X-ray films confirm the diagnosis of intertrochanteric femoral fracture. Knowing that M.C. is going to beadmitted, you draw admission labs and call for the orthopedic consultation
What laboratory and diagnostic studies will be ordered to evaluate M.C.'s condition, and what critical information will each give you?
Complete blood count (CBC): To evaluate blood loss.
Complete metabolic panel (CMP): The sodium, potassium, chloride, carbon dioxide, calcium, and
glucose will be assessed to evaluate electrolyte status. BUN and creatinine will be used to
calculate the BUN/creatinine ratio, which is used to evaluate renal function.
Urinalysis (UA): This will assess for the presence of hemoglobinuria caused by trauma or
myoglobinuria related to (R/T) rhabdomyolysis. Rhabdomyolysis results from prolonged pressure
on muscular tissue with damage to cells. Release of myoglobin into the vascular system might
result in damage to renal tubules that become occluded with myoglobin.
Type and crossmatch (T&C): For 4 units of packed red blood cells (PRBCs) to replace blood loss.
Prothrombin time/international normalized ratio (PT/INR) and partial thromboplastin time (PTT): To
evaluate presence of bleeding disorders and to record baseline coagulation level.
Electrocardiogram (ECG): This is necessary because M.C. is especially at risk for myocardial ischemia,
infarction, and dysrhythmias. It is possible that a cardiac dysrhythmia contributed to her fall.
Chest x-ray (CXR): To check for cardiac and respiratory abnormalities.
Arterial blood gases (ABGs): To check oxygenation as a source of confusion.
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