Interpreting Lab Values Flashcards
Markers for MI
Tropinin
Creative Kinase
Myogolbin
Other (BNP, CRP, Homosteine)
What does Troponin tell you and what is the caution for PT?
Most specific for cardiac muscle damage
- Sharply elevated in myocardial infarction
- Mild elevations also seen with heart failure, cardiac surgery, renal failure
Begins to rise 4–6 hours post event
Peaks 12–24 hours, declines by 72
PT should wait until values have peaked and begin to decline
What does Creatine Kinase indicate
MI
Sensitivity and specificity not as high as for troponin
Peaks 18–24 hours
What can Myoglobin indicate?
Least specific for MI (elevated with skeletal muscle damage, renal failure)
Fastest to rise and peak
Returns to baseline within 20–36 hours
Complete Blood Count (CBC) components
White blood cells
Hemoglobin
Hematocrit
Platelets
White blood cells (leukocytes) changes and symptoms?
Leukocytosis—increased
- Infection, inflammation (trauma, surgery)
- Check for fever, symptoms — Malaise, lethargy, ability to participate
Leukopenia—decreased
- Blood-borne cancers (bone marrow disease), chemotherapy; Viral infections, HIV, autoimmune disease —check for fever, symptoms
- Fatigue, weakness, shortness of breath, headache
Hematocrit (Hct) and Hemoglobin (HgB) changes and symptoms?
Anemia—decreasing
- Hemorrhage, leukemia
- Poor endurance, tachycardia, orthostatic hypotension, pallor
Polycythemia—increasing
- Burns, dehydration, chronic pulmonary conditions
- Weakness, fatigue common
Increased viscosity—increased risk of clotting
What is Hct?
Fraction of blood that is cells
HbG is what?
Reflects oxygen carrying capacity
Platelets changes and symptoms?
Critical for blood clotting
Thrombocytosis—increasing
- Weakness, headache, dizziness, chest pain
Thrombocytopenia—decreasing
PT implications: Bruising, fatigue, risk for bleeding
- Under 50,000—light activity, screen for fall risk
- Under 20,000—no exercise
Components of Basic Metabolic Panel
Sodium
Chloride
Blood Urea Nitrogen (BUN)
Potassium
Bicarbonate
Creatinine
Glucose
Sodium function, changes and symptoms
Primary determinant of extracellular fluid volume
Hypernatremia—increasing
- Excess salt intake, dehydration, vomiting, heart failure
- Agitation, seizure, hypotension, tachycardia
Hyponatremia—decreasing
- Diuretic use, GI impairment
- Confusion, lethargy, diminished reflexes, nausea and vomiting, seizure, orthostatic hypotension
Potassium function, changes and symptoms
Critical for membrane potentials
Hyperkalemia—increasing
- Renal failure, metabolic acidosis, muscle damage
- Muscle weakness/paralysis, bradycardia, heart block, fibrillation
Hypokalemia—decreasing
- Diuretic use, alcohol abuse
- Weakness, decreased reflexes, paresthesia, cramps, ECG changes, hypotension
Glucose changes and symptoms
Hyperglycemia—increasing
- Diabetes mellitus
- Decreased activity tolerance
Hypoglycemia—decreasing
- Excess insulin
- Lethargy, irritability, shaking, weakness, loss of consciousness possible
Note that exercise will cause blood glucose to fall
BUN function, changes and symptoms
Waste product of protein metabolism, cleared by kidneys
Increases with: Renal failure, CHF, dehydration
Decreases with: Liver disease, malnutrition
