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U of R SCHOOL OF NURSING - 372 > NUR 372 CLASS 5 LAB VALUES > Flashcards

NUR 372 CLASS 5 LAB VALUES Flashcards

1
Q

WHITE BLOOD COUNT

A
  • 5 - 10 THOU/uL
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2
Q

CBC (COMPLETE BLOOD COUNT) TEST

A
  • basic screening test
  • provides valuable information on the patient’s hematologic state and other disease process
  • consists of: WBC, RBC, hematocrit and hemoglobin, platelet, differential (neutrophils, eosinophils, basophils, lymphocytes & monocytes)
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3
Q

CRITICAL WBC VALUES

A
  • < 2500 or > 30,000
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4
Q

INCREASED WHITE BLOOD CELL COUNT

A
  • infection
  • inflammation
  • invasive lines
  • inadequate primary defense
  • neoplasm’s
  • medication
  • stress
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5
Q

ASSESSMENT OF INCREASED WHITE BLOOD CELL COUNT

A
  • fever
  • fatigue
  • history or presence of infection of potential exposure
  • flushed skin appearance
  • increased RR, HR
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6
Q

INTERVENTIONS FOR INCREASED WHITE BLOOD CELL COUNT

A
  • medical asepsis
  • appropriate timing of antibiotics
  • follow P & P for invasive lines & drains
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7
Q

DECREASED WHITE BLOOD CELL COUNT

A
  • medication induced (chemotherapy)
  • radiation
  • bone marrow failure
  • severe infection
  • dietary deficiencies
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8
Q

ASSESSMENT OF DECREASED WHITE BLOOD CELL COUNT

A
  • assess for signs and symptoms of infection
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9
Q

INTERVENTIONS FOR DECREASED WHITE BLOOD CELL COUNT

A
  • basic aseptic practices of hand washing

- possibly reverse isolation in some cases (protective precautions)

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10
Q

HEMOGLOBIN COUNT

A
  • M 14-18 g/dL

- F 12-16 g/dL

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11
Q

CRITICAL HEMOGLOBIN VALUES

A
  • < 5 or > 20 g/dL
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12
Q

HEMATOCRIT

A
  • percentage of RBC in plasma
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13
Q

HEMATOCRIT COUNT

A
  • M 42-52%

- F 37-47%

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14
Q

CRITICAL HEMATOCRIT VALUES

A
  • < 15% or > 60%
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15
Q

INCREASED HEMOGLOBIN/HEMATOCRIT RISK FACTORS

A
  • congenital heart disease
  • COPD
  • overproduction by the bone marrow (polycythemia vera)
  • dehydration
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16
Q

ASSESSMENTS FOR INCREAESED HEMOGLOBIN/HEMATOCRIT

A
  • assess for smoking history
  • living at high altitudes for extended periods
  • chronic breathing difficulties
  • sleep disturbances
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17
Q

INTERVENTIONS FOR INCREASED HEMOGLOBIN/HEMATOCRIT

A
  • lack of volume, an increased oral intake or parenteral fluid replacement may be ordered
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18
Q

DECREASED HEMOGLOBIN/HEMATOCRIT RISK FACTORS

A
  • anemia
  • cirrhosis
  • hemorrhage
  • dietary deficiencies
  • renal disease
  • autoimmune diseases
  • cancers
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19
Q

ASSESSMENTS FOR DECREASED HEMOGLOBIN/HEMATOCRIT

A
  • assess for s/s of fatigue
  • cool extremities
  • dyspnea
  • tachycardia
  • pallor
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20
Q

INTERVENTIONS FOR DECREASED HEMOGLOBIN/HEMATOCRIT

A
  • correct nutritional deficiencies
  • alternate rest & activity
  • blood transfusion
  • supplemental oxygen
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21
Q

PLATELET COUNTS

A
  • 150,000 - 400,000
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22
Q

THROMBOCYTOPENIA

A
  • platelet count < 100,000
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23
Q

CRITICAL PLATELET VALUES

A
  • < 50,000 or > 1,000,000
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24
Q

PARTIAL THROMBOPLASTIN TIME COUNT

A
  • 21 - 35 seconds
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25
PARTIAL THROMBOPLASTIN TIME CRITICAL VALUES
- >70 increased risk of bleeding
26
PROTHROMBIN TIME COUNT
- 11 - 13 seconds (INR 0.8 - 1.2)
27
PTT, PT/INR need to be ________ times control if anti coagulated
- 1.5 - 2
28
INCREASED PLATELET RISK FACTORS
- myeloproliferative disorders - leukemia - splenectomy
29
DECREASED PLATELET RISK FACTORS
- certain anemia's - viral and bacterial infections - HF - HIV - hypersplenism
30
INCREASED PTT RISK FACTORS
- congenital defects such as hemophilia | - heparin therapy
31
DECREASED PTT RISK FACTORS
- cancer | - immediately after acute hemorrhage
32
INCREASED PT RISK FACTORS
- deficiencies in clotting factors - Vit K def - liver disease - warfarin therapy
33
DECREASED PT RISK FACTORS
- Increase in green leafy vegetables - excessive alcohol intake - dehydration
34
WHAT TYPE OF PRECAUTIONS WOULD YOU IMPLEMENT FOR LOW PLATELET LEVEL?
- electric razors - soft-bristled toothbrushes - protective helmets
35
PURPOSE OF CULTURE AND SENSITIVITY LAB
- identify if there is an infectious organism, and if so what organism is
36
GRAM STAIN (C&S)
- identifies class of organism and guides antibiotic choice until organism identified
37
SENSITIVITY (C&S)
- determines sensitivity of organisms to various antibiotics
38
EXAMPLES OF C&S
- wounds, sputum, urine, blood
39
PAN CULTURE
- culture of different things at one time
40
NURSING CONSIDERATIONS FOR C&S
- confirm cultures obtained BEFORE antibiotic therapy - if culture grows out and antibiotic needs to be changed, then can change after - follow proper procedure for obtaining culture - timing of cultures
41
NORMAL SODIUM VALUES
- 136 - 145 mmol/L
42
CRITICAL SODIUM VALUES
- < 120 or > 160 mmol/L
43
INCREASED SODIUM CAUSES
- net loss of water or gain of sodium
44
DECREASED SODIUM CAUSES
- net gain of water or loss of sodium rich fluids
45
REGULATION OF SODIUM
- regulated by diet and kidneys (ADH and aldosterone) | - essential for neurological, endocrine and cardiac function
46
INCREASED SODIUM RISK FACTORS
- associated with dehydration - insufficient fluid intake - fluid loss
47
S/S OF HYPERNATREMIA
- CNS issues - confusion - seizures - cardiac issues
48
DECREASED SODIUM RISK FACTORS
- associated with severe burns - CHF - excessive IV - PO hydration - excessive ADH
49
S/S OF HYPONATREMIA
- headache - confusion - fatigue - restlessness - muscle weakness - spasms and cramps - seizures - coma - death
50
NORMAL POTASSIUM LEVELS
- 3-5 - 5.0 mEq/L
51
CRITICAL POTASSIUM LEVELS
- < 3 or > 6 mEq/L
52
REGULATION OF POTASSIUM
- regulated by insulin and aldosterone - concentration is small and minor changes have significant consequences especially related to skeletal and cardiac muscle
53
INCREASED POTASSIUM RISK FACTORS
- dietary - acute or chronic renal failure - potassium sparing diuretics - potassium supplements - crush/burn injuries - infection - acidosis - dehydration
54
DECREASED POTASSIUM RISK FACTORS
- dietary - GI loses - diuretics - alkalosis - trauma/burns
55
S/S WITH HYPERKALEMIA
- muscle fatigue - weakness - paralysis - arrhythmias (asystole)
56
S/S WITH HYPOKALEMIA
- weakness - tingling - numbness - arrhythmias
57
NORMAL CALCIUM VALUES
- 9 - 10.5 mg/dL
58
CRITICAL CALCIUM VALUES
- < 6 or > 13 mg/dL
59
REGULATION OF CALCIUM
- regulated by parathyroid hormone, Vit D, and phosphate. - extracellular cation, integral to nerve, muscle, bone formation, blood clotting, skeletal and cardiac muscle contractility
60
INCREASED CALCIUM RISK FACTORS
- hyperparathyroidism; - bone malignancies - Paget disease - prolong immobilization - lymphoma
61
DECREASED CALCIUM RISK FACTORS
- hypoparathyroidism - renal failure - hyperphosphatemia - Vit D deficiency - malabsorption
62
S/S OF HYPERCALCEMIA
- CNS changes - lethargy - confusion - weakness - fatigue - weight loss - bone pain
63
S/S OF HYPOCALCEMIA
- muscle spasms - cramps - tetany
64
ASSESSMENT TECHNIQUES FOR HYPOCALCEMIA
- chovstek's sign | - trousseau's sign
65
NORMAL MAGNESIUM VALUES
- 1.3 - 2.1 mEq/L
66
CRITICAL MAGNESIUM VALUES
- < 0.5 or > 3 mEq/L
67
INCREASED MAGNESIUM RISK FACTORS
- renal failure - ingestion of magnesium products - hypothyrodism
68
DECREASED MAGNESIUM RISK FACTORS
- malnutrition - malabsorption - alcoholism - hypoparathyroidism
69
REGULATION OF MAGNESIUM
- regulated by kidneys | - regulates, neuromuscular and cardiac function
70
NORMAL GLUCOSE VALUES
- 70 mg/dL - 110 mg/dL
71
CRITICAL GLUCOSE VALUES
- F < 40 or > 400 mg/dL | - M < 50 or > 400 mg/dL
72
REGULATION OF GLUCOSE
- controlled by feedback mechanism of glucagon and insulin
73
INCREASED GLUCOSE RISK FACTORS
- diabetes - acute stress response - infection - chronic renal failure - acute pancreatitis - corticosteroid therapy
74
DECREASED GLUCOSE RISK FACTORS
- hypothyroidism - extensive liver disease - insulin overdose - starvation
75
NORMAL BLOOD UREA NITROGEN (BUN) VALUES
- 10 - 20 mg/dL
76
CRITICAL BUN VALUES
- >100 mg/dL
77
REGULATION OF BUN
- reflects urea nitrogen in the blood as end product of protein metabolism - formed in liver and reflects direct metabolic function of liver and indirect excretory function of the kidneys - value affected by protein intake and hydration
78
INCREASED BUN RISK FACTORS
- hypovolemia - shock - dehydration - CHF - GI bleeding - excessive protein ingestion - starvation: catabolism
79
DECREASED BUN RISK FACTORS
- liver failure - over hydration - malnutrition - pregnancy
80
NORMAL CREATININE VALUES
- M 0.6 - 1.2 mg/dL | - F 0.5 - 1.1 mg/dL
81
CRITICAL CREATININE VALUES
- > 4 mg/dL
82
REGULATION OF CREATININE
- catabolic product of creatine phosphate from skeletal muscle contraction - creatinine like BUN is excreted entirely by the kidneys and thus serves as an indicator of renal function.
83
INCREASED CREATININE RISK FACTORS
- renal disease
84
DECREASED CREATININE RISK FACTORS
- debilitation | - decreased muscle mass
85
HOW TO ASSESS PATIENT'S RENAL FUNCTION
- output may be low - edema - tachypnea - tachycardia - JVD - increased weight - elevated BP - crackles/rhales in lungs

U of R SCHOOL OF NURSING - 372 (12 decks)

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