lab tests and values

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created 6 years ago by ryan9004
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updated 6 years ago by ryan9004
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pathology
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1

APACHE:

-Acute Physiology And Chronic Health Eval
-a system of prognosis for critically ill patients
-first 24 hrs of hospital admit, predicts death rate and length of icu stay

2

lab tests serve three purposes:

1- screening
2- Dx
3- monitoring

3

CHEM 7 (BMP)

card image
4

Basic Metabolic Panel

-screen for electrolytes, diabetes and kidney disease
-taken by venipuncture 10-12 hrs after fasting

5

BMP changes indicate:

acute kidney failure, insulin shock, diabetic coma, respiratory distress

6

Sodium Na

-135-145 mEq/L
-increase = water retention
-concentration altered by water intake and excess antidiuretic hormone
-increased by profuse sweating or increase in ADH production
-increased fluid volume= increase in bp and cell volume and can cause AMS, confusion, weakness, coma, and intracranial hemorrhaging

7

Potassium K

-3.5-5.1 mEq/L
-hyperkalemia causes arrhythmias and cardiac arrest, mm weakness, nausea and diarrhea
-hypokalemia causes dangerous ventricular arrhythmias, cardiac irritability, dizziness, hypotension,

8

Blood Glucose -normal and hypo

-ideal range 80-120 mg/dL
-hypoglycemia <70, cause overdose of insulin, illness, lake or skipped meals or overexertion
-Sxs include headache, weakness, irritability, mm coordination, apprehension, inability to respond to verbal commands

9

Blood glucose cont.

-eating increases blood sugar
-Ex and insulin decrease blood sugar
-don't exercise after insulin and before eating
-monitor glucose with new activities

10

Blood Glucose- hyper

->300
-may become dehydrated, fruity acetone smell of breath
-diabetic ketoacidosis is an emergency

11

BUN and Creatinine

-screen for kidney disease and monitor kidney funct.
-high values of creatinine represents a decline in kidneys capacity to excrete waste
-renal disease sxs: anemia htn decreased endurance, and deconditioning

12

BUN

-10-20 mg/dL
-rises with decreased renal blood flow and increased protein
-elevated with burns bc dehydration
-severe liver disease have decreased BUN
-sxs: light-headedness, dizziness
-abnormal levels can cause AMS

13

comprehensive metabolic panel CMP

-liver is the first organ exposed to bacteria and toxins
-liver failure= high risk of multi-organ failure-sepsis

14

hepatic dysfunction

-check mental status, fluctuating levels of consciousness, peripheral edema, ascites(swollen stomach),R upper abdominal pain, musculoskeletal pain
-increased risk of infections
-check vital signs
-may have problems with wound healing and coagulation

15

Albumin

-3.5-5.0 mg/L
-indicator of long term nutrition

16

Prealbumin

-180-357 mg/L
-best indicator of daily nutrition
-slow wound healing if <75

17

CBC

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18

complete blood count

-concentration of rbc's, wbc's, and platelets

19

H and H - hematocrit

-Hematocrit HCT- %of total blood volume made of RBC'S
-males 40-5
-females-37-47

20

H and H - hemoglobin

-Hemoglobin Hbn- o2 to tissues
-males 13.5-17.5 g/dL
-females 12-16

21

H and H abnormalities

-low- blood loss, hemolysis, cancer, anemia, abnormal hydration
-sxs: weakness, fatigue dyspnea heart palp., tachycardia
-hold if less than 8
-high- polycythemia vera, chronic hypoxemia, high altitude, tobacco, lung disease

22

ESR

...

23

White Blood Cell differential

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Platelets

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thrombocytosis

thrombocytopenia

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platelet treatment implications

>150k no restrictions
80-150k mod resistance, amb adls
<50k no resistance
20-50k functional activities
10-20k light adls and amb
<10k no therapy

27

prothrombin time

1.5-2.5
>2.5 therapy is contraindicated

28

INR

2-3

29

central venous pressure

0-.5mm Hg
indicates working pressure of R ventricle

30

elevated troponin indicates:

angina and MI

31

ejection fraction

55-70%

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more on ppt

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