Term
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Definition
Normal
4.6 - 6.0 million/mm3 men
4.0 - 5.0 million/mm3 women
Critical Value - 10% decrease is anemia
Sig. of decreased : Anemia, dilutional, overhydration, cirrhosis, hemorrhase, renal disease
Sig. of increased Value: dehydration, COPD, Congenital heart disease
HGB & HCT also looked at
RBC count of the number of circulating RBCs in 1 mm of peripheral venous blood, life of one RBC 120days
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Term
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Definition
Normal:
13.5 - 17.0 g/dl men
12 -15 g/dl women
Critical Values - below 5.0 or 20 g/dl
Decreased Values: Anemia, dilutional overhydration, cirrhosis, hemorrhage, renal disease
Increased Value - dehydration, COPD, congenital heart disease
Hct is 3X Hgb
Hemoglobin - transports 02 & C02 in the blood, test determines the 02 carrying capacity of the blood, important to the acid-base buffer system
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Term
Nursing interventions for Abnormal HGB Values
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Definition
Decreased Value
Blood transfusion Hbg<8g/dl, or Hct<24
Monitor patient for fatigue, paleness, tachycardia & bleeding
Increased Value
With dehydration, Rehydrate with IV fluids
Check S&S of Dehydration - thirst, poor skin turgor, dry mucous membranes, tachycardia, hypotension, low urinary output
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Term
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Definition
Normal Values 40% - 54% men
36% - 46% women
Critical Values <15% or >60%
>60% = blood clot formation danger
Decreased Values: Anemia, dilutional overhydration, cirrhosis, hemorrhage, renal disease
Increased Value - dehydration, COPD, congenital heart disease
Hematocrit - indirect measure of RBC number & volume, measure of the percentage of total blood volume that is made up of RBCs, Hight of RBC is compaired to the ratio height of the total blood volume, closely reflects the Hgb & RBC values, Hct is 3 times the Hgb
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Term
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Definition
N: 150,000 - 400,000/mm3
CV: <50,000 or > 1 million/mm3
Decreased Values - <100/mm3 have thrombocytopenia,
< 20,000 have spontaneous bleeding, hemorrhage, leukemia, DIC, infection, post chemotherapy, ESLD
Increased Values: untreated cancer - leukemia, colon cancer, & lymphoma; polycythemia vera=high plt. & high RBC
DIC=diseminated intravascular coagulation FYI
Platelets -part of the hemostatic mechanism is platelet aggregation (clumping), platelets initiate coagulation, life of a platelet 7-9 days, essential for blood clotting |
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Term
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Definition
Count of the number of circulation RBC's in 1 mm of peripheral venous blood, part of the complete blood count, produced by erythroid elements in the bone marrow, life of RBC 120 days.
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Term
Nursing Interventions for Abnormal Platelet Values
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Definition
- Decreased Values
At risk for bleeding
Apply pressure to venipuncture sites for at least 5 mins.
No IM injections, only use and elctric razor
Check body orifices for bleeding, guaic stool
Increased Values:
For the Doctor to treat the disease process.
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Term
MCV - Mean Corpuscular Vol
Anemias
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Definition
- Normal: 80 - 98/um3 (cubic micro meters) Size of RBC
Decreased Value
Small RBC = microcytic Anemia
Conditions - Fe deficiency anemia
Thalassemia, genetic in meditranian area
Increased Value
Larger RBC = Macrocytic Anemia
Conditions - pernicious anemia, folic acid anemia, ETOH, liver disease
*ETOH from lack of B1
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Term
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Definition
- Normal: 27 - 31 pg (picamole) weight of RBC
Decreased Value
Microcytic Anemia, Hypochromic Anemia
Increased Value
Macrocytic Anemia
Treatment: Treat the cause of the anemia. B1, Fe, Folic Acid
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Term
MCHC - Mean Corpuscular Hgb Concentration
% of Hemoglobin in 1 RBC
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Definition
- Normal 32% - 36%
Decreased Value - Hypochromic Anemia, Fe Deficiency Anemia, Thalassemia
Increased Value - Spherocytosis(cell count error), Intravascular Hemolysis, Cold Agglutins (antigen antibody reaction in RBC)
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Term
RDW - Red Blood Cell
Distribution Width
Size/Witdth differencial of RBC
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Definition
- Normal: 11.5% - 14%
No Decreased Value
Increased Value - Anemias (Fe,B12) Folic Acid Deficiency Anemia, Sickle Cell Anemia, Hemolytic Anemia, increased variation in RBC
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Term
General Interventions for
Anemias
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Definition
Assess patient for fatigue, pallor, dyspnea on exertion, tachycardia, HA-head ache
For Fe Deficiency Anemia - High Fe diet & Fe supplement tablets
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Term
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Definition
Normal: 50 - 70%
FXN: Phagocytosis kill & digest bacteria
Decreased Values - aplastic anemia, overwhelming bacterial infection, viral infection, post chemotherapy or radiation therapy
Increased Values - acute bacterial infection, leukemia, stress, trauma, inflammatory disease, acute MI
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Term
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Definition
Normal: 25 - 35% of WBC count
FXN: Tcells = killer cells/supressor cells & Bcells+antibody production
Decreased VAlues - leukemia, cancer, post radiation or chemotherapy, sepsis, immunodeficiency disease HIV AIDS
Increased Values - chronic bacterial infection, viral infection, leukemia, Hodgkin's disease, mononucleosis, hepatitis
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Term
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Definition
Normal: 4 - 6% of WBC count
FXN: Phagocytic, produce interferon, kill bacteria,
Decreased Values - prednisone drug therapy, lymphocytic leukemia, aplastic anemia
Increased Values - chronic inflammatory disease (ulcerative colitis), viral infection, cancer, TB, parasites (malaria) Parasitic infection
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Term
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Definition
Normal 1 - 3% of WBC count
FXn: Phagocytic Antigen/Antibody responce, alergic responce Asthma-alergic reaction
Decreased Values - burns, shock, increased adrenosteroid production
Increased Values - parasitic infections GI, autoimmune diseases, allergic reaction, asthma, leukemia, renal failure
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Term
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Definition
Normal: 0.4% - 1.0%
FXN: Phagocytic antigen/antibody responce-Alergic responce Asthma. Same as Eosinophils
Decreased Values - allergic reaction, hyperthyroidism, stress
Increased Values - Myeloproliferative diseases (cancer), leukemia, inflammatory process, healaing process, post surgery, asthma, cold.
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Term
Interventions for Abnormalities in
WBC & WBC Diff.
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Definition
1.Treat infections - antibacterials, antifungals, etc.
2. Take temperature q4hrs 101or 101.5 Doc may give Tylenol
3. Monitor patient for S&S of infection - increased temp. & pulse, redness, swelling, drainage, tenderness
4. Check patient for S&S of allergies
5. For patients with decreased WBC &/or neutrophils, protect them from infection. they should avoid sick people & crowds
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Term
BUN
Blood Urea Nitrogen
(# of Urea Nitrogen in the blood) |
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Definition
- NV: 5 - 25 mg/dl
CV: 100mg/dl serious renal disease - Dialysis necessary
DV: Liver failure, overhydration, low protein diet, early pregnancy
IV: Renal disease (infection, failure); hypovolemia, shock, burns, CHF, MI, High protein diet, starvation
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Term
BUN Blood Urea Nitrogen
Interventions for Increased Value |
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Definition
1. Check pt. for dehydration - tachycardia, hypotension, low UO, dry skin
2. Give IV fluids to the dehydrated pt.
3. Check UO for pt. with renal failure
4. Check dietary protein intake
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Term
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Definition
Breakdown of Creatine Phosphate
NV: 0.5 - 1.5 mg/dl
CV: >4.0mg/dl Serious renal disease, 2.5 mg/dl indicates renal impairment,
DV: debilitation, decreased muscle mass (muscular dystrophy) eclampsia, elderly
IV: renal disease, cancer, acute MI acromegaly, high meat diet, shock, lupus, drugs toxicity-Gentamycin, Vancomycin, Cephalosporins - peak & trough dosing
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Term
Cr - Creatinine
Treatment for Elevated Values |
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Definition
- Low protein diet
Treat renal disease
Decrease the dose or discontinue renal toxic meds
Check UO
Elevate BUN & Cr levels qd
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Term
NA - Sodium
Hyponatremia
Specifications |
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Definition
- NV: 135 - 145 Meq/L
CV: <120
DV: Hyponatremia
Signs & Symptoms
<125 WEAKNESS
<115 CONFUSION, LETHARGY THAT PROGRESSES TO STUPOR & COMA
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Term
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Definition
Causes of Hyponatremia
Low Na intake in foods or IV fluids
Increased NA losses - Addison's disease, diarrhea vomiting paralytic ileus, diuretics
Increased free water - excessive po fluid intake or IV fluid w/o Na, CHF, ascites, edema |
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Term
NA - Sodium
Hyponatremia
Interventions for |
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Definition
- Interventions for Hyponatremia, low Na - Sodium levels in the blood
1. Check for S&S - anxiety, muscle twitching or weakness, HA head ache, tachycardia, hypotension
2. Na replacement in IV fluids or Na tablets with meals
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Term
NA - Sodium
Hypernatremia
Specifications |
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Definition
- NV: 135 - 145 Meq/l
CV: > 160 meq/l
Increased Value is Hypernatremia
Signs & Symptoms - dry mucous mmembranes, thirst, restlessness, hyperreflexia, mania, convulsions/seizures, urine specific gravity >1.030
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Term
NA - Sodium
Hypernatremia
Interventions for |
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Definition
- Monitor for S&S
IV fluid replacement without NA
Seizure Precautions
Strict I & O
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Term
K – Potassium
Hyperkalemia |
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Definition
NV:3.5 - 5.3 Meq/l
Increased Value – Hyperkalemia >6.5meq/l 1. S&S – EKG – peaked t waves, widen QRS, Depressed ST segment; irritability, nausea, vomiting, intestinal colic, bradycardia, decreased UO, numbness, tingling 2. Causes – excessive dietary or IV intake, renal failure, Addison's disease, taking a K sparing diuretic – Aldactone, hemolysis of RBCs, blood transfusion with hemolyzed blood, infection, acidosis, dehydration 3. Treatment – Low K diet, Kayexalate po or enemas, Lasix , Check I&O, IV infusion of glucose & insulin solution to move K back into the cells
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Term
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Definition
NV: 3.5 - 5.3 meq/l
Critical Values - < 2.5 or > 6.5 meq/l Decreased Values – Hypokalemia >6.5meq/l 1. S&S – cardiac dysrhythmias, flattened T waves, prominent U waves, weakness, paralysis, dizziness, hyporeflexia, ileus, decreased bowel sounds and deep tendon reflexes, confusion 2. Causes – decreased dietary intake, IV fluid deficit, burns, diarrhea, vomiting, diuretics, hyperaldosteronism, renal disease, ascites 3. Treatment – Potassium replacement po or in IV fluid bag, check patient for S&S of overhydration, monitor K level for patients taking diuretics, increase dietary intake of high K foods – bananas, tea, dried fruits, meat, nuts |
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Term
ALT - Alanine Aminotransferase
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Definition
NV: 4 - 36 Iu/l International
Decreased Values - due to exercise effect or ASA Increased Values 1. Significantly increased - hepatitis, liver necrosis or ischemia 2. Moderately increased – cirrhosis, hepatic tumor, drug toxicity, obstructive jaundice, severe burns 3. Mildly increased – myositis, pancreatitis, MI, CHF, shock, mononucleosis C. Interventions - monitor liver enzyme lab values & for jaundice, check patient’s medication profile for liver toxic medications
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Term
| LDH – Lactic Dehydrogenase |
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Definition
NV: 70 - 250 u/l
No Decreased Value
Increased Total LDH – MI, pulmonary disease, hepatic disease, cirrhosis, skeletal muscle disease & trauma
Liver enzyme
C. Increased LDH –5 – hepatitis, cirrhosis, liver cancer
D. Treatment – treat the disease process |
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Term
AST –Aspartate Aminotransferase
Liver & Heart Enzyme |
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Definition
NV: 8 - 38 u/l
Decreased Values – acute renal disease, beriberi, DM, ketoacidosis, pregnancy Increased Values – MI, post cardiac surgery, liver disease ( hepatitis, cirrhosis, cancer, tumor); skeletal muscle disease, pancreatitis Interventions for Increased Values – check patient’s medication list for liver toxic drugs, IM injections cause false high values, assess patient for S&S of liver disease & MI |
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Term
| ALP – Alkaline Phosphatase |
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Definition
NV: 42 - 136 u/l -Kupfer cells & Biliruben, monitor liver & bone disease
Decreased Values – hypophosphatemia, malnutrition, pernicious anemia, scurvy, hypothyroidism Increased Values 1. Large increase – cirrhosis, extra hepatic and intrahepatic obstructive biliary disease 2. Smaller increase – hepatic tumor, hepatotoxic drugs, hepatitis, bone tumor, new bone growth, rheumatoid arthritis, Piaget’s disease, MI C. Interventions for a Patient with an Elevated Value – check for S&S of liver or bone disease, check patient’s medication list for liver toxic medications, IV Albumin can increase the value by 5 – 10 times normal |
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Term
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Definition
NV: 0.1 - 1.2 mg/dl
Critical Values – Adult > 12 mg/dl Newborn > 15 mg/dl Increased Level of Conjugated (Direct Bilirubin) – gallstones, extra hepatic duct obstruction, extensive liver metastases Increased Level of Unconjugated (Indirect) Bilirubin – hepatitis, cirrhosis, neonatal hyperbilirubinemia, transfusion reaction Treatment – low protein diet for patients with liver disease, check skin & sclera for jaundice |
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Term
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Definition
NV: 3.5 - 5 g/dl
A. Decreased Values – liver disease, 3rd spacing (ascites, burns); malnutrition, overdehydration, preeclampsia Interventions for Decreased Values – high protein diet if not in liver failure, assess patient for ascites & peripheral edema, transfuse with albumin as orderedIncreased Values – dehydration Intervention for Increased Value – Rehydrate the patient with oral or IV fluids |
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Term
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Definition
NV: 70 - 110 mg/dl
Critical Values < 40 or > 400 mg/dl Decreased Values – insulinoma, hypothyroidism, liver disease, insulin overdose, starvation 1. Treatment – give a concentrated glucose source & a long acting CH2O, do not skip meals, check for S&S of hypoglycemia nervous, weak, confusion, cold, clammy skin, tachycardia Increased Values – diabetes mellitus (DM), acute stress response, Cushing’s disease, acute pancreatitis, drug therapy with diuretics or corticosteroids 1. Treatment – for DM give regular or aspart insulin |
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Term
Urinalysis UA
Normal Results
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Definition
Appearance - Clear
Color - Light Straw to Dark Amber
Odor - Aromatic
pH - 4.5 -8.0
Protein - 2-8 mg/dl usual
Specific Gravity - 1.005-1.030
Leukococyte esterase, Nitrites, Ketones & Glucose ALL NEGATIVE
Crystals - 0
Casts - occasional hyaline
WBC 3-4 per low-power field
WBC casts -0
RBC <=2 per low field power
RBC casts -0
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Term
| Interpretation of Urinalysis Abnormalities |
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Definition
| 1. Appearance – cloudy = infection 2. Color – straw color = overhydration deep amber = fever, dehydration dark red = bleeding from kidney bright red = lower urinary tract bleeding Odor – strong, sweet odor = DM foul odor = UTI fecal odor = enterovesicle fistula |
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Term
Interpretation of Urinalysis Abnormalities Cont. |
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Definition
4. pH – a. Elevated – alkalemia, UTI, vomiting, diet high in fruits & vegetables b. Decreased – acidemia, DM, starvation, COPD, diet high in protein 5.Specific Gravity – a. Elevated – dehydration, decreased renal blood flow, glycosuria, proteinuria, vomiting, diarrhea b. Decreased – overhydration, diabetes insipidus, renal failure, diuretics 6.Leukocyte Esterase – positive in UTI |
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Term
| Interpretation of Urinalysis Abnormalities Cont. |
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Definition
7. Nitrates – positive in UTI 8. Ketones – positive in DM out of control, ETOH, fasting, starvation, high protein diet, severe stress 9.9.Casts– many in renal disease 10.10.WBC– increased in UTI 11.11.WBC Casts– increased in kidney infection 12.12.RBCs– increased in renal disease, bladder or renal tumor, trauma, anticoagulant use, menstruation
13. RBC Casts - incrased in glomerulonephritis, renal infarction, lupus, vasculitis, malignant hypertension
14. Glucose - present with DM, renal disease |
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Term
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Definition
1. GI Tests – iodine contrast dyes should be scheduled before barium studies 2. GI Tests – NPO 8 hours before the test 3. Studies Using Iodine – a. ask the patient if (s)he is allergic to shellfish or iodine b. the patient should be well-hydrated before & after the exam |
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Term
CBC
All test involved +
Normal Values
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Definition
RBC - 4.6 - 6.0 million/mm3 men
4.0 - 5.0 million/mm3 women
Hgb - 13.5 - 17.0 g/dl men
12 - 15 g/dl women
Hct - 40% - 54% men
36% - 46% women
Plt 150,000 - 400,000/mm3
MCV 80 -98/um3
MCH 27 - 31 pg
MCHC 32% - 36%
RDW 11.5% - 14.5%
WBC 4,500 - 10,000/mm3 |
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Term
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Definition
* Called the RBC Indices - part of a routine CBC, help determine type of anema
1. Mean Corpuscular Volume (MVC) -Measure average volume or size of a single RBC
2. Mean Corpuscular Hemoglobin (MCH) - average amount (weight of Hgb in a RBC
3. Mean Corpuscular Hemoglobin Concentration (MCHC) - average concentration or percentage of Hbg in a single RBC
4. RBC Distribution Width (RDW) - RBC size variation or width differences of RBC's
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Term
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Definition
1.Serum Sodium Na - major cation in extracellular space, major determinant of extracellular osmolarity
2. Serum Potassium K - Major cation in the cell, need for protein synthesis, maintenance of oncotic (fluid) pressure, cellular electrical neutrality, membrane electrical potential, & acid-base balance. |
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Term
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Definition
1. Alanine Aminotransferase (ALT) - used to diagnose & monitor liver disease, hepatocellular enzyme, mainly found in the liver also found in kidney, heart, & skeletal muscle
2. Lactic Dehydrogenase (LDH) - intracellular enzyme found in many body tissues - liver, heart, RBCs brain, skeletal muscle, & lungs, 5 separate enzymes make up LDH. LDH-5 -isoenzyme in the liver
3. Asparate Aminotransferase (AST) - enzyme found in highly metabolized tissue especially the liver & heart, when liver cells lyse, AST is released.
4. Alkaline Phosphatase (ALP) - found in the liver's Kupffer cells in the biliary system, increases pH, use to monitor liver & bone disease.
5. Bilirubin - evaluates liver fxn, breakdown of RBCs in reticuloendothelial system (Heme--->Bilirubin).
Indirect (Unconjugated) Bilirubin - assesses hepatocellular fxn, increased destruction of RBCs hemolysis
Direct (conjugated) Bilirubin - obstruction of extrahepatic fxn (gallstones, bile duct blockage or intrahepatic; conjugated bilirubin cannot escape in the bile into the small intestine |
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Term
White Blood Cell Count
WBC count & WBC Diff.
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Definition
Total Number of WBC's (leukocytes) in 1 mm of blood
WBC Differential Count:
Percent of each type of cell in 1mm of blood, increase one type of WBC results in a decrease in another type of WBC, total percent of each type of cell equals 100%
Neutrophils 50-70%
Lymphocytes 25-35%
Monocytes 4-6%
Eosinophils 1-3%
Basophils 0.4-1.0%
Never Let Monkeys Eat Bananas |
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Term
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Definition
Blood Urea Nitrogen - A measure of renal function, glomerular filtration, & liver function, Urea is formed in the liver as an end product of protein metabolism & digestion, the kidney excretes ura
Creatinine-used to diagnose impaired renal function, is a breakdown product of creatine phosphate, excreted by the kidney, when the creatinine level doubles then glomerular filtration is 50% of normal
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