Lab Values

Question 1

What does creatine measure, what are normal levels, what can cause a decrease?

Answer 1

• Creatine measures kidney function and protein status.
• Normal levels are 0.8–1.5 mg/dL.
• Malnutrition decreases creatine levels, indicating impaired kidney function and protein status.

Question 2

How does malnutrition affect creatine levels?

Answer 2

Malnutrition decreases creatine levels, indicating impaired kidney function and protein status.

Question 3

What is serum albumin, and what role does it play in the body?

Answer 3

• Serum albumin is the most abundant plasma protein produced by the liver.
• It regulates water flow between plasma and interstitial space.
• Decreased levels lead to edema.

Question 4

What are normal serum albumin levels, and what do low levels indicate?

Answer 4

• Normal levels are at least 3.5 mg/dL.
• Low levels correlate with increased severity of pressure ulcers and are associated with conditions like infection, liver/kidney disease, malabsorption, and starvation.

Question 5

How is albumin affected by dehydration, and why is it not a good short-term nutritional marker?

Answer 5

High levels of albumin usually indicate dehydration, and its 21-day half-life makes it ineffective for assessing short-term diet changes.

Question 6

What is prealbumin, and what are its normal values?

Answer 6

• Prealbumin is a major transport protein with normal values of 16–40 mg/dL.
• It has a short half-life (2-4 days), making it sensitive to short-term changes in nutritional status.

Question 7

How do low prealbumin levels affect patient outcomes, and what conditions can cause low prealbumin levels?

Answer 7

• Low prealbumin levels increase mortality risk and may indicate liver disease, inflammation, or tissue death.
• Levels below 17 mg/dL suggest malnutrition.

Question 8

What are the differences between low and high prealbumin scores?

Answer 8

• Low scores may indicate liver disease or malnutrition.
• High scores may suggest chronic kidney disease, steroid use, or alcoholism.

Question 9

What is C-reactive protein (CRP), and what does its increase indicate?

Answer 9

CRP increases with systemic inflammation, making it a marker for inflammatory conditions.

Question 10

How is serum cholesterol used to assess pressure ulcer risk, and what are the critical levels?

Answer 10

Serum cholesterol levels below 160 mg/dL, combined with poor intake and weight loss, increase the risk for pressure ulcers.

Question 11

What are the normal and critical levels for hemoglobin and hematocrit, and how are they linked to anemia and pressure ulcers?

Answer 11

• Hemoglobin below 12 mg/dL, and hematocrit below 33% indicate anemia, increasing the risk of pressure ulcers.

Question 12

What lab values monitor anticoagulant therapies, and which medications do they correspond to?

Answer 12

• INR monitors Coumadin
• PTT monitors Heparin
• PT monitors non-steroidal drugs like Aspirin and Lovenox

Question 13

What is Blood Urea Nitrogen (BUN), what are its normal levels, and what are elevated levels are associated with?

Answer 13

• BUN measures urea, a by-product of protein metabolism, and indicates renal function.
• Normal levels are 5–25 mg/dL.
• Elevated levels are associated with decreased wound healing.

Question 14

How do elevated BUN levels affect wound healing?

Answer 14

Elevated BUN levels are associated with decreased wound healing, due to impaired renal function.

Question 15

What does Total Lymphocyte Count (TLC) indicate, and what are normal levels?

Answer 15

• Total Lymphocyte Count (TLC) is an indirect measure of nutritional status and immune function
• Normal levels between 3000–3500 cells/mcL

Question 16

What causes elevated or decreased TLC levels, and what are the implications for wound healing?

Answer 16

• Elevated TLC may indicate infection or leukemia.
• While decreased TLC (<1800/mm³) is linked to chemotherapy, malnutrition, or surgery, causing delayed wound healing.

Question 17

How are decreased TLC levels classified, and what are the thresholds for immunocompromised and protein deficiency states?

Answer 17

• <1500 indicates immunocompromised status
• <1200 suggests protein deficiency
• <900 indicates severe deficiency

Question 18

What is the goal for blood glucose levels, and what are normal levels?

Answer 18

• The goal is to keep blood glucose below 150 mg/dL
• Normal levels ranging from 70–110 mg/dL

Question 19

How do elevated blood glucose levels impact ulceration risk and wound healing?

Answer 19

• Levels above 180 mg/dL impair neutrophil chemotaxis.
• Levels above 200 mg/dL affect neutrophil oxidative burst, increasing the risk of ulceration and delayed wound healing.

Question 20

What is glycosylated hemoglobin (HbA1C), and what does it indicate?

Answer 20

• HbA1C measures glucose binding to hemoglobin, reflecting average blood glucose levels over 2-3 months.
• Normal HbA1C levels are 4–6.1%.

Question 21

What are the implications of high HbA1C levels in wound healing?

Answer 21

• High HbA1C levels (>6.1%) indicate poor long-term glucose control, increasing the risk for impaired wound healing.

Question 22

What lab values are used to assess hydration status?

Answer 22

Hydration Status:

• serum osmolality
• hematocrit
• urine specific gravity

Question 23

What serum osmolality level indicates dehydration, and why is it important for wound care?

Answer 23

• Serum osmolality above 29 mOsm/L suggests dehydration, which can complicate wound healing.

Question 24

How is INR used to monitor anticoagulation therapy, and what is the target range for patients on Coumadin?

Answer 24

• INR measures blood clotting time, with a target range of 2.0–3.0 for patients on Coumadin.

Question 25

What is Partial Thromboplastin Time (PTT), and how is it used in heparin therapy?

Answer 25

* PTT measures the effectiveness of heparin therapy, ensuring proper anticoagulation levels.

Question 26

How is Prothrombin Time (PT) used to monitor aspirin and other non-steroidal anticoagulants?

Answer 26

PT assesses clotting function and ensures effective anticoagulation with medications like aspirin and Lovenox.

Question 27

What are the effects of elevated serum cholesterol on pressure ulcer development?

Answer 27

* Elevated serum cholesterol (**>200 mg/dL**) contributes to atherosclerosis, limiting blood flow and increasing ulcer risk.

Question 28

What factors can lead to low serum albumin levels, and how does it affect fluid balance?

Answer 28

Conditions like infection, malabsorption, and liver/kidney disease cause low albumin, leading to fluid imbalances and edema.

Question 29

What conditions can elevate BUN levels, and what impact do they have on nutrition and wound healing?

Answer 29

Renal dysfunction, dehydration, and high protein intake can raise BUN levels, slowing wound healing.

Question 30

How do TLC levels correlate with HIV, and what are the implications for immune function?

Answer 30

Low TLC (<1500/mm³) indicates compromised immune function, increasing vulnerability to infections.

Question 31

How does glucose interfere with vitamin C transport in wound healing?

Answer 31

Elevated glucose interferes with vitamin C transport into fibroblasts and leukocytes, reducing collagen synthesis and immune response.

Question 32

Why is prealbumin a better marker than albumin for short-term nutritional changes?

Answer 32

Prealbumin has a shorter half-life (2-4 days), making it more sensitive to recent dietary changes.

Question 33

What are the clinical implications of total lymphocyte count in surgical patients?

Answer 33

Low TLC in surgical patients is associated with increased infection risk, delayed healing, and higher mortality.

Question 34

How does decreased hemoglobin affect oxygen transport and pressure ulcer risk?

Answer 34

Low hemoglobin impairs oxygen delivery to tissues, increasing the risk of tissue breakdown and pressure ulcers.

Question 35

What is the role of creatine as a marker in evaluating malnutrition and renal function?

Answer 35

Low creatine indicates malnutrition, while elevated creatine suggests impaired kidney function, affecting overall nutritional status.

Question 36

Which of the following lab values is most commonly used as an indicator of short-term nutritional status? * **A**) Serum Albumin * **B**) Prealbumin * **C**) Blood Urea Nitrogen (BUN) * **D**) Total Lymphocyte Count (TLC)

Answer 36

* A (Serum Albumin): Albumin has a longer half-life (around 21 days), so it reflects more long-term nutritional status rather than short-term changes. * **B** (**Prealbumin**): Prealbumin has a short half-life (2-4 days) and is sensitive to short-term changes in nutritional status, making it an ideal marker for recent dietary changes. * C (Blood Urea Nitrogen - BUN): BUN is primarily an indicator of renal function and protein metabolism, not directly of nutritional status. * D (Total Lymphocyte Count - TLC): TLC can reflect immune function and nutritional status over a longer period but is not as sensitive to short-term changes.

Question 37

Elevated levels of which lab value are typically associated with systemic inflammation? * **A**) Serum Albumin * **B**) Hemoglobin * **C**) C-reactive protein (CRP) * **D**) Total Lymphocyte Count (TLC)

Answer 37

* A (Serum Albumin): Serum albumin levels can decrease in inflammatory states but are not a direct marker for inflammation. * B (Hemoglobin): Hemoglobin levels are used to assess anemia and oxygen-carrying capacity, not inflammation. * **C** (**C-reactive protein - CRP**): CRP levels increase in response to systemic inflammation, making it a reliable marker for inflammatory conditions. * D (Total Lymphocyte Count - TLC): While TLC may change due to infections or immune status, it is not a specific marker of inflammation like CRP.

Question 38

When _ is below 12 mg/dL, and _ is below 33%, you're thinking theirs an increased risk of anemia and pressure ulcers? * **A**) Serum Albumin * **B**) Hemoglobin and Hematocrit * **C**) Serum Cholesterol * **D**) Blood Glucose

Answer 38

* A (Serum Albumin): Low serum albumin is associated with edema and protein deficiency, but it is not a marker for anemia. * **B** (**Hemoglobin** and **Hematocrit**): Hemoglobin levels below 12 mg/dL and hematocrit levels below 33% are indicative of anemia, which can increase the risk of pressure ulcers due to reduced oxygen delivery to tissues. * C (Serum Cholesterol): Low serum cholesterol is linked to poor nutrition and ulcer risk but is not directly related to anemia. * D (Blood Glucose): Blood glucose levels are important for managing diabetes and wound healing but do not indicate anemia.

Question 39

Low levels of which lab value may lead to edema due to its role in regulating water flow between plasma and interstitial spaces? * A) Serum Albumin * B) Hemoglobin * C) Blood Urea Nitrogen (BUN) * D) Prealbumin

Answer 39

* **A** (**Serum Albumin**): Serum albumin helps regulate the flow of water between plasma and interstitial spaces. Low levels reduce oncotic pressure, leading to fluid leakage and edema. * B (Hemoglobin): Hemoglobin is responsible for oxygen transport and does not directly influence fluid balance. * C (Blood Urea Nitrogen - BUN): BUN levels indicate kidney function and protein metabolism but do not impact fluid regulation directly. * D (Prealbumin): While prealbumin is a transport protein, it does not play a significant role in water regulation between plasma and interstitial spaces.

Question 40

Which lab value, if less than 160 mg/dL, is associated with poor intake and weight loss, putting a patient at risk for pressure ulcers? * A) Serum Albumin * B) Serum Cholesterol * C) Hemoglobin * D) Blood Glucose

Answer 40

* A (Serum Albumin): Low serum albumin is linked to protein deficiency and edema but is not a marker for weight loss and calorie intake specifically. * **B** (**Serum Cholesterol**): Serum cholesterol levels below 160 mg/dL are associated with malnutrition, poor intake, and weight loss, which increase the risk for pressure ulcers. * C (Hemoglobin): Low hemoglobin indicates anemia, which is related to oxygen transport, not directly to weight loss or pressure ulcer risk. * D (Blood Glucose): Blood glucose levels relate to blood sugar management rather than direct indicators of nutrition intake or pressure ulcer risk.

Question 41

Elevated levels of which lab value suggest kidney dysfunction and are associated with decreased wound healing? * A) Blood Urea Nitrogen (BUN) * B) Hemoglobin * C) Serum Albumin * D) Total Lymphocyte Count (TLC)

Answer 41

* **A** (**Blood Urea Nitrogen** - **BUN**): Elevated BUN levels indicate kidney dysfunction and can negatively impact wound healing due to the buildup of metabolic waste in the body. * B (Hemoglobin): Low, not elevated, hemoglobin levels are associated with anemia, affecting oxygen delivery but not directly linked to kidney function. * C (Serum Albumin): Low albumin levels are typically related to protein deficiency and may indicate malnutrition rather than kidney dysfunction. * D (Total Lymphocyte Count - TLC): Low TLC is associated with immune suppression or malnutrition, but it is not an indicator of kidney function.