π βHemoglobin holds the oxygen of life.β
π¨οΈ Hemoglobin (Hb) is the iron-containing protein in red blood cells (RBCs) responsible for transporting oxygen from lungs to tissues and carbon dioxide back to lungs.
π₯ Population Group | π― Normal Range (g/dL) |
---|---|
π¨ Adult Male | 13.5 β 17.5 g/dL |
π© Adult Female | 12.0 β 15.5 g/dL |
π€° Pregnant Women | 11.0 β 12.0 g/dL |
π§ Children | 11.0 β 13.5 g/dL |
πΆ Infants (0β1 year) | 10.0 β 12.5 g/dL |
πΌ Newborns | 14.0 β 24.0 g/dL |
π» Causes:
πΉ Symptoms: Fatigue, pallor, SOB, dizziness
πΊ Causes:
πΉ Symptoms: Headache, ruddy skin, high BP, visual disturbance
βοΈ Collect venous blood sample with EDTA tube (purple cap)
βοΈ Avoid hemolysis by gentle handling
βοΈ Monitor signs of anemia or hypoxia
βοΈ Educate on diet rich in iron (e.g., green leafy, red meat)
βοΈ Follow-up for iron supplements or transfusion
β
Q: What is the normal Hb level in adult females?
π
°οΈ 12β15.5 g/dL
β
Q: What tube is used for Hb test?
π
°οΈ EDTA (lavender/purple)
β
Q: What is a major symptom of low Hb?
π
°οΈ Fatigue and pallor
β
Q: Hb level in pregnancy is considered normal if…?
π
°οΈ β₯11.0 g/dL
β
Q: Hb >17.5 in male may suggest…?
π
°οΈ Polycythemia
β These values are part of Complete Blood Count (CBC) and help classify anemia types.
π Measures | π― Interpretation |
---|---|
Average size of RBCs | |
πΉ Normal: 80β100 fL | |
πΈ β MCV = Microcytic anemia | |
πΈ β MCV = Macrocytic anemia |
π Measures | π― Interpretation |
---|---|
Average amount of hemoglobin per RBC | |
πΉ Normal: 27β33 pg | |
πΈ β MCH = Hypochromia | |
πΈ β MCH = Macrocytic (often) |
π Measures | π― Interpretation |
---|---|
Hemoglobin concentration in RBCs | |
πΉ Normal: 32β36 g/dL | |
πΈ β MCHC = Hypochromic | |
πΈ β MCHC = Spherocytosis (rare) |
π Measures | π― Interpretation |
---|---|
Variation in RBC size (anisocytosis) | |
πΉ Normal: 11.5β14.5% | |
πΈ β RDW = Mixed RBC populations (e.g., iron + B12 deficiency) |
π©Έ RBC Indices | π§ͺ Suggestive Anemia |
---|---|
β MCV, β MCH | Iron deficiency |
β MCV, Normal MCHC | Megaloblastic (B12/Folic acid) |
Normal MCV, β Hb | Normocytic normochromic (e.g., acute blood loss) |
β RDW | Mixed anemia or early deficiency state |
βοΈ Monitor signs & symptoms: fatigue, pallor, SOB, tachycardia
βοΈ Collect CBC samples using EDTA tube
βοΈ Educate on dietary sources:
π Iron β red meat, spinach
π₯ B12 β eggs, milk
π½ Folic acid β leafy greens, cereals
βοΈ Administer iron, folic acid, or B12 supplements
βοΈ Prepare for blood transfusion if ordered
β
Q: What does MCV measure?
π
°οΈ Average size of red blood cells
β
Q: What type of anemia is seen in iron deficiency?
π
°οΈ Microcytic hypochromic
β
Q: MCV >100 fL suggests…?
π
°οΈ Macrocytic (Megaloblastic) anemia
β
Q: Which index is increased in mixed anemia?
π
°οΈ RDW (Red cell distribution width)
β
Q: What is the normal range for MCHC?
π
°οΈ 32β36 g/dL
π§« βHealthy liver, healthy life β test, detect, protect.β
π¨οΈ Liver Function Test (LFT) is a panel of blood tests used to assess the health and function of the liver by measuring enzymes, proteins, and waste products.
β Helps detect liver inflammation, damage, obstruction, infection, or liver failure.
𧬠Test Name | π Normal Range | π― Purpose |
---|---|---|
ALT (SGPT) | 7β56 U/L | Liver cell injury indicator |
AST (SGOT) | 10β40 U/L | Detects liver/muscle damage |
ALP (Alkaline Phosphatase) | 44β147 U/L | Bile duct/liver/bone disease |
Total Bilirubin | 0.3β1.2 mg/dL | Measures liver’s ability to clear bilirubin |
Direct Bilirubin | 0.1β0.3 mg/dL | Conjugated bilirubin (obstruction) |
Indirect Bilirubin | 0.2β0.8 mg/dL | Unconjugated bilirubin (hemolysis) |
Total Protein | 6.0β8.3 g/dL | Overall protein status |
Albumin | 3.5β5.0 g/dL | Synthesized by liver β indicates function |
Globulin | 2.3β3.5 g/dL | Immune protein β changes in liver disease |
Prothrombin Time (PT) | 11β13.5 sec | Coagulation time β affected in liver failure |
βοΈ Jaundice (yellow skin/eyes)
βοΈ Abdominal pain (RUQ)
βοΈ Alcohol abuse or hepatitis
βοΈ Drug-induced liver injury
βοΈ Monitoring cirrhosis, fatty liver, hepatitis B/C
βοΈ Pre-operative evaluation
π Finding | π‘ Possible Condition |
---|---|
β ALT & AST | Hepatitis, liver injury |
β ALP | Bile duct obstruction, bone disease |
β Bilirubin (Total/Direct) | Jaundice, gallstones, liver failure |
β Albumin | Chronic liver disease, malnutrition |
β PT/INR | Liver failure (β clotting factor synthesis) |
βοΈ Ensure fasting if ordered (for bilirubin)
βοΈ Collect venous blood sample (plain/red-top tube)
βοΈ Avoid hemolysis during collection
βοΈ Monitor signs: jaundice, ascites, bruising, itching
βοΈ Educate on liver-friendly diet (low fat, no alcohol)
βοΈ Administer prescribed hepatoprotective meds
βοΈ Record/report abnormal findings immediately
πΈ Avoid alcohol before test
πΈ Do not take hepatotoxic medications (unless advised)
πΈ Use unclotted sample for accurate testing
β
Q: What does ALT primarily indicate?
π
°οΈ Liver cell damage
β
Q: What is the normal range for total bilirubin?
π
°οΈ 0.3β1.2 mg/dL
β
Q: Low albumin in LFT indicates…?
π
°οΈ Chronic liver disease
β
Q: Which enzyme is elevated in bile duct obstruction?
π
°οΈ ALP (Alkaline Phosphatase)
β
Q: Prothrombin Time is prolonged in…?
π
°οΈ Liver failure
π KIDNEY FUNCTION TEST (KFT) π
π§ͺ βFilter check for life β test your kidneys before itβs too late.β
π¨οΈ Kidney Function Tests (KFT) are a group of blood and urine tests used to assess how well the kidneys are filtering waste, balancing fluids, and regulating electrolytes.
β These tests help detect renal dysfunction, failure, and systemic diseases affecting the kidneys.
π¬ Test | π― Normal Range | π― Significance |
---|---|---|
Serum Creatinine | 0.6 β 1.2 mg/dL | Measures glomerular filtration ability |
Blood Urea Nitrogen (BUN) | 7 β 20 mg/dL | Waste from protein breakdown |
BUN/Creatinine Ratio | 10:1 β 20:1 | Differentiates pre-renal and renal failure |
Uric Acid | M: 3.4β7.0 mg/dL F: 2.4β6.0 mg/dL | Elevated in gout, renal dysfunction |
eGFR (Estimated Glomerular Filtration Rate) | >90 mL/min/1.73 mΒ² | Indicates filtration rate (best renal marker) |
Electrolytes (NaβΊ, KβΊ, Clβ», HCOββ») | NaβΊ: 135β145 mmol/L KβΊ: 3.5β5.0 mmol/L | Assesses fluid and electrolyte balance |
Calcium (CaΒ²βΊ) | 8.5 β 10.5 mg/dL | May decrease in chronic kidney disease |
Phosphate | 2.5 β 4.5 mg/dL | Often increased in renal failure |
Urine Output | >0.5 mL/kg/hr | Critical in ICU monitoring |
Urinalysis | Clear, protein-negative, no blood | Detects infection, proteinuria, hematuria |
π§ͺ Result | β οΈ Possible Indication |
---|---|
β Creatinine | Renal failure, dehydration, nephrotoxic drugs |
β BUN | High protein intake, renal dysfunction, GI bleed |
β eGFR (<60) | Chronic Kidney Disease (CKD) |
β Uric acid | Gout, renal dysfunction |
Protein in urine | Early sign of kidney disease |
β Calcium / β Phosphorus | Chronic renal failure (mineral imbalance) |
βοΈ Hypertension
βοΈ Diabetes mellitus
βοΈ Edema, puffiness
βοΈ Frequent urination or retention
βοΈ Flank pain
βοΈ Monitoring nephrotoxic drugs (e.g., aminoglycosides)
βοΈ Before contrast imaging or major surgery
βοΈ Collect fasting blood sample in plain/red-top tube
βοΈ Collect 24-hour urine sample if ordered
βοΈ Maintain intakeβoutput chart accurately
βοΈ Educate on low-protein, low-sodium renal diets
βοΈ Monitor for fluid overload or electrolyte imbalance
βοΈ Report abnormal findings to physician promptly
π« Avoid high-protein meals before testing
π« Some medications (e.g., diuretics, NSAIDs) may alter results
π« Always check hydration status before interpreting BUN/Cr
β
Q: What is the best marker for kidney function?
π
°οΈ eGFR
β
Q: Normal range of serum creatinine in adults?
π
°οΈ 0.6β1.2 mg/dL
β
Q: Which value increases in chronic kidney disease?
π
°οΈ Phosphate and creatinine
β
Q: What is the critical urine output to monitor in ICU?
π
°οΈ > 0.5 mL/kg/hour
β
Q: BUN/Creatinine ratio >20:1 suggests…?
π
°οΈ Pre-renal causes like dehydration
π βWhen the heart cries, biomarkers speak.β
π¨οΈ Cardiac biomarkers are enzymes, proteins, or hormones released into the bloodstream when the heart muscle is damaged, such as during a myocardial infarction (MI) or other cardiac events.
β Used for diagnosis, monitoring, and prognosis of heart conditions.
𧬠Biomarker | β±οΈ Time of Rise | π Peak Time | β³ Return to Normal | π― Normal Range | π― Clinical Use |
---|---|---|---|---|---|
Troponin I (TnI) | 3β6 hrs | 14β20 hrs | 5β10 days | < 0.04 ng/mL | Most specific marker for MI |
Troponin T (TnT) | 3β6 hrs | 12β48 hrs | 10β14 days | < 0.01 ng/mL | Detects even small infarcts |
CK-MB (Creatine Kinase β Myocardial Band) | 4β6 hrs | 12β24 hrs | 2β3 days | < 3β5 ng/mL | Useful for reinfarction detection |
Myoglobin | 1β3 hrs | 6β9 hrs | 24 hrs | < 85 ng/mL | Early but nonspecific marker |
BNP (B-type Natriuretic Peptide) | Variable | Variable | Variable | < 100 pg/mL | Diagnosis of heart failure |
NT-proBNP | Variable | β | β | < 300 pg/mL (age-dependent) | Prognostic in heart failure |
LDH (Lactate Dehydrogenase) | 12β24 hrs | 48β72 hrs | 7β14 days | 100β190 U/L | Used when troponin not available |
CRP (C-Reactive Protein, hs-CRP) | Non-specific | β | β | < 1 mg/L (low risk) | Indicates inflammation, risk of MI |
πΉ Most specific and sensitive
πΉ Rise within 3β6 hours of heart muscle damage
πΉ Remain elevated for days (great for late diagnosis)
πΉ Not influenced by skeletal muscle injury
π Marker Elevated | π‘ Indication |
---|---|
β Troponin I/T | Acute MI, myocarditis |
β CK-MB + Troponin | MI or reinfarction |
β BNP/NT-proBNP | Heart failure |
β Myoglobin (early) | Muscle injury (cardiac or skeletal) |
β CRP | Systemic inflammation, MI risk |
βοΈ Chest pain > 20 minutes
βοΈ Shortness of breath, sweating
βοΈ History of CAD, hypertension
βοΈ Post-surgical cardiac monitoring
βοΈ Heart failure symptoms (fatigue, edema, orthopnea)
βοΈ Collect blood sample in timely manner (serially at 0, 3, 6, 12 hrs)
βοΈ Use correct tubes (serum separator or lithium heparin)
βοΈ Handle specimen gently (avoid hemolysis)
βοΈ Monitor vital signs, chest pain characteristics
βοΈ Educate patient on heart attack symptoms
βοΈ Report abnormal values urgently to physician
β
Q: What is the most specific cardiac marker for MI?
π
°οΈ Troponin I
β
Q: Which marker rises first after myocardial injury?
π
°οΈ Myoglobin (1β3 hrs)
β
Q: BNP is used to assess…?
π
°οΈ Heart failure
β
Q: CK-MB returns to normal within…?
π
°οΈ 2β3 days
β
Q: Elevated CRP levels indicate…?
π
°οΈ Inflammation and cardiovascular risk
π« βTime is muscle β quick action saves the heart.β
π¨οΈ Myocardial Infarction (MI) is the death of heart muscle (myocardium) due to sudden blockage of coronary artery, leading to oxygen deprivation and tissue necrosis.
πΉ Crushing chest pain (radiating to arm/jaw)
πΉ Shortness of breath (dyspnea)
πΉ Sweating (diaphoresis)
πΉ Nausea, vomiting
πΉ Fatigue, anxiety
πΉ Cold, clammy skin
πΉ Hypotension or arrhythmia
π©Ί Nursing Action | π‘ Rationale |
---|---|
β Monitor vital signs & ECG | Detect arrhythmia, monitor perfusion |
β Administer oxygen (2β4 L/min) | Increase oxygen supply to myocardium |
β Administer medications as ordered | MONA: |
π M β Morphine | |
π O β Oxygen | |
π N β Nitrates (Nitroglycerin) | |
π A β Aspirin | |
β Start IV line | Administer fluids, emergency meds |
β Ensure bed rest (Semi-Fowlerβs) | β oxygen demand, improve breathing |
β Assess chest pain (PQRST) | Monitor for recurrence or worsening |
β Prepare for cardiac catheterization | Identify and open blocked artery |
β Collect cardiac markers (Troponin, CK-MB) | Confirm MI diagnosis |
π©Ί Nursing Action | π‘ Rationale |
---|---|
β Monitor I/O | Detect renal perfusion, fluid overload |
β Daily weight & lung sounds | Monitor for heart failure (crackles, edema) |
β Provide low-sodium, low-fat diet | Reduce cardiac workload |
β Administer anticoagulants / beta-blockers | Prevent thrombus, reduce workload |
β Promote deep breathing & coughing | Prevent pneumonia, maintain lung function |
β Reduce stress & anxiety | Prevent catecholamine surge |
π©Ί Nursing Action | π‘ Rationale |
---|---|
β Gradually increase activity | Enhance cardiac conditioning |
β Educate on lifestyle changes | Smoking cessation, diet, exercise |
β Medication teaching | Importance of antiplatelets, statins, beta-blockers |
β Referral to cardiac rehab | Structured recovery plan with monitored exercise |
β Teach warning signs of MI | Early intervention in future episodes |
π Drug Class | π§ͺ Example | π― Purpose |
---|---|---|
Antiplatelet | Aspirin, Clopidogrel | Prevent clot formation |
Nitrates | Nitroglycerin | Dilate vessels, relieve pain |
Beta-blockers | Metoprolol | β HR & BP, β oxygen demand |
ACE inhibitors | Enalapril, Ramipril | Prevent remodeling, lower BP |
Statins | Atorvastatin | Lower cholesterol, stabilize plaque |
Anticoagulants | Heparin, Enoxaparin | Prevent new clots |
π΄ Arrhythmias (V-tach, V-fib)
π΄ Heart failure
π΄ Cardiogenic shock
π΄ Recurrent MI
π΄ Pericarditis
π΄ Pulmonary edema
β
Q: What is the immediate drug given in MI for pain?
π
°οΈ Morphine
β
Q: What does MONA stand for?
π
°οΈ Morphine, Oxygen, Nitrates, Aspirin
β
Q: What position improves oxygenation in MI?
π
°οΈ Semi-Fowlerβs
β
Q: Which enzyme is most specific for MI?
π
°οΈ Troponin I
β
Q: What is the major goal of MI nursing care?
π
°οΈ Relieve pain and restore myocardial perfusion
Would you like a step-by-step MI nursing care plan, MI medication chart, or continue with topics like Heart Failure Nursing Care, Cardiac Rehab Teaching Plan, or ECG Changes in MI? ππβ€οΈβπ₯π§
PULMONARY FUNCTION TEST
Here is your complete and colorful guide to π Pulmonary Function Test (PFT) π, presented in your favorite structured, emoji-enriched, and exam-focused style β ideal for respiratory assessment, nursing diagnostics, and competitive exams π―ππ«π§ͺ
π« βMeasure the breath β understand the lungs.β
π¨οΈ Pulmonary Function Test (PFT) refers to a group of non-invasive tests that measure how well the lungs work, including lung volume, capacity, flow rates, and gas exchange efficiency.
β Used for diagnosis, monitoring, and evaluation of respiratory conditions.
βοΈ Diagnose lung diseases (asthma, COPD, fibrosis)
βοΈ Evaluate shortness of breath
βοΈ Monitor treatment effectiveness
βοΈ Pre-operative assessment (especially in thoracic surgery)
βοΈ Detect occupational lung diseases
βοΈ Differentiate between obstructive vs restrictive disorders
π§ͺ Test Type | π§ What It Measures | π‘ Use |
---|---|---|
Spirometry | Airflow in and out of lungs | Detects obstruction/restriction |
Lung Volume Test | Total lung size & subdivisions | Diagnoses restrictive disorders |
Diffusion Capacity (DLCO) | Gas transfer efficiency across alveoli | Used in fibrosis, emphysema |
Peak Flow Meter (PEFR) | Maximum speed of exhalation | Asthma self-monitoring |
Arterial Blood Gases (ABG) | Oxygen, COβ, pH in blood | Assesses gas exchange and acid-base status |
Pulse Oximetry | Oxygen saturation (SpOβ) | Screening and continuous monitoring |
π Parameter | π― Normal Value | π Significance |
---|---|---|
FVC (Forced Vital Capacity) | β₯ 80% predicted | Total air exhaled forcefully |
FEVβ (Forced Expiratory Volume in 1 sec) | β₯ 80% predicted | Air expelled in first second |
FEVβ/FVC Ratio | > 0.7 (or 70%) | Distinguishes between obstructive/restrictive disease |
PEFR (Peak Expiratory Flow Rate) | Age/sex dependent | Measures maximal speed of exhalation |
π Finding | π‘ Possible Condition |
---|---|
β FEVβ, β FEVβ/FVC | Obstructive (asthma, COPD) |
β FVC, normal FEVβ/FVC | Restrictive (fibrosis, obesity, scoliosis) |
β DLCO | Emphysema, pulmonary fibrosis |
β PEFR | Asthma exacerbation |
π©ββοΈ
βοΈ Explain procedure and demonstrate breathing techniques
βοΈ Instruct patient to avoid smoking/caffeine 6 hrs before test
βοΈ Hold bronchodilators as ordered
βοΈ Ensure proper seal of mouthpiece during spirometry
βοΈ Monitor for dizziness, fatigue, SOB during test
βοΈ Document any pre-existing conditions or medications
π« Recent chest/abdominal surgery
π« Recent myocardial infarction (MI)
π« Hemoptysis of unknown origin
π« Pneumothorax
π« Uncooperative or very young patient
β
Q: What is the main test to diagnose obstructive lung disease?
π
°οΈ Spirometry
β
Q: What does FEVβ measure?
π
°οΈ Volume of air exhaled in first second
β
Q: What FEVβ/FVC ratio indicates obstruction?
π
°οΈ < 70%
β
Q: What test measures gas exchange efficiency?
π
°οΈ DLCO (Diffusing capacity)
β
Q: Which test can be done at home by asthma patients?
π
°οΈ Peak Flow Meter (PEFR)
𧬠βHormones in balance β tests reveal the secret messengers.β
π¨οΈ Endocrine function tests are blood, urine, or stimulation/suppression tests that help assess the functioning of endocrine glands and the hormone levels they produce.
β Used to diagnose hormonal imbalances, gland dysfunction, and endocrine disorders.
π§ Gland | π Key Tests | π§ͺ Hormones Checked |
---|---|---|
Pituitary | Serum ACTH, GH, TSH, LH, FSH | Growth hormone (GH), ACTH, TSH, LH, FSH, prolactin |
Thyroid | T3, T4, TSH, TRH stimulation | TSH, Free T4, T3 |
Parathyroid | Serum calcium, PTH | Parathyroid hormone, CaΒ²βΊ, phosphate |
Adrenal | Serum cortisol, ACTH stimulation, DHEA, aldosterone, renin | Cortisol, Aldosterone, Androgens |
Pancreas | Fasting blood sugar, HbA1c, insulin, C-peptide | Insulin, Glucagon |
Ovaries/Testes | Estrogen, Progesterone, Testosterone, LH/FSH | Sex hormones |
π§ͺ Test | π Purpose |
---|---|
Serum GH | Assess gigantism/acromegaly |
Serum ACTH | Stimulates cortisol production |
TSH, FSH, LH, Prolactin | Evaluate anterior pituitary function |
Water deprivation test | Assesses ADH (diabetes insipidus) |
π§ͺ Test | π Normal Range |
---|---|
TSH | 0.4 β 4.0 mIU/L |
Free T4 (FT4) | 0.8 β 2.8 ng/dL |
T3 (Total or Free) | 80 β 180 ng/dL |
Thyroid Antibodies (TPO, TgAb) | For autoimmune thyroiditis |
π§ Used to diagnose hypothyroidism, hyperthyroidism, goiter, thyroiditis
π§ͺ Test | π Normal Value |
---|---|
PTH (Parathyroid Hormone) | 10 β 65 pg/mL |
Serum Calcium | 8.5 β 10.5 mg/dL |
Phosphorus | 2.5 β 4.5 mg/dL |
Vitamin D | 20β50 ng/mL (affects CaβΊ regulation) |
π§ͺ Test | π Normal Value |
---|---|
Serum Cortisol (AM) | 6 β 23 mcg/dL |
ACTH Stimulation Test | β cortisol = normal response |
Dexamethasone Suppression Test | For Cushingβs syndrome |
Aldosterone / Renin Ratio | For Connβs syndrome (hyperaldosteronism) |
Serum DHEA-S | For adrenal androgen excess |
π§ͺ Test | π Normal Value |
---|---|
Fasting Blood Glucose (FBS) | 70 β 100 mg/dL |
HbA1c | < 5.7% (Normal) 5.7β6.4% (Pre-DM) β₯ 6.5% (Diabetes) |
Serum Insulin | 2 β 20 Β΅IU/mL |
C-Peptide | Differentiates type 1 & 2 DM |
Glucose Tolerance Test (GTT) | Tests body’s response to glucose |
π©ββοΈ
βοΈ Explain the test, fasting requirements (especially for glucose, cortisol, GH)
βοΈ Ensure rest before cortisol or GH tests
βοΈ Time-based sample (e.g., morning cortisol)
βοΈ Use correct sample tubes (EDTA, plain, fluoride)
βοΈ Monitor for hypoglycemia or hypertension during dynamic tests
βοΈ Document medication history (steroids can alter cortisol tests)
β
Q: Which test is used for thyroid hormone monitoring?
π
°οΈ TSH
β
Q: What is the best test for diabetes diagnosis?
π
°οΈ HbA1c
β
Q: What hormone is elevated in Cushing’s syndrome?
π
°οΈ Cortisol
β
Q: Water deprivation test is used to diagnose…?
π
°οΈ Diabetes insipidus
β
Q: What does a high TSH with low T3/T4 indicate?
π
°οΈ Primary hypothyroidism