| Course | NSG 120 Nursing Pathophysiology |
|---|---|
| Unit | Unit 5 |
| Paper type | Laboratory value pattern study |
| Length | About 790 words, 5 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | BSN |
| Updated | October 2026 |
Free sample paper for NSG 120 Unit 5
Red Cells Breaking Down Faster Than They Are Made: Reading One Panel as a Pattern in a 24-Year-Old Man With Dark Urine After a Family Dinner
Student Name
Department of Nursing, Herzing University
NSG 120: Nursing Pathophysiology
Instructor Name
February 13, 2026
Red Cells Breaking Down Faster Than They Are Made: Reading One Panel as a Pattern in a 24-Year-Old Man With Dark Urine After a Family Dinner
The Patient and the Panel
A composite 24-year-old man, a graduate student whose family comes from southern Italy, comes to the emergency department two days after a family dinner that included a dish of fresh fava beans. He feels exhausted, his urine has turned the color of cola, and his girlfriend says his eyes look yellow. He takes no regular medicines. The panel below was drawn on arrival. Reference intervals are those printed in the course laboratory manual; they differ between laboratories and are used here only as that manual gives them.
| Test | Result | Reference interval (course manual) | Direction |
|---|---|---|---|
| Hemoglobin | 9.2 g/dL | 13.5-17.5 g/dL | Low |
| Mean cell volume (MCV) | 92 fL | 80-100 fL | Within |
| Reticulocytes | 6.8% | 0.5-2.5% | High |
| Lactate dehydrogenase (LDH) | 640 U/L | 140-280 U/L | High |
| Total bilirubin | 3.6 mg/dL | 0.2-1.2 mg/dL | High |
| Direct (conjugated) bilirubin | 0.3 mg/dL | 0.0-0.3 mg/dL | Within |
| Indirect (unconjugated) bilirubin | 3.3 mg/dL | 0.2-0.9 mg/dL | High |
| Haptoglobin | Below 10 mg/dL | 30-200 mg/dL | Low |
| Aspartate aminotransferase (AST) | 68 U/L | 10-40 U/L | High |
| Alanine aminotransferase (ALT) | 28 U/L | 7-56 U/L | Within |
| Potassium | 5.7 mmol/L | 3.5-5.1 mmol/L | High |
| Urine dipstick, blood | 3+ | Negative | High |
| Urine microscopy, red cells | 0-2 per high-power field | 0-2 per high-power field | Within |
Group 1: The Signs of Red Cells Being Destroyed
LDH high, indirect bilirubin high, haptoglobin very low, and AST high while ALT is normal. These values move together because all of them come from the inside of a red cell or from the body's handling of its contents.
When red cells break open, they release LDH and AST, both enzymes that red cells contain, into the blood. The hemoglobin they release is caught by haptoglobin, a carrier protein that binds free hemoglobin and takes it to the liver; so much hemoglobin is being released that the haptoglobin is used up, which is why it is almost unmeasurable. The heme part of hemoglobin is broken down into unconjugated, or indirect, bilirubin, which the liver then has to process. When more is made than the liver can handle, indirect bilirubin rises, while direct bilirubin, the kind the liver has already processed, stays normal. That split points away from a liver or bile duct problem and toward too much bilirubin being produced (Barcellini & Fattizzo, 2015).
The AST and ALT pair is worth reading together. If the liver were the source, both would usually rise. Here only AST rises, which fits red cells as the source.
Group 2: The Marrow's Response
Hemoglobin low and reticulocytes high, with a normal MCV. Reticulocytes are young red cells newly released from the bone marrow. A high count with a low hemoglobin means the marrow is working hard to replace cells that are being lost, not failing to make them. That rules against anemias from low production, such as iron deficiency, where the reticulocyte count would be low and the cells small (Rogers, 2023). The normal cell size fits cells that were made normally and then destroyed.
Group 3: Where the Destruction Is Happening
Urine dipstick strongly positive for blood, but almost no red cells under the microscope. The dipstick reacts to hemoglobin, not only to intact red cells. Blood in the urine from bleeding in the kidney or bladder would show red cells on microscopy. Hemoglobin with no cells means free hemoglobin has passed from the blood into the urine, which happens when red cells break open inside the blood vessels and the haptoglobin is already used up. This explains the cola-colored urine.
The process that produces all three groups together is hemolysis inside the blood vessels. In a young man of Mediterranean family background who became ill after eating fava beans, one well-described cause is glucose-6-phosphate dehydrogenase (G6PD) deficiency: red cells that lack this enzyme cannot protect themselves from oxidizing substances in fava beans and break apart (Luzzatto et al., 2020). That is a hypothesis for the team to test, not a conclusion this pattern proves.
The Value Outside the Pattern
Potassium is slightly high. It could belong to the pattern, since red cells hold a great deal of potassium and release it when they break open. But it could also be an artifact: if red cells are damaged during the blood draw itself, for example by a small needle or a long tourniquet, potassium leaks from them in the tube and the result is falsely high. The laboratory's specimen comment does not settle it. Because a true high potassium can affect the heart rhythm, this value is not explained away. It is flagged for a repeat draw, taken carefully, and an ECG would be looked at by the team.
What Would Be Repeated, and Why
Hemoglobin and reticulocytes, to see whether the destruction is slowing and the marrow is keeping up. Bilirubin and LDH, which should fall as hemolysis settles. Potassium, repeated as above. Kidney function, because free hemoglobin in large amounts can injure the kidneys. A G6PD level would be sent, with the caution that it can read falsely normal during an acute episode, when the oldest, most deficient cells have already been destroyed and the young reticulocytes have more enzyme (Luzzatto et al., 2020). Reference intervals in this study were taken from the course laboratory manual and will differ in other laboratories.
References
Barcellini, W., & Fattizzo, B. (2015). Clinical applications of hemolytic markers in the differential diagnosis and management of hemolytic anemia. Disease Markers, 2015, Article 635670. https://doi.org/10.1155/2015/635670
Luzzatto, L., Ally, M., & Notaro, R. (2020). Glucose-6-phosphate dehydrogenase deficiency. Blood, 136(11), 1225-1240. https://doi.org/10.1182/blood.2019000944
Rogers, J. L. (Ed.). (2023). McCance & Huether's pathophysiology: The biologic basis for disease in adults and children (9th ed.). Elsevier.
What the NSG 120 Unit 5 instructions ask for
Unit 5 asks you to interpret a set of laboratory values as a pattern. Expect to present the patient and panel, group values by what they show, explain the mechanism behind each group, address values that do not fit and say what should be repeated. Many versions ask which reference ranges to use and whether you should reach a diagnosis. Check whether your section supplies the panel. Use the reference ranges your course or lab provides. The goal is to explain what the pattern shows about the process, not necessarily to diagnose. A value outside the pattern deserves a sentence on whether it belongs or has another explanation. Repeat tests should track whether the process is improving.
How the NSG 120 Unit 5 example is put together
The study opens with the patient's history and the panel in a table. Three group sections follow, each listing the values and explaining what they show together. The destruction group links LDH, bilirubin and haptoglobin to broken red cells. The marrow group shows that the bone marrow is responding with young cells. The location group explains the dipstick and microscopy result, pointing to destruction inside blood vessels. The outlier section considers whether potassium reflects the hemolysis or a sample problem. The repeat section names tests to track and why. The grouping is the study's key feature, since it turns a list of numbers into an explanation of what is happening in the body.
Reading the NSG 120 Unit 5 rubric
Herzing's rubric for a lab pattern study usually covers the presentation of values, grouping into patterns, mechanisms for each group, handling of outliers, follow-up and writing. Grouping and mechanisms carry the most weight, since graders want values interpreted together with the reason each moves. Presentation points reward clear values with ranges. Outlier criteria look for thoughtful explanation. Follow-up earns credit for tests that track the process. Reference ranges should come from the course or lab. A diagnosis is not required. Explaining why a normal MCV fits acute hemolysis is often credited, since it shows the values were read together. Luzzatto's G6PD review and Barcellini and Fattizzo's paper belong in the APA 7 list.
NSG 120 Unit 5 help: mistakes that cost points
Lab pattern studies in Unit 5 often slip by interpreting each value alone, high or low, without grouping. Another frequent problem is jumping to a diagnosis without explaining the pattern. Students often skip the outlier or force it into the pattern. Mechanisms are missing, so values are labeled but not explained. Reference ranges are not stated. Repeat tests are not chosen with a purpose. The patient history is not used. Terms like haptoglobin are not defined. Finally, explain what each group shows about the process, because graders reward a study that reads the panel as a story about red cells rather than a list of abnormal numbers. Another gap is ignoring the trigger in the history, here fava beans, which links the pattern to G6PD deficiency.
Get a NSG 120 Unit 5 example written to your instructions
Send the Unit 5 instructions and the rubric from your NSG 120 classroom, along with the panel or the case the assignment provides. We write a custom example that shows the values before reading them, groups results that move together, gives each group a process and keeps every interval attributed. First custom sample free, back in 24 to 48 hours.
More NSG 120 papers and BSN samples
- NSG 120 Unit 1: Disease process summary
- NSG 120 Unit 2: Sign and symptom rationale
- NSG 120 Unit 3: Complication watch list
- NSG 120 Unit 4: Body system comparison
- NSG 120 Unit 6: Condition study set
- NSG 120 Unit 7: Risk factor and prevention table
- NSG 120 Unit 8: Patient teaching rationale
- NSG 121 Unit 5: Head to toe rehearsal log
- NSG 122 Unit 5: Patient needs ordering brief
- NSG 123 Unit 5: Preoperative and postoperative record
- NSG 124 Unit 5: Monitoring and counseling brief
NSG 120 Unit 5 questions, answered
Which reference ranges should I use?
The ones your course supplies, and say so in the document. Intervals differ between laboratories, between adult and pediatric populations and between texts, so a range without an attribution cannot be checked by your instructor. Where your section provides a table, use it throughout rather than mixing sources, and note any value where your reading and the supplied interval disagree.
Am I supposed to reach a diagnosis from the panel?
Generally not in this course. The pattern study asks what process would produce the shape in front of you and what a nurse would then watch, which is a different question from naming a condition. Where your instructions do ask for a likely process, phrase it as consistent with rather than as settled, and keep the reasoning visible above it.
What do I do with a value that contradicts the pattern?
Write it up. An outlier explained, or honestly marked as unexplained and flagged for repeating, shows more control of the material than a study that quietly drops it. Say whether it could be a sampling issue, a separate process or something your reading does not account for, and let the uncertainty stand where it belongs.
Where can I find a free NSG 120 Unit 5 sample paper?
You can read the whole NSG 120 Unit 5 hemolysis pattern study here for free, three value groups, the outlier and what to repeat. A study of a different lab panel can be written on request.
What lab values show red blood cells are being destroyed?
High LDH, high indirect bilirubin and low haptoglobin together suggest hemolysis, and a high reticulocyte count shows the marrow is responding. This sample reads those values as a pattern in a young man after eating fava beans.