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79 Cards in this Set

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K.T.

Erythrocyte
A mature red blood cell.
K.T.

Hematocrit
The measure of the percentage of red blood cells in the total blood volume. An absolute term for a centrifuge for separating solids from plasma in the blood. The total volume of erythrocytes packed by centrifugation is in a given volume of blood.
K.T.

Hemoglobin Test
The measure of the total amount of hemoglobin (The component of red blood cells that carries oxygen) in the blood.
K.T.

CBC
Complete blood Count: Includes the following tests: Hemoglobin, Hematorcrit, RBC's and WBC's.
K.T.

Leukocyte
A white blood cell.
Leukemia is low white blood count
K.T.

Monocyte
Phagocytic white blood cell derived from myeloid stem cells. Monocytes circulate in the blood stream for about 24 hours and then move into tissues at which point they mature into macrophages.
Macrophages and monocytes are one of the first line in defense in the inflammatory process.
K.T.

Lymphocyte
A white blood cell responsible for much of the body’s immune protection.
T and B varieties.
K.T.

Occult
Hidden, obscure, not easily understood, mysterious, concealed.
K.T.

Peak level
Indicates the highest level of concentration of the drug in the blood serum.
K.T.

Phlebotomist
A person from a lab who performs venipuncture. Collects the blood specimen for the tests ordered by the physician.
K.T.

Reagent
Substance used in a chemical reaction to detect a specific substance. (could be an occult substance)
K.T.

Through Level
Represent the lowest level of concentration of the drug in the blood serum.
K.T.

Venipuncture
Puncture of a vein for collection of a blood specimen.
2. Describe how diagnostic and laboratory tests can provide information about the client.
1. a basic screening as part of a wellness check
2. help confirm diagnosis, monitor an illness, and provide valuable information about the client’s response to treatment
2. One basic reason that nurses need to be knowledgeable of common lab and diagnostic tests?
Because one primary role of the nurse is to teach the client, family, or significant other how to prepare for the test and care that may be required following the testing.
3. Identify the three phases of diagnostic testing:
Pretest
Intratest
Post-test
3. What is nurses responsibility during pretest?
Client preparation. Thorough assessment and data collection assist nurse in determining communication/ teaching strategies. Nurses need to ask females if they are or may be pregnant before having an x-ray, etc... The nurse also needs to know what equipment and supplies are needed for the specific test.
3. What is the focus of intratest?
Specimen collection and performing or assisting with certain diagnostic testing
3. Nurses role during intratest, beyond specimin collection?
nurse provides emotional and physical support while monitoring the client as needed (vital signs, pulse oximetry, ECG).
Ensures correct labeling, storage, and transportation of the specimen to avoid invalid test results.
3. Describe Post-test:
The focus of this phase is on nursing care of the client and follow-up activities and observations. As appropriate, the nurse compares the previous and current test results and modifies nursing interventions as needed. The nurse also reports the results to appropriate health team members.
4. What are normal values for the hemoglobin (Hgb) test (part of CBC)?
M: 14-18 g/dL or 8.7 - 11.2 mmol/L

F: 12-16 g/dL or 7.4 – 9.9 mmol/L
4. What are conditions associated with increased hemoglobin (Hgb) counts?
Polycthemia
Dehydration
Severe burns
COPD
4. What are conditions associated with decreased hemoglobin (Hgb) counts?
Hemorrhage
Anemia
Cancer
Kidney disease
Sickle cell anemia
4. What are normal values for the Hematocrit (Hct) test (part of CBC)?
M: 42 – 52%

F: 37 - 47%
4. What are condition associated with increased Hematocrit (Hct) counts?
Same as increased hemoglobin.
4. What are conditions associated with decreased hematocrit (Hct) counts?
Hemorrhage
Anemia
Hyperthyroidism
Dietary deficiency
Pregnancy
RBC INDICIES
4. What are normal values for the Mean corpuscular volume (MCV) test (part of CBC)?
80 – 95 um3
RBC INDICIES
4. What are condition associated with increased Mean corpuscular volume (MCV) counts?
Liver disease
Alcoholism
Pernicious anemia
RBC INDICIES
4. What are condition associated with decreased Mean corpuscular volume (MCV) counts?
Iron deficiency anemia
RBC INDICIES
4. What are normal values for the Mean corpuscular hemoglobin (MCH)
test (part of CBC)?
condition associated with increase/decrease?
27 - 31 pg
increase: Macrocytic anemia
decreased: Microcytic anemia; Hypochromic anemia
RBC INDICIES
4. What are normal values for the Mean corpuscular hemoglobin concentration(MCHC) test (part of CBC)?
32 – 36 g/dL
4. What are conditions associated with increased Mean corpuscular hemoglobin concentration(MCHC)?
Intravascular hemolysis
4. What are conditions associated with decreased Mean corpuscular hemoglobin concentration(MCHC)?
Iron deficiency anemia
RBC INDICIES
4. What are normal values for the WBC Count test (part of CBC)?
5 – 10 X 103/mL3
4. What are conditions associated with increased WBC counts?
(Leukocytosis)
Infection
Inflammation
Trauma
4. What are conditions associated with decreased WBC counts?
(Leukopenia)
Autoimmune disease
Drug toxicity
Bone marrow failure
DIFFENTIAL COUNT
4. What are normal values for Neutrophils?
55 – 70%
DIFFENTIAL COUNT
4. What are conditions associated with increased Neutrophils?
Stress
Acute infection
DIFFENTIAL COUNT
4. What are conditions associated with decreased Neutrophils?
Aplastic anermia
Dietary deficiciency
Radiation therapy
DIFFENTIAL COUNT
4. What are normal values for
Lymphocytes?
20 – 40%
DIFFENTIAL COUNT
4. What are conditions associated with increased Lymphocytes?
Chronic infection
Viral infection
Mononucleosis
DIFFENTIAL COUNT
4. What are conditions associated with decreased Lymphocytes?
Leukemia
Sepsis
Immunodeficiency diseases
DIFFENTIAL COUNT
4. What are normal values for
Monocytes?
2 – 8%
DIFFENTIAL COUNT
4. What are conditions associated with increased Monocytes?
Chronic inflammatory disorders
Tuberculosis
Chronic ulcerative colitis
DIFFENTIAL COUNT
4. What are conditions associated with decreased Monocytes?
Drug therapy – Prednisone
DIFFENTIAL COUNT
4. What are normal values for Eosinophils?
1 – 4%
DIFFENTIAL COUNT
4. What are conditions associated with increased Eosinophils?
Parasitic infections
Allergic reaction
Leukemia
DIFFENTIAL COUNT
4. What are conditions associated with decreased Eosinophils?
Increased adrenosteriod production
DIFFENTIAL COUNT
4. What are normal values for Basophils?
0.5 – 1%
DIFFENTIAL COUNT
4. What are conditions associated with increased Basophils?
Leukemia
DIFFENTIAL COUNT
4. What are conditions associated with decreased Basophils?
Acute allergic reaction
Hyperthyroidism
DIFFENTIAL COUNT
4. What are normal values for Platelets?
150 – 400 X 103/mL3
DIFFENTIAL COUNT
4. What are conditions associated with increased Platelets?
Malignant disorder
Polycythemia
Rheumatoid arthritis
Iron deficiency anemia
DIFFENTIAL COUNT
4. What are conditions associated with decreased Platelets?
Hemorrhage
Leukemia
Pernicious anemia
Hemolytic anemia
Chemotherapy
RENAL FUNCTION
4. What are normal values for Blood urea nitrogen (BUN)?
280 – 300 mOsm/kg
RENAL FUNCTION
4. What are conditions associated with increased Blood urea nitrogen (BUN)?
Fluid volume deficit
RENAL FUNCTION
4. What are conditions associated with decreased Blood urea nitrogen (BUN)?
Fluid volume excess
RENAL FUNCTION
4. Another test that relates to renal excretory function:
Creatinine
5. What are some nursing responsibilities associated with specimen collection (x6)?
1. provide for client comfort, safety and privacy
2. Explain purpose of and procedure for sp. collection.
3. Use or ensure correct procedure for obtaining a specimen
4. Note relevant information on the laboratory requisition slip, for example medications that may affect the lab results.
5. Transport the specimen to the laboratory promptly
6. • Report abnormal laboratory findings to the health care provider
6. What is the purpose of some of the tests that are performed on stool specimens?
• To determine the presence of occult (hidden) blood.
• To analyze for dietary products and digestive secretions.
• To detect the presence of ova or parasites.
• To detect the presence of bacteria or viruses.
7. Discuss nursing responsibilities associated with the collection of stool specimens?
See #5 for many of these. Additionally:
The nurse is responsible for collection stool specimens; nurse needs to determine the reason for collecting the stool specimen and the correct method of obtaining and handling; needs to be careful when transferring the sample to a specimen container, and disposing of the bedpan contents; must follow aseptic techniques meticulously; must ensure the specimen label/ laboratory requisition has the correct information on them and are securely attached to the specimen container; must also document all the information
8. Describe the techniques for collection the following urine specimens.

Routine analysis (clean voided):
Males normally void directly into specimen container. Females sit or squat over the toilet holding the specimen container between their legs. (should discard tp apart from bedpan or sample)
Specimen must be free of fecal contamination.
Lid container tightly to prevent spillage / contamination of other objects.
If outside of the container has been contaminated by urine, clean it with disinfectant.
8. What is the prep for "Clean-catch" or "midstream" urine collection method for a female?
Use each towelette only once. Clean the perineal area from front to back and discard the towelette Use all towelettes provided.
8. What is the prep for "Clean-catch" or "midstream" urine collection method for a female?
If uncircumcised, retract the foreskin slightly to expose the urinary meatus.
Using a circular motion, clean the urinary meatus and distal portion of the penis. Use each towelette once then discard. Clean several inches down the shaft of the penis.
8. What is the prep for "Clean-catch" or "midstream" urine collection method for a client who requires assistance washing perineal area?
For a client who requires assistance wash the perineal area with soap and water, rinse and dry.
8. Steps in "Clean-catch" or "midstream" urine collection method:
• Open the clean catch kit.
• Put on clean gloves.
• Clean the urinary meatus and perineal area.
• Collect the specimen from a nonambulatory client or instruct the ambulatory client on how to collect it.
• Instruct the client to start voiding.
• Place the specimen in the container into the stream of urine and collect the specimen, taking care not to touch the container to the perineum or penis.
8. How large a specimen should be collected in "Clean-catch" or "midstream" urine collection method?
• Collect 30 to 60 mL of urine in the container.
8. What happens once specimen is collected in "Clean-catch" or "midstream" urine collection method?
• Cap the container tightly, touching only the outside of the container and the cap.
• If necessary, clean the outside of the specimen container with disinfectant.
• Label the specimen and transport it to the lab.
• Ensure the label is on properly.
• Arrange to have the specimen immediately.
• Document pertinent data.
8. Timed urine specimen: specific preparations:
• Obtain specimen container with preservative (if indicated) from lab. Label the container with identifying information for client, test to be performed, time started and date of completion.
• Provide a clean receptacle to collect urine. (bedpan, commode, toilet collection device)
• Post signs in the clients’ chart, Kardex, room, and bathroom alerting personnel to save all urine during the specified time.
8. Timed urine specimen: specific collection instructions:
• At start of collection period, have client void/ discard urine.
• Save all urine produced during timed collection period in container, refrigerating or placing container on ice as indicated. Avoid contamination with toilet paper or feces.
• At the end of the collection period, instruct client to completely empty bladder and save this voiding as part of specimen. Take the entire amount of urine collected to lab with correct requisition.
8. Timed urine specimen: last duty:
• Record collection of the specimen, time started and completed, and any pertinent observations of the urine on appropriate records.
8. How to collect Urine specimen from an indwelling catheter:
• If there is no urine in catheter, clamp drainage tubing for about 30 minutes, allowing fresh urine to collect in catheter.
• Wipe area where needle will be inserted with disinfectant swab.
• Insert the needle at a 30 to 45 degree angle.
• Unclamp catheter.
• Withdraw the required amount of urine, normally 30mL for a routine urinalysis.
• Transfer urine to the specimen container.
8. Other duties pertaining to Urine specimen from an indwelling catheter:
• Put on disposable gloves
(procedure)
• Removes gloves and discard appropriately.
• Label container send urine to laboratory immediately for analysis or refrigeration.
• Record collection of specimen and any pertinent observations of urine to appropriate records.
• Note that procedure can be followed if needless port systems are being used.
9. Identify normal values and clinical implications of the following urine test:

URINALYSIS
Specific gravity
1.010 – 1.025

High levels indicate fluid deficit or dehydration or excess solutes such as glucose in the urine.
9. What is normal ph range for urinalysis?
Urinary ph
Average is 6
7 is neutral
Less than 7 is acidic
Greater than 7 is alkaline
9. What are normal values of Glucose, Ketones, Protein in urinalyisis?
?
9. What are normal values of Occult Blood in urinalyisis?
Normal urine is free of blood.
9. What are normal values of Osmolality in urinalyisis?
500 – 800m/Osm/kg
9. What are clinical implications of elevated/decreased Osmolality in urinalyisis?
An increase indicates fluid volume deficit and decrease represents a fluid volume excess.