Lab Values #2

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  1. What is Specific urine gravity
    • A measure of the concentration of solutes in urine
    • Routine part of urinalysis
  2. What is the normal range for Specific gravity, Urine
    1.002 - 1.030

    The higher the number, the more dehydrated you may be
  3. Why would a specific urine gravity be ordered
    Can be used to assess kidney's ability to concentrate or dilute urine
  4. How is specific gravity urine tested?
    Urine sample and dipstick
  5. Symptoms of low specific gravity urine
    • May indicate fluid overload or presence of diabetes insipidus
    • Also can occur in patients renal abnormalities
  6. Symptoms of high specific gravity urine
    • Can indicate dehydration or infection
    • May occur in patients with:
    • adrenal insufficiency
    • hepatic disease
    • congestive heart failure
    • or in pts experiencing excessive water loss due to sweating, fever, vomiting, or diarrhea
  7. What is hemoglobin
    • a protein molecule in RBC which enables tham to transport oxygen and carbon dioxide
    • Used to screen for, evaluate, and monitor anemia
  8. Normal range for hemoglobin
    • Men: 14 - 18 g/dL
    • Women: 12 - 16 g/dL
  9. Why would hemoglobin be tested/ordered?
    • Test or monitor anemia
    • Also test or monitor for polycythemia vera, which is a slow-growing blood cancer in which bone marrow makes too many RBC, causing blood to be too thick
  10. How is hemoglobin tested
    blood sample
  11. What is hemoglobin is low?
    • If it's not severe, usually no sx. 
    • If it's severe, pt will feel drowsy, dizzy, or fatigued and will have pale skin, palpitations, and restless leg syndrome
  12. What if hemoglobin is high?
    Can happen if living at higher altitude, from smoking, or polycythemia vera.
  13. What is hematocrit
    blood that determines the percentage of RBC in the blood
  14. Normal ranges for Hematocrit
    • Men: 38 - 50%
    • Women: 35 - 45%
  15. Why would hematocrit ordered?
    Measures the proportion of RBC in the blood in order to diagnose certain diseases
  16. Hematocrit to hemoglobin ratio
    three to one:

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  17. Normal range for platelets
    150 k - 450 k
  18. Why would platelets be ordered
    • Monitor for formation of clots and risk for bleeding
    • Done by blood draw
  19. What if Low platelets
    Thrombocytopenia, frequent bruising, and/or bleeding
  20. What if high platelets
    • Thrombocytosis
    • Blood clot formation in legs and arms, which can lead to an MI or stroke
  21. What are neutrophils and what is Normal range for neutrophils
    • 45 - 70%
    • Most abundant type of WBC
  22. How and why to test neutrophils
    • Blood test
    • Neutrophils defend against bacteria and fungi and produce relatively small inflammatory responses as first responders
  23. Low neutrophil meaning:
    • Called neutropenia ~ increased risk for infection
    • Can be caused by chemotherapy or bone marrow transplant
  24. High neutrophil meaning
    • Can indicate immune system response, including acute infection, gout, trauma
    • Diseases associated with higher levels include rheumatoid, thyroiditis, and myelocytic leukemia
  25. What are Lymphocytes and what is normal range
    20-40%

    Type of WBC, includes natural killer cells (NK) and T cells & B cells
  26. Why would lymphocytes be ordered?
    • Assess for infection
    • Lymphocytes defend against viral infections
    • Do NOT release histamine during allergic reaction
  27. Low lymphocyte meaning:
    • Most common disorders include AIDS and undernutrition
    • Increased risk for infection and developing leukemia and lymphoma
  28. High lymphocyte meaning
    Normal after infection
  29. RBC count for Male and Female
    • Male: 4.3 - 5.7  trillion
    • Female: 3.9 - 5.0 trillion
  30. Low RBC meaning
    Could be decrease in RBC production in bone marrow, trauma, chronic inflammatory disease,

    Treat with PRBC
  31. High RBC meaning
    • could polycythemia vera
    • prob with bone marrow
  32. ESR
    • Erythrocyte sedimentation rate
    • Rate at which RBC sediment (settle to bottom of tube) in a period of one hour
    • Common hematology test, is non-specific measure of inflammation
  33. Normal range for ESR
    • Male: 15 mm/hr
    • Female: 22 mm/hr
  34. Why would ESR be ordered
    Can indicate acute or chronic inflammation, necrosis (tissue death), or infection
  35. How is ESR tested
    Blood test, in lavender tube
  36. Low ESR sx
    • No actual sx
    • Measures how heavy RBC is and how much plasma from inflammation is weighing it down
    • Could indicate sickle cell anemia, polycythemia
  37. Increase levels of ERS
    • Could mean:
    • chronic renal failure
    • malignant disease
    • bacterial infection
    • necrotic tissue
    • severe anemia
  38. PTT
    • Partial thromboplastin time
    • Blood test that measures the time it takes for blood to clot
    • Can be used to check for bleeding problems
  39. Normal PTT time
    25 -35 seconds
  40. Why would PTT be ordered
    • Monitors effectiveness of Heparin
    • Will also be drawn if there is any unexplained bleeding to dx any clotting disorders
  41. How is PTT tested
    Blood sample, duh
  42. Low (shortened) PTT
    Usually due to DIC or some form of severe cancer
  43. High PTT
    hemophilia or some other clotting disease
  44. PT/INR
    • INR is International Normalized Ratio 
    • Calculation based on results of PT (prothrombin time) and used to monitor effectiveness of anticoagulant WARFARIN

    Recall this drug effect function of coagulation cascade and helps inhibit formation of blood clots.
  45. Desired range for PT/INR
    People on warfarin should have INR of 2.0 - 3.0 for basic blood thinning
  46. Dilantin
    • Phenytoin
    • Is an anti-epileptic drug (anticonvulsant)
  47. Dilantin dosage
    10 - 20 mcg/mL

    • Toxic >30
    • Bwtn 40 and 50: Lethargy and confusion
    • Higher than 50: coma and seizures
  48. How to test for Dilantin levels
    Blood/serum test

    tests for levels of seizure management
  49. Low levels of Dilantin
    • risk of seizure
    • risk for nystagmus (vision condition where eyes make repetitive, uncontrolled movements)
  50. High levels of Dilantin
    • Ataxia
    • slurred speech
    • N/V
  51. Antidote for Dilantin
    • No specific antidote 
    • treatment is supportive
  52. Theophylline
    • Bronchodilator
    • Oral medication used to treat asthma, emphysema, chronic bronchitis and other lung diseases
  53. Theophylline dosage
    Dosage depends on patient

    • Therapeutic level: 10 - 15 mcg/mL
    • Toxic: >20 mcg/mL
  54. Low levels of theophyliine
    • No therapeutic effect
    • SOB, lung constriction and difficulty breathing
    • Low O2
  55. High levels of theophylline
    • Seizures, hypotension, and significant dysrhythmias are usually observed when serum levels approach 80 mcg/mL
    • Seizures are more common with acute overdose than with chronic overdose
  56. Antidote for theophylline
    • Administer activated charcoal, which enhances elimination 
    • Very effective, but important to aggressively control N/V in order for charcoal to work

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Author:
jskunz
ID:
328753
Filename:
Lab Values #2
Updated:
2017-02-22 19:41:57
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Labs
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Labs
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