It is essential that a critical finding be communicated immediately to the requesting health-care provider (HCP). A listing of these findings varies among facilities. Timely notification of a critical finding for lab or diagnostic studies is a role expectation of the professional nurse.Obtain a history of the patients complaints, including a list of known allergens, especially allergies or sensitivities to latex. Obtain a history of the patients endocrine system, symptoms, and results of previously performed laboratory tests and diagnostic and surgical procedures.
Positively identify the patient, and label the appropriate specimen container with the corresponding patient demographics, initials of the person collecting the specimen, date, and time of collection. Perform a venipuncture. Remove the needle and apply direct pressure with dry gauze to stop bleeding.While no histocompatibility-linked antigens (HLA) that would suggest a predisposition for Hashimoto's disease have been identified, there is a familial tendency for its occurrence, and a predominance of females to males and whites to blacks of about 4:1.
There may also be end organ unresponsiveness, defects in the receptors on the thyroid or at the peripheral tissue level. Hypopituitarism (secondary hypothyroidism) due to pituitary aplasia or midline brain developmental defects.Borderline T4 readings. Because neonatal hypothyroidism is usually caused by an ectopic or hypoplastic hypothyroid gland, there may be some thyroid hormone released that will be picked up on a T4 assay.
Peter's sallow complexion (from high carotene concentrations low blood pressure, slow heart rate, pseudomuscular hypertrophy and retarded bone age, while not dramatically diagnostic, complement a panel of blood chemistries that clearly indicate hypothyroidism caused by autoimmune thyroid disease: T4 1ug/dl, T3 resin uptake 36, TSH 64 S.I.Obtain a list of the patients current medications, including herbs, nutritional supplements, and nutraceuticals (see Effects of Natural Products on Laboratory Values online at DavisPlus). Review the procedure with the patient.
Reported information includes the patients name, unique identifiers, critical value, name of the person giving the report, and name of the person receiving the report. Documentation of notification should be made in the medical record with the name of the HCP notified, time and date of notification, and any orders received.Conventional Units - International Units Using this table: To convert from a conventional unit to a SI Unit, multiply by the conversion factor listed (eg Albumin 3 g/dl x 10 30 g/L.
SI to Conventional (multiply by) 0.1 100 0.20 1 0.10 1 0.362 0.19 33.0 1 5.587 5.587 0.06 0.288 0.288 NA 9.01 9.01 20.70 207.04 NA.43 24.31 0.055 0.055 Analyte blood urine Methadone, serum Methanol, blood Myoglobin, serum N-Acetylprocainamide (NAPA serum 5 Nucleotidase Osmolality serum urine Oxalate, urine Parathyroid hormone, intact Phencyclidine (PCP serum or.The elevation of antithyroid antibodies reflects this immune-mediated destruction of thyroid tissue. Hashimoto's disease has been associated with other autoimmune disorders, including Addison's disease, hypoparathyroidism (as well as a form of pseudohypoparathyroidism pernicious anemia and insulin-dependent diabetes mellitus.
Reinforce information given by the patients HCP regarding further testing, treatment, or referral to another HCP. Answer any questions or address any concerns voiced by the patient or family. Depending on the results of this procedure, additional testing may be performed to evaluate or monitor progression of the disease process and determine the need for.Refer to the Endocrine System table at the end of the book for related tests by body system. Link to this page: a href"m/Thyroxine2cTotal" Thyroxine, Total /a.
NA 1 NA 0.10 NA 36.10 0.361 NA.95 1.69 NA 28.7 1 1 g/L g/L units/L mg/dL mg/dL g/mL 0.0133 0.0133 NA 17.1 17.1 0.0125 mol/L mol/d units/L mol/L mol/L mmol/L 75.2 75.2 NA 0.0584 0.0584 799.Neonatal Hypothyroidism Hypothyroidism in the young child, particularly the neonate, is truly an urgent situation. Because proper development of normal brain and neural tissue in early life required adequate levels of thyroid hormone, deficiency can cause severe, irreversible mental and physical handicaps, a condition known as cretinism.
Peter's medical history was unremarkable, but his parents were concerned about his short stature and observed that his interest in participating in sports had diminished and that he was sluggish and hard to motivate.His blood pressure was 90/50 mmHg, and his heart rate was 62. Peter was assessed to be at Stage 3 of puberty on the Tanner scale - normal for his age.
NA 1 NA 10 NA 0.0277 2.77 NA 0.01 1 1 0.0371 0.59 NA 0.0349 1 1 units/L ng/L units/L g/L units/L nmol/L nmol/d units/L g/L mg/L g/L mol/L mol/L units/L nmol/L units/L ng/L.Together these abnormalities account for over 80 of the cases. A definitive diagnosis may be obtained with an iodine 123 or a technetium 99m scan. Dyshormonogenesis, a serious error in thyroid hormone synthesis.
Congenital hypothyroidism may be due to several etiologies: Thyroid dysgenesis, including aplasia or hypoplasia of the thyroid gland; and ectopy of the thyroid, often with hypoplasia, in which there is insufficient tissue to match the demands of the infant or growing child.Screening. Today, in the United States, neonates are required to be screened for low T4 levels on the third to fifth day of life, at the same time that blood is obtained on a piece of filter paper for PKU testing.
And because cholesterol is part of routine SMA, it's an economical and accessible indicator. With the movement toward early detection and prevention of heart disease, pediatricians are beginning to take new interest in their patients' cholesterol and triglyceride levels.Analyte Cadmium blood Cadmium urine Caffeine, serum Calcitonin Calcium ionized serum urine Carbon dioxide Carboxyhemoglobin Carcinoembryonic antigen (CEA) Carotene, serum Catecholamines, fractionation, urine Ceruloplasmin Chloramphenicol, serum Chloride serum urine Cholesterol HDL LDL Cholinesterase, serum Chromium, plasma Codeine, serum Complement C3 activator Compound S (11-deoxycortisol) Copper serum urine Coproporphyrins blood fluid Conventional Units Conventional to SI.
Clinical presentation. For all practical purposes, over 90 of all cases of neonatal hypothyroidism are detected by laboratory screening, reducing the opportunity for clinical diagnosis. Occasionally, however, I see a report in the literature about a patient with hypothyroidism masked by Down's syndrome.Acetoacetic acid mg/dL 0.098 mmol/L Acetone mg/dL 0.172 mmol/L Alanine mg/dL 112.2 mol/L Albumin g/dL 10 g/L Aldosterone ng/dL 0.0277 nmol/L Aluminum ng/mL 0.0371 mol/L Aminobutyric acid mg/dL 97 mol/L Amitriptyline ng/mL 3.61 nmol/L Ammonia (as NH3) g/dL 0.587 mol/L Androstenedione ng/dL 0.0349 nmol/L Angiotensin I pg/mL 0.772 pmol/L Angiotensin II pg/mL 0.957 pmol/L Anion.
NA 1 53.7 0.169 0.10 0.61 38.61 38.61 0.001 0.052 0.299 0.10 34.5 63.7 63.7 0.067 0.67. Analyte urine Cortisol blood Cortisol urine C-Peptide, serum Creatine kinase (CK) Creatinine serum urine Cyanide, blood Cyclic AMP, urine Cystine, urine DHEA DHEA sulfate Erythropoietin Estradiol (E2 serum Estriol (E3 serum Estrone (E1 serum Ethanol, blood Ethylene glycol.Instruct the patient to cooperate fully and to follow directions. Direct the patient to breathe normally and to avoid unnecessary movement. Observe standard precautions, and follow the general guidelines in Patient Preparation and Specimen Collection.
Data should be separated in coma space ( tab, or in separated lines).Other Publications Articles Hypothyroidism in Infancy and Childhood Richard Levy, M.D. Assistant Professor of Medicine and Pediatrics Rush-Presbyterian/St. Luke's Medical Center, Chicago, Illinois. Case Summary Peter R, a 15-year-old male, was referred to a pediatric endocrinologist by his pediatrician because of a decreased growth rate since the age of 10.
SI to Conventional (multiply by).0032 1 0.277 NA NA NA 0.088 1 0.243 0.232 0.1 3.10 0.031 0.226 1 1 0.321 0.337 0.314 1 0.10 0.18 62.5 0.250 138.1 176 Analyte Sodium blood urine T3 uptake (T3U) Testosterone Theophylline, serum Thyroglobulin Thyroid-stimulating hormone (TSH) Thyroxine binding globulin (TBG) Thyroxine (T4) Thyroxine, free (FT4) Transferrin Triglycerides.SI to Conventional (multiply by) 0.67 0.036 0.362 3.03 NA 0.0113 0.113 113.1 0.026 0.329 0.24 28.8 38 1 0.272 0.288 0.27 0.00461 0.019 0.442 0.442 1 NA 1 0.478 18.02 18.02 18.02 Analyte Glutamine, CSF Glycohemoglobin Gold, plasma Growth hormone (GH) Haptoglobin, serum Human chorionic gonadotropin (hCG serum 17-Hydroxycorticosteroids (17OHCS urine 5-Hydroxyindoleacetic acid (5HIAA.