Nursing Fundamentals - Lab Interpretation

Brain cells and skeletal muscle cells.

Symptoms from brain cell and skeletal muscle dysfunction:

decreased level of consciousness (↓ LOC)

seizures

muscle twitching

headaches

Heart and skeletal muscle cells.

Symptoms from heart and skeletal muscle dysfunction:

heart dysrhythmias

muscle weakness and cramps

muscle numbness and tingling (paresthesia)

Skeletal and heart muscle cells, and cells for nerve function.

To fight infection.

Decreased WBC: the client is immunosuppressed (risk for infection)

Increased WBC: the client has an active infection

Leukopenia and neutropenia both indicate ↓ WBCs​.

To carry oxygen to all the organs.

Erythrocyte is another name for RBC (red blood cells).

Anemia: the body doesn’t have enough oxygen causing fatigue and weakness.

A protein on RBCs that carries oxygen.

RBC = red blood cell

The proportion of RBCs in the blood.

RBC = red blood cell

Both indicate how much blood and oxygen the client has.

Hemoglobin and hematocrit are commonly referred to as “H and H”.

anemia or bleeding

There is not enough oxygen or RBCs due to bleeding. RBC = red blood cell.

dehydration

The volume of fluid in the blood is decreased making the red portion of the blood look more concentrated.

For the blood to clot properly.

Indicates low platelets.

This can cause an increased risk of bleeding.

BUN is the waste product of protein breakdown in the liver excreted by the kidneys.

An increased BUN may or may not indicate a kidney problem because other conditions can increase the BUN.

Creatinine is the breakdown product of muscle and other proteins that are excreted by the kidneys.

Any increase in creatinine indicates a kidney problem.

GFR is how much urine gets filtered through the kidneys:

It is controlled by blood pressure

It is the best way to measure kidney function

The breakdown product of old red blood cells and is secreted in bile by the liver.

It causes the yellow color in urine and stool.

Can indicate liver damage or liver disease.

ALT, AST, and ALP are liver enzymes released by the liver when there is inflammation.

ALP can also be elevated with bone disorders.

Fat in the body. It is needed to build healthy cells, but an increased level can increase the risk of heart disease and stroke.

HDL and LDL are types of cholesterol:

HDL is the "Happy" or good cholesterol

LDL is the bad cholesterol

A waste product of proteins.

The liver helps the body get rid of ammonia by turning it into urea and disposing of it by the kidneys (see BUN).

A protein made by the liver.

Functions of albumin/proteins:

prevents fluids from leaking out of the vascular space

transports substances throughout the body

nourishes tissues

malnutrition: not eating enough protein

liver disease: the liver can't make proteins

kidney disease: kidneys are damaged and can't hold onto the proteins and are excreted

aPTT (activated partial thromboplastin time)

PTT (partial thromboplastin time)

PT (prothrombin time)

INR (international normalized ratio)

These labs refer to bleeding time. The higher the number the more likely the client will bleed. Depending on the situation, a higher number (called therapeutic) is desired to prevent blood clots.

Enzymes released by the pancreas when there is inflammation.

An increased level indicates pancreatitis.

The average level of blood sugar over the past 2 to 3 months.

It indicates how well the client has controlled their blood sugar.

An enzyme released by the heart when it is stretched due to too much fluid in the heart.

An increased brain natriuretic peptide (BNP) means worsening heart failure.

A protein released by the heart during a myocardial infarction (heart attack).

It is the best indicator of a heart attack.

CK/CPK (creatine kinase) is an enzyme released by the heart during a myocardial infarction.

It can also be raised with muscle damage from other reasons.

The breakdown of purines found in foods or old cells.

Elevated levels are caused by:

kidney disorder: cannot eliminate uric acid efficiently

tumor lysis syndrome: breakdown of old cells from chemotherapy releases uric acid into the blood

Indicates the presence of a blood clot.

Gout

The high uric acid causes inflammation in the joints, especially the big toe.

TSH (thyroid-stimulating hormone)

T3 (triiodothyronine)

T4 (thyroxine)

↓T3 and ↓T4

↑TSH

T3 and T4 are decreased so the body compensates by making more TSH.

↑T3 and ↑T4

↓TSH

T3 and T4 are elevated so the body compensates by making less TSH.

Looking at several values of the same lab test can indicate if the client is improving or getting worse by recognizing trends.

A blood lab test where all the hematology labs are included as one test.

WBC (white blood cells)

RBC (red blood cells)

Hgb (hemoglobin)

Hct (hematocrit)

platelets

A set of labs that includes electrolytes and kidney function:

sodium

chloride

potassium

carbon dioxide (CO2)

blood glucose

BUN

creatinine

A set of labs that includes everything in a BMP (electrolytes and kidney labs) in addition to the liver labs:

bilirubin

protein

ALT, AST, and ALP

Low blood counts of RBCs, WBCs, and platelets.

RBC = red blood cell

WBC = white blood cell

A systemic infection - an infection throughout the entire body.

A high temperature can indicate sepsis.

Indicates low or deficient.

It is a common ending to many different labs.

creatinine

BUN (blood urea nitrogen)

GFR (glomerular filtration rate)

ALT, AST, and ALP

bilirubin

albumin

protein

ammonia

troponins

BNP (B-type natriuretic peptide)

CK (Creatine kinase)

amylase

lipase

hemoglobin A1c

blood sugar

neutrophils: bacterial infections

lymphocytes: viral infections

monocytes: severe infections

eosinophils: parasite infections

basophils: parasite infections

Temp: to check for infection and dehydration

RR: to check for respiratory problems

HR: to check for irregular heart rhythm, tachycardia or bradycardia

BP: to check for fluid volume issues such as fluid volume overload or fluid volume deficit

O2: to check for decreased oxygen level

Hypotension: Blood pressure \< 90/60

Hypertension: Blood pressure > 130/80

pulse oximetry reading \< 95%

Bradycardia: heart rate \< 60

Tachycardia: heart rate > 100

Febrile: a temperature above normal

Afebrile: temperature is within normal limits

The average pressure in systemic cardiac circulation.

at least 60 to maintain perfusion

MAP = systolic blood pressure + 2(diastolic blood pressure) / 3

Ex: (120 + 160) / 3 = 93.3

How much blood the heart pumps per minute.

Cardiac output = heart rate x stroke volume (L/min)

average is 4-7 L/min