Page 317 - Saunders Comprehensive Review For NCLEX-RN

20 mg/dL (3.6 to 7.1 mmol/L)
e. Elevated levels indicate a slowing of the
glomerular filtration rate.
f. Elevated values occur in the following:
burns, dehydration, GI bleeding,
increase in protein catabolism (fever,
stress), renal disease, shock, urinary
tract infection
g. Below normal values occur in the
following: fluid overload,
malnutrition, severe liver damage,
syndrome of inappropriate antidiuretic
hormone
L. White blood cell (WBC) count
1. WBCs function in the immune defense system of the
body.
2. The WBC differential provides specific information on
WBC types.
3. A “shift to the left” (in the differential) means that an
increased number of immature neutrophils is present
in the blood.
4. A low total WBC count with a left shift indicates a
recovery from bone marrow depression or an
infection of such intensity that the demand for
neutrophils in the tissue is higher than the capacity of
the bone marrow to release them into the circulation.
5. A high total WBC count with a left shift indicates an
increased release of neutrophils by the bone marrow
in response to an overwhelming infection or
inflammation.
6. An increased neutrophil count with a left shift is
usually associated with bacterial infection.
7. A “shift to the right” means that cells have more than
the usual number of nuclear segments; found in liver
disease, Down’s syndrome, and megaloblastic and
pernicious anemia.
3
8. Normal reference interval: 5000 to 10,000 mm (5.0 to
9
10.0 × 10 /L)
9. Elevated values occur in the following: inflammatory
and infectious processes, leukemia
10. Below normal values occur in the following: aplastic
anemia, autoimmune diseases, overwhelming
infection, side effects of chemotherapy and irradiation

Monitor the WBC count and differential closely in clients

receiving chemotherapy because of the risk for neutropenia;

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