Module 9: Interpreting Clinical & Lab Data Flashcards
1
Q
White Blood Cell Count (WBC)
A
3.9-11.7x 10(3)/mcL
2
Q
Leukocytosis
A
WBC count above normal.
Common with infection, stress, and trauma.
3
Q
Leukopenia
A
WBC below normal.
4
Q
Why does leukopenia occur?
A
Occurs with overwhelming infections and when immune system is depressed due to disease or certain cancer therapies. (Chemotherapy)
5
Q
Neutrophils Relative Value?
A
40%-75%
6
Q
Bands
A
Immature Neutrophils
7
Q
Segs
A
Mature Neutrophils
8
Q
Lymphocytes Relative Value
A
20%-45%
9
Q
Lymphocyte abnormalities?
A
Causes of abnormalities: Increased with viral and other infections; reduced with immunodeficiency problems.
10
Q
Eosinophils Relative Value
A
0%-6%
11
Q
Basophils Relative Value
A
0%-1%
12
Q
Monocytes Relative Value
A
2%-10%
13
Q
Red blood cell count reference range for MEN
A
Men: 4.4-5.9 x10(6)/mcl
14
Q
Red blood cell count reference range for WOMEN
A
Women: 3.8-5.2x 10(6)mcl
15
Q
Reduced RBC is called?
A
Anemia
16
Q
Polycythemia?
A
Abnormal elevation of RBC count
17
Q
HEMOGLOBIN RBC Count Reference Range for WOMEN
A
Women: 11.7-15.7 g/dl
18
Q
HEMOGLOBIN RBC Count Reference Range for MEN
A
Men: 13.3-17.7 g/dl
19
Q
Hematocrit levels (RBC) Reference Range for Men
A
40%-52%
20
Q
Hematocrit levels (RBC) Reference Range for WOMEN
A
Women: 35%-47%
21
Q
Sodium (Na+) Reference Range
A
136-145 mEq/L
22
Q
Hypermatremia
A
Dehydration from excessive water loss or fluid restriction; excessive administration of saline fluids or diuretics.
23
Q
Hyponatremia
A
Over-hydration or abnormal secretion of anti diuretic hormone; severe vomiting or diarrhea; congestive heart failure, renal or hepatic failure, Addison disease.
24
Q
Potassium (K+) reference range
A
3.5-5.0 meq/L
25
Hyperkalemia
Acute or chronic kidney disease, Addison disease, severe alcoholism, rhabdomyolysis; values >6 mmol are life threatening.
26
Hypokalemia
Severe vomiting or diarrhea; chronic renal disease; high dose beta-agonist therapy.
27
Chloride (CI-) reference range
98-106 meq/L
28
Hyperchloremia
Excessive chloride administration (usually saline resuscitation during shock); metabolic acidosis, diabetes insipidus.
29
Hypochloremia
Severe vomiting or diarrhea; metabolic alkalosis , adrenal insufficiency, severe burns, excessive intravenous dextrose administration.
30
Total carbon dioxide (CO2) reference range
22-29 meq/L
31
Calcium (Ca)
Reference range: 4.5-5
32
Glucose Reference Range
70-139 mg/dl
33
Creatinine (Cr) Reference Range
0.7-1.3 meq/L
34
Blood Urea Nitrogen (BUN) Reference Range
8-23 mg/dl
35
What are the two tests used to evaluate renal function?
Creatinine and Blood Urea Nitrogen (BUN)
36
Normal level for Anion Gap?
8-14 mmol/L
True normal: 11 mmol/L
37
Lactate reference range
0.7-2.1 meq/L
38
International Standardized Ratio (INR) reference range
0.9 to 1.3
39
5.0 indicate?
A high likelihood for bleeding.
40
0.5 tends toward to?
Increased clotting.
41
Sputum Gram Stain
Legitimate sputum sample will have numerous pus cells and few epithelial cells.
If too many epithelial cells are present obtain a new sputum sample.
42
Sweat chloride
Cystic Fibrosis
43
Invasive procedure requires?
Insertion of sensor or collection device into body.
44
Noninvasive monitoring is?
Means of gathering data externally.
45
Physiologic monitoring can be either?
Invasive or noninvasive.
46
What are the three common causes of malfunction for O2 analyzers?
Low batteries (MOST COMMON)
Sensor depletion
Electronic failure
47
Why is the radial artery mostly used?
Near surface and easy to stabilize
Collateral circulation usually exists (confirmed with the allen test)
No large veins are near
48
Indications for analyzing blood gases.
Sudden , unexplained dyspnea
Cardiopulmonary resuscitation (CPR)
Changes in mechanical ventilation settings
49
Analyzing blood gases contraindications.
Abnormal results of a modified Allen test
Lesion
Surgical shunt
History of peripheral vascular disease
50
Possible complications for sampling and analyzing blood gases.
Ateriospasm
Hemorrhage
Air or clotted emboli
Patient or sampler contamination
Infection
51
Modified Allen’s Test
Normal test indicating collateral circulation- hand flush pink within 5-10 seconds, if color is not returned, perform an Allen’s test on the other hand.
Cannot be performed on critically ill patient who are uncooperative or unconscious.
52
Clinicians can avoid most preanalyctical errors by ensuring that sample is?
Analyzed within 15 to 30 minutes.
53
What happens to your blood gas sample if you wait up to 30 minutes to analyze?
Waiting up to 30 minutes after any major change in ventilatory support may be necessary before sampling and analyzing the blood ashes of a critically ill patient.
54
Good capillary sample can accurately reflect and provide?
Clinically useful estimates of arterial pH and PCO2 levels.
55
CapillaryPO2 is of no value in estimating?
Arterial oxygenation.
56
Capillary blood gas indications.
ABG analysis is indicated, but arterial access is unavailable.
Noninvasive monitor readings are abnormal.
Change in therapy.
A change in patient status
Monitoring the severity and progression of a documented disease process is desirable.
57
Capillary blood gases precautions and possible complications.
Contamination and infection of the patient
Inappropriate patient management may result from reliance on capillary PO2 value
Burns
Hematoma
Scarring
Bleeding
Hemorrhage
58
Capillary blood gases analyze
PH, PCO2, & PO2 levels in blood samples.
59
Electrodes: PaO2
Clark polarographic electrode
60
Electrodes: PaCO2
Severinghaus electrode
61
Electrodes: pH
Ph electrode actually consists of two electrodes or half cells:
Measuring electrode
Reference electrode
62
What is transcutaneous monitoring?
Provides continuous, noninvasive estimates of PO2 and PCO2 using skin sensor.
Agreement between PtcCO2 and PaCO2 is better because CO2 is more diffusible through skin.
63
What are the most common sites for transcutaneous monitoring on infants and children?
Abdomen
Chest
Lower back
64
Indications for transcutaneous monitoring.
The need to monitor continuously the adequacy of arterial oxygenation or ventilation in infants and children.
65
Hazards and possible complications of transcutaneous monitoring?
Tissue injury (eg. Erythema, burns, skin tears) may occur at the measuring site.
66
Clinical indications for tissue oxygen (PtO2)
Monitor brain tissue oxygen as an early sign of ischemia.
67
What does oximetry measure?
Hemoglobin saturation using spectrophotometry.
68
Hemoximetry
(Cooximetry) laboratory analytical procedure requiring invasive sampling or arterial blood.
69
Pulse oximetry
Noninvasive monitoring technique performed at bedside.
70
Indications for pulse oximetry?
To monitor the adequacy of arterial oxyhemoglobin saturation.
To quantify the response of arterial oxyhemoglobin saturation to therapeutic intervention or to diagnostic procedures, such as bronchoscopy.
71
Pulse oximetry precautions?
Factors affecting SpO2 accuracy include motion artifact, abnormal hemoglobins, intravascular dyes, low perfusion states, skin pigmentation, and nail polish.
72
What is the greatest hazard of pulse oximetry?
Is a false result that leads to incorrect decision making.
73
Pulse oximetry cannot distinguish HbCO from HbO2 because?
Due to reading falsely in high CO poisoning.
74
Phase 1 capnogram?
Normal capnogram shows PCO2 of zero at start of expiratory breath.
75
End tidal PCO2 (PETCO2) is used to estimate?
Dead space ventilation and normally averages 3-5 mmHg less than PaCO2.
