Blood Sample
ABG
I: assess adequacy of oxygenation;
used to manage pt's respiratory and
metabolic acid-base and electrolyte
homeostasis
• pH: 7.35-7.45
• pH
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
• pO2
I: measures pressure of O2
dissolved in the plasma; determines
effectiveness of O2 therapy
• HCO3
I: measure of metabolic
component of acid-base equilibrium
• O2 Saturation
I: indicates % of hemoglobin
saturated w/O2
Apoliopoprotein
I: Evaluates risk of atherosclerosis
and CAD
CBG
I: Direct measurement of blood
glucose level
Normal (“stable”) Abnormal (“unstable”)
• Any ↑-Metabolic alkalosis
(hypokalemia, chronic vomiting);
Respiratory alkalosis (hypoxemic states-
CHF, CO poisoning, acute severe
pulmonary disease; pain)
Any ↓-Metabolic acidosis (ketoacidosis,
severe diarrhea); Respiratory acidosis
(respiratory failure)
• pCO2: 35-45mm Hg • ↑-COPD, oversedation, head trauma,
Venous: 40-50mm Hg overoxygenation in a pt. with COPD
↓-hypoxemia, pulmonary emboli,
anxiety, pain
• pO2: 80-100mm Hg • ↑-polycythemia (inc. amt. hemoglobin),
Venous: 40-50mm Hg inc. inspired O2, hyperventilation
↓-mucus plug, bronchospasm,
pneumothorax, pulmonary edema,
restrictive lung disease, inadequate O2 in
inspired air, severe hypoventilation
• HCO3: 21-28mEq/L
• ↑-chronic vomiting, COPD
↓-chronic/severe diarrhea, starvation,
diabetic ketoacidosis, acute renal failure
• O2 Sat: 95-100% • Used to find O2 content (rqs Hgb
values and pO2); once obtained results
are those found with pO2 ↑ or ↓ (see
above)
• 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,
starvation
RBC
I: Related to hemoglobin and
hematocrit levels, another way to
evaluate the # of RBCs in the
peripheral blood
Glycosylated hemoglobin
I: Monitor diabetes treatment;
measures amount of HbA1c; gives
average glucose levels of last 100-
120 days
Urinalysis
Urine sugar
I: Reflects degree of glucose
elevation in the blood; used to
monitor effectiveness of therapy for
DM
Mechanical Testing
EKG
I: Assist in the diagnosis and
condition of pulmonary diseases
Pulmonary function
(Spirometry)
I: Measures lung volume, evaluates
response to bronchodilator therapy,
determines the diffusing capacity of
the lungs
Bronchography (X-ray)
I: Assess pulmonary function
I: Indications (reason why test is performed)
Adult/elderly male: ↑-erythrocytosis (illness, physiologic
4.7-6.1 response to environment), severe COPD
RBCx10^6/microL (chronic state of hypoxia), severe
dehydration
↓-hemolytic anemia (transfusion
reaction), hemorrhage, dietary deficiency
(iron, VitB), lymphoma
Nondiabetic adult: ↑-poorly controlled diabetic
2.2%-4.8% ↓-hemolytic anemia, chronic blood loss,
Good diabetic control: chronic renal failure
2.5%-5.9%
Fair diabetic control:
6%-8%
Poor diabetic control:
>8%
Random specimen- ↑-diabetes mellitus, renal glycosuria
Negative (excretion of glucose), nephrotoxic
24-hr specimen- chemicals (carbon monoxide)
<0.5g/day
Normal HR (60- Cor pulmonale or pulmonary embolus
100bpm), rhythm, and (acute cor pulmonale-S1Q3T3)
wave deflections
Vary with patient age, Decreased lung volume/capacity,
sex, height, and weight reduced or impaired diffusing capacity,
reduced PIFR, reduced air flow rates and
VC, abnormal air flow curves, increased
RV and ERV...a specific combination of
these can indicate a particular problem
Normal Bronchiectasis (bronchial destruction,
tracheobronchial tree pockets of infection), bronchial
obstruction (cancer, mucus plug), or
tracheobronchoesophageal fistula