Lab Values and Diagnostics( TEST 4) Flashcards
Divisions of the Clinical Lab
Hematology, Chemistry, Microbiology, Blood Bank
What is measured in Hematology (CBC)?
WBC COUNT
HEMOGLOBIN
PLATELETS
BMP (Basic Metabolic Panel)
SODIUM
POTASSIUM
CREATININE
GLUCOSE
CMP (Comprehensive Metabolic Panel)
Same as BMP
Additional Electrolytes
Phosphorus
Magnesium
Amylase
Microbiology
Sputum Gram Stain
Sputum Culture and Sensitivity
Pleural Fluid culture and sensitivity
Purpose of Blood Bank?
Blood typing and storage
Term for WBC?
Leukocytes
Leukocyte normal value, abnormal value, and lifespan
5,000-10,000
<2,000 or >40,000mm/3
Lifespan: 13-20 days
Names of granulocytes & percentage:
Neutrophils: 55-70%
Bands: 3-5%
Eosinophils: 1-4%
Basophils: .5-1%
Names of Agranulocytes & percentages:
Lymphocytes: 20-40%
Monocytes: 2-8%
What are bands?
Immature neutrophils, make up <5% of circulating neutrophils.
Function: Locate, Ingest, and kill bacteria
What is a left shift?
Increase in the number of bands. Common with acute infection
Term for High and Low WBC:
Causes
Leukocytosis/Neutrophilia: Trauma, stress, inflammation, tissue nekrosis, leukemia, infection
Leukopenia/Neutropenic: Drug Toxicity, chemo, bonne marrow infection , dietary deficiency
If WBC count is high what do you do?
note and report s/s of infection or inflammation
If WBC count is low what do you do?
initiate neutropenic precautions
Normal RBC values in men and women
Men: 4.7-6.1 million/mm3
Women: 4.2-5.4 million/mm3
M Hemoglobin: 14-18
W Hemoglobin: 12-16
M Hematocrit: 42-52%
W Hematocrit: 37-47%
Term for High and Low RBC Count:
Causes
Polycythemia: living at high altitude, chronic lung disease with hypoxia, some drugs
Anemia: Pregnancy, decreased bone marrow production, over hydration, some drugs
What is the rule of three?
Used to detect errors in RBC count, Hemoglobin, and Hematocrit
RBC, 3X= Hemoglobin, 3X= Hematocrit
Term for High and Low platelet count:
Causes
Thrombocythemia: polycythemia, iron deficiency anemia, rheumatoid arthritis
Thrombocytopenia/Thrombocytosis: Heparin induced cytopenia(HIT), DIC, bone marrow disease, liver failure, sepsis, bleeding
Normal Platelet count and lifespan
150,000-400,000/mm3
10 days
What does PT stand for? What med is regulated with it?
Prothrombin, 11-12.5 seconds
Med: Coumadin
What is PTT? What med is regulated with it? Assess intrinsic or extrinsic system?
Patients on anticoagulant therapy?
Partial Thromboplastin Time
Med: Warfarin
Intrinsic
1.5-2.5 X the control value in seconds
What is INR?
In healthy people?
On anticoagulants?
Atrial Fibrillations/Mechanical Heart Valves?
International Normalized Ratio. Measures the time it takes blood to clot and compares it to average Healthy: .8-1.1 Anticoagulants: 2-3 Mechanical Heart Valves: 3-4
Sodium Value*
136-145 mEq/L
Potassium Value*
3.5-5 mEq/L
Glucose Value*
70-110 mg/dl
Creatinine Value*
.5-1.1 mg/dl
Chloride Value
98-106 mEq/dl
BUN value
10-20 mg/dl
Calcium Value
9-10.5 total
What is a CXR? Implications?
Chest X-ray
Cost-effective way to identify disorders. X-ray absorbs dense objects and passes through less dense objects. Dense objects appear white and lesser dense objects appear black or light gray.
Is patient pregnant? Lie or stand still, hold breath. Remove Jewelry
What is an EKG? Implications?
Electrocardiogram. Records electrical activity of heart on paper.
Evaluate meds
Remove Jewelry and some clothing
Term for EKG used in healthcare setting?
Telemetry
What is an ultrasound? Implications?
Uses soundwaves to create images of organs and structures inside the body. Less expensive than MRI and CT scan
Patient NPO?
Bladder Empty?
Fluids increased?
Remove Jewelry
What is a CT scan? Implications?
Computed Tomography Scan
X-ray beam rotates around patient, takes detailed thin slice image of patient.
Evaluate medications Claustrophobic? Pregnant? Breastfeeding? Remove Everything Allergies: shellfish, latex, iodine, contract dye
What is an MRI? Implications?
Magnetic Resonance Imaging
Uses pulsating radio waves in a magnetic field to produce an image of inside patient’s body.
2 types: open and closed
Remove all metal
Same as CT scan
What is thoracentesis? Implications?
Needle into pleural space for removal of fluid.
Obtain informed consent
fasting/sedation not necessary
movement minimized
positioning
What is paracentesis? Implications?
Needle or Catheter into peritoneal cavity for removal of ascetic fluid. Lose proteins
Obtain informed consent
fasting/sedation not necessary
measure abdominal girth, weight, VS
position
What is a lumbar puncture? Implications?
Needle in subarachnoid space of spinal column for pressure measurement and to obtain CSF
Obtain Informed Consent
fasting/sedation not necessary
empty bladder/bowel
sharp pain down legs= spinal root has been touched
NO reclining/ lifting of head post procedure
What is a Bone Marrow Biopsy? Implications?
Removal of Bone Marrow.
Prone, Supine, or Lateral Position Obtain Informed Consent May give sedation Inform to stay still Instruct to be on bedrest for 30-60 minutes after procedure
