Lab studies

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Lab studies
2011-12-10 14:02:28

Lab studies final
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  1. Anemia
    decreased RBC, Hgb, and Hct
  2. Bacterial infection
    • WBC elevated (can be normal or low)
    • Elevation fo segs and bands
  3. Viral infection
    • WBC elevated (can be normal or low)
    • Elevation of lymphocytes
    • Sometime segs are low
    • Atypical lymph's suggest infectious mononucleosis
  4. Leukemia - acute
    • Increased WBC (blasts in circulation)
    • Low RBC, Hgb, Hct (anemia)
    • Low platelet count (thrombocytopenia)
    • Choking of bone marow
  5. Leukemia - chronic
    • Increased WBC (not blasts)
    • Slightly low RBC, Hgb, Hct (anemia)
    • No thrombocytopenia
    • No choking of bone marrow
  6. Clotting disorders - DIC
    • Increased PT and PTT, FDP, D-dimer
    • Decreased fibrinogen, factor assays, and platelets
  7. Clotting disorders - DVT
    • Normal PT and PTT, fibrinogen, factor assays, and platelets
    • Increased FDP and D-dimer
  8. What is the main difference between bacterial and viral infections?
    • Viral has elevation of lymphocytes and degs are low; bacterial has elevation of segs and bands
    • Bacterial includes toxic ganulations, Dohie bodies, and vacuolization
    • Atypical lymphocytes in viral may lead to infectious mononucleosis
  9. Whats are the main differences between chronic and acute leukemia?
    • Acute is rapid onset, rapid clinical course, and affects all ages; chronic has slower onset, smoldering clinical course, and affects older patients
    • Increased WBCs in acute are blasts, adn in chronic are not blasts
    • Acute has low platelets (thrombocytopenia), while chronic has no thrombocytopenia
    • Chronic has less bone marrow choking than acute
    • Acute has more severe lowering of RBC count than chronic
    • More weakness and fatigue in acute
  10. What does a Gram stain tell you?
    • Whether a bacteria is gram positive or gram negative based on chemical and physical properties of their cell walls
    • Gram positive: purple/ blue
    • Gram negative: red/ pink
  11. What is gout?
    • Increase in uric acid in the blood causes joint inflammation
    • Symptoms: pain, swelling, inflammation
  12. Signs and symptoms of electrolyte imbalance
    • Confusion
    • Muscle tightness/ weakness/ cramps
    • CNS changes (decreases DTRs)
    • EKG changes
    • Changes in vital signs
  13. What is the relationship between serum sodium and overhydration? Dehydration?
    • Hyponatremia: low sodium in blood (increase body water in comparison to sodium)
    • Hypernatremia: increased sodium in comparison to body water
    • Normal nerve and muscle function; may elevate HR, but lethargic
  14. What is BUN? Creatinine?
    • BUN (blood urea nitrogen): waste product of protein metabolism - Increased in kidney disease & Decrease is not clinically significant
    • Creatinine: waste product of muscle metabolism - Increased in kidney disease & Decrease is not clinically significant
  15. What is creatine kinase and what does it tell you?
    • Found especially in kneletal muscle
    • Energy reservoir for regeneration of ATP
    • Marker for myocardial infaction (elevuates muscle disease/health)
  16. What are the different types of leukocytes (WBCs)?
    • Segmented neutrophil (segs)
    • Band neutrophil
    • Lymphocyte (lymph)
    • Monocyte (mono)
    • Eosinophil (eos)
    • Basophil (baso)
  17. Segmented neutrophil (seg)
    Most mature neutrophil that fights bacterial infection
  18. Band neutrophil
    Less mature neutrophil that functions like the seg
  19. Lymphocyte (lymph)
    Fights infections byt specializes in viral infections
  20. Monocyte (mono)
    Fights all types of infections
  21. Eosinophil (eos)
    Fights parasitic infections and involved in allergic reactions
  22. Basophil (baso)
    Involved in allergics and helps fight parasite infections
  23. What does PT evaluate?
    • PT evaluates extrinsic pathways of hemostasis - activates outside bloodstream by tissues
    • PT evaluates common pathways of hemostasis - activates by intrinsic and extrinsic pathways
    • PT monitors pts on coumadin
  24. What does PTT evaluate?
    • PTT evaluates intrinsic (activated in bloodstream) and common pathways
    • PTT moniters pts on hepain
  25. What is latency?
    • Incubation period
    • Time between expsoure to a pathogen and a showing of symptoms
  26. Electrolytes - Sodium
    • Hypoatremia: low sodium in blood (increase water vs. Na); form heart, liver, and renal failure or GI surgery
    • Hyperatremia: increased sodium in blood in cmparison to water; sweaty, dehydrated, diarrhea, diuretics
    • Considerations: mental status and vital signs
  27. Electrolytes - Potassium
    • Hypokalemia: decreased potassium concentration in blood
    • Hyperkalemia: increased potassium concentration in blood
    • Caused in clued kidney disease, burns, diuretics/medications, diarrhea/vomitting
    • Considerations: vitals and msut ahve EKG/ECG
    • Nerve transmission, muscle function, electrical activity of heart
  28. Electrocytes - Calcium and Magnesium
    • Ca imblances affect bones, muscles, and GI tract - promote weight-bearing activities to improve bone density (calcium)
    • Mg imbalnces cause primarily dysrhythmias and confusion, muscle weakness/cramps, low BP
    • Considerations: vitals, EKG, mental status
  29. Causes of electrolyte imbalance
    • Diarrhea
    • Sweating
    • Improper diet
    • Vomitting
    • Kidney dysfunction
    • Burns
    • Bleeding after trauma
    • Certain diseases
  30. Sign and symptoms of electrolyte imbalance
    • Confusion
    • Muscle tightness/ weakness/ cramps
    • CNS changes (decreased DTRs)
    • EKG changes
    • Changing of vital changes (precautions: vitals)
  31. BUN increase can indicate ....
    • BUN increase can indicate: heart or renal failure
    • Must have creatinine levels to determine if there is renal failure (increased levels if not cleared normally by kidneys)
    • Considerations: mental status, kidney functioning, fatigue, weakness
  32. Glucose
    • Low levels: may be due to strenuous activity, poor food intake, liver insufficiency
    • High levels: due to diabetes, pancreatitis, or recent surgery
    • Considerations: if low, no exercise; if high, ketoacidosis and need insulin
    • HbA1C-glycated hemoglobin level; percent of sugar sticking to Hb (3 month measure of glucose)
  33. White Blood Cell count
    • Tells immune stem status and inflammatory process
    • Considerations: how to keep incision sites clean
  34. WBC count - high
    • aka Leukocytosis
    • normal for infants and children
    • Considerations: protect you from them
  35. WBC count - low
    • aka Leucopenia - high risk fo rinfection because immunosuppressed
    • considerations: universal precautions (masks, hygiene, etc.) - protect them form you
    • if low and fever, don't treat
  36. Increased neutrophils
    bacterial infection
  37. increased lymphocytes
    viral infection
  38. increased monocytes
    chronic infection
  39. increased eosinophils
  40. increased basophils
    allergic reactions
  41. Hemoglobin/Hematocrit - numbers
    12.1-15.1 gm/dl---36.1-44.3%
  42. Hemoglobin
    Measures protein carrying capacity of blood
  43. Hematocrit
    Is % of RBCs that have hemoglobin
  44. Hemoglobin vs. Hematocrit
    Hemoglobin is 1/3 of hematocrit
  45. hemoglobin/ hematocrit - low
    • Low values are caused by bledding (trauma, surgery, etc)
    • Can cause fatigue and weakness
    • Considerations: paleness, under 8 is contraindication, change in vitals
  46. Platelet count
    Clotting factors
  47. Platelet count - high
    High levels: found in splenectomy, leukemia and other cancers
  48. Platelet count - low
    • Low levels: thrombocytopenia (bleeding risk - must teach safety) due to drugs, immunosuppression, leukemia, etc.
    • Considerations: under 20,000 is red flag (call doctor)
  49. Troponin
    • Used to diagnose myocardial infarction
    • Protein found in cardiac muscle that can stay elvated in plasma for up to 1 week after MI
    • Considerations: understand history of infaction
  50. Troponin - numbers
    • 3-4: small infarction
    • 10-14: moderate infaction
    • >14: large infarction
  51. INR (international normalized ratio)
    • Values of 2-3 are desirable/ therapeutic for those on anticoagulent therapy due to valve replacements, stents, atrial fibrillation
    • Considerations: no manual muscle testing, don't let pt bump in to anything
    • If increased INR and decreased platelets: bleeding risk
  52. Serum albumin
    • Used to test for kidney or liver disease
    • Transports thyroid, other hormones and drugs; buffers pH
    • Low levels: indicate liver disease (cirrhosis), kidney disease (glomerulonephritis, nephrotic syndrome), malnutrition/ malaabsoprtion, ascites, extensive burns
    • Considerations: juandice
  53. Ammonia
    • Used to evaluate liver function
    • Results form breakdown of protein in body
    • Increased levels indicates: cirrhosis, severe hepatitis, Reye's syndrome, severe heart disease, kidney failure, severe bleeding of stomach or intestines
  54. Hct values
    • < 25%: evaluate trend, but generally no exercise
    • > 25%: light exercise
    • approx. 30-32% add resistive exercise as tolerate
  55. Hgb values
    • <8: evaluate trend, but generally no exercise
    • 8-10: light exercise
    • >10: resistive exercise
  56. WBC values
    • <5000 with fever: no exercise
    • >5000: light exercise and progress to resistive
  57. Platelets values
    • <20,000: no exercise
    • 20-50,000: light exercise
    • >50,000: resistive exercise