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Older Adults 2 > Chapter 8 > Flashcards

Chapter 8 Flashcards

0
Q

what can cause alterations in lab values

A
  1. dehydration
  2. inadequate nutrition
  3. infections
  4. inflammation
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1
Q

bone marrow alterations with age

A

hematooietic tissue decreases by around 20%

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2
Q

normal red blood cell range

A

4.2-6.1

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3
Q

normal hemoglobin range

A

12-18

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4
Q
  • main component or rbc

- used as an indicator for anemia

A

hemoglobin

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5
Q

critical hemoglobin value

A

<

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6
Q

hemoglobin value that indicates anemia

A

< 13 in men

< 12 in women

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7
Q

normal hematocrit range

A

37%-52%

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8
Q

percentage of rbc to plasma

A

hematocrit

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9
Q

elevations in hct and hgb usually early sign of…

A

hypovolemia

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10
Q

signs of hypovolemia

A
  1. malnutrition
  2. dehydration
  3. diarrhea
  4. volume depletion
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11
Q

lifespan of white blood cells

A

15-20 days

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12
Q

number of wbc’s is regulated by…

A

endocrine system

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13
Q

types of white blood cells

A
  1. neutrophil
  2. eosinophil
  3. basophil
  4. monocyte
  5. lymphocyte
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14
Q

normal wbc range

A

5000-10000

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15
Q

critical wbc values

A

30,000

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16
Q

neutrophil normal range

A

55%-70%

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17
Q
  • wbc
  • first responder
  • phagocytes
A

neutrophils

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18
Q

increased neutrophils

A

neutrophilia

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19
Q

what can cause neutrophilia

A
  1. meds (corticosteroids)
  2. connective tissue disease
  3. arthritis
  4. malignancies
  5. trauma
  6. gout or uremia
  7. thyrotoxicosis
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20
Q

normal lymphocyte range

A

20%-40%

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21
Q

lymphocyte responsible for cell to cell combat

A

T cells

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22
Q

lymphocyte responsible for antibody production

A

b-cells

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23
Q

lymphocyte changes with age

A

decrease T cells, elevated B cells

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24
Q

normal monocyte range

A

2%-8%

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25
Q
  • migrating wbc’s

- grow up to be macrophages

A

monocytes

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26
Q

normal eosinophils range

A

1%-4%

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27
Q

wbc that work against allergens and parasites

A

eosinophils

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28
Q

eosinophil aging effect

A

decreased mucosal immune response

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29
Q

normal basophils

A

0.6%-1%

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30
Q

transport histamine and histamine

A

basophils

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31
Q

younger adults s/s of infection

A
  1. elevated temp
  2. lymph node enlargement
  3. increase in total wbc count
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32
Q

older adult s/s of infection

A
  1. all may be absent until they are very ill or septic

2. immature neutrophils usually the first indicator of illness

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33
Q

rules for neutropenic pts

A
  1. ppe
  2. visitors ppe
  3. handwashing
  4. equipment hygiene
  5. pt wears mask
  6. no fresh vegetables or fruits
  7. no flowers
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34
Q

leukocytosis range

A

2,500-5,000

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35
Q

neutropenic range

A

below 2,500

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36
Q

normal platelet (thrombocytes) range

A

150,000-400,000

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37
Q

stimulate the clotting cascade

A

platelets (thrombocytes)

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38
Q

platelet related aging changes

A
  1. no change in number

2. increase in clotting factors

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39
Q

platelet count less than 100,000

A

thrombocytopenia

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40
Q

spontaneous hemorrhage may occur when platelet counts are less than…

A

20,000

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41
Q

common diagnostics for hematological testing

A
  1. erythrocyte sedimentation rate (esr)
  2. C-reactive protein (crp)
  3. iron studies
  4. b vitamins
  5. vitamin d
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42
Q

rate at which a rbc settles/falls to the bottom of a saline or plasma solution

A

erythrocyte sedimentation rate (esr)

43
Q

problem with esr

A
  1. very nonspecific

2. can be used to measure status of treatment for inflammatory disorders

44
Q

elevation in esr indicates

A
  1. common in healthy adults with chronic illness
  2. elevated serum proteins
  3. inflammation
45
Q

produced by liver in acute phase of inflammation, surgery, injuries, or infection

A

C-reactive protein (crp)

46
Q

crp test results indicate:

A
  1. evaluation of acute mi

2. risk for cad

47
Q

heart risk of crp at <1

A

low risk

48
Q

heart risk of crp at 1-3

A

average risk

49
Q

heart risk with crp at >3

A

high risk

50
Q

source of iron

A
  • dark, green, leafy vegetables

- red meats

51
Q

what is iron needed for?

A
  • o2 transport

- energy production in the mitochondria

52
Q

normal serum iron range

A

60-170 mcg/dL

53
Q

normal TIBC range

A

250-450 mcg/dL

54
Q

normal transferrin saturation

A

20%-50%

55
Q

b vitamins needed for normal functioning of wbc and rbc and dna synthesis
-stored in liver

A

folic acid

56
Q

b vitamin needed for normal development of rbc, neurologic function, dna synthesis
-need intrinsic factor for absorption

A

b12

57
Q

thrombocytopenia precautions

A
  • bleeding precautions

- fall precautions

58
Q

what can cause low levels of b vitamins

A
  • protein energy malnutrition
  • liver and renal disease
  • alcoholism
59
Q

what can cause decreased vitamin d levels

A
  1. aging skin
  2. decreased uv light exposure
  3. decreased intrinsic factor
60
Q

decreased vitamin d levels =

A

bone resorption

61
Q

electrolytes

A
  1. sodium and chloride
  2. potassium
  3. calcium and phosphorus
  4. glucose
62
Q

sodium and chloride are influenced by:

A
  1. renal filtration
  2. renal blood flow
  3. cardiac output
  4. glomerular filtration rate
63
Q
  • asymptomatic in beginning
  • can cause seizures, coma, and death
  • <135
A

hyponatremia

64
Q
  • > 145
  • most often free water loss and dehydration
  • mental status changes
A

hypernatremia

65
Q

function of potassium

A
  • cell osmolarity
  • muscle function
  • transmission of nerve impulses
  • acid base balance
66
Q

normal potassium range

A

3.5-4.5

67
Q

decrease in lean muscle mass=

A

decreased potassium

68
Q

s/s of hypokalemia

A
  1. generalized muscle weakness
  2. fatigue, muscle cramps
  3. constipation
  4. ileus
  5. flaccid paralysis
  6. hyporeflexia
  7. hypercapnia
  8. tetany
69
Q

ecg changes with hypokalemia

A
  • qt prolonged
  • t wave flattened or depressed
  • st segment depressed
70
Q

s/s of hyperkalemia

A
  1. impaired muscle activity
  2. weakness
  3. muscle pain/cramps
  4. increased gi motilityy
  5. bradycardia
  6. cardiac arrest
71
Q

ecg changes with hyperkalemia

A
  1. p wave flattened
  2. t wave large, peaked
  3. qrs broad
  4. biphasic qrs-t complex
72
Q

diagnostic criteria for diagnosing diabetes

A
  1. one random plasma glucose of 200 when exhibiting symptoms
    or
  2. two of any on or combo of positive tests on different days
    -fasting glucose 126
    -oral glucose tolerance test 200 2 hours after glucose
    -random plasma glucose 200 without symptoms
73
Q

additional diagnostic test for diabetes

A

hgb a1c

74
Q

general cut off for hgb a1c

A

<6.5%

75
Q

normal creatinine kinase (ck) level

A

0-3 ng/mL

76
Q
  • indicator of acute mi
  • also measures myocardial muscle damage, unstable angina, shock, malignant hyperthermia, myocarditis
  • rises in 3-6 hours, peaks in 12-24 hours
A

creatinine kinase (ck)

77
Q

what can cause false elevated ck?

A
  1. anticoagulants
  2. dexamethasone
  3. furosemide
  4. captoril
  5. cholchicine
  6. lovastatin
  7. propanolol
  8. morphine
78
Q
  • gold standard for diagnosing acute mi

- elevated within 6 hours and will stay elevated 7-14 days

A

troponin

79
Q

normal troponin level

A

<0.03 ng/mL

80
Q

normal total protein range

A

6.4-8.3

81
Q

normal serum albumin range

A

3.5-4.8

82
Q
  • measures nutritional status

- most useful as indicator of severity of illness and risk of mortality

A

serum albumin

83
Q

protein is needed for…

A
  1. energy
  2. drug and chemical transportation
  3. maintaining intravascular pressure
84
Q

normal blood urea nitrogen (BUN) range

A

7-21

85
Q

measurement of nitrogen portion of urea; used as gross measurement for renal functioning

A

BUN

86
Q

normal creatinine range

A

0.5-1.4

87
Q

measures breakdown of muscle creatinine phosphate

A

creatinine

88
Q

normal/therapeutic digoxin level

A

0.8-2.0

89
Q

breakthrough seizures can occur with dilantin levels below…

A

10

90
Q

dilantin toxicity

A

above 20

91
Q

most common disturbance seen in older adults

A

hypothyroidism

92
Q

free thyroxine (T4 free) levels

A

0.8-1.5

93
Q

tsh level

A

0.4-4.5

94
Q

t4 total level

A

5.5-12.3

95
Q

t3 level

A

60-181

96
Q

normal specific gravity of urine

A

1005-1030

97
Q

normal pH of urine

A

4.6-8

98
Q

bilirubin level in urine

A

0.2-1.0

99
Q

negative urine studies

A

protein, glucose, ketones, blood, nitrates, leukocytes

100
Q

what to do to fix protein levels

A

colloid followed by diuretic

101
Q

what can raise tsh levels

A

lithium

102
Q

what can lower tsh levels

A

heparin and aspirin

103
Q

what is key to promoting max health for older adults in the long term care setting (cmp, cbc, thyroid)

A

annual lab testing

104
Q

most lab findings and their meanings are the same for…

A

older and younger adults

105
Q

an indicator of cardiac events and inflammation

A

CRP

Older Adults 2 (7 decks)

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