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what do you find on a

COMPLETE BLOOD COUNT CBC

WHAT IS FOUND ON A CBC?
HEMOGLOBIN
HEMATOCRIT
WHITE BLOOD CELL COUNTS
PLATLETS
SHAPES OF CELLS (DON'T WORRY)
COMPLETE RED BLOOD CELL COUNT
EVALUATE THE # OF RBC IN PERIPHERAL BLOOD AND VALUES WILL VARY ACCORDING TO ...
AGE
GENDER
THE RBC TEST WILL BE REPEATED SERIALLY IN PTs W/ ONGOING BLEEDING PROBLEMS. SO A SURGERY THEY WILL DO A CBC TO SEE WHAT YOUR WHAT IS?
YOUR BASELINE IS SO...
AFTER SURGERY THEY WILL DO ANOTHER CBC WHY? TO SEE IF THE SURGERY HAS LOWERED YOUR RBC! MAYBE FROM LOSS OF BLOOD. TO SEE IF YOUR STILL BLEEDING. THEY'LL DO ANOTHER B/F LEAVING THE HOSPITAL TOO JUST IN CASE
WHAT DO RBC DO? CARRY o2. THE HEMOGLOBIN CARRYS o2. THE IDEA HERE IS LOOKING FOR FALSE HIs EX FOLLOWS...
IF ITS NORMAL FOR YOU TO HAVE 5 AND YOUR DEHYDRATED, AND THEY PULL ON mL OF BLOOD, THEY WILL GET MORE o2 THAN NORMAL. WHY? YOUR BLOOD IS MORE CONCENTRATED!!! THIS IS ALSO TRUE OF ANYTHING IN YOUR BLOOD!!! ANTYHING IN SOLUTION IN YOUR BLOOD WILL BE HIGHER IF YOUR DEHYDRATED
CAN YOU ALSO HAVE A FALSE LOW IF YOUR OVER HYDRATED??? SO WE WILL DO SERIAL RBCs WE KNOW RBC LIVE FOR ABOUT ...
120 days

so what about rbc and diabetics? the A1C test, the hemoglobin and A1C test, the glucose sticks to the RBCs!!!
makes them sticky! so blood doesn't have the vicosity it just to have. So diabetics are more up to strokes!
so if your a diabetic with COPD your in big trouble. what happens to RBCs when you have COPD????
the body compensates by making more RBCs so it can carry more o2. So now you have too many RBCs and they are sticky. So more blood clots, more apt to stick together, form more clots.
Put more on top of that like AF or a bad valve in your heart, anywhere there is turbulance in the blood, causes what
the blood to stick together so people with AF or cronic bad heart valves are put on Coumodin or aspirin a day to decrease to co agulation.
****************************
so the pt has AF, COPD, and diabetes and we know whats important about ...
clotting why?
stickyness of blood (diabetes)
turbulince of the blood (AF)
increase of RBCs (COPD)
****************************
what is anemia?
when the value is decreased by 10% of the baseline normal.
what are the causes of anemia?
diet, hemorrage, diet is big for anemia. think of iron defiency from bad diet.
what else can lower the RBC, make you anemic?
surgery
a draining wound
marrow failure
organ failure
renal disease
what else can lower RBC?
a vitamin deficency can do this
Vit B12 deficency, cirrosis of the liver, chronic fluid overload will dilute RBC count
what can a deficency in Vit E cause?
cellular destruction of RBCs
vit. E builds cell walls, the cell membrane.
radiation and chemo can screw with bone marrow, so what?
again, these things lower RBC.
why would people that live in hi altitudes have a higher RBC than us down here?
the air is thinner so they develop / adapt to it so can
so if RBC is down what can we conclude about the hemoglobin?
hemoglobin will be down too!
*****************************
if test says list 3 lab values that indicate malnutrtion, what would I say?
RBC & hemoglobin(sucks but ok)
so the CBC test, the Hemoglobin Hgb test indicates ...
Hgb is Iron surrounded by globulins, the test is the total amt of Hgb in the blood!
Hgb is an Anion, carrys a positive charge, meaning acidic.
what problems result in bad shaped RBCs?
Sickle cell anemia
Thatassemia
Hematocrit Hct is a function of the RBC, the # and volume of RBCs! How are Hct values altered?
same way RBCs are altered, your just counting how much in a particular volume. So, a dehydrated pt the hematocrits will be HIGH. not low. A over hydrated patient will be LOW!
b/c its how many you count in a volume. A great value of dehydration, not overhydration.
Now RBC indices: MCV MCH MCHC
The indices: what they do.
MCV is the size of the RBC
MCH is the weight of the RBC
what does the MCHC mean?
MCHC relates to weight of RBC
RDW relates to the size
*****************************
this shit helps in diagnosing what kind of anemia the patient has.
So, MCV increase in pernis anemia and a decrease in MCV in an iron defeciency in anemia. The MCH will be decreased in microacidic anemia? what does this mean?
the cell is too small, its micro.
MCB = iron defecency anemic is decreased

MCH = is the microcitic (size thing)
and pernicous anemia = ?
MCB is increased
******************************
Again the MCHC = is also decreased in iron defency. usually has to do w/ intake. So, malnutrition issue.
What is it when RDWs are decreased?
no relation to anemia at all.
cancer treatment can decrease RBCs
drugs can decrease RBCs
Dialantin can do this. so malnution can affect lab results. If you give iron supplements to a pt, what do you give along w/ iron what do you give to get it to transpose across?
vitamin C helps iron transpose across the intestional muscoa.
So always give Vit c w/ iron.
iron can cause constipation and also cause a positive guiac test. b/c its not all absorbed and goes into the stool. so taking iron can cause a ____ guiac test
a positive guiac test
would transfusion therapy have an effect on RBCs?
yes.
what does an increase of WBC indicate?
infection.
what age group may not show WBC increase? the elderly! or anyone taking prednisone or immunosuppressed. So the prednisone (if on it forever) will mask infection.
Prednisone, given to COPD patients to decrease inflamation, have a problem b/c the drug can mask infection why?
the lab work might not show an increase in WBC b/c the prednisone is masking it. Since prednisone causes false lows and highs on lab work, they will hit a hidden infection with a broad spectrum antibiotic.
if neurtophils are hi on a lab test, the lymphocytes will always be ...
low. why?
Neutrophis are first front line short lived WBCs. And so lympocyctes will be low if Neutrophiles are hi b/c if there are more neutrophils by volume, then the % is higher so there are less lympocytes.
so a lab slip will show neutrophils are up and lympocyctes are down, all this means is that ...
these are all in solution together, and when there is more of one, there is less of the other. BUT if neutrophils are up, there is an infection.
so neutrophils are the dominating main WBC that circulates in the blood.
what are basophils?
phagocytes. in small numbers in the blood, usually out there in the tissue, they release the histomines and cersatonine.
what are Eosinophils?
have to do with a big antigen antibody response. This will be elevated with anyone with an allergic response.
****************************
Will someone with atopic asthma have a increase in Eosinophils? an increase. They also contain histomines, and have prodiolytic emzymes so they can destroy the protein based invaders!
******************************
protiolytic means attack protein, digests proteins
what does platlet count mean in the blood?
count # of platlet in the blood and used to monitor the force of disease or therapy for Thrombocytopia, or small amt of clotting RBCs. means you don't have enough. Platlets are thromobcytes
WBC other than infection, what else can increase leukocytes? (remember, this increase would be an immune response, so what would turn it on?)
stress
toxic fumes your exposed to
liver disease
what would decrease amt of leukocytes?
anemia
malnutritions
***************************
why does untreated septicemia result in shock and death?
yop'll see a dramatic increase in leukocytes then a dramatic decease b/c the body can't keep up w/ untreated septicmia so you run out! run out of amno (not enough anyway) and so untreated septicemia results in shock and death
what is a blood smear?
a microscopic examination of peripheral blood. it looks for size abnormalities, shape abnormaliities, color abnormalities, or intracellular structure and that is hemoglobin b/c RBCs don't have a increase. They are non nuclated.
when we look at a pt's lab, what are some things that are going to increase their BG?
infection
diabetes
stress
what else can cause increase in BG?
stroke b/c of damage to tissue
and the stress w/ it
Azedazolimide drug
Albuterol increases BG, why?
its a beta allenergic, b/c godzilla comes in the door, the beta response to dialate the broncials to outrun godzilla, this increases BG
prednizone will increase BG. *****************************
so the test will ask to list a drug or two that increase BG and you would write
albuterol
Azedazolimide
adult pre diabetes or fasting glucose is b/t 100-125 BG. Teacher wakes up w/ a BG of 60! she gains weight in the middle, has too much insulin on board much of the time, and is a hi risk to becoming a
type 2 diabetic. why, her morning fasting is low. She's at risk of heart diease, type 2 diabetes, and hyperclolesteral & has to do w/ the shape of her body.
so teacher eats a snack, she gets hit with all that insulin, and makes her sleepy, and the function b/t carbs and metabolism which contributes to hyperlipodemia so to fight this ...
eat breakfast BUT don't eat alot of carbs.
what decreases BG?
starvation will over time
drinking alot will cause your BG to go down!
sodium normal values are:
135-145 mEq/L
what happens when its 125?
if your hyponatrinic w/ sodium?
confusion...feelings of impending doom
what about hypernutrinia? retaining soduim? what would be indicatins of that?
fluid volume excess
water follows salt!
why? natural thing for water to go over and dilute the water
what pts are a biggy to be looking at their sodium levels?
heart patients
cardiac or heart failure
Hypertension any cardiac thing
renal failure
b/c solutes can give false hi and lows
EX your dehydrated and your sodium level is up and you go to the ER, and they dump alot of IV fluid into ya, what can happen?
they can become hyponutrinia, or lo sodium b/c your diluting their sodium. and creat a fluid shift if you put in the wrong solution
memorize hyponutrina
*****************************
hypernutrina
*****************************
hyperkalemia/hypokalmenia too
memorize these words
we need to know & understand the relationship b/t sodium & potassium when you have a pt on diuretics. How can you theraptically dehydrate someone?
give them a diurectic like an osmotic diuretic (which acts in the renal approximal tubing, you'll dump everything like glucose,
a Drug like Manatau dumps everything, all electrolytes and water. It will dehydrate on purpose. great for a head injury to drop internal pressure b/c of swelling
they will also give Manatau to folks after chemotherapy to let chemo do its job and then flush it out so the ...
chemo doesn't hang around too long.
what does potassium do for you?
helps acid base equalibirum
its inversely related to sodium b/c of sodium potassium pump...if sodium leaves the potassium stays
it stimulates heart beat
hypokalemia produces digitoxicity...a pt who is on lasix and we know lasix is a loop diuretic, and they are also on digoxin, if potassium gets too low, the dig will get too hi. this has to do w/ the dig action on the sodium pump
what can cause a pt to become digtoxic?
reading the label wrong and take 2 a day instead of one a day. this makes me also hyperkalemic or hi potassium, 2 problems. So, loose too much potassium, your digitoxin, and loose too much dig and your hyperkalemic
total protein ... and albumin are a good measure of ...?
nutrition
so if I had to list 3 labs
******************************
that you use to assess the nutritional status of a 75 year old patient, you say
RBCs
glucose
totals of potassium
albumin
also could say WBCs too b/c they are part of the immune response and this is part of our nutritional status.
****************************so leukocytes could be down or lympocytes down
albumin is a good measure of how you have eaten in the last few days. Also is responsible for maintaining onconic pressure. whats that?
onconic pressure in our vascular system. its that big protein that keeps water in the veins and arteries
liver emzymes are AST ALT ALP
which is indicitive of a problem w/ the liver?
ALT is
these things AST ALT ALP are about liver health. ALT is most important. why?
most specific to the liver
others have to do with the liver tissue damage. ALT points right at the liver.
so a pt on 650 of tylenol and also takes Vicodin for pain, should I be thinking about the liver here?
yes b/c of the liver problems
we know tylenol is an acetomifin and is hepatitoxic
a pt shows up on med surg floor from a car wreck. what can I expect on his lab work? what increases in his lab?
glucose up from stress
leukocytes up
look at liver emzymes for any indication of muscle or tissue damage
renal? well, kidneys got to clear all this stuff out so any damage to kidneys so look BUN/Creatinine is all kidney.
measures renal function & glomelular filtration
drug abuse will show elevated liver failure or work in exposed area or drink alot, you;ll see elevations in liver ...
emzymes
****************************
test questions about liver emzymes will have to do with your liver like a drug ...
like a drug wabbe wabbe drug is hepatic toxic so I would be looking at what labs for this patient. So you have to know what hepatoxic meant and then know which specific emzyme would be related to that drug Think Digitoxin or if my patient had cancer what would I expect to see w/ a pt w/ leukemia expect to see in the WBCs? you'd expect to see an increase. EXAMPLE or in an infection
***************************
lipids are asked for in tests to establish a baseline, to screen people for heart disease, too much fat in blood system, eat too many carbs, then triglcerides will be ...
elevated b/c of the relationship b/t carbs and triglycerides and fatty acids. So eat more protein than carbs! eat too much wrong protein then LDLs go up! too fat will cause LDLs to go up. HDL fats are like polyunsaturated and monosaturated oils are the best, olive oil. canola oil.
if your patient is on lipitore or some statin drug and you see its for hi cholesterol and they don't have a diagnosis of hi cholesterol, then assume ...
my pt has no diagnsos of chlosterol but HDL or LDL so i should be looking at these lipids b/c he's on the medicine
concerning the red blood count and concentration or diluted blood is, what about a pt that gets hooked up to an IV, is his blood going to get diluted ?
yes. and a dehydrated pt's blood will become thick b/c it becomes more concentrated. the vicosicty goes up
RBCs last about 120 days so what (concerning diabetes)
glucose will stick to RBCs so the blood gets thick over that 120 days because the sticky cells start to stick together and the blood no longer has the vicosity it used to have. it causes CVA
the body will make more RBCs if you have COPD to compensate for not being able to breathe o2 much. so what?
so you have alost of RBCs and they are all sticking together. You have a bad heart, AF, bad heart valve causes turbulence. turbulence causes RBCs to stick together. so all 3 of these things, COPD, Diabetes, and AF will cause CVA because of sticky blood cells sticking to each other. so they put these pts COPD, CVA, and diabetes. this is why they put them on Coumadin and/or aspirin, to try and reverse the blood clotting issue.
They are more risk for stroke b/c of this clotting
*****************************
so the labs show RBCs up? trouble
enemia is when ?
diet, hemorrhage, DIET is a big one. related to iron or B12.
what 3 things are important for the development of RBCs?
iron
B12
folic acid
why is Vitamin E crucial to the health of a cell?
vitamin E is needed to protect the membrane
radiation and chem tears up RBCs. So does stress. what does training in hi altitiudes do concerning RBCs?
the air is thin so people there can be adjusted but those who arn't can't accomdate. not enough o2 at that altitude so you can't breathe
so hemoglobin, is on RBC. so if rbc is down, then ...
hemoglobin is down on labs.
******************************
so if she says list 3 lab values that indicate malnutrition, you write rbc, and hemoglobin she'll take it.
****************************
hemoglobin has something to do w/ the acid/base buffer system in your body. Know if someone is acidotic and low on hemoglobin, something. right.
hematocrit Hct is packed red cell count. so what?
a dehydrated pt the hematocrit will be... higher
****************************
and a over hydrated pt the hemocrate will be lower
hematocrit is a great measure of hydration
***************************
so what ever affects RBC will also affect Hct???
yes
red blood Indices:

what is this?
Indices measure the type of anemia
******************************
MCV MCH MHCH
RED BLOOD CELL INDICE MCV IS WHAT
HAS TO DO W/ THE SIZE OF THE RBC,
WHAT DOES MCH MEAN?
THE WEIGHT OF THE RBC
MHCH IS ABOUT WEIGHT TOO.
WHAT IS RDW ABOUT?
THE SIZE
SO INDICES ARE ABOUT DIAGNOSIING WHAT KIND OF ANEMIA
SOMEONE HAS
SO MCVs ARE INCREASED OR DECREASED IN PERNICIOUS ANEMIA?
INCREASED. THIS MEANS A LACK OF B12 IS PERNICIOUS ANEMIA
WHAT WILL BE DECREASED IN MICROACIDIC ANEMIA
MCH WILL BE DOWN IN MICROCIDIC ANEMIA . THE CELL IS TOO SMALL.
WHEN YOU THINK MCV, THINK IRON DEFECENCY. MCH IS MICROCYIC, THE CELL TOO SMALL TO CARRY.
AGAIN, FORGET ALL THAT SHIT B/C OF BETH, IN IRON DEFECENCY, WHAT IS THE INDICES AT?
MCV IS IRON DEFECENY ANEMIA
MCH IS MICROCYTIC
PERNICIOUS ANEMIA THE MCV IS INCREASED
THE MCHC IS DECREASED ALSO IN IRON DEFENCY ANEMIA. HAS TO DO W/ INTAKE
*****************************
WHEN RDW IS DECREASED, IT HAS NOTHING TO DO W/ ANEMIA!
***************************
THERE ARE DRUGS THAT CAN DECREASE RBCs OR CREATE ANEMIA LIKE ...
DIALANTIN!
WHAT DO YOU GIVE WITH IRON TO HELP IT TRANSPORT IT ACROSS THE
VIT C CARRYS IRON ACROSS THE INTESTINAL WALL MEMBRANE
DILANTAN DECREASES THE ...
MCV SO IT MAKES YOU ANEMIC
WHITE BLOOD CELL COUNT
WHAT AGE GROUP WON'T SHOW WBC INCREASE? OLD PEOPLE WHO ELSE?
HIV
ANYBODY W/ IMMUNE SUPPRESSED
COPD ON PREDNISONE FOR A LONG TIME WON'T SHOW WBC COUNT DOWN EVEN THO THEY COULD HAVE AN INFECTION
**************************
PREDNISONE IS TO DECREASE THE INFLAMATION OF COPD BUT THEN IT ...
WILL MASK AN INFECTION HOW?
BY NOT SHOWING WBCs UP IN A LAB!
SO ANYONE ON LONG TERM CORTICOSTERIOD Tx AND THEY COME IN TO ER W/ AN ALLERGIC REACTION, AND YOU GIVE THEM SODIUM MEDEROL TO GET THEIR REACTION UNDER CONTROL, TO DECREASE SWELLING, WILL YOU SEE AN INCREASE IN WBC? PROBABLY NOT. SO MDs WILL SAY ITS A HIDDEN INFECTION AND HIT IT WITH A BROAD SPECTRUM ANTIBIOTIC AND SHOTGUN THE THING. NOT THE BEST CHOICE.
OTHER THAN AN INCREASE IN FEVER AND WHCs WHAT CAN BE AN INDICATION OF AN INFECTION WITH A LUNGER?
MORE COUGHING
GET A SPUTUM SAMPLE CULTURED
WHAT DO NEUTROPHILS DO?
MOST COMMON WBC
PRODUCED IN 7-14 DAYS
LAST ONLY 6 HOURS
ARE FIRST TO ARRIVE ON SITE
IS A GRANULOCYTE THAT KILLS BACTERIA
A SHIFT TO THE LEFT MEANS A BACTERIA INFECTION.
IF NEUTROPHILES ARE INCREASED, WHAT WILL LOOK LIKE ITS LOW?
NEUTROPHILS HI ON LAB TESTS
THEN LYMPHOCYTES WILL BE LOW
WHY? THE TESTS ARE %, SO PERCENTAGE IS HI ON NEUTRO, THEN LYMPO WILL BE LOW % WISE
THIS DOESN'T MEAN LYMPOCYTES ARE LOW, THE NEUTROPHILS ARE HI
WHATS THE DIFF B/T NEUTRO AND LYMPHOCYTES?
LYMPHS ARE NATURAL KILLER CELLS OR NK CELLS. T AND B. THEY ATTACK VIRAL SHIT BY RELEASING A CYTOTOXIC STUFF THAT KILLS THE WHOLE CELL. CALLED CELL MEDIATED, MORE VIRAL.
SO WHAT IS THE PREDOMINANT CIRCULATING WHC IN THE BLOOD?
neutrophils
what are basophils?
phagocytes. small # out there in the tissue. they release histomines, serotonin, and heperin. so what?
basophils attack parasites!
what are eosinophils? hint: they have proteolitic enzymes so they can destroy protein based invaders like...? proteolytic means digest protein. they go after parasitic worms.
pollen for example.
also phagocytes
have to do with big antigen antibody response. when you see this elevated in an allergic response,
***************************
so a person with atopic asthma will have increase in eosinophils and a problem b/c this is what causes congestion response to allergic reactions.*
****************************
there is a protein component in pollen that eosinophils
what do platlete count mean?
used to monitor the course of therapy or disease for thrombocytopenia or bone marrow failure.
whats thrombocytopenia
small count for thrombo or
are platletts thrombocytes?
yes. and platletts are essential to clotting.
what increases WBC?
stenous exercise, estrogen, and oral contraceptives.
besides infection, what else can increase WBC?
exercise, estrogen, oral contraceptives. its an immune response. so stress can turn it on production of WBCs.
toxic fumes can turn it on
liver diseases, cancers, any stressors can turn on immune response, our defense system. malnution. someone that is septic, an infection, you'll see a big increase, then a big decrease, b\c the body can't keep up w/ the septisemia so it results in shock and death.
what will you look for in a blood smear?
*****************************
RBCs size abnormalities, shape abnormalities, color abnormalities, intracellular structure like at the hemoglobin b'c RBCs don't have a nucleous.
again, what does a blood smear show what is it
an exam of peripheral blood
RBC size abnormals
RBC shape abnormals
RBC color abnomals
RBC intracellular strucure
why would albuterol increase increase blood glucose?
its a beta angionerigic, a broncho dialator. this means it...the beta response to get the heck out, the godzilla thing, get enough air to do this so its going to increase glucose. A vit B defecency will cause an increase in blood glucose
cortezone and prednesone use will increase glucose. ****************************
even using these cortecosteriods will make the pt diabetic from the glucose it generates...from the ...
long term use.
****************************
know this: are there drugs that have factors that would influence glucose yes
normal value 70-110 BG
goes down w/ poor nutriton
increases with:
diabetes
IV feeding
surgery(healing makes glucose go up) trauma makes it go up, stress,
you can't look at static numbers and freak out on people. Ex: Marsha's BG is a fasting BG of 65 so what?
so look at your pt, look at # for guidelines, but interview them and ASSESS, then the labs, and say, glucose is --- but they don't have polyuria, so look at the person and relate it to the Dx
what decreases glucose?
poor nutrition
over time it would
acute alcohol alcoholism
whats normal for sodium?
135-145 mEq/L SALT
what happens when its at 125?
your then hyponatrinic
****************************
low in salt, hyponatrinic w/ sodium, THE WORLD IS COMING TO AN END. LIKE AN ATHELETE SODIUM DEPLETION. KNOW THIS. SEVERE DIARRHEA, LOSING ELECTROLYTES, AND FEELINGS OF IMPENDING DOOM, HYPONUTRINIAL.
HYPERNUTRINIA...FLUID VOLUME EXCESS. WATER FOLLOWS SALT. WHY? ITS GOT TO GO OVER AND DILUTE IT. SO WHAT?
CARDIAC PTS WE WOULD BE LOOKING AT THEIR SODIUM LEVELS
CARDIAC HEART FAILURE
HYPERTENSION
RENAL FAILURE
SO SOMEONE COMES IN DEHYDRATED AND WE DUMP ALOT OF IV LIQUIDS INTO THEM, THE DEHYDRATED PT WILL HAVE ...
ELEVATED SODIUM LEVELS AND
THEN DUMP IV FLUID INTO THEM
THEN...THERE CAN BE A FLUID SHIFT IF YOU PUT THE WRONG FLUID IN THEM AND THEN GO HYPO SOMETHING
LEARN ABOUT HYPONUTRINA
LEARN ABOUT HYPERNEUTRINA
*****************************
WE NEED TO KNOW THE RELATIONSHIP B/T SODIUM AND POTASSIUM. WHICH ONE IS LEAVING AND WHICH ONE IS STAYING. THE SODIUM POTASSIUM PUMP IN THE KIDNEY. WHERE IN THE NEPHRON IS THE DIURETIC HAVING THE EFFECT? THE PT ON DIURETICS?
MANATAU IS GIVEN TO THERAPUTICALLY DEHYDRATE SOMEONE LIKE A HEAD INJURY
WHAT ARE SOME FACTS ABOUT POTASSIUM
IT IS INVERSLY RELATED TO SODIUM. ONE GOES IN, THE OTHER GOES OUT, (USUALLY)
AND VICE VERSA
STIMULATES HEART BEAT, B/C OF AN ION AGAINST A GRADIENT
HYPOKALEMIA = DIGITOXICTY SO A PT. ON LASIX (LOOP DIRUETIC) SO ITS GOING TO DUMP K+ AND ALSO ON DIGOXIN, WHAT HAPPENS? K+ GETS LOW AND THE DIG GETS TOO HI. THATS TOXIC. B/C OF DIGOXIN AFFECT ON SODIUM/POTASSIUM PUMP.
SO I HAVE AN ARHYMIA, DOC PUTS ME ON DIGOXIN, AND I MAKE A MISTAKE AND TAKE THE MED WRONG AND TAKE 2 TABS ONE DAY INSTEAD OF 2 AND B/C DIGTOXIC, WHAT HAPPENS NOW?
DIGTOXICITY MAKES YOU HYPERKALEMIC, SO NOW, LOOSE TOO MUCH K+ YOU BECOME DIGTOXIC, AND IF I HAVE TOO MUCH DIGOXIN, I WILL HAVE TOO MUCH K+ ! WHY? DIG AFFECTS THE SODIUM/POTASSIUM PUMP.
TOTAL PROTEIN AND ALBUMIN IS A GREAT MEASURE OF ...
NUTRITION
SO SHE SAID LIST 3 LABS THAT YOU USE TO ASSESS THE NUTRITIONAL STATUS OF A 75 YEAR OLD WOMAN SAY THIS:
RBC
GLUCOSE
TOTAL POTASSIUM
ALBUMIN
ALSO TALK ABOUT WBC TOO THEY ARE PART OF IMMUNE RESPONSE AND THIS IS PART OF NUTRITION STORY TOO
ALBUMIN IS A GOOD MEASURE FOR CHRONIC MALNUTRITION.
****************************
ALBUMIN IS ALSO RESPONSIBLE FOR ONCONIC PRESSURE , THE BIG PROTEIN THAT KEEPS O2 in the ...
veins and arteries
liver enzymes. AST ALT ALP

which is indicitive w/ a problem w/ the liver?
ALT

most specific test to the liver
****************************
so a pt is on 650 of tylenol and takes vicodin prn for pain. are we looking at the liver stuff, the ALT enzyme? why?
tell whats going on from the liver problems b/c these drugs are hepatotoxic. so,
what about a pt w/ trauma?
look at liver enzymes looking for tissue damage
look at renal b/c they have to clear shit out of the system. so look at creatinine for this.
you know drug blah blah is hepatotoxic so
****************************
you would be looking at which following labs for this pt
know what hepatoxic meant
know what which one of these were specific to them
if your pt has cancer, what would you expect to see in a pt with leukemia, in wbc? an increase. obvious. 35.10 marked on tape w/ red marker to go over this test question
**************************
lipids too much fat in someone's blood. so, watch what?
ldl
hdl should be hi ex poly, conolo, polyunsaturated, monosaturated, canola oil.
being lazy affects ldl hdl levels.
so your pt is on a statin drug but doesn't have any diagnosis for hi cholesterol, and they are on lipitor, what do you do?
look at their lipids
thats all.