Crozer- lab Flashcards
whats in a cbc
wbc, hemoglobin, hematocrit, platelets
normal wbc
4.8-10.8 k/uL
normal hemoglobin
male 14-18 g/dL
female 12-16 g/dL
normal hematocrit
male 42-52
female 37-47
normal platelets
145-400 k/uL
w infection, whats expected to happen to WBC count
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.
what should be done if WBC over 10?
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?
what to do if platelets are low (under 150)
can transfuse platelets but this is not commonly done
what are minimum levels for hemoglobin and hematocrit for elective surgery?
hemoglobin 10 gm/dL and Hct 30%
what should be done if hemoglobin/hematocrit is below 10/30?
whats this condition called?
transfuse 1-2 units of packed RBC
anemia
what are causes of microcytic hypochromic anemia
iron def, thalassemia, lead poisoning
what are causes of macrocytic, megaloblaastic anemia
vit B12/folate deficency
following a transfusion of PRBC when will changes in H/H be seen?
3 hours, new labs drawn 4 hrs after last unit given
whats BPM
Na, K, Cl, CO2, BUN, creatinine, glucose
whats CMP
BMP with alkaline phosphatase, ALT, AST, bilirubin, albumin, total protein, and calcium
normal Na
134-145mmol/L
normal K
3.5-5.1mmol/L
normal Cl
96-106 mmol/L
Normal CO2
24-32mmol/L
Normal BUN
10-20 mg/dL
normal creatinine
0.7-1.3 mg/dL
normal glucose
70-110 mg/dL
what do Na, K, Cl, CO2 tell you
electrolytes indicating nutritional status
what should be done if Na is low
Give NSS or regular salt
what should be done if K+ is too low
Hypokalemia may cause cardiac arrhythmias, muscle weakness, paresthesias, cramps
Manage hypokalemia
Give K-Dur (potassium chloride supplement)
Give potassium-rich foods (i.e. banana)
what should be done if K is too high?
Hyperkalemia may cause cardiac arrhythmias, lethargy, respiratory depression, coma Order EKG Manage hyperkalemia Calcium gluconate Sodium bicarbonate Dextrose with insulin Kayexalate
what do bun and creatine indicate
renal function
What should be done if creatine is too high
consult renal if creat is over 1.5 for a couple of results (increased after muscle breakdown or loss)
which is more important bun or creatinine
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.
What do PT/PT T/INR tell you?
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.
what are normal PT
11.7-14.5 sec
normal INR
.9-1.1
PTT
23-36
elevated PT/INR
Coumadin Malnutrition Alcoholism Antibiotics Vitamin K disorders
what does INR stand for
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.
coumadin INR?
anticoag 2-3
causes PTT to be high
heparin
