Lab values and tests 101

Lab tests are used for:

Screening to identify those at risk, diagnosis, monitoring pt conditions

APACHE stands for:

Acute Physiology and Chronic Health Evaluation

APACHE is:

A system for prognosis for critically ill for predicted death rate and length in ICU

APACHE measures:

Body temperature, mean arterial pressure, hematocrit, WBC, arterial pH, GCS, serum bicarbonate, potassium, and creatinine

NEWS stands for:

National Early Warning Score

NEWS is:

A method to escalate care for deteriorating patients in the ICU, also shows some predictive validity for discharge planning

NEWS measures:

RR, hypercapnic respiratory failure, type of supplemental O2, Temperature, BP, HR, consciousness

Most common tests:

Basic Metabolic Panel (electrolyte level, acid-base balance, blood sugar, and kidney status), Comprehensive Metabolic Panel (BMP + hepatic function panel), and Complete Blood Count

PTs should not rely on a single lab finding, instead consider:

Time of draw, patient's recent meals, drug interactions, chronicity of condition

BMP includes how many tests?

8 tests, for: electrolyte level, acid-base balance, blood sugar, kidney status

Complete Blood Count includes:

WBCs, platelets, RBCs (hemoglobin, hematocrit)

Erythrocyte Sedimentation Rate:

Common test for inflammatory disorders, nonspecific, abnormality indicates inflammation somewhere

White blood cell test reasons:

Various disease states are characterized by their effects on specific types of WBCs, elevation or depression may be useful in diagnosis, a CBC can only demonstrate normal, decreased, or elevated levels

Neutrophils:

Most common WBC

Neutropenia:

Decreased neutrophil count, significant as a risk factor for infection, numerous causes

Neutrophilia:

Increased neutrophil count

Basophils:

Implicated in immune responses, particularly allergies

Eosinophils:

Elevated in the presence of certain disease states, worm infestation, or allergies

Monocytes:

Migrate to tissues as needed during injury or infections, after migration they are referred to as macrophages

Lymphocytes:

Divided into B cells (produce antibodies), and T cells (produce direct injury to cells carrying foreign markers, or assist in modulating B and T cell function). # naturally drops with age

Hemostasis:

Process of body stopping bleeding. Can be both excessive and deficient.

Hemostasis tests look at:

Platelets, enzymes, coagulation factors, calcium

Liver Panel (within CMP):

Bilirubin, total protein, albumin, and serum enzymes (AST, ALT, LDH, GGT, and ALP)

Decreased liver function is associated with:

Increased risk of infection, edema, excessive coagulation

B-Type Natiuretic Peptide (BNP):

Strongest independent predictor of congestive heart failure, values tend to increase with age and are higher in women

Hepatic Panel Interpretation:

Assesses the liver's ability to clear bilirubin, total protein, and albumin

A1C:

Snapshot of blood sugar control over period of 2-3 months

Fasting blood glucose test:

Snapshot of current blood glucose levels

Pulmonary function tests:

Screening or diagnosis of pulmonary diseases, looks for abnormalities of airways, alveoli, and pulmonary vascular bed

Other lab values:

Serum hormones, immunologic, urinalysis, drug screening, microbiological studies, fluid analysis