Lab Values Flashcards
Normal RBC values for male and female
male - 4.7-6.1 x 10^6
female - 4.2-5.4 x 10^6
Normal HgB values for male and female. What is cutoff value for working w/ patient?
male - 14-17 Gm/dl
female - 12-16 Gm/dl
< 8 Gm/dl - hold PT
male - <9g/dl
female - <7g/dl
Normal HCT values for male and female. What is cut off value for working w/ patient?
male - 43-49%
femaile - 38-44%
<25% - hold PT
Pt may have SOB, tachycardia, fatigue, muscle cramping
Normal WBC values. What is cutoff value for working w/ patient?
4,500 - 10,000 x 10^6 ul
<5,000 w/ fever - hold PT
Normal Platelets. What is cutoff value for working w/patient?
150,000 - 350,000 x 10^6
< 10,000 and/or temp > 100.5 degrees
What is leukocytosis? What does it mean?
> 11,000/mm^3
- indicates infection
What is leukopenia? What does it mean?
<4,000/mm^3
- infection and immunocompromised state
- patient at high risk for additional infection
neutropenia levels
<1500/m^3
What does elevated Hg or Hct mean? Decreased?
elevated - thicker blood/increased risk for clots
decreased - low O2/low activity tolerance
What are implications of ANC 1000-500 ul?
pt needs mask and MD approval to ambulate in hall
- should stay in their room
What are implications of ANC <500 ul?
isolation to room
Implications of platelets 150k-50k
limited resistive exercises, encourage ambulation, ADLs, aerobic exercise equipment
Implications of platelets <50k
No MMT, no resistive exercise, AROM
Implications of platelets > 20k-35k
light exercise, no bicycle, treadmill, ADLs Nustep, UE ergometer, ambulate as tolerated
- No AROM - any pressure could cause bleeding/bruising
Implications of platelets < 20k
Guarded therapy intervention. High risk for bleeding into extracellular space
- watch bleeding times
- AAROM and sitting/standing as tolerated
What has a more narrow reference range for clotting time?
aPTT over PTT
What does aPTT assess?
clotting risk
What does high INR mean? Low? cutoff for PT?
high INR - risk for bleed
low INR - risk for clot
> 6 PT contraindicated
INR for Afib/DVT/PE
2-3
INR for valve replacement
2.5-3.5
Coumadin INR to mobilize
< 2 no mobility
2-5 to mobilize
> 5 check w/ MD
NOAC (novel oral anticoagulants) time since admin
< 2 h no mobile
2-3 check w/ MD
> 3 hours to mobilize
UFC (unfractionated heparin) time since admin
< 24 h no mobility
24-48 h check w/ MD
>48 h mobility
Fondaparinux time since admin
< 2 h - no mobility
2-3 h check w/ MD
> 3 h to mobilize
LMWH time since admin. What should you do if new DVT despite preventive dosage?
< 3 h no mobility
3-5 h check w/ MD
> 5 to mobilize
- wait for higher dose to be given
Cna you mobilize a patient with an IVC filter?
yes
High vs low sodium meaning
low - cramps, weakness, confusion
high - fluid retention, swelling, hypertension
high vs low potassium meaning
low - flattened T waves, arrhythmias, muscle weakness
high - peaked T waves, shortened Q-T wave interval, chest pain
high vs low calcium meaning
low - parathesis, muscle spasms and seizure, and QT interval prolongations
high - bradycardia, AV block, and short QT interval, coma
high vs low magnesium
low - prolonged PR or QT intervals, T wave flattening or inversion, SVT, ventricular arrhythmias
high - weakness, respiratory failure, coma, paralysis
high vs low chloride
low - metabolic alkalosis - increased pH
high - metabolic acidosis - decreased pH
When is creatine kinase (CK) levels high? What activity can be done?
CK elevated after MI, muscle injury, strenuous exercise
- activity should be limited or held when CK trend is rising (clears 48-72 hours)
what troponin levels indicates myocardial damage?
> 0.2 mcg/L
- hold activity until 24 hour after troponin peak and it begins trending down
- peaks 12-16 hours after MI and returns to normal after 1 wk
Respiratory alkalosis
Hyperventilation - lowers arterial CO2 and increased pH
Associated with nervousness, anxiety, pain, pregnancy, PE
Respiratory acidosis
Hypoventilation
Associated with COPD, pneumonia, sleep apnea, head trauma
Metabolic alkalosis
Associated with severe vomiting, excess use of antacids, diuretics, hypokalemia
Metabolic acidosis
Associated with chronic diarrhea, shock/sepsis, trauma, diabetic ketoacidosis, renal failure/uremia, hypoxia
elevated BUN meaning
renal disease, high protein diet, decreasing volume, CHF
normal glucose range
70-100 mg/dl
What should be done if patient glucose is < 70 mg/dl?
give carbs before activity
What should be done if patient glucose is > 240 mg/dl?
hold activity until patient receives insulin
What is albumin used to measure? What is the difference between albumin and pre-albumin and which is more accurate?
- used to measure nutritional status - important for wound healing
- difference between albumin and pre-albumin is ½ life – pre-albumin is more accurate (2 days vs 21 days)
