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Hogan NCLEX Review > Ch.46 Common Laboratory Tests > Flashcards

Ch.46 Common Laboratory Tests Flashcards

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1
Q

When do they usually collect specimens in general? NCLEX

A

Usually collected in early morning before intake of food and fluids; if done in fasting state, withhold
food and fluids for 8–12 hours prior to test.

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2
Q

What kind of precautions should be used when collecting a specimen?

A

Collect using standard precautions to protect against exposure to blood or other body fluids; use strict
aseptic technique to protect client from infection.

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3
Q

How should a lab specimen be labeled?

A

. Label specimens with client name, date, exact time of collection, and type of specimen

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4
Q

Why should you avoid shaking blood?

A

Avoid shaking blood specimens to avoid hemolysis and send promptly to lab.

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5
Q

Do you put a 24 hour specimen cup on ice?

A

If indicated.

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6
Q

For a 24 hour urine wat should be done with the first urine?

A

At beginning of collection period, have client void and discard this urine; save all urine for next 24 hours

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7
Q

What precautions do you wear for a 24 hour urine collection?

A

Transfer voided specimen into collection device using standard precautions.

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8
Q

What does a ABG tell us?

A

A. Consist of serum (blood) pH, partial pressure of arterial oxygen (PaO2), partial pressure of carbon dioxide
(PaCO2), bicarbonate (HCO3¯), and base excess

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9
Q

What is the normal pH range?

A

7.35-7.45

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10
Q

What is the normal ABG for oxegen?

A

80–100 mmHg

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11
Q

What is the normal ABG Carbon dioxide?

A

35–45 mmHg

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12
Q

What is the normal Bicarb values?

A

22–26 mEq/L

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13
Q

What is the normal sodium?

A

135–145 mEq/L

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14
Q

What is the normal Potassium?

A

3.5 to 5

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15
Q

What is the normal Chloride?

A

95–105 mEq/

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16
Q

What is the normal venous bicarbonate?

A

23–29 mEq/L

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17
Q

What is the normal calcium?

A

8.5–10.5 mg/dL or 4.5–5.5 mEq/L

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18
Q

What is the normal magnesium?

A

1.6–2.5 mg/dL or 1.5-2.5 mEq/L

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19
Q

What is the normal phosphate?

A

3–4.5 mg/dL

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20
Q

What is glucose?

A

Glucose is an end product of carbohydrate digestion, glycogenolysis, and gluconeogenesis.

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21
Q

What is the job of glucose?

A

Primary fuel source for cellular energy, especially for brain and red blood cell function.

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22
Q

What do we use glucose studies to diagnoses?

A

Used to diagnose diabetes mellitus and hypoglycemia.

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23
Q

How long must a patient fast for a glucose study?

A

Client must fast for 8–12 hours prior to drawing lab sample, with no ingestion of foods, beverages, or
medications (oral antidiabetics or insulin).

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24
Q

What is the normal fasting glucose?

A

70–110 mg/dL

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25
Q

What is the normal random glucose fingerstick?

A

60–110 mg/dL

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26
Q

What is the normal two hour postprandial blood glucose?

A

less than 140 mg/dL

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27
Q

Why do we do a Glucose Tolerance Test?

A

Used as a screening test for clients at risk of DM and as diagnostic aid.

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28
Q

How should glucose levels rise and fall?

A

predictable amounts following ingestion of a specific glucose load

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29
Q

How can you tell if they have Diabetese Mellitus with a Glucose tolerance test?

A

with DM, glucose levels peak at higher levels and fall more slowly than normal

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30
Q

How should the client eat before a glucose tolerance test?
What should you not eat or drink before test?

A

. Eat high-carbohydrate (CHO) diet (200–300 grams daily) for 3 days prior to test (give client list of
high-CHO foods as needed).

Do not drink alcohol or coffee or smoke for 36 hours before test (eliminates alcohol, caffeine, and
nicotine as interfering factors with test results)

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31
Q

How long do you have to fast before a glucose tolerance test?

A

Fast for 10–16 hours before test as instructed by healthcare provider.

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32
Q

What should not be taken before a glucose tolerance test?

What else should dth client not do before the test?

A

Do not take any oral antidiabetic medications or insulin prior to test

Do not exercise vigorously for 8 hours before or after test; sit quietly during test

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33
Q

What is a normal A1C?

A

3.5–6%

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34
Q

What is considered a good A1C?

A

7% or lower

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35
Q

What is considered a poor A1C?

A

8% or higher.

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36
Q

What does Prothrombin and international ratio INR measure?

A

Measures time needed for prothrombin (a vitamin K–dependent glycoprotein produced in liver) to
form a fibrin clot via extrinsic clotting pathway.

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37
Q

What do we usually use PT and INR to assess?
NCLEX

A

. Commonly used to assess effectiveness of oral anticoagulant warfarin or to diagnose disseminated
intravascular coagulopathy (DIC), vitamin K deficiency, or liver dysfunction.

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38
Q

What is the normal PT?

A

. Normal reference ranges for PT may vary slightly by lab but are generally 11–13 seconds. (Plus or minus 2).

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39
Q

What is the normal refernace for warfarin?

A

therapeutic range for warfarin is
1.5–2 times the control value

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40
Q

What makes INR diffrent from PT?

A

INR is similar to PT but standardizes normal values across all lab systems.

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41
Q

What is the therapeutic range for warfarin?

A

Therapeutic range for
warfarin is 2.0–3.0 for standard therapy and 3.0–4.5 for high-dose therapy.

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42
Q

What is the normal baseline ranges for INR?

A

baseline normal reference
range is 0.8–1.2 (U.S. and Canada).

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43
Q

How should you go about drawing a PT?

A

Draw baseline PT before beginning oral anticoagulation and repeat at specified intervals to monitor
progress of therapy; apply pressure to venipuncture site for 3–5 mins.

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44
Q

What does it mean if PT and INR IS LOW?

A

Low values indicate ineffective therapy and
high values indicate risk for bleeding or hemorrhage.

45
Q

What do we need to teach the clients about green leafy vegtables?

A

. Teach client to maintain steady but moderate intake of green leafy vegetables (they are rich in vitamin
K and will decrease PT/INR).

46
Q

What is aPTT?

A

Activated partial thromboplastin time.

47
Q

What does aPTT measure?

A

Measures time needed for recalcified, citrated plasma to clot after adding activated thromboplastin
reagent; reflects intrinsic clotting pathway.

48
Q

What is the main thing we measure with aPTT?

A

Commonly used to assess heparin therapy.

49
Q

What two diseses can elevated aPTT indicate?

A

Elevated in liver disease and DIC.

50
Q

What is the normal aPTT?
NCLEX

A

Normal reference range is 20–35 seconds.

51
Q

What is the normal therpetic range for heparin?
NCLEX

A

therapeutic range for heparin
therapy is 1.5–2.5 times the control in seconds (often 60–80 secs).

52
Q

What should be done before starting heparin?

Emergency Room

A

Draw baseline aPTT before beginning heparin therapy and repeat at specified intervals to monitor
progress of therapy.

53
Q

Where can you not draw lab values from with heparin?

NCLEX

A

Never draw from the bein in same arm that heparin is infsing.

54
Q

What do low levels indicate for heaprin?

A

Low values indicate ineffective therapy.

55
Q

What do high aPTT numbers mean with heparin?

A

High values indicate risk for bleeding or hemorrhage.

56
Q

What does bleeding time tell us?

A

Evaluates overall functioning of platelets in achieving hemostasis.

57
Q

What is the normal bleeding times?

A

Normal adult reference range is 1–3 minutes (Duke method), 3–6 minutes (Ivy method), 180–570
seconds (Canada)

58
Q

How do you conduct a bleeding test?

A

Skin puncture is done to determine time needed for bleeding to stop.

59
Q

Before a bleeding test what should not be given?

A

Ensure that client has not received drugs that interfere with test (aspirin, aspirin-containing products,
anticoagulants) for 3 days prior to test, and apply pressure dressing after procedure if needed.

60
Q

What does a D-dimer tell us?

A

That there is a blood,clot somewhere in the body.

61
Q

What is the normal D-dimer?

A

Normal value is 0.5 mcg/mL FEU (fibrinogen equivalent units) or 0–3 nmol/L.

62
Q

What are the main conditions that causes an elevated D-dimer?

A

Results are prolonged in
conditions such as DIC, deep vein thrombosis, pulmonary embolism, and other arterial or venous thromboses.

63
Q

What are the coagulation studies?

A

PT
INR
D-DIMER
aPTT
Bleeding time

64
Q

What labs are on the coagulation studies?

A

Hematocrit
Hemoglobin
Red blood Cell count,
Plalet count
White blood cell count

65
Q

What is hematocrit?

A

Is the proportion of RBCs to plasma (liquid portion of blood), reported as a percentage.

66
Q

What is a buffy coat?

A

Hematocrit can be falsely elevated when white blood cell (WBC) counts are markedly elevated (referred to as
“buffy coat”).

67
Q

Waht can fasly lower hematocrit?

A

Can be falsely lowered with hemodilution (increased water component of blood)

68
Q

What is the normal reference range for hematocrit?

A

Normal reference range is 40–50% for males and 38–47% for females.

69
Q

What is hemoglobin?

A

Hemoglobin is a major component of erythrocytes that combines loosely with oxygen (O2) and carbon
dioxide (CO2) for transport in circulation

70
Q

What are the main condictions that can cause a abnormal hemoglobin?

A

Abnormal hemoglobinopathies include sickle cell disease and thallasemias; decreased Hgb commonly
indicates anemia.

71
Q

What i sthe normal Hemoglobin?

NCLEX

A

Normal reference range is 13.5–18 grams/dL for males and 12–16 grams/dL for females in U.S.

72
Q

What is the relation between H&H?

A

Normally, Hgb and Hct levels parallel each other; Hct is usually three times higher than Hgb level.

73
Q

What is another name for red blood cells?

A

Erththrocyte.

74
Q

Where are red blood cells formed?

A

RBCs are formed in bone marrow and removed by liver, spleen, and bone marrow.

75
Q

How long do RBC’s live?

A

Lifespan of RBC is approximately 120 days.

76
Q

What is the main job of red blood cells?

A

Carry hemoglobin molecules responsible for O2 transport to tissues.

77
Q

What is the main thing a low hemoglobin indicate?

A

Anemia.

78
Q

What is the normal red blood cell range?

A

Normal reference range: 4.0–5.5 million cells/microliter for adult females and 4.5–6.2 million cells/
microliter for adult males in U.S.

79
Q

How do we further evaluate anemia?

NCLEX

A

Abnormal values indicate anemia or blood dyscrasias; further evaluation of anemia can be done by
evaluating RBC indices (mean corpuscular volume [MCV], mean corpuscular hemoglobin [MCH], and
mean corpuscular hemoglobin concentration [MCHC]).

80
Q

What is the normal range for platlets?

A

Normal reference range: 150,000–450,000 per cubic mm (mm3
) in U.S.

81
Q

Where are platlets made?

A

Bone marrow.

82
Q

How long do platelets live?

A

A lifespan of about 10 days.

83
Q

Wat happens when you get a cut,m what do platlets do?

A

When microtrauma occurs and damages blood vessels, platelets aggregate to form hemostatic plug to
initiate clot formation.

84
Q

What is somthing that can stop pleatlets?

A

Platelet aggregation is inhibited by drugs such as aspirin.

85
Q

What is thrombocytopenia?

A

Decreased platelet levels.

86
Q

What are some diseases that cause thrombocytopenia?

A

cancer chemotherapy from bone marrow
suppression, idiopathic thrombocytopenic purpura (ITP), most leukemias, uremia, and some infections
such as infectious mononucleosis.

87
Q

What does decreased platlets put you at risk for?

NCLEX

A

An insufficient number of platelets leads to increased risk of bleeding; bleeding precautions should be
instituted if platelet count drops below 50,000 cells/mm3
or 50 * 109
/L

88
Q

What is the normal White blood cell count?

NCLEX

A

Normal total WBC reference range: 5000–10,000 cells/mm3
(U.S.).

89
Q

What are neutrophils?

A

Neutrophils defend against inflammation, tissue injury, and infection.

90
Q

What does a shift to the left mean?

NCLEX

A

A “shift to the left” indicates a greater number of neutrophils are immature (bands) because of need
for more rapid production to combat inflammation or infection.

91
Q

What does a shift the the right mean?

A

A “shift to the right” indicates cells with excessive nuclear segments, seen with liver disease, megaloblastic and pernicious anemias, and Down syndrome.

92
Q

What do eosinophils do?

A

Eosinophils increase during allergic and parasitic conditions and decrease with higher levels of steroids.

93
Q

When do basophils increase?

A

Basophils increase during healing process and decrease when steroid levels rise.

94
Q

What is the job of monocytes?

A
  1. Monocytes (“monos”) are second line of defense against bacterial infection and foreign substances;
    these macrophages ingest larger particles and debris from cellular destruction; may also kill tumor
    cells—mechanism unclear
95
Q

What do lymphocytes do?

A

Lymphocytes (“lymphs”) elevate during chronic and viral infections and lymphocytic leukemia; consist
of B lymphocytes and T lymphocytes.

96
Q

What is the normal range for neutrophils?

A

50–70% or 2500–7000 cells/microliter

97
Q

What are the three cardiac function test?

A

Serum Lipids
Creatine Kinase (CK) OR Cpk
Troponins

98
Q

What are the two main lipids?

A

Primary measurements include total cholesterol, low-density lipoproteins (LDLs), high-density
lipoproteins (HDLs), and triglycerides.

99
Q

What does increased serum lipids lead to?

NCLEX

A

Increase risk of heart disease, stroke, and peripheral vascular
disease.

100
Q

What is special about HDL?

A

High HDL levels seem to be cardioprotective.

101
Q

What do elevated triglycerides indicate?

A

Hyperlipidemia
(possibly familial)

102
Q

What should you teach the client before having serum lipids drawn?

NCLEX

A

Teach client to avoid alcohol intake for 24 hours before test and avoid high-cholesterol foods the
evening before blood is drawn.

103
Q

Can they eat before serum lipid panel?

A

Client must fast (except water) for 12–14 hours prior to test.

104
Q

What is the normal total cholesterol?

A

less than 200.

105
Q

What is the normal LDL?

A

Less than 130.

106
Q

What is the desired HDL?

A

60 OR ABOVE.

107
Q

What are the normal triglycerides?

A

less than 200

108
Q

What is Creatine kinase and creatinine phosphokinase?

A

An enzyme found in large amounts in cardiac and skeletal muscle and in low amounts in brain tissue;
enzyme is released from cells upon cell death

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