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Hemoglobin (Hgb or Hb)
Allosteric PROTEIN found in every erythrocyte (RBC) that carry O2 and CO2
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Normal Hemoglobin ranges
Males: 14-18g/dl
Females: 12-16g/dl
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Hemoglobin Low Count
Enemia
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Hemoglobin Below 10g/dl
- Shortness of breath
- Tiredness
- Pale skin
- PANIC VALUE
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Hemoglobin Below 5g/dl
No LIFE
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Hemoglobin TOO High
- Polycythemia - bone marrow makes too many RBC
- Weakness and fatigue results
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Hemoglobin Test
- 1. Lancet finger, place large drop blood on reagent card
- 2. Place card in machine, read / record results
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Hematocrit (Htc)
Measures PERCENTAGE sample of blood (RBC)
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Normal Hematocrit Range
- Males: 40-54%
- Females: 37-47%
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Hematocrit Collection and Process
- 1. Use lancet to draw blood out
- 2. Micro tubes placed at blood sight to draw into capillary tube (no bubbles)
- 3. Plug with clay card
- 4. Draw 2 tubes, place in machine, spin
- 5. Use machine scale to read/record results
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Hematocrit Tube Contents
- 1. Bottom Layer RBC (heaviest)
- 2. Buffy Coat (Leukocytes / Platelets)
- 3. Plasma top layer
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Hemoglobin / Hematocrit Conversion
- Hgb to Hc = Hgb x3 +- 3 estimate
- Hc to Hgb = Hc /3 +- 3 estimate
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Erythrocyte Sedimentation Rate (Sed-Rate) (ESR)
Measures rate RBC settle in calibrated tube in given time (1-2hrs)
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Erythrocyte Sedimentation Rate (Sed-Rate) Tests For
- 1. Acute Inflammatory Infection
- 2. Autoimmune Dissorders
- 3. Arthritis / Polymialgia
- 4. Acute / Chronic Infection
- 5. Lupis
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Normal Erythrocyte Sedimentation Rate (Sed-Rate) Range
- Males: 0-10mm/hr
- Females: 0-20mm/hr
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Erythrocyte Sedimentation Rate (Sed-Rate) Can't Detect
- Sickle Cell
- Polycythemia Vera
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Erythrocyte Sedimentation Rate (Sed-Rate) Test Comprimise
- Reading before time can yield false negative
- Reading after time can yield false positive
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Blood Glucose Test
Uses capillary blood to screen glucos levels for Diabetes
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Normal Fasting Gluclose Level
- 70-120mg/dl
- Fasting Blood Sugar (FBS)
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Glucose Tolerance Testing (GTT)
Used to diagnose diabetes, gestational diabetes, and hypoglycemia
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Glucose Tolerance Testing (GTT) Procedure
- 1. Patient drinks a glucose concentrated drink
- 2. Urine and blood collected at 30min, 30min, 1hr, 2hr incriments
- If FBS is over 150mg/dl, DO NOT TEST!
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Symptoms to cause Glucose Tolerance Testing (GTT)
- 1. extreme thirst, dehydration
- 2. fatigue
- 3. weight loss
- 4. visual difficulties
- 5. high glucose reading
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Glucose Tolerance Testing (GTT) Adverse Reactions
- 1. Weakness
- 2. Fainting (Syncopy)
- 3.Excessive sweating
- 4. Vomitting
- 5. Pancrease failure to metabilize sugar
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Hemoglobin A1C (HbA1c)
Glycohemoglobin
- Modified form of hemoglobin elevated when glucose remains too high
- Used to determine how much control patient has with glucose diet
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Cholesterol
Too much can cause atherosclerosis / arteriosclerosis, hardening of the arteries
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Normal Cholesterol Range
130-200mg/dl
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Phenylketonuria (PKU)
- tested on newborns for congenital disease caused by inability to metabolize certain amino acids (Phenylalanine)
- Prevents brain from developing (MR)
- Required in all 50 states and Canada
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Urinalysis - 3 Major Catagories
- 1. Physical, Chemical, Microscopic
- 2. Must test within 1hr or refrigerate for later testing
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Urinalysis - Physical
- Cloudy - cloudy, hazy, turbid
- Volume - how much
- Odor - acrid
- Specific Gravity - waste particles 1.005-1.030 most fall 1.010-1.025
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Urinalysis - Chemical
- Measures variety of chemicals on reagent strip
- 1. Blood
- 2. pH
- 3. Ketones
- 4. Glucose
- 5. Leukocytes
- 6. Bilirubin
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Urinalysis - Microscopic
We only prep for specimen
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Urinalysis - Midstream (Sterile)
- 1. Clean meatus (front to back)
- 2. Urinate small amount into toilet, stop
- 3. Catch in jar without touching inside, stop
- 4. Continue urination into toilet
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Urinalysis - First Morning Pee
- 1. Best to catch
- 2. Been in bladder over night
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Urinalysis - 24hr
- 1. Collect for 24hr from first urination
- 2. Keep in same jar in refridgerator
- 3. Annotate time of first pee on jar
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Substance Abuse Analysis
Used to detect presence of illigal / illicit drugs or chemical substances
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Substance Abuse Analysis Requirements
- 1. Patient must sign Chain-of-Custody form to concent for collection
- 2. Tape lid closed after collection, patient signs
- 3. Patient signs Lab request form to verify test complete and agrees
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Fecal (stool) Sample
Used to provide diagnostic insight
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Fecal (stool) Sample Can Detect
- 1. Occult (hidden) blood
- 2. Ova / parasites (O&P)
- 3. Bacterial / Viral infections
- 4. Fat content (lipids)
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Fecal (stool) Sample
Guaiac Test
- Tests for blood in stool
- Early detection for Colon Cancer Px 50+
- Turns BLUE if positive
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Fecal (stool) Sample
Patient Education before sample
- 1. Increase fluids
- 2. Avoid laxatives
- 3. Avoid straining during collection
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Sputum
Detect serious infections of lower respiratory tract
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Sputum Facts
- 1. First morning is best
- 2. Lower respiratory tract is sterile
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Sputem Diagnosis
- 1. Cancer
- 2. Bacterial / Viral Infection
- 3. Fungal Infection
- 4. Tuberculosis
- 5. Meningitis
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Bacteria Collection (24-48hr Growth)
- 1. Wound / Skin collection
- 2. Blood cultures
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Bacteria Culture Sensitivity
Culture bacteria while using different types antibiotics (which ones work)
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Bacteria Culture Media
- 1. Primary Agar (most common) encourages growth of all microorganisms
- 2. Selective Agar lets some grow but not others
- 3. Enrichment Agar has nutrients added
- 4. Place Ager plates (dishes) in incubator upside down (lid down)
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