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28 Cards in this Set
- Front
- Back
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RBC
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4.5 - 5.9
Erythropoietin : stimulates production of RBCs by the bone marrow. Lifespan of 120 days |
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Hgb
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12 - 17
iron and protien measure disorder response to tx |
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Hct
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36 - 51
whole blood amount of space it occupies RBC helpful in the degree of blood loss |
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Plt
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150, 000 - 450, 000 cells/ml
Critical Levels <50,000 and >1,000,000 Produce by the bone marrow Function : Control bleeding Thrombocytosis (risk for thrombosis) Thrombocytopenia (risk of spontaneous bleeding) |
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WBC
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4.3 - 10.8 x 109/L
Infection-Fighting System Monitor bone marrow response to cancer treatment “Differentials” |
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Erythrocyte Sedimentation Rate (ESR)
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RBCs settle in saline or plasma.
larger -- fall faster than normal and visa versa Increase indicates inflammatory process or neoplastic condition Decreased value blood deficiency |
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Activated Partial Thromboplastin Time (APTT)
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Reference range: 24 - 35 seconds
Therapeutic Range: 1.5 - 2.5 X normal value Critical Range: APTT > 70 seconds seconds needed for a clot to form PTT reflects serum heparin at the moment the sample is taken(Heparin activity varies from moment to moment) Protamine Sulfate- antidote to heparin |
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Prothrombin Time (PT)
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Reference Range: 10 - 14 seconds
Therapeutic Range: 1.5 - 2.5 X the normal Critical Values: >20 seconds time it takes blood to clot oral anticoagulant therapy- Coumadin (range monitored through INR) NSAIDs, Aspirin and other anti-platelet agents can affect PT level Vitamin K- Reduces the anticoagulation effect |
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International Normalized Ratio (INR)
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Range: 1.00 - 1.30
Critical value: > 4.0 - 5.0 Oral anticoagulant only measure the clotting time INR level needs to be monitored for clients on coumadin for: Deep vein thrombosis (DVT), pulmonary embolism (PE), myocardial infarction (MI) & mitral valve disease |
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Serum Proteins
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Albumin: 4 - 6 g/L.
Prealbumin: 15.0 - 35.0 mg/dL Total serum protein manufacture in the liver osmotic pressure (electrolytes transport) Prealbumin *(Nutritional assessment) Increase albumin usually indicates Dehydration Decrease value causes fluid shifts that result in edema. |
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Creatinine Phosphokinase (CPK)
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CPK-II (MB) Heart Muscle ( 0 - 6% )
Remains elevated 12-48* Returns to normal |
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Troponins
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Cardiac troponin T: <0.2mcg/L
Cardiac troponin I: <0.03mcg/L Value > 1.5 ng/ml- Dx. Myocardial Infarction Protein - helps to regulate cardiac contractility Troponin I (specific to cardiac muscle injury) Enzymes earlier, remains longer than CPK |
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Uric Acid
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Range: 2.8 – 8.5 mg/dl
Critical levels: >12mg/dl End product of purine metabolism renal failure Chemotherapy or radiation causes elevation Gout: disease associated with consistently high serum uric acid levels ( more common in men) Tx: allopurinol prevents elevation |
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Calcium ( Ca+ )
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8.5 - 10.5 mg/dl
Controlled & regulated by parathyroid & calcitonin hormones Increase in PTH causes an increase in Calcium Calcium & phosphorous have an inverse relationship |
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Hypocalcemia
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< 8.5mg/dl
Cause Hypoparathyroidism Low albumin Prolonged IV fluid therapy Diuretics Malnutrition Signs/Symptoms Diarrhea Cardiac changes Trousseau’s & Chvostek’s signs Intervention Oral calcium supplements ( Taken with Vitamin D) |
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Hypercalcemia
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>10.5mg/dl
Cause Hyperparathyroidism Dehydration Immobilization Signs & Symptoms Cardiac dysrhythmias Constipation Renal calculi Hypercoagulation |
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Phosphorus ( HPO4- )
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2.5 - 4.5 mg/dL
Inverse relationship between phosphorus & calcium increased PTH = increase calcium will result in decrease phosphorus (increase excretion of phosphorus by the kidney) |
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Hyperphosphatemia
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>4.5 mg/dl
Cause Hypoparathyroidism *Renal failure Hypovolemia Dehydration Signs/Symptoms Cardiac irregularities Hyperreflexia Oliguria Interventions Insulin binds phosphorus Dialysis Check pt’s EKG for changes (hypocalcemia) Monitor BUN & Creatinine levels |
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Magnesium Mg+
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1.5 - 2.5 mg/dL
Essential for neuromuscular function Used to monitor patients with cardiac disorders Change will affect other serum ions |
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Hypermagnesemia
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Cause
*Renal failure Excessive antacids use (MOM) magnesium Signs/Symptoms Lethargy/Drowsiness Diminished or absent deep-tendon reflexes Bradycardia Hypotension Dysrhythmias Cardiac arrest in severe state Thirst Interventions Loop diuretics Calcium supplements |
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Hypomagnesemia
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Cause
Hemodialysis Malabsorption/ malnutrition Signs/Symptoms Hyperactive deep tendon reflexes Seizures Anorexia & arrhythmias Interventions Monitor for EKG changes and monitor K+ & Ca++ (Hypo states) |
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Blood Urea Nitrogen (BUN)
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10 - 20 mg / dL
Elevated BUN ( kidney damage, increased protein intake, dehydration Decreased BUN ( liver failure, decreased protein, ) |
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Creatinine (Cr+)
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0.5 - 1.5 mg / dL
Evaluate renal dysfunction Increased ( renal damage, nephrotoxic drugs, etc. Decreased (muscle atrophy) |
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Glucose
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60 - 120 mg / dL
Critical Value: <60 or >400). Diagnose diabetes mellitus (DM) |
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Hypoglycemia(<60)
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Insulin shock (excess insulin)
Confusion Hunger Cool moist skin (clammy skin) Vision disturbance Coma Indicate the need for orange juice, sugar, milk,candy or food (if client is awake) or I.V. bolus of 50% dextrose (if client is unconscious) |
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Hyperglycemia(>140)
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Hyperglycemia(>140)
Insulin deficiency/resistance Polyuria(Increase urination) Polydipsia(increase thirst) Polyphagia(increase appetite) Weight loss Lethargy Indicate need to determine the client’s glucose level and give insulin |
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Insulin Sliding Scale
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Regular Insulin control glucose
Rise: 10mins Peaks: 30mins-45mins Returns to balance: 90mins BS < 60 give OJ and call MD BS > 400 give 12 units and call MD |
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HgbA1c (Glycosylated Hemoglobin Assay)
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4 - 6% (no diabetes)
2.5 - 6% (controlled diabetes) >8 (uncontrolled diabetes) Monitor diabetic pt. Prolonged blood glucose elevation |
