LAB VALUES

Question 1

What is the normal value of CREATININE

Answer 1

0.6 to 1.2

Question 2

What lab value monitors coumadin…. Also reflects PT (or Prothrombin time)

Answer 2

2 to 3

Question 3

What lab value of INR do we consider critical?

What do we do?

Answer 3

When it is 4 or above

Action to take in following order … Hold Coumadin ! —> Focus Assessment for bleeding ! —> Prepare to give vit K ! —> Call HCP

Question 4

When do we consider Potassium level “critical”

When is it HIGHEST PRIORITY

Answer 4

If lower tha 3.5
If higher than 5.3

Dangerous when over 6

Question 5

What is low potassium level?

What do we do?

Answer 5

Lower than 3.5

Action to take in the following order … Nothing to hold ! Assess heart
(EKG) ! Prepare to give K+ ! Call HCP

Question 6

What is high potassium level?

What do we do?

Answer 6

A high potassium level is 5.4-5.9

—> Action to take in the following order … Hold K+ !
—> Assess heart (EKG) !
—> Prepare to give Insulin/Kayexelate !
—> Call HCP

Question 7

What is very high Potassium level?

What to do?

Answer 7

6 more more

Action to take in the following order …
—> Hold K+ !
—> Assess heart (EKG) !
—> Prepare to give Insulin/Kayexelate STAT !
—> Call HCP, stay with pt

Question 8

What value of pH is highest priority?

Answer 8

If pH is in the 6s

Question 9

What is the normal BUN level

What does it mean if elevate? What to assess? What to do

Answer 9

Normal level is 8 to 25

Assess dehydration

Action to take …
—> Nothing to hold !
—> Assess for dehydration !
—> Prepare IV fluid !
—> Call HCP

Question 10

What is the nomal Hemoglobin level?
What is considered low Hgb level?
What is considered critical level of Hemoglobin?

Answer 10

Normal: 12-18
Low: 8-11
Critical: <8

Question 11

What is considered a critically low Hemoglobin level?

In critical hemoglobin level, what do we do?

Answer 11

Less than 8

Action to take in level C,
—> nothign to hold
—> assess for bleeding/anemia/malnutrition
—> Prepare blood
—> Call HCP

Question 12

What is the normal BICARBONATE(HCO3) LEVEL?

Answer 12

22 to 26

Question 13

What is considered Level C “critical” CO2 level?

What is the course of action>?

Answer 13

CO2 level C is if in the 50s

Nothinbg to hold
—> Assess for breathing
—> Ask pt to perform purse-lipped breathing
—> Call HCP
(***this lab value does not apply to COPD patients)

Question 14

What is considered Level D “top priority” lab value of CO2

What is the course of action

Answer 14

If CO2 level is in the 60s

Action to take for a Level D … Nothing to hold !
—> Prepare to intubate/ventilate !
—> Call (Respiratory therapy ! HCP), do not leave pt

o This is respiratory failure

Question 15

What are the 5 priority pts based on their lab values

Answer 15

K+ >6
PH in the 6s
CO2 in the 60s
PO2 <60
Platelets <40,000

Question 16

Neutropenic Precautions

Answer 16

Strict handwahsing
Vital q4 hrs
Dedicated stethoscope, BP cuff
Reverse/protective isolatiom
Shower
BID with microbial soap
Avoid crowds
Limit staff/visitors
No fresh flowers/potted plants
No raw fruits/veggies/undercooked meat
No water ptcher standing for over 15 minutes
Check WBC daily
No indwelling catheters
Do not reuse sups or disposable plates

Question 17

Normal RBC value

Answer 17

4-6 million

Question 18

What is the normal value of Platelet (PLT)

When is it considered Level C “critical”?
Whenis it considered Level D “highest priority”?

Answer 18

PLT

Normal: 150,000-450,000
Level C: <90,000
Level D: <40,000

Question 19

It is the lab value we look at in HIV, AIDS patients

Answer 19

CD4

Question 20

CD4 normal level:

CD4 in HIV patients: >200 but <500
CD4 levels in AIDS: <200
When is it considered Level C “critical”: <200

What is the action we take for cd4 (WBC and ANC?)?

Answer 20

Normal level: > 200

CD4 in HIV patients:
CD4 levels in AIDS:
When is it considered Level C “critical”:

Action for WBC, ANC and CD4 … Assess and put on pt neutropenic precautions
o Refer to neutropenic precautions below

Question 21

What is the normal ANC (Absolute neutrophil count)?

When is it considered Level C “critical”? What do we do

Answer 21

Normal ANC: >500

Level C “critical”: <500
When it is <500, Action for WBC, ANC and CD4 … Assess and put on pt neutropenic precautions

Question 22

What is the normal WBC count?

When is it considered Level C “critical”? What do we do?

Answer 22

Normal WB: 4,000-11,000

Level C is <4,000, We assess and put pt on neutropenic precautions

Question 23

What is the normal Sodium (Na) level?

When is it considered Level B “Abnormal”? What do we do
When is it considered Level C “critical”?

Answer 23

Normal Sodium level: 135-145

Level B if abnormal.
Action to take for a Level B… Nothing to hold —>

Question 24

What are the 5 priority pts based on their lab values

Answer 24

1. K+ >6
2. PH in the 6s
3. CO2 in the 60s
4. PO2 <60
5. Platelets <40,000

Question 25

What is thenormal value of phosphorus

Answer 25

3.0-4.5 mg/dL

Question 26

What are causes of hyperphosphatemia

Answer 26

1. Excessive dietary intake of phosphorus 2. Tumor lysis syndrome (a solid tumor bursts open thenr eleases its contents) 3. Renal failure 4. HYpoparathyroidism -> Hypocalcemia -> Hyperphosphatemia

Question 27

What are signs of hypophosphatemia

Question 28

What are the causes of hypophosphatemia

Answer 28

Malnuitrition Alcoholism (impais GI tract to absorb nutrients) TPN Hyperparathyroidism -> hypercalcemia -> hypophosphatemia

Question 29

The nurse is caring for a client with a phosphorus level of 5.0 mg/dL. They know that whoch of the following are possible causes of this condition? SATA A. Tumor lysis syndrome B. Hypoparathyroidism C, Hypercaldemia D. Renal failure E. Superior Vena Cava syndrome

Answer 29

A. Correct B. Hypoparathyroidism causes hypocalcemia = hyperphosphatemia D. Kidneys don’t work well and phosphorus builds up

Question 30

Normal # of Magnesium

Answer 30

1.6-2.6 mg/dL

Question 31

Stored in the bones and cartilage Plays a major role in skeletal muscle contraction Important for ATP formation Activates vitamins Necessary for cellular growth Id directly related to calcium

Answer 31

Magnesium (Mg)

Question 32

What cause hypermagnesemia

Answer 32

Excessive dietary intake Too many magnesium containing medications Over-correction of hypomagsesemia Renal failure

Question 33

What does hypermagnesemia look like

Answer 33

Neuromuscular: weakness, shallow breathing, slowed reflexes, decreasewd deep tendon reflexes Cardiovascular: bradycardia, hypotension, vasodilation (fluthed, feel warm) Neuro: drowsy, lethargy, coma

Question 34

What is the treatment for hypermagnesemia?

Answer 34

Calcium gluconate Dialysis Loop diuretics Treat the cause / hold any fluids containing Mag

Question 35

What are causes of maypomagnesemia

Answer 35

Alcoholism Malnutrition Malabsorption Hypoparathyroidism Hypocalcemia Diarrhea

Question 36

What are S/Sx or Hypomagnesemia

Answer 36

CV: Torsades de pointes*** Neuromuscular: numbness, tingling, cramping, tetany, seizures, increased deep tendon reflexes Neuro: psychosis, confusion GI: nausea, vomiting, abd cramps, anorexia

Question 37

What lab changes causes TORSADE DE POINTES? What is the treatment?

Answer 37

Hypomagnesemia TX: IV PUSH MAGNESIUM, or PO Magnesium hydroxide Monitor cardiac rhythm Treat the cause

Question 38

The nurse is caring for a client with a serum magnesium level of 3.2 mg/dL. They know that which of the following have caused this electrolyte abnormality? SATA a. Renal failure b. ALcoholism c. Anorexia d. Diarrhea e. Malnutrition

Answer 38

A.