Ch 7 Lab values Flashcards
Important baseline of a patient’s basic physiology
Metabolic panel
Metabolic panel measures __ analytes and calculates an anion gap
8
Used to assess kidney status, electrolyte, acid/base balance, and blood glucose
Metabolic panel
Changes in serum sodium most often reflect changes in _____ balance rather than sodium balance
water
Sodium
Hyponatremia (<136) may indicate
over hydration
Sodium
Hypernatremia (>145) may indicate
Need for water
Concentration of nitrogen (as urea), produced in the liver and is the end product of protein metabolism filtered by the kidneys
BUN
Test used to help diagnose liver and kidney diseases
Urea Nitrogen (BUN)
Low BUN (6-8 mg) may be a sign of
Overhydration or liver disease
Normal range of BUN
10-20 mg
BUN, implies serious impairment of renal function
50-150 mg
Percentage of calcium found in blood
1%
90% of hypercalcemia is caused by:
Malignancy
Hyperparathyroidism
Used to evaluate the acid-base balance of blood
Carbon Dioxide
High CO2 is seen in
Respiratory acidosis
Low CO2 is seen in
Respiratory alkalosis
Used as a confirmatory test to identify fluid balance and acid-base abnormalities
Chloride
Hyperchloremia is seen in
Dehydration and acidemia
Hyperchloremia is seen in
Dehydration and acidemia
Hypochloremia is seen in
Vomiting, over hydration and alkalemia
Produced in muscle. Filtered by the kidneys, levels can be used to measure renal insufficiency.
Creatinine
Regulates muscle and nerve excitability
Potassium
Primary cause of Hyperkalemia (potassium) is:
Renal Failure
Hypokalemia (potassium) is seen with
Alkalosis, diuretic use, alcoholism, fluid loss
Low magnesium can cause:
Refractory hypokalemia
Involved in metabolism and energy production. It is needed for normal muscle contractility and neurologic functions as well as oxygen-carry by hemoglobin
Phosphorus
Measure liver injury
ALT and AST
Components of a Liver Function Test
Albumin
Alkaline phosphates
Bilirubin
ALT/AST
Total protein
Helps maintain plasma oncotic pressure. Long half life of 20 days.
Decreased levels may be due to any liver condition affecting protein synthetization.
Albumin
Group of enzymes
Alkaline phosphates
4x rise of alkaline phosphates with no rise in ALT/AST is indicative of:
Biliary disease
Levels less than 4x of alkaline phosphates with elevated ALT/AST is indicative of:
liver damage
Byproduct of breakdown of heme pigments in RBC
Bilirubin
Elevated levels of bilirubin are responsible for:
Jaundice
Used to assess hepatocellular damage
AST/ALT
Ratio of AST to ALT may be of value in diagnosing:
Alcoholic hepatitis
AST is also found in:
Cardiac muscle, skeletal muscle, kidneys, brain, lungs, intestines
Screening for nutritional deficiencies and gammopathies
Total protein
Increase in total protein is seen with:
Myeloma
Hypovolemia
Decrease in total protein is seen in:
Malnutrition
Liver diseases
Severe skin diseases
A lipid profile measures:
Total cholesterol
HDL
LDL
Triglycerides
Lipid panel may be ordered if there is specific concern about:
Cardiovascular disease (CAD)
It is recommended that all adults over ___ get a fasting lipid screening every 5 years
20
Collection term for blood tests used to check the function of the thyroid
Thyroid Function Tests (TFTs)
Critical Values of TFTs that should be reported quickly
Extremely high or low
Most accurate reflection of thyrometabolic status.
High levels = Hyperthyroidism
Low levels = Hypothyroidism
Free Thyroxine (T4)
Glycoprotein secreted by the anterior pituitary gland.
Tests assesses true metabolic status.
High = Hypothyroidism Low = Hyperthyroidism
Thyroid-stimulating hormone (TSH)
Glucose that gives the big picture of the average levels over the past 2 to 3 months
A1C
Normal glucose
70-100mg
Critical value low glucose
<40
Critical value high glucose
> 500mg with no history of DM
Best indication of glucose homeostasis
Fasting glucose
Prediabetes range
100-125
Glucose range for provisional diagnosis of diabetes
> 126
Confirmed diagnosis of diabetes
> 126 on 2 separate occasions
Major cause of high glucose
DM type 1/2
Excessive intake
Major cause of low glucose
Insulin overdose
Sulfonylureas or other hypoglycemic drugs
An A1C >___% suggests poor glucose control
6.5%
Protein located in the cardiac muscle
Increase is indicative of an acute MI
Troponin
Enzyme found primarily in the cardiac muscle
CK-MB
Troponin and CK-MB rise within 3-12 hours of symptoms and peak at:
24 hours
Critical value:
Low sodium
<120
Critical Value
High Sodium
> 160
Critical value:
Low Calcium
<6.0
Critical value:
High calcium
> 14
Critical value:
Low Creatinine
None
Critical value:
High Creatinine
> 3.0
Critical Value:
Low Potassium
<2.5
Critical value:
High Potassium
> 6.5
Critical value:
Low Magnesium
<1.2
Critical value
High Magnesium
> 4.9
