Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

NUR Th II > Lecture 03 Lab values > Flashcards

Lecture 03 Lab values Flashcards

1
Q

Normal Values for

Hematocrit

What’s the sig when it’s

decreased?

increased?

A

Normal value:

Male: 42%~ 52%

Female: 37~47%

Decreased: Anemia/active bleeding

Increased: chronic hypoxia, or polycythemia vera

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Normal Values for

Hemoglobin

What’s the sig when it’s

decreased?

increased?

A

Male: 14~18 g/dl

Female 12~16 g/dl

Decreased: anemia / active bleeding

Increased: chronic hypoxia/polycythemia vera

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Normal Values for

RBC count

What’s the sig when it’s

decreased?

increased?

A

Male: 4.7 ~6.1 u/L

Female: 4.2~5.4 u/L

Decreased: Anemia, active bleeding

Increased:: Chronic hypoxia or polycythemia vera

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Normal Values for

Reticulocyte count

What’s the sig when it’s

decreased?

increased?

A

1~2% of RBCs

Increase: May indicate chronic blood loss (being released from the bone marrow before they mature)

Decreased: possible inadequate RBC func

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How does hydration status affect Hgb and Hct?

A

Dehydration can show falsely high levels and hemodilution (over hydration) can show a disease.

HCT is calculated as the percentage of RBCs in total blood volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are reticulocytes and what is it’s role?

A

It’s an immature RBC and normal levels are necessary to stimulate the bone marrow to produce RBCs in the kidney.

If they are low levels, look at the level of hormone erythropoietin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is MCV and what does it indicate?

A

MCV: Mean Corpuscular Volume is the size of RBC

Too big: indication of megaloblastic anemia

Too small: iron deficiency anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is MCHC and what does it indicate?

A

MCHC: Mean corpuscular hemoglobin concentration, the level is an indication of a variety of anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Types of Anemia

What are normocytic/normochromic?

what causes it?

A

The cell size and Hgb content is normal with low Hct

Causes: Early iron deficiency, chronic illness, sepsis, tumor processes, acute blood loss, renal disease d/t loss of erythropoietin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Types of Anemia

What is Macrocytic normochromic?

What causes it?

A

Large cell size and normal Hgb content

Causes are: B12 deficient, folic acid deficiency, chemotherpay

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Types of Anemia

What are microcytic hypochromic cells like?

What is it caused by?

A

They are small size and low hgb

Causes: Late iron deficiency anemia, lead poisoning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Types of anemia

What are microcytic like?

causes?

A

small RBC and normal Hgb

Causes: Chronic illness (any type), aging process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

White Blood Cells

What is the typical count?

A

5000 to 10000 ul

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

White Blood Cells

Neutrophil

What are the percentages?

What causes it to rise?

A

Overall percentage is 55% to 75%

Increase in bacterial infection causes it to rise

Segmented neutrophils: phagocytosis in response to bacterial infection

Bands: immature neutrophils increased production in response to increased neutrophil use

Left shift: greater percentage increase in band neutrophils than segmented neutrophils; normal and ongoing response to bacterial infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

White Blood Cells

Monocytes

What are the percentages?

What causes it to rise?

A

2~8%

Phagocytic or myelodysplastic disorders causes it rise.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

White Blood Cells

Lymphocytes

What are the percentages?

What causes it to rise?

A

20~40%

Cause to rise: Humoral and cellular immunity, viral infection.

B cell response (humoral immunity) formation of antibody to antigen

T cell response (cellular immunity) cytotoxic, memory T, helper T, and suppressor T cell immune

response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

White Blood Cells

Eosinophils

What are the percentages?

What causes it to rise?

A

1~4%

Increase in alelrgic reaction/parasite infection, anaphalytic response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

White Blood Cells

Basophils

What are the percentages?

What causes it to rise?

A

0.5%~1~

Increase in allergic reaction

: (mast cells which contain histamine, potent endogenous vasodilator) increased in allergic responses

Eosinophils and basophils do not increase in viral or bacterial infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are neutrophils bands?

What percentage do they account for?

A

0~5%

Immature neutrophils and an indication of an infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What does a Left shift mean?

What is it in a presence of?

A

Left shift is: greater percentage increase in band neutrophils than segmented neutrophils; normal and ongoing response to bacterial infection

In presence of infection (likely bacteria) the number of immature bands will increase and this is known as left shift.

Pay atten to Segs vs bands ratio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are normal neutrophil counts?

What’s it derived from?

A

normal > 2000

Derived from WBC

Normal value for ANC is based on the patient’s WBC and percentage of neutrophils and bands.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are clinical implications when

critical absolute neutrophil count is <1000?

A

Pt is at high risk for infection and have little immunity to fight infection

Neutropenic precautions must be taken: remove fresh fruits, cut flowers, flowers with dirt and use hand hygiene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are normal platelet counts?

What are critical values?

A

normal count is 150,000 to 400,000 mm^3

Crtical values < 50,000

x> 1 million

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is thrombocytopenia?

Causes of it?

A

It’s a decrease in platelets

Causes: bone marrow suppression, hemorrhagic disorders, coagulation disorders (liver), occasionally r/t heparin or mechanical heart devices

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is thrombocytosis and what causes it?
Increase in platelets Causes: Polycythemia vera, malignancy
26
When does platelet count decrease?
Platelet count decreased in patients with liver disease, medications such as heparin, febrile illness, Decreased in patients with prosthetic metal and ball heart valves (not porcine or bovine valves) and ventricular assist devices used for heart failure and bridge to heart transplant
27
What happens to the WBC in viral infections?
WBC remains normal/slightly decreased
28
What happens to WBC in bacterial & fungal infection?
WBC is increased
29
What happens to WBCs during a myelodysplastic disorder?
Look at lymph/monocyte counts for lymphomas, may have extreme increase in WBC/increased blasts for differentiation of leukemias
30
What do you look at for clotting abnormalities?
Look at platelet count
31
Blood Urea Nitrogen Normal values? Sig of Increase? Sig of decrease?
Normal values 10~20 mg/dl Indication of renal func Increased: dehydration, GI bleeding Decreased: over hydration, malnutrition and severe hepatic damage
32
Creatine Normal values? Sig of Increase? Sig of decrease?
Female 0.5 ~1.1 mg/dl Male .5 ~ 1.2 mg/dl More accurate than BUN in the indication of renal func Increased: kidney impairment Decreased: decreased muscle mass
33
Sodium Normal values? Sig of Increase? Sig of decrease?
Normal 136~ 145 mEq/L Increased: dehydration, kidney disease, hypercortisolism Decreased: fluid overload, liver disease, adrenal insufficiency
34
Potassium Normal values? Sig of Increase? Sig of decrease?
3.5~5 mEq/L Increased: dehydration, kidney disease, acidosis, adrenal insufficiency, and crush injuries Decreased: fluid overload, diuretic therapy, alkalosis, insulin admin, hyperaldosteronism
35
Chloride ## Footnote Normal values? Sig of Increase? Sig of decrease?
98~106 mEq/L Increased: metabolic acidosis, respiratory alkalosis, hypercortisolism Decreased: fluid overload, excessive comiting/diarrhea, adrenal insufficiency, diuretic therapy
36
CO2/HCO3 ## Footnote Normal values? Sig of Increase? Sig of decrease?
35~45 mEq/L 21~28 mEq/L Implications are related to blood gas interpretation
37
Magensium ## Footnote Normal values? Sig of Increase? Sig of decrease?
1.3~2.1 mEq/L Increased: kidney disease, hypothyroidism, adrenal insufficiency Decreased: malnutrition, alcoholism, ketoacidosis
38
Calcium ## Footnote Normal values? Sig of Increase? Sig of decrease?
9~10.5 mg/dL Increased: hyperthyroidism, hyperparathyrodism Decreased: Vitamin D defiency, hypothyroidism, hypoparathyroidism, kidney disease, excessive intake of phosphorus containing food
39
Phosphorus ## Footnote Normal values? Sig of Increase? Sig of decrease?
3~4.5 mg/dl increased: kidney disease, hypoparathyoidism, hypocalcemia decreased: chronic acid intake, hyperparathyroidism, hypercalcemia, vitamin d deficiency, alcoholism, malnutrition
40
Why is Creatine more accurate than BUN?
It's more accurate because it's a constant metabolic end product of muscle metabolisma nd reflects the GFR
41
What relationship does P and C
They're in a reciprocal relationship
42
What are two conditions that may occur if there's a decrease in Ca and an increase in P?
1. Chvostek's sign: sign of tetany tap trigeminal nerve 2. Trousseau's sign: carpal spasm induced by mechanism of occluding arm vessels with BP cuff for 3 min (10 mm above SBP). place the blood pressure cuff around the upper arm, inflate the cuff to greater than the patient’s systolic pressure and the cuff inflated for 1-4 minutes- positive sign occurs when the hand and the fingers go into spasm in palmer flexion
43
What are assessment considerations for decrease/increased potassium?
Cardiac symptoms are the biggest concern
44
What assessment considerations do you take if there's a a decrease in Sodium? (2)
1. Change in level of consciousness and mental status 2. Muscle weakness
45
What lab values would you look at for renal func? (2)
BUN, creatine
46
What lab values would you look at for cellular func? (6)
Na, K, Cl, Ca, Mg, P
47
What lab values would you look at for enzymatic func? (2)
Mg, P
48
What lab values would you look at for glucose metabolism? (2)
Fasting glucose and random glucose
49
What lab values would you look at for baseline info. (2)
PCP, electronic info
50
What is Hgb A1C?
It's the value of hemoglobing A1C, and would be the average glucose over 120 days. It's a good indication of glucose metabolism steady state.
51
How does interpretation of Hgb A1C work? what's consider non diabetic and diabetic values?
Interpretation: baseline info about no diabetes or if diabetic following a lab test to determine how effective the meds uare (In managing Type I or Type II diabetes. Can test if patient adheres or don't adheres to therapeutic regime) Non diabetic value: 3.9%~5.2% Diabetic: Good 6.9 ~ 8% Fair: 8~9%
52
What compareison of the Hemoglobin A1C test have with fasting glucose?
Fasting glucose is only a spot check at a given moment of time
53
What are uncontrolled values of Hemoglobin A1C typically associated with?
Uncontrolled diabetes mellitus; individual is at risk for long term complications associated with diabetes mellitus. There may be changes in wound healing, eyes, kidneys.
54
TSH and T4 are used to monitor what? (2)
1. Thyroid replacement 2. Suppression therapy
55
Secondary hypothyroidism invovles what?
Decreased activity of the thyroid caused by failure of the pituitary gland.
56
TSH Normal Values? Increase leads to Decrease leads to
helps differentiate between thryoid disorder (primary hypothyroidism) and secondary (pituitary disorder) Values: 2~10 ml Increased : hypothyroidism Decreased: hyperthyroidism
57
T3 Normal Values? Increase leads to Decrease leads to
72~205 ng/dl (20~50 years old) 40~180 ng/dl (\>50 years old Increased: hyperthyroidism Decreased: Hypothyroidism
58
T4 Normal Values? Increase leads to Decrease leads to
Male: 4~12 mcg/dl female 5~12 mcg/dl Increase: hyperthryoidism (Graves) Decreased: Hypothyroidism (Myxedema)
59
Free T4 Normal Values? Increase leads to Decrease leads to
.8 ~2.8 ng/dl Increased: hyperthryoidism Decreased: hypothyroidism
60
Signs & Symptoms Hypothyroidism Increased TSH/Decreasead T3 and T4 (7)
1. Fatigue 2. Delayed reflexes 3. irregular menstrual cycle 4. cold intolerance 5. hair loss 6. chf 7. hypothermia
61
Hyperthyroidism Decreased TSH/Incresaed T3 and T4 (5)
1. Hyperthermia 2. Heat intolerance 3. Acute, involuntary weight loss 4. exopthalmus 5. CHF
62
Total Protein Normal Value: Significance?
Normal values 6.4~8.3 g/dl Sig: Contribute to maintaining osmotic pressure in the vascular space, thereby keeping fluid in the vascular space. Albumin+ Gamma Globulin: Total Protein Proteins: contribute to maintaining osmotic pressure in the vascular space thereby keeping fluid in the vascular space
63
Albumin ## Footnote Normal Value: Significance?
3.5~5 g/dl Decreased albumin indicates: acute/chronic infection, tissue necrosis, surgery, stress response, liver cirrhois Albumin is produced in the liver and its main function is to maintain colloidal osmotic pressure, transporter or medications, hormones, and enzymes Considerations for analysis include evaluating nutritional status vs liver disease
64
Gamma Globulin is: Normal value: Sig?
Gamma globulin: immunoglobulins (antibodies); decreased in multiple myeloma, decreased or absent in agammaglobulinemia (inherited disorder) Normal values: 2.3~3.4 g/dl Decreased indicates: muptiple myeloma, decreased or absent (inheritated disorder)
65
Pre Albumin Normal Values Sig:
Sig: Prealbumin: Used to monitor a patient’s nutritional status and component of liver functional status. It’s use as a monitor and assessment of nutritional status bases on short half life and consumed quickly in acute stress response in illness, also decreases with inflammation, malignancy, and protein wasting diseases of intestines and kidneys. Used as indicator for effectiveness of repletion nutritional stores in patients receiving total parenteral nutrition. Normal Values: 15~36 mg/dl
66
Total Bilirubin Normal Values Sig
Normal .3~1mg/ dl Total Bilirubin= Indirect +direect bilirubin
67
Direct Bilirubin Normal Values Sig of Increase
Normal value: 0.1 ~0.3 mg/dl Increased: gallstones, biliary obstruction, trauma, liver Ca or Liver mets
68
Indirect Bilirubin Normal values Sig of Increase
0.1 ~1.0 mg/dl Increased indication: hepatoma, newborn jaundice, hepatitis, cirrhosis
69
What is LDH 5? Normal values:
It's an isoenzyme that will be elevated with liver disease 100~190 U/L
70
What does the liver function test do?
It monitors for pt's response to life style modification, cholesterol, and reducing meds
71
Cholesterol When is it increased? When is it decreased?
Increased:: HTN, uncontrolled diabetes, high cholesterol diet, biliary cirrhosis Decreased: malabsorption, malnutrition, cholesterol reducing meds
72
Triglycerides: ## Footnote When is it increased? When is it decreased?
Increased: hyperlipidemias, HTN, alcohol induced liver disease, high carb diet Decreased: malabsorption, manutrition
73
LDL Cholesterol ## Footnote When is it increased? When is it decreased?
Increased: familiar LDL lipoproteinemia, nephrotic syndrome, chronic liver disease Decreased: hypoproteinemia such as malabsorption, malnutrition, severe trauma, burns
74
HDL Cholesterol ## Footnote When is it increased? When is it decreased?
Increased: Excessive exercise, familial HDL, lipoproteinemia Decreased: hepatitis, cirrhosis
75
Cholesterol Normal Values Sig of Increase, decrease?
Normal \<200 mg/dl Increased: HTN, uncontrolled DM, biliary cirrhosis Decreased: Malabsorption, malnutrtion
76
Triglcyerides Normal values in Females? Males? Increased values indicate
Female: 35~135 mg/dl Male: 40~160 mg/dl Increased levels increases risk of CAD, may be an indication of alcohol induced liver disease or high carb diet
77
LDH Normal Values Increased sig? Decreased sig?
Normal Values: 60~180 mg/dl Increased: In pt with familial LDL lopoprotein, chronic liver disease Decreased: malabsorption, malnutrition, severe trauma, burns
78
HDL Normal Values with male? Females? Sig of increase and decrease?
Malse \>45 mg/dl Female\>55mg/dl Increased: excessive exercise, familial HDL Decreased: Hepatitis, Cirrhosis
79
Partial Thromboplastin Time (PTT) What does it do? Normal?
evalutes intrinsic pathway of clotting system Normal is 60 to 70 seconds
80
Activated Partial Thromboplastin Time (APTT) What's the normal? Seen in? What's the antidote?
Normal 30 to 40 seconds Seen in clotting factor deficiencies, liver cirrhosis, DIC, Vit K deficiency Used to monitor effects of IV heparin therapy *Antidote for Heparin overdose is Protamine Sulfate*
81
Prothrombin Time (PT) Evalutes what? What's normal? Prolonged in what disease? Guided by what? What's the antidote for coumadin?
PT and INR evalute the extrinsic and final common pathway of clotting cascade PT and INR are used to regulate dosing. Normal 11 ~12.5 seconds PT is prolonged in liver disease, obstructive biliary disease, Vit K def, DIC. PTT used with INR to regulate **Coumadin dosing** When pt is being weaned off heparin infusion t Coumadin, PT is initially used to guide coumadin therapy; coumadin dosing long term is monitored and guided by INR Antidote for Coumadin overdose: Vit K
82
What are acceptable ranges based on idications for therpay (Coumadin)? Guided by INR, International Normalized Ratio
§Acceptable Ranges Based on indications for therapy (Coumadin) 1. §Standard therapy \< 2.5 INR § - minimize risk of bleeding during procedures 2. §2.0 INR (range 1.6 to 2.5) §stroke prevention in persons with atrial fibrillation over 75 years of ag 3. §2.5 INR (range 2.0 to 3.0) §for stroke prevention in persons with atrial fibrillation up to 75 years of age 4. §2.0 to 3.0 INR §management of DVT, prevention of systemic embolism, prosthetic valve prophylaxis 5. §2.5 to 3.5 INR (high intensity therapy) §recurrent systemic embolism, prophylaxis in high risk surgery
83
Urine Analysis How is pH affected?
Diet Meds Acid base distrubances renal tubuular func
84
Urine Analysis What does presence of ketones mean?
associated with poorly managed diabetes
85
Urine Analysis Protein indicates
Sensitive indicator of glomerular and renal tubular func

NUR Th II (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions