Lab Values Flashcards
what are the 3 reasons for performing lab testing
screening, diagnosis, monitoring
what is the norm for WBC
3.6-10.8 K/uL
what are WBC labs useful for
infection
neoplasm
allergy
immunosuppression
an increase in WBC=
(leukocytosis) infection, dehydration, stress, abscess, meningitis, appendicitis or tonsillitis
a decrease in WBC=
(leukopenia) drug toxicity, chemo, dietary deficiency, bone marrow depression, viral infection or toxic reaction
what are the 3 main stages of lab testing
screening
diagnosis
monitoring
why do you perform a screening
for evidence of disease
why do you give a diagnosis
helps detect the presence of a condition
why do you monitor labs
to correlate serum levels with patient responses
different additives in tubes can affect the lab result if…
not drawn up in the correct order
what are things that can affect lab values
age, gender, race, pregnancy
what are the most common drugs that affect lab testing
oxygen
NSAIDS
antibiotics
diuretics
BMP tests for
tests for heart failure
Hepatic function is for the
liver
D Dimer is for the
bleeding problems or clots
what are the labs for CBC
WBC, RBC, Indices, H& P, Plts, differential
of red cells per cc/blood
RBC
O2 carrying protein
Hemoglobin
packed volume of RBCs, % of total volume
Hematocrit
MCV, MCH, MCHC all deal with
anemia
red cell distribution width
RDW
of ptl. per cc/blood
platelet
of white cells per cc/blood
WBC
what are the common indications for a CBC
infection, weakness or anemia, bleeding, fluid status
what is the normal lab value for HGB
12.0-16.0g
a protein in HGB give blood its
red color
HGB and Hct are
closely related
an increase in HGB=
congenital heart disease, COPD
a decrease in HGB=
anemia, hodgkin disease, renal disease
what is the normal lab values for Hct
37.0-47.0%
the rapid measurement of RBC count could be seen by what lab
Hct
Hct is __x higher than Hgb level
3x
an increase in Hct levels=
congenital heart disease, COPD
a decrease in Hct levels=
anemia, hemorrhage, renal disease
what is the normal level for Plt
150-400 L/uL
at what platelet count should you hold lovenox
under 100,000
an increase in plt lab values=
(thrombocytosis) Fe deficiency anemia
a decrease in plt lab values=
(thromocytopenia) leukemia and other myelofibrosis disorders
what are the 2 main platelet disorders
thrombocytopenia
thrombocytosis
< 50,000 (too few plts is significant bleeding)
thrombocytopenia
> 600,000 (too many plts and risk for clotting> 1 mill)
thrombocytosis
what are the RBC indices
MVC
RDW
MCH
MCHC
shape of RBC is known as
MCV
size of RBC is known as
RDW
average weight of hemoglobin within a single RBC is known as
MCH
% of hemoglobin within a single RBC is known as
MCHC
watch pt with low Hgb closely bc they are at increase risk of
angina, MI, CHF, and stroke
RBC indices are used to classify
anemias
what are the 6 differential WBC count
- neutrophils
- bands
- lymphocytes
- monocytes
- eosinophils
- basophils
neutrophils indicate
bacterial
bands indicate
immature wbc- bacterial
lymphocytes indicate
viral
monocytes indicate
fungal
eosinophils indicate
allergic reactions, autoimmune disorders
basophil indicates
cancer
the basic metabolic panels (BMP) measure the status of
acid/base balance
blood glucose
electrolyte balance
kidney function
the complete metabolic panels (CMP) measure status of
BMP plus: liver function, blood proteins
what labs show kidney function
BUN and creatinine
what are the normal values for sodium
135-145 meq/L
what are the normal values for potassium
3.5-5.1 mmol/L
what are the normal values for chloride
99-112 mmol/L
what are the normal values for calcium
8.5-10.0 mg/dl
what are the normal values for glucose
76-106 mg/dl
what are the normal values for BUN
7-21 mg/dl
what are the normal values for creatinine
0.6-1.3 mg/dl
what lab is most commonly used in the evaluation of diabetic patients
glucose
what are some interfering factors of glucose levels
stress, caffeine, pregnancy, IV fluids, drugs can increase or decrease
what are S/S of hypoglycemia
confusion, tachycardia, coma, restelss, tremors, personality change, seizures, appears drunk
what are S/S of hyperglycemia
polyuria, polydipsia, polyphagia, hypotensive, headache, drowsy, lethargic, hyporeflexia, muscle weakness, hot dry flushed skin, acetone breath, kussmauls breathing
test used to monitor diabetes and or treatment of diabetes
Hgb A1c and tells the physician the patient’s average blood glucose level over the last few months
non diabetic level would be
4%-5.9%
good diabetic control level would be
<7%
fair diabetic control level would be
8%-9%
poor diabetic control
> 9%
a Hgb A1c level of > 6.5 means
person has diabetes
what can affect the color in a urinalysis
over hydration
ETOH
dehydration
foods
what lab values should be NEGATIVE in a urinalysis
glucose, ketones, bilirubin, blood, protein and urobilinogen, nitrate, leukocytes, bacteria
what should the pH be in a urinalysis
5-8 (slightly acidic)
if blood is positive in urine it could indicate
hemoglobinuria
myoglobinuria
hematuria
kidney stones
if ketones are positive in urinalysis it could indicate
diabetes and ETOH, decreased carb intake
if nitrate is positive in urinalysis it could indicate
significant bacteria and or infection
if bacteria is present in urinalysis it could indicate a
UTI
what are 3 types of to look at a urinalysis
gross (color and appearance), dipstick and microscopic
a urinalysis provides info about
kidneys and metabolic processes
urinalysis is frequently used for testing
UTIs
what is the norm level for sodium
134-145 meq/L
sodium is the major cation in the
Extracellular space
sodium is the balance between ______ intake and ______ excretion
dietary; renal
increased sodium levels=
(hypernatremia) increase intake, decreased sodium loss, increase water loss, pt restless, can’t drink enough
decreased sodium levels =
(hyponatremia) decrease in sodium intake, increase sodium loss, increase free body water, pt increase of weight, not easy to arouse, pulse is elevated, BP is low
what are the potassium normal levels
3.5-5.1 mmol/L
potassium is the major cation within the ______ and is important for ____ ______/ _____ _______
cell: nerve conduction/acid base
increased potassium levels indicate
((hyperkalemia) excessive intake, acidosis, renal failure, addison disease, dehydration
decreased potassium levels indicate
(hypokalemia) deficient intake, birns, hyperaldosteroneism, cushing syndrome, RTA, licorice ingestion, alkalosis, renal artery stenosis and pt is lethargic, thirsty, muscle irritability, cramping, EKG changes
potassium levels are important in telling us about
cardiac issues
what is the normal lab value for Chloride
98-108 mEq/L
increased Cl could mean
(hyperchloremia); dehydration, metabolic acidosis, RTA, cushing syndrome, renal dysfunction, resp alkolosis, hyperparathyroidism
decreased Cl could mean
(hypochloremia); overhydration, CHF, chronic resp acidosis, metabolic alkalosis, addisons disease, aldosteroneism, V/prolonged gastric suction, hypokalemia
Cl lab values can give an indication of acid base balance and
hydration status
interfering factors of Cl are
excessive infusions of saline drugs
chloride maintains cellular integrity via influence on
osmotic pressure, acid base balance, water balance,
Cl transport is passive and usually follows
sodium
3.6-10.8 L/uL
WBC
12.0-16.0 g/
HGB
37.0-47.0%
HCT
150-400 K/uL
PLT
134-145 meq/L
Sodium
3.5-5.1 mmol/L
Potassium
8.5-10.0 mg/dl
Ca
76-106 mg/dL
glucose
7-21 mg/dL
BUN
0.6-1.3 mg/dL
creatinine
10-43 U/L
AST
13-56 U/L
ALT
amylase should be
<130 U/L
lipase should be
<160 U/L
9.7-12.7 sec
PT/Protime
30-45 sec
PTT/ partial thromboplastin
1.0-1.5 (not on coumadin)
INR/international normalized ratio
if on coumadin the INR should be
2.0-3.0
