Course 5: ED Course COPY Flashcards
CBC
Complete Blood Count
WBC
White Blood Cells
High WBC [term]
Leukocytosis
Significance: High WBC
Infection
Hgb
Hemoglobin
Hct
Hematocrit
Plt
Platelets
Significance: Low Hgb
Anemia
Significance: Low Hct
Anemia
Significance: Low Plt
Prone to bleeding
Low Platelets [Medical Term]
Thrombocytopenia
CBC with DIFF
Complete Blood Count with Differential
Bands
Band Cells
Segs
Segmented Neutrophils
Lymphs
Lymphocytes
Monos
Monocytes
Eos
Eosinophils
Eosinophils are a type of disease-fighting white blood cell. This condition most often indicates a parasitic infection, an allergic reaction or cancer. You can have high levels of eosinophils in your blood (blood eosinophilia) or in tissues at the site of an infection or inflammation (tissue eosinophilia).
High Band Cells [term]
Bandemia
High Segmented Neutrophils
Left Shift—»acute infection
Significance: High Bands
Serious infection (possibly sepsis)
Significance: High Segs
Acute infection
neuter cute puppy, you get acute infection
Significance: High Lymphs
Viral infection
Significance: High Monos
Bacterial infection
Significance: High Eos
Parasitic infection
BMP
Basic Metabolic Panel
Na
Sodium
K
Potasium
BUN
Blood Urea Nitrogen
Creat
Creatine
Gluc
Glucose
HCO3-
Bicarbonate
Cl-
Chloride
Chem-7
Basic Metabolic Panel
High Sodium [term]
Hypernatremia
High Potassium [term]
Hyperkalemia
High Glucose [term]
Hyperglycemia
High Bicarbonate [term]
Hypercarbia
High Chloride [term]
Hyperchloremia
Low Sodium [term]
Hyponatremia
NA
Low Potassium [term]
Hypokalemia
Low Glucose [term]
Hypoglycemia
Low Bicarbonate [term]
Hypocarbia
Significance: High Na
Dehydration
Significance: Low Na
Dehydration
Significance: High K
Poor kidney function
special K bad for kids
Significance: Low K
May cause arrhythmias
kale/spinach leaf–>heart
Significance: High BUN
Renal insufficiency or failure
butts too high in grass hard to pee, must squat low
Significance: High Creat
Renal insufficiency or failure
Significance: High Gluc
High blood sugar
Significance: Low Gluc
Low blood sugar
Significance: High HCO3-
Possible respiratory disease
Significance: Low HCO3-
Hyperventilation (Possible DKA)
Significance: High Cl-
Possible dehydration
CHLORIDE- CHLORINE, DONT DRINK WATER IF CHLORINE
CMP
Comprehensive Metabolic Panel
T Prot/Alb [term]
Total Protein/Albumin
T bili
Total bilirubin
AST (SGOT) [term]
Aspartate Transaminase
LFT (liver function test) —» “wALT, wALKs, fAST”
ALT (SGPT) [term]
Alanine Transaminase
LFT (liver function test) —» “wALT, wALKs, fAST”
Alk Phos [term]
Alkaline Phosphatase
LFT (liver function test) —» “wALT, wALKs, fAST”
LFT
Liver Function Test
3 parts of LFT
AST, ALT, Alk Phos
Chem-12
Comprehensive Metabolic Panel
Significance: Low T Prot/Alb
Poor nutrition
loww protien, poor nutrition
Significance: High T bili
Jaundice/Liver failure
Significance: High AST
Liver damage
Significance: High ALT
Liver damage
Significance: High Alk Phos
Liver damage
CEP
Cardiac Enzyme Panel
Trop
Troponin
CK
Creatine Kinase
calvin klien, waers it because no mucke
creatine, muscle damage
CK-MB
Creatine Kinase-Muscle Breakdown
CK-RI
Creatine Kinase Relative Index
Myo
Myoglobin
Significance: High Trop
Specific to heart damage
Significance: High CK
Heart damage or Rhabdomyolysis
Significance: High CK-MB
Heart damage
Significance: High CK-RI
Heart damage
Significance: High Myo
Heart damage
Significance: Negative D-Dimer
No PE
Significance: High D-Dimer
Must rule out PE
Tests to rule out PE
CTA Chest or VQ Scan
BNP
B-type Natriuretic Peptide
ABG
Arterial Blood Gas
VBG
Venous Blood Gas
Significance: High BNP
Congestive Heart Failure (CHF)
Significance: Low pH ABG
Acidosis
Significance: High/Low HCO3 ABG
Metabolic problem
Significance: High/Low pCO2 ABG
Respiratory problems
Significance: Low pO2 ABG
Hypoxia
Significance: Low pH VBG
Acidosis
Significance: Low pH VBG
Alkalosis
Set of orders for almost every adult pt with CP
CBC, BMP, CK (or CK-MB), Troponin, EKG, CXR
Significance: Low CSF Gluc
Possible bacterial meningitis
Significance: High CSF Prot
Possible Meningitis
Significance: >0 CSF RBC in Tube 4
Subarachnoid Hemorrhage
Significance: >3 CSF WBC in Tube 4
Possible Meningitis
Significance: Positive CSF Gram Stain
Likely bacterial meningitis
tubes obtained for LP
4
3 types of coagulation studies
PT, INR, PTT
Significance: High PT
Blood is too thin
(prothrombin time)
Significance: >3.0 INR
- Too much Coumadin
- (Supratherapeutic)
Significance: High PTT
Blood is too thin
Partial Thromboplastin Time
4 ENT Labs
Strep, Monospot, Influenza A+B, RSV
monospot-tests infection
RSV-respiratory syncical virus
Significance: Positive RSV
Likely Bronchiolitis
Respiratory Syncytial Virus
2 Pancreatic Enzymes
Lipase, Amylase
Significance: High Lip
Specific to pancreatitis
Lab type: TSH, T3, T4
Thyroid lab
Significance: High TSH
Possible Hypothyroidism
Significance: Low TSH
Possible Hyperthyroidism
Thyroid Stimulating Hormone
Significance: Low T3/T4
Hypothyroidism
CRP
C-Reactive Protein
ESR (or Sed Rate)
Erythrocyte Sedimentation Rate
Significance: High CRP
Active inflammation in the body
C-Reactive Protein
Significance: High ESR or Sed Rate
Active inflammation in the body
Significance: Positive hCG
Pregnant
Significance: Positive Serum HCG Qual
Pregnant
Significance: Higher Serum HCG Quant
Further along in pregnancy
Significance: Rh-Negative T+S/ABORh
Needs RhoGAM shot if pregnant
Significance: T+X
Possible blood transfusion
Type of Pelvic Exam Lab reported same day and documented by scribe
Wet Prep
Lab tests for BV, Trich (STD), and Vaginal Yest Infection
Wet Prep
BV
Bacterial Vaginosis
Significance: Positive GC/CT
STD (Gonorrhea or Chlamydia)
Qualitative UA (urinalysis)
Urine Dip
Glucose in urine [term]
Glycosuria
Blood in urine
Hematuria
Blo
Blood
Nit
Nitrite
Significance: Positive Urine Dip Leuks
Likely UTI
Significance: Positive Urine Dip Nit
UTI
Significance: Positive Urine Dip Gluc
High blood sugar (DM)
Significance: Positive Urine Dip Blo
Kidney stone
Kidney stone, kidney bleeds, you bleed
4 components of Urinalysis
WBC, RBC, Bact, Epi (Epithelial Cells)
POC
Point of Care
High RBC in urine
Hematuria
High WBC in urine
Pyruia
Significance: Many Epi in Micro UA
Contaminated Sample
3 components of Sepsis Lab
CBC, Lactate, Blood Cx
Significance: High Lactate
Specific to sepsis (cell death in the body)
3 characteristics of pts in sepsis
Febrile, Tachycardic, Hypotensive
sick with fever, fast heart rate, low blood pressure
dizzy warm and beating
Anticipate physician ordering 3 tests to rule out DDx for Sepsis
CXR, UA, LP
Sepsis: helps r/o PNA
CXR
Sepsis: helps r/o UTI
UA
Sepsis: helps r/o meningitis
LP
Ordered to diagnose type of sepsis
BC (Blood Cultures)
Cx
Cultures
Make sure to document for cultures
“____ cultures ordered, results pending.”
3 Toxicology labs taken from serum
- ASA (aspirin),
- APAP (acetaminophin),
- EtOH
UTox
Urine Drug Screen
APAP
Acetaminophen (Tylenol)
2 diabetes labs
Ketones, Accu-Check
Medication for AFIB
Digoxin
either use electricity or make the oxin dig
3 Key Labs for Efficiency
D-Dimer, Troponin, Creatinine (from BMP)
Significance: D-Dimer for efficiency
Must order CTA Chest or VQ Scan
Significance: Troponin for efficiency
Acute MI: give ASA, NTG, b-blocker, Heparin
Significance: Creatinine for efficiency
Assess kidney function prior to ordering CT with IV contrast
CBC w/ Diff used to access
Infection (WBC) or anemia (H&H)
BMP used to access
Electrolytes (Na + K), Renal function (BUN + Creat), Glucose
CMP used to access
BMP + LFT’s (liver function)
Trop used to access
Acute MI (if high)
uDip + UA used to access
UTI or blood (possible kidney stone)
BNP used to access
Acute CHF (if high)
Coags (PT/INR/PTT) used to assess
Risk for bleeding (if high)
ABG used to access
Respiratory function (hypoxia)
D-Dimer used to access
Possible blood clot (if high, need Creat for CTA Chest)
CXR Potential Dx (5)
PNA, PTX, Widened Mediastinum (Dissection), Pleural Effusion, CHF
AAS/KUB
Acute Abdominal Series/Kidneys Ureters Bladder
AAS Potential Dx (4)
Free air (Rupture), SBO, Constipation, Large kidney stones
Non-Chest/Abd XR Potential Dx (3)
Fx, Dislocation, Joint effusion
fracture, dislocation, joint effusion—>rib cage
“Dry CT” or CT w/o
CT without IV contrast
CTA
CT Angiogram (or CT w/ IV contrast)
CT A/P w/ PO
CT Abd/Pelvis with PO contrast
CT Head Potential Dx (2)
Large Hemorrhagic CVA, Large Ischemic CVA
CT C/T/L-Spine Potential Dx (2)
Spine Fx, Spine Subluxation
Subluxation
Partial dislocation
CT Chest Potential Dx (4)
PNA, PTX, Pleural effusion, Rib Fx
CT Abd/Pel Potential Dx (2)
Kidney Stones, Pyelonephritis
CTA Chest Potential Dx (2)
PE, Aortic Dissection
CTA Head Potential Dx (2)
Hemorrhagic CVA, Ischemic CVA
CTA Neck Potential Dx (2)
- Carotid dissection: tear of the inner layer of the wall of an artery. The tear lets blood get in between the layers of the wall and separate them.
- Carotid occlusion: blockage of the artery
CT A/P w/ PO Potential Dx (4)
Appendicitis, SBO, Diverticulitis, Ischemic Gut
Diver-An inflammation or infection in one or more small pouches in the digestive tract.
UTZ
Ultrasounds
Type of imaging study used for reproductive organs
US
Type of imaging study that does not require specialized radiologist
XR
Associated Procedure: Joint Injury
Splint Application
Associated Procedure: Laceration
Laceration Repair
Associated Procedure: Abscess
Incision & Drainage
Associated Procedure: Joint effusion
Arthrocentesis/joint aspiration
Arthrocentesis is the clinical procedure of using a syringe to collect synovial fluid from a joint capsule
Associated Procedure: Dislocation
Joint Reduction
Associated Procedure: Headache, Fever
Lumbar Puncture
Associated Procedure: Joint reduction
Procedural Sedation
critical care procedure
Associated Procedure: Respiratory failure
Intubation
Associated Procedure: Sepsis
Central Line Placement
Associated Procedure: PTX
Chest Tube
Associated Procedure: Abnormal Heart Rhythm
Cardioversion
Associated Procedure: Cardiac Arrest
CPR
Associated Procedure: COPD/CHF Exacerbation
- CPAP/BiPAP
- critical care procedure
Associated Procedure: Ear complaints
Cerumen Disimpaction
Associated Procedure: Constipation or fecal impaction
Rectal Disimpaction
Associated Procedure: Subungual hematoma
Nail Trephination
Associated Procedure: Nosebleed
Epistaxis Management (cautery vs. packing)
NSR
Normal Sinus Rhythm
SB
Sinus Bradycardia
ST
Sinus Tachycardia
A fib
Atrial Fibrillation
A flutter
Atrial Flutter
Paced
Pacemaker is functioning
SVT
Supraventricular Tachycardia
PVC
Premature Ventricular Contraction
PAC
Premature Atrial Contraction
LAD
Left Atrial Deviation
RAD
Right Axis Deviation
LAFB
Left Anterior Fascicular Block
LBBB
Left Bundle Branch Block
RBBB
Right Bundle Branch Block
1° AVB
First Degree AV Block
LVH
Left Ventricular Hypertrophy
PRWP
Poor R Wave Progression
ST ↑
Acute ST Elevation
ST ↓
Acute ST Depression
NSSTΔ’s
Non-Specific ST/T changes
“Normal EKG at 80”
NSR at a rate of 80 bpm, no acute ST/T changes
“Sinus at 72”
NSR at a rate of 72 bpm
“Sinus at 114”
Sinus tachycardia at a rate of 114 bpm
“Sinus at 56”
Sinus bradycardia at a rate of 56 bpm
“Sinus Brady”
Sinus bradycardia
“Sinus Tachy”
Sinus tachycardia
“Left bundle”
LBBB
“Right bundle”
RBBB
“Left axis”
LAD
“Nothing acute”
No acute ST/T changes
“Non specific changes”
Non-specific ST/T changes
“Lead one, lead two”
Lead I, Lead II
“V one, V two”
V1, V2
Ask physician 2 questions for any seriously ill pt
Does this patient qualify for critical care? How many minutes of Critical Care Time were provided?
Blood taken from an artery
Arterial Blood Gas
The clear liquid separated from clotted blood
Serum
The change of blood from liquid to solid
Coagulation
Medication that suppresses the central nervous system that results in unconsciousness and lack of sensation
Anesthesia
POC
Point of Care
The propagation of microorganisms or of living tissue cells in media conductive to their growth
Cultures
Care provided to any patient that is at serious risk for deterioration that may lead to permanent bodily harm or death
Critical Care Time
What lab order contains the “H&H”?
CBC-Complete Blood Count
What is the difference between BMP and CMP?
BMP-basic metabolic panel; contains electrolytes, kidney function and glucose levels CMP-comprehensive metabolic panel; BMP in addition to e LFTs
What part of the CBC does a “differential” further characterize, RBC or WBC?
WBC
What does creatinine measure?
Renal function
What is high potassium level called?
Hyperalkalemia
What organ do LFTs investigate?
Liver
How would you document Aspartate Transaminase?
AST
Which cardiac enzyme is more specific to heart damage, troponin or CK-MB?
Troponin
What does a negative D-Dimer mean?
No evidence of a PE
What does a positive D-Dimer mean?
Possible PE, must order a CTA chest or VQ scan
What does an elevated BNP diagnose?
Congestive Heart Failure
Dies the blood sample for an ABG come from a vein or an artery?
Artery
Name the parts of the cardiac order set (5)
- CBC 2. BMP 3. Troponin 4. EKG 5. CXR
What procedure must first be performed before CSF Cana be obtained?
Lumbar puncture
What do “Coag” lab tests examine?
Blood coagulation/ Coumadin levels
Name the 3 “Coag” level tests
-PT -PTT -INR
What does lipase diagnose?
Pancreatitis
What do both CRP and ESR test for?
Inflammation CRP=C-Reactive Protein ESR=Erythrocyte Sedimentation Rate
Will cultures ever result during an ED visit?
No
What is the difference between a Urine Dip and a Urine Micro?
Urine Dip: done bedside and detects leuks, nitrites, glucose, blood
Urine Nitro: in last and detects WBC, RBC and bacteria
Name the 3 labs important to track for efficiency
1) Troponin 2) Creatinine 3) D-Dimer
What type of body structure are XR’s best suited to examine?
Bones
What is the difference between CTA and CT?
CTA= CT angiogram looks at the arteries using IV contrast CT=no IV contrast but may or may not use PO contrast
What does an US of the RUQ rule out or diagnose?
Cholelithiasis, cholecystitis, gallbladder wall thickening, bile sludge, bile duct obstruction
Name one type of ortho procedure that may be performed by EP
-splinting -joint reduction -arthrocentesis
What does I&D stand for?
Incision & Drainage
Name 2 procedures that qualify patient for critical care time
- cardioversion —» Abnormal Heart Rhythm
- Central line placement —» sepsis
- Endotracheal intubation —» Resp. failure
- Chest tube placement —» PTX
- CPR —» cardiac arrest
- CPAP/BiPAP —» COPD/CHF
- Lumbar puncture —» fever, headache
- Procedural Sedation —» joint reduction
What does LAD stand for as an EKG abbreviation?
Left Axis Deviation
Name 2 diagnoses that would qualify a patient for critical care time?
-AFIB with RVR -CVA -MI -Sepsis -DKA -CPR -Severe hypotension/hypertension -Severe anemia -PTX -PE -OD
When might an ER doctor obtain a Physician Consult?
Regarding admission, advice over treatment plan, inform primary physician of results, etc.
