Lab Values

Question 1

what are the 4 most common blood tests that we see in acute/subacute care?

Answer 1

• CBC
• differential metabolic profile
• basic metabolic profile
• routine chemistry

Question 2

the normal values at each institution are typically determined based on __% of healthy people in a certain group

Answer 2

95

Question 3

in addition to looking at lab values and determining whether they are within normal ranges/guidelines, clinical decision making also needs to be based on what 4 things?

Answer 3

• thorough chart review
• trends of labs or vital signs
• clinical discussions with the team
• the ability to monitor for clinical signs and hemodynamic stability during intervention

Question 4

electrolyte panels might change with what 3 things?

Answer 4

• IV infusions
• medications
• diet

Question 5

CBC is the calculation of the ____ of blood

Answer 5

formed elements

Question 6

what 3 types of blood cells make up a major portion of the CBC?

Answer 6

• WBCs
• RBCs
• Platelets

Question 7

what are the 3 types of granulocytes, and what are their roles?

Answer 7

• neutrophils: most abundant WBC
• eosinophils: allergies
• basophils: allergies, release of histamine and heparin

Question 8

what are the 2 types of agranulocytes, and what are their roles?

Answer 8

• monocytes: differentiate into macrophages

- lymphocytes: T and B; big role in immunity

Question 9

elevated WBC levels usually indicate what? how will the pt present?

Answer 9

• infections

- pt may present with fever, malaise, lethargy

Question 10

decreased WBC levels may indicate what? what is the pt at high risk for?

Answer 10

• infection and immunocompromised state

- high risk for additional infection

Question 11

if a pt has elevated or decreased WBCs, you may need to implement ____ precautions

Answer 11

neutropenic

Question 12

what are the 3 parts that RBC values consist of?

Answer 12

hemoglobin, hematocrit, platelets

Question 13

what is hemoglobin (Hb)?

Answer 13

protein contained in RBCs that delivers O2 to tissues

Question 14

what is hematocrit (Hct)?

Answer 14

it measures the vol of RBCs compared to the total blood vol

Question 15

____ and ____ values vary bw males and females

Answer 15

Hb and Hct

Question 16

____ are the same for males and females

Answer 16

platelets

Question 17

implications for ANC 1000-1500

Answer 17

initiate neutropenic precautions, however pt may ambulate in hall

Question 18

implications for ANC 500-1000

Answer 18

pt needs mask and MD approval to ambulate in hall

Question 19

implications for ANC < 500

Answer 19

isolation to room

Question 20

Hb < __ g/dL is generally not good for males or females

Answer 20

8.0

Question 21

implications for Hb < 9.0 g/dL (male) and < 7.0 g/dL (female)

Answer 21

tx to pt tolerance and communicate w healthcare team

Question 22

implications for Hct < 20% (males and females)

Answer 22

pt may have SOB, tachycardia, fatigue, muscle cramps

Question 23

implications for plt 50-150K

Answer 23

• limited resistive exercise
• encourage ambulation
• ADLs
• aerobic exercise equipment

Question 24

implications for plt < 50K

Answer 24

• no resistive exercise
• no MMT
• AROM allowed

Question 25

implications for plt 20-35K

Answer 25

• light exercise
• no bicycle
• treadmill, NuStep, UE ergometer
• ADLs
• ambulate as tolerated

Question 26

implications for plt < 20K

Answer 26

• guarded PT intervention
• high risk for bleeding into extracellular space
• watch bleeding times
• AAROM and sitting/standing as tolerated

Question 27

what does prothrombin time (PT) measure?

Answer 27

speed of clotting

Question 28

what is INR used for?

Answer 28

to correct for differences in lab reagents to test prothrombin time

Question 29

what does aPTT (activated partial thromboplastin time) measure?

Answer 29

speed of clotting with activator added that quickens the clotting time, resulting in a more narrow reference range