Lab Values Flashcards
What do you do when you are acting in an emergency situation?
ID yourself to victim; inform victim of your training that certifies that you are a health care provider. Obtain permission to treat if patient is able; if not, proceed with treatment. Inform witnesses of your training/certification; instruct them as what to do.
When an emergency happens…
1) Respond quickly and calmly; be assertive and directive as needed
2) Obtain assistance from the most qualified individual available
3) Alert response team before starting care
4) After providing care: Document!!
5) Notify your superior/Risk Management . . .and insurance carrier
6) Avoid conferring with family members or witnesses
What are the signs/symptoms of a mild to moderate allergic reaction?
itchy skin skin redness, rash, areas of swelling itchy, watery eyes sneezing hives at several body sites
What are the signs/symptoms of a severe allergic reaction?
swelling of the face, mouth or tongue difficulty swallowing, speaking wheezing, difficulty breathing abdominal pain, nausea, vomiting dizziness or syncope
When does anaphylaxis occur?
when two or more body systems are affected by an allergen
What are adverse reaction to medications?
nausea muscle ache vomiting visual disturbance drowsiness abdominal discomfort intestinal cramping diarrhea headache
How do you know if there is too much bleeding of a wound?
cannot control bleeding
patient becomes pale, loses breath
What are the signs and symptoms of shock?
pale, moist, cool skin shallow, irregular breathing dilated pupils weak, rapid pulse sweating dizziness or nausea syncope
How is shock treated?
- remove cause of shock is possible
- monitor vital signs
- position patient supine with head lower than extremities (unless breathing is labored)
- cool compress on head
- light blanket to avoid loss of body heat
- remain quiet/avoid exertion
What causes orthostatic hypertension?
decreased venous return from extremities to left ventricle of the heart=decreased cardiac output; in turn creates decreased cerebral perfusion=dizziness and possible syncope
How is orthostatic hypertension prevented and treated?
avoid prolonged sitting if possible
Instruct person in ankle pumps, quad sets, glut sets (to encourage venous return) prior to standing
Allow person to accommodate to upright position slowly
What are the signs of heat exhaustion?
profuse diaphoresis nausea headache shallow rapid breathing weak, rapid pulse pale color temperature normal or slightly elevated acting exhausted or collapse unconscious pupils normal
What are the signs of heat stroke?
no diaphoresis nausea headache labored breathing strong, rapid pulse flushed or gray color temperature very elevated (106-110 F) acting exhausted or collapse unconscious pupils contract, then dilate
How are heat related illnesses treated?
place in position of comfort
cool then quickly (ice on large blood vessels: wrists, feet, ankle, groin, axillae, lateral neck areas)
Observe the patient for shock or other physiologic changes; monitor vitals
Patient should be transported to care facility for proper recovery and monitoring
What are the warning signs of hypoglycemia?
sudden onset pale and moist skin excited, agitated normal breath odor breathing normal to shallow no vomiting moist tongue hunger not thirsty no /slight glucose in urine
What are the warning signs of hyperglycemia?
gradual onset flushed, dry skin drowsy fruity breath odor deep, labored breathing vomiting tongue dry not hungry thirsty large amounts of glucose in urine
How is hypoglycemia treated?
ingest some form of sugar that patient best tolerates
How is hyperglycemia treated?
medical emergency: patient needs injection
When does autonomic hyperreflexia (dysreflexia) occur?
patient w/recent spinal cord injuries (Ct to T6)
Noxious stimuli cause a massive sympathetic response with no higher level regulatory mechanism in check, due to cord injury
parasympathetic response goes unregulated
What is a Level 1 trauma?
neurosurgeon in house 24/7
What was the nation’s first hospital?
Pennsylvania Hospital in 1751
What caused an increase in acute care facilities?
development of Medicare in 1964
What is medication reconciliation?
checking to see if the patient is getting what they are supposed to be getting
What considerations should be made when treating in an acute care setting versus outpatient?
- shorter treatment session
- fewer repetition
- less demand for active participation
What are the treatment goals in an acute setting versus outpatient?
- prevent/minimize adverse effects of immobility/inactivity
- prevents contractures
- improve general conditioning, bed mobility, respiration, prevent pressure ulcers
What is critical illness polyneuropathy?
distal extremity weakness, muscle wasting, sensory loss, decreased or absent DTRs
What is critical illness myopathy?
muscle weakness affects large, proximal muscles; steroid induced
What are substance abuse withdrawal symptom?
increased BP, tachycardia, agitation, sweating, SOB, nausea, tremor
What are abnormal, undesired or expected responses?
- changes in vital signs
- changed in breathing pattern
- indication of increased pain
- reduced mental awareness or alterness
SaO2 or O2
percentage of oxygen carried by hemoglobin
minimum of 90%
pH levels
normal: 7.35 to 7.45
What happens if blood is acidic?
the force of cardiac contractions diminish
What happens if blood is alkaline?
neuromuscular function becomes impaired =coordination
What levels of blood pH are fatal?
below 6.8 or
above 7.8
What is PaCO2?
partial pressure of arterial CO2: reflects level of CO2 in blood
What is a normal PaCO2?
35 to 45 mmHg
What does a high PaCO2 indicate?
hypoventilation from shallow breathing
What does a low PaCO2 indicate?
hyperventiliation
What is HCO2?
amount of alkaline substance dissolved in arterial blood
What is PaO2?
partial pressure of oxygen at seal level
significant because it is directly related to ventilation and oxygenation
What is normal PaO2?
What is critical PaO2?
normal: 80 mmHg-100mmHg
critical: less than 40mmHg
What is polycythemia?
RBC count too high, change that RBC could clump together and block vessels
What is a hematocrit?
measures amount of space (volume) red blood cells take up in the blood
What are the normal hematocrit values for males and females?
males: 40-54 ml/dl
females: 37-48 ml/dl
What are normal hemoglobin values for males and females?
male: 14-18g/dl
females: 13-16 g/dl
What is bilirubin?
checks liver functions & signs of liver disease
medications can damage the liver
What is creatinine?
-produced by body during normal muscle breakdown
high=kidney impairement, LB or HBP
low=myathenia gravis over hydration
skin injury can be related to low levels
What does potassium do?
plays important role in muscle contraction and cell function
both high & low levels can cause problems with rhythm f the heart
What is TSH?
-thyroid test
What symptoms can an underactive thyroid cause?
weight gain, tiredness, dry skin, constipation, too cold, frequent menstrual periods
What symptoms can overactive thyroid cause?
weight loss, rapid heart beat, nervousness, diarrhea, feeling of being too hot, irregular periods
What is BUN?
-blood, urea, nitrogen
-measure of kidney function
high levels can affect cognitive status
What is ESR?
- sed rate=measures how quickly RBCs settle in test tube in one hour
- when inflammation is present, RBC stick together and fall more quickly
What do sodium levels show?
-levels fluctuate with dehydration or over-hydration; key indicator of hydration
What are normal blood glucose levels?
70-115mg/dl
What are critical levels of blood glucose?
less than 40mg/dl
greater than 500mg/dl
What blood glucose level is too low to safely exercise?
100mg/dl (5.6mmol.L)
What is a safe pre-exercise blood sugar level?
100-250mg/dl (13.9 mmol/L)
What blood glucose level is too high to exercise safely?
300mg/dl (16.7mmol/L)
PTT (23.8-36.6 seconds) therapeutic range
60-80 seconds (2-3x upper limit)
INR (0.9-1.1) therapeutic range
2.0 to 3.0
PLT > 20,000
Therapeutic exercise/ bike with or without resistance
PLT: 10,000-20,000
Therapeutic exercise/bike without resistance
Hgb > 8 gm/dL
Ambulation and self care as tolerated; resistance exercises
Hgb: 8-10 gm/dL
Essential ADL, assistance as needed for safety; light exercise
Hct >35%
Ambulation and self care as tolerated; resistance and aerobic exercises
Hct > 25%
Essential ADL, assistance as needed for safety, light aerobics, light weights (1-2 lbs)
CPK-MB begins to rise at _____ hours, peaks in ____ hours and returns to normal within _____ hours
4-6, 12-24, 48-72
Adult Female Hgb
12-16 Gm/dL
Adult Female Hct
36-47%
Adult Female RBCs
20-30 mL/kg
Adult Female WBCs
3.9-10.7 x 10^3
Adult Male Hgb
14-17 Gm/dL
Adult Male Hct
41-51%
Adult Male RBCs
25-35 mL/kg
O2 Sat
> 94%
Creatinine Phospho-Kinase (CPK)
30-170 U/L
What is the caution level of blood glucose for exercise?
250-300mg/dL
PLT less than 10,000 or temp. greater than 100.5
No therapeutic exercise/hold therapy
Hgb less than 8gm/dL
Essential ADL
HCO3
22-26 mEq/L
INR >5.0
no exercise
INR between 4.0-5.0
light exercise
INR less than 4.0
resistive exercise
WBC less than 5000mm3
no exercise
WBC >5000mm3
light exercise/resistive
Hematocrit less than 25%
no exercise
