Blood Sample ABG

I: assess adequacy of oxygenation; used to manage pt's respiratory and metabolic acid-base and electrolyte homeostasis

Normal (“stable”)

Abnormal (“unstable”)

• pH

• pH: 7.35-7.45 I: test for respiratory or metabolic Venous: 7.31-7.41

alkalosis or acidosis

• pCO2
I: measure of lung compensation for respiratory alkalosis or acidosis

• pCO2: 35-45mm Hg Venous: 40-50mm Hg

• Any ↑-Metabolic alkalosis (hypokalemia, chronic vomiting); Respiratory alkalosis (hypoxemic statesCHF, CO poisoning, acute severe pulmonary disease; pain) Any ↓-Metabolic acidosis (ketoacidosis, severe diarrhea); Respiratory acidosis (respiratory failure) • ↑-COPD, oversedation, head trauma, overoxygenation in a pt. with COPD ↓-hypoxemia, pulmonary emboli, anxiety, pain • ↑-polycythemia (inc. amt. hemoglobin), inc. inspired O2, hyperventilation ↓-mucus plug, bronchospasm, pneumothorax, pulmonary edema, restrictive lung disease, inadequate O2 in inspired air, severe hypoventilation • ↑-chronic vomiting, COPD ↓-chronic/severe diarrhea, starvation, diabetic ketoacidosis, acute renal failure • Used to find O2 content (rqs Hgb values and pO2); once obtained results are those found with pO2 ↑ or ↓ (see above)

• pO2
I: measures pressure of O2 dissolved in the plasma; determines effectiveness of O2 therapy

• pO2: 80-100mm Hg Venous: 40-50mm Hg

• HCO3
I: measure of metabolic component of acid-base equilibrium

• HCO3: 21-28mEq/L

• O2 Saturation
I: indicates % of hemoglobin saturated w/O2

• O2 Sat: 95-100%

Apoliopoprotein
I: Evaluates risk of atherosclerosis and CAD

• ApoB-adult male: 50- • ↑-CAD, diabetes, hypothyroidism 125mg/dL ↓-hyperthyroidism, malnutrition, chronic pulmonary disease • Lp(a)-Caucasian • ↑-premature CAD, uncontrolled DM, male: 2.2-49.4mg/dL, severe hypothyroidism A-A male: 4.6↓-malnutrition 71.8mg/dL Normal: 70-110mg/dL Critical value for adult male: <50 and >50yo: increase in >400mg/dL normal range ↑-hyperglycemia, DM, acute stress response, chronic renal failure, acute pancreatitis, diuretic therapy, corticosteroid therapy ↓-insulinoma, hypothyroidism, hypopituitarism, insulin overdose,

CBG
I: Direct measurement of blood glucose level

starvation RBC
I: Related to hemoglobin and hematocrit levels, another way to evaluate the # of RBCs in the peripheral blood

Adult/elderly male: 4.7-6.1 RBCx10^6/microL

↑-erythrocytosis (illness, physiologic response to environment), severe COPD (chronic state of hypoxia), severe dehydration ↓-hemolytic anemia (transfusion reaction), hemorrhage, dietary deficiency (iron, VitB), lymphoma ↑-poorly controlled diabetic ↓-hemolytic anemia, chronic blood loss, chronic renal failure

Glycosylated hemoglobin
I: Monitor diabetes treatment; measures amount of HbA1c; gives average glucose levels of last 100120 days

Nondiabetic adult: 2.2%-4.8% Good diabetic control: 2.5%-5.9% Fair diabetic control: 6%-8% Poor diabetic control: >8%

Urinalysis Urine sugar
I: Reflects degree of glucose elevation in the blood; used to monitor effectiveness of therapy for DM

Random specimenNegative 24-hr specimen<0.5g/day

↑-diabetes mellitus, renal glycosuria (excretion of glucose), nephrotoxic chemicals (carbon monoxide)

Mechanical Testing EKG
I: Assist in the diagnosis and condition of pulmonary diseases

Normal HR (60100bpm), rhythm, and wave deflections

Cor pulmonale or pulmonary embolus (acute cor pulmonale-S1Q3T3)

Pulmonary function (Spirometry)

Vary with patient age, Decreased lung volume/capacity, sex, height, and weight reduced or impaired diffusing capacity, I: Measures lung volume, evaluates reduced PIFR, reduced air flow rates and response to bronchodilator therapy, VC, abnormal air flow curves, increased determines the diffusing capacity of RV and ERV...a specific combination of the lungs these can indicate a particular problem Bronchography (X-ray)
I: Assess pulmonary function

Normal tracheobronchial tree

Bronchiectasis (bronchial destruction, pockets of infection), bronchial obstruction (cancer, mucus plug), or tracheobronchoesophageal fistula

I: Indications (reason why test is performed)

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