Labs Flashcards
Normal sodium range
135-145 mEq/L
normal K+ range
3.5 - 5.0 mEq/L
normal Chloride range
98-107 mEq/L
normal Bicarbonate range (Venous)
22-29 mEq/L
3 roles of serum sodium
maintains osmotic pressure, maintains acid-base balance, and assists in the transmission of nerve impulses. (it is a major extracellular cation)
3 roles of serum potassium in the body
(a major intracellular cation) that regulates cellular water balance, electrical conduction in muscle cells, and acid-base balance.
4 things that potassium levels tell us
We can use K+ levels to evaluate cardiac function, renal function, GI function, and the need for IV replacement therapy
Define aPTT
Activated partial thromboplastin time: evaluates how well the coag. sequence (intrinsic clotting system) is functioning by measuring the amount of time (in seconds) for recalcified citrated plasma to clot after partial thromboplastin is added to it.
What is aPTT used for?
To screen for coagulation disorders: detects deficiencies and inhibitors of all factors , except factors VII and XIII. It also evaluates the effectiveness of Heparin therapy.
Define INR
International Normalized Ratio is a test frequently used to assess the effectiveness of oral anticoagulants. It is calculated in the lab using PT values.
What is the normal range for aPTT? For someone receiving Heparin?
20-36 seconds (depending on the type of activator used). When receiving Heparin the aPTT should be 1.5-2 (kaplan, other source says 1.5-2.5) times the norm. *initiate bleeding precautions if >90seconds
At what degree of aPTT should we initiate bleeding precautions?
> 90seconds
What is prothrombin?
A vitamin K dependent glyco-protien produced by the liver that is necessary for fibrin clot formation.
What is the normal range for PT?
Each institution establishes their own normal range. Typically for adult males: 9.6-11.8, and adult females: 9.5-11.3. within 2 seconds of the control is considered normal. NCLEX-RN says: 11-12.5, on warfarin 1.5-2x greater.
What is DIC?
disseminated intravascular coagulation
What is the normal range for an INR?
2-3 for standard warfarin therapy; 3-4.5 for high dose warfarin therapy.If PT exceeds 30 seconds, initiate bleeding precautions.
What is the normal range for platelets ?
150,000-400,000 cells/mm3
What is the normal level of HDL?
> 60mg/dL
What is the normal level of LDL?
What are normal total cholesterol levels?
What is the normal range for triglycerides?
30-150 mg/dL
Normal range of Neutrophils?
55-70%
Normal range of Lymphocytes?
20-40%
Normal range of Monocytes?
2-8%
Normal range of Eosinophils
1-4%
Normal range of Basophils?
0.5-1%
What type of infection does elevated lymphocytes indicate?
Viral Infection
Normal range of phosphate?
3-4.5
Normal range of HCO3
22-28
Normal range of total serum calcium
9-10.5 (levels of free calcium are lower)
Normal range of TSH
0.35-4.94
hypoglycemia = BS
25mg/dl
s/s of hypoglycemia in infant
cyanosis, apnea, irregular resp, diaphoreses, jitters, weak cry, lethargy, convulsions, coma
s/s hypokalemia
abnormal EKG, There may be more than one symptom involving the gastrointestinal (GI) tract, kidneys, muscles, heart, and nerves.
Weakness, tiredness, or cramping in arm or leg muscles, sometimes severe enough to cause inability to move arms or legs due to weakness (much like a paralysis)
Tingling or numbness
Nausea or vomiting
Abdominal cramping, bloating
Constipation
Palpitations (feeling your heart beat irregularly)
Passing large amounts of urine or feeling thirsty most of the time
Fainting due to low blood pressure
Abnormal psychological behavior: depression, psychosis, delirium, confusion, or hallucinations.
EKG Findings for hypokalemia
EKG: depressed or inverted Twave. a U wave, ST depression, and a wide PR interval. Due to prolonged repolarization of ventricular Purkinje fibers, a prominent U wave occurs, frequently superimposed upon the T wave and therefore produces the appearance of a prolonged QT interval.
definitive test for CF. how does it work?
chloride sweat test. people with CF have higher chloride and sodium in their sweat. the chloride pump does not work correctly, so chloride is not resorbed. the sodium pump works, but the Na+ follows the Cl- to achieve balance.
s/s of hyperkalemia
Abnormal heart rhythm – v-fib and potential death, Slow heart rate, Weakness
normal range of wbc
4500-10,000 wbc/mcl
normal specific gravity
1.003-1.030
normal hematocrit
Men: 38.8 to 50 percent
Women: 34.9 to 44.5 percent
The normal range for children 15 years of age and younger varies by age and sex.
normal BUN for adults under 60
10-20 mg/dl
what is aspartate aminotransferase (AST) and what is the normal range?
norm: 10 - 40 units/L
aspartate aminotransferase is an enzyme normally found in red blood cells, liver, heart, muscle tissue, pancreas, and kidneys. When body tissue or an organ such as the heart or liver is diseased or damaged, additional AST is released into the bloodstream. The amount of AST in the blood is directly related to the extent of the tissue damage. After severe damage, AST levels rise in 6 to 10 hours and remain high for about 4 days.
what is alinane aminotransferase (ALT) and what is the normal range?
norm: 10 - 40 units/L
ALT is measured to see if the liver is damaged or diseased. Low levels of ALT are normally found in the blood. But when the liver is damaged or diseased, it releases ALT into the bloodstream, which makes ALT levels go up. Most increases in ALT levels are caused by liver damage.
The ALT test is often done along with other tests that check for liver damage, including aspartate aminotransferase (AST), alkaline phosphatase, lactate dehydrogenase (LDH), and bilirubin. Both ALT and AST levels are reliable tests for liver damage.
normal serum albumin range.
3.5-5.5 g/dL
normal fasting Blood sugar
60-110 mg/dL
what is a normal HBA1c level for a person who does not have diabetes, a person at risk for diabetes and a person with diabetes?
what is the acceptable range for someone with diabetes to show that their diabetes is controlled?
For people without diabetes, the normal range for the hemoglobin A1c test is between 4% and 5.6%.
Hemoglobin A1c levels between 5.7% and 6.4% indicate increased risk of diabetes
levels of 6.5% or higher indicate diabetes.
An HBA1c level at 7% or below indicated the diabetes is being controlled at an acceptable level.
Normal hemoglobin ranges.
For men, 13.5 to 17.5 grams per deciliter.
For women, 12.0 to 15.5 grams per deciliter.
Why is it common and sometimes acceptable for a pregnant woman to have a low HGB and Hematocrit?
physiological anemia of pregnancy occurs because the vascular volume is increased up to 3fold during pregnancy, diluting the serum concentrations.
what are 2 types of anemia that pregnant women might experience?
physiological and pathological
what is the cause of pathological anemia of pregnancy? how common is it?
Pathologic anemia is a common complication of pregnancy, occurring in approximately half of all pregnancies. Disordered production of erythrocytes may result from nutritional deficiency of iron, folic acid, or vitamin B12 or from sickle cell or another chronic disease, malignancy, chronic malnutrition, or exposure to toxins.
Why is ketoacidosis a major concern for a pregnant patient?
it is a major cause of intrauterine death.
what is an oral glucose tolerance test (OGTT) most commonly used for?
to test for gestational diabetes.
what is the procedure for performing an oral glucose tolerance test (OGTT) ?
To prepare for the glucose tolerance diagnostic test:
Eat a balanced diet that contains at least 150 grams (g) of carbohydrate per day for 3 days before the test. Fruits, breads, cereals, grains, rice, crackers, and starchy vegetables such as potatoes, beans, and corn are good sources of carbohydrate.
Do not eat, drink, smoke, or exercise strenuously for at least 8 hours before your first blood sample is taken.
Tell your doctor about all prescription and nonprescription medicines you are taking. You may be instructed to stop taking certain medicines before the test.
The glucose tolerance diagnostic test may take up to 4 hours. Since activity can interfere with test results, you will be asked to sit quietly during the entire test. Do not eat during the test. You may drink only water during this time.
On the day of testing, the following steps will be done:
A blood sample will be collected when you arrive. This is your fasting blood glucose value. It provides a baseline for comparing other glucose values.
You will be asked to drink a sweet liquid containing a measured amount of glucose. It is best to drink the liquid quickly. For the standard glucose tolerance test, you will drink 75 grams or 100 grams.
Blood samples will be collected at timed intervals of 1, 2, and sometimes 3 hours after you drink the glucose. Blood samples may also be taken as soon as 30 minutes to more than 3 hours after you drink the glucose.
what does an antistreptolysin O (ASO) titer show?
elevated antistreptolysin O indicates glomerulonephritis
what is autonomic dysreflexia? how is it caused? what are the s/s?
Acute AD is a reaction of the autonomic (involuntary) nervous system to overstimulation.
It is often caused by damage to the spinal cord.
It is characterized by paroxysmal hypertension (the sudden onset of severe high blood pressure) associated with throbbing headaches, profuse sweating, nasal stuffiness, flushing of the skin above the level of the lesion, slow heart rate, anxiety, and sometimes by cognitive impairment.
What is the expected level of t4 and tsh in a patient with Graves’ disease?
Elevated thyroid hormones t3 and t4 and low tsh - thyroid stimulating hormone due to negative feedback loop. the high levels of hormones closes the feedback loop Hyperthyroidism. normal t4: 0.8-2.8ng/dl, normal tsh is 0.5-4 mlu/l
WBC pneumonic
never let my engine blow; 60,30,8,2,0(0-1)
lithium range for acute treatment, maintenance treatment and toxic level.
The appropriate serum lithium level for acute mania is 1.0 to 1.5 mEq/L.
For maintenance it is 0.6 to 1.2 mEq/L. Levels exceeding 1.5 to 2.5 mEq/L begin to produce toxicity.
normal magnesium level
1.3 - 2.1 mEq/L (0.65-1.05 mmol/l)
normal calcium level
9.0-10.5 mg/dL
What is an AST test?
aspartate aminotransferase (AST) is normally found in red blood cells, liver, heart, muscle tissue, pancreas, and kidneys. When body tissue or an organ such as the heart or liver is diseased or damaged, additional AST is released into the bloodstream. The amount of AST in the blood is directly related to the extent of the tissue damage. After severe damage, AST levels rise in 6 to 10 hours and remain high for about 4 days.
What is Alkaline phosphatase (ALP) ? why is it measured? normal range?
Alkaline phosphatase (ALP) is a protein found in all body tissues. Tissues with higher amounts of ALP include the liver, bile ducts, and bone. levels become elevated if bone is forming, bile ducts blocked, and celiac.
Normal ALP levels in adults are approximately 20 to 140 IU/L, though levels are significantly higher in children and pregnant women.
how often are liver tests such as AST required for patients using atorovastatin?
Get baseline before. monitor 12 weeks after initiation or elevation in dose and then Q6months.
normal central venous pressure
2-6 mmhg
how do you determine the pulse pressure, and what is it used to assess?
pulse pressure is the difference between the systolic and diastolic BP readings. 120/80=PP of 40. Any pulse pressure greater than 40 is a sign of increased ICP. - used to assess ICP
normal range of RBCs - male/female
Male: 4.7 to 6.1 million cells per microliter (cells/mcL)
Female: 4.2 to 5.4 million cells/mcL.
what type of a wbc is a T-cell?
lymphocyte. low levels seen in HIV - CD4 count
what does a Guthrie blood test test for ?
A simple screening blood test for phenylketonuria (PKU). (blood from heel is applied to multiple paper circles) It is done to check whether a newborn baby has the enzyme needed to use phenylalanine in his or her body. Phenylalanine is an amino acid that is needed for normal growth and development. If a baby’s body does not have the enzyme that changes phenylalanine into another amino acid called tyrosine, the phenylalanine level builds up in the baby’s blood and can cause brain damage, seizures, and intellectual disability. performed btw 24h-2 weeks after birth. If positive give Lofenalac formula (nutrients minus phenylalanine.)
what is haemophilius influenzae? precautions? tx?
HIB. it is a bacterial infection mainly effecting children. there is a vaccine. does not cause “the flu”. droplet precautions, isolation until antibiotics (pennicilin) administered for 24 h.iv fluids.