Lab Values Flashcards
K
3.5-5.0
INVERSE relationship w/ Na
HYPOkalemia S/Sx
5 L’s
Lethargic Limp muscles (weakness) Lethal dysrhythmias (↑↓ HR, U-wave) Low, shallow respiration Less stool (constipation, ↓ GI motility)
HYPOkalemia Causes
DAANG Cushion
Diuretics ↑ Aldosterone Alkalosis NG suction (lots K+ in stomach) GI loss (V/D) Cushing's syndrome
HYPOkalemia Interventions
PO or IV Potassium (NEVER IV push, Assess UO) Use Spironolactone (K+ sparing)
FOODS: raisins, bananas, apricots, oranges, beans, potatoes, carrots, celery NO digoxin (↑ risk Dig Tox)
HYPERkalemia S/Sx
MURDER
Muscle twitching (1st) → muscle weakness → flaccid paralysis
Urine - Oliguria, Anuria Respiratory distress Decreased HR EKG changes (peaked T, small P waves, PVCs, VFib) Reflexes - hyper/hypo
HYPERkalemia Causes
MARCH
Meds (ACE I, Steroids, Beta Blockers) Acidosis Renal failure (excreted by kidneys) Cellular destruction (burns, crushing injuries, trauma) Hypoaldosteronism - Addison's (↓ adrenal hormones)
HYPERkalemia Interventions
DDICK
Dialysis (impaired kidney)
Diuretics
Insulin + Dextrose (shifts K INTO cells ∴ √ hypokalemia, hypoglycemia)
Ca Gluconate (tx arrythmias)
Kayexalate (↑ excretion, causes diarrhea)
Na
135-145
HYPOnatremia S/Sx
NIMO “Nimo lives in the water”
N
ICP ↑ - confusion, muscle twitching, *seizures
Muscle cramps
Output ↑, USG ↓ (conc of urine)
HYPOnatremia Causes
V/D
DIuretics
Diaphoresis
Excess IV dextrose + water
HYPOnatremia Interventions
IV LR or NS
FOODS: beef broth, tomato juice
↓ Water intake (safest)
I&O, daily WT
HYPERnatremia S/Sx
THUNDER
Temperature (fever) HTN, ↑ HR Urine output (↓), USG (↑) Need water (Thirst, dry tongue) Delusions, hallucinations Edema Restless
HYPERnatremia Causes
D
diabetes insipidous
hyperventilation
hypertonic tube feedings w/o water
HYPERnatremia Intervention
IV hypotonic solutions - 0.3%, 0.45% NaCl, or D5W
Kayexalate (causes diarrhea, ↑ excretion)
Ca
Action
Regulated by
8.6-10
Action: blood clotting, skeletal muscle contraction
Regulation: PARATHYROID hormone + VITA D
HYPOcalcemia S/Sx
EXCITABLE CNS
tetany (muscle spasms)
Trousseau’s sign - carpal spasm w/ BP cuff
Chvostek’s sign - contract facial muscle w/ light tap to facial nerve
↑ DTR, ↓ HR, ↓ BP seizures confusion paresthesia (tingling/ prickling d/t dmg to peripheral nerve) irritability
HYPOcalcemia Causes
hypoparathyroidism, post-thyroid surgery pancreatitis renal failure steroids loop diuretics
HYPOcalcemia Interventions
Ca Gluconate PO CaCl, Vita D Al Hydroxide - ↓ P to ↑ Ca NO digoxin Admin Ca supplement, Vita D
HYPERcalcemia S/Sx
SEDATED CNS
↓ DTR, ↑ HR, ↑ BP muscle weakness lack coordination C, abd distention confusion
HYPERcalcemia Causes
hyperparathyroidism
immobility
HYPERcalcemia Interventions
IV NS ↑ Fluids Furosemide Calcitonin - ↓ Ca levels mobility, ambulation
Mg
Action
1.3-2.3
Mg acts as DEPRESSANT
DIRECT relationship w/ Ca
HYPOmagnesium S/Sx
Low Mg = EXCITABLE CNS
↑ neuromuscular irritability
tremors, tetany, seizures
depression, confusion
dysphagia - assess swallowing
HYPOmagnesium Causes
D
diuretic or laxative abuse
alcoholism
GI suction
HYPOmagnesium Interventions
IV MgSO4
FOODS: green veggies, nuts, bananas, oranges, peanut butter, chocolate
HYPERmagnesium S/Sx
*DEPRESSES CNS* ↓ BP, ↓ DTR, paralysis flushed face muscle weakness shallow respirations
HYPERmagnesium Causes
renal failure Mg hydroxide (antacid)
HYPERmagnesium Interventions
EMERGENCY!! D/C PO and IV MgSO4 support ventilation IV Ca gluconate monitor DTR
RBC
4.2 - 6.2 million/mm3
WBC
5,000 - 10,000
Hgb
13 - 18
Bleeding time
1.5 - 9.5 minutes
PTT (partial thromboplastin time)
Action
Monitors effectiveness of HEPARIN therapy
25-35 seconds
PT (prothrombin time)
Action
Monitors effectiveness of COUMADIN (Warfarin) therapy
9 - 12 seconds
INR
Action
Monitors effectiveness of ANTICOAGULATION therapy
1.0
2 - 3 = Afib, DVT, PE therapy
2.5 - 3.5 = prosthetic heart valves therapy
ESR (erythrocyte sedimentation rate)
Action
Indicated inflammation
0 - 20
Hct
40 - 50%
Increase 4+% in 2wks – HTN, SEIZURES (even if still within norm/low)
PLT
150,000 - 450,000
LDL
NC
HDL
60+
Creatinine
BUN
Creatinine: 0.6 - 1.2
BUN: 7 - 18
Tests renal func
Albumin
Action
Detects protein malnutrition
3.5 - 5.5
ALT/ AST
10 - 40 units
Tests hepatic func
PaCO2
35 - 45
Resp Acidosis = 45+
Resp Alkalosis = 35-
HCO3
22 - 26
Metabolic Acidosis = 22-
Metabolic Alkalosis = 26+
Urine Specific Gravity (USG)
1.01 - 1.03
CVP (Central Cenous Pressure)
3-12 cm of water pressure
2-6 mmHg
Monitors fluid load and effectiveness of fluid replacement therapy
- 12+ cm or 6+mm = HYPERvolemia
- 3-cm or 2-mm = HYPOvolemia
