Blood Sample Normal (“stable”) Abnormal (“unstable”)

ABGI: assess adequacy of oxygenation; used to manage pt's respiratory and metabolic acid-base and electrolyte homeostasis• pH I: test for respiratory or metabolic 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

• pH: 7.35-7.45Venous: 7.31-7.41

• pCO2: 35-45mm HgVenous: 40-50mm Hg

• pO2: 80-100mm HgVenous: 40-50mm Hg

• HCO3: 21-28mEq/L

• O2 Sat: 95-100%

• 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)• ↑-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)

ApoliopoproteinI: Evaluates risk of atherosclerosis and CAD

• ApoB-adult male: 50-125mg/dL

• Lp(a)-Caucasian male: 2.2-49.4mg/dL, A-A male: 4.6-71.8mg/dL

• ↑-CAD, diabetes, hypothyroidism ↓-hyperthyroidism, malnutrition, chronic pulmonary disease• ↑-premature CAD, uncontrolled DM, severe hypothyroidism ↓-malnutrition

CBGI: Direct measurement of blood glucose level

Normal: 70-110mg/dL>50yo: increase in normal range

Critical value for adult male: <50 and >400mg/dL ↑-hyperglycemia, DM, acute stress response, chronic renal failure, acute pancreatitis, diuretic therapy, corticosteroid therapy↓-insulinoma, hypothyroidism, hypopituitarism, insulin overdose, starvation

RBCI: 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

Glycosylated hemoglobinI: Monitor diabetes treatment; measures amount of HbA1c; gives average glucose levels of last 100-120 days

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

↑-poorly controlled diabetic↓-hemolytic anemia, chronic blood loss, chronic renal failure

Urinalysis

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

Random specimen- Negative24-hr specimen- <0.5g/day

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

Mechanical Testing

EKGI: Assist in the diagnosis and condition of pulmonary diseases

Normal HR (60-100bpm), rhythm, and wave deflections

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

Pulmonary function (Spirometry)I: Measures lung volume, evaluates response to bronchodilator therapy, determines the diffusing capacity of the lungs

Vary with patient age, sex, height, and weight

Decreased lung volume/capacity, 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

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)