Question

You are the triage nurse in the Emergency Department. Your patient, Mr. Sawyer, is a 48 year old man who presents with severe abdominal pain, poor appetite, and fatigue. He states the pain awakened him from sleep and he began vomiting. He denies any relief from the pain and he can’t get comfortable as the pain radiates to his back and right shoulder. He rates his current pain level as 10/10. He denies any previous medical or surgical history. He denies any tobacco or drug use. States he drinks “just a beer or two after work each day” though he reports to “more than usual” alcohol consumption this past weekend after attending a bachelor party. He lives with his wife and 2 children and works fulltime as a construction foreman. Initial vital signs: BP 160/94, resp 24, pulse 100, temp 99.6 orally, pulse ox 99%.

After you have completed your physical assessment on Mr. Sawyer you receive orders from the ER provider to draw bloodwork for laboratory studies and send them to the lab stat for processing. Within a few minutes you receive a call from the laboratory technician with the following results:

Amylase	418 U /L
Lipase	307 U/L
White Blood Cells	15.5 bc/L
Hemoglobin	13.8 g/dl
Hematocrit	39.2 %
Platelets	300 b/L

a. Interpret the above laboratory orders and indicate their meaning in the body. State whether Mr. Sawyer’s lab values are normal or abnormal. (10 points)

b. Now that you have reviewed Mr. Sawyer’s laboratory values and have a better understanding of their meaning what do think is wrong with him? (What is his potential medical diagnosis?) (10 points)

Answer 1

Amylase is a digestive enzyme present in saliva and digestive juices. Amylase is produced by pancreas. Its normal value is 35-80U/L

Lipase is digestive enzyme present in digestive juice produced by pancreas. Normal lipase level is 0-160U/L.

WBC are the cells present in plasma that acts as a defence mechanism and protect the body against infections. Normal value is 4.5 to 11.0 × 10⁹/L.

Hematocrit level is the percentage of RBC in blood. It tells the oxygen delivering capacity of blood. Normal value is 40% for men.

Platelets are component of blood that take part clotting of blood. Normal range is 1.5-4.5 lakh per microlitre of blood.

Patient’s lab results show high level of amylase, lipase and WBC.

The above lab results indicates condition known as pancreatitis.