Lab values

screen, monitor, diagnosis

Three major reasons we do lab tests

screening test

running tests to see if there are any issues

screening test example

getting blood work done before an appointment so they can run it through a bunch of tests to see if anything is happening

monitoring test

tests to see if changes need to be made

monitoring test example

Blood work to assess thyroid levels after taking a new medication to see if it works

diagnostic test

confirm that something is going on

diagnostic test example

A blood pregnancy test

Factors that affect lab values

• medications (legal, illegal)

• age

• gender

• weight

• physiological status

• technical errors

Only illegal drugs alter lab results

false

What can affect a lab value?

all

Norms for lab values are usually the same for men and women

false

basic metabolic channel (BMP)

8 different tests for electrolytes, blood sugar, and kidney status

What does BMP NOT look at?

bilirubin

What does BUN NOT asses?

blood sugar

BUN or creatine is off indicates an issue for which organ?

kidneys

The first stage of multi organ failure starts at which organ?

kidneys

The norm for glucose levels?

80-120

complete blood count (CBC)

determines the volume of different elements in the blood

A CBC can diagnose and monitor

false

What is a CBC most likely to be used for

screening

red blood cells (RBC)

carry oxygen from the lungs to body tissues

HCT and PVC refers to?

hematocrit

hematocrit (HCT)

percentage of blood occupied by red blood cells (RBC)

Normal hematocrit for females is higher than males

true

normal hematocrit for females

mid 30s to mid 40s

normal hematocrit for males

mid 30s

hemoglobin

iron containing pigment in erythrocytes

hemoglobin

measures the oxygen carrying capacity of red blood cells

normal hemoglobin for females

12 -16

normal hemoglobin for males

13-18

you are not getting enough blood flow to the tissues or brain if your hemoglobin is this

low

People with low hemoglobin are more likely to what with physical activity?

pass out

low hemoglobin makes a patient do what?

all

Which person should not do PT?

a person with a hemoglobin of 7

How is someone treated for low hemoglobin or hemocrit

blood transfusion

What does it mean if a person who gets a blood transfusion and their hemoglobin or hematocrit levels don’t go up?

internal bleeding

Who would have a low hemoglobin or HCT after a blood transfusion?

all

Normal WBC

10,000

Someone with a WBC count of 20,000 probably has what?

an infection

A pt. has a low WBC. what does that mean?

compromised immunity

When is reverse PPE a priority?

when pt. has < 5,000 WBC

Which person will you not make exercise?

Hematocrit < 25%

no exercise

<25% hematocrit

light exercise

>25% hematocrit

resistive exercise

> 10g/dL hemoglobin

light exercise

8–10g/dL hemoglobin

no exercise

< 8 g/dL hemoglobin

resistive exercise

30-32% hematocrit

What should you do if someones INR is over 2.5?

consult their doctor

increased erythrocyte sedimentation rate (ESR) indicates

inflammation

erythrocyte sedimentation rate (ESR) tells us where the inflammation is

false

PT (not physical therapy one)

evaluates prothrombin production

PT

prothrombin time

hemostasis

arrest of bleeding or circulation or stagnation of blood

Hemostasis evaluation

looks at clotting and bleeding times

INRO

International normalized ratio

APTT

activate partial thromboplastin time

What is the issue if blood clots too much and too fast?

blood clots

What is the issue if your blood hardly clots or doesn’t clot fast enough?

bleeding

INR

tells us how fast blood is clotting or not clotting

desirable and recommended total cholesterol

< 200

borderline high or moderate risk total cholesterol

200-239

higher risk total cholesterol

>240

Which do you want high for total cholesterol: HDL or LDL?

HDL

Which do you want low for total cholesterol: HDL or LDL?

LDL

which should be greater than 60?

HDL

which should be less than 160?

LDL

when heart muscle starts to die, what does it release in blood?

troponin

Is troponin trending up a good thing?

no

Is troponin trending down good?

yes

heart attack

indicated by troponin trending up regardless of symptoms

O2 saturation normal value

96-100

Is is bad for a person who has had COPD to do exercise if thye have an O2 saturation of 88%?

no

If a healthy person as far as you can tell has an O2 saturation dropping below 95, should you call someone?

yes

arterial line

used to look at arterial blood gases (oxygen and CO2)

goes in the artery

IA

Monitors ABGs

IA

ABGs

arterial blood gases

what happens if you pull out an IA?

blood shoots everywhere

What is usually in a forearm and has a spint to indicate its there?

IA

serum chemistries

look at the plasma and what its made of

serum chemistries

can be used to look at hormones

only people with RA can have rheumatoid factor

false

urinanalysis

looks at physical and chemical components of urine

what color should urine be?

pale yellow to amber

occult blood

hidden blood

What can be tested with a urinanalysis?

all

Means you take too many vitamins or taking UTI medication

bright orange pee

culture

gets a sample and smear on petri dish to see what it grows

cultures

used to diagnose infections

synthesis

pull fluid from somewhere other than blood

arthrosynthesis

synthesis of a joint

if an arthrosynthesis shows blood, what does it mean?

fracture

synthesis

can be used to diagnose things

thorosyntesis

looks at pleural fluid

lumbar puncture

synthesis used to look at cerebrospinal fluid (CSF)