Question Answer
What is an abnormally elevated white blood cell (WBC) count called? Leukocytosis (Egan’s, Pg 344, P2)
What is an abnormally elevated red blood cell (RBC) count called? Polycythemia (Egan’s, Pg 345, P6)
What type of pneumonia is present with WBC increase of 15,000/mm3, with 75% neutrophils, but only 10% lymphocytes? N lymphocyte differential is 20-45%. Bacterial pneumonia due to the number of elevated neutrophils. (Egan’s, Pg 345, Mini Clini)
What is the name for the detailed description of the number of circulating WBC, RBC, and platelets? Complete Blood Count (CBC) (Egan’s, Pg 344, P1)
Name of immature neutrophils. Bands (Because their nucleus has a “band like” shape.) (Egan’s, Pg 345, P2)
Significant reduction in platelet count is called what? Thrombocytopenia (Egan’s, Pg 346, P2)
What is hyponatremia? Low Na+ (sodium) level. (Egan’s, Pg 346, P5)
What is the number for elevated sweat chloride levels, shown on lab work, that will help with diagnosing cystic fibrosis. If sweat chloride level is more than 60-80 mEq/L. (Egan’s, Pg 347, P2)
What is the normal anion gap? 8-16 mEq/L (Egan’s, Pg 347, P3)
How do you calculate the anion gap? Add the HCO3- and Cl- together and then subtract this total from the serum Na+. (Egan’s, Pg 347, P3)
What blood glucose level indicates the presence of diabetes? Blood glucose level above 140mg/dl on TWO occassions indicates diabetes in most cases (after night of fasting). (Egan’s, Pg 348, P4)
What type of white blood cell (WBC) will be increased with the invasion of foreign material? Monocytes (Egan’s, Pg 344, Table 16-2)
Patiens who have existing chronic lung disease, and live in areas of high altitude, will most certainly experience chronic hypoxia. What will they also most likely develop in conjunction? Secondary polycytemia. (Egan’s, Pg 345, P5)
What does an anion gap of greater than 16 signify? Metabolic acidosis. (Egan’s, Pg 347, Rule of thumb notation.)
What is a normal blood glucose level? 70-110mg/dl (Egan’s, Pg 348, P3)
True or false? A legitimate sputum sample has many leukocytes (pus cells) and few epithelial cells? True (Egan’s, Pg 348, Rule of thumb)
Common test to determine kidney function. Blood urea nitrogen (or BUN) (Egan’s, Pg 347, P4)
If kidney disease caused many of the renal nephrons to become dysfunctional, what blood waste product would increase? Creatinine (Egan’s, Pg 347, P5)
What test is performed to determine a “specific” microorganism causing the infection? Sputum Gram Stain (Egan’s, Pg 348, P3)
What does anemia do to the body? It reduces the oxygen-carrying capacity of the blood and increases the chance of tissue hypoxia. (Egan’s, Pg 349, Key Points)
What are platelets called? Thrombocytes (Egan’s, Pg 344, P1)
What is normally/approximately the ratio of hematocrit to hemoglobin? 3:1 (Egan’s, Pg 346, Rule of Thumb)
What is the name of the disorder when there is an abnormal elevation of glood glucose? Hyperglycemia (Egan’s, Pg 348, P3)
What are the “classic three” symptoms for hyperglycemia? Excessive thirst, excessive need to urinate, and increased appetite. (Egan’s, P348, P7)
What common strain of bacterial pneumonia stains as “encapsulated, lancet-shaped, gram-positive diplococci. Streptococcus pneumoniae (Egan’s, Pg 348, P12)
Question Answer
Percentage of basophils in WBC? 1%
Percentage of monocytes in WBC? 3%
Percentage of lymphocytes in WBC? 30%
WBC normal value 5k-10k
Normal value RBC? 4-6mill
Normal value Hg? 12- 16 gm/100 cc of blood (gm/dl)
Normal value HCT? Normal is 40% to 50%
Normal value K? Normal 4.0 meq/l (3.5 to 5.0)
Normal Cl? 95 – 105 mEq/L
Normal Mg? 1.3 – 2.5 mEq/L
Normal Na? 140 (range 135 –145 meq/l)
Normal PO4? 1.4 – 2.7 mEq/L
Normal Ca? 4.5-5.8 mEq/L
Normal HCO3? 22-26 mEq/L
Normal anion gap? 7 – 16 mEq/L
Normal lactic acid? 5 – 20 mEq/L
Normal creatinine? 0.7 to 1.3 mg/dl
Normal BUN? 8 to 25 mg/dl
Normal bleeding time? up to 6 minutes
Normal Activated Partial Thromboplastin time (APTT) Normal value 24-32 seconds
What is APTT used for? monitoring heparin therapy
What does APTT measure? length of time required for plasma to form a fibrin clot
What is Prothrombin Time (PT)? 12-15 seconds
What is PT used for? Coumadin therapy
Question Answer
what is the normal vaule of WBC’S? 45-11,500
Neutrophils Relative value is? absoulute value is? 40-75% 1800-7500
Lymphocytes relative value is? absolute value is? 20%-45% 900-4500
monocytes relative value is? absolute value is? 2%-10% 90-1000
lymphocytes increase do to? viral and other infections
monocytes increase do to? foreign material
easinophils relative value absolute value 0-6% 0-600
easinophils increase do to? parasitic infections and allergic reactions
basophils relative value is absoulte value is 0-1% 0-100
basophils increase do to allergic reactions
red blood cells normal levels 4.6-6.2 men 4.2-5.4 women
hemoglobin normal levels 13.5-16.5 men 12-15 women
hematocrit normal levels 40-54% men 38-47% women
what causes hct to increase dehydration
what causes hct to decrease overhydration
platelet count normal range is 150,000-400,000
platelet count is important for what? blood clotting
serum glucose normal range 70-110
Question Answer
The difference between diagnoses and monitoring patients: ATS- American Thoracic Society= -+5% Accuracy monitoring devices versus -+3% for diagnostic spiratory.
ATS- American Thoracic Society= -+5% Accuracy monitoring devices versus -+3% for diagnostic spiratory. Neuromuscular disorders & pulmonary strengths
Reasons for weaning: • Weaning from mechanical ventilation • Assessing the need for mechanical ventilation • Extubation especially in the PACU • Evaluation of neuromuscular disease progression • Evaluation of flows in asthmatics pt (peak flow meters)
Three types of Spirometer: 1. Wright Spirometer 2. NIF- inspiratory pressure 3. PEFR –Peak Expiratory Flow Rate
Proper technique when using the SVC Wright Spirometer 1. Zero the device 2. Use filter to protect from contamination 3. For accurate Vt measure the VE and divide by the respiratory rate Repeat 3x
Normal Values for Wright Spiratory Vt 7-9 ml of ideal body weight, VE 5-10 L/M, SVC 15-50 ml/kg of IBW
Proper Technique when using the NIF 1. Block/occlude the airway for 20 seconds 2. Three attempts unless the 1st was off scale 3. Report the higher of all 3 attempts
What are the Predicted Values for NIF -20 cwp (to start the weaning process), -90 cwp to -120 cwp
What are two driving ways PEFR- Peak Expiratory Flow Rate- Electrical and Mechanical
Proper technique for PEFR: Deep breathe in and blast out- recording in the first ½ second. Best of three.
Normal Values for PEFR: Vary but approx. 300-600 ml. (based on gender, ht, age) Look at sheet and normal should be between 80-120 of predicted value
Bedside weaning procedures: MIP- 20cwp Vt 5-7 ml/kg VE <30 breaths per minute VE < 10 lpm VC 10-15 ml/kg
Two things that effect weaning: 1. Strength 2. Demand
True or false: A pt who can pull -15 cm H2O P on the P max test is ready to wean? False
Tidal Volume= ______ divided by _____ VE, RR
To measure diaphragm strength you would do a ? MIP, NIP, MIF
What are three ways to check the validity of the readings on a pulse oximeter test youreslf, take a manual pulse, Look at the pulse indicatior light strip
The device for bedside VC is called a? Wright Respraometer
A peak flow meter is usally used for pt with what? asthma
What is my average tidal volume if my VE is 6L and my RR 12 6000/12=500m