Blood Exam: White Blood Cells and Fasting Blood Sugar

Blood Exam

• White Blood Cell count: 5,000 to 10,000/ul
• Leukocytosis: infection or inflammation, indicated by an increased WBC count
• Leukopenia: risk of infection, indicated by a decreased WBC count

Lipoprotein

• Lipoprotein: transporter of fats
• HDL (Good): fats move from blood vessels to liver
• LDL (Bad): fats move from liver to blood vessels

Hematocrit and Hemoglobin

• Hematocrit (Hct): RBC concentration to blood
• Male: 41%-51%, Female: 36%-46%
• Hemoglobin (Hb): Male: 14g/dl to 18g/dl, Female: 12g/dl to 16g/dl
• Relationship: Hct and Hb are directly related
• Polycythemia: increased RBC count, indicated by increased Hct
• Anemia: decreased RBC count, indicated by decreased Hct

Arterial Blood Gases (ABG)

• pH range: 7.35-7.45
• Respiratory Opposite pH (ROME)
• Metabolic Equal or same direction with pH
• Buffers: Respiratory PaCO2 and Metabolic HCO3
• Parameter that meets ROME = PROBLEM
• Parameter that fails ROME = other values

Barium Studies

• Fluoroscopy: series of x-rays
• Contraindicated: Pregnant women
• Barium Swallow:
  • NPO: post midnight
  • Assess for allergy to barium
  • Position: Fowler's
• Barium Enema:
  • Low residue diet
  • Laxative
  • NPO: post midnight
  • If affected side is posterior, place patient in prone position

Chest Physiotherapy (CPT)

• Best time: before meals or bedtime, 2 hours after meals, after nebulization
• Time: 10-15 minutes
• Entire CPT should not be more than 30 minutes
• Vest: increase frequency chest wall oscillation (suction after)

Suctioning

• To clear airway and maintain patent airway
• Who needs suctioning?
• Remove old ties and insert new ties
• Ties fit snugly if 2 fingers can be inserted
• Tied at the side of the neck

Nasogastric Tube Insertion

• Position:
  • Conscious: Upright/ High-fowlers
  • Unconscious: Upright/ high-fowlers with head turned to RIGHT
• Prepare at bedside: suction machine, obturator, and inner cannula