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Section 5 of 6 · Open sections

Required section · Section 5 of 6

Choose the next laboratory action

For this case, the NRBC-related review flag, atypical WDF pattern, and WNR reporting status meet the stated local decision rule: perform and document a peripheral smear review before release. The tube has no visible turbidity or platelet clumps. No shortcut calculation rule is used to override method-declared results; the decision rests on the validated criterion and observed evidence.

The required smear review supplies morphology evidence. It confirms NRBCs and occasional immature granulocytes, records platelet-clump absence, and confirms no RBC agglutination in this teaching case. Because WNR has already separately enumerated NRBCs, the WBC is not manually corrected a second time.

The local rule outcome is: document the WDF/NRBC review evidence and smear findings, release the WNR-derived WBC with the locally authorized morphology comment, and escalate only if the laboratory's reporting policy requires it. A laboratory must validate or verify its own flag-to-action rule for its population, configuration, software, and review process.

Illustrative drawing — this picture was drawn rather than captured.

Decision workflow. First declare the platform, channel, and result status. Then compare results and inspect the specimen. If a validated local criterion is met, obtain the specified evidence such as a smear, repeat, or alternate method. Document one bounded outcome: release with authorized comment, repeat or alternate measurement, recollect, or escalate. The guided NRBC case leads to smear review then release of the already WNR-corrected WBC with an authorized comment.
Figure 1Decision pathway for the local rule: declared WDF/WNR evidence leads to a documented release, repeat/alternate measurement, recollection, or escalation outcome.

Ordering exercise

Place the decisions required by the validated local rule for the guided WDF/WNR case in order.

  1. 1. Perform and document the rule-required smear review

    Record labeled morphology evidence: NRBCs, immature granulocytes, clump absence, and agglutination absence.

  2. 2. Declare WDF/WNR method and whether WNR-derived WBC is already corrected

    Establish the method-specific reporting status before any correction decision.

  3. 3. Release WNR-derived WBC with authorized comment or escalate per policy

    Use the bounded outcome validated by the laboratory; do not apply a second correction.

  4. 4. Inspect specimen and compare results for clumps, turbidity, or agglutination

    Identify whether an interference pathway requires a different local action.

Knowledge checks

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Knowledge check 1

The local rule is met: NRBC-related review flag plus atypical WDF pattern. The tube has no clumps or turbidity; WNR-derived WBC is already corrected. Which documented outcome follows?

Choose one option.

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