Lab Values

Question 1

what are the components of a basic metabolic panel? (BMP)

Answer 1

1. Na and Cl
2. K
3. HCO3
4. BUN
5. Creatinine
6. glucose

Question 2

what is sodium’s role in the body

Answer 2

major positive ion in the extracellular fluid

Question 3

what happens to the body during hypernatremia or hyponatremia?

Answer 3

cognitive changes

Question 4

what happens during hyper/hypokalemia?

Answer 4

muscle weakness and irritability most notably and importantly in the heart. Critical values contraindicate PT due to risk of arrhythmia and tetany

Question 5

what is BUN?

Answer 5

blood urea nitrogen - breakdown product of protein

Question 6

what is serum creatinine

Answer 6

byproduct of creatine -> muscle metabolism

Question 7

what do BUN and serum creatinine tell you?

Answer 7

how the kidneys are working

Question 8

what is normal adult fasting glucose?

Answer 8

70-100 mg/dL

Question 9

what is older adult (>60) fasting glucose?

Answer 9

80-110 mg/dL

Question 10

what is normal Hb A1C

Answer 10

4-6%

Question 11

what Hb A1C is considered poor glucose control

Answer 11

> 7%

Question 12

what do you do if your patients glucose is too low?

Answer 12

15:15 rule - give the pt 15g sugar, wait 15, repeat if needed, wait 15, if it doesnt rise then talk to nurse, if it does then proceed with tx

Question 13

what is the alert value for low plasma glucose?

Answer 13

<70 mg/dL

Question 14

what usually has 15 g sugar that you would give your pt for 15:15 rule

Answer 14

6-7 hard candies, 1/2 cup fruit/juice/soda

Question 15

what is defined as hyperglycemia in the hospital setting

Answer 15

> 140 mg/dL

Question 16

what are symptoms of hyperglycemia?

Answer 16

tiredness, malaise, fruity breath, headache

Question 17

what is a comprehensive metabolic panel (CMP)?

Answer 17

BMP plus liver tests (bilirubin, total protein, albumin, ammonia, and serum enzymes)

Question 18

what are common liver panel items on the CMP?

Answer 18

bilirubin, total protein, albumin, ammonia, and serum enzymes

Question 19

what does low serum prealbumin indicate?

Answer 19

protein depletion - may make the pt feel weak

Question 20

what are the items on a CBC?

Answer 20

WBC count and differential, Hgb, Hct, and platelets

Question 21

what is hematocrit (Hct)

Answer 21

percentage of RBCs in whole blood

Question 22

what usually causes high hematocrit

Answer 22

polycythemia, severe dehydration, acclimatization to altitude, or tobacco use

Question 23

what usually causes low hematocrit

Answer 23

anemia from blood loss or hemodilution

Question 24

what usually causes high Hb?

Answer 24

chronic hypoxia and high altitude

Question 25

what usually causes low Hb?

Answer 25

cancer and blood loss

Question 26

what is normal female hematocrit?

Answer 26

36-47

Question 27

what is normal male hematocrit?

Answer 27

41-51

Question 28

what is the alert value for hematocrit?

Answer 28

<25

Question 29

what is normal female Hb?

Answer 29

12-16

Question 30

what is normal male Hb?

Answer 30

14-17

Question 31

what is the alert value for Hb?

Answer 31

<8

Question 32

what is normal adult female WBC

Answer 32

3900-10700

Question 33

what is normal adult male WBC

Answer 33

4500-11000

Question 34

what is considered leukopenia values? why does this matter for us?

Answer 34

WBC <1000 - the patient usually wears a protective mask

Question 35

what is considered neutropenia values?

Answer 35

WBC <1000 and ANC <500

Question 36

what is normal adult platelet count?

Answer 36

150,000 - 400,000

Question 37

what is the alert value for platelets?

Answer 37

< 20,000

Question 38

what value is considered for thrombocytopenia

Answer 38

platelets < 140,000

Question 39

what value is considered for throbocytosis

Answer 39

platelets > 400,000

Question 40

what three tests are considered for a coagulation profile

Answer 40

aPTT (activated partial thromboplastin time), PT, and INR (internation normalized ratios)

Question 41

what lab value monitors warfarin (coumadin) administration? reference range?

Answer 41

INR (0.9-1.1)

Question 42

what is the therapeutic range for administration of coumadin and how long does it take to achieve?

Answer 42

2.0-3.0 achieved in 2-5 days

Question 43

when is it safe to mobilize a patient on warfarin/coumadin in the presence of a DVT?

Answer 43

when INR is in the therapeutic range

Question 44

what is the lab value, reference range, therapeutic range, and safety parameters surrounding unfractionated heparin administration?

Answer 44

- PTT - 24-36 seconds - PTT 2-3x upper limit of normal - when in therapeutic range

Question 45

what is the lab value, reference range, and safety parameters surrounding administration of low molecular weight heparin (lovenox)

Answer 45

- not routinely measured | - safe to mobilize 3-5 hours after 1st injection administered

Question 46

what is the lab value, reference range, and safety parameters surrounding administration of fondaparinux?

Answer 46

- not routinely measured | - 1.7 hours after 1st injection administered

Question 47

what is an SCD and what does it do

Answer 47

sequential compression device: provides intermittant pressure to LE to prevent DVT and VTE

Question 48

should you take off SCDs during a tx session?

Answer 48

yes, they are worn when the pt is in bed or sitting in a chair, but can be taken off and put back on for PT

Question 49

when is an SCD contraindicated

Answer 49

1. area of known DVT 2. area of acute cellulitis 3. over fx or open wound