Lab Values

Question 1

SpO2

Answer 1

98-100%

• supplemental O2 indicated below 88-90%

Question 2

PaO2

Answer 2

90-100mmHg

• increase in hyperOx
• decrease in cardiac decompensation, COPD, and some NMSK disorders

Question 3

PaCO2

Answer 3

35-45mmHg

• increase in COPD, hypoventilation
• decrease in hyperventilation, pregnancy, pulmonary embolism, anxiety

Question 4

pH

Answer 4

7.35-7.45

<7.35 = acidic
>7.45 = alkalotic

• increase in respiratory alkalosis: hyperventilation, sepsis, liver disease, fever
• increase in metabolic alkalosis: vomiting, K+ depletion, diuretics, volume depletion
• decrease in respiratory acidosis: hypoventilation, COPD, respiratory depressants, myasthenia
• decrease in metabolic acidosis: increased acids (diabetes, alcohol, starvation), renal failure, increased acid intake, loss of alkaline body fluids

Question 5

Prothrombin time (PT)

Answer 5

11-15 sec

• increased in factor X deficiency, hemorrhagic disease, cirrhosis, hepatitis drugs (warfarin)

Question 6

Partial thormboplastin time (PTT)

Answer 6

25-40 sec

• increased in factor VIII, IX, and X deficiency

Question 7

International normalized ratio (INR)

Answer 7

ratio of indifividuals PT to reference range
.9-1.1

• pts with DVT, PE, mechanical valves, AF on anticoagulation therapy will have target INFs 2-3. Pts with these conditions and/or genetic clotting disorders may have a target INR 3.5
• look for active signs of bleeding when treated these pts and use compensatory strategies to reduce falls

Question 8

Bleeding time

C-reactive protein (CRP)

Answer 8

2-10 min
<10mg/L

• increased in platelet disorders, thrombocytopenia
• increased levels associated with increased risk of atherosclerosis
• > 100mg/L associated with inflammation and infection

Question 9

WBC

Answer 9

4300-10,800 cells/mm3

• indicative of status of immune system
• increased in infection: bacterial, viral, inflammation, hematologic malignancy, leukemia, lymphoma, drugs (corticosteroids)
• decreased in aplastic anemia, B12 or folate deficiency

*use mask when <1000-2000 or Absolute Neutrophil Count <500-1000

Question 10

RBC

Answer 10

M: 4.6-6.2
F: 4.2-5.9

• increased in polycythemia
• decrease in anemia

Question 11

Erythrocyte sedimentation rate (ESR)

Answer 11

M: <1.5
F: <20

• increased in infection/inflammation: rheumatic or pelvic inflammatory disease, osteomyelitis
• used to monitor effects of tx (RA, SLE, Hodgkins)

Question 12

Hematocrit

Answer 12

% of RBC of whole blood, age dependent

M: 45-52%
F: 37-48%

• increased in erythrocytosis, dehydration, shock
• decreased in severe anemia, acute hemmorhage
• can cause decreased exercise tolerance, increased fatigue, tachycardia

Question 13

Hemoglobin

Answer 13

M: 13-18
F: 12-16
*age dependent

• increased in polycythemia, dehydration, shock
• decreased in anemia, prolonged hemorrhage, RBC destruction
• can cause decreased exercise tolerance, incrased fatigue, tachycardia

Question 14

Platelet count

Answer 14

150,000-450,000

• increased in chronic leukymia, hemoconcentration
• decreased in thrombocytopenia, acute leukemia, aplastic anemia, CA chemo
• increased risk of bleeding with low levels, monitor for hematuria, petechiae, other active bleeding signs

<20,000: AROM, ADLs only
20-30,000: light exercise only
30-50,000: moderate exercise