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IV Therapy, Fluids, Electrolytes & Lab Values > Lab Values > Flashcards

Lab Values Flashcards

1
Q

What is BUN?

A

Blood Urea Nitrogen

Nitrogen in blood from the waste product UREA and is produced when protein is broken down in our bodies.

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2
Q

BUN: expected range

A

10-20 mg/dL

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3
Q

Complications related to BUN > 20 mmol/L

A

Kidney disease
Dehydration
Other conditions that decrease blood flow to kidneys (CHF, MI, shock)

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4
Q

What is creatinine?

A

Creatinine is the waste product produced by normal breakdown of muscles in our bodies.

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5
Q

Creatinine: expected range

A

0.6 - 1.2 mg/dL

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6
Q

Increased creatinine levels are indicative:

A

Kidney Dysfunction

*Fun fact: Creatinine is a more accurate assessment of kidney function than BUN.

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7
Q

What is GFR?

A

Glomerular Filtration Rate

GFR is used to assess kidney function by measuring how much blood passes through the glomeruli/min.

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8
Q

GFR: expected range

A

> 90 mL/min

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9
Q

GFR ranges r/t stages of CKD (chronic kidney disease):

A

Stage 1 = > 90 mL/min; minimal kidney damage

Stage 2 = 60-89 mL/min; mild kidney damage

Stage 3 = 30-59 mL/min; moderate kidney damage

Stage 4 = 15-29 mL/min; severe kidney damage

Stage 5 = < 15 mL/min; kidney failure

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10
Q

What is INR?

A

International Normalized Ratio

Ratio of patient’s prothrombin time (PT)… (aka patient’s clotting time) to a control PT; used to assess effectiveness of warfarin (anticoagulant) therapy.

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11
Q

INR: expected range

A

08 - 1.1

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12
Q

INR: therapeutic range on warfarin therapy

A

2 - 3

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13
Q

Elevated INR is indicative of:

A

Warfarin therapy
Bleeding disorders
Liver disease
Sudden decrease in Vitamin K intake (antidote to warfarin)

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14
Q

What is PT?

A

Prothrombin time

Clotting time; extrinsic and common pathways in coagulation cascade

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15
Q

PT: expected range

A

11 - 13 seconds

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16
Q

PT: therapeutic range on warfarin

A

(1.5 - 2 times the baseline)

Approx. 17 - 26 seconds

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17
Q

Increased PT would be indicative of:

A

DIC (disseminated intravascular coagulation)
Liver disease
Vitamin K deficiency
Clotting factor deficiency

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18
Q

What is aPTT?

A

Activated partial thromboplastin time

Clotting time; intrinsic system and common pathways in coagulation cascade

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19
Q

aPTT: expected range

A

30 - 40 seconds

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20
Q

aPTT: therapeutic range on warfarin

A

(1.5 - 2 times the baseline)

Approx. 45 - 80 seconds

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21
Q

Increased aPTT would be indicative of:

A

Heparin therapy
DIC (disseminated intravascular coagulation)
Hepatic disease

*Fun fact: Protamine sulfate is the antidote to heparin.

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22
Q

What is ALT?

A

Alanine aminotransferase

This is an enzyme produced by the liver and important in metabolism.

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23
Q

ALT: expected range

A

4 - 36 units/L

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24
Q

Increased ALT would be indicative of:

A

Liver dysfunction

*Fun fact: ALT is more specific to the liver than AST.

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25
Q

What is AST?

A

Aspartate aminotransferase

This is an enzyme found mostly in the liver, but also in the muscles.

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26
Q

AST: expected range

A

0 - 35 units/L

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27
Q

Increased AST is indicative of:

A

Liver dysfunction

Tissue damage in the body (heart, skeletal muscle)

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28
Q

What is pH?

A

Measure of hydrogen ion (H+) concentration in our blood.

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29
Q

pH: expected range

A

7.35 - 7.45

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30
Q

Increased pH is indicative of:

A

Alkalosis

  • Respiratory alkalosis = pH > 7.45 & PaCO2 < 35
  • Metabolic alkalosis = pH > 7.45 & HCO3 > 26
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31
Q

Decreased pH is indicative of:

A

Acidosis

  • Respiratory acidosis = pH < 7.35 & PaCO2 > 45
  • Metabolic acidosis = pH < 7.35 & HCO3 < 22
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32
Q

What is PaO2?

A

Partial pressure of oxygen

Measure of oxygen pressure in our arterial blood.

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33
Q

PaO2: expected range

A

80 - 100 mmHg

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34
Q

Decreased PaO2 is indicative of:

A

Poor oxygenation in arterial blood due to COPD, pneumonia, asthma, pneumothorax, acute respiratory distress, and failure.

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35
Q

What is PaCO2?

A

Partial pressure of carbon dioxide

Measure of carbon dioxide in our arterial blood.

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36
Q

PaCO2: expected range

A

35 - 45 mmHg

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37
Q

Increased PaCO2 is indicative of:

A

Respiratory or metabolic alkalosis (<35)

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38
Q

Decreased PaCO2 is indicative of:

A

Respiratory or metabolic acidosis (>45)

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39
Q

What is HCO3?

A

Bicarbonate “bicarb”

This is an important buffer regulated by our kidneys.

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40
Q

HCO3: expected range

A

22 - 26 mEq/L

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41
Q

Increased HCO3 is indicative of:

A

Respiratory or metabolic acidosis (>26)

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42
Q

Decreased HCO3 is indicative of:

A

Respiratory or metabolic alkalosis (<22)

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43
Q

What could be the cause of respiratory alkalosis due to a decrease in PaCO2?

A

Hyperventilation

Compensation for metabolic acidosis

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44
Q

What could be the cause of respiratory acidosis due to an increased PaCO2?

A

Hypoventilation

Compensation for metabolic alkalosis

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45
Q

What could be the cause of metabolic acidosis due to a decreased HCO3?

A

DKA (diabetic ketoacidosis)
Kidney failure
Diarrhea
Compensation for respiratory alkalosis

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46
Q

What could be the cause of metabolic alkalosis due to an increased HCO3?

A

Excess antacids
Vomiting
NG suctioning
Compensation for respiratory acidosis

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47
Q

What is SaO2?

A

Oxygen saturation of hemoglobin

Amount of oxygen bound to hemoglobin in our arterial blood.

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48
Q

SaO2: expected range

A

95 - 100%

Low 90s for COPD patients

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49
Q

Decreased SaO2 is indicative of:

A

Hypoxemia (abnormally low oxygen level in blood) due to: Anemia
COPD
Pneumonia
Asthma
ARDS (acute respiratory distress syndrome)
Pneumothorax
Pulmonary edema

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50
Q

What is Na and its expected range?

A

Sodium - important electrolyte for nerve/muscle function and maintaining fluid balance.

135 - 145 mEq/L

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51
Q

What Na range is indicative of hyponatremia?

A

<135 mEq/L

52
Q

What Na range is indicative of hypernatremia?

A

> 145 mEq/L

53
Q

What is K and its expected range?

A

Potassium - important electrolyte for maintaining ICF (intracellular fluid and the regulation of heart/muscle contractions.

3.5 - 5 mEq/L

54
Q

What K range is indicative of hypokalemia?

A

<3.5 mEq/L

55
Q

What K range is indicative of hyperkalemia?

A

> 5 mEq/L

56
Q

What is Ca and its expected range?

A

Calcium - important electrolyte for bone/teeth formation, muscle/nerve function, and clotting.

9 - 10.5 mg/dL

57
Q

What Ca range is indicative of hypocalcemia?

A

<9 mg/dL

58
Q

What Ca range is indicative of hypercalcemia?

A

> 10.5 mg/dL

59
Q

What is Mg and its expected range?

A

Magnesium - important electrolyte for nerve/muscle function and biochemical rx in our bodies.

1.3 - 2.1 mEq/L

60
Q

What Mg range is indicative of hypomagnesemia?

A

<1.3 mEq/L

61
Q

What Mg range is indicative of hypermagnesemia?

A

> 2.1 mEq/L

62
Q

What is Cl and its expected range?

A

Chloride - important electrolyte for maintaining fluid balance and component of digestive juices.

98 - 106 mEq/L

63
Q

What Cl range is indicative hypochloremia?

A

<98 mEq/L

64
Q

What Cl range is indicative of hyperchloremia?

A

> 106 mEq/L

65
Q

What is P and its expected range?

A

Phosphorus - important electrolyte for bone/teeth formation, metabolism, and protein synthesis.

3 - 4.5 mg/dL

66
Q

What P range is indicative of hypophsphatemia?

A

<3 mg/dL

67
Q

What P range is indicative of hyperphosphatemia?

A

> 4.5 mg/dL

68
Q

What is CKMB and its expected range?

A

Creatine kinase MB

This is an enzyme found primarily in heart muscle and is released with heart damage.

ER = 0% of creatine kinase

69
Q

Increased CKMB is indicative of:

A

Damage to the heart due to ischemia (blood flow and oxygen restricted/reduced in a part of the body).

70
Q

What is Troponin T and its expected range?

A

This is a protein in heart muscle fibres and released with heart muscle injury.

<0.1 ng/mL

71
Q

Increased Troponin T is indicative of:

A

Damage to the heart due to ischemia.

*Fun fact: Troponin T is the most specific and reliable cardiac enzyme to diagnose a myocardial infarction.

72
Q

What is Troponin I and its expected range?

A

This is a protein in heart muscle fibres and released with heart muscle injury.

<0.03 ng/mL

73
Q

Increased Troponin I is indicative of:

A

Damage to the heart due to ischemia.

74
Q

What is Myoglobin and its expected range?

A

This is an oxygen-binding protein found in heart and skeletal muscles.

<90 mcg/L

75
Q

An increased Myoglobin is indicative of:

A

Myocardial infarction

Muscle damage/inflammation

76
Q

What is Cholesterol and its expected range?

A

This is a waxy, fat-like substance.

*Fun fact: Excess cholesterol in the blood can combine with other substances to form plaque and lead to atherosclerosis (thickening/hardening of arteries due to plaque build-up).

77
Q

What is LDL and its expected range?

A

Low density lipoprotein that can lead to a build-up of cholesterol in the arteries.

<130 mg/dL

*TIP: Think “L” for “lousy cholesterol”.

78
Q

Increased LDL is indicative of:

A

Increased risk for atherosclerosis
Heart disease
Myocardial infarction

79
Q

What is HDL and its expected range?

A

High density lipoproteins that carry cholesterol from other parts of the body back to the liver where it can be removed from the body.

Females: >55 mg/dL
Males: >45 mg/dL

80
Q

Decreased HDL is indicative of:

A

Increased risk of heart disease

81
Q

What are Triglycerides and its expected range?

A

This is a type of fat; extra calories are turned into triglycerides and stored in fat cells.

Females: 35 - 235 mg/dL
Males: 40 - 160 mg/dL

82
Q

Increased Triglycerides is indicative of:

A

Increased risk for atherosclerosis
Heart disease
Myocardial infarction

83
Q

What is hBNP and its expected range?

A

Human B-type natriuretic peptides

This is a hormone produced in our ventricles and released in response to fluid overload.

<100 pg/mL (no heart failure)

84
Q

What is RBC and its expected range?

A

Red blood cells

Circulating cells that transport oxygen to the body’s cells.

Females: 4.2 - 5.4 million/uL
Males: 4.7 - 6.1 million/uL

85
Q

Increased RBCs is indicative of:

A

Polycythemia (increased RBCs)

Severe dehydration

86
Q

Decreased RBCs is indicative of:

A

Anemia
Hemorrhage
Kidney disease

87
Q

What is WBC and its expected range?

A

White blood cells

Part of our body’s immune system; WBCs fight infection and disease.

5 000 - 10 000 mm3

88
Q

What is the term for increased WBCs, the range, and indications:

A

Leukocytosis >10 000 mm3

Infection
Inflammation

89
Q

What is the term for decreased WBCs, the range, and indications:

A

Leukopenia <5 000 mm3

Autoimmune disease
Bone marrow suppression
Drug toxicity

90
Q

What are the types of WBCs and their percentage in circulation?

A 
Neutrophils 40-60%
Lymphocytes 20-40%
Monocytes 2-8%
Eosinophils 1-4%
Basophils 0.5-1%
91
Q

What causes an increase in neutrophils?

A

Acute bacterial infections

92
Q

What causes an increase in lymphocytes?

A

Chronic bacterial or viral infections

93
Q

What causes an increase in monocytes?

A

Protozoal and viral infections
Tuberculosis
Chronic inflammation

94
Q

What causes an increase in eosinophils?

A

Allergic reactions

Parasite infections

95
Q

What causes an increase in basophils?

A

Leukemia

96
Q

What are platelets and its expected range?

A

Blood cell fragments used to form clots in the body (to stop bleeding).

150 000 - 400 000 mm3

*Note: low platelets = high risk of bleeding

97
Q

What causes a decreased in platelets?

A

Hemorrhage
Leukemia
Splenomegaly

98
Q

What causes an increased platelet count?

A 
Polycythemia (increased RBCs)
Inflammatory diseases
Infection
Cancer
Splenectomy
99
Q

What is Hgb and its expected range?

A

Hemoglobin

Iron-rich protein in RBCs that carry oxygen.

Females: 12 - 16 g/dL
Males: 14 - 18 g/dL

100
Q

What causes decreased Hgb?

A

Anemia
Hemorrhage
Kidney disease

101
Q

What causes increased Hgb?

A

COPD

Severe dehydration

102
Q

What is Hct and its expected range?

A

Percentage of the blood made up of RBCs

Females: 37 - 47%
Males: 42 - 53%

103
Q

What causes a decreased Hct?

A

Anemia
Hemorrhage
Kidney disease

104
Q

What causes an increased Hct?

A

COPD

Severe dehydration

105
Q

What is D-Dimer and its expected range?

A

This is a protein fragment from the breakdown of a blood clot.

<0.4 mcg/mL (negative/normal result)

106
Q

What is Amylase and its expected range?

A

This is an enzyme produced in the pancreas and salivary glands, and helps to digest carbohydrates.

30 - 220 units/L

107
Q

What is Lipase and its expected range?

A

This is a protein released by the pancreas into the small intestine and helps the body absorb fat.

0 - 160 units/L

108
Q

What is Bilirubin (total) and its expected range?

A

This is a yellow substance found in bile and produced during normal breakdown breakdown of RBCs.

0.3 - 1 mg/dL

109
Q

What is Albumin and its expected range?

A

This is a protein made by the liver and important for keeping fluid in the bloodstream.

3.5 - 5 g/dL

110
Q

What is Prealbumin and its expected range?

A

This is a protein made by the liver and important for transport of substances and synthesis of other proteins.

15 - 36 mg/dL

111
Q

What is “total protein” and its expected range?

A

This is the total of albumin and globulin in the fluid portion of the blood.

6.4 - 8.3 g/dL

112
Q

What is Ammonia and its expected range?

A

This is a waste product produced by the body during digestion of protein.

10 - 80 mcg/dL

113
Q

What is CRP and its expected range?

A

C-Reactive Protein

This is a protein made by the liver and released into the bloodstream during inflammation.

<3 mg/dL

114
Q

What is Urine Specific Gravity and its expected range?

A

Compares the density of urine to the density of water

1.010 - 1.025

*Note:
<1.010 = dilute urine
>1.025 = concentrated urine

115
Q

What is Urine Osmolality and its expected range?

A

Urine concentration; amount of dissolved substances in urine

300 - 900 mOsm/kg

*Note:
Decreased levels = dilute urine
Increased levels = concentrated urine

116
Q

What is Serum Osmolality and its expected range?

A

Measures the amount of dissolved substances in the liquid part (plasma) of the blood.

275 - 295 mOsm/L

*Note:
<275 = dilute blood
>295 = concentrated blood

117
Q

What is T3 and its expected range?

A

Triiodothyronine

Hormone produced by thyroid gland and regulates metabolism and growth.

70 - 204 ng/dL

*Note:
Decreased levels = hypothyroidism
Increased levels = hyperthyroidism

118
Q

What is T4 and its expected range?

A

Thyroxine

Hormone produced by thyroid gland and regulates metabolism and growth.

4 - 12 mcg/dL

*Note:
Decreased levels = hypothyroidism
Increased levels = hyperthyroidism

119
Q

What is TSH and its expected range?

A

Thyroid Stimulating Hormone

Hormone produced by the pituitary gland that regulates the amount of hormones released by the thyroid gland.

0.5 - 5 mU/L

*Note:
Decreased levels = hyperthyroidism
Increased levels = hypothyroidism

120
Q

What is PSA and its expected range?

A

Prostate-Specific Antigen

This is a protein produced by the prostate gland cells.

<4 ng/mL

*Note:
Increased levels could indicate presence of prostate cancer or benign prostatic hypertrophy (BPH).

121
Q

What is the expected range for urine output?

A

> 30 mL/hr

*Note:
Decreased output can be indicative of shock, infection, or trauma. Notify HCP.

122
Q

What is the diagnostic criteria for diabetes?

A

Fasting blood glucose = >126 mg/dL
Casual blood glucose = >200 mg/dL
2 hr Oral glucose tolerance test = >200 mg/dL
HgbA1C = >6.5%

123
Q

What are the expected ranges of blood glucose?

A

Fasting = <100 mg/dL
2 hr Oral glucose tolerance = <140 mg/dL
HgbA1C = < 6%

124
Q

What is the lab value for hypoglycemia?

A

<75 mg/dL blood glucose

125
Q

What is the lab values for DKA and HHS (hyperglycemic-hyperosmolar state)?

A 
DKA = > 300 mg/dL blood glucose
HHS = > 600 mg/dL blood glucose
126
Q

What is the expected range for CO (cardiac output)?

A

4 - 8 L/min

127
Q

What is the expected range for ICP (intracranial pressure)?

A

10 - 15 mmHg

IV Therapy, Fluids, Electrolytes & Lab Values (3 decks)

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