Lymphocytes 90 10–30 Higher than the normal

range. Cerebrospinal

fluid lymphocytosis is

common in acute

bacterial meningitis

CSF-TOTAL PROTEIN

Date: 23-Nov-18

TEST RESULT REFERENCE INTERPRETATION

CSF-TOTAL 1120.56 <500 mg/dl Higher than the normal range.

PROTEIN Moderate or pronounced elevation

may be caused by acute bacterial

meningitis. Increased in protein

caused by increased in permeability

of the blood brain barrier and higher

molecular weight proteins to enter

the CSF or proteins may be

synthesized within the cerebrospinal

canal by inflammatory or other

invading cell.