Chapter 8 Flashcards
(106 cards)
0
Q
what can cause alterations in lab values
A
- dehydration
- inadequate nutrition
- infections
- inflammation
1
Q
bone marrow alterations with age
A
hematooietic tissue decreases by around 20%
2
Q
normal red blood cell range
A
4.2-6.1
3
Q
normal hemoglobin range
A
12-18
4
Q
- main component or rbc
- used as an indicator for anemia
A
hemoglobin
5
Q
critical hemoglobin value
A
<
6
Q
hemoglobin value that indicates anemia
A
< 13 in men
< 12 in women
7
Q
normal hematocrit range
A
37%-52%
8
Q
percentage of rbc to plasma
A
hematocrit
9
Q
elevations in hct and hgb usually early sign of…
A
hypovolemia
10
Q
signs of hypovolemia
A
- malnutrition
- dehydration
- diarrhea
- volume depletion
11
Q
lifespan of white blood cells
A
15-20 days
12
Q
number of wbc’s is regulated by…
A
endocrine system
13
Q
types of white blood cells
A
- neutrophil
- eosinophil
- basophil
- monocyte
- lymphocyte
14
Q
normal wbc range
A
5000-10000
15
Q
critical wbc values
A
30,000
16
Q
neutrophil normal range
A
55%-70%
17
Q
- wbc
- first responder
- phagocytes
A
neutrophils
18
Q
increased neutrophils
A
neutrophilia
19
Q
what can cause neutrophilia
A
- meds (corticosteroids)
- connective tissue disease
- arthritis
- malignancies
- trauma
- gout or uremia
- thyrotoxicosis
20
Q
normal lymphocyte range
A
20%-40%
21
Q
lymphocyte responsible for cell to cell combat
A
T cells
22
Q
lymphocyte responsible for antibody production
A
b-cells
23
Q
lymphocyte changes with age
A
decrease T cells, elevated B cells
24
normal monocyte range
2%-8%
25
- migrating wbc's
| - grow up to be macrophages
monocytes
26
normal eosinophils range
1%-4%
27
wbc that work against allergens and parasites
eosinophils
28
eosinophil aging effect
decreased mucosal immune response
29
normal basophils
0.6%-1%
30
transport histamine and histamine
basophils
31
younger adults s/s of infection
1. elevated temp
2. lymph node enlargement
3. increase in total wbc count
32
older adult s/s of infection
1. all may be absent until they are very ill or septic
| 2. immature neutrophils usually the first indicator of illness
33
rules for neutropenic pts
1. ppe
2. visitors ppe
3. handwashing
4. equipment hygiene
5. pt wears mask
6. no fresh vegetables or fruits
7. no flowers
34
leukocytosis range
2,500-5,000
35
neutropenic range
below 2,500
36
normal platelet (thrombocytes) range
150,000-400,000
37
stimulate the clotting cascade
platelets (thrombocytes)
38
platelet related aging changes
1. no change in number
| 2. increase in clotting factors
39
platelet count less than 100,000
thrombocytopenia
40
spontaneous hemorrhage may occur when platelet counts are less than...
20,000
41
common diagnostics for hematological testing
1. erythrocyte sedimentation rate (esr)
2. C-reactive protein (crp)
3. iron studies
4. b vitamins
5. vitamin d
42
rate at which a rbc settles/falls to the bottom of a saline or plasma solution
erythrocyte sedimentation rate (esr)
43
problem with esr
1. very nonspecific
| 2. can be used to measure status of treatment for inflammatory disorders
44
elevation in esr indicates
1. common in healthy adults with chronic illness
2. elevated serum proteins
3. inflammation
45
produced by liver in acute phase of inflammation, surgery, injuries, or infection
C-reactive protein (crp)
46
crp test results indicate:
1. evaluation of acute mi
| 2. risk for cad
47
heart risk of crp at <1
low risk
48
heart risk of crp at 1-3
average risk
49
heart risk with crp at >3
high risk
50
source of iron
- dark, green, leafy vegetables
| - red meats
51
what is iron needed for?
- o2 transport
| - energy production in the mitochondria
52
normal serum iron range
60-170 mcg/dL
53
normal TIBC range
250-450 mcg/dL
54
normal transferrin saturation
20%-50%
55
b vitamins needed for normal functioning of wbc and rbc and dna synthesis
-stored in liver
folic acid
56
b vitamin needed for normal development of rbc, neurologic function, dna synthesis
-need intrinsic factor for absorption
b12
57
thrombocytopenia precautions
- bleeding precautions
| - fall precautions
58
what can cause low levels of b vitamins
- protein energy malnutrition
- liver and renal disease
- alcoholism
59
what can cause decreased vitamin d levels
1. aging skin
2. decreased uv light exposure
3. decreased intrinsic factor
60
decreased vitamin d levels =
bone resorption
61
electrolytes
1. sodium and chloride
2. potassium
3. calcium and phosphorus
4. glucose
62
sodium and chloride are influenced by:
1. renal filtration
2. renal blood flow
3. cardiac output
4. glomerular filtration rate
63
- asymptomatic in beginning
- can cause seizures, coma, and death
- <135
hyponatremia
64
- >145
- most often free water loss and dehydration
- mental status changes
hypernatremia
65
function of potassium
- cell osmolarity
- muscle function
- transmission of nerve impulses
- acid base balance
66
normal potassium range
3.5-4.5
67
decrease in lean muscle mass=
decreased potassium
68
s/s of hypokalemia
1. generalized muscle weakness
2. fatigue, muscle cramps
3. constipation
4. ileus
5. flaccid paralysis
6. hyporeflexia
7. hypercapnia
8. tetany
69
ecg changes with hypokalemia
- qt prolonged
- t wave flattened or depressed
- st segment depressed
70
s/s of hyperkalemia
1. impaired muscle activity
2. weakness
3. muscle pain/cramps
4. increased gi motilityy
5. bradycardia
6. cardiac arrest
71
ecg changes with hyperkalemia
1. p wave flattened
2. t wave large, peaked
3. qrs broad
4. biphasic qrs-t complex
72
diagnostic criteria for diagnosing diabetes
1. one random plasma glucose of 200 when exhibiting symptoms
or
2. two of any on or combo of positive tests on different days
-fasting glucose 126
-oral glucose tolerance test 200 2 hours after glucose
-random plasma glucose 200 without symptoms
73
additional diagnostic test for diabetes
hgb a1c
74
general cut off for hgb a1c
<6.5%
75
normal creatinine kinase (ck) level
0-3 ng/mL
76
- indicator of acute mi
- also measures myocardial muscle damage, unstable angina, shock, malignant hyperthermia, myocarditis
- rises in 3-6 hours, peaks in 12-24 hours
creatinine kinase (ck)
77
what can cause false elevated ck?
1. anticoagulants
2. dexamethasone
3. furosemide
4. captoril
5. cholchicine
6. lovastatin
7. propanolol
8. morphine
78
- gold standard for diagnosing acute mi
| - elevated within 6 hours and will stay elevated 7-14 days
troponin
79
normal troponin level
<0.03 ng/mL
80
normal total protein range
6.4-8.3
81
normal serum albumin range
3.5-4.8
82
- measures nutritional status
| - most useful as indicator of severity of illness and risk of mortality
serum albumin
83
protein is needed for...
1. energy
2. drug and chemical transportation
3. maintaining intravascular pressure
84
normal blood urea nitrogen (BUN) range
7-21
85
measurement of nitrogen portion of urea; used as gross measurement for renal functioning
BUN
86
normal creatinine range
0.5-1.4
87
measures breakdown of muscle creatinine phosphate
creatinine
88
normal/therapeutic digoxin level
0.8-2.0
89
breakthrough seizures can occur with dilantin levels below...
10
90
dilantin toxicity
above 20
91
most common disturbance seen in older adults
hypothyroidism
92
free thyroxine (T4 free) levels
0.8-1.5
93
tsh level
0.4-4.5
94
t4 total level
5.5-12.3
95
t3 level
60-181
96
normal specific gravity of urine
1005-1030
97
normal pH of urine
4.6-8
98
bilirubin level in urine
0.2-1.0
99
negative urine studies
protein, glucose, ketones, blood, nitrates, leukocytes
100
what to do to fix protein levels
colloid followed by diuretic
101
what can raise tsh levels
lithium
102
what can lower tsh levels
heparin and aspirin
103
what is key to promoting max health for older adults in the long term care setting (cmp, cbc, thyroid)
annual lab testing
104
most lab findings and their meanings are the same for...
older and younger adults
105
an indicator of cardiac events and inflammation
CRP
