Lab Values Flashcards
what are the components of a basic metabolic panel? (BMP)
- Na and Cl
- K
- HCO3
- BUN
- Creatinine
- glucose
what is sodium’s role in the body
major positive ion in the extracellular fluid
what happens to the body during hypernatremia or hyponatremia?
cognitive changes
what happens during hyper/hypokalemia?
muscle weakness and irritability most notably and importantly in the heart. Critical values contraindicate PT due to risk of arrhythmia and tetany
what is BUN?
blood urea nitrogen - breakdown product of protein
what is serum creatinine
byproduct of creatine -> muscle metabolism
what do BUN and serum creatinine tell you?
how the kidneys are working
what is normal adult fasting glucose?
70-100 mg/dL
what is older adult (>60) fasting glucose?
80-110 mg/dL
what is normal Hb A1C
4-6%
what Hb A1C is considered poor glucose control
> 7%
what do you do if your patients glucose is too low?
15:15 rule - give the pt 15g sugar, wait 15, repeat if needed, wait 15, if it doesnt rise then talk to nurse, if it does then proceed with tx
what is the alert value for low plasma glucose?
<70 mg/dL
what usually has 15 g sugar that you would give your pt for 15:15 rule
6-7 hard candies, 1/2 cup fruit/juice/soda
what is defined as hyperglycemia in the hospital setting
> 140 mg/dL
what are symptoms of hyperglycemia?
tiredness, malaise, fruity breath, headache
what is a comprehensive metabolic panel (CMP)?
BMP plus liver tests (bilirubin, total protein, albumin, ammonia, and serum enzymes)
what are common liver panel items on the CMP?
bilirubin, total protein, albumin, ammonia, and serum enzymes
what does low serum prealbumin indicate?
protein depletion - may make the pt feel weak
what are the items on a CBC?
WBC count and differential, Hgb, Hct, and platelets
what is hematocrit (Hct)
percentage of RBCs in whole blood
what usually causes high hematocrit
polycythemia, severe dehydration, acclimatization to altitude, or tobacco use
what usually causes low hematocrit
anemia from blood loss or hemodilution
what usually causes high Hb?
chronic hypoxia and high altitude
what usually causes low Hb?
cancer and blood loss
what is normal female hematocrit?
36-47
what is normal male hematocrit?
41-51
what is the alert value for hematocrit?
<25
what is normal female Hb?
12-16
what is normal male Hb?
14-17
what is the alert value for Hb?
<8
what is normal adult female WBC
3900-10700
what is normal adult male WBC
4500-11000
what is considered leukopenia values? why does this matter for us?
WBC <1000 - the patient usually wears a protective mask
what is considered neutropenia values?
WBC <1000 and ANC <500
what is normal adult platelet count?
150,000 - 400,000
what is the alert value for platelets?
< 20,000
what value is considered for thrombocytopenia
platelets < 140,000
what value is considered for throbocytosis
platelets > 400,000
what three tests are considered for a coagulation profile
aPTT (activated partial thromboplastin time), PT, and INR (internation normalized ratios)
what lab value monitors warfarin (coumadin) administration? reference range?
INR (0.9-1.1)
what is the therapeutic range for administration of coumadin and how long does it take to achieve?
2.0-3.0 achieved in 2-5 days
when is it safe to mobilize a patient on warfarin/coumadin in the presence of a DVT?
when INR is in the therapeutic range
what is the lab value, reference range, therapeutic range, and safety parameters surrounding unfractionated heparin administration?
- PTT
- 24-36 seconds
- PTT 2-3x upper limit of normal
- when in therapeutic range
what is the lab value, reference range, and safety parameters surrounding administration of low molecular weight heparin (lovenox)
- not routinely measured
- safe to mobilize 3-5 hours after 1st injection administered
what is the lab value, reference range, and safety parameters surrounding administration of fondaparinux?
- not routinely measured
- 1.7 hours after 1st injection administered
what is an SCD and what does it do
sequential compression device: provides intermittant pressure to LE to prevent DVT and VTE
should you take off SCDs during a tx session?
yes, they are worn when the pt is in bed or sitting in a chair, but can be taken off and put back on for PT
when is an SCD contraindicated
- area of known DVT
- area of acute cellulitis
- over fx or open wound
