PT 539: Cardio Lab Values

what is tested for in a complete blood count?

white blood cells

platelets

hemoglobin

hematocrit

what do white blood cells do?

cells that fight against infection and react against foreign bodies or tissues

what is the normal amount of WBC?

5-10x10^9/L

what does leukocytosis mean? what does this typically tell us?

WBCs are trending upwards

typically tells us the body is trying to fight off an infection

what symptoms are associated with leukocytosis?

present with fever, lethargy, dizziness, bruising

symptoms based approach especially with fever

what does leukopenia mean?

WBCs are trending downwards

this is worse than leukocytosis

what symptoms are associated with leukopenia?

present with anemia, fatigue, fever, and weakness

individuals with leukopenia may need neutropenic precautions. what are these?

visitors and providers need to wash hands and mask up before entering the room to protect the patient from them

what are platelets?

small cells that assist in clotting

what is the normal platelet value?

140-400 k/uL

what is thrombocytosis?

number of platelets in trending upwards

ultimately could cause blood clotting

what are the symptoms associated with thrombocytosis?

present with weakness, headache, chest pain, tingling in the hands/feet

what is thrombocytopenia?

number of platelets is trending downwards

this causes thinner blood and bleeding could continue for a very long time

what are the symptoms associated with thrombocytopenia?

present with petechiae, ecchymosis, fatigue, jaundice

if platelet number are not number, what is the implication for PTs?

need to be very aware of fall risk with low levels and clotting with higher levels

thrombocytopenia is even worse, need to be very conservative of these types of patients

what is hemoglobin?

number of hemoglobin protein in the blood

red protein responsible for carrying oxygen in the blood

what is the normal hemoglobin value for men?

14-17.4 g/dL

what is the normal hemoglobin value for women?

12-16 g/dL

what are the critical values of hemoglobin?

<5-7 g/dL or >20 g/dL

what is polycythemia?

number of hemoglobin and/or hematocrit is trending upwards

this is seen in chronic disease or doping

what are the symptoms associated with polycythemia?

hemoglobin: orthostasis, dizziness, arrhythmias, seizure, chest pain

hematocrit: fever, headache, dizziness, weakness, fatigue, bruising

what is anemia?

the number of hemoglobin is trending downwards

and/or the number of hematocrit is trending downwards

what are the symptoms associated with anemia?

hemoglobin: poor endurance, pallor (pale), tachycardia (heart beating faster to try and make up for the lack of oxygen)

hematocrit: headache, dizziness, pallor, chest pain, arrhythmia, dyspnea

what are the PT implications for working with a patient with anemia?

maybe do not do aerobic conditioning but could move them

shorter bouts of activity

resistance training

what is hemocrit?

the actual amount of RBCs

percentage of whole blood occupied by RBCs

what are normal hemocrit values for men?

42-52%

what are normal hematocrit values for women?

37-47%

what are the critical values of hematocrit?

<15-20% or >60%

critically low hemoglobin and hematocrit can cause what?

lead to cardiac failure or death

critically high hemoglobin and hematocrit can cause what?

lead to spontaneous clotting

where are the CBC values placed in the fishbone chart?

WBC - left

Plt - right

Hgb - top

Hct -bottom

what is the normal values of sodium?

134-142 mEq/L

what is hypernatremia and what are the symptoms associated with it?

high sodium

irritability, seizure, hypotension, tachycardia, decreased urinary output

what is hyponatremia and what are the symptoms associated with it?

low sodium

headache, lethargy, decreased reflexes, orthostatic hypotension, pitting edema

what are normal potassium levels?

3.7-5.1 mEq/L

what is hyperkalemia and what are the symptoms associated with it?

high potassium

muscle weakness, bradycardia, heart block, cardiac arrest, cramping

** exercise could make this worse!

what is hypokalemia and what are the symptoms associated with it?

low potassium

extreme weakness, leg cramps, EKG changes, cardiac arrest, hypotension, diarrhea, vomiting

what is the normal values for calcium?

8.6-10.3 mg/dL

what is hypercalcemia and what are the symptoms associated with it?

high calcium

ventricular dysrhythmias, asystole, coma, N/V, lethargy, weakness

what is hypocalcemia and what are the symptoms associated with it?

low calcium

confusion, anxiety, seizure, EKG changes, fatigue, muscle cramps, numbness

what are the normal values for chloride?

98-108 mEq/L

what is hyperchloermia and what are the symptoms associated with it?

high chloride

lethargy, tachycardia, weakness, edema, tachypnea, HTN

what is hypochloremia and what are the symptoms associated with it?

low chloride

agitation, hypertonicity, cramping, twitching

generally what are the normal values of phosphate?

2.3-4.1 mg/dL

what is hyperphosphatemia and what are the symptoms associated with it?

high phosphate

ventricular dysrhythmia, heart block, asystole, coma, muscle weakness, N/V, lethargy

what is hypophosphatemia and what are the symptoms associated with it?

low phosphate

anxiety/confusion, agitation, seizure, EKG changes, fatigue, muscle cramps

generally what are the normal values of magnesium?

1.2-1.9 mEq/L

what is hypermagnesemia and what are the symptoms associated with it?

high magnesium

diaphoresis, N/V, lethargy, weakness, flaccidity, hypotension, heart block

what is hypomagnesemia and what are the symptoms associated with it?

low magnesium

spasticity, seizures, EKG changes, emotional lability

what is tested in a electrolyte panel?

sodium

potassium

chloride

calcium

phosphate

magnesium

electrolyte imbalance often presents with the following ....

altered mental status, weakness, lethargy, EKG changes, change in reflexes, N/V, muscle cramping, hypotension

what does the globular filtration rate tell us?

how quickly stuff gets filtered out of the kidney

what does the blood urea nitrogen amount tell us?

urea is made in the liver when protein is broken down and passed out of the body through urine

tells us how much urea is left in the blood

what is the normal amount of BUN?

6-25 mg/dL

what is serum creatinine?

byproduct of muscle metabolism that is excreted through the kidneys

what is the normal amount of serum creatinine for males?

.7-1.3 mg/dL

what is the normal amount of serum creatinine for females?

.4-1.1 mg/dL

what is glucose?

simple sugar

most abundant monosaccharide, a subcategory of carbohydrates

what is the normal amount of glucose?

70-100 mg/dL

what is hyperglycemia and what are the symptoms associated with it?

high glucose

>200 mg/dL

diabetic keto acidosis, severe fatigue

** exercise can help lower this

what is hypoglycemia and what are the symptoms associated with it?

low glucose

<70 mg/dL

lethargy, irritability, shaking, extremity weakness, loss of consciousness

what is Hgb A1C?

also known as glycolated hemoglobin because it is the average amount of glucose covalently bonded to hemoglobin over the last 3 months!!!!!!!!

great to test longer period of time

what is a normal Hgb A1C?

<5.7%

what percentage of Hgb A1C is considered pre-diabetic?

5.7-6.4%

what percentage of Hgb A1C is considered diabetic?

>6.5%

what are the risks of high Hgb A1C?

can present with heart disease, kidney disease, nerve damage, stroke, non-traumatic amputations

what are the normal values for pH?

7.35-7.45

what are the normal values for PaO2?

80-95 mmHg

partial pressure of oxygen

what are the normal values for PaCO2?

37-43 mmHg

partial pressure of CO2

what are the normal values for HCO3?

20-30 mmol/L

bicarbonate

what two things indicate liver function?

serum albumin and serum bilirubin

what is serum albumin?

the most abundant protein in human blood plasma, constituting about half of serum protein and is created in the liver

(gives us a measure of protein intake)

what is serum bilirubin?

created during normal breakdown of RBCs and prepared for exertion in the liver

should be close to 0

what are the normal values for serum albumin?

3.5-5.2 g/dL

what are the normal values for serum bilirubin?

0.3-1.0 mg/dL

what is the critical value for serum bilirubin?

>12 mg/dL

what are high density lipoproteins?

happy cholesterol

helps remove excess cholesterol deposits from the arterial lining and bring them to the liver

what is the normal value of HDLs for males?

> 40 mg/dl

what is the normal value of HDLs for females?

> 50 mg/dl

what are low-density lipoproteins?

bad cholesterol - deposits in the arterial lining and compromises blood flow

what is the desired level of LDLs?

<100 mg/dl

what is the borderline high level of LDLs?

130-159 mg/dl

what is the high level of LDLs?

160-189 mg/dl

what is the very high level of LDLs?

>190 mg/dl

what are triglyercides?

main constituents of natural fats and oils and high concentrations in the blood indicate elevated risk of stroke

what are the levels of normal to very high triglyercides?

normal = <150 mg/dl

borderline high = 150-199 mg/dl

high = 200-499 mg/dl

very high = >500 mg/dl

how do you determine total cholesterol?

LDL + HDL + (triglyercide/5) = total

what is considered normal - high total cholesterol?

normal = 200 mg/dl

borderline high = 200-239 mg/dl

high = >240 mg/dl

what factors tell us about coagulation?

activated partial thromboplastin time (aPTT)

prothrombin time (PT)

when is activated partial thromboplastin time used?

utilized for heparin

what is the normal clot time when using aPTT?

21-35 seconds

when taking aPTT ___ seconds increased risk for spontaneous bleeding

>70 seconds

therapeutic for effectiveness of anticoagulant when taking aPTT is what?

2-2.5x the normal range

when is prothrombin time utilized?

coumadin

what is the normal clot time when using prothrombin time?

11-13 seconds

when taking prothrombin time what time is considered high risk for bleeding?

>25 seconds

what does the internal normalized ratio tell us?

discusses bleeding risk

what is normal INR?

0.8-1.2 (should be about 1)

what is the therapeutic range for VTE, PE, and a-fib for an INR?

2-3

what is the therapeutic range for stroke prophylaxis for an INR?

2-2.5