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Boards: Cardiopulmonary & Lymphatic > Lab Values > Flashcards

Lab Values Flashcards

1
Q

Respiratory Rate Rhythm and Pattern

A
  • Interpretation
    • Newborn: 33-45
    • 1 year: 25-35
    • 10 years: 15-20
    • Adult: 12-20
  • Rhythm
    • normal: Inspiration:Expiration = 1:2
    • COPD: I:E = 1:3 , 1:4
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2
Q

ABGs: SpO2

A

Normal: 98-100%

High: n/a

Low: below 88-90% requires supplemental O2

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3
Q

ABGs: PaO2

A

Normal: 90-100 mmHg

High: in hyperoxygenation

Low: in cardiac decompensation, COPD, some NMS

PT: n/a

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4
Q

ABGs: PaCO2

A

Normal: 35-45 mmHg

High: in COPD, hypoventilation

Low: hyperventilation, pregnancy, PE and anxiety

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5
Q

ABGs: pH, whole blood

A

Normal: 7.35-7.45 (< acid, > alkaline)

High:

  • respiratory alkalosis: hyperventilation, sepsis, liver disease, fever
  • metabolic alkalosis: vomiting, potassium depletion, diuretics, volume depletion

Low:

  • respiratory acidosis: hypoventilation, COPD, respiratory depressants, myasthenia
  • metabolic acidosis: bicarbonate deficit, increased acids (diabetes, alcohol, starvation); renal failure , increased acid intake and loss of alkaline fluids
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6
Q

Hemostasis: Prothrombin Time (PT)

A

Normal: 11-15 sec

High: factor X deficiency, hemorrhagic dx, cirrhosis, hepatitis drugs (warfarin)

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7
Q

Hemostasis: Partial Thromboplastin Time (PTT)

A

Normal: 25-40 sec

High: Factor VII, IX, X deficiency

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8
Q

Hemostasis: INR

A

Normal: .9-1.1

  • Target INR 2-3 = DVT, PE, Mechanical valves, A-fib
  • Target INR 3.5 = pts with clotting disorders

PT: look for active signs of bleeding when treating patients and use compensatory training to reduce fall risk

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9
Q

Bleeding Time and C-reactive protein (CRP) <10mg/L

A

Bleeding Time 2-10 min

C-reactive protein (CRP) <10mg/L

High: platelet disorders, thrombocytopenia, high levels associated with increased risk atherosclerosis

>100 mg/L associated with inflammation and infection

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10
Q

CBC: White Blood Cells WBCs

A

Normal: 4300-10800 cells/mm3 - indicative of immune system

High: infection (all kinds), inflammation, hematologic malignancy, leukemia, lymphoma, drugs (corticosteroids)

Low: aplastic anemia, B12 or folate deficiency

PT: consider metabolic demands in presence of fever and use of mask when WBCs <1000-2000 or ANC <500-1000

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11
Q

Exercise Guidelines: WBC Count

A

4800-10,800 cells/mm3 = Normal exercise

> 5,000 = light or regular exercise

< 5,000 +Fever = no exercise

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12
Q

CBC: Red Blood Cells RBCs

A

Normal:

  • male: 4.6-6.2
  • women: 4.2-5.9 x106/uL

High: polycythemia

Low: anemia

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13
Q

CBC: Erythrocyte Sedimentation Rate ESR

A

Normal:

  • male <15
  • women< 20 mm/hr

High: infection and inflammation: rheumatic or pelvic inflammatory dx, osteomyelitis - used to monitor treatment; e.g. RA, SLE, Hodgkins Dx

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14
Q

CBC: Hematocrit %

A

Normal:

  • male: 45-52%
  • female: 37-48%

High: erythrocytosis, dehydration, shock

Low: severe anemia, acute hemmorhage

PT: can cause decreased exercise tolerance and increased fatigue, tachycardia

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15
Q

Exercise Guidelines: HCT %RBC whole blood

A

Men = 45-52%, women = 37-48% = Normal Exercise

>25% light or regular exercise

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16
Q

CBC: Hemoglobin Hgb

A

Normal:

  • male: 13-18 g/dL
  • women: 12-16 g/dL

High: polycythemia, dehydration, shock

Low: anemia, prolonged hemmorhage, RBC destruction (cancer, sickle cell)

PT: can cause decreased exercise tolerance and increased fatigue, tachnycardia

17
Q

Exercise Guidelines: HgB

A

men = 13-18, women = 12-16 g/dL = normal unrestricted

>10 regular exercise

8-10 = light exercise

_< 8 = no exercise _

18
Q

CBC: Platelet Count

A

Normal: 150,000-450,000 cells/mm3

High: chronic leukemia, hemoconcentration

Low: thrombocytopenia, acute leukemia, aplastic anemia, cancer chemo,

PT: increased risk of bleeding with low levels so monitor for hematuria, petechiae and other signs

  • <20k = AROM, ADLs only
  • 20-30k = light exercise only
  • 30-50k = moderate exercise
19
Q

Exercise Guidelines: Platelet Count

A

150,000-450,000 = normal, unrestricted

50,000-150,000 = some limitations

30,000-50,000 = moderate exercise

20,000-30,000 = light exercise

< 20,000 = ROM, ADLs, walking w/ physician approval

20
Q

Pre-Albumin

A

20-40 mg/dL

2-day half life (short term gauge of nutrition)

<15 mg.dL = malnutrition

21
Q

Albumin

A

3.5-5.5 g/dL

18-20 day half life (long term gauge nutrition)

<3.5 = malnurished

22
Q

Creatinine

A

Normal: _ 115-125 mL/min _

measures GFR as a measure of renal function, regulated by arterial blood pressure and renal blood flow

23
Q

BUN

A

Normal:

is urea produced in the liver as a by-product of protein metabolism that is eliminated by the kidneys

  • elevated with increased protein intake, GI bleeding and dehydration*
  • BUN-creatinine ratio is abnormal in liver disease
24
Q

Glucose Levels

A

70-115 mg/dL (Fasting)

Short term management of diabetes

25
Q

Glycosylated Hemoglobin Levels (HbA1C)

A

4-6%

long term management of diabetes

26
Q

Hypokalemia

A
  • low potassium
  • causes:
    • deficient potassium
    • excessive loss from diarrhea, vommiting
    • metabolic acidosis
    • renal tubular disease
    • alkalosis
  • observe:
    • ms weakness
    • fatigue
    • cardiac arrhythmias
    • abdominal distention
    • nausea/vommiting
27
Q

Hyperkalemia

A
  • high potassium
  • causes
    • inadequate secretion w/ acute RF
    • kidney disease
    • metabolic acidosis
    • diabetic ketoacidosis
    • sickle cell anemia
    • SLE
  • observe:
    • symptomless until very high levels
    • ms weakness
    • arrhythmias
    • ECG changes (tall T wave, prolonged PR & QRS)
28
Q

Hyponatremia

A
  • low sodium
  • causes
    • water intoxication (extracellular water)
    • excess ADH
  • observe:
    • confusion
    • decreased mental alertness to convulsions
    • signs of high ICP
    • poor motor coordination
    • sleepiness
    • anorexia
29
Q

Hypernatremia

A
  • high sodium
  • causes
    • water deficits (not salt excess) dehydration
    • insufficient water intake
  • observe
    • circulatory congestion
    • pulmonary edema w/ dyspnea
    • HTN
    • tachycardia
    • agitation
    • restlessness
    • convulsions
30
Q

hypocalcemia

A
  • low calcium
    • reduced albumin levels
    • hyperphosphatemia
    • hypoparathyroidism
    • malabsorption of Ca or Vit D
    • alkalosis
    • acute pancreatitis
    • vit D deficiency
  • observe:
    • muscle cramps
    • tetany
    • spasms
    • parasthesias
    • anxiety
    • irritability
    • twitching
    • convulsions
    • arrhythmias
    • hypotension
31
Q

hypercalcemia

A
  • high calcium
    • hyperparathyroidism
    • tumors
    • hyperthyroidism
    • vit A intoxication
  • observe
    • fatigue
    • depression
    • mental confusion
    • nausea/vommiting
    • increased urination
    • occasional cardiac arrhythmias
32
Q

hypomagnesemia

A
  • low magnesium
    • hemodialysis
    • blood transfusions
    • chronic renal disease
    • hepatic cirrhosis (alcoholism)
    • chronic pancreatitis
    • hypoparathyroidism
    • malabsorption syndromes
    • severe burns
    • excessive loss of body fluids
  • Observe
    • hyperirritability
    • confusion
    • leg and foot cramps
33
Q

hypermagnesemia

A
  • high magnesium
    • renal failure
    • diabetic acidosis
    • hypothyroidism
    • Addison’s Dx
    • dehydration
    • use of antacids
  • Observe:
    • hyporeflexia
    • muscle weakness
    • drowsiness
    • lethargy
    • confusion
    • bradycardia
    • hypotension
34
Q

Normal Urine Sample

Color

Clarity

Specific Gravity

pH

Protein

Sugar

A
  1. Color - yellow-amber
  2. Clarity - clear
  3. Specific Gravity - 1.010-1.025
  4. pH - 4.6-8.0 (6 avg)
  5. Protein - 0.8 mg/dL
  6. Sugar - none
35
Q

Cardiac Biomarkers

A

Enzymes in blood stream after MI.

  • creatine phosphokinase (CK-MB)
    • appears ~4 hrs after infarction
    • peaks 12-24 hrs
    • declines over 48-72 hrs
  • troponin protein (T-1)
    • remains elevated for 5-7 days

Boards: Cardiopulmonary & Lymphatic (17 decks)

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