LAB VALUES Flashcards
sodium levels
135-145
hypernatremia: dextrose 5% for acute, 0.45 for chronic hypernatremia
potassium levels
3.5-5
NEVER push IV! NEVER BY GRAVITY
- HYPERKALEMIA = TALL, PEAKED T WAVES
-
NEVER more than 40 of potassium per liter of IV fluid = If more than 40, question & clarify with
DOC first!
if doctor writes 60 of potassium, call and clarify
POTASSIUM CHLORIDE
- it irritates vein and can cause discomfort so if client report discomfort, SLOW IT DOWN. don’t stop it
- it is prescribed for clients taking furosemide to prevent hypokalemia
potassium chloride of IV should be a max of 10mEq over 1 hour (10 mmol/hr)
- KCL OF 20-40 SHOULD BE ADMISTERED THROUGH A CENTRAL LINE
- minimum of 10, max of 40 and should be giving on infusion pump so that the rate can be regulated
PH AND POTASSIUM
- inverse relationship. as one goes up, the other goes down
POTASSIUM SPARING DIRETICTS
- SAME
- Sprinolactone
- Amiloride
- Milrinone
- Eplerenone
calcium levels
9 -10.5
CHVOSTEK AND TROUSSEAU = both due to LOW CALCIUM (UP symptoms)
-
Chvostek sign: when you touch their CHEEK, they go into a spasm of the face (neuromuscular
irritability associated with a LOW calcium) -
Trousseau sign: when you put a blood pressure cuff on, blow it up & they go into a spasm of
the hand.
LOW CALCIUM ANTIDOTE: phosphorus, calcitonin, IV biphosphonates
BUN (blood urea nitrogen) levels
6-20
- nitrogen waste products in the blood
- IF HIGH, NO BIG DEAL = ASSESS THEM FOR DEHYDRATION
- poor renal perfusion
CAN BE ELEVATED BY
- nsaids
- dehydration = check them for this if elevated. especially if vomiting and losing a lot of fluids
creatinine level
0.6-1.3 (same range as lithium)
- best indicator to determine kidney/RENAL function
- NEVER PRIORITIZE A PERSON WITH HIGH CREATININE AS YOUR HIGHEST PRIORITY but should watchout when taking aminoglycosides
- if taking a mycin = elevated will be a priority cus they cause nephrotoxicity
- to test for creatinine clearance, 24 hour urine is needed
LOW PRIORITY BUT…
if the pt is going for a test/procedure (the next morning) that involves a DYE; but it is not priority to let
them know (it can wait until 6am/7am).
- MAINTAIN ADEQUATE FLUID BEFORE AND AFTER contrast media is given ( also closely monitor kidney function )
magnesium levels
1.3 to 2.1 = monitor reflexes and respiration
remember magnesium do opposite of prefix
LOW MAGNESIUM = TORSADE DES POINTES
glycosylated hemoglobin (HbA1c)
average glucose rate over 3 months = BEST INDICATOR FOR LONG TERM BLOOD GLUCOSE CONTROL
- can still be tested when the client is not fasting
normal is 4-6 in non diabetics
5.7-6.4 prediabetic
people with diabetes, we wanna keep this LESS THAN 7
- 7 = need to check on it (evaluation)
- 8 and above = OUT OF CONTROL
INR/ PT
INR = 0.75 - 1.25
PT: 11-16
- therapeutic range when receiving warfarin is 2-3
- therapeutic is genrally 1.5-2 times control value
- therapeutic range for clients with mechanical heart valve is 2.5 to 3.5
anything over 4, hold warfarin
Prothrombin time = 11-16 seconds
—————————
- anything above 4 is high priority ( don’t ignore, do something )
CHECK INR BEFORE GIVING WARFARIN
- INR of 4.2 will be a higher priority than a creatinine of 30
- INR monitors warfarin/coumadin therapy
———————
A PATIENT HAS INR OF 4.7
- hold coumadin
- assess for bleeding
- prepare to give vitamin K
- call doc
- sometimes there’s nothing to HOLD, so jump to ASSESS.. sometimes there’s nothing to
PREPARE, so jump to CALL - but you should always go through the process in your mind, so
you don’t miss a step
NG TUBE IRRIGATION ML
30-50
STEPS
- measure the length of the ng tube from bridge of the nose to earlobe to xiphoid process (THIS ONLY APPLIES TO CHILDREN OVER 1 YEAR)
- lubricate the tip of the NG tube
- insert the ng tube in the nare pushing it gently back and down toward the ear
- encourage the patient to swallow few sips of water and advance the NG tube past the oropharyn
- secure the NG tube at the pre-measured mark
for children under 1 year= measure to the midpoint of the xiphoid process
SHOULD BE CLAMPED FOR 30 MINUTES AFTER MEDICATION ADMINISTRATION
- does not require patient to stay in bed
paralytic ileus
when the abdominal wall is distended.
MAINTAIN THEM ON NPO ( reason why ng tube is needed)
interruption of peristalsis. NG tube is put in to decompress the stomach and relieve pressure from the ileus
- this complication occurs after surgery from anesthesia used during abdominal surgery
aPTT levels
- normal: 25-35 seconds
- therapeutic: 1.5-2 times the normal = 46-70
glucose levels
70-110
less than 70 is hypoglycemia
NEWBORN less than 24hrs = 40-60. lower is a concern
- if newborn is asymptomatic and has low blood glucose = FEED THEM
- cold stress in newborns can cause hypoglycemia!
1 HOUR GLUCOSE TEST
- does not require fasting
- is a screening test not diagnostic test
- the nurse draws one blood sample an hour after ingestion of 50-g glucose
STRESSED INDUCED HYPERGLYCEMIA
- for critically ill, goal is to keep glucose 140-180
white blood count range
5k to 11k
hemoglobin levels
male: 14 to 18
female: 12 to 16
- if low 8-11 = assess them for anemia (bleeding or malnutrition)
- if even lower than 8 = do something = ASSESS for bleeding, PREPARE to administer blood and CALL DOCTOR
MANIFESTATIONS OF VERY LOW HEMOGLOBIN (SEVERE ANEMIA)
- dyspnea
- pallor
- tachycardia
HEMATOCRIT
men 41-50
women 38-48
hemoglobin and hematocrit are both increased in burns
phosphate
2.4-4.4
hyperphosphatemia is controlled with calcium acetate which binds to the phosphate in foods and excretes it through feces
