9-17-09 - Blood Clotting Tests Prothrombin Time time it...

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Blood Clotting Tests
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Prothrombin Time – time it takes blood thrombin to clot Normal 11-13 sec Panic value >30sec – blood takes a long time to clot Partial Thrombin Time (PTT) – not commonly done Normal 30-45 sec ***International Normalized Ratio (INR) Normal value 1.0
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2 to 3 for Rx of DVT or PE (blood thinners); not normal unless on blood thinners – exercise more gently – no over-stretching DVT -deep venous thrombosis – blood clot in veins, usually in calf of legs PE - pulmonary embolus >3 pt at risk for hemarthrosis (bleeding or blood in the joint) – not going to be treating patient
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Erythrocyte Sedimentation Rate (ESR)
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Normal - male 0-17 mm/hr, Normal - female 1-25 mm/hr Measures the rate that RBCs settle out of anticoagulated blood in 1 hr Slow rate may mean rheumatoid arthritis or Lupus – then do other tests Not a specific test for any disease
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Bone Marrow Aspiration
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Sample is taken from the PSIS Used to check the function of the hematopoetic tissues (marrow) and to test for leukemia, lymphoma and multiple myeloma
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Bone Marrow Aspiration
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See picture
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Blood Chemistry – electrolyte levels
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Potassium (K) Normal 3.5-5.3 mEq/L Critical Value <2.5 or >6.6 PT contraindicated if less than 3.2 or greater than 5.1 – Above or below critical value, don’t treat patient Signs and Symptoms of decreased K decreased muscle strength, disorientation, EKG
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changes; can have problems with heart muscle being weak Cause of ↓ K – dehydration, diarrhea
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Sodium (Na)
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Normal 135 – 145 mEq/L Critical Value ≤110 Effects of ↓ Na – mental changes, brain hemorrhage, coma
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Chloride
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Normal 95-105 mEq/L Critical Values <80 or >115 Above or below, don’t treat
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Acid – Base Balance
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Acidosis – increased acidity in the blood. Decreased pH of the blood Alkalosis – decreased acidity in the blood. Increased pH of the blood
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Bicarbonate
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Normal 23-30 mmo/L Panic value <6 .0 – don’t treat Low values indicate acidosis. May see increased respiratory rate w/ acidosis – rapid breathing.
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Monitor vital signs.
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Calcium
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Normal 9-11 mg/dL Critical Value <7 (tetany) – muscles are stiff and contracting Critical Value >12 (coma) May see seizures w/ low levels and cardiac arrythmias w/ high levels - ? fairly common
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Magnesium
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Normal 1.5-2.5 mEq/L Critical Value <0.5 or >3.0 Low levels can cause tetany (like low levels of calcium), High levels can cause respiratory paralysis or cardiac arrest
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Blood Glucose Levels
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Tests and Normal Values Fasting Blood Sugar 70-110 mg/dL Oral Glucose Tolerance Test – after 1 hr. 120- 160 mg/dL; keep measuring Hemoglobin A 1C
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9-17-09 - Blood Clotting Tests Prothrombin Time time it...

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