Lab Values for PT Tx

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ljblmt79
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220487
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Lab Values for PT Tx
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2013-05-20 23:13:23
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Lab Values
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Appropriate Lab Values for PT Tx
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  1. Cardiac Enzymes
    25-225 microliters/liter 

    *Updated Values30-170 U/L

    • Cardiac dysfunction 
    • Detects and diagnose acute myocardial infarction 
    • Evaluate possible causes of chest pain 
    • Monitor the severity of myocardial infarction
  2. Arterial Blood Gases 
    ABG
    • pH 7.35-7.45
    • < 7.35 = Acidosis
    • > 7.45 = Alkalosis 

    PaCO2 35-45 mmHg 

    HCO3 22-26 mEq/L 

    • PaCO2 80-100 mmHg
    • *> 80 mmHg 

    • O2Sat 95%-98%(SaO2)
    • *> 94%

    Accesses gas exchange of the cardiopulmonary system 

    pH Measures of blood acidity 

    PaCO2 measures partial pressure of carbon dioxide dissolved in arterial blood (influenced by pulmonary function) 

    HCO3 measures amount of bicarbonate or alkaline substance dissolved in blood (influenced mainly by metabolic changes) 

    PaO2 measures partial pressure of oxygen dissolved in arterial blood 

    O2Sat measures percentage of oxygen carried by hemoglobin
  3. Hypoxemia
    Reduced O2 in blood

    Initial S/S = tachy,lightheadedness, impaired judgment

    S/S Worsens = incoordination, restlessness,rapid breathing, cardiac arrhythmias and/or cardiac arrest.
  4. Metabolic Alkalosis
    • high levels of HCO3 & pH
    • *HCO3 and pH are directly related
  5. Metabolic Acidosis
    Low levels of HCO3 & pH

    *HCO3 and pH are directly related
  6. Respiratory Acidosis
    CO2 levels high & pH level low

    *PaCO2 and pH are inversely related
  7. Respiratory Alkalosis
    CO2 levels low & pH level high

    *PaCO2 and pH are inversely related
  8. Complete Blood Count 
    CBC
    Components of venous blood sample:  

    • WBC = white blood cell count 
    • RBC = red blood cell count 
    • Hgb = hemoglobin 
    • Hct = hematocrit 
    • Plts/Plt = Platelets
  9. CBC Levels
    WBC 4,500 – 11,000 cells/mm3 

    • RBC  4.7-5.5 Million/uL Male
    • *25-35 mL/kg 
    • 4.1-4.9 Million/uL Female
    • *20-30 mL/kg 

    • Hct  43-49 % Male
    • *41-51%
    • 38-44 % Female
    • *36-47% 

    • Hgb  14.4-16.6 Gm/dL Male
    • *14-17 Gm/dL 
    • 12.2-14.7 Gm/dL Female
    • *12-16 Gm/dL 

    Platelets  150,000-350,000/uL
  10. Leukocytosis
    • Increased WBC = Leukocytosis
    • (> 11,000/ mm3)

    • infection, fever, inflammation
    • (hand washing essential)
  11. Anemia
    Reduced RBC

    Paleness in palmar region of hands and nail beds, weak, listless, easily fatigued, dyspnea on exertion, palpitations and/or rapid pulse
  12. Polycythemia
    Increased RBC

    Headache, dizziness, blurred vision, decreased mental acuity, sensory disturbances in hands and feet, increased risk for stroke & thrombosis
  13. Leukopenia
    Decreased WBC = (< 5000 / mm3)
  14. Thrombocytosis
    Platelet count more than 1 million/uL

    Iron deficiency, inflammation or infection
  15. Thrombocytopenia
    Platelet count less than 150,000/uL

    Heavy bleeding into CNS & GI tract
  16. Glucose
    70-110 mg/dL for a fasting test
  17. Hypoglycemia
    Below 60

    low activity tolerance and overexertion might cause hypoglycemic reaction (headache, dizziness, irritability, cold sweats, decreased muscle control, and eventual psychosis)
  18. Hyperglycemia
    300-350 = diabetic ketoacidosis (DKA);

    acetone breath, dehydration, weak, rapid pulse, stupor, coma; modify or postpone intervention until level has been corrected
  19. International Normalized Ratio (INR)
    Ratio of prothrombin time to the reference range of prothrombin time

    • INR
    • 0.9-1.1

    INR > 3.5 = activity needs to be modified due to risk of bleeding I

    NR > 5 = no activity due to high risk of bleeding

    • Increased INR levels c pt taking anticoagulants for any of the following:
    • Atrial fibrillation (A-fib)
    • Deep vein thrombosis (DVT)
    • Left ventricle assistive device (LVAD)
    • Post myocardial infarction (Post MI)
  20. Exercise Guidelines
    NO Exercise when:

    • Hct           < 25%
    • PLTS         <20,000
    • Hgb          < 8
    • WBC         < 5,000 w/fever
    • Glucose*   < 70        
    • INR           > 3.5 (Modify) > 5 (NO)

    *have pt eat snack before tx

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