Crozer- lab

Question 1

whats in a cbc

Answer 1

wbc, hemoglobin, hematocrit, platelets

Question 2

normal wbc

Answer 2

4.8-10.8 k/uL

Question 3

normal hemoglobin

Answer 3

male 14-18 g/dL

female 12-16 g/dL

Question 4

normal hematocrit

Answer 4

male 42-52

female 37-47

Question 5

normal platelets

Answer 5

145-400 k/uL

Question 6

w infection, whats expected to happen to WBC count

Answer 6

Eventually it should go down, but in post-op days 1-2, the WBC may actually increase a bit.This is may occur because surgery activates the body’s reaction to the infection.

Question 7

what should be done if WBC over 10?

Answer 7

If there is an infection, then antibiotics and possible incision and drainage (I&D) shoulddecrease the WBC count
If there is not an infection, then the cause must be determined. Is the increase acute orchronic? Is there another source of infection (other than the foot)? Is the patient on corticosteroids? Is there a combination of medical conditions causing this?

Question 8

what to do if platelets are low (under 150)

Answer 8

can transfuse platelets but this is not commonly done

Question 9

what are minimum levels for hemoglobin and hematocrit for elective surgery?

Answer 9

hemoglobin 10 gm/dL and Hct 30%

Question 10

what should be done if hemoglobin/hematocrit is below 10/30?

whats this condition called?

Answer 10

transfuse 1-2 units of packed RBC

anemia

Question 11

what are causes of microcytic hypochromic anemia

Answer 11

iron def, thalassemia, lead poisoning

Question 12

what are causes of macrocytic, megaloblaastic anemia

Answer 12

vit B12/folate deficency

Question 13

following a transfusion of PRBC when will changes in H/H be seen?

Answer 13

3 hours, new labs drawn 4 hrs after last unit given

Question 14

whats BPM

Answer 14

Na, K, Cl, CO2, BUN, creatinine, glucose

Question 15

whats CMP

Answer 15

BMP with alkaline phosphatase, ALT, AST, bilirubin, albumin, total protein, and calcium

Question 16

normal Na

Answer 16

134-145mmol/L

Question 17

normal K

Answer 17

3.5-5.1mmol/L

Question 18

normal Cl

Answer 18

96-106 mmol/L

Question 19

Normal CO2

Answer 19

24-32mmol/L

Question 20

Normal BUN

Answer 20

10-20 mg/dL

Question 21

normal creatinine

Answer 21

0.7-1.3 mg/dL

Question 22

normal glucose

Answer 22

70-110 mg/dL

Question 23

what do Na, K, Cl, CO2 tell you

Answer 23

electrolytes indicating nutritional status

Question 24

what should be done if Na is low

Answer 24

Give NSS or regular salt

Question 25

what should be done if K+ is too low

Answer 25

Hypokalemia may cause cardiac arrhythmias, muscle weakness, paresthesias, cramps
Manage hypokalemia
 Give K-Dur (potassium chloride supplement)
 Give potassium-rich foods (i.e. banana)

Question 26

what should be done if K is too high?

Answer 26

Hyperkalemia may cause cardiac arrhythmias, lethargy, respiratory depression, coma
Order EKG
Manage hyperkalemia
 Calcium gluconate
 Sodium bicarbonate
 Dextrose with insulin
 Kayexalate

Question 27

what do bun and creatine indicate

Answer 27

renal function

Question 28

What should be done if creatine is too high

Answer 28

consult renal if creat is over 1.5 for a couple of results (increased after muscle breakdown or loss)

Question 29

which is more important bun or creatinine

Answer 29

Creat is more important, because BUN is influenced by hydration state. If the BUN is high but
creat is normal, then the patient is most likely dehydrated and rehydration should correct the
BUN. However, if both BUN and creat are high, then the patient most likely has renal damage.

Question 30

What do PT/PT T/INR tell you?

Answer 30

The coagulable state of the patient. If the levels are high, it will take longer for the patient to
develop a clot and stop bleeding. It requires blockage of only one pathway to anticoagulate the
patient.

Question 31

what are normal PT

Answer 31

11.7-14.5 sec

Question 32

normal INR

Answer 32

.9-1.1

Question 33

PTT

Answer 33

23-36

Question 34

elevated PT/INR

Answer 34

Coumadin
Malnutrition
Alcoholism
Antibiotics
Vitamin K disorders

Question 35

what does INR stand for

Answer 35

International Normalized Ratio
There are different methods to determine PT, and thus each lab has a different normal value for
PT. INR was devised to standardize all the results.

Question 36

coumadin INR?

Answer 36

anticoag 2-3

Question 37

causes PTT to be high

Answer 37

heparin