Lab Values Flashcards
Complete Blood Cell Count (CBC) & Differential
- Hemoglobin
- Red blood cell index (MCV, MCHC, RDW)
- Reticulocyte coute
- Hematocrit
- Platelet
- WBC
Hemoglobin (part of CBC)
oxygen carrying capacity
Red blood cell index (MCV, MCH, MCHC, RDW) (part of CBC)
provide information on the physical features of the RBCs
Reticulocyte count (part of CBC)
a measurement of the absolute count of newly released young red blood cells
Hematocrit (part of CBC)
the volume of red blood cells in whole blood
Platelet (part of CBC)
colorless blood cells integral to clotting
- ASA can interfere with formation of platelet
WBC (part of CBC)
exit in the blood, lymphatic system and tissues; protect against infection
Low hemoglobin means:
blood loss, inadequate nutrition
High hemoglobin means (8)
- lung disease, heart disease, polycythemia vera, kidney tumors, dehydration, hypoxia, carbon monoxide exposure, high altitude
Low hematocrit means: (6)
overhydration, anemia, bone marrow suppression, leukemia, lead poisoning, chemotherapy treatment
High hematocrit means (6)
dehydration, low oxygen availability due to smoking, polycythemia vera, tumors, lung diseases, congenital heart disease
High platelet means: (5)
leukemia, myeloproliferative disorders (which cause blood cells to grow abnormally in bone marrow), inflammatory conditions, acute infections, iron deficiency
Low platelet means (5)
viral infections, lupus, leukemia, chemotherapy, pernicious anemia (due to vitamin B12 deficiency)
Five types of WBC
Neutrophils lymphocytes basophils eosinophils monocytes/lymphocytes
neutrophils
increase with bacterial infection
lymphocytes
increase with viral infections
Eosinophils
increase with allergic reactions
++ Blast cells
- immature WBCs
- present in leukemia and advanced infections
Magnesium
muscle relaxation
Hyper magnesium cause
- ingestion of antacids that contain magnesium
- decreased ability of the kidneys to excrete magnesium
Hyper magnesium manifestations
- muscle relaxed
- decreased DTR
- respiratory arrest
hyper magnesium: intervention
- IV calcium
- Diuretics
- Dialysis
Hypo magnesium: cause
malnutrition
malabsorption
Hypo magnesium manifestations
muscle excitement
increase DTR (deep tendon reflex)
- seizure
- tachycardia
Hypo magnesium intervention
IV magnesium
Phosphate
muscle contraction, regulation of calcium
hyper phosphate cause
- CKD
- hypoparathyroidism, or metabolic respiratory acidosis
- associated with hypocalcemia
hyper phosphate manifestations
- symptoms of hypocalcemia
- trousseau’s sign
- chvostek sign
- weak bone
Hyper phosphate intervention
- IV N/S with diuretic to increase urinary phosphate excretion
- In/out monitor
- Dialysis
Hypo phosphate cause
- alcohol use disorder
- burns, starvation, and diuretic use
Hypo phosphate manifestations
- constipation
- kidney stones
- muscle weakness
- decreased HR and RR
Hypo phosphate intervention
- IV phosphate
- Monitor s/s of low cardiac output (dyspnea, hypotension)
Chloride
Maintain BP, blood volume, and pH balance
Hyper chloride cause
prolonged dehydration, high level of blood sodium, diabetes insipidus (not enough ADH)
Hyper chloride manifestations
N&V, dry mouth, swollen tongue, confusion
Hyper chloride intervention
- treating underlying cause
- PO/IV fluid
Hypo chloride cause
vomiting, diarrhea, CHF, chronic lung disease, chemo
Hypo chloride manifestations
Diarrhea, vomiting, sweating, fever
Hypo chloride: intervention
IV N/S
Kidney Function Test: 3 components
- Blood urea and nitrogen (BUN)
- Creatinine
- GFR
Blood urea and nitrogen (component of kidney function test)- BUN
is a waste product formed in liver from protein breakdown and carried to kidneys, then filtered out of blood, and excreted through urine
creatinine (component of kidney function test)
a chemical waste produced by muscle metabolism
GFR (component of GFR)
amount of blood the glomeruli can process in 1 minute
Normal Urinalysis: Normal findings
- appearance
- color
- odor
- leukocyte
- nitrites
- ketones
- protein
- clear
- amber yellow
- aromatic
- negative
- none
- none
- none
Clear to dark yellow
normal
amber to honey yellow
dehydrated
orange
dehydration, intake of rifampicin, consumption of orange food dye
brown ale
severe dehydration, liver disease
Pink to reddish
consumption of beets, rhubarb, or blueberries, mercury poisoning, tumors, kidney diseases, prostate problems, UTI
Blue or green
consumption of asparagus, genetic disorders, excess calcium, heartburn medications, multivitamins
Deep purple
porphyria
Nitrites
bacterial infection is present in the urinary tract
Ketones
ketones are by-products of fat metabolism, and they form whenever there is not enough carbohydrate present for energy production
Albumin
- presence of albumin in urine is the sign of kidney disease
- causes: preeclampsia, multiple myeloma inflammation, urinary tract injury, malignancies and other disorders that destroy red blood cells
LFT
- primary liver damage
- altered biliary function
- altered synthesis
Primary liver damage (part of LFT)
- ALT
- AST
Altered Biliary Function (Part of LFT)
- total bilirubin
- alkaline phosphatase (ALP)
- GGT
Altered synthesis (part of LFT)
- albumin
- clotting factors (measured by prothrombin time or PT)
Prothrombin Time (PT)
- it is a measure of how quickly blood clots. result is the time in seconds that is required for the blood to clot.
- blood plasma normally takes between 11 and 13.5 seconds to clot if you are not taking blood-thinning medication. PT results often are reported as international normalized ratio (INR) thats expressed as a number
INR - what does high number mean?
- what does low number mean?
- international normalized Ratio
- high number: the higher your INR, the longer it takes your blood to clot therefore the risk of bleeding increases
- low number: the lower the INR, the faster the blood clots putting you at risk for thromboembolism
Lactate Dehydrogenase (LD or LDH) - what is being tested?
an enzyme involved in energy production that is found in almost all body cells. with the highest levels found in the cells of the heart, liver, muscles, kidneys, lungs, and in blood cells: bacteria also produce LD. This test measures the level of LD in the blood or sometimes other body fluids,
- ordered as part of LFT (Not always)
- more of a blood test for trending tissue damage
Cardiac Markers
High sensitivity troponin
Brain Natriuretic Peptide (BNP)
High Sensitivity Troponin
- troponin T
- can help ID patients who have experienced damage to their heart
- can be elevated in patients with stable angina even when they are without symptoms; indicates increased risk of future heart events
- levels can become elevated within 3-4h after injury
- can remain elevated for 10-14 days following injury
Brain Natriuretic Peptide (BNP)
- a small protein
- continually produced in the heart
- released in larger quantities when the heart is having to work harder
- supports fluid retention and volume expansion intravascularly
- tested when heart failure is suspected
How often are lab values ordered?
- once a day
- depends on condition: q8h, q4h, prn
what do you do if lab values are abnormal?
notify the doctor and begin interventions
