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NCLEX ( fundamentals/MegSurg) > Laboratory Values > Flashcards

Laboratory Values Flashcards

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1
Q

What labs are included in CBC

A
  • RBC
  • HCT
  • HGB
  • WBC
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2
Q

Normal RBC level in Males

A

4.5 - 6.2 million cells

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3
Q

Normal RBC level in Females

A

4.2 - 5.4 million cells

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4
Q

What causes an increase in RBCs? think excess bleeding

A
  • Dehydration
  • Polycythemia Vera (blood cancer, too many blood cells that will thicken and slow blood flow causing clots in blood vessels)
  • Hemorrhage (early)
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5
Q

What causes a decrease in RBCs ?

A
  • Anemia
  • Blood loss
  • Overhydration
  • Subacute endocarditis (anemia)
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6
Q

Normal HCT level in males ?

A

42-52%

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7
Q

Normal HCT level in females ?

A

37-47%

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8
Q

What causes an increase in hematocrit

A
  • Severe dehydration
  • Polycythemia Vera
  • Cyanotic heart disease (CHD) *present at birth/blue baby
  • Severe chronic COPD
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9
Q

What causes a decrease in hematocrit

A
  • Active bleeding
  • Hemolytic anemia
  • dietary deficiency (iron)
  • Hemoglobinopathy ( blood dyscrasias) *low Rbc, Wbc, platelet
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10
Q

Normal Hgb for Males

A

14-18g/dl

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11
Q

Normal Hgb for females

A

12-16g/dl

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12
Q

What causes an increase in Hgb ?

A

Severe dehydration

  • Polycythemia Vera
  • Congenital Heart Disease
  • Erythrocytosis (High Altitude) *think same as polycythemia vera, too many red blood cells
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13
Q

What causes a decrease Hgb ?

A
  • Anemia
  • Hemoglobinopathy - Hemolytic anemia
  • Cirrhosis
  • Dietary deficiency (iron)
  • Bone marrow failure
  • Renal disease
  • Normal pregnancy
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14
Q

Normal WBC Level

A

5,000-10,000

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15
Q

Normal WBC for a child <2 years

A

6,200 - 17,000

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16
Q

Normal WBC for a newborn

A

9000-30,000

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17
Q

What causes an increase in WBC ?

A
  • Bacterial infection
  • Leukemia
  • Injury
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18
Q

What causes decrease in WBC ?

A
  • Viral infection
  • Aplastic anemia
  • Immune disorders
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19
Q

Normal Value of Neutrophils

A

48-77% (3,000- 7,500)

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20
Q
  • Infection
  • Acute Inflammatory process
  • Appendicitis
  • Cholecystitis (inflamed gallbladder)
  • Leukemia
  • Tissue Necrosis
  • MI
  • Burns
  • remember infection is always increased in ?
A

Increased Neutrophils

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21
Q
  • Viral infection
  • Sepsis
  • Radiation
  • Chemo
  • Drug- induced (lithium)
    Are signs of increased or decreased neutrophils
A

Decrease in Neutrophils

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22
Q

What are bands and what is the normal level ?

A
  • Bands are immature neutrophils

- Normal levels are 3-5 % (150-700)

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23
Q

What causes an increase of bands ?

A

Acute infection

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24
Q

Normal values for Eosinophils

A

1-4% (50- 400)

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25
Q

What causes increase in Eosinophils ? difficulty with breathing disorders

A
  • Allergic reaction
  • Fever
  • Asthma
  • Autoimmune disorders
  • Parasitic infections
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26
Q

What causes a decrease in Eosinophils ?

A
  • Cushing’s Syndrome
  • Steroids
  • Stress
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27
Q

Normal Basophils level

A

0-1% (25-100)

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28
Q

What causes an increase in basophils

A
  • Allergic reaction
  • Hyperparathyroidism
  • Healing phase of inflammation
  • Stress
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29
Q

What causes a decrease in basophil’s

A
  • Stress
  • Pregnancy
  • Ovulation
  • Hyperparathyroidism
  • Severe allergic reactions
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30
Q

Normal level of monocytes

A

1-9 % (100-500)

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31
Q

What are causes of Monocytes

A
  • Chronic inflammation
  • TB
  • mononucleosis
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32
Q

What type of drug therapy would you use for monocytes ?

A

Corticosteroids therapy (prednisone)

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33
Q

Normal level of Lymphocytes

A

25-40% (1,500-4,500)

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34
Q

What causes an increase in lymphocytes ?

A
  • Lymphocytosis - Chronic bacterial infection
  • Viral infection(mumps, rubella)
  • lymphocytic anemia
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35
Q

What causes a decrease in lymphocytes ?

A
  • Lymphocytopenia - Leukemia
  • Sepsis
  • immunodeficiency disease
  • Lupus erythematous (SLE)
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36
Q

Normal Value for T lymphocytes ?

A

60-80% of lymphocytes (mature thymus)

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37
Q

What causes an increase in T lymphocytes ?

A
  • Infectious mononucleosis

- Infectious hepatitis

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38
Q

What causes a decrease in T lymphocytes ?

A
  • Drug- induced
  • Adrenocorticosteroids
  • Antineoplastics
  • Radiation
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39
Q

Normal Value for B lymphocytes ?

A

10 - 20 % of lymphocytes (mature bone marrow)

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40
Q

What causes an increase in B lymphocytes ?

A
  • T lymphocytes are killer cells
  • Suppressor cells
  • T- Helper cells
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41
Q

What causes a decrease in B lymphocytes ?

A
  • lymphocytes are responsible to fight chronic bacterial and acute viral infection
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42
Q

Normal platelets level ?

A

150,000- 450,000

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43
Q

What causes an increase in platelet levels ?

A
  • Polycythemia Vera
  • Injury
  • Acute infection
  • Cirrhosis
  • TB
  • Post splenectomy syndrome
  • Malignant disorders:
    * Leukemia
    * Lymphoma
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44
Q

What causes a decrease in platelets ?

A
  • Hemorrhage
  • DIC
  • Pernicious anemia
  • Hemolytic anemia
  • Leukemia
  • Post massive blood transfusion
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45
Q

Normal level for BNP

A

<100

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46
Q

What is BNP and what is it specifically for ? * Think of what is needed to recover your muscles and what type of heart disease is affected*

A
  • Cardiac protein

- Is increased in CHF

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47
Q

CPK (Creatinine Phosphokinase) normal level ?

A

50- 325

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48
Q

What are causes of CPK ? (Creatinine Phosphokinase) and what organ does it effect ?

A
  • Elevated early in MI

- myocardial muscle

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49
Q

When do you what to test for CPK-MB ?

A
  • Within the first 24 hours after onset
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50
Q

What is CPK-MB specific for ?

A

Heart muscle

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51
Q

What do levels rise in CPK-MB ?

A

Rise in 3-6 hours after myocardial cell injury

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52
Q

What is CPK-BB specifically for ?

A

Brain and Lungs

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53
Q

What is CPK-MM specifically for ?

A

Skeletal muscle

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54
Q

What are normal levels for isoenzymes:

  • CPK-MB
  • CPK-BB
  • CPK- MM
A

0%

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55
Q

What is LDH ? (Lactic dehydrogenase) *cells found in which organs? *

A

Cells found in heart, liver, skeletal muscles, kidneys, and lungs

56
Q

What is LDH1 specific to ?

A

Heart

57
Q

What is the normal level for LDH ?

A

100-190

58
Q

What is Myoglobin ? what can it help in determining ?

A

Early index damage to the myocardium

59
Q

When is myoglobin increased ?

A
  • MI
  • Rhabdomyolysis
  • Myositis
60
Q

What are troponins ?

A
  • Proteins found in striated muscles (skeletal and myocardial)
61
Q

What happens when there is an increase in troponins? Think of what will happen to myocardium?

A
  • Troponins are released into the bloodstream when an infarction causes damage to the myocardium
62
Q

How long does it take for troponin levels to rise ?

A

As early as 3 hours after myocardial injury

63
Q

How many days do Troponin levels stay elevated ?

A

7-10 days remain elevated for up to 10-14 days

64
Q

Troponin I (cTnI) normal value ?

A

<0.03 ng/ml

65
Q

Troponin T (cTnT) normal value ?

A

<0.02 ng/ml

66
Q

How long can Troponin I remain elevated ?

A

7-10 days

67
Q

How long can Troponin T remain elevated ?

A

10 - 14 days

68
Q

How long can LDH remain elevated ?

A

More than 24 - 48 hours after the onset of symptom

69
Q

What is albumin ?

A
  • Main plasma protein of blood
  • Maintains oncotic pressure and transports bilirubin, fatty acids, medications, hormones, other substances insoluble to water
70
Q

When are albumin levels high ?

A
  • Dehydration
  • Diarrhea
  • Metastatic carcinoma
71
Q

When are albumin levels decreased ?

A
  • Acute infection
  • Ascites
  • Alcoholism
72
Q

Is having albumin or protein in the urine normal ?

A

No

73
Q

What is the normal value of Albumin ?

A

3.4 - 5 g/dL

74
Q

What is the normal Value of LDH ? When is it increased ? *diseases *

A 
100 - 190 IU/L or SI 
Increased in: 
- MI 
- Hepatic disease 
- Hemolytic or megaloblastic anemia 
- Skeletal muscle disease/injury 
- neoplasms 
- testicular 
- lymphoma 
- pancreatitis
75
Q

What is LDH1 specific to ? What is the normal value for it in adults ?

A

Specific to Heart

Normal Value: 17-27%

76
Q

What is LDH2 specific to ? and what is the normal value ?

A

Specific to heart, liver, skeletal muscles

Normal Value: 27 - 37%

77
Q

AST (SGOT) aspartate aminotransferase is increased in what ? think liver, GI

A
  • Pancreatitis
  • Hepatic failure
  • Opiates may cause increase
78
Q

What is the normal value for AST ?

A

10 - 26 IU/mL or 15-40 U/L

79
Q

ALKP ( alkaline phosphatase)

Used to detect and monitor diseases of the liver or bone. What is the normal value ?

A

20-130 U/L

80
Q

What does an increase in ALKP cause ?

A
  • Primary cirrhosis
  • Intrahepatic and biliary obstruction
  • Liver tumor ( primary or metastatic)
  • Penetrating PUD into the pancreas
81
Q

ALT (SGPT) alanine aminotransferase, Where is it predominantly found ?

A

Liver

82
Q

What is the normal value of ALT ?

A

10 - 30 IU/L or 2.4 - 7 U/L

83
Q

What does an increase in ALT cause ?

A
  • Cirrhosis
  • Hepatic tumor
  • Obstructive jaundice
  • Hepatotoxic drugs
84
Q

What causes an mild increase in ALT ?

A
  • Pancreatitis
  • MI
  • Infectious mononucleosis
  • Myositis
85
Q

What is Ammonia ?

A

When proteins are broken down by the bacteria in intestines

86
Q

What does ammonia help in diagnosing ?

A

Helps in diagnosing severe liver diseases (Cirrhosis, fulminant hepatitis)

87
Q

What is the normal value for ammonia ?

A

80 - 110 ug/dl or 47 - 65 umol/L

88
Q

What happens when ammonia is elevated ?

A

Liver is unable to convert ammonia into urea for excretion in the kidneys due to hepatic dysfunction

89
Q

Increased in hepatocellular disease, hepatic encephalopathy(ALOC due to liver failure), and portal hypertension
What is the cause of this ?

A

Increased level of Ammonia

90
Q

What is amylase ?

A
  • Enzyme
  • Produced by the pancreas
  • Salivary glands aids in digestion of complex carbs and is excreted by the kidneys
91
Q

What is amylase a specific enzyme for ? What kind of disease did Patrick Swayze die from ?

A

Pancreatitis

92
Q

If amylase is elevated what kind of disease can develop think both are inflamed

A

Pancreatitis and Cholecystitis

93
Q

How many hours can amylase increase after the onset of abdominal pain ?

A

24-48 hours are onset of abdominal pain

94
Q

What is the normal value of amylase ?

A

25- 125 IU/L

95
Q

What is lipase ? how is it excreted ?

A

Pancreatic enzyme that converts fats and triglycerides into fatty acids and glycerol
it is excreted by the kidneys

96
Q

Normal value of lipase ?

A

0-160 U/L

97
Q

Pancreatitis, pancreatic cancer
Biliary diseases Cholecystitis, cholangitis, extra hepatic duct obstruction
Renal failure and bowel obstruction
What enzyme can cause these if elevated ?

A

Lipase

98
Q

What is Bilirubin? where is it produced ? Think hepatic

A

Produced by liver, spleen, bone marrow also byproduct of hemoglobin breakdown

99
Q

What is the normal value for direct bilirubin(conjugated) ?

A

0.1 - 0.4mg/dl

100
Q

An increased serum bilirubin is due to excessive destruction of RBC ? Is this Direct bilirubin ( conjugated or indirect bilirubin unconjugated ?

A

Direct Bilirubin (conjugated) Soluble in water ?

101
Q

Liver is unable to excrete normal amounts of bilirubin. Elevated in biliary obstruction. Is this Direct of indirect bilirubin ?

A

Indirect bilirubin (Unconjugated)

102
Q

What is the normal value for indirect bilirubin (conjugated) ?

A

0.2 - 0.8 mg/dl

103
Q

Increased due to hepatocellular dysfunction What type of bilirubin is this ?

A

Total serum bilirubin

104
Q

What is the normal value for Total serum

A

0.3-1.3mg/dl

105
Q

What do lipids consist of ?

A

Primarily of cholesterol, triglycerides, and phospholipids

106
Q

What do lipid assessments include ?

A

HDL (High density lipoprotein)

LDL (Low density lipoprotein

107
Q

Triglycerides, what do they play a major part in ?

A
  • Very low density lipoproteins (VLDL)

- Small part in low density lipoproteins

108
Q

Synthesized in liver from fatty acids, protein, and glucose. Obtained from diet What is this ?

A

Triglycerides

109
Q

Increase in cholesterol, LDL, and triglyceride levels. What do risk do these place on Pt. Think cardio diseases specifically causing plaque in arteries

A

Coronary artery disease

110
Q

do they help protect against ? Think coronary arteries

A

Good

Help in protecting Pt. at risk for coronary artery disease

111
Q

What should the total cholesterol level be ?

A

< 200 mg/dL

112
Q

What value should LDLs be ?

A

> 130 mg/dL (Near Ideal)

113
Q

What value should LDLs be if a Pt, is at risk for heart disease ?

A

> 100 mg/dL

114
Q

What value should LDLs be if Pt is a very high risk of heart disease ?

A

> 70 mg/dL

115
Q

Nursing considerations for what can cause an increase in lipid ? What do women take to prevent getting pregnant ?

A

Oral contraceptives

116
Q

What is a glucose tolerance test ? How can it determine diabetes ? think how long should be fasting and when levels rise or after how many hours after it rises

A

Glucose levels peak at higher than normal in 1 -2 hours after inj or ingestion of glucose and slower than normal to return to level of fasting blood sugar levels then diabetes mellitus is confirmed

117
Q

What is normal fasting glucose level in Pt. without diabetes ?

A

60-110 mg/dL

118
Q

Glucose Tolerance Test, Oral (nonpregnant)

A

Baseline fasting 60 min
120 min fasting
Glucose, 2 hour postprandial

119
Q

Increased levels for renal function indicate what ?

A

slowing of the glomerular filtration rate

120
Q

What is blood urea nitrogen ? Where is it formed ?

A

Nitrogen portion of urea,

It is formed in the liver as an end product of protein and metabolism and digestion (liver function)

121
Q

When is BUN Increased ? *Think fluids and not getting enough hydration *

A

Increased in dehydration (vomiting, low fluid intake, diarrhea, diuresis

122
Q

When is BUN decreased ?

A

Water intoxication
malnutrition
severe liver disease
in adequate protein intake

123
Q

What is the normal value of BUN

A

10-2mg/dL

124
Q

What is creatinine ? and where is it excreted ?

A

Catabolic by product muscle energy metabolism and is excreted in the kidney and is used for indication of renal function

125
Q

What can an increase in creatinine cause ? Think of andre the giant what kind of disease does he have, what organs are affected

A

Gigantism
Acromegaly
Renal disease
Large muscle mass

126
Q

What can a decrease in creatinine cause ? * Think of opposite of the increase and what foods are low in intake*

A

Small muscle mass
Elderly
inadequate intake of protein

127
Q

What is the normal value of creatinine ?

A

0.6 - 1.2 mg/dL

128
Q

In albumin what disease can be incated ?

A

Liver and Renal disease (Nephrotic syndrome)

129
Q

An increase in albumin can be caused by ? *how do you feel when you do not drink enough fluids ?

A

Dehydration

130
Q

A decrease in albumin is caused by ?

A

Liver disease

malnutrition

131
Q

What does calcium aid in ? think of what blood does after 5 min

A

Blood clotting

132
Q

What does Mg determine ?

What is it needed for ?

A

Metabolic activity and renal function

It is needed for neuromuscular activity

133
Q

What does T3 (triiodothyronine) evaluate ? What is it used for and what is it used commonly to diagnose ?

A

It is used to evaluate thyroid function. It is used primarily to diagnose Hyperparathyroidism. It is also used to monitor thyroid replacement or suppressive therapy

134
Q

What is the normal value for T3 ?

A

70- 220 mcg/dl

135
Q

What does T4 (Total thyroxine) evaluate? what is it used to diagnose ?

A

Reliable test for thyroid function, used to diagnose thyroid function and also monitors thyroid replacement and suppressive therapy

136
Q

What is the normal value for T4 ?

A

5-12 mcg/dl

137
Q

What does TSH (Thyroid stimulating hormone) evaluate ? What does it diagnose ?

A

It is used to diagnose Hypoparathyroidism and to differentiate it from (pituitary) and tertiary (Hypothalamus) hypothyroidism

NCLEX ( fundamentals/MegSurg) (8 decks)

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