Lab Values - Exam 1 Flashcards
Why are lab values used for?
- screening
- diagnosis
- monitoring
What are factors that affect lab values?
- age
- gender
- race
- pregnancy
- food ingestion
CBC
Complete blood count
Erythrocyte count (RBC) - value
3.89- 5.40 M/uL
RBC count
The number of circulating RBCs in blood
These carry oxygen?
RBCS
Contain hemoglobin molecules
Erythrocytes (RBCs)
Hemoglobin - value
12-16 g/dL
Measurement of the total amount of Hgb in the blood
Hemoglobin
Hematocrit -value
37.0-47.0
Indirect measurement of RBC number and volume
Hematocrit
Part of routine testing and anemia testing
Hematocrit
Critical value for hematocrit
<15%- >60%
Women usually have a lower value in this
Hematocrit
Decrease number in RBCs
Anemia
If a patient has impaired RBC production, blood loss, or RBC destruction
OR
a combination of all three what does this patient have?
Anemia
Platelet count - value
150,000
Formed in the bone marrow
Platelets
If platelets are less than 100,00 what is a patient at risk for?
Bleeding
Platelets count >1million
Risk of clotting
Platelet count >600,000
Potential problems
Platelet count below 50,000
High risk of bleeding
High platelet count name
Thrombocytosis
Low platelet count name
Thrombocytopenia
Total WBCs value
3.6 -10.8 K/uL
Part of routine testing on CBC
Total WBCs
White cell differential count
% of each type of leukocyte present in specimen
High WBC name
Leukocytosis
Low WBC name
Leukopenia
Measurement of % of each WBC type in the blood
WBC differential
Normal value - neutrophils (WBC)
50-70%
Normal value- lymphocytes (WBC)
20-40%
Normal value - monocytes (WBC)
2-8%
Normal value - Eosinophils (WBC)
1-4%
Normal value- Basophils (WBC)
0.5-1.0%
Leukocytosis
Abnormally large number of leukocytes
Lymphocytosis
Form of actual or relative leukocytosis due to increase in numbers of lymphocytes
Left shift
Increase in the number of immature neutrophils (bands/stabs) found in the blood
What makes up the comprehensive metabolic panel?
- glucose
- calcium
- sodium
- chloride
- potassium
- CO2
- BUN
- creatinine
PLUS
ALP, AST, ALT, Bili, total protein, albumin, Globulin
Basic (BMP)
- kidney function
- blood glucose
- acid/base balance
- electrolyte imbalance
Comprehensive (CMP)
- BMP PLUS
- blood proteins
- liver function
What’s included in the BMP plus?
- albumin
- total protein
- ALP
- AST
- ALT
- Bili
Blood urea nitrogen value
10-20 mg/dL
Creatinine value
0.5-1.1 mg/dL
Glucose value
70-110 mg/dL
Calcium value
9-10.8 mg/dL
Chloride value
98-106 mmol/L
Potassium value
3.5-5.0 mmol/L
Sodium value
136-145 mEq/L
Blood sugar
Glucose test
Direct measurement of blood glucose level
Glucose test
High glucose lvl name
Hyperglycemia
Low glucose lvl name
Hypoglycemia
Blood test used to monitor diabetes and the treatment of diabetes
A1C
This test tells the average blood glucose lvl of the last 3 months
A1C
Non diabetic “normal” range
4-5.9%
Good diabetic control range
<7%
Fair diabetic control range
8-9%
Poor diabetic control range
> 9%
-Major cation in the extra cellular space
- balance between dietary sodium intake and renal excretion
What test am I?
Sodium 135-145 mEq/L
High sodium name
Hypernatremia
Low sodium name
Hyponatremia
Important to cardiac function
Potassium 3.5-5.1
High potassium name
Hyperkalemia
Low potassium name
Hypokalemia
Major extracellular anion
Transport is passive and usually follows sodium
Chloride
High for chloride
Hyperchloremia
Low chloride
Hypochloremia
Bicarbonate value
20-30 mEq/L
Major role in acid/base balance
Regulated by kidneys
Used to evaluate pH status and electrolytes
Bicarbonate
Critical value of bicarbonate
<6 mEq/L
Calcium value
7.6-10.4 mg/dL
Used to evaluate parathyroid function and calcium metabolism
Calcium
Used to monitor patients with renal failure, renal, transplantation, hyperparathyroidism, and various malignancies, monitor calcium levels during and after large volume blood transfusions
Calcium
High- calcium
Hypercalcemia
Low- calcium
Hypocalcemia
Phosphorus level
3.0-4.5
Assist in the interpretation of parathyroid and calcium abnormalities
Phosphorus
High- phosphorus
Hyperphosphatemia
Low- phosphorus
Hypophosphatemia
Magnesium level
1.3-2.1 mEq/L
Around half of it in the bone
Magnesium
Important in calcium metabolism, and closely tied to calcium levels
Magnesium
Monitor EKG
Magnesium
Total protein level
6.4-8.3
Combination of pre-albumin, albumin, and globulins
Total protein
What tests go along with the hepatic functions
- albumin
- AST
- Alk phos
- ALT
- Bili total
- direct Bili
- ammonia
Albumin level
3.5- 5.0
A protein formed and synthesized within the liver
Albumin
Comprises of 60% of total protein in blood
Albumin
Regulates osmotic pressure
Albumin
Transports blood, hormones, enzymes, and drugs
Albumin
Hepatic function and nutritional state
Albumin
ALP lvl
30-120 u/L
Detect and monitor diseases of liver and bone
ALP
ALT lvl
4-36 u/L
Predominantly found in the liver
ALT
Injury or disease affecting the liver parenchyma causes the release of ALT into the bloodstream
ALT
Used to identify and monitor hepatocellular disease of the liver
ALT
AST lvl
0-35 u/L
Found in very high concentrations within Harley but if all of tissues
- Liver and muscle cells, heart, muscle cells, Skeletal muscle cells
AST
Disease/injury of one of these tissues causes dying of cells, and released into bloodstream
AST
Elevation proportional to number of cells injuries
AST
Used for evaluation of patients with suspected hepatocellular diseases
AST
Unconjugated Bilirubin lvl
0.02-0.08 mg/dL
Level of indirect bilirubin in blood
Unconjugated Bili
Conjugated bilirubin level
0.1-0.3 mg/dL
Level of direct bilirubin in blood
Conjugated bilirubin
Kidney function tests
- BUN
- creatinine
BUN - blood urea nitrogen level
10-20 mg /dL
Kidney and liver function
BUN test
End product of protein metabolism - produced in the liver
BUN test
Indirect and rough measurement of renal function and glomerular filtration rate
BUN test
Creatinine lvl
0.5-1.1 mg/dL
Excreted entirely by kidneys
Creatinine
Direct measure of renal function
Creatinine
Critical value for creatinine
> 4 mg/dL
Amylase lvl
<130 u/L
Pancreatic test helpful in evaluation of abdominal pain
Amylase
Lipase lvl
< 160 u/L
Enzyme secreted by pancreas into small intestine
Lipase
Helps break down triglycerides into fatty acid
Lipase
Highly specific for pancreatic diseases
Lipase
pH of urine
4.6-8.0
Protein in urine
0-8 mg/dL
Specific gravity in urine
1.005-1.030
WBCs in urine
0-4
RBCs in urine
<2
24 hour urine
Collection of urine for 24hrs
To start the 24 hour urine what do you do with the first void?
Discard
Where do you store the 24 hour urine?
On ice or fridge
How long can urine sit at room temp?
1 hour
Monitor kidney function
Urinary protein
Normally not present in normal kidney due to size barrier in glomerulus
Urinary protein
How long does PT clotting factor take to clot blood and when is it critical?
11.0-13.0 seconds - normal value
>20 seconds - critical value
INR Clotting times- normal and critical
0.8-1.5seconds - normal
>5.5 seconds - critical
PTT - clotting time
30-45seconds
Peak
Highest amount of medication in the body
- level 1 1/2 hours after IVPB
Trough
Lowest amount of medication in the body
- level 30min prior to dose
Therapeutic lvl
Right amount of medication in the body
Culture & sensitivity test
Urine, blood, wound drainage, tissues, and devices
Obtain specimen prior to antibiotic treatment before which test?
C&S
What is the preliminary report for C&S time?
24hours
Final report time for C&S
72 hours
How long does it take for a fungus culture to come back?
Up to 6 weeks
Culture may be performed after
Therapy completion
Always collect this first
Blood culture
What two things are crucial in obtaining a blood culture
- site prep
- aseptic technique
Obtain 2 separate BC from
2 different sites
What is preferred over central line sites
Venipuncture
