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Cardiopulmonary PT > Cardiovascular labs and diagnostic testing > Flashcards

Cardiovascular labs and diagnostic testing Flashcards

1
Q

What does a CBC consist of

A
  • Hemoglobin
  • hematocrit
  • WBCs
  • Platelts
  • RBCs
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2
Q

Hemoglobin

A
  • Normal: 12-18
  • Decreased levels = decreased oxygen carry capacity
  • <7-8 essential activities only/No exercise
  • > 8 symptoms based approach
  • low critical values can lead to heart failure
  • High critical values can lead to clogging of capillaries due to concentration of hemoglobin
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3
Q

Hematocrit

A
  • 36-45.2%
    (37-47 females 42-52 males)
  • Low values are critical and can lead to heart failure
  • High values lead to clogging of arteries
  • > 25 - symptom based approach
  • <60 symptoms based approach
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4
Q

White blood cells- acute care section guidelines

A
  • 5-10.8 K/uL
  • <4,000 with fever = no exercise
  • > 4,000 light exercise, symptoms based approached
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5
Q

Platelets

A
  • 140-400 K/uL
  • <50,000 - risk of spontaneous hemorrhage
  • greater than 1 million = risk of clotting
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6
Q

RBCs - normal range

A

3.85-5.15

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7
Q

Prothrombin time (PT)

A
  • Warfarin use
  • Normal 11-13 seconds
  • Increase risk of bleeding with increase PT
  • Increase risk of clotting with decrease PT
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8
Q

INR

A
  • Normal: 0.9-1.1
  • DVT/clot prevention 2-3
  • Post MI/valve replacement 2.5-3.5
  • Increase risk of bleeding (>3.6 hold therapy)
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9
Q

aPTT`

A
  • Normal 21-35 seconds
  • 2-2.5 upper normal limit with heparin use
  • Increase risk of bleeding with increased PTT
  • > 100 second - patient should not be mobilized)
  • Increase risk of clot formation with decreased
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10
Q

what measures coagulation

A
  • PT
  • INR
  • aPTT
  • D-dimers
  • platelts count
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11
Q

Basic metabolic panel

A
  • A lab panel where multiple tests are grouped together in a single profile for ease of ordering
  • Monitors:
    Electrolyte and fluid states
    Kidney function tests
    Blood sugar levels/Glucose
    Calcium
    Sodium
    Chloride
    Potassium
    CO2
    BUN
    Creatinine
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12
Q

Comprehensive metabolic panel

A
  • BMP + protein albumin and liver function
  • ALP- liver
  • AST - liver
  • ALT- liver
  • Bilirubin: liver
  • Total protein
  • Albumin
  • Globulin
  • BUN/creatinine ratio: kidney function
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13
Q

Diabetes mellitus type 1

A
  • Occurs when the pancreas is unable to produce enough insulin
  • Tends to develop at a young age
  • Cannot be prevented
  • Requires insulin therapy
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14
Q

Diabetes mellitus type 2

A
  • Occurs due to insulin resistance
  • Tends to develop older age
  • Can be prevented with lifestyle changes
  • Can be managed with lifestyle modifications alone if diagnosed early
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15
Q

Common symptoms of both types of diabetes

A

Both share symptoms of

  • frequent urination,
  • increase thirst,
  • extreme hunger,
  • unintentional weight loss,
  • fatigue,
  • blurry vision,
  • sores or wounds that heal slowly,
  • numbness and tingling sensation in hands and feet
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16
Q

What could both types of diabetes benefit from

A

Both can benefit from lifestyle modifications such as

  • a healthy diet,
  • physical activity,
  • blood sugar level monitoring,
  • management of stress and other existing health conditions
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17
Q

Fasting blood glucose

A
  • 99 mg/dL or lower = normal
  • 100-125 mg/dL = prediatbetic
  • 126 or above is diabetes
  • Use caution if < 70mg/dL (supplement with carbs) or > 200mg/dL (use of insulin); and no exercise of >300mg/dL
18
Q

A1C

A

<5.7% = normal
5.7-6.5 = prediabetic
>6.5 = diabetic

19
Q

Blood glucose of diabetes diagnosis goal levels of A1C and preprandial and postprandial

A
  • A1C targets different based on age and health
  • More or less stringent glycemic goals may be appropriate for each individual
  • A1C less than 6.5-7 typically for people with diabetes
  • Before a meal (preprandial): 80-130 mg/dL
  • 1-2 hours after beginning of the meal: less than 180 mg/dL
20
Q

Hyperglycemia causes

A

too much food, too little insulin or diabetes pills, illness or stress

21
Q

hyperglycemia onset

A

often starts slowly; may lead to medical emergency if not treated

22
Q

hyperglycemia symptoms

A

Extreme thirst
Need to urinate
Dry skin
Hungry
Blurry vision
Drowsy
Slow healing wounds

23
Q

Hyperglycemia: type 1 and type 2

A
  • Type 1: insulin needed
  • Type 2: antihyperglycemic medication/insulin if prescribed
    *If signs of diabetic ketoacidosis call 911- Fruity smelling breath , Confusion
    Fatigue
24
Q

Hypoglycemia causes

A
  • too little food or skipped a meal
  • too much insulin or diabetes pills
  • more active than usual
25
Q

hypoglycemia onset

A

often sudden, may pass out if untreated

26
Q

hypoglyecmia symptoms

A

Shaky
Fast heartbeat
Sweating
Dizzy
Anxious
Hungry
Burred vision
Weakness or fatigue
Headache
Irritable

27
Q

what to do if hypoglycemic

A
  • Provide snack or juice
  • Monitor
  • Do not exercise until stable
28
Q

Total cholesterol level

A

Desirable = <200
moderate/borderline high = 200 - 240
High > 240

29
Q

LDL cholesterol level

A

Desirable <100
Near desirable 100-130
Border line high 130-160
High = 160-190
Very high <190

30
Q

HDL cholesterol level

A

Major risk: <40
Less risk >60

31
Q

triglycerides

A

Standard range <150 mg/dL
150-199 = borderline high
200-400 = high
>499 very high

32
Q

cardiac enzymes

A

Troponin: spikes during a heart attack
Troponin T and troponin I
AST
LDH
CKMB: muscle breakdown associated with MI

33
Q

Natriuretic peptides

A

ANP - a type natriuretic peptide
BNP - b-type natriuretic peptide

34
Q

Cardiac testing tools

A
  • EKG/ECG/Holter monior
  • stress testing
  • echocardiography
  • X-ray, Pet, MRI, CT, Angiograms
  • Cardiac catheterization
35
Q

EKG/ECG/Holter monitoring:

A

monitors the electrical activity of the heart and heart rate - check to see what is happening over a period of time

36
Q

Stress testing/exercise testing

A
  • Max or sub max
  • Activity: treadmill, bicycle, other
  • Pharmacological: an injection that elicits a similar response to the activity for those who cannot do the activity
  • All involve monitoring response of patient to increased stress on the cardiac, vascular and/or pulmonary systems
  • Exercise testing with imaging: use of non-invasive image pre and post exercise for greater diagnostic accuracy
  • Usually used to look at cardiac perfusion
  • Radioactive isotope
37
Q

Echocardiography

A

another way of getting an image of the heart that uses US

38
Q

Cardiac catherterization

A
  • A procedure that examines the inside of your hearts blood vessels using special X-rays called angiograms
  • Dye visible by X-ray is injected into blood vessels using a thin hallow tub called a catheter
  • Can go into the brachial artery, radial artery, femoral artery or vein
39
Q

interventions for blockages of coronary arteries

A
  1. CABG: by pass
    - Take a smaller vein such as saphenous and use it to reperfuse parts of the heart
  2. Stenting (PTCA ro PCI)
    - Use a balloon to squish or scrape plaque and open the artery
40
Q

types of peripheral vascular testing

A

Arterial and venous angiography (not done by PT)
Ankle brachial index
Doppler ultrasound
Rubor dependency
Venous filling time
Homans sign

Cardiopulmonary PT (25 decks)

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