Basics Flashcards
The 8 specific levels that a BMP will test
Serum concentrations of sodium, potassium, chloride, calcium, blood urea nitrogen (BUN), creatinine, glucose, carbon dioxide.
What are the most common lab tests referred to collectively?
Basic Metabolic Panel (BMP)
Comprehensive metabolic panel
Hepatic function panel
Why is Potassium important?
Vitally important in the function of excitable cells (nerve, muscles, heart).
Heart most affected. Leads to arrhythmia or cardiac arrest.
Also causes muscle weakness or irritability.
Respiratory Acidosis
Uncompensated
Compensated
Uncompensated. pH 45. HCO3 normal. Signs. HA, sweating, tachycardia, disorientation, agitation, cyanosis, lethargy, decreased DTRs
Compensated. pH normal. PCO3 >45 HCO3 >26
Signs to look for with potassium imbalance
Dizziness, muscle cramping or weakness, numbness or tingling, and balance issues.
Why is Chloride important?
Changes in chloride levels usually occur with changes in sodium and water.
HCO3- is a critical component in the pH of the blood.
Low HCO3 leads to metabolic acidosis.
Doctors can change the HCO3 levels by means of respiration or renal measures, but renal measures take several days to work.
Why is Sodium important?
Critical determinant of fluid volume in the body.
Under normal circumstances:
Increased sodium = retention of water
Decreased sodium = loss of water
Can be decreased by: taking in excessive fluid or production of anti-diuretic hormone.
Can be increased by: profuse sweating or decreased anti-diuretic hormone.
Increased fluid volume can increase blood pressure and increases in cell volume. Neurons are especially vulnerable to this increase.
Metabolic Acidosis
Uncompensated
Compensated
Uncompensated: pH < 7.35 PCo2 normal HCO3 <22
Signs. Increased respiratory rate.
Metabolic Alkalosis
Uncompensated
Compensated
Uncompensated. pH >7.45. PCO3 normal. HCO3 > 26. Signs. N/V, diarrhea, confusion, irritability, agitation, muscle twitching, muscle cramping, muscle weakness, parenthesis, convulsions, slow breathing.
Compensated. pH normal PCO3 > 45 HCO3 > 26. Signs decreased respiratory rate.
Average reference glucose levels
Adults 70-100 mg/dl
What value is considered hypoglycemic and what action should be taken?
Below 70 and provide them with carbohydrate snack such as OJ, honey, hard candy
Signs of a hypoglycemia
HA, weakness, irritability, lack of muscular coordination, apprehension, inability to respond to verbal commands, psychosis.
Symptoms related to activation of sympathetic nervous system.
Due to a sudden drop in blood glucose levels that might not be below 70 but the sympathetic effects will mirror hypoglycemia.
HA, nervousness, irritability, decreased coordination, shaking, tachycardia, complaints of weakness, decreased responsiveness, psychosis.
Effects on glucose by eating and exercising
Eating with increase glucose, exercise and insulin decrease it.
Be careful with people if they just ate or just had insulin.
What lab values to look at for someone with kidney disease or failure?
BUN, Creatine
Creatinine and kidney function
Normally the skeletal muscle produces a set level of creatinine and the kidneys are able to handle it. If the value goes up that indicates that the kidney function is in decline and/or there was a lot of skeletal muscle damage.
Decreased renal function leads to what change in BUN?
BUN will increase because of decreased renal blood flow.
Could be elevated by protein catabolism or increases protein intake.
What two organs will affect BUN levels
Kidney disease and liver disease
Kidney: increased BUN
Liver: decreased BUN
People that have both at the same time might be normal.
Blood ammonia
By product of breaking down amino acids. Severe liver injury results in the inability to convert ammonia into urea.
Can lead to signs of confusion, lethargy, dementia, tremors, deterioration of speech and fine motor skills.
Normal range for blood ammonia
< 75 mcg/dl
Symptoms of hepatic disease
Altered behavior or mental status, fluctuating levels of consciousness, peripheral edema, right upper abdominal,pain, musculoskeletal pain. Ascities
ALT and AST levels
Measure liver function.
Normal AST: 8-20
Normal ALT: 5-35
Can also be elevated by severe muscle injury. Serum creatine kinase CK-MM can differentiate.
RBC count
Similar way of assessing the capacity of the blood to carry oxygen such as hemoglobin or hematocrit correlating with a person’s endurance and orthostatic tolerance.
Men: 4.5-5.3
Women: 4.1-5.1
Leukocytes
White blood cells, to fight infection, and react against foreign bodies or tissues
Women’s and Men: 4500-11,000
Elevated, fighting infection or high level of inflammation
Depressed, on chemo, bone marrow transplant, or organ transplant. At risk for nosocomial infection.
