Lab Flashcards
NA+
Sodium 135-145
Primary extracellular cation
Helps nerves and muscles contract
K+
Potassium 3.5-5.0
Primary intracellular cation
Most dangerous abnormality
Cell excitability
CL-
Chlorine 96-106
Extracellular anion
Tends to shift with NA+
Hypochloremia impending renal dysfunction
CO2
22-26
Helps maintain acid-base balance
BUN
Blood urea nitrogen
8-23 mg/dl
Provides picture of renal clearance
Tends to increase with age
Creatinine (CR)
.7- 1.4 mg/dl
High levels = permanent kidney damage
Glucose
70-110
High levels = coma/death
Calcium
8.5-10.2
Most essential electrolyte in body
Hypercemia
Kidney transplant, hyperparathyrodism, tb
Hypocalcemia
Alcoholism, pancreatitis, renal failure
Cvosteks sign
Cheek muscle spasms with facial nerve
Trousseaus sign
Forearm tetany with no cuff
Treat with calcium glucanate
Ionized calcium
4.5-5.6
Decreased levels from receiving blood transfusions
Sepsis and low albumin
Anion gap
Poor man’s abg
Sodium, chloride and bicarbonate factored together
Normal = 12 (+-4)
Large number is bad
Replacement formula
.1 x (-be) x kg = bicarbonate required
Therapy for anion gap trt with bicarbonate
RBCS,hmglobin, hematocrit
5/15/45
WBCs
4500-11000 ul
Low = seen in sepsis destroyed at rate that exceeds production
High= inflammation, infection and trauma
Platelets
150-400k ul
Total protien
6-8 g/dl
Albumin and immunoglobulins
Albumin
3.5-5.5 g/dl
Produced by liver, transport protein
Coagulation intrinsic pathway
Triggered by endothelial dmg
Platelets activate
Initiates clotting
Formation of clot
Dissolves 7-10days
Coagulation panel
PT 10-13 sec (prothrombin time extrinsic)
PTT 25-40 sec (partial thromboplastin time intrinsic)
INR .9-1.3 sec (international normalized ratio)
“Pt do outside”
Heparin/lovenox
Affects intrinsic pathway
Overdose trt with Protamine Sulfate
Coumadin (warfarin)
Affects extrinsic pathway
Overdose with vitamin k
Extrinsic pathway
Damaged tissue
Release tissue thromboplastin
Highest in Brain and placenta
Platelets arrive
Initiate clotting
Form clot
7-10 days dissolve
ALT
Alanine transaminase
7-55 units per liter
AST
Aspartame transaminase
8-48 u l
Increase indicate liver damage or disease
Alkaline phosphotase
45-115
Increase indicates damage
Albumin
Decrease levels indicate liver damage
Lactate
.5-1 mmol/L
Hyper= 2-4
Lactic acidosis 4-5
Most commonly caused by decrease blood flow to cells
Amylase
25-125
Test used for pancreatitis
>300
Lipase
5-60
Test used to detect pancreatitis
Urine 2/1/.5
Infant 2ml/hr
Child 1 ml/hr
Adult .5 ml/hr
Average output is 30/50ml/hr
Electrical burs/ rabdo 100ml/hr
DKA
Common in type 1
Glu>350 occasionally exceeds 800
Ella Ted ketones, metabolic acidosis
Kussmal respirations
DKA TRX
Bolus insul .1
Inufusion .1
Do not lower glucose <100
Hhnk
Common type 2
Extremely elevated glu> 600
Non ketonix, non acidotic and no kussmal
Hhnk trx
7-10 liter deficient
Insulin bolus and infusion
Glu not <100
DI
Kidneys are unable to conserve water
Central/neuro DI
ADH no longer produced by pituitary gland
Nephrgenic DI
Kidneys do not respond to AHD
Caused by Dilantin Od and head injuries
DI trx
Fluid resuscitation and DDAVP