Lab Values Chart PDF

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Lab Values Chart...

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Lab Values evaluate the health status of the individual. It captures 95% of normal, therefore it IS NOT USED ALONE FOR DI look at the “total clinical” picture of an individual. Complete Blood Count (CBC) Lab Test One of the most commonly ordered tests 3 Critical Components of CBC Test: 1. Red Blood Cells 2.White Blood Cells 3.Platelets Review of the Blood: I is the body’s major fluid tissues and is pumped by the heart. The blood circulates/carrier vital elements to every part of body. It is separated into 1. Plasma and 2. Formed Elements Plasma: Formed Elements suspended in  Erythrocytes – RBCs The liquid component.  Leukocytes – WBCs Functions: 1. Neutrophils  Regulate acid-base balance & immune response 2. Lymphocytes  Mediates nutrition by carrying nutrients to tissue 3. Monocytes Also: 4. Eosinophils  With platelets, provide material that accelerates blood coagulation – 5. Basophils especially factor II (I think the word covered up by a picture so check)  Thrombocytes – Plt  Hct Rises when # of RBCs increases or when plasma volume reduced (dehydration) *These are the 3 critical components of the CBC Test    

Red Blood Cells/Erythrocytes (Hgb & Hct) RBCs Info  A critical component of CBC 4 to 6 million/mm3 Function: Carry O2  tissues; CO2 away from tissues  Polycythemia: high RBC count  Anemia: low RBC count  Production of RBCs:  Made in bone marrow in adults  Made in Liver/Spleen in Fetus  Regulated by tissues’ demand for O2. Lack of O2 in tissues(anoxia) leads to formation +release of erythropoietin(hormone made by kidneys) that stimulates bone marrow to make more RBCs Hemoglobin (Hgb) Info  RBCs contain hemoglobin. Hemoglobin contains heme, which has an iron center. O2 binds to the heme and is carried by the iron center!!  Contains ironiron carries O2!!!!  12 to 18 grams/100 ml of blood  Hgbmonitors if our treatments for polycythemia/anemia are working  Monitoring Hgb helps us make decisions about blood transfusions if the anemia is severe  High Hgb caused by:  Dehydration

White Blood Cells/Leukocytes

Platelets/thrombocytes (Plt)

A critical component of CBC  A critical component of CBC 150,000-400,000 plts/mm3 5000-10000 WBCs/mm3 Description: cells made in bone marrow and circulate in blood. Function: protects body against harmful They are very sticky, so first components to be activated to bacteria/infection. can live 6hours-years form a blood clot when a blood vessel is injured. Leukocytosis: high WBC count. Caused by infection, Thrombocytopenia: low # of Plt. Occurs in: inflammation, leukemia, trauma, stress  patients with long-term bleeding probs, Leukopenia: low WBC count. From chemotherapy,  individuals with autoimmune disorder which destroys radiation, disease of immune system. platelets (lupus – body attacks it’s own organs) 5 Types of WBCs  patients undergoing chemo 1. Neutrophils (60% of WBCs) Live 7-10 days  Phagocytes engulfing bacteria/cellular debris 3 functions:  1st line of defense bc most numerous  Shrink damaged blood vessels to minimize blood loss  See an increase in these when acute infection,  Form hemostatic plugs in injured blood vessels certain malignant neoplastic diseases, some other  With plasma, provide material that accelerates blood disorders coagulation – especially factor II (I think the word 2. Lymphocytes (20-40% WBCs) covered up by a picture so check)  2 forms: B & T cells  B Cells: chief agents of humoral immune system. Recognizes specific antigens & make antibodies against them  T Cells: agents of the cell-mediated immune system. Secrete immunologically active compounds and assist B Cells in their function  See increase in these when chronic/viral infection

 Excess RBC production in bone marrow  Severe lung disease  Several other conditions  Low levels caused by:  Anemia (iron deficiency)  Inherited Hgb defects (sickle cell anemia/thalassemias)  Cirrhosis of liver  Excessive bleeding  Excessive destruction of RBCs (DIC)  Kidney diseaseimportant**  Other chronic illnesses  Bone marrow failure/cancers that affect bone marrow Hematocrit (Hct) Info  40-50% (40-50 milliliters RBCs/100ml blood)  Hct measures amount of space RBCs take up in blood, reported as a %  Hct Rises when # of RBCs increases or when plasma volume reduced (dehydration)  Hct falls = anemia. Happens when body decreases production of RBCs or increases destruction of RBCsor if blood lost due to bleeding

Test PT(prothrombin)/ PTT(Parial Thromboplastin Time)

3.

Monocytes (4-6% WBCs)  Second line of defense – devours invading organisms 4. Eosinophils (1-3% WBCs)  Function in allergic responses  Defend against parasite infections & fight lung/skin infections 5. Basophils (0.5-1% of WBCs)  Release heparin and histamine into blood and participate in delayed allergic reaction

Normal Levels PT (Prothrombin Time)= 11-12.5 seconds

High Levels Prolonged/increased PT/PTT level means = blood taking too long to clot

PTT (Partial Thromboplastin Time) = 30-40 seconds

ASPIRIN INCREASES BLEEDING TIME

Low Levels

What it does/Regulates PT (Prothrombin) is made in Liver, needed for clotting Process PTT (Partial Thrombolplastin Time) measures functionality of intrinsic and common pathways of coagulation cascade. It will

detect deficiencies in clotting factors. Can be called Activated PTT (APTT)

Together, PT and PTT values evaluate bleeding, monitors effectiveness of anticoagulant therapy (heparin, warfarin) if pt is receiving it Sodium (Na)

135-145 mEq/1

*THE MOST ABUNDANT CATION OF EXTRACELULAR FLUID

Potassium (K)

3.5-5.0 mEq/1 ANY vue outside of this rang requires medical attention, especially if youre taking a diuretic (water pill) or heart pill (digitalis, lanoxin, etc)

Chloride (Cl)

95-105 mEq/1

MAJOR NION OF EXTRCELLULAR FLUID Magnesium (Mg)

1.5-2.5 mEq/1

Plentiful in

HYPERNATREMIA: High sodium Caused by:  Decreased water intake  High sodium diet Symptoms:  Thirst,  Skin flushed  Restlessness  Oliguria  Seizures if severe

HYPERKALEMIA: high K Caused by:  Kidney disease  Burns  Acidosis  Certain drugs Symptoms:  Irritable, cardiac arrhythmias, nausea, diarrhea, muscle weakness

HYPERMAGNESEMIA: high Mg Caused by:  mostly kidney disease,

HYPONATREMIA: low sodium. Caused by:  Sodium loss (Addison’s disese, Diarrhea, Vomiting, Excessive sweating, Diuretic administration, Kidney disease)  Drinking to omuch water  Heart failure  Cirrhosis  Kidney diseases causing protein loss (nephrotic syndrome)  Malnutrition Symptoms:  If falls quickly, weak, fatigued; severe cases = confusion/coma  Apprehensive, dizzy, personality change, muscle weakness, nausea, vomiting, seizures if severe HYPOKALEMIA: low K Caused by:  Diarrhea  Vomiting  gastric suctioning,  sweating excessively,  diuretics (water pills) Symptoms:  fatigue, muscle weakness, confusion, irregular pulse/cardiac arrhythmias The loss of chloride particles parallels the loss of sodium

HYPOMAGNESEMIA: Caused by:  alcoholism

Maintains body fluids Responsible for conduction of neuromuscular impulses via sodium pump Regulates acid/balance

Controlled by kidneys Needed for proper function of nerves and muscles (heart)

Needed for neuromuscular activity

extracellular fluid

antacids symptoms: flushing/sweating, hypotension, drowsy, weak deep tendon reflexes, decreased rate/depth respirations, bradycardia, cardic arrythmias

 liver malfunction symptoms: tremor, hyperactive deep reflexes, disoriented, cramps, tachycardia, seizures, cardiac arrhythmias Overtime, low Mg level can cause persistently low calcium and potassium levels. Therefore, low Mg can be checked to help diagnose probs with calcium, phosphorus, potassium, and/or parathyroid hormone (involved with calcium regulation)

Phosphorus (Ph)

2.7-4.5 mg/dL

80-85% total phosphate in body is combined with calcium in teeth and bones

Intracellular electrolyte Has an inverse relationship with Ca Calcium (Ca)

Total Ca = 8.5-10.5 mEq/1 Ionized Ca = 4.5 – 5.5 mEq/1 50% of calcium is ionizedionized Ca is the only Ca that ban be used in the body. After that, protein/albumin binds with Ca in blood, further decreasing free, ionized Ca. THEREFORE: ionized Ca is a better indication of calcium metabolism, BC IT IS NOT AFFECTED BY CHANGES IN PROTEIN/ALBUMIN

Glucose

70-110mg/100ml Fasting blood glucose level (collected after an 8-10hr fast) used to screen for diabetes/pre-diabetes.

HYPERCLCEMIA: Causes:  cancer  prolonged immobilization  hyperparathyroidism Symptoms: nausea, vomiting, lethargy, hypotonic skeletal muscles, personality changes, cardiac dysthrhthmias

HYPOCALCEMIA: low Ca Causes:  parathyroid gland dysfuction  diarrhea  renal failure  burns symptoms: numbness, tingling of fingers and circumoral region, muscle cramps, hyperactive reflexes, convulsions, cardiac dysrhythmias

Regulated by parathyroid hormone. Important for maintaining normal transmission of nerve impulses Has an inverse relationship with Ph

Glucose = simple sugar that serves as main source of energy for the body. To use glucose, we need insulin (made by pancreas). Insulin is what moves glucose into a cell and tells liver to store excess glucose as glycogenshort term storage. *we cannot live unless glucose and insulin are in balance.

OGTT/GTT Oral Glucose Tolerance Test

Glucose Hemoglobin A1C Test

Also used to diagnose diabetes Involves a fasting glucose, followed by pt drinking standard amount of glucose solution to “challenge” their system, followed by another glucose test 2 hrs later Hemoglobin A1C measures effectiveness of blood glucose control over a period of time

As amount of plasma glucose increases, fraction of glycated hemoglobin increases in a predictable way

It measures GLYCAED HEOGLOBIN = form of hemoglobin telling average plasma glucose concentration. As amount og plasma glucose increases, fraction of glycated hemoglobin increases in a predictable way

5% = 90 mg/dl 6% = 120 mg/dl 7%=150mg/dl 8%=180 mg/dl 9%=210mg/dl 10%=240 mg/dl 11%=270mg/dl Bun (Blood Urea Nitrogen)

10-20 mg/100ml

Creatinine (CRT)

0.6-1.2 mg/100ml

Bun & Creatinine Measures amount of nitrogen in your blood coming from the waste product urea BUN produced when protein broken down/metabolized Kidneys eliminate more than 90% of the BUN, so it indicates how well kidneys are working too Can fluctuate with hydration level and protein intake

The end product of muscle metabolismthe part of the cycle that produces energy needed to contract muscles Produces at a constant rate Excreted by kidneys, so blood levels are good indication of how well kidneys are workingMORE ACCURATE OF KIDNEY FUNCTION THAN BUN

Routine Urinalysis: UA Looks at: pH, Specific Gravity (SG), glucose, Blood, bilirubin, Nitrate, Leukocyte esterase, and protein pH The measures acidity Specific Gravity (SG)

Measures how dilute urine is. Water SG = 1.000, most Urine SG ~1.1010, but it varies based on 1. When you last drank fluid . if dehydrated

Glucose

Normally, NO GLUCOSE IN URINE. Positive for glucose in urine = diabetes. A small number of people have glucose in urine with it being normal – but any glucose in urine raises possibility of diabetes or glucose intolerance

Blood

Normally, NO BLOOD IN URINE. If blood in urine, can = infection, kidney stones, trauma, bleeding from bladder/kidney tumor

Bilirubin

Normally, NO BILIRUBIN OR UROBILINOGEN IN URINE. These pigments usually clared by liver. Either being in urine can = liver or gallbladder disease

Nitrate Leukocyte esterase Protein

Normally NEGATIVE. If positive = UTI Normally NEGATIVE. WBC = Pus Cells. Any WBCs/Pus Cells in urine = urinary tract infection (UTI) Normally, protein not detectable on urinalysis strip. If protein = kidney damage, blood in urine, infection Up to 10% children have protein in urine Certain disease require use of special, more sensitive & $$ test for protein called MICROALBUMIN test

Microalbumin

Certain disease require use of special, more sensitive & $$ test for protein called MICROALBUMIN test Very useful for screening for early damage to kidneys from diabetes...