Labs and EKGs Flashcards
2 major hematology tests
CBC
Coagulation
Complete Blood Count (CBC)
Erythrocytes Leukocytes Thrombocytes Hemoglobin (Hb) Hematocrit (Hct)
Red Blood Cells (RBC) are
Erythrocytes
RBC primary function is to carry oxygen. The normal range is
4 - 6 million cells/ul (microliter)
RBC < 4
Anemic - Loss of blood or bone marrow production decreased
RBC > 6
Polycythemia - overstimulation of bone marrow
Hematocrit normal range
40 - 50%
Increased hematocrit
Dehydration or polycythemia
Decreased hematocrit
Hypovolemia, fluid overload, anemia
Hemoglobin (Hb) normal range
12 - 16 g/dl
Increased hemoglobin (Hb)
Polycythemia
Decreased hemoglobin (Hb)
Anemia
White Blood Cells (WBC) are
Leukocytes
WBC normal range
5,000 - 10,000 mm3
Increased WBC
Leukocytosis
Infection, stress, trauma
Decreased WBC
Leukopenia
Immunodeficiency produced in bone marrow
Neutropenia
Decrease in WBC due to a decrease in neutrophils
Caused by bone marrow failure, chemotherapy or leukemia, or when cells are destroyed rapidly
WBC Differential
Neutrophils Eosinophils Lymphocytes Basophils Monocytes
Neutrophils normal range
WBC Differential
40 - 70% of total WBC
Neutrophils
1st to attack infection
Produced in bone marrow
Phagocytosis
Attacks acute bacterial infection and trauma
Eosinophils normal range
WBC Differential
0 - 6% of total WBC
Allergic Reactions, cause yellow sputum
Basophils normal range
WBC Differential
0 - 1% of total WBC Allergic Reactions (asthma), release
Bands
Immature cells, neutrophils
0 - 6% of WBC
Increases with bacterial infection
Segs
Mature cells
40 - 75%
Decreases with bacterial infection
Differential Test
Shows values of all WBC to determine where infection lies
Monocytes normal range
WBC Differential
2 - 10%
In lungs, monocytes convert into macrophage, clears foreign material through phagocytosis (see infections like TB)
Lymphocytes normal range
WBC Differential
No number to remember
2 types
T and B cells
reduces with immunodeficiency
T-lymphocytes
“T” Thymus
Act against tumor cells and cells infected with viruses
B-Cells
“B” Bursa
Produce antibodies that help phagocytes to recognize foreign material
Thrombocytes normal range
Platelet count 150,000 - 440,000 mm3
Platelet
Can be seen in bone marrow disease
DIC (disseminated intravascular coagulation) < 20 internal organ bleed
Prothrombin Time normal range
9.0 - 13 seconds
Tests how long for blood to clot
Measures time plasma forms fibrin clot
Tests effects of coumadin (warfarin)
Thrombocytopenia
Low platelet count
Blood Chemistry Test
Electrolyte Concentration
Used to assess dehydration, nutritional status, side effects of drugs
Venous sampling
Na+, K+, Cl-, HCO3-
Sodium (Na) normal range
137 - 147 mEq/L
electrolyte positive charge
regulated by kidneys
Hypernatremia
From loss of water, dehydration or decreased intake
Hyponatermia
Excessive water or sodium loss
ex) diuretics, diarrhea, CHF, burn victims
Causes confusion, decreased LOC, muscle twitch, seizure
Potassium (K) normal range
3.5 - 4.8 mEq/L
Hypokalemia
With diuretics, vomitting, diarrhea, Weakened cardiac muscle Decreased CO and Flatten T wave Shift from extra to intracellular Water space due to metabolic acidosis
Hyperkalemia
T waves peak, nausea, irritability, fatigue, dehydration, dietary intake/IV infusion
Chloride (CL) normal range
98 - 105 mEq/L
negative charge
Hypochloremia
Renal, long use of diuretics, COPD, metabolic alkalosis
Anion Gap normal range
8 - 16 mEq/L
>16 lactic acidosis (lack of O2), ketoacidosis (low insulin), cause metabolic acidosis
Sweat Chloride Test
> 60 - 80 mEq/L
Diagnostic for CF
Results in high levels of Na and Cl
BUN normal range
Renal Function Test
7 - 20 mg/dl
Blood Urea Nitrogen
Urea is byproduct of metabolism and excreted through kidneys
If kidneys quit, urea is not excreted
Urea is also affected by protein intake, hormones and hyrdrations status
Creatnine normal range
Renal Function Test
0.7 - 1.3 mg/dl
Waste product excreted by kidney
More specific for kidney failure than BUN
BNP
How well ventricles are working (CHF, Left)
Ideal BNP < 100
>100 cardiac
<100 pulmonary
ALT
Serum Enzyme
Liver enzyme (hepatitis)
LDH
Serum Enzyme
Heart, liver, brain, kidneys
Increased with pulmonary infarction
CK
Serum Enzyme
Increased post MI
Increased muscle damage skeletal Heart
also weight lifting
surgery procedures
Troponin
Serum Enzyme
Rise within first 4 hours after MI
Increased contractility of muscle
Amylase/Lipase
Serum Enzyme
Enzyme produces by pancreas
Albumin normal range
Serum Enzyme
3.5 - 4.8 g/dl
Decreased level loss of fluid from vascular spaces
Edema, maintain osmotic pressure between blood vessel and tissue, keeps water within vascular space
Hypoalbumin: poor nutrition, liver disease
Glucose normal range
70 - 105 mg/dl (fasting)
Blood glucose creates energy
Hyperglycemia occurs from Type II diabetes (ketoacidosis, Kussmaul’s breathing)
Hypoglycemia caused by too much insulin produced by pancreas