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U of R SCHOOL OF NURSING - 372 > NUR 372 CLASS 5 LAB VALUES > Flashcards

NUR 372 CLASS 5 LAB VALUES Flashcards

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1
Q

WHITE BLOOD COUNT

A
  • 5 - 10 THOU/uL
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2
Q

CBC (COMPLETE BLOOD COUNT) TEST

A
  • basic screening test
  • provides valuable information on the patient’s hematologic state and other disease process
  • consists of: WBC, RBC, hematocrit and hemoglobin, platelet, differential (neutrophils, eosinophils, basophils, lymphocytes & monocytes)
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3
Q

CRITICAL WBC VALUES

A
  • < 2500 or > 30,000
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4
Q

INCREASED WHITE BLOOD CELL COUNT

A
  • infection
  • inflammation
  • invasive lines
  • inadequate primary defense
  • neoplasm’s
  • medication
  • stress
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5
Q

ASSESSMENT OF INCREASED WHITE BLOOD CELL COUNT

A
  • fever
  • fatigue
  • history or presence of infection of potential exposure
  • flushed skin appearance
  • increased RR, HR
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6
Q

INTERVENTIONS FOR INCREASED WHITE BLOOD CELL COUNT

A
  • medical asepsis
  • appropriate timing of antibiotics
  • follow P & P for invasive lines & drains
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7
Q

DECREASED WHITE BLOOD CELL COUNT

A
  • medication induced (chemotherapy)
  • radiation
  • bone marrow failure
  • severe infection
  • dietary deficiencies
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8
Q

ASSESSMENT OF DECREASED WHITE BLOOD CELL COUNT

A
  • assess for signs and symptoms of infection
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9
Q

INTERVENTIONS FOR DECREASED WHITE BLOOD CELL COUNT

A
  • basic aseptic practices of hand washing

- possibly reverse isolation in some cases (protective precautions)

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10
Q

HEMOGLOBIN COUNT

A
  • M 14-18 g/dL

- F 12-16 g/dL

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11
Q

CRITICAL HEMOGLOBIN VALUES

A
  • < 5 or > 20 g/dL
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12
Q

HEMATOCRIT

A
  • percentage of RBC in plasma
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13
Q

HEMATOCRIT COUNT

A
  • M 42-52%

- F 37-47%

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14
Q

CRITICAL HEMATOCRIT VALUES

A
  • < 15% or > 60%
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15
Q

INCREASED HEMOGLOBIN/HEMATOCRIT RISK FACTORS

A
  • congenital heart disease
  • COPD
  • overproduction by the bone marrow (polycythemia vera)
  • dehydration
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16
Q

ASSESSMENTS FOR INCREAESED HEMOGLOBIN/HEMATOCRIT

A
  • assess for smoking history
  • living at high altitudes for extended periods
  • chronic breathing difficulties
  • sleep disturbances
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17
Q

INTERVENTIONS FOR INCREASED HEMOGLOBIN/HEMATOCRIT

A
  • lack of volume, an increased oral intake or parenteral fluid replacement may be ordered
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18
Q

DECREASED HEMOGLOBIN/HEMATOCRIT RISK FACTORS

A
  • anemia
  • cirrhosis
  • hemorrhage
  • dietary deficiencies
  • renal disease
  • autoimmune diseases
  • cancers
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19
Q

ASSESSMENTS FOR DECREASED HEMOGLOBIN/HEMATOCRIT

A
  • assess for s/s of fatigue
  • cool extremities
  • dyspnea
  • tachycardia
  • pallor
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20
Q

INTERVENTIONS FOR DECREASED HEMOGLOBIN/HEMATOCRIT

A
  • correct nutritional deficiencies
  • alternate rest & activity
  • blood transfusion
  • supplemental oxygen
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21
Q

PLATELET COUNTS

A
  • 150,000 - 400,000
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22
Q

THROMBOCYTOPENIA

A
  • platelet count < 100,000
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23
Q

CRITICAL PLATELET VALUES

A
  • < 50,000 or > 1,000,000
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24
Q

PARTIAL THROMBOPLASTIN TIME COUNT

A
  • 21 - 35 seconds
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25
Q

PARTIAL THROMBOPLASTIN TIME CRITICAL VALUES

A
  • > 70 increased risk of bleeding
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26
Q

PROTHROMBIN TIME COUNT

A
  • 11 - 13 seconds (INR 0.8 - 1.2)
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27
Q

PTT, PT/INR need to be ________ times control if anti coagulated

A
  • 1.5 - 2
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28
Q

INCREASED PLATELET RISK FACTORS

A
  • myeloproliferative disorders
  • leukemia
  • splenectomy
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29
Q

DECREASED PLATELET RISK FACTORS

A
  • certain anemia’s
  • viral and bacterial infections
  • HF
  • HIV
  • hypersplenism
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30
Q

INCREASED PTT RISK FACTORS

A
  • congenital defects such as hemophilia

- heparin therapy

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31
Q

DECREASED PTT RISK FACTORS

A
  • cancer

- immediately after acute hemorrhage

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32
Q

INCREASED PT RISK FACTORS

A
  • deficiencies in clotting factors
  • Vit K def
  • liver disease
  • warfarin therapy
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33
Q

DECREASED PT RISK FACTORS

A
  • Increase in green leafy vegetables
  • excessive alcohol intake
  • dehydration
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34
Q

WHAT TYPE OF PRECAUTIONS WOULD YOU IMPLEMENT FOR LOW PLATELET LEVEL?

A
  • electric razors
  • soft-bristled toothbrushes
  • protective helmets
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35
Q

PURPOSE OF CULTURE AND SENSITIVITY LAB

A
  • identify if there is an infectious organism, and if so what organism is
36
Q

GRAM STAIN (C&S)

A
  • identifies class of organism and guides antibiotic choice until organism identified
37
Q

SENSITIVITY (C&S)

A
  • determines sensitivity of organisms to various antibiotics
38
Q

EXAMPLES OF C&S

A
  • wounds, sputum, urine, blood
39
Q

PAN CULTURE

A
  • culture of different things at one time
40
Q

NURSING CONSIDERATIONS FOR C&S

A
  • confirm cultures obtained BEFORE antibiotic therapy
  • if culture grows out and antibiotic needs to be changed, then can change after
  • follow proper procedure for obtaining culture
  • timing of cultures
41
Q

NORMAL SODIUM VALUES

A
  • 136 - 145 mmol/L
42
Q

CRITICAL SODIUM VALUES

A
  • < 120 or > 160 mmol/L
43
Q

INCREASED SODIUM CAUSES

A
  • net loss of water or gain of sodium
44
Q

DECREASED SODIUM CAUSES

A
  • net gain of water or loss of sodium rich fluids
45
Q

REGULATION OF SODIUM

A
  • regulated by diet and kidneys (ADH and aldosterone)

- essential for neurological, endocrine and cardiac function

46
Q

INCREASED SODIUM RISK FACTORS

A
  • associated with dehydration
  • insufficient fluid intake
  • fluid loss
47
Q

S/S OF HYPERNATREMIA

A
  • CNS issues
  • confusion
  • seizures
  • cardiac issues
48
Q

DECREASED SODIUM RISK FACTORS

A
  • associated with severe burns
  • CHF
  • excessive IV
  • PO hydration
  • excessive ADH
49
Q

S/S OF HYPONATREMIA

A
  • headache
  • confusion
  • fatigue
  • restlessness
  • muscle weakness
  • spasms and cramps
  • seizures
  • coma
  • death
50
Q

NORMAL POTASSIUM LEVELS

A
  • 3-5 - 5.0 mEq/L
51
Q

CRITICAL POTASSIUM LEVELS

A
  • < 3 or > 6 mEq/L
52
Q

REGULATION OF POTASSIUM

A
  • regulated by insulin and aldosterone
  • concentration is small and minor changes have significant consequences especially related to skeletal and cardiac muscle
53
Q

INCREASED POTASSIUM RISK FACTORS

A
  • dietary
  • acute or chronic renal failure
  • potassium sparing diuretics
  • potassium supplements
  • crush/burn injuries
  • infection
  • acidosis
  • dehydration
54
Q

DECREASED POTASSIUM RISK FACTORS

A
  • dietary
  • GI loses
  • diuretics
  • alkalosis
  • trauma/burns
55
Q

S/S WITH HYPERKALEMIA

A
  • muscle fatigue
  • weakness
  • paralysis
  • arrhythmias (asystole)
56
Q

S/S WITH HYPOKALEMIA

A
  • weakness
  • tingling
  • numbness
  • arrhythmias
57
Q

NORMAL CALCIUM VALUES

A
  • 9 - 10.5 mg/dL
58
Q

CRITICAL CALCIUM VALUES

A
  • < 6 or > 13 mg/dL
59
Q

REGULATION OF CALCIUM

A
  • regulated by parathyroid hormone, Vit D, and phosphate.
  • extracellular cation, integral to nerve, muscle, bone formation, blood clotting, skeletal and cardiac muscle contractility
60
Q

INCREASED CALCIUM RISK FACTORS

A
  • hyperparathyroidism;
  • bone malignancies
  • Paget disease
  • prolong immobilization
  • lymphoma
61
Q

DECREASED CALCIUM RISK FACTORS

A
  • hypoparathyroidism
  • renal failure
  • hyperphosphatemia
  • Vit D deficiency
  • malabsorption
62
Q

S/S OF HYPERCALCEMIA

A
  • CNS changes
  • lethargy
  • confusion
  • weakness
  • fatigue
  • weight loss
  • bone pain
63
Q

S/S OF HYPOCALCEMIA

A
  • muscle spasms
  • cramps
  • tetany
64
Q

ASSESSMENT TECHNIQUES FOR HYPOCALCEMIA

A
  • chovstek’s sign

- trousseau’s sign

65
Q

NORMAL MAGNESIUM VALUES

A
  • 1.3 - 2.1 mEq/L
66
Q

CRITICAL MAGNESIUM VALUES

A
  • < 0.5 or > 3 mEq/L
67
Q

INCREASED MAGNESIUM RISK FACTORS

A
  • renal failure
  • ingestion of magnesium products
  • hypothyrodism
68
Q

DECREASED MAGNESIUM RISK FACTORS

A
  • malnutrition
  • malabsorption
  • alcoholism
  • hypoparathyroidism
69
Q

REGULATION OF MAGNESIUM

A
  • regulated by kidneys

- regulates, neuromuscular and cardiac function

70
Q

NORMAL GLUCOSE VALUES

A
  • 70 mg/dL - 110 mg/dL
71
Q

CRITICAL GLUCOSE VALUES

A
  • F < 40 or > 400 mg/dL

- M < 50 or > 400 mg/dL

72
Q

REGULATION OF GLUCOSE

A
  • controlled by feedback mechanism of glucagon and insulin
73
Q

INCREASED GLUCOSE RISK FACTORS

A
  • diabetes
  • acute stress response
  • infection
  • chronic renal failure
  • acute pancreatitis
  • corticosteroid therapy
74
Q

DECREASED GLUCOSE RISK FACTORS

A
  • hypothyroidism
  • extensive liver disease
  • insulin overdose
  • starvation
75
Q

NORMAL BLOOD UREA NITROGEN (BUN) VALUES

A
  • 10 - 20 mg/dL
76
Q

CRITICAL BUN VALUES

A
  • > 100 mg/dL
77
Q

REGULATION OF BUN

A
  • reflects urea nitrogen in the blood as end product of protein metabolism
  • formed in liver and reflects direct metabolic function of liver and indirect excretory function of the kidneys
  • value affected by protein intake and hydration
78
Q

INCREASED BUN RISK FACTORS

A
  • hypovolemia
  • shock
  • dehydration
  • CHF
  • GI bleeding
  • excessive protein ingestion
  • starvation: catabolism
79
Q

DECREASED BUN RISK FACTORS

A
  • liver failure
  • over hydration
  • malnutrition
  • pregnancy
80
Q

NORMAL CREATININE VALUES

A
  • M 0.6 - 1.2 mg/dL

- F 0.5 - 1.1 mg/dL

81
Q

CRITICAL CREATININE VALUES

A
  • > 4 mg/dL
82
Q

REGULATION OF CREATININE

A
  • catabolic product of creatine phosphate from skeletal muscle contraction
  • creatinine like BUN is excreted entirely by the kidneys and thus serves as an indicator of renal function.
83
Q

INCREASED CREATININE RISK FACTORS

A
  • renal disease
84
Q

DECREASED CREATININE RISK FACTORS

A
  • debilitation

- decreased muscle mass

85
Q

HOW TO ASSESS PATIENT’S RENAL FUNCTION

A
  • output may be low
  • edema
  • tachypnea
  • tachycardia
  • JVD
  • increased weight
  • elevated BP
  • crackles/rhales in lungs

U of R SCHOOL OF NURSING - 372 (12 decks)

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