ch 8 - lab diagnostics and geriatrics Flashcards
(78 cards)
1
Q
what can elevations in Hct/Hg indicate
A
early sign hypovolemia
2
Q
what factors may affect hematological testing (4)
A
- dehydration
- malnutrition
- infection
- inflammation
3
Q
normal RBC range
A
4.4-5.8
4
Q
normal Hg range
A
14-18
5
Q
normal Hct range
A
39-48%
6
Q
potential effects of reduced Hg levels in older adults
A
- reduced quality of life
- clinical depression
- falls
- functional impairment
- reduced walking speed
- loss of mobility
- loss of grip strength
7
Q
tests for anemia (5)
A
- CBC w/ differential
- iron studies
- reticulocyte count
- folic acid
- vit B12
8
Q
what Hct levels indicate anemia (M and F)
A
M: <41%
F: <36%
9
Q
normal neutrophil count
A
55-70%
10
Q
normal eosinophil count
A
1-4%
11
Q
normal basophil count
A
0.5-1%
12
Q
what cells make up granulocytes (3)
A
- neutrophil
- eosinophil
- basophil
13
Q
what cells make up agranulocytes (2)
A
- monocytes
- lymphocytes
14
Q
normal monocyte count
A
-2-8%
15
Q
normal lymphocyte count
A
20-40%
16
Q
what are subtle signs of illness that may be observed in older adult before elevated WBCs (3)
A
- new onset/increased confusion
- falling
- incontinence
17
Q
purpose of neutrophils
A
(stimulated by infection)
fight bacteria
18
Q
purpose of eosinophils
A
(stimulated by allergic response)
fight antigens and parasites
19
Q
purpose of basophils
A
(stimulated by presence of allergens)
transport histamine
20
Q
purpose of lymphocytes
A
(stimulated by presence of viral infection)
T cells and B cells
21
Q
purpose of monocytes
A
defend body against foreign substances
become macrophages
22
Q
normal WBC
A
5-10k
23
Q
normal platelet count
A
1.5-4
24
Q
what changes in coagulation may be seen in older adults
A
hypercoagulability
25
Indicator of inflammation, infection, necrosis,
| infarction, or advanced neoplasm
ESR (erythrocyte sedimentation rate)
26
vitamin: important for normal function of
red blood cells (RBCs) and
white blood cells
folate (B9)
27
what older adults may have folate deficiencies (3)
- significant nutritional deficiencies
- very frail
- alcohol abuse
28
vitamin: important for normal development of RBCs,
neurological function, and DNA
synthesis
B12
29
what puts older adults at risk for vit B12 deficiency
age-related decrease in
the production of gastric acid
and intrinsic factor
30
what puts older adults at risk for vit d deficiency (3)
- lack of UV light
- skin changes
- decreased intake vit d/calcium
31
purpose of electrolytes (4)
- maintain balance between intracellular and extracellular environment
- regulate hydration
- regulate blood pH
- critical for nerve and muscle function
32
normal Na range
135-145
33
normal K range
3-5.5
34
normal fasting glucose
70-126
35
is hyponatremia or hypernatremia commonly seen in long term care facilities
hyponatremia
36
4 causes hyponatremia for older adult
- increased ECF volume
- impaired water excretion
- SIADH
- caused by meds
37
most common cause hypernatremia in older adult
impaired thirst
38
S+S hyponatremia (3)
- drop in bp
- tachycardia
- mental changes
39
S+S hypernatremia (3)
- poor skin turgor
- dry mucous membranes
- mental changes
40
most common causes hypokalemia (2)
- increased renal excretions (due to meds)
| - increased GI excretions (diarrhea)
41
most common causes hyperkalemia (3)
- decreased excretion by kidneys
- acidosis
- med side effect
42
S+S hypokalemia
- muscle weakness
- fatigue
- muscle cramps
- constipation
- ileus
- flaccid paralysis
- hyporeflexia
- tetany
- ECG changes (prolonged QT, flattened T wave, depressed ST)
43
S+S hyperkalemia
- impaired muscle activity
- weakness
- muscle pain/cramps
- increased GI motility
- bradycardia
- cardiac arrest
- ECG changes (flattened P wave, peaked T wave, broad QRS)
44
what HA1C level is considered poor control for diabetic pts
>9%
45
S+S slight hypoglycemia in older adults
- confusion
| - depressed CNS activity
46
what test is important in evaluating renal failure and gout
uric acid
47
enzyme that is released when there is damage
| to heart muscle
creatinine kinase
48
biomarkers for cardiac damage
troponin I and T
49
4 labs to test for and monitor risk factors and general health concerning cardiac health
- C reactive protein (inflammation)
- homocysteine (high levels = high risk heart disease/stroke)
- BNP (>100=HF)
- lipid panel (cholesterol, triglycerides)
50
protein: Most often used to measure
nutritional status; useful as indicator of
severity of illness and risk of
mortality; measures past 3 weeks
serum albumin
51
protein: half life 2-3 days; more informative of current nutritional status
prealbumin
52
2 labs measured for renal health
- BUN
| - creatinine
53
normal BUN levels
10-20
54
Key component in determining GFR; Used to diagnose and monitor renal function
creatinine
55
why are causes of frequent abnormalities for urinalysis for older adults (3)
- diabetes
- renal insufficiency
- subclinical proteinuria and bacteriuria
56
3 coagulation studies
PT
aPTT
INR
57
med used to control HR; have to blood test to observe for peak levels and watch for toxicity
digoxin
58
what is included in thyroid panel (3)
TSH
T3
T4
59
most common types anemia in older adults (4)
- iron deficiency
- vit b12 deficiency
- result of renal insufficiency
- w/ chronic inflammation
60
how is production of T and B cells (lymphocytes) affected in older adults
- slight decrease T cells
| - slight increase B cells
61
what meds could cause leukopenia in older adults (6)
- antibiotics
- anticonvulsants
- antihistamines
- analgesics
- sulfonamides
- diuretics
62
most common causes electrolyte imbalances in older adult (3)
- over diuresis
- med interactions
- dehydration
63
S+S electrolyte imbalances in older adults (5)
- weakness
- fatigue
- immobility
- falling
- delirium
64
S+S dehydration older adults (4)
- poor tissue turgor
- increased HR
- decreased bp
- decreased urinary output
65
leukocytosis can be a side effect of what drugs (4)
- allopurinol
- aspirin
- heparin
- steroids
66
where are T cells produced and what do they do
- produced by: thymus
| - purpose: active in cell-mediated immunity
67
where are B cells produced and what do they do
- produced by: bone marrow
| - purpose: production of antibodies
68
in bloodwork what is a "shift to the left"
increased production immature neutrophils (bands)
69
what conditions/situations may cause increase in uric acid (5)
- hypothyroidism
- binge alcohol drinking
- meds (thiazide diuretics)
- surgery
- acute mental illness
70
what lab is measured for men when evaluating for prostate cancer
PSA
71
when do CK-MB levels peak after acute MI
12-24 hours
72
elevated homocysteine levels put pt at higher risk for and are seen in what diseases (5)
- dementia
- atherosclerosis
- strokes
- acute MI
- PVD
73
what factors could cause unreliable lab results when it comes to renal health (4)
- reduced lean body mass
- excessive protein intake
- alterations in metabolism
- strenuous physical activity before measurement
74
term for BUN elevation
azotemia
75
how are BUN and creatinine affected by aging
- higher BUN
| - lower creatinine
76
desired INR range for normal people and desired INR range for pts receiving treatment for afib/flutter
normal: 2-3
| afib/flutter: 2.5-3.5
77
what does urinalysis test for
- pH
- specific gravity
- protein
- glucose
- ketones
- blood
- bilirubin
- nitrates
- leukocytes
78
how is urine specific gravity affected by increasing age
decreases urine specific gravity (because of decreased nephrons)
