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Lab Values Flashcards

1
Q

Lab Values Used for:

A

-Screening for diseases
-Confirming diseases
-Preventative therapy

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2
Q

Acute changes

A

Associated with blood loss due to trauma or surgery, may require the therapist to select a more
conservative plan of care
~may not allow the pt to compensate quickly enough

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3
Q

Chronic changes

A

Associated with chronic conditions or longer-term medical interventions allow the
patient a period of time for their body to adapt or attempt to adapt to the changes in lab values
~May allow them to have more resources to deal with potential adverse events caused by increasing cardiorespiratory demand,
mobility, and exercise

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4
Q

Complete Blood Count Panel

A

Hemoglobin
Hematocrit
Platelets
White blood cells

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5
Q

CBC

A

Evaluate the different cellular components of blood

Simple blood draw from a peripheral vein

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6
Q

White Blood Cells (WBC)

A

Determines status of immune system; detects presence of infection/inflammation
Infection may increase O 2 demand, affecting occupational performance
WBC counts are age-related
Normal newborns/infants > adults

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7
Q

WBC Normal Values

A

Child > 2 years/adult: 5,000-10,000 mm3
5-10.0 x103 /uL

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8
Q

WBC Possible critical value

A

< 2,500 or > 30,000

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9
Q

Leukocytosis

A

High WBC
> 11.0 x 10 3 /uL

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10
Q

Leukocytosis Effects

A

Bacterial or viral infections
Inflammation/inflammatory condition (RA,
vasculitis, IBD)
Leukemia
Tissue necrosis (ex: trauma, burns, surgery, heart
attack)
Allergic response
Intense exercise
Severe emotional or physical stress
Pregnancy in final month and labor

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11
Q

Leukopenia

A

Low WBC
< 5.0 x 10 3 /uL

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12
Q

Leukopenia Effects

A

Bone marrow damage
Bone marrow disorders
Lymphoma
Autoimmune disorders (ex: lupus)
Sepsis
Immune system diseases (ex: HIV)

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13
Q

Neutropenia

A

Abnormally low levels of neutrophils (type of WBC) in the blood
< 1.8 x 10 3 /uL
Institutional guidelines determine neutropenic precautions

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14
Q

Why are neutrophils important?

A

Fighting infections

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15
Q

Hemoglobin (HB)

A

Measurement of blood’s oxygen
carrying capacity
Enables RBCs to bind to O 2 in the
lungs and carry it to tissues/organs

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16
Q

HB Normal Values

A

Adult Male:
14-18 g/dL

Adult Female:
12-16 g/dL

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17
Q

HB Possible Critical Values

A

< 5 or > 20

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18
Q

Anemia (Low HB)

A

Bleeding
Iron, vitamin B-12, or folate deficiency
CA (leukemia)
Kidney or liver disease
Hypothyroidism
Hemolytic anemia
Bone marrow damage or disorders
Chronic inflammatory conditions
Thalassemia (↓ Hb production) – inherited

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19
Q

Polycythemia (high HB)

A

Dehydration (artificial ↑)
Living @ high altitude
Heavy smoking
Burns
Excessive vomiting
Extreme physical exercise
Congenital heart disease
Lung disease
Kidney tumors (↑ erythropoietin production)
Genetic causes:
Polycythemia vera (↑ RBC production) – bone marrow disorder, gene defect

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20
Q

Critically low value of HB

A

< 5 g/dL

Can lead to heart failure or death

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21
Q

Critically high value of HB

A

> 20 g/dL

Increased blood viscosity, clogging of capillaries,
tissue ischemia

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22
Q

Hematocrit (HCT)

A

Measurement of RBC % in total blood volume
Low RBCs: similar to Hb
High RBCs: similar to Hb

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23
Q

HCT Normal Values

A

Adult Male:
42-52%

Adult Female:
37-47%

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24
Q

Critically low value of HCT

A

< 15%

May result in cardiac failure/death

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25
High HCT
> 60% Associated with spontaneous blood clotting
26
Platelets
Responsible for forming platelet plugs for blood clotting May be used as a workup for: Bleeding disorders Bone marrow disease Excessive clotting disorder
27
Platelets Signs and Symptoms of bleeding disorder
Unexplained/easy bruising Prolonged bleeding from small cut Numerous nosebleeds GI bleeds Petechiae Purpura
28
Petechiae
small, flat, red, purple, or brown spots that appear on the skin or mucous membranes due to bleeding under the skin
29
Purpura
a condition that causes red or purple spots or patches to appear on the skin or in mucus membranes
30
Platelets Reference value
140-400 k/uL
31
Platelets - Trending upward (thrombocytosis)
: >450 k/uL Symptoms-based approach when determining appropriateness for activity; monitor symptoms; collaborate with interprofessional team Elevated levels can lead to thromboembolism
32
Platelets - Trending downward (thrombocytopenia)
< 150 k/uL In presence of severe thrombocytopenia (< 20 k/uL) use a symptoms-based approach when determining appropriateness for activity; monitor symptoms; collaborate with interprofessional team Fall-risk awareness (risk of spontaneous hemorrhage)
33
Platelets Possible Critical Values
< 50,000 or > 1 million
34
Basic Metabolic Panel
Sodium Potassium Chloride Calcium Magnesium Blood Urea Nitrogen Creatinine Blood Glucose Total Carbon Dioxide
35
Fluid Imbalances
-Total fluid is distributed between the intracellular and extracellular compartments -Intracellular fluid Contains ~2/3 of the body’s fluid -Extracellular fluid Interstitial and intravascular fluid Blood and plasma
36
Loss of Fluid
Inadequate intake Hemorrhage Plasma loss (burns) Vomiting/diarrhea Fluid shift into the interstitial space Ascites – liver failure Pleural effusion – heart failure
37
Loss of fluid Signs and Symptoms
Decreased BP Increased HR Changes in mental status Thirst Dizziness Poor skin turgor Orthostatic hypotension
38
Excess of fluid
Increased intake of fluid Excessive sodium intake Kidney failure (acute and chronic) Ventricular failure Liver failure – loss of serum albumin Fluid overload
39
Excess of fluid Signs and Symptoms
Weight gain Pulmonary edema Peripheral edema Bounding pulse Tachycardia Hypotension
40
Electrolyte imbalance
The result of fluid imbalances Vice versa
41
Cellular function is reliant on proper electrolyte balance
Neuromuscular excitability Secretory activity Membrane permeability
42
Electrolyte Balance - Sodium (Na+)
135-145 mmol/L or mEq/L Vital to normal body processes: Nerve function Muscle function Regulates amount of fluid in body Primary determinant of ECF volume
43
Reason to test Sodium (Na+)
Usually done as part of electrolyte or basic metabolic panel In the presence of dehydration or edema Monitor blood pressure
44
Possible critical value of Sodium (Na+)
: < 120 or > 160
45
Hypernatremia
High Na+ > 145 mEq/L
46
Causes of hypernatremia
Increased fluid loss (excessive sweating, diarrhea, use of diuretics, or burns) Inadequate fluid intake and dehydration Too much salt or sodium bicarbonate in the diet Renal insufficiency and failure Adrenal gland problems (Cushing Syndrome or hyperaldosteronism) DM and Diabetes insipidus Use of certain medicines NSAIDs (ibuprofen or naproxen) Antibiotics Laxatives Corticosteroids Anabolic steroids
47
Hypernatremia S/S
Dry mucous membranes Decreased urine output Thirst Agitation Restlessness Acting irrational Coma Convulsions
48
Hyponatremia
Low Na+ < 135 mEq/L
49
Causes of hyponatremia
Dehydration, vomiting, diarrhea Increase in total body water (heart failure, certain kidney diseases, or cirrhosis of the liver) Too much water intake or retention Adrenal insufficiency Use of certain medications Diuretics (water pills) Morphine SSRI antidepressants
50
Hyponatremia S/S
~Hypovolemia: Poor skin turgor Dry mucous membranes Orthostatic hypotension/tachycardia/weak pulse ~Hypervolemia: Hypertension Tachycardia Pitting edema
51
Potassium (K + )
3.5 - 5.0 mEq/L Vital to normal body processes: Muscle function Heart function Cell metabolism
52
Possible Critical Value of Potassium (K+)
< 2.5 or > 6.5
53
Reason to test K+
Part of a basic or comprehensive metabolic panel Diagnose or monitor kidney disease Signs of high blood pressure or heart problems Suspect metabolic acidosis (uncontrolled diabetes) Suspect alkalosis (excess vomiting) May be done for person having an attack of paralysis
54
Hyperkalemia
High K+ > 5.0 mEq/L
55
Causes of hyperkalemia
Blood transfusion Crushed tissue injury Kidney failure Metabolic or respiratory acidosis RBC destruction Certain medications (NSAIDs, ACEi)
56
Hyperkalemia S/S
Muscle weakness Flaccid paralysis Bradycardia, heart block, ventricular fibrillation Cardiac arrest
57
Hypokalemia
Low K+ < 3.5 mEq/L
58
Causes of hypokalemia
Vomiting Chronic diarrhea Nasogastric suction Diuretics Not enough potassium in the diet Malnutrition Alcoholism
59
Hypokalemia S/S
Extremity weakness Hyporeflexia Paresthesia Leg cramps ECG changes (ST depression, T wave inversion), dysrhythmias, cardiac arrest Hypotension Diminished bowel function, constipation, abdominal distension, paralytic ileus
60
Chloride (Cl)
Reference value: 98-108 mEq/L
61
Trending upward (hyperchloremia):
high levels in blood Determine if appropriate for treatment if exhibiting decreased level of consciousness Hypertension, tachycardia
62
Trending downward (hypochloremia):
low levels in blood Monitor level of consciousness and motor function
63
Creatinine
Creatine is a compound primarily made in liver and transported to muscles to be used as energy A waste product produced by muscles from breakdown of creatine is creatinine Almost all creatinine is excreted by kidneys (except with kidney disease)
64
Reason to test Creatinine
To determine if kidneys are functioning normally Monitor treatment for kidney disease Often used as part of a comprehensive or basic metabolic panel
65
Creatinine Normal range
0.66-1.25 mg/dL
66
Higher than normal level of Creatinine may be due to:
Reduced renal blood flow (shock, dehydration, CHF, atherosclerosis, or complications with diabetes Blocked urinary tract Kidney damage, infection Dehydration Muscle problems, such as breakdown of muscle fibers (rhabdomyolysis) Problems during pregnancy, such as seizures or high blood pressure caused by pregnancy (preeclampsia) Bacterial infection of kidneys (pyelonephritis)
67
Kidney - Blood Urea Nitrogen (BUN)
Urea nitrogen is what forms from protein breakdown
68
Reason to test BUN
To check protein balance (how much protein a person takes in) Measures amount of urea the kidneys excrete (shows kidney function)
69
BUN Normal value
Normal value 9-20 mg/dL
70
Low levels of BUN indicate:
Kidney problems Malnutrition (inadequate protein in diet)
71
High levels of BUN indicate:
Increased protein breakdown in the body Too much protein intake
72
High levels of BUN due to:
Congestive heart failure Heart attack Excessive protein levels in the gastrointestinal tract Hypovolemia (dehydration) Kidney disease Kidney failure Shock Urinary tract obstruction
73
Glucose Normal Range
70-100 mg / dL
74
Carbon Dioxide
Normal range 22 – 26 mEq/L A bicarbonate (HCO 3-) test is part of an electrolyte panel or metabolic panel used to identify or monitor an electrolyte imbalance or acid-base (pH) imbalance This test measures the total amount of carbon dioxide (CO 2) in the blood, which occurs mostly in the form of HCO 3- Measuring HCO 3– as part of an electrolyte or metabolic panel may also help diagnose acidosis or alkalosis

Patho (13 decks)

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