exam 1 misc labs Flashcards
BMP components
- glucose
- BUN
- Cr
- Na
- K
- Cl
- CO2
Indications for order BMP
basic lab information for a patient on IV hydration check for the adequacy of hydration patients on diuretics are monitored check kidney function assessing the acid-base balance Electrolyte levels Glucose levels
creatinine is produced as result of what
protein turnover in muscular tissue
BUN is …
by product of protein metabolism in the liver
BUN to Cr ratio
10:1
BUN and Cr are excreted by what organ
kidneys
if kidney fx is reduced, what happens to bun and Cr
they build up in the blood
higher concentrations usually indicate worsening kidney fx
GFR formula
calculated from Cr, age, body size, and gender
GFR used for staging what
kidney disease
adjusted GFR
depends on if they are AA or non-AA
BUN is produced in what organ
liver
what happens to BUN in severe liver failure
reduced
BUN can be raised by what
a heavy protein load in the diet
upper GI bleeding
Dehydration – most often seen in PCP
Does dehydration cause BUN and Creatinine to rise at the same time?
In dehydration, filtration of
no
BUN is effected before that of creatinine, so BUN rises out of proportion to creatinine
Calcium is controlled by what
calcitonin and parathyroid hormone
small alterations in ca can lead to what
major dysrhythmias and neuromuscular symptoms
calcium concentration is proportional to what
phosphate
calcium is absorbed in what
the gut
calcium is stored where
98% skeletal system
2% bone
50% is reionized calcium, so this means it is active and 50% is bound to protein- primarily the proten in albumin
calcium is excreted by
primarily the kidneys
bicarbonate aka HCO3- is measure of what
acid base balance
bicarbonate is largely controlled by what organ
kidneys
chloride is useful for what
assessing acid-base balance
used to calculate the anion gap
chloride is inversely r/t what levels
bicarbonate levels
do chloride levels increase or decrease with dehydration
increase
what electrolytes are vital in maintaining proper cardiac and NM fx
Na+
K+
sodium levels elevate with what
- dehydration
- excessive h2o intake
- vomiting
potassium decreases whit what
diuretics
K+ increases with
renal disease
unneeded K supplementation
glucose controlled by what
insulin and glucagon
glucose increases with
- DM
- Cushing’s syndrome
- acute stress
- cortiocosteriod therapy
- chronic renal failure
glucose decreases with
- hypothyroidism
- Addison’s disease
- insulin overdose
CMP includes
BMP labs, calcium, and liver enzymes
liver fx labs included in CMP
- albumin
- AST
- ALT
- bilirubin
- alkaline phosphatase
purpose of liver fx labs in CMP
to detect asymptomatic liver disease
ex- hep C, fatty steatosis, early alcoholic liver disease, metastatic liver disease
also used to follow progression of liver disease after dx
check for complications of meds
hypercalcemia may indicate
dysfx of parathyroid gland, bone CA, hyperthyroidism, sarcoidosis, TB, excessive vit D
hypocalcemia may indicate
ca deficiency, magnesium deficiency, high phosphorus, pancreatitis, kidney failure, malnutrition, alcoholism
calcium measurement
8.5 - 10.2 mg/dL
total protein measurement
5.0 - 8.3 gm/dl
total protein is measurement of what
measures the total amount of protein in blood plasma
total protein used to determine
nutritional status, presence of kidney or liver disease, edema
increased total protein indicates
hepatitis or chronic inflammatory disease
decreased total protein associated with
malnutrition, malabsorption, or bleeding disorder
increased sodium levels
dehydration, hyperventilating, or some kind of kidney disease
decreased Na + levels
heart disease, poor fx of adrenal glands, liver disease
potassium stimulates what
muscle contraction
increased levels of K+
seen in Addison’s disease, HD
ppl with DM are also likely to have high levels of K+ in bloodstream
decreased levels of K+ - you see these kind of things with it
vomiting, muscle spasms, dehydration
CO2, bicarbonate
results that fall outside WNL range typically indicate electrolyte imbalance, usually the result of dehydration
chloride range
98-107
are chloride levels increased or decreased with dehydration
increased
BUN range
10-20
bun stands for what
blood urea nitrogen
increased BUN levels indicate what
the kidneys are having trouble filtering out
high BUN is seen with
high protein diets, certain ATBs (eg tobramycin), bleeding
low BUN is seen with
liver disease, low protein consumption, severe muscle injury, pregnancy
CMP includes all of following accept:
a. Na
b. tests of liver fx
c. INR
d. total protein
INR
Blood culture and sensitivity
done to determine the presence or absence of bacteria in the blood
blood is collected in culture medium and allowed to incubate for a specified period of time - usually 24 hours
the mixture is placed on culture medium to identify any bacterial organisms that might be in the blood.
Determines what meds the bacteria is sensitive too
uses for blood cx and sensitivity
- results help guide tx so that narrower spectrum ATBs can be used
- when the source of infection is not easily available (ie IE)
- source of fever cannot be determined
a positive blood culture result might occur in which of the following situations?
a. viral PNA
b. renal failure
c. viral enteritis
d. bacterial pyelonephritis
d
