PCM 2 Medical Chart Review

Question 1

What does WBC count measure?

Answer 1

This identifies the functional status of the immune system. WBC protect against infections and immune responses

Question 2

What is the Normative Values for WBC?

Answer 2

5.0 -10.0 x 10^9/L

Question 3

Abnormal WBC counts

What are the Lab Values when a patient has Leukocytosis?

Answer 3

> 11.0 x 10^9/L
- Critical Value > 50,000

Question 4

Abnormal WBC counts

With Leukocytosis, what are the patient presentations/Sx? What are the Clinical Implications?

Answer 4

• Fever, malaise, lethargy, dizziness, weight loss, bruising, painful joints

Clinical Implications:
- Symptoms-based approach

• Decreased exercise tolerance

Question 5

Abnormal WBC counts

What are the Lab Values of Leukopenia?

Answer 5

< 4.0 x 10^9/L

Question 6

Abnormal WBC counts

With Leukopenia, what are the patient presentations/Sx? What are the Clinical Implications?

Answer 6

• Low grade fever, weakness, fatigue, headache

Clinical Implications:
- Symptoms-based approach

• Consider postponing with high infection

Question 7

Abnormal WBC counts

What are the Lab Values of Neutropenia?

Answer 7

< 1.5 x 10^9/L
- Critical Value < 2000

Question 8

Abnormal WBC counts

With Neutropenia, what are the patient presentations/Sx? What are the Clinical Implications?

Answer 8

• Low grade fever, skin abscesses, sore mouth, symptoms of pneumonia

Clinical Implication:
- Symptoms-based approach

• Neutropenic isolation precautions required

Question 9

What does Hemoglobin (Hgb) measure?

Answer 9

Assesses anemia, blood loss, and fluid balance. Reflects the oxygen carrying component of RBC

Question 10

What are the Normative Values of Hemoglobin for Male and Female?

Answer 10

Male: 14 - 17.4g/dL
Female: 12-16g/dL

Question 11

Abnormal Hemoglobin count

What are the Lab Values of Polycythemia?

Answer 11

Critical Value > 20 g/dL

Question 12

Abnormal Hemoglobin

With Polycythemia, what are the patient presentations/Sx? What are the Clinical Implications?

Answer 12

Orthostasis, dizziness, arrhythmia, seizure, angina

Clinical Implication:
- Critical high can lead to clogging capillaries

Question 13

Abnormal Hemoglobin

What are the Lab Values of Anemia?

Answer 13

Critical Value < 6.5g/dL

Question 14

Abnormal Hemoglobin

With Anemia, what are the patient presentations/Sx? What are the Clinical Implications?

Answer 14

Decreased endurance/activity intolerance, pallor, tachycardia

Clinical Implication:
- Critical low values can lead to heart failure or death

–Monitor SpO2

• < 8 symptoms-based approach
• 8-10 modify treatment to activity tolerance

Question 15

What does Hematocrit (Hct) measure?

Answer 15

Assesses anemia, blood loss, and fluid balance

Question 16

What are the Normative Hematocrit values for Males and Females?

Answer 16

Male: 42-52%
Female: 37-47%

Question 17

Abnormal Hematocrit

What are the Lab Values of Polycythemia?

Answer 17

Critical Value > 60%

Question 18

Abnormal Hematocrit

With Polycythemia, what are the patient presentations/Sx? What are the Clinical Implications?

Answer 18

Fever, headache, dizziness, weakness, fatigue, easy bruising

Clinical Implication:
- Critical high can lead to spontaneous clotting

Question 19

Abnormal Hematocrit

What are the Lab Values of Anemia?

Answer 19

Critical Value < 25%

Question 20

Abnormal Hematocrit

With Anemia, what are the patient presentations/Sx? What are the Clinical Implications?

Answer 20

Pale skin, headache, dizziness, arrhythmia, shortness of breath, cold hands/feet, chest pain

Clinical Implication:
- Critical low values < 15-20% cardiac failure or death

–Monitor SpO2

• < 25% symptoms-based approach, possible orthostatic hypotension

Question 21

What do Platelets Measure?

Answer 21

Primary clotting process that allows for wound healing to start and bleeding to stop

Question 22

What is the Normal Value for Platelets?

Answer 22

140-400 k/uL

Question 23

Abnormal Platelet

What is the lab value of Thrombocytosis?

Answer 23

> 450 k/uL

Question 24

Abnormal Platelet

With Thrombocytosis, what are the patient presentations/Sx? What are the Clinical Implications?

Answer 24

Weakness, headache, dizziness, chest pain, tingling in hands/feet

Clinical Implication
- Symptoms-based approach, caution potential venous thromboembolism

Question 25

Abnormal Platelet

What are the lab values of Thrombocytopenia?

Answer 25

< 150 k/uL
- Critical Value < 20 k/uL

Question 26

What does Glucose Measure?

Answer 26

Blood sugar at the time sample collected

Question 27

What is the Normative Value for Glucose?

Answer 27

70-100 mg/dL

• Hopsitalized non-critical care units target 140-180mg/dL

Question 28

Abnormal Glucose

What are the Lab Values for Hyperglycemia?

Answer 28

> 200mg/dL
- Critical Value >500mg/dL

Question 29

Abnormal Glucose

With Hyperglycemia, what are the patient presentations/Sx? What are the Clinical Implications?

Answer 29

• Diabetic ketoacidosis, severe fatigue

Clinical Implication
- Symptoms-based approach, decreased activity tolerance Consider hold therapy in critical ranges

Question 30

Abnormal Glucose

What are the Lab Values for Hypoglycemia?

Answer 30

< 70mg/dL
- Critical value < 40mg/dL

Question 31

Abnormal Glucose

With Hypoglycemia, what are the patient presentations/Sx? What are the Clinical Implications?

Answer 31

• Lethargy, irritability, shaking, weakness, blurry vision, confusion, loss of consciousness

Clinical Implication
- Symptoms-based approach
- Consider hold therapy in critical ranges

Question 32

What does Sodium (Na) measure?

Answer 32

Electrolytes; Na is an electrolyte improtant for nerve conduction, muscle contraction and cell function

Question 33

What is the Normative Value for Sodium (Na)?

Answer 33

134-142mEq/L