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Lab Values > Quiz #2 > Flashcards

Quiz #2 Flashcards

1
Q

Specific Gravity (value range)

A

Adult: 1.005-1.030 (the values decrease as the person gets older)

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2
Q

Why would specific gravity be ordered for a patient?

A

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.

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3
Q

What is specific gravity measuring?

A

The concentration of particles including wastes and electrolytes in the urine. High specific gravity = concentrated urine

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4
Q

S/S for high and low specific gravity.

A 
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)
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5
Q

Hemoglobin value ranges

A 
Male = 14-18
Female = 12-16 (prego women >11)

critical values are <5 and >20

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6
Q

Why would hemoglobin be ordered for a patient?

A

Normally this test is performed as part of a CBC. Decreased levels indicate anemia and increased levels indicate erythrocytosis.

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7
Q

What is hemoglobin measuring?

A

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.

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8
Q

S/S for high and low hemoglobin.

A

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
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9
Q

Hematocrit value range

A 
Male = 42-52%
Female = 37-47% (prego > 33%)

Critical values = < 15% and > 60%

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10
Q

Why would Hct be ordered for a patient?

A

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.

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11
Q

What is Hct measuring/testing?

A

It’s measuring the percentage of total blood volume made up by the RBC’s. Reflects hemoglobin and RBC values.

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12
Q

Platelets value range.

A

150,000-400,000

Critical = <50,000 or > 1 million

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13
Q

Why would platelets be ordered for a patient?

A

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.

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14
Q

What is being measured/tested with platelets?

A

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!

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15
Q

S/S for high and low platelets.

A

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
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16
Q

Neutrophils (value range)

A

55-70%

Absolute count = 2500-8000

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17
Q

Why would Neutrophils be ordered for a patient?

A

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.

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18
Q

What is Neutrophils testing?

A

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.

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19
Q

S/S for high and low neutrophil count.

A

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
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20
Q

Lymphocytes (value range)

A

20-40%

Total count = 1000-4000

21
Q

Why would lymphocytes be ordered for a patient?

A

Used to determine chronic bacterial and acute viral infections.

22
Q

What are lymphocytes testing?

A

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.

23
Q

S/S of high and low lymphocytes.

A

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
24
Q

RBC (value ranges for M/F)

A 
M = 4.7-6.1
F = 4.2-5.4
25
Q

Why would RBC’s be ordered for a patient?

A

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.

26
Q

What are RBC’s testing?

A

Testing the amount of circulating RBC’s in 1 mm3 of peripheral venous blood.

27
Q

S/S for high and low RBC.

A

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
28
Q

WBC (value range)

A

5,000-10,000

critical values: <2500 or >30,000

29
Q

Why would a WBC be ordered for a patient?

A

WBC would be ordered for a patient to determine infection, inflammation, tissue necrosis, or leukemic neoplasia. Trauma or stress may increase the WBC count.

30
Q

What is a WBC testing?

A

WBC is testing a differential count that includes neutrophils, lymphocytes, monocytes, eosinophils, and basophils.

31
Q

S/S for high and low WBC.

A

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
32
Q

ESR (value range)

A 
Male = up to 15 mm/hr
Female = up to 20 mm/hr
33
Q

Why would ESR be ordered for a patient?

A

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)

34
Q

What is ESR testing?

A

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.

35
Q

S/S for high and low ESR.

A

H:

  • fever
  • infection
  • joint pain
  • rash
  • HA
  • sore throat
  • fatigue

L:
- asymptomatic???

36
Q

PTT (value ranges)

A

60-70 sec

*patients with anticoagulation therapy are 1.5-2.5 times the control value in sec.

critical when> 100 sec

37
Q

Why would PTT be ordered for a patient?

A

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.

38
Q

What is PTT testing?

A

It’s testing the intrinsic system and common pathway of clotting. It can also test the ability of the liver to produce clotting proteins.

39
Q

S/S of high and low PTT.

A

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???

40
Q

PT/INR (value ranges)

A

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???

41
Q

Why would PT/INR be ordered for a patient?

A

If there are clotting or bleeding problems. Also if patient is on Coumadin/Warfarin. These drugs inhibit Vitamin K dependent clotting factors.

42
Q

What is PT/INR testing?

A

Used to test the extrinsic system and common pathway. Measures ability of prothrombin and fibrinogen.

43
Q

S/S for high and low PT/INR.

A

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
44
Q

What to administer if PT/INR is elevated?

A

Vitamin K and blood components

45
Q

How to avoid elevated PT/INR?

A
  • Eat Vitamin K at regular level
  • Limit alcohol (alcohol increases INR)
  • Don’t smoke (smoking affects clotting)
46
Q

Dilantin (toxic level)

A

*Dilantin is a medicine used to treat/prevent seizures

Therapeutic range = 10-20
Toxic = >50??? and <10

47
Q

Theophylline (toxic level)

A

Therapeutic range = 10-20

Toxic = >20

48
Q

Antidote for Dilantin and Theophylline:

A

Dilantin: GI decontamination and Benzo’s
Theophylline: activated charcoal

49
Q

S/S for Dilantin Toxicity

A
  • coma
  • confusion
  • nystigmas
  • fever
  • hypotension
  • slurred speech
  • seizures
  • tremor

Lab Values (3 decks)

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