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FP-C > CBC/BMP/ABG/CMP Lab Values > Flashcards

CBC/BMP/ABG/CMP Lab Values Flashcards

1
Q

White Blood Cells (WBC) -
Normal Range / How You See It

A

NR: 4,000-10,000/L
HYSI: 4 ->10

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2
Q

Red Blood Cells (erythrocytes) -
Normal Range / How You See It

A

NR: 4 -> 6
HYSI: 5

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3
Q

Hemoglobin (a red protein responsible for transporting oxygen in the blood of vertebrates. Its molecule comprises four subunits, each containing an iron atom bound to a heme group) -
Normal Range / How You See It

A

NR: 12 -> 17 g/dL
HYSI: 15

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4
Q

Hematocrit (the ratio of the volume of red blood cells to the total volume of blood) -
Normal Range / How You See It

A

NR: 36 -> 50%
HYSI: 45

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5
Q

Platelets -
Normal Range / How You See It

A

NR: 150,000 - 400,000/L
HYSI: 150 -> 400

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6
Q

CBC Breakdown of WBCs

A

Neutrophils (most common; granules with cytotoxic enzymes)

Basophils (least common; release histamines/heparin)

Eosinophils (discharge cytotoxic enzymes)

Lymphocytes (large; provide specific immunity; move btwn blood/peripheral tissues/lymph organs)

Monocytes (largest; spend a day in bloodstream before going to the peripheral tissues/becoming macrophages)

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7
Q

CBC with Differential - Neutrophils

A

44 -> 70%

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8
Q

CBC with Differential - Basophils

A

0 -> 3%

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9
Q

CBC with Differential - Lymphocytes

A

22 -> 44%

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10
Q

CBC with Differential - Monocytes

A

4 -> 11%

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11
Q

CBC with Differential - Eosinophils

A

0 -> 8%

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12
Q

Complete Blood Count - Basic

A

Labs Include:
- White Blood Cells
- Red Blood Cells
- Hemoglobin
- Hematocrit
- Platelets
- CBC with Differential (break down of WBCs - neutrophils/ basophils/ lymphocytes/ monocytes/ eosinophils)

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13
Q

Arterial Blood Gas - Basic

A

Labs Include:
- pH
- PaCO2
- HCO3
- PaO2
- Base Excess (BE)

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14
Q

Arterial Blood Gas - pH

A

pH: 7.35 -> 7.45

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15
Q

Arterial Blood Gas - PaCO2

A

PaCO2: 35 -> 45 mmHg

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16
Q

Arterial Blood Gas - HCO3

A

HCO3: 22 -> 26 mEq/L

17
Q

Arterial Blood Gas - PaO2

A

PaO2: 80 -> 100 mmHg

18
Q

Arterial Blood Gas - Base Excess (BE)

A

Base Excess (BE): -2 -> +2 mmol/L

19
Q

Basic Metabolic Panel (BMP) - Basic

A

Labs Include:
- Sodium
- Potassium
- Chloride
- Carbon Dioxide
- Blood Urea Nitrogen (BUN)
- Creatinine
- Glucose
- Calcium
-Magnesium

20
Q

BMP - Sodium

A

Normal Sodium: 135 -> 145 mEq/L
- RAS (renin-angiotensin system): controls blood pressure
- Cardiovascular Effects: moves Na+ into the cell for myocardial contraction

ELEVATED/HYPERNATREMIA:
- gain in Na+ ions + loss of water
- >145-155 mEq/L
Sx/Sy:
- ALOC/coma; weakness; irritability; focal neurological decline; seizures
Cx:
- Dehydration (v/d); Diabetes; CHF; Renal/Liver dysfunction; Acclimated person sweating (lose water NOT Na+)
Tx:
- address Cx of water loss/correct water deficit (drink fluids, etc.)
- hypovolemic = normal saline or D5 + 1/2 Normal Saline

LOW/HYPONATREMIA:
- <130-135 mEq/L
Cx:
- GI Suctioning; Over-fluid resuscitation; Addison’s Disease; Burns; Diuretics; Edema
Sx/Sy:
- ALOC/coma; weakness; irritability; focal neurological decline; seizures
Tx:
- 3% saline (SLOWLY over 48-72 hours; rapid correction can cause Central Pontine Myelinolysis (CPEM) which blows myelin sheath off of your neurons)

More Complex Tx:
HYPERNATREMIA as a TREATMENT:
- Want higher (145-155 mEq/L) with TBI/head injury (3% saline or Sodium BiCarb)
- Body will attempt to dilute by pulling edema from brain to vasculature

HYPONATREMIA as a TREATMENT (135 mEq/L bc they are retaining salt already — will activate renin system -> bad):
- CHF / Renal Failure / Liver Disease

21
Q

BMP - Potassium

A

Normal Potassium (K+): 3.5 -> 5 mEq/L
- Assists with Renal Function
- Assists with acid-base balance
- Role in myocardial contraction

HYPERKALEMIA (>5 mEq/L):
- Cx: Acidosis (metabolic — lactic acid); Crush injury / Rhabdo; Lg volume blood admin; Burns (destroys RBCs); Cellular damage; Addison’s Disease (adrenal failure); Penetrating eye trauma (why you cannot give SUX); Renal Dysfunction (acute AND chronic)
- Sy/Sx: fatigue; weakness; palpitations; paralysis
- Clinical Sy/Sx: peaked T wave (more peaked = more severe; sin-wave DANGER!); cardiac pause; bradycardia; ectopic beats; decreased motor strength; decreased deep tendon reflexes; renal failure
- Med Tx: calcium chloride (pulls Ca+ into cell and decreases risk of v-fib); insulin + glucose (pulls glucose into cell and brings K+ with it); sodium bicarb (increases pH -> shifts K+ intracellular); albuterol / beta 2 adrenergic agonists (cells re-uptake K+); diuretics (pulls K+ out through kidney filtration); mag sulfate (indicated for acute OD of slow release oral K+)
- Tx:
— MILD (5-6 mEq/L) = Lasix @ 40-80 mg IV; Kayexalate @ 15-30 in 50-100 mL
— Moderate (6-7 mEq/L) = glucose (25G dextrose) + insulin (10U) over 15-30 mins; sodium bicarb (50 mEq IV over 5 mins); Albuterol (10-20 mg over 15 mins)
— SEVERE (>7 mEq/L) = Calcium Chloride @ 10% 500 mg - 1 G over 2-5 mins; Sodium Bicarb @ 50 mEq over 5 mins; glucose (25G dextrose) + insulin (10U) over 15-30 mins; Albuterol (10-20 mg over 15 mins); diuretics / kayexalate enema / dialysis

HYPOKALEMIA (<2.5 mEq/L):
- Cx: v/d; diuretics (!!!); metabolic alkalosis; kidney dysfunction; excessive sweating; primary aldosteronism; SOME antibiotics
- Sy/Sx: weakness; fatigue; paralysis; respiratory difficulty; leg cramps; orthostatic hypotension
- Clinical Sy/Sx: U waves; flattened T-waves; ventricular arrhythmia; PEA; asystole
- Tx: IV K+ (rate of 10-20 mEq/h WITH ECG MONITORING); cardiac arrest imminent - rapid infusion of K+ (10 mEq IV over 5 mins + DOCUMENTATION OF REASON)

22
Q

BMP - Chloride

A

Normal Chloride (Cl-): 95-105 mEq/L
- Assists with maintaining blood volume
- Assists with fluid balance intra/extra-cellular (works with potassium/sodium/Co2)
- Cardiovascular effects (maintains BP and assists with pH)
- Osmotic Pressure
- Normal anion-cation balance in extracellular space

HYPERCHLOREMIA:
- Cx: dehydration; increased salt intake; renal disease (renal tubular acidosis); Hyperparathyroidism; metabolic acidosis; DI; ASA toxicity
- Sx/Sy: muscle twitching; spasms; weakness; confusion; respiratory distress

HYPOCHLOREMIA:
- Cx: overhydration; SIADH; Addison’s Disease; Metabolic Alkalosis; CHF; frequent/continual vomiting; burns; excess sweating

23
Q

BMP - Carbon Dioxide

A

Normal Carbon Dioxide: 22-30 mmol/L
- NOT: Co2 in lungs!
- IS: Bicarbonate in the blood (produced by kidneys)
- Assesses: imbalance of O2 and CO2; imbalance of pH levels

HIGH Co2:
- Cx: Metabolic alkalosis/Increased HCO3; dehydration; vomiting; blood transfusion; antacid overuse; anorexia; COPD; pulmonary edema; Cushing’s disease; heart and renal failure

Low Co2:
- Cx: metabolic acidosis/decreased HCO3; hyperventilation; ASA/ETOH OD; diarrhea; severe malnutrition; liver and renal disease; post AMI; hyperthyroidism; lactic acidosis; diabetes (uncontrolled -> DKA)

24
Q

BMP - Blood Urea Nitrogen (BUN)

A

Blood Urea Nitrogen (BUN): 6->23 mg/dL

25
Q

BMP - Creatinine

A

Creatinine: 0.6 -> 1.2 mg/dL

26
Q

BMP - Glucose

A

Normal Glucose:
- Neonate (birth to 28 days old): 40-64 mg/dL (Tx at 40)
- Newborn (>24 hours): 42-68 mg/dL
- Child: 60-85 mg/dL (Tx at 60 for infants/kids/adults)
- ADULT: 60 -> 100 mg/dL

HYPOGLYCEMIA:
- Tx:
— ADULT: <60 mg/dL (D50; 25G IV)
— Pediatric: <60 mg/dL (D10 or D25 - 0.5-1 g/kg IV; D25 - 2-4 ml/kg)
— Infants (up to 1 yr): D10; Babies (2-5): 25%; Adult: D50
— Infants + Peds are 2-4 cc/kg

27
Q

BMP - Calcium

A

Normal Calcium: 8 -> 11 mg/dL
- more calcium than all other minerals in body
— 99% stored in bones, also found in blood, muscle and fluid (btwn cells), as heart/nerves/clotting depend on it
— extracted from foods (dairy, leafy greens, fish, tofu, fruit juice)
— excreted from sweat/skin/waste
- causes muscles and vessels to contract and expand
- secretes hormones and enzymes in nervous system

HYPERCALCEMIA:
- Cx: hyperparathyroidism; parathyroid tumors

HYPOCALCEMIA:
- Cx: renal insufficiency; massive blood transfusion; hypomagnesemia

Calcium Tx: rickets; osteomalacia; PMS; leg cramps with pregnancy; pre-eclampsia; Lyme disease; HLD; post gastric by-pass

28
Q

Complete Metabolic Panel (CMP) - Basic

A

Labs Include:
- AST (aspartate aminotransferase; high levels may be a sign of hepatitis, cirrhosis, mononucleosis, or other liver diseases)

  • ALT (alanine transaminase; high levels may be a sign of a liver injury or disease)
  • Alk Phos (alkaline phosphatase; high levels may indicate liver disease or certain bone disorders)
  • Albumin (liver and kidney function)
  • Protein (two types of protein albumin/globulin)
  • Ammonia (high levels may be a sign of hepatic encephalopathy/severe liver disease)
29
Q

CMP - AST

A

AST: 7 -> 40 IU/L

30
Q

CMP - ALT

A

ALT: 0 -> 40 IU/L

31
Q

CMP - Alk Phos

A

Alk Phos: 38 -> 126

32
Q

CMP - Albumin

A

Albumin: 3.5 -> 5.5

33
Q

CMP - Protein

A

Protein: 6.3 -> 8.2

34
Q

CMP - Ammonia

A

Ammonia: 10 -> 50 mmol/L

35
Q

BMP - Magnesium (Mg)

A

Normal Magnesium: 1.3-2.1 mEq/L
- located in bones and inside cells (only slight amt in blood)
- required for: regulation of BP/HR; muscle function; nerve function; enzyme function; assists with body using ATP (resp for 300 biochemical reactions); moves K+/Na+ in and out of cells
- extracted from foods

HYPERMAGNESEMA:
- Cx: dehydration; Addison’s Disease; Chronic Renal Failure; DKA; Oliguria
- Sy/Sx: confusion; diarrhea; nausea; bradycardia; low BP

HYPOMAGNESEMIA:
- Cx: chronic alcoholism/DTs; chronic GI/Crohn’s; diuretics; hemodialysis; cirrhosis; hyperaldosteronism; pancreatitis; elevated insulin; pre-eclampsia; ulcerative colitis
- Rare Cx: heavy menstrual cycle; severe burns; uncontrolled diabetes; excessive sweating
- Sy/Sx: decreased appetite; fatigue; N/V; weakness; numbness/tingling; seizures; muscle cramps; change in personality; dysrrhythmia

FP-C (14 decks)

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