Lab Analysis & Diagnostic Flashcards
What is the normal range for sodium (Na)?
135-145 mEq/L
What is the normal range for potassium (K)?
3.5-5 mEq/L
What is the normal range for chloride (Cl)?
96-106 mEq/L
What is the normal range for Carbon dioxide (C02)?
22 - 26 mEq/L
What is the normal range for blood urea nitrogen (BUN)?
8 - 23 mg/dL
What is the normal range for creatinine (Cr)?
0.7 - 1.4 mg/dL
What is the normal range for glucose?
70 - 110 mg/dL
What is hyponatremia?
<135 mEq/L
Caused By: CHF Liver Disease Heavy Exercise Dehydration
[ Below 125 mEq/L can cause behavioral problems, muscle twitching, cardiac abnormalities]
What is hyperkalemia?
> 5.0 mEq/L
Caused By: Tissue breakdown Drug administration Metabolic acidosis Acute renal failure
[EKG will show tall peaked T waves]
What is the treatment for hyperkalemia?
Push K into the cells:
Bicarb, insulin, D 50, albuterol
Get rid of excess K:
Lasix, Kayexalate (poop it out)
[Calcium Gluconate to prevent VTach]
What is hypokalemia?
<3.5 mEq/L
Caused By:
Cellular shift via insulin or hypothermia
Too much Lasix
Causes:
Malaise, weakness, poor dietary intake
[EKG will show depressed, inverted, or flattened T waves]
What is the treatment for hypokalemia?
Oral potassium 60 mEq
IV potassium 10 mEq
[NEVER bolus, rapid administration is fatal]
What are two facts about chloride?
- It is a Extracellular anion
2. It’s shifts with sodium Na
What are two facts about carbon dioxide?
- It’s the same as HC03 on an ABG
2. It’s important for maintaining the acid base balance
What are two facts on blood urea nitrogen (BUN)?
- Helps provide a picture of renal clearance
2. BUN tends to increase with age
What is a fact about creatinine?
High levels can result in permanent kidney damage
What is a fact about glucose?
High levels can potentially result in coma and death
What is Chvostek’s Sign?
The cheek muscle spasms when the facial nerve (CN VII) is tapped
[CN VII is located in front of the ear]
What is Trousseau’s Sign?
Forearm tetany when BP cuff is inflated
[Treat with Calcium Gluconate]
What is anion gap acidosis and how is it factor?
It’s the “Poor man’s ABG“
Sodium, chloride, bicarb are factor together to determine the anion gap
What is a normal anion gap?
12 (+/-4)
[If >15 the patient has an anion gap metabolic acidosis]
What is MUDPILES?
Methanol uremia DKA Propylene glycol Isoniazid iron Ethylene glycol Salicylates
What is GOLDMARK?
Glycols Oxyproline L-Lactate D-Lactate Methanol Aspirin Renal Failure Ketoacidosis
What is a complete blood count?
Red blood cells
5 million
Hemoglobin
15 g/dL
Hematocrit
45%
White Blood cells
4500/uL - 11,000/uL
Platelets
150K/uL - 400K/uL
What are some additional lab values?
Total protein
6.0 - 8.0 g/dL
Albumin
3.5 - 5.5 g/dL
Lactate
0.5-1 mmol/L
Amylase
25-125 Units/L
Lipase
5-60 Units/L
Osmolality
275 - 295 mOsm/L
Urine Output “2/1/0.5” Infant 2 ml/kg/hr Child 1 ml/kg/hr Adult 0.5 ml/kg/hr [Average for adults is 30 - 50 ml/hr]
What triggers intrinsic pathways?
Endothelial damage with collagen exposure
What triggers extrinsic pathways?
Damaged tissue/organs
What drugs affect the coagulation panels?
Heparin (Lovenox) and Coumadin (Warfarin)
What is a liver function test?
It measures the levels of protein enzymes in Bilirubin in your blood
What does a liver function test consist of?
Alanin transaminase (ALT) 7 - 55 units/L
Aspartame transaminase (AST) 8 - 48 Units/L
Alkaline phosphatase (ALP) 45 - 115 Units/L
Albumin
3.5 - 5.5 g/L
Bilirubin
0.1 - 1.2 mg/dL
How low is pH, when a patient is in severe shock?
pH <7.2
How bad is your CO2 during ventilatory failure?
CO2 >55
How bad is your PaO2 during an Oxygenation Failure?
PaO2 <60
What is the pH in CO2 formula?
For every 10mmHg of ETCO2, the pH will change 0.08 the OPPOSITE direction
What is the pH and bicarb formula?
For every 0.15 in pH, the HCO3 will change 10 mmol/L the SAME direction
What is the pH and potassium formula?
Every PH change of 0.10, the K will shift 0.6 the OPPOSITE direction
What is the CO2 and potassium formula?
Every see CO2 change of 10 mmHg, changes K by 0.5 mEqs in the SAME direction
If your PAO2 is 40, What is your SAO2?
70