Lab Values

Question 1

WBC

Answer 1

White blood cell count
Indicates fx status of immune system
5,000-10,000 uL

Question 2

Leukocytosis

Answer 2

High WBC

Due to acute/chronic infection or malignancy

Question 3

Leukopenia

Answer 3

Low WBC

Disease of immune system or radiation/chemo

Question 4

WBC implication for tx

Answer 4

> 11,000 may have decreased tolerance to activity

<5,000 w/ fever - consider postponing due to risk of infection

Question 5

Hct

Answer 5

Hemotcrit - vol of RBC in whole blood
Eval Armenia and abnormal state of hydration

Male 42-52%
Female 37-47%

Question 6

Increased Hct

Answer 6

Tobacco use, severe Lung disease

Question 7

Decreased Hct

Answer 7

Anemia or hemodilution

Question 8

Hct implications for tax

Answer 8

Low: weakness, fatigue, DOE, tachycardia
25-30% consider modifying tx
<25% consider postponing tx
Frequent vital monitoring and rest period recommended

Question 9

Hb

Answer 9

Hemoglobin- reflects O2 carrying component of RBC - indicates severity of anemia
Male: 14-18 g/dL
Female: 12-16 g/dL

Question 10

Hb levels

Answer 10

Increased: smokers and lung disease
Decreased: anemia

Question 11

Hb implications for tax

Answer 11

8-10 g/dL —> modify due to reduced exercise capacity

<8 g/dL—>consider postponing tax

Question 12

Plts

Answer 12

Platelets - clotting process, bleeding stopped and would healing begins

150,000-400,000

Question 13

Thrombocytosis

Answer 13

High Plt count

Iron deficiency, neoplasm, inflammation, infection

Question 14

Thrombocytopenia

Answer 14

Low Plt count

Liver disease, platelet disorders, viral infection

Question 15

Plts implication for tx

Answer 15

-low levels, bleeding can occur form mucosal surfaces w/ inor truama
-20,000-50,000 light AROM if asymptomatic; gait training as tolerated, no resistive
<20,000 NO TX!!

Question 16

Na

Answer 16

Sodium - electrolyte important in nerve conduction, muscle contraction, cell fx

Changes cause cells to shrink or swell

136-145 mEq/L

Question 17

Hypernatremia

Answer 17

Increased NA

> 160 mEq/L

Question 18

Hyponatremia

Answer 18

Decreased Na

<120 mEq/L

Question 19

Na levels affected by

Answer 19

Diuretics, diarrhea, CHF

Question 20

Na implications for tx

Answer 20

Be aware of potential symtpoms when Na is LOW:

Weakness, confusion, stupor, hypotension, seizures, edema, weight gain

Question 21

K

Answer 21

Potassium - electrolyte important for muscle and nerve conduction

3.5-5.0 mEq/L

Question 22

Hyperkalemia

Answer 22

Increased K - due to kidney disease or certain meds

Can produce EEG changes, nausea, diarrhea

Question 23

Hypokalemia

Answer 23

Decreased K - caused by diarrhea, vomiting, dehydration

Can lead to dangerous ventricular arrhythmia, cardiac irritability, dizziness, hypotension

Question 24

K implications for tx

Answer 24

Minor changes can have sig consequence for cardiac fx.

Pts w/ abnormal K should be seen for tx after the levels have been corrected

Question 25

BUN

Answer 25

Blood urea nitrogen - waist product for protein metabolism, directly related to metabolic fx of liver and excretory fx of kidneys 10-20 mg/dL

Question 26

BUN levels

Answer 26

Increased: renal and liver disease pt may need dialysis, kidneys not fx properly Decreased: inadequate protein intake, malabsorption, liver damage

Question 27

BUN implications for tx

Answer 27

No specific activity guidelines but pt w/ renal dysfunction may experience fatigue, muscle weakness, decreased mental status as BUN levels rise

Question 28

Creatinine

Answer 28

By product of normal muscle metabolism, regulated and excreted by kidney .6-1.2 mg/dL

Question 29

Creatinine levels

Answer 29

High: reflect worsening kidney fx Low: inadequate protein intake, liver disease, kidney damage

Question 30

Creatinine implications for tx

Answer 30

No specific activity guidelines but patients with renal dysfunction may experience fatigue, muscle weakness, and decreased mental status as creatinine levels rise

Question 31

Blood glucose

Answer 31

Measure of sugar content in blood - detect hyper, hypo, and diabetes Fasting: 70-110 mg/dL

Question 32

Hypoglycemia

Answer 32

Low blood glucose Can lead to low activity tolerance Sweating, hunger, trembling, anxiety, blurred vision, confusion <60 mg/dL = hold tx until it has been corrected

Question 33

Hyperglycemia

Answer 33

High blood glucose - can lead to diabetic ketoacidosis Increased thirst, fatigue, blurred vision, <300-350 mg/dL = hold tx

Question 34

A1C test

Answer 34

Blood test provides info about average blood close level over past 3mo <5.7% =normal 5.7-6.4% = prediabetes >6.5% = diabetes

Question 35

Coagulation profiles

Answer 35

Determine ability to initiation clotting sequence - dx clotting disorders, monitor anticoagulant therapy

Question 36

“Therapeutic level” for coagulation

Answer 36

Level when the blood has been sufficiently antigoagulated given pt’s medical condition

Question 37

PT or Pro Time

Answer 37

Prothrombin time - test to screen for bleeding disorders, measures the clotting time Monitors effectiveness of oral anticoagulant therapy 11-12.5 seconds

Question 38

Pro Time implications for tx

Answer 38

Patients receiving anticoagulant therapy may have levels that are 2 - 3 times the laboratory control values With abnormally high levels, treatment may be held due to increased risk of bleeding

Question 39

PTT

Answer 39

Partial thromboplastin Time - measures clotting time in plasma - disorders of both excessive clotting and excessive bleeding Monitors effectiveness of heparin anticoagulant therapy 30-40 seconds

Question 40

PTT implications for tx

Answer 40

Patients receiving anticoagulant therapy mayhave levels that are 1.5 – 2.5 times the laboratory control values With abnormally high levels, treatment may be held due to increased risk of bleeding

Question 41

Chart

Answer 41

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