Lab Values Flashcards
What is included in a CBC (4)
-WBC
-Hemoglobin
-Hematocrit
-Platelets
What are normal lab values in a CBC (4)
Male female distinction
-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
With an infection, what is expected to happen to the WBC count after surgery
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
What should be done if the patient’s WBC is over 10?
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?
What to do if platelets are low? (under 150k-350k)
can transfuse platelets but this is not commonly done
What are the minimum levels for hemoglobin and hematocrit for elective surgery?
Hemoglobin 10gm/dL
Hct 30%
What should be done if the Hemoglobin/Hematocrit is below 10/30?
If necesary, transfuse 1-2 units of packed red blood cells
What is the condition called with low hemoglobin/hematocrit
anemia
What are causes of microcytic, hypochromic anemia
Iron deficiency, thalassemias, lead poisoning
What are cuases of macrocytic, megaloblastic anemia
Vitamin B12/ Folate deficiency
Following a transfusion of packed red blood cells when will changes in the Hemoglobin/Hematocrit be seen
approximately 3 hours. Therefore, order new labs to be drawn 4 hours after last unit given
What is a Basic Metabolic panel (7)
Sodium, Potassium, chloride, carbon dioxide, BUN, creatinine, glucose
What is in a complete metabolic panel
+7
BMP with ALP, ALT, AST, bilirubin, albumin, total protein and calcium
What are normal values for BMP
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
What do Na, K, Cl and CO2 tell you
These electrolytes indicate nutritional status
What should be done if Na is low
Give NSS or regular salt
What should be done if K+ is too low
Hypokalemia may cause cardiac arrhythmias, muscle weaknes, paresthesia, cramps
–Give K-Dur (potassium chloride supplement)
– Give potassium rich foods
What should be done if the K+ is too high
Hyperkalemia may cause cardiac arrhythmias, lethargy, respiratory depression, coma.
-Order EKG
-Manage Hyperkalemia with :
-Calcium Gluconate
-Sodium bicarbonate
-dextrose with insulin
- Kayexalate
What do BUN and creatinine indicate
Renal Function
What can be done if the creatinine is too high
consult renal if creatinine is over 1.5 for a couple of results
What is a more important indicator. BUN or creatinine?
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
What do PT/PTT/INR tell you?
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.
What are normal values for PT/PTT/INR
PT: 11.7-14.5 sec
INR: .9-1.1
PTT: 23-36 seconds
What can cause an elevated PT/INR (5)
-Coumadin
-Malnutrition
-Alcoholism
-Antibiotics
-Vitamin K disorders
If the patient is on Coumadin for anticoagulation what should the INR be?
Intense anticoagulation 2-3
What causes the PTT to be high
Heparin
Which pathway does PTT check?
Intrinsic
“PITT”
Which Pathway does PT check
Extrinsic
“PET”
Total calcium value
8.4-10.2mg/dL
Albumin level:
3.5-5.5g/dL
Total protein level:
6-8g/dL
Leukocyte cells in order from most populous to least
1) Neutrophils
2)Lymphocytes
3) Monocytes
4)Eosinophils
5)Basophils
