chart reading literacy Flashcards
Signs and symptoms of abnormal lab values in acute care.
What values are used for complete blood count?
WBC, platelets, hemoglobin, hematocrit
WBC? Symptoms? Importance?
Too much: fever, malaise, lethargy, dizziness, bleeding, bruising, unintentional weight loss, lympadenopathy, painful inflamed joints. Slightly too little: anemia, weakness, fatigue, fever, headache, SOB.
Way too little: low-grade fever, skin abscesses, sore mouth, pneumonia
Id’s presence of infection, inflammation, allergens.
RBC? Symptoms? Importance?
Symptoms: Test results ordered by doctor can indicate high RBC count. High RBC count can indicate doping.
HCT? Symptoms? Importance?
Too much: fever, headache, dizziness, weakness, fatigue, easy bruising or bleeding-spontaneous blood clotting.
Too little: pale skin, headache, dizziness, cold hands/feet, chest pain, arrhythmia, SOB-cardiac failure, patient may progress slowly in treatment.
Assess blood loss and fluid balance.
Hemoglobin? Symptoms? Importance?
Too much: orthostasis, presyncope, dizziness, arrhythmias, CHF onset/exacerbation, seizure, TIA, angina.-clogging of capillaries.
Too little: decreased endurance, decreased activity tolerance, pallor, tachycardia-heart failure, also monitor SpO2
Assess anemia, blood loss, bone marrow suppression.
Platelets? Symptoms? Importance?
Too much: weakness, headache, dizziness, chest pain
Too little: bruising, risk for bleeding, light activity, fall risk, way too low= no exercise
Critical for blood clotting.
Sodium? Symptoms? Importance?
Too much: irritability, agitation, seizure, coma, hypotension, tachycardia, decreased urinary output.-Impaired cog status, seizure risk
Too little: confusion, lethargy, diminshed reflexes, nausea, vomiting, seizure, orthostatic hypotension. GI impairment, diuretic use.
Primary determinant of extracellular fluid vol.
CPK/CK-MB? Symptoms? Importance?
Creatine Kinase
MB found in cardiac muscle. Sens and spec not as high as troponin, peaks 18-24 hours, returns to normal within 2-3 days.
Troponin? Symptoms? Importance?
Modulation actin/myosin. Most specific for cardiac muscle damage. Rise 4-6 hours post event, peaks 12-24 hours, declines by 72 hours.
Indicates when PT can begin.
BNP? Symptoms? Importance?
B-type natriuretic protein.
Hormone secreted by heart under pressure, sensitive marker of heart failure when elevated >10.
Respiratory Alkalosis?
pH > 7.45, PaCO2, <35 mmHg.
Dizziness, paresthesia, chest pain, confusion, seizure-may experience somnolence and fatigue
aPTT? Symptoms? Importance?
Activated Partial Thromboplastin Time.
Monitors heparin-intrinsic cascade. 24-45 sec is typical, therapeutic dose is double.
Prothrombin? Symptoms? Importance?
Monitors Coumadin.
Monitors extrinsic pathway. 11-15 seconds is normal, therapeutic range is double.
INR? Symptoms? Importance?
Normalization of prothrombin time to a reference value.
2-3 is considered therapeutic. > 3.6 increases risk of bleeding, so assess fall risk.
Glucose? Symptoms? Importance?
Too much: diabetic ketoacidosis, severe fatigue. -decreased tolerance for activity.
Too little: lethargy, irritability, shaking, extremity weakness, loss of consciousness-may not be allowed to do activity until levels increase. Too much insulin.
What is a CPET?
Graded exercise test+ expired gas analysis
Why is a CPET important?
Measure of functional capacity
Ability to perform activities that require sustained aerobic metabolism
What measurements are taken in a CPET?
BP, RPE at each stage
ECG continuously
VO2 max= (HR*SV) *a-vO2 difference, expressed in METs
Indications for CPET
diagnostic: CAD, etc
prognostic: heart failure, criteria for heart transplant
basis for exercise prescription
What are indication to terminate a CPET?
subject request
drop in spb > 10mmHg with increasing work rate
angina, syncope/dizziness, signs of poor perfusion, ventricular dysrhythmias
spb >250, dbp >115
ecg signs of ischemia
