NAME: _______________________________________________________ RATING: ________________________

GROUP NO. _________________________________________________ DATE: ________________________

ACTIVITY 19

CLINICAL CHEMISTRY

Clinical chemistry refers to the biochemical analysis of body fluids. 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.Techniques such as spectrophotometry, immunoassays, and
electrophoresis are also used in clinical chemistry to measure the concentration of substances such as glucose, lipids, enzymes,
electrolytes, hormones, proteins, and other metabolic products present in human blood and urine.

When an individual test alone is not sufficient to assess a medical condition, a combination of several tests may be used. The pattern
of results from the combination of tests may provide better insight into the status of the patient than any single test result. Such tests,
done on the same sample, are often ordered as a group called a panel or profile.

Blood is the most common biologic fluid collected for clinical laboratory testing. It is usually drawn from a vein (in the arm) directly
into an evacuated tube. Typically a tube will hold about 5 mL of blood – enough to perform many clinical chemistry tests, since
automated analyzers require only small amounts (usually from 2 to 100 μL) for a single test. Occasionally, when collection of blood
from a vein is difficult, a sample of capillary blood may be collected by pricking the skin and collecting several drops of blood from the
puncture site. An example is the use of heelstick blood for testing of newborns.Phlebotomy – the act of drawing a blood sample from
a blood vessel. For clinical chemistry testing, blood is usually drawn from a vein, typically a vein in the arm or back of the hand.
Collecting blood from a vein is called venipuncture. The medical professional drawing the blood sample is called a phlebotomist.
Other biologic fluids (matrices) often used for testing include urine, saliva, cerebrospinal fluid (CSF), amniotic fluid, synovial fluid,
pleural fluid, peritoneal fluid and pericardial fluid. These fluids often contain the same biologic analytes of interest – such as glucose
and protein – but differ greatly from each other in physical and chemical properties. These differences in fluid characteristics are
termed matrix differences. Test methods that are designed for determination of an analyte in blood plasma may not be suitable for
determination of that same analyte in other fluids (other matrices). When using a test method for analysis of a fluid other than blood
plasma or serum, it is important to validate that the method is acceptable for the type of fluid sample being used

I. LEARNING OBJECTIVES:

After completing this worksheetthe students should be able to:

1. Describe the kinds of analytes that are measured using clinicalchemistry tests
2. Identify different types of biologic specimens that may be usedfor testing
3. Know the normal values and describe how the results of tests are interpreted

II. II. MATERIALS

Work sheet Biochemistry book E-article/E-book on Biochemistry

III. PROCEDURE

1. Answer the research questions

IV. RESEARCH QUESTIONS

1. What is the significance of clinical chemistry in nursing?

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2. Fill up table with the needed information. Kindly review the answers.

EXAMINATIONS NORMAL INDICATIONS SIGNIFICANCE

VALUES
MALE FEMALE INCREASE DECREASE
A. Erythrocyte Studies
1. RBC

2. Hemoglobin

3. Hematocrit

4. Mean corpuscular
volume (MCV

5. Mean corpuscular
hemoglobin (MCH)

6. Mean corpuscular
 hemoglobin
concentration
(MCHC)
a. Erythrocyte
sedimentation rate
(ESR)
B. White Blood Cells and
Differential
1. White Blood Cell
(WBC) Count

2. Neutrophils

3. Lymphocytes

4. Monocytes

5. Eosinophils

6. Basophils

7. Bands

8. Bleeding Time
C. Coagulation Studies
1. Platelet count (PLT)

2. Activated partial
thromboplastin time
(APTT)

3. Prothrombin time
(PT)

4. Partial
Thromboplastin Time
(PTT)

5. International
Normalized Ratio
(INR)

6. Fibrinogen

7. Bleeding time

8. D-Dimer
D. Serum Electrolytes
1. Potassium (K+)

2. Sodium (Na+)

3. Chloride (Cl-)

4. Calcium (Ca+)
a. Total calcium

b. Ionized calcium

5. Phosphorus (P)

6. Magnesium (Mg)

7. Serum Osmolality

8. Serum bicarbonate
E. Renal Function Studies
1. Creatinine

2. Blood urea nitrogen

(BUN)

F. Glucose Studies
1. Glucose, fasting

2. Glucose, monitoring

3. Glucose, 2-hr
postprandial

4. Glucose Tolerance
Test (GTT)

5. Glycosylated
hemoglobin (HbA1c)

6. Diabetes Mellitus
autoantibody panel
G. Arterial Blood Gases
(ABGs)
1. Arterial blood pH
 2. Oxygen saturation
(SaO2)

3. Partial pressure of
carbon dioxide
(PCO2)

4. Partial pressure of
oxygen (PaO2)

5. Bicarbonate (HCO3)

H. Liver Function Tests

1. Alanine
Aminotransferase
(ALT)

2. Aspartate
Aminotransferase
(AST)

3. Total bilirubin

4. Direct bilirubin
(conjugated)
 5. Indirect bilirubin
(unconjugated)

6. Albumin

7. Ammonia

8. Amylase

9. Lipase

10. Protein

I. Lipoprotein Profile
1. Cholesterol

2. High-density
lipoprotein (HDL)

3. Low density
lipoprotein (LDL)

4. Triglycerides
J. Cardiac Markers and
Serum Enzymes
1. Creatine kinase (CK)

2. Creatinine kinase
isoenzymes

3. Myoglobin

4. Troponin

a. Troponin T

b. Troponin I

K. HIV and AIDS Testing

1. CD4+ T-cell count

L. Thyroid function test

1. Triiodothyronine (T₃)

2. Thyroxine (T₄)
 3. Thyroxine, free (FT₄)

4. Thyroid-stimulating
hormone (thyrotropin)

M. Urinalysis
1. Color

2. Odor

3. Turbidity

4. Specific Gravity

5. pH

6. Protein

7. ketones
 8. Magnesium

9. Glucose

10. RBC

11. WBC

12. Bacteria

13. Casts

14. Crystals

15. Uric acid

16. sodium

17. Potassium

18. Magnesium
N. CEREBROSPINAL
FLUID
1. Appearance
 2. Glucose

3. Protein

4. Cell

5. Culture

6. Serology

O. Fecalysis
1. Macroscopic
a. Color

b. Consistency

c. Blood

d. Mucus

e. Parasites

2. Microscopic
a. WBC
 b. RBC

c. Ova

d. Parasites

V. Reference/s

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