Chapter 4-Lab Values and Drug Monitoring Flashcards
Point of care testing
Provides rapid results at the site of patient care. There are many POC tests, including tests for cardiac enzymes, A1C, INR, and dvarious infections.
Complete Blood Count
Analyzes WBCs, RBCs, and PLTs
Hg and Hct
CBC with differential
the types of neutrophils are analyzed
Basic Metabolic Panel
Includes 7-8 tests that analyze electrolytes, glucose, renal function, and acid/base (with HCO2 or bicarbonate) status. Some labs calculate and report an anion gap along with the BMP.
Comprehensive Metabolic Panel (CMP)
Includes the tests of the BMP plus albumin, ALT, AST, total bilirubin, and total protein.
> ——<
…………..Hgb
WBC>———–<PLT
Hct
—-|——|—–<
Na |Cl |BUN
————————<Glucose
K |HCO3|SCr
Leukocytosis
Increased WBC
Polycythemia
Increased RBC
Thrombocytosis
Increased platelets
Leukopenia
Decreased WBC
Anemia
Decreased RBC or Hgb
Thrombocytopenia
Decreased platelets
Myelosuppression
Decreased WBCs, RBCs, and platelets
Agranulocytosis
Decreased granulocytes (WBCs that have secretory granules in the cytoplasm). Includes decreased neutrophils, basophils, and eosinophils
Drug causes of agranulocytosis
Clozapine, propylthiouracil, methimazole, procainamide, carbamazepine, sulfamethoxazole/trimethoprim, isoniazid
Granulocytes
Neutrophils, basophils, eosinophils
TJC requires that accredited facilities create and follow a protocol to
identify and report critical values to the responsible healthcare provider, who has an established timeframe to manage the result.
Calculate corrected calcium when
albumin is low.
Correction is not needed for ionized calcium
Increased calcium is due to
Calcium supplementation, vitamin D, thiazide diuretics
Decreased calcium is due to
Long-term heparin, loop diuretics, bisphosphonates, cinacalcet, systemic steroids, calcitonin, foscarnet, topiramate
When should you supplement calcium?
Pregnancy, osteoporosis/osteopenia and with certain drugs
Increased Mg is due to
Magnesium-containing antacids and laxatives (higher risk with renal impairment)
Decreased Mg is due to
PPIs, diuretics, amphotericin B, foscarnet, echinocandins, diarrhea, chronic alcohol intake