Lab Values

Question 1

Name 4 commonly ordered tests

Answer 1

• CBC (complete blood count) • BMP (basic metabolic panel) • Cardiac Enzymes test • Coagulation tests (PTT and INR)

Question 2

Key components of CBC (Complete blood count) are:

Answer 2

Red blood cells, white blood cells, platelets, hemoglobin, hematocrit

Question 3

Low red blood cell levels indicate ____ , high levels indicate _______or ____

Answer 3

anemia

dehydration or bleeding

Question 4

High white blood cell levels indicate ____ or _____

Answer 4

Infection or

immune disorder

Question 5

Platelets are ____ factors,

Answer 5

clotting

Question 6

Low platelet levels indicate ___ disorder, high levels increase risk of ____

Answer 6

bleeding

clots

Question 7

Hemoglobin carries ____ in the blood, low levels results in _____

Answer 7

Oxygen

anemia

Question 8

Hematocrit – how much space ___ take up in blood.

Answer 8

RBCs

Question 9

High hematocrit levels indicate ____, low levels indicate ___

Answer 9

dehydration

anemia

Question 10

The BMP tests for what four things?

Answer 10

• Glucose
• Calcium
• Electrolytes (sodium, potassium, CO2 chloride)
• Kidney function (BUN and creatinine)

Question 11

The basic metabolic panel (BMP) looks at different chemicals in the ____

Answer 11

blood plasma.

Question 12

Extremely low blood sugar is below ____

Extremely high blood sugar is over ___

Answer 12

70

350

Question 13

Calcium is an important ion for ___ function, ___ function, and ___ function.

Answer 13

Bone, kidney, thyroid

Question 14

Abnormal calcium levels are associated with ___

Answer 14

cancer

Question 15

Hypercalcemia (high levels of calcium) can indicate ___ or ____

Answer 15

hyperparathyroidism or bone cancer

Question 16

Hypocalcemia (low levels of calcium) can indicate which four diseases?

Answer 16

Liver disease (alcoholism,) hypoparathyroidism, pancreatitis, and renal failure.

Question 17

Hypernatremia, or high sodium, is a sodium level over __

Answer 17

140

Question 18

Hyponatremia, or low sodium, is a sodium level under ___

Answer 18

120

Question 19

Hypernatremia, or high sodium usually results from ___ or sometimes _____

Answer 19

dehydration or

sometimes diabetes insipidus

Question 20

Hyponatremia, or low sodium, indicates what 6 things?

Answer 20

diarrhea, kidney disease, Addison

disease, heart failure (fluid overload), cirrhosis, or malnutrition

Question 21

• Hypokalemia – low potassium (<3.0) can occur with diarrhea, Tylenol
overdose, or excess urination due to diuretic medication

Answer 21

potassium

Question 22

Potassium levels should be between __ and ___

Answer 22

3 and 5

Question 23

Hyperkalemia can result from?

Answer 23

kidney disease, Addison

disease, diabetes, dehydration, infection, and injuries to tissue

Question 24

Hypokalemia can occur with?

Answer 24

diarrhea, Tylenol

overdose, or excess urination due to diuretic medication

Question 25

High CO2 levels can indicate

Answer 25

``` lung disease (COPD), metabolic alkalosis (high pH), and certain syndromes ```

Question 26

Low CO2 levels can indicate

Answer 26

shock, Addison disease, metabolic acidosis (low pH), kidney disease, methanol or ethylene glycol poisoning, kidney disease, or diabetic ketoacidosis

Question 27

High chloride levels can indicate | -

Answer 27

dehydration, Cushing syndrome, or | kidney disease and metabolic acidosis

Question 28

Low chloride levels can indicate

Answer 28

CHF, emphysema and chronic lung | disease, Addison disease, and metabolic alkalosis

Question 29

Blood urea nitrogen is used to identify

Answer 29

acute or chronic kidney | disease

Question 30

High blood urea nitrogen levels are associated with? (4 things)

Answer 30

congestive heart failure, shock, heart attack, | and dehydration.

Question 31

BNP elevation is also present with excess ____ breakdown

Answer 31

protein breakdown

Question 32

Excess protein breakdown is also called?

Answer 32

Rhabdomyolysis

Question 33

Low BUN levels are associated with severe ____, but low BUN is uncommon

Answer 33

severe liver disease

Question 34

Elevated creatinine levels indicate ___ injury due to infection, autoimmune disease, toxicity, prostate disease, dehydration, septic shock, CHF, or diabetes.

Answer 34

kidney

Question 35

Low creatinine levels are not ____

Answer 35

significant.

Question 36

The BMP measures certain cardiac enzymes including (name two) include: • •

Answer 36

Creatine kinase | Troponins

Question 37

Creatine Kinase is a blood product released when

Answer 37

heart muscle is | damaged

Question 38

Troponins- protein involved in

Answer 38

muscle contraction

Question 39

High troponin levels indicate

Answer 39

heart muscle damage

Question 40

High levels of creatine or “positive” troponins indicate the presence of a

Answer 40

heart attack.

Question 41

If a client has high cardiac enzyme levels, hold treatment unless.

Answer 41

They are cleared by the physician.

Question 42

In most circumstances, if a client has high cardiac enzyme levels, it is generally OK to

Answer 42

treat if they are | trending down.

Question 43

INR is a chemical marker associated with the use of . | • H

Answer 43

coumadin (warfarin)

Question 44

High INR levels indicate ___ risk, and low levels indicate increased risk for ____

Answer 44

Bleeding risk, low levels indicate | increased risk for blood clots

Question 45

PTT is a chemical marker associated with the use of

Answer 45

heparin.

Question 46

High PTT levels indicate ___, low levels indicate increased risk for ___

Answer 46

bleeding risk | blood clots

Question 47

____ is a chemical released when heart muscle is stretched.

Answer 47

Brain Natriuretic Peptide (BNP)

Question 48

High levels of BNP (>___ pg/ml) are an indicator of congestive heart failure (CHF). Levels above___ pg/ml indicate severe heart failure.

Answer 48

300 | 900

Question 49

Patients in severe heart failure should be monitored for symptoms of (4 things)

Answer 49

shortness of breath, low blood pressure, swelling of the legs, and dizziness.

Question 50

Treatment should be held for any lab value labeled as a ___ or ____lab unless treatment is specifically ordered by the physician after they have been made aware of the abnormal result. (This varies by the physician- always follow the protocol for that facility!).

Answer 50

critical or panic

Question 51

Therapy is also held for any ___ radiology procedures (MRI, CT, ABG’s, Ultrasound, EKG).

Answer 51

STAT

Question 52

Therapy should be held for potassium levels less than __ or greater than ___

Answer 52

3 | 5

Question 53

Therapy should be held for hemoglobin below __ or hematocrit below ___

Answer 53

8 | 24

Question 54

• Blood sugar less than __ may cause patients to become unresponsive. If they regain consciousness quickly, their symptoms are usually relieved by giving them a snack (OJ, peanut butter crackers) and waiting a few minutes for their sugar to come back to a safe range. Hold if blood sugar is above ___ .

Answer 54

70 | 350

Question 55

Which abnormal lab value is associated with Severe anemia and increase risk of dizziness, falls, and fatigue or muscle cramping and soreness due to decreased oxygenation of tissues.

Answer 55

Hemoglobin below 8 and hematocrit below 24

Question 56

Therapy should be held for sodium less than ___ and greater than ___

Answer 56

120 | 140

Question 57

Therapy should be held for INR greater than __ or PTT greater than ___. This indicates excessive risk of bleeding due to very thin blood serum

Answer 57

4.0 | 120