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Crozer Surgery Keegan Duelfer > Lab Values > Flashcards

Lab Values Flashcards

1
Q

What is included in a CBC (4)

A

-WBC
-Hemoglobin
-Hematocrit
-Platelets

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2
Q

What are normal lab values in a CBC (4)

Male female distinction

A

-WBC: 4.8-10.8 K/ uL
-Hemoglobin:
—-Male: 14-18g/dL
—-Female: 12-16g/dL

-Hematocrit:
—-Male: 42-52%
—-Female: 37-47%
-Platelets: 145-400K/uL

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3
Q

With an infection, what is expected to happen to the WBC count after surgery

A

Eventually it should go down, but in post-op days 1-2, the WBC may actually increase a bit.

This may occur because surgery activates the body’s reaction to the infection

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4
Q

What should be done if the patient’s WBC is over 10?

A

First decide if pt has infection:
-If infected, then antibiotics and possible incision and drainage should decrease the WBC count

-If there is not an infection, then the cause must be determined. Is the increase acute or chronic? Is there another source of infection? Is the patient on corticosteroids? Is there a combination of medical conditions causing this?

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5
Q

What to do if platelets are low? (under 150k-350k)

A

can transfuse platelets but this is not commonly done

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6
Q

What are the minimum levels for hemoglobin and hematocrit for elective surgery?

A

Hemoglobin 10gm/dL

Hct 30%

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7
Q

What should be done if the Hemoglobin/Hematocrit is below 10/30?

A

If necesary, transfuse 1-2 units of packed red blood cells

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8
Q

What is the condition called with low hemoglobin/hematocrit

A

anemia

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9
Q

What are causes of microcytic, hypochromic anemia

A

Iron deficiency, thalassemias, lead poisoning

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10
Q

What are cuases of macrocytic, megaloblastic anemia

A

Vitamin B12/ Folate deficiency

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11
Q

Following a transfusion of packed red blood cells when will changes in the Hemoglobin/Hematocrit be seen

A

approximately 3 hours. Therefore, order new labs to be drawn 4 hours after last unit given

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12
Q

What is a Basic Metabolic panel (7)

A

Sodium, Potassium, chloride, carbon dioxide, BUN, creatinine, glucose

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13
Q

What is in a complete metabolic panel

+7

A

BMP with ALP, ALT, AST, bilirubin, albumin, total protein and calcium

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14
Q

What are normal values for BMP

A

Sodium-135-146mmol/L
Potassium: 3.5-5.1mmol/L
Chloride: 96-106 mmol/L
CO2: 24-32mmol/L
BUN:10-20 mg/dL
Creatinine: .7-1.3 mg/dL
Glucose: 70-110

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15
Q

What do Na, K, Cl and CO2 tell you

A

These electrolytes indicate nutritional status

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16
Q

What should be done if Na is low

A

Give NSS or regular salt

17
Q

What should be done if K+ is too low

A

Hypokalemia may cause cardiac arrhythmias, muscle weaknes, paresthesia, cramps

–Give K-Dur (potassium chloride supplement)
– Give potassium rich foods

18
Q

What should be done if the K+ is too high

A

Hyperkalemia may cause cardiac arrhythmias, lethargy, respiratory depression, coma.

-Order EKG

-Manage Hyperkalemia with :
-Calcium Gluconate
-Sodium bicarbonate
-dextrose with insulin
- Kayexalate

19
Q

What do BUN and creatinine indicate

A

Renal Function

20
Q

What can be done if the creatinine is too high

A

consult renal if creatinine is over 1.5 for a couple of results

21
Q

What is a more important indicator. BUN or creatinine?

A

Creatinine is more important because BUN is influenced by hydration state.

If BUN is high but creatinine is normal then the patient is most likely dehydrated and rehydration should correct the BUN

If both BUN and creatinine are high then the patient most likely has renal damage

22
Q

What do PT/PTT/INR tell you?

A

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.

23
Q

What are normal values for PT/PTT/INR

A

PT: 11.7-14.5 sec

INR: .9-1.1

PTT: 23-36 seconds

24
Q

What can cause an elevated PT/INR (5)

A

-Coumadin
-Malnutrition
-Alcoholism
-Antibiotics
-Vitamin K disorders

25
Q

If the patient is on Coumadin for anticoagulation what should the INR be?

A

Intense anticoagulation 2-3

26
Q

What causes the PTT to be high

A

Heparin

27
Q

Which pathway does PTT check?

A

Intrinsic

“PITT”

28
Q

Which Pathway does PT check

A

Extrinsic
“PET”

29
Q

Total calcium value

A

8.4-10.2mg/dL

30
Q

Albumin level:

A

3.5-5.5g/dL

31
Q

Total protein level:

A

6-8g/dL

32
Q

Leukocyte cells in order from most populous to least

A

1) Neutrophils
2)Lymphocytes
3) Monocytes
4)Eosinophils
5)Basophils

Crozer Surgery Keegan Duelfer (16 decks)

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