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63 Cards in this Set

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What is Blood Testing and who can do it??
Venipuncture performed by phlebotomist, nurse, tech, occasionally MD (anesthesia)
Measures constituents of serum;cannot measure intracellular components
WHat is the Blood Testing Technique, and why is it so important
aseptic technique
specimen handling
preventing hemolysis of specimens
Proper storage of specimen
Complete Blood Count involves what?
A basic screening test for information about the hematologic system
Includes
WBC’s,
Differential white count
RBC’s,
Hgb,
Hct,
Red blood cell indices
Platelets
What is the WBC’s normal range in adult ??
WBC =white blood cell
Norm:4-10,000 mm3
WBC’s are divided into 2 groups--- they are???
granulocytes (also called polymorphonuclear leukocytes or PMN’s)
agranulocytes (also called mononuclear leukocytes)
granulocytes (also called polymorphonuclear leukocytes or PMN’s) Include
granulocytes (also called polymorphonuclear leukocytes or PMN’s)
neutrophils,basophils, eosinophils

Granny loves phils the world...lol
agranulocytes (also called mononuclear leukocytes)
agranulocytes (also called mononuclear leukocytes)
leukocytes, monocytes
a granny has leukima and mono..poory granny
What are the possible causes of Leukocytosis=increase in number of leukocytes;>10,000mm3
can be caused by acute infection,leukemia, steroid use, surgery, drugs (ether, quinine,epinephrine,splenectomy
May also be physiologic (no identifiable cause)
ultraviolet light, stress, exercise, anesthesia
What are the possible causes of Leukopenia=decrease in WBC’s, <4,000
Causes include overwhelming viral and bacterial infections, hypersplenism,bone marrow suppression, pernicious and aplastic anemia, cancer, chemotherapy
Differential
Neutrophils: norm-50-60% of total WBC’s
Eosinophils:norm-0-3%
Basophils: norm-0-1%
Lymphocytes: norm:-25-40%
Monocytes: norm-3-7%
Neutrophils: norm-50-60% of total WBC’s
Neutrophils: norm-50-60% of total WBC’s
Combat bacterial infections
Eosinophils:norm-0-3%
Eosinophils:norm-0-3%
Combat allergic disorders and parasitic infections
Basophils: norm-0-1%
Basophils: norm-0-1%
Combat parasitic infections
Lymphocytes: norm:-25-40%
Lymphocytes: norm:-25-40%
Combat viral infections
Monocytes: norm-3-7%
Combat severe infections through phagocytosis
What is the RBC’s function in the body?
RBC=red blood cells
carry O2 from lungs to body tissues and CO2 from tissues to lungs.
What is the RBC norm value in an adult??
Norm:4-5 106/mm3
What situations cause Decreased RBC’s?
Anemia
reduction in # of circulating erythrocytes, many causes
Hodgkins disease
Lupus
Hemorrhage
Erythrocytosis=increased RBC’s
Can be caused by primary erythrocytosis
polycythemia vera
erythemic erythrocytosis (over production in the bone marrow)
high altitude
pulmonary diseases (COPD)
cardiovascular diseases
pregnancy
dehydration (causes hemoconcentration which makes interpretation of results difficult)
Hct= Hematocrit
Norm: 37-74% in women; 39-50% in men Is the percentage of blood that is RBC’s
Usually about 3 times the hemoglobin
Low Hct is caused by?? and can be treated by ??
anemia, excess IV fluid administration, hemorrhage, leukemia, drugs(ex:penicillin) and can be treated by diet, transfusion, d/c medication
What ar the causes of high Hct and thier TX??
high Hct caused by dehydration, shock, surgery, polycythemia, COPD and can be treated with IV fluids, phlebotomy(apheresis)
What is
Hgb=Hemoglobin
Norm values??
Hgb
Hgb=Hemoglobin
Norm:12-16g/dl in women;14-17 g/dl men
Low Hgb caused by and treatment is Treatment??
Norm:12-16g/dl in women;14-17 g/dl men
Low Hgb caused by anemia,IV fluids, liver disease, hemorrhage, transfusions of incompatible blood,SLE. Treatment includes dietary changes, transfusions, treating underlying cause
Norm:12-16g/dl in women;14-17 g/dl men

What causes Elevated Hgb is caused by and treatment???
Hgb
Hgb=Hemoglobin
Norm:12-16g/dl in women;14-17 g/dl men
Elevated Hgb is caused by CHF, living at high altitudes, COPD, burns, dehydration, polycythemia and treatment includes IV fluids, apheresis
What are the Red blood cell indices?
MCV
mean corpuscular volume

MCHC
mean corpuscular hemoglobin concentration
MCH
mean corpuscular hemoglobin
What is the MCV
mean corpuscular volume
Measures the volume occupied by a single erythrocyte.Tells whether erythrocyte is small(microcytic), large (macrocytic) or normal (normocytic)
What is the MCHC
mean corpuscular hemoglobin concentration and what is the purpose of it.
MCHC
mean corpuscular hemoglobin concentration
Measures the average concentration of Hgb in the RBC’s.Helpful in evaluating anemia.
What is the MCH and what is the purpose of it??
MCH
mean corpuscular hemoglobin
Measures average weight of the Hgb in each RBC
RDW
red cell size distribution width
Measures the amount of variation in the size of the RBC’s (also called anisocytosis)
RDW
red cell size distribution width
Measures the amount of variation in the size of the RBC’s (also called anisocytosis)
Platelets
Indicates clotting ability of the blood
Also reports abnormalities in size and shape of platelets
norm:150-450
Platelets
Indicates clotting ability of the blood
Also reports abnormalities in size and shape of platelets
norm:150-450
Serum Electrolytes
Review values of all
Chemistry Panels
ex: Chem 8, Chem Panel
Include serum electrolytes, LFT’s (liver function tests) and CO2
What do they Provide information about?
Provide information about electrolyte balance. Helpful in diagnosing diseases affecting the liver and other metabolic diseases.
Osmolality and water load test (water-loading antidiuretic hormone supression test and how it is conducted...
After overnight fast client is given 300ml of H2O. Client then drinks “test load” of water (20ml/kg body wt) within 30minutes and urine is collected for the next 4-5 hours. Each specimen is tested for osmolality and specific gravity. Serum specimens are also obtained hourly. In client with decreased renal function <80% of the water is excreted.
Sweat test
Done to diagnose cystic fibrosis
Clients with CF will have higher amounts of Na+ and Cl- in their sweat.
Test uses pilocarpine or other perspiration inducing medication followed by analysis of sweat on the skin.
Done to diagnose cystic fibrosis
Clients with CF will have higher amounts of Na+ and Cl- in their sweat.
Test uses pilocarpine or other perspiration inducing medication followed by analysis of sweat on the skin.
CPK-MB, myoglobin, TreponinT&I provide information about...
information about injury to heart muscle. Important for diagnosing acute MI.
ABG=arterial blood gas
measures....
measures amount of O2 and CO2 in the serum. Helpful in diagnosing conditions of the respiratory system and for evaluating acidosis and alkalosis.
Drug monitoring:
Peak and trough (ex: Gentamycin)
Drug levels (ex: Dilantin, Digoxin,)
Drug monitoring:
Peak and trough (ex: Gentamycin)
Drug levels (ex: Dilantin, Digoxin,)
PT/PTT
PT=prothrombin time
PTT =partial thromboplastin time
PT=prothrombin time
tests??
tests ability of blood to clot. Used to adjust Coumadin dosages.
PTT =partial thromboplastin time
tests ability of???
tests ability of blood to clot. Used for clients taking Heparin
What is the BUN=blood urea nitrogen norm value??
BUN=blood urea nitrogen
norm:7-18mg/dl
BUN=blood urea nitrogen
norm:7-18mg/dl
Measures what???
BUN=blood urea nitrogen
norm:7-18mg/dl
Measures glomerular function.
What causes and increassed BUN????????
Increased protein metabolism and renal disease will result in an elevated BUN Increased BUN (azotemia) can be caused by renal failure, CHF, shock, acute MI, loss of Na+ and H2O
What causes a decreased BUN???
Decreased BUN can be caused by liver disease,low protein diets, celiac disease, anabolic steroid use
What is the Norm level?? and what is it composed of
Creatinine
norm:0.6-1.5 mg/dl
It is a byproduct of the breakdown of muscle due to metabolism. Reflects renal function. Increased serum levels caused by decreased renal excretion

Increased creatinine levels can be caused by renal disease, obstruction of urinary tract, gigantism, rhabdomyolysis
What causes Increased serum levels
Increased creatinine levels can be caused by renal disease, obstruction of urinary tract, gigantism, rhabdomyolysis
What causes Decreased creatinine levels ???
Decreased creatinine levels can be caused by small stature, inadequate po protein, loss of muscle mass, liver disease
What ar ethe different types of Urine Tests???
Urinalysis
Urine culture
24 hour urine
Urinalysis what are we looking for???
Urinalysis
analyzes composition of urine
glucose, ketones, nitrites, leukocytes, protein, RBC, specific gravity (norm: 1.003-1.030)
Urine culture what are we looking for???
identifies presence of microorganisms in urine
bacteria, parasites
24 hour urine what are we looking for???
evaluates renal function
What Stool tests are done and what are we looking for in each???
Hemocult testing looking for blood
Ova and Parasite Testing looking for Ova and parasites
Stool cultures (viral and bacterial)
Stool fat testing (steatorrhea)
diagnoses cystic fibrosis, diseases of intestinal malabsorption
Where can we take Cultures and what are we looking for at each site??
Any body orifice can be cultured
Bacterial cultures are more common, but viral cultures for certain diseases are available.
Influenza (nasopharengeal swab)
herpes
norovirus (stool culture)
AFB (sputum;bacterial culture)
What are the Visualization Procedures: that occur from Top to Bottom???? and what we looking for???
Endoscopy (upper and lower GI)
laparoscopy (exploratory)
colposcopy
cystoscopy/voiding cystoscopy
colonoscopy/sigmoidoscopy
Barium enema/barium swallow
What are Other Types of tests… what are we looking for
KUB
IVP
angiography
arteriography
echocardiography(ECG)
electromyography(EMG)
electroencephalogram (EEG)
What are the other types of scans and RAD studies and what are we looking at wiuth them???
CT scan
PET scan
MRI
Ultrasonography
Lung scan
Bone density scan
Mammography
Nursing Responsibilities
Assessment/analysis
What is the test for?
What preparation/teaching will the client need?
Planning
Where will the testing be done?
Who will conduct the test?
What are my responsibilities for ensuring that the test is completed?
What is the test for?
What preparation/teaching will the client need?
Planning
Planning
Where will the testing be done?
Who will conduct the test?
What are my responsibilities for ensuring that the test is completed
Implementation
Implementation what we are doing!!!
Evaluation
What was the outcome of the test?
Will the test need to be repeated?
Who will discuss the results with the patient?
Evaluation
What was the outcome of the test?
Will the test need to be repeated?
Who will discuss the results with the patient?
Documentation
Was not Documented was not done!!!!
After care
Will additional care be needed after the diagnostic study?
Ex: monitoring airway after upper GI exam, increasing oral fluids after renal studies, lower GI exam.