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NPTE Stuff > Lab Values > Flashcards

Lab Values Flashcards

1
Q

What is a CBC

A

Complete blood count — provides results regarding the concentration of RBCs, WBCs, and platelets in a bloods sample

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2
Q

Which test is routine to identify presence of infection, inflammation, and allergens?

A

WBC count
Reference value is 5-10 10^9/L

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3
Q

> 11.0 10^9/L WBC result

A

trending upward
- Could be because of infection, cancer, surgery, trauma, stress, smoking, obesity, congenital, chronic inflammation, CT disease
- May presents with fever, malaise, lethargy, dizziness, bleeding, bruising, unintentional weight loss

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4
Q

Clinical implication of HIGH WBCs

A
  1. SYMPTOM-based approach when determining appropriateness for activity, especially in the presence of fever
  2. Consider timing of therapy session due to early-morning low level and late afternoon high peak
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5
Q

< 4.0 10^9/L WBC result

A

trending downward
- May be because of viral infections, chemo, aplastic anemia, autoimmune disease, hepatitis
- Presents with anemia, weakness, fatigue, fever, headache, SOB

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6
Q

Clinical implications of LOW WBC’s

A
  1. SYMPTOM-based approach when determine appropriateness for activity, esp. in presence of fever
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7
Q

< 1.5 10^9/L WBC result

A

REALLY LOW
0.5-1.0 = mod neutropenia
<0.5 = severe neutropenia
- May be because of stem cell disorder, bacterial or viral infection, and radiation
- Presents with low grade fever, skin abscesses, sore mouth, pneumonia sxs

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8
Q

Clinical implications of really low WBCs

A

Neutropenic precautions !!
1. Also symptom-based, esp. with fever

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9
Q

Which test assesses anemia, blood loss, bone marrow suppression?

A

Hemoglobin count
Reference value: males = 14-17 g/dL^13
Reference value: females = 12-16 g/dL^13

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10
Q

HIGH hemoglobin

A

polycythemia
- May be because of CHD, severe dehydration, COPD, CHF, severe burns, high altitude
- May present with orthostasis, presyncope, dizziness, arrhythmias, seizure, SYMPTOMS OF TRANSIENT ISCHEMIC ATACH, MI, ANGINA

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11
Q

Clinical implication of HIGH hemoglobin

A
  1. Symptom-based approach, monitor symptoms, collaborate with inter professional team
    High critical value >20 g/dL can lead to clogging of capillaries as a result of hemoconcentration
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12
Q

LOW hemoglobin

A

Anemia
- May be because of hemorrhage, nutritional deficiency, cancer, renal disease, stress to bone marrow, RBC destruction
- May present with decreased endurance and activity tolerance, pallor, and tachycardia

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13
Q

Clinical implication of LOW hemoglobin

A
  1. Monitor vitals esp. SPO2 to predict tissue perfusion since they might present with tachycardia and OH
  2. Low critical value of <5-7 can lead to heart failure or death
  3. <8 — symptom based approach
  4. Consult with team about how to go about monitoring
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14
Q

What assess blood loss and fluid balance

A

Hematocrit levels
Reference values: males = 42-52%
Reference values: females = 37-47%

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15
Q

What about HIGH hematocrit

A

polycythemia
- May be caused by burns, eclampsia, severe dehydration, higher altitude, hypoxia because of pulmonary conditions
- May present with fever, headache, dizziness, weakness, fatigue, easy bruising/bleeding

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16
Q

Clinical Implications of HIGH hematocrit

A
  1. High critical value >60% can cause spontaneous blood clotting
  2. Symptom based approach with activity, monitoring symptoms, collaborating with team
17
Q

Low hematocrit

A

anemia
- May be caused by cancer, dietary deficiency, pregnancy, hyperthyroidism, cirrosis, RA, hemorrhage, high altitude
- May present with pale skin, headache, dizziness, cold hands/feet, chest pain, arrhythmia, SOB

18
Q

Clinical implications of LOW hematocrit

A
  1. Low critical value <15% can lead to cardiac failure/death
  2. Patients may have impaired endurance and progress slowly with activity
  3. Monitor vitals esp. SPO2
  4. If <25% symptom based approach with consult with team because might need transfusion
19
Q

Reference value for platelets

A

140-400 k/uL^13

20
Q

HIGH platelets

A

thrombocytosis >140 k/uL^13
- May be caused by splenectomy, inflammation, cancer, stress, iron deficiency, infection, hemorrhage, high altitude, trauma
- May present with weakness, headache, dizziness, chest pain, tingling in hands/feet

21
Q

Clinical implications for HIGH platelets

A
  1. Symptom based approach for activity, monitor symptoms
  2. Elevated levels can lead to venous thromboembolism
22
Q

LOW platelets

A

thrombocytopenia <150 k/uL
- May be caused by viral infection, nutrition deficiency, cancer, radiation, chemo, live disease, pre-menstraul and postpartum
- May present with petechiae, ecchymosis, fatigue, jaundice, spleenomegaly, risk for bleeding

23
Q

Clinical implication of LOW platelets

A
  1. In presence of severe thrombocytopenia <20 = symptom based approaches and collaborating with team regarding possible transfusion
  2. Fall risk awareness!! Risk of spontaneous hemorrhage
24
Q

INR ranges

A

INR = international normalized ration (serum viscosity thing)
Normal = 0.8-1.2
Therapeutic range for stroke prophylaxis = 2.0-2.5
Therapeutic range (VTE, PE, atrial fib) = 2.0-3.0
Therapeutic range for higher risk patients = 2.5-3.5
Therapeutic range for patients with lupus = 3.0-3.5
Patient at high risk for bleeding = >3.6

25
Q

What test assesses primary determinant of extracellular fluid volume

A

Electrolyte panel — sodium !!
Reference value = 134-142 mEq/L^13

26
Q

HIGH sodium values

A

hypernatemia >145 mEg/L
- May be caused by increased sodium intake, severe vomitting, CHF, renal insufficiency, Cushing, DM
- May present with irritability, agitation, seizure, coma, hypotension, tachycardia, decreased urinary output

27
Q

Clinical implications of hypernatremia

A
  1. Impaired cognitive status
  2. Seizure precautions for patients with past medical history
28
Q

Low sodium values

A

hyponatremia <130 mEg/L
- May be caused by diuretic use, GI impairment, burns/wounds, hypotonic IV use, cirrosis
- May present with headache, lethargic, decreased reflexes, N/V, diarrhea, seizure, coma, OH, pitting edema

29
Q

Clinical implications for LOW sodium

A
  1. Impaired cog status
  2. Monitor vitals secondary to risk of OH!
30
Q

What test would show important function of excitable cells like nerves, muscles, and heart

A

Electrolyte panel — POTASSIUM
Reference value = 3.7-5.1 mEg/L^13

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