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maturing family > ch 8 - lab diagnostics and geriatrics > Flashcards

ch 8 - lab diagnostics and geriatrics Flashcards

1
Q

what can elevations in Hct/Hg indicate

A

early sign hypovolemia

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2
Q

what factors may affect hematological testing (4)

A
  • dehydration
  • malnutrition
  • infection
  • inflammation
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3
Q

normal RBC range

A

4.4-5.8

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4
Q

normal Hg range

A

14-18

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5
Q

normal Hct range

A

39-48%

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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
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7
Q

tests for anemia (5)

A
  • CBC w/ differential
  • iron studies
  • reticulocyte count
  • folic acid
  • vit B12
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8
Q

what Hct levels indicate anemia (M and F)

A

M: <41%
F: <36%

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9
Q

normal neutrophil count

A

55-70%

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10
Q

normal eosinophil count

A

1-4%

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11
Q

normal basophil count

A

0.5-1%

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12
Q

what cells make up granulocytes (3)

A
  • neutrophil
  • eosinophil
  • basophil
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13
Q

what cells make up agranulocytes (2)

A
  • monocytes

- lymphocytes

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14
Q

normal monocyte count

A

-2-8%

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15
Q

normal lymphocyte count

A

20-40%

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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
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17
Q

purpose of neutrophils

A

(stimulated by infection)

fight bacteria

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18
Q

purpose of eosinophils

A

(stimulated by allergic response)

fight antigens and parasites

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19
Q

purpose of basophils

A

(stimulated by presence of allergens)

transport histamine

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20
Q

purpose of lymphocytes

A

(stimulated by presence of viral infection)

T cells and B cells

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21
Q

purpose of monocytes

A

defend body against foreign substances

become macrophages

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22
Q

normal WBC

A

5-10k

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23
Q

normal platelet count

A

1.5-4

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24
Q

what changes in coagulation may be seen in older adults

A

hypercoagulability

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25
Q

Indicator of inflammation, infection, necrosis,

infarction, or advanced neoplasm

A

ESR (erythrocyte sedimentation rate)

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26
Q

vitamin: important for normal function of
red blood cells (RBCs) and
white blood cells

A

folate (B9)

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27
Q

what older adults may have folate deficiencies (3)

A
  • significant nutritional deficiencies
  • very frail
  • alcohol abuse
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28
Q

vitamin: important for normal development of RBCs,
neurological function, and DNA
synthesis

A

B12

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29
Q

what puts older adults at risk for vit B12 deficiency

A

age-related decrease in
the production of gastric acid
and intrinsic factor

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30
Q

what puts older adults at risk for vit d deficiency (3)

A
  • lack of UV light
  • skin changes
  • decreased intake vit d/calcium
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31
Q

purpose of electrolytes (4)

A
  • maintain balance between intracellular and extracellular environment
  • regulate hydration
  • regulate blood pH
  • critical for nerve and muscle function
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32
Q

normal Na range

A

135-145

33
Q

normal K range

A

3-5.5

34
Q

normal fasting glucose

A

70-126

35
Q

is hyponatremia or hypernatremia commonly seen in long term care facilities

A

hyponatremia

36
Q

4 causes hyponatremia for older adult

A
  • increased ECF volume
  • impaired water excretion
  • SIADH
  • caused by meds
37
Q

most common cause hypernatremia in older adult

A

impaired thirst

38
Q

S+S hyponatremia (3)

A
  • drop in bp
  • tachycardia
  • mental changes
39
Q

S+S hypernatremia (3)

A
  • poor skin turgor
  • dry mucous membranes
  • mental changes
40
Q

most common causes hypokalemia (2)

A
  • increased renal excretions (due to meds)

- increased GI excretions (diarrhea)

41
Q

most common causes hyperkalemia (3)

A
  • decreased excretion by kidneys
  • acidosis
  • med side effect
42
Q

S+S hypokalemia

A
  • muscle weakness
  • fatigue
  • muscle cramps
  • constipation
  • ileus
  • flaccid paralysis
  • hyporeflexia
  • tetany
  • ECG changes (prolonged QT, flattened T wave, depressed ST)
43
Q

S+S hyperkalemia

A
  • impaired muscle activity
  • weakness
  • muscle pain/cramps
  • increased GI motility
  • bradycardia
  • cardiac arrest
  • ECG changes (flattened P wave, peaked T wave, broad QRS)
44
Q

what HA1C level is considered poor control for diabetic pts

A

> 9%

45
Q

S+S slight hypoglycemia in older adults

A
  • confusion

- depressed CNS activity

46
Q

what test is important in evaluating renal failure and gout

A

uric acid

47
Q

enzyme that is released when there is damage

to heart muscle

A

creatinine kinase

48
Q

biomarkers for cardiac damage

A

troponin I and T

49
Q

4 labs to test for and monitor risk factors and general health concerning cardiac health

A
  • C reactive protein (inflammation)
  • homocysteine (high levels = high risk heart disease/stroke)
  • BNP (>100=HF)
  • lipid panel (cholesterol, triglycerides)
50
Q

protein: Most often used to measure
nutritional status; useful as indicator of
severity of illness and risk of
mortality; measures past 3 weeks

A

serum albumin

51
Q

protein: half life 2-3 days; more informative of current nutritional status

A

prealbumin

52
Q

2 labs measured for renal health

A
  • BUN

- creatinine

53
Q

normal BUN levels

A

10-20

54
Q

Key component in determining GFR; Used to diagnose and monitor renal function

A

creatinine

55
Q

why are causes of frequent abnormalities for urinalysis for older adults (3)

A
  • diabetes
  • renal insufficiency
  • subclinical proteinuria and bacteriuria
56
Q

3 coagulation studies

A

PT
aPTT
INR

57
Q

med used to control HR; have to blood test to observe for peak levels and watch for toxicity

A

digoxin

58
Q

what is included in thyroid panel (3)

A

TSH
T3
T4

59
Q

most common types anemia in older adults (4)

A
  • iron deficiency
  • vit b12 deficiency
  • result of renal insufficiency
  • w/ chronic inflammation
60
Q

how is production of T and B cells (lymphocytes) affected in older adults

A
  • slight decrease T cells

- slight increase B cells

61
Q

what meds could cause leukopenia in older adults (6)

A
  • antibiotics
  • anticonvulsants
  • antihistamines
  • analgesics
  • sulfonamides
  • diuretics
62
Q

most common causes electrolyte imbalances in older adult (3)

A
  • over diuresis
  • med interactions
  • dehydration
63
Q

S+S electrolyte imbalances in older adults (5)

A
  • weakness
  • fatigue
  • immobility
  • falling
  • delirium
64
Q

S+S dehydration older adults (4)

A
  • poor tissue turgor
  • increased HR
  • decreased bp
  • decreased urinary output
65
Q

leukocytosis can be a side effect of what drugs (4)

A
  • allopurinol
  • aspirin
  • heparin
  • steroids
66
Q

where are T cells produced and what do they do

A
  • produced by: thymus

- purpose: active in cell-mediated immunity

67
Q

where are B cells produced and what do they do

A
  • produced by: bone marrow

- purpose: production of antibodies

68
Q

in bloodwork what is a “shift to the left”

A

increased production immature neutrophils (bands)

69
Q

what conditions/situations may cause increase in uric acid (5)

A
  • hypothyroidism
  • binge alcohol drinking
  • meds (thiazide diuretics)
  • surgery
  • acute mental illness
70
Q

what lab is measured for men when evaluating for prostate cancer

A

PSA

71
Q

when do CK-MB levels peak after acute MI

A

12-24 hours

72
Q

elevated homocysteine levels put pt at higher risk for and are seen in what diseases (5)

A
  • dementia
  • atherosclerosis
  • strokes
  • acute MI
  • PVD
73
Q

what factors could cause unreliable lab results when it comes to renal health (4)

A
  • reduced lean body mass
  • excessive protein intake
  • alterations in metabolism
  • strenuous physical activity before measurement
74
Q

term for BUN elevation

A

azotemia

75
Q

how are BUN and creatinine affected by aging

A
  • higher BUN

- lower creatinine

76
Q

desired INR range for normal people and desired INR range for pts receiving treatment for afib/flutter

A

normal: 2-3

afib/flutter: 2.5-3.5

77
Q

what does urinalysis test for

A
  • pH
  • specific gravity
  • protein
  • glucose
  • ketones
  • blood
  • bilirubin
  • nitrates
  • leukocytes
78
Q

how is urine specific gravity affected by increasing age

A

decreases urine specific gravity (because of decreased nephrons)

maturing family (36 decks)

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