Lab Values Flashcards by Hannah Holland

What are lab results for?

Screening
Diagnosis
Monitoring

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Factors affecting lab values

Age
Gender
Race
Pregnancy
Food ingestion

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Urine studies are used to

Detect/diagnose and monitor renal and urinary disease
Detect metabolic/systemic disease

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Urine reflects ________ __________ of a substance if kidney function normal

Blood levels

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Desired result of urinalysis

Clear, yellow-amber color
No ketones, WBCs, or protein

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24 hour urine is for

Hormones, protein, creatinine

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When doing a 24 hour urine test, what do you do before?

Ask pt to void, and discard the first voiding.

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All urine is saved in a container for 24 hr, and must be kept

Cool

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24 hour urine sources of error:

Contaminants in the urine
Failure to collect all urine in time period
Including 1st voided urine
Improper storage/preservation of specimen

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CrCl

Creatinine clearance

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CrCl can detect and diagnose

Kidney dysfunction and/or decreased blood flow to kidneys

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CrCl test requires

24 hr urine test and 1 blood specimen

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Osmolality of urine measures

Dissolved particles in urine

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Osmolality of urine determines

Kidneys concentrating ability
Fluid & electrolyte abnormalities

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Normal serum osmolality

280-300 mOsm/L

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HCT

Hematocrit

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HCT values assess

Hydration status, anemia, oxygen transport

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Buffy coat

White blood cells, platelets

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High levels of HCT

Dehydration, diuretics, burns
High altitude, hypoxemia, COPD

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Low levels of HCT

Levels tend to decrease with age
s/s of anemias, blood loss, over hydration
Extremely elevated WBCs

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High levels of serum osmolality

Dehydration
Increased Na or glucose
HHNK or DKA
Diuretic therapy

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Low levels of serum osmolality

Over hydration
SIADH
CA- breast, colon, lung

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PreAlbmin is used to monitor

Nutrition status and effects of treatment
Liver function

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Increased PreAlbumin

Hodgkins disease, pregnancy

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Decreased PreAlbumin

Malnutrition, liver disease, inflammation

Culture and sensitivity

Urine, blood, wound drainage, tissue and devices

Culture for fungus may take up to

6 weeks

Gram positive

Blue staining organism

Gram negative

Red staining organism

Gram stain results take

10 mins

Therapeutic drug monitoring determines

Effective dose and prevents toxicity

Peak

Drug highest level in blood but below toxic level

Trough

Drug lowest level in blood but in therapeutic range

PT/INR

Monitoring or warfarin Evaluation for vitamin K deficiency or severe malnutrition Assessment of liver failure

PTT

Monitoring (but not initiation) of heparin Assessment of clotting factor function in hemophilia and von Willebrand disease

Both PT/INR and PTT

Active bleeding without obvious cause History of abnormal, excessive, or spontaneous bleeding High risk patients

Production occurs in the

Bone marrow

Granulocytes

Basophils, eosinophils and neutrophils

CBC

Complete blood count

CBC is used to diagnose

Anemias Bleeding disorders Infections Blood cell changes

CBC elements

WBC RBC HCT HGB Platelet count

WBC assessment of

Infection Neoplasm Allergy Immunosuppression

WBC’s > 10,000 =

Leukocytosis (Anemias, viral infections, ETOH, RA, trauma, physical or emotional stress)

WBC’s < 4,000 =

Leukopenia (Acute infection, MI, cirrhosis, burns, dietary deficiencies)

Polymorphonuclear

Having a lobed nucleus Commonly referred to as “polys”

Neutrophils

Phagocytosis Bacterial infection, trauma

Eosinophils

Allergic reactions Parasitic conditions

Basophils

Mast cells Increase during healing process

Lymphocytes

Increase during chronic bacterial and viral infections B lymphocytes T lymphocytes

RBC

Red blood cells

Red blood cells are formed in

Bone marrow

Red blood cells:

Erythrocytes Transport oxygen Assess for anemias

High RBC levels =

Erythrocytosis (Severe dehydration, COPD, polycythemia vera )

Low RBC levels =

Erythropenia (Anemia, hemorrhage, bone marrow failure, cirrhosis, renal disease, lymphoma, leukemia)

Tourniquet on for >1min =

Hemolysis

HGB is highest in the

Morning

HGB is lowest around

Bedtime

HGB high levels

Dehydration, CHF, lung disease, heavy smokers

HGB low levels

Anemias, hemorrhage, hodgkins, kidney disease

MCV

Mean corpuscular volume Average size of erythrocytes HCT / RBC =MCV

MCH

Mean corpuscular hemoglobin Average weight of erythrocytes HGB / RBC = MCH

MCHC

Mean corpuscular hemoglobin concentration Concentration of hemoglobin in 100 ml PRBC HGB /HCT = MCHC

Platelets promote

Coagulation, vascular integrity

Platelets are produced in the

Bone marrow

Platelets are

Thrombocytes

Increased platelet levels =

Thrombocytosis (>400,000)

Thrombocythemia

> 1 million platelets

low levels of platelets

Thrombocytopenia (<100,000)

Normal urine osmolality

300-900 mOsm/L

Serum osmolality rough estimate

Na level x 2