Quiz #2 Flashcards
Specific Gravity (value range)
Adult: 1.005-1.030 (the values decrease as the person gets older)
Why would specific gravity be ordered for a patient?
To determine the concentrating and excretory power of the kidney. Renal disease tends to diminish the concentrating capability of the kidney. As a result, kidney disease is associated with low specific gravity.
Also determines hydration status of the patient.
What is specific gravity measuring?
The concentration of particles including wastes and electrolytes in the urine. High specific gravity = concentrated urine
S/S for high and low specific gravity.
H: (display symptoms of dehydration) - decreased UO - thirst - dizziness - dry skin - dry mouth - HA
L: (display symptoms of renal disease/failure) -itching - swelling of feet and ankles - inability to urinate/produce urine - HTN - flank pain - periorbital edema - HF symptoms (SOB, chest pain)
Hemoglobin value ranges
Male = 14-18 Female = 12-16 (prego women >11)
critical values are <5 and >20
Why would hemoglobin be ordered for a patient?
Normally this test is performed as part of a CBC. Decreased levels indicate anemia and increased levels indicate erythrocytosis.
What is hemoglobin measuring?
Measures the total amount of Hgb in the peripheral blood, which reflects the number of RBC’s in the blood. Hgb is a vehicle for oxygen and CO2 transport.
S/S for high and low hemoglobin.
H: happens when body’s need for oxygen increases (smoking, higher altitude, abuse of drugs)
- HA
- dizziness
- HA
- enlarged spleen
- flushing
*not sure about H
L:
- fatigue
- weakness
- dizzy
- pale skin and gums
- SOB
- irregular or fast HR
- strange cravings (pica)
- tongue swelling
- tingling
- brittle nails
Hematocrit value range
Male = 42-52% Female = 37-47% (prego > 33%)
Critical values = < 15% and > 60%
Why would Hct be ordered for a patient?
To determine if the patient is experiencing anemia with low levels and erythrocytosis with high levels. Know that this value is altered by many factors including hydration status. Dehydration would give a high Hct.
What is Hct measuring/testing?
It’s measuring the percentage of total blood volume made up by the RBC’s. Reflects hemoglobin and RBC values.
Platelets value range.
150,000-400,000
Critical = <50,000 or > 1 million
Why would platelets be ordered for a patient?
This test is performed when patients develop petechiae, spontaneous bleeding, or increasingly heavy menses. Also used to monitor course of the disease or therapy for thrombocytopenia or bone marrow failure.
What is being measured/tested with platelets?
Measures the count of platelets per cubic mL of blood. Platelets are essential to blood clotting so we need to see what our levels are at!
S/S for high and low platelets.
H:
- HA
- Dizziness
- Chest pain
- Fainting
- Temporary vision changes
- Tingling in hands and feetE
L:
- Easy or excessive bruising (purpura)
- Petechiae
- Prolonged bleeding
- Bleeding from gums/nose
- Heavy menstrual flow
- Enlarged spleen
- Jaundice
Neutrophils (value range)
55-70%
Absolute count = 2500-8000
Why would Neutrophils be ordered for a patient?
To determine if there is an infection present or not in the patient. These are produced in 7-14 days and exist in circulation for 6 hours. Neutrophils main role is phagocytosis.
What is Neutrophils testing?
Neutrophils are the most common granulocyte. They respond to acute bacterial infections and trauma resulting in increased WBC count. It indicates an ongoing acute bacterial infection.
S/S for high and low neutrophil count.
H: elevated in infection, trauma, inflammation, chronic illness, leukemia
- fever
- cough
- abdominal pain
- weight loss
- fatigue
L: radiation, chemo, bone marrow problems, nutritional deficiency
- ulcers
- abscesses
- rashes
- wounds that take a long time to heal
- prolonged fever
Lymphocytes (value range)
20-40%
Total count = 1000-4000
Why would lymphocytes be ordered for a patient?
Used to determine chronic bacterial and acute viral infections.
What are lymphocytes testing?
Lymphocytes include B and T cells. T cells are cell mediated and B cells provide humoral immunity. Lymphocytes in the differential count include the 2.
S/S of high and low lymphocytes.
H: infection, cancer, chronic inflammation
- mostly asymptomatic
- swollen lymph nodes
- fever
- exhaustion
- inflammation of spleen and liver
- nausea/vomiting
- constipation
- enlarged tonsils
L: Aids, undernutrition
- unusual infections
- increased frequency of infections
- unresolved infections
- enlarged lymph nodes and spleen
- cough, runny nose, fever
- small tonsils/lymphnodes
- swollen/painful joints
- rash
RBC (value ranges for M/F)
M = 4.7-6.1 F = 4.2-5.4
Why would RBC’s be ordered for a patient?
To determine oxygenation of the body tissues/delivery of oxygen to the body for suspection of chronic hypoxia. Also to determine if there is significant bleeding, reduced bone marrow production, or increased hemolysis.
What are RBC’s testing?
Testing the amount of circulating RBC’s in 1 mm3 of peripheral venous blood.
S/S for high and low RBC.
H: increased oxygenation needs, increased production of erythropoeitin due to tumor (polycythemia)
- weakness
- fatigue
- HA
- itching
- bruising
- joint pain
- dizziness
- abd pain
L: anemia
- fatigue
- pale
- fast HR
- SOB
WBC (value range)
5,000-10,000
critical values: <2500 or >30,000
Why would a WBC be ordered for a patient?
WBC would be ordered for a patient to determine infection, inflammation, tissue necrosis, or leukemic neoplasia. Trauma or stress may increase the WBC count.
What is a WBC testing?
WBC is testing a differential count that includes neutrophils, lymphocytes, monocytes, eosinophils, and basophils.
S/S for high and low WBC.
H:
- fever
- fainting
- bruising
- bleeding
- weight loss
- general pain
- typically asymptomatic
L:
- fever
- loss of appetite
- weight loss
- fatigue
- feeling cold
- SOB
- recurring infections
- unresolved infections
- abnormal infections
ESR (value range)
Male = up to 15 mm/hr Female = up to 20 mm/hr
Why would ESR be ordered for a patient?
ESR is typically used to determine an acute illness. It’s not specific or diagnostic for a particular organ disease or injury. ESR is reactive to worsening disease (it increases)
What is ESR testing?
It is testing the rate with which RBC’s settle in saline or plasma over a specific time period. In diseases the ESR is increased.
S/S for high and low ESR.
H:
- fever
- infection
- joint pain
- rash
- HA
- sore throat
- fatigue
L:
- asymptomatic???
PTT (value ranges)
60-70 sec
*patients with anticoagulation therapy are 1.5-2.5 times the control value in sec.
critical when> 100 sec
Why would PTT be ordered for a patient?
To determine effective clotting ability and to assess patients on anticoagulation therapy. We want to make sure the right dose of medicine is being used.
What is PTT testing?
It’s testing the intrinsic system and common pathway of clotting. It can also test the ability of the liver to produce clotting proteins.
S/S of high and low PTT.
H:
- frequent of heavy nose bleeds
- heavy or prolonged menstrual periods
- blood in urine
- swollen and painful joints
- easy bruising
L: early causes of DIC, cancer
- blood clots???
PT/INR (value ranges)
11.0- 12.5 sec
>1.5-2 times control value with full anticoagulation therapy
INR = 0.8-1.1
critical values:
>20 sec
INR >5.5
*note that INR may vary depending on reason for anticoagulation with meds
–> about 2.0-3.0 for people on Coumadin/Warfarin???
Why would PT/INR be ordered for a patient?
If there are clotting or bleeding problems. Also if patient is on Coumadin/Warfarin. These drugs inhibit Vitamin K dependent clotting factors.
What is PT/INR testing?
Used to test the extrinsic system and common pathway. Measures ability of prothrombin and fibrinogen.
S/S for high and low PT/INR.
High:
- cuts that bleed more than normal
- tarry/black stools
- bruise easily
- frequent nose bleeds
- more HA than normal
- pain in joints
Low:
- blood clots
- sudden weakness in any limb
- numbness/tingling anywhere
- visual changes
- slurred speech immediate onset
- new pain, redness, swelling, heat in one area of body
- SOB
- intense HA
What to administer if PT/INR is elevated?
Vitamin K and blood components
How to avoid elevated PT/INR?
- Eat Vitamin K at regular level
- Limit alcohol (alcohol increases INR)
- Don’t smoke (smoking affects clotting)
Dilantin (toxic level)
*Dilantin is a medicine used to treat/prevent seizures
Therapeutic range = 10-20
Toxic = >50??? and <10
Theophylline (toxic level)
Therapeutic range = 10-20
Toxic = >20
Antidote for Dilantin and Theophylline:
Dilantin: GI decontamination and Benzo’s
Theophylline: activated charcoal
S/S for Dilantin Toxicity
- coma
- confusion
- nystigmas
- fever
- hypotension
- slurred speech
- seizures
- tremor
