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Gerontological RN exam > Chapter 12. Assessment Of Laboratory Values > Flashcards

Chapter 12. Assessment Of Laboratory Values Flashcards

0
Q

What is a normal hemoglobin level?

A

12.5 to 17 g/100ml

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1
Q

What does a complete blood count or CBC consist of?

A

Consists of the red blood cells, white blood cells and platelets.

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2
Q

What is a normal hematocrit?

A

40.5% to 52.5%

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3
Q

What is a normal white blood cell count?

A

5.1 to 10.8 Thousand

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4
Q

What is a normal total iron binding lab value?

A

250 to 450 mg/100 mL

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5
Q

What is a normal prothrombin time?

A

10.9 to 13.4 seconds

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6
Q

What is a normal therapeutic value of an INR?

A

2-3

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7
Q

What is a normal sodium level?

A

136 to 145 mEq/L

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8
Q

What is normal potassium level?

A

3.5 to 5.1mEq/L

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9
Q

What is a normal calcium level?

A

98-207 mEq/dL

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10
Q

What is a normal fasting glucose?

A

70-120 mg/dL

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11
Q

What is a normal albumin level?

A

3.5 to 5.5 g/100mL

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12
Q

What is a normal blood urea nitrogen, BUN?

A

7-22mg/100mL

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13
Q

What is a normal creatinine?

A

0.5-1.2 mg/100mL

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14
Q

What is a normal B12 level?

A

200 to 800pg/mL

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15
Q

What is a normal total cholesterol?

A

120- 200 mg/100mL

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16
Q

What is a normal high density lipoprotein or HDL?

A

> 45/100mL = Low risk

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17
Q

What is a normal low-density lipoprotein or LDL?

A

60-180 mg/100mL

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18
Q

What is a normal SGOT?

A

14-59 IU/L, Varies for men and women

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19
Q

High red blood cell value suggests a low oxygen state. Excess numbers of RBCs can result in what?

A

Polycythemia and can be seen in chronic obstructive pulmonary disease, living in high altitudes, or common hematological problems.

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20
Q

The percentage of whole blood that is made up of RBCs is known as what?

A

Hematocrit

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21
Q

The three types of white blood cells that are produced in the bone marrow and have granules in the nuclei. often referred to as granulocytes. These specialized cells are involved in phagocytosis.

A

Neutrophils, eosinophils, and basophils.

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22
Q

This granulocyte contains histamine, Bradkinin and serotonin, which are important in the normal inflammatory response.

A

Basophil

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23
Q

The function of this white blood cell which is also produced in the marrow, is to destroy large bacteria and viral infected cells.

A

Monocyte

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24
Q

The smallest of the white blood cells, are divided into two types B and T. They are made in the bone marrow and Thymus. They are stored in the lymph nodes, spleen, and tonsils. These cells produce in immunity by manufacturing the human antibody and other specialized immune mediators. They become less active with aging.

A

Lymphocytes

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25
Q

A decrease in white blood cells is known as?

A

Leukopenia

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26
Q

Certain classes of medications can cause a decrease in white blood cells. Name at least five drug classes?

A

Antibiotics, anticonvulsants, antihistamines, antimetabolites, cytotoxic’s, analgesics, phenothiazine’s, and diuretics.

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27
Q

Platelets, the small cells essential for clotting are produced in the bone marrow, lungs, and spleen. A platelet count of less than 100,000 per cubic millimeter of blood is called?

A

Thrombocytopenia

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28
Q

This is a plasma protein that is converted to thrombin in the first step of the clotting cascade. It measures how effectively the vitamin K dependent factors of the extrinsic and common paths of the clotting cascade are working.

A

Prothrombin time

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29
Q

Prothrombin time will be elevated in? (4)

A

Liver disease, vitamin K deficiency, bile duct obstruction, and use of warfarin.

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30
Q

This test indicates inflammation and is used to monitor the course of conditions such as rheumatoid arthritis, Temporel arteritis, and polymyalgia Rheumatic. It is the rate at which RBCs fall through plasma.

A

Erythrocyte sedimentation rate or ESR.

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31
Q

An ion caring a positive charge is called a?

A

Cation

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32
Q

An ion carrying a negative charge is known as a ?

A

Anion

33
Q

The most serious and electrolyte disturbance seen in geriatric care is?

A

Dehydration

34
Q

Sodium is important in maintaining what?

A

Normal blood pressure, transmitting nerve impulses, and regulating intracellular fluids.

35
Q

Hypernatremia can be the result of what?

A

Infusion of high sodium fluids, dehydration, excess water loss, diarrhea, or laxative abuse.

36
Q

Potassium is important in?

A

Cell osmolarity, muscle function, transmission of nerve impulses, and regulation of acid-base balance. The cardiac muscle is especially sensitive to imbalances in this electrolyte.

37
Q

Hyperkalemia could be caused by?

A

Salt substitutes, potassium sparing diuretics, excess use potassium supplements, taking anti- hypertensives Such as ACEI’s or ARBs Or use of nonsteroidal anti-inflammatory drugs.

38
Q

Hypokalemia can because by?

A

Vomiting or use of diuretics.

Hypokalemia may predispose older individuals to tachyarrhythmias or potentiate digitalis toxicity.

39
Q

Abnormalities in chloride are closely associated with what electrolyte?

A

Sodium

40
Q

This cation is important in blood clotting, conduction of nerve impulses, enzyme activity, and muscle contraction and relaxation.

A

Calcium

41
Q

Calcium is inversely related to what?

A

Phosphorus

42
Q

This hormone is an integral part of the relationship between calcium and phosphorus and influences the reabsorption of both to keep the levels in harmony.

A

Parathyroid hormone

43
Q

Low levels of calcium are most commonly seen in?

A

Renal disease

44
Q

Elevated levels of calcium signal?

A

Excess bone degradation, cancers with bony metastasis, prolonged immobility, or paget’s disease.

45
Q

The role of the anion phosphorus is?

A

Maintenance of homeostasis, Metabolism of fats, carbohydrates, and proteins, and transfer of the storage form of energy ATP

46
Q

Elevated levels of phosphorus are commonly seen in?

A

Renal disease

47
Q

Magnesium is important in the function of?

A

Muscles and nerves

48
Q

Total protein measures what?

A

The amount of albumin & globulin within the body

49
Q

The ratio of albumin to globulin is?

A

60% albumin and 40% globulin

50
Q

What is the importance of globulin?

A

It is important in antibody formation and maintenance of osmotic pressure

51
Q

Albumin is a measure of?

A

It is a measure of nutritional status. Albumin is important for wound healing. Low levels are associated with prolonged hospital stays, nonhealing wounds, and increased mortality.

52
Q

BUN is a measure of?

A

The amount of urea in the blood. Urea is the major remanent of protein metabolism, it is the result of ammonia conversion in the liver and this is excreted by the renal system.

53
Q

Abnormal BUN levels can be indicative of ?

A

Either liver or renal disease. In older adults elevated BUN usually indicates renal insufficiency or dehydration.

54
Q

Creatinine clearance is important for what?

A

It is important and drug dose calculations for older adults. In this population a creatinine clearance of 55 mL a minute or more is desirable.

55
Q

Alkaline phosphatase is an enzyme present in many tissues, especially the liver and bones. measuring this enzyme helps identify what?

A

Bone and liver abnormalities

56
Q

An ALT level is a direct reflection of?

A

The hepatocyte, This is a marker for liver disease.

57
Q

The AST is less specific for liver disease but it can be helpful and monitoring for what?

A

Drug toxicity

58
Q

Elevated GGT, Gamma glutamyl transpeptidase, Is seen in patients with what?

A

Patients who are taking barbiturates and Dilantin or who drink large amounts of alcohol.

59
Q

Folic acid is a vitamin needed for normal functioning of what?

A

Red blood cells and white blood cells

60
Q

What conditions can lower folic acid levels?

A

Protein calorie malnutrition, macrocytic anemia, liver disease, or renal disease. Alcohol and certain drugs such as methotrexate and drugs used to treat malaria will decrease folic acid levels.

61
Q

Low vitamin B12 can lead to?

A

Degeneration of the posterior columns in the spinal cord, leading to profound peripheral neuropathy. It can also cause mental status changes, fatigue and macrocytic anemia.

62
Q

Elevated Uric acid levels are found in?

A

Persons with renal insufficiency or gout.

63
Q

Amylase is important in the breakdown of what?

A

Carbohydrates

64
Q

Elevated amylase and patient’s symptoms of nausea vomiting and abdominal pain usually indicate what?

A

Pancreatitis

65
Q

Lipase is an enzyme used to break down what?

A

Fats, so that it can be absorbed in the intestines. Most older people produce enough lipase, but people with cystic fibrosis, Crohn’s disease, and celiac disease may be lipase deficient.

66
Q

This neurohormone is secreted from the ventricles of the heart when they are overstretched by too much circulatory volume.

A

Brain naturetic Peptide BNP

67
Q

This is a measure of cardiac myofibrillar proteins into the blood. These levels are specific for cardiac muscle death And they appear 2 to eight hours after an episode of cardiac hypoxia, usually caused by vessel occlusion.

A

Troponin. Troponin may remain elevated for 5 to 7 days following a myocardial infarction.

68
Q

This enzyme is present in various parts of the body and is used as a marker inflammation. There are three isoenzymes of This and each reflects specific areas of inflammation.

A

Creatinine Kinase.

Ck-mb: Found in the heart. These levels rise after an MI and generally normalize within 24 hours.

69
Q

Pre-albumin is used to measure nutritional status of adults over a short period of time. it is helpful for judging the response of what?

A

Patients nutritional therapy

70
Q

HDL cholesterol is referred to as?

A

The good cholesterol.

71
Q

LDL-cholesterol is referred to as?

A

Known as the bad cholesterol since their level correlates with cardiovascular risk.

72
Q

This is manufactured in the end carrier pituitary and stimulates the gland to produce and release T3 and T4.

A

Thyroid stimulating hormone or TSH.

73
Q

Low serum free T4 levels and high TSH levels signify what?

A

Hypothyroidism. This is the most common thyroid abnormality seen in older adults.

74
Q

When the TSH is low and the free T4 is high what state is the patient in?

A

Hyperthyroidism

75
Q

If a urine test finds proteins present what does this indicate?

A

The presence of proteins indicates some sort of disruption in the kidneys basement membrane. This warrants a workup for uncontrolled blood pressure or diabetes, infection, or intrinsic renal disease.

76
Q

Urine bacteria are present in the urine in small amounts in healthy adults if the bacterium count is greater then what? This indicates infection.

A

105 Colony forming units or CFU’s per milliliter of urine

77
Q

The usual signs and symptoms of urinary tract infections may not be present in older adults and instead may present as?

A

Confusion, lethargy, nocturia, or new onset of incontinence.

78
Q

Urine ketones are never seen a normal healthy adults. They are sign of fatty acid breakdown. Urine ketones can be seen when the patient is what?

A

Ingesting a high-protein diet, is fasting or starving question or has ingested isopropyl alcohol.

79
Q

Hematuria can indicate the following:

A 
Kidney stones
Kidney trauma
Inflammation
Infection
Malignancy

Gerontological RN exam (15 decks)

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