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MedSurg Nursing; N1110 > Lab Values > Flashcards

Lab Values Flashcards

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1
Q

What is the normal range for potassium?

A

3.5 - 5.0 mEq/L

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2
Q

What is the normal range for sodium?

A

136 - 145 mEq/L

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3
Q

What is the normal range for calcium?

A

9.0 - 10.5 mg/dL

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4
Q

What is the normal range for glucose?

A

70 - 100 mg/dL

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5
Q

What is the normal range for creatinine?

A

0.6 - 1.2 mg/dL

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6
Q

What is the normal range for blood urea nitrogen?

A

10 - 20 mg/dL

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7
Q

What is the normal range for chloride?

A

98 - 106 mEq/L

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8
Q

What is the normal range for total CO2 (Carbon Dioxide Content)?

A

23 - 30 mEq/L

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9
Q

What is the normal value for estimated Glomerular Filtration Rate (eGFR)?

A

> 60 mL/min

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10
Q

When is sodium considered critically low?

A

< 120 mEq/L

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11
Q

When is sodium considered critically high?

A

> 160mEq/L

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12
Q

When is potassium considered critically low?

A

< 3.0 mEq/L

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13
Q

When is potassium considered critically high?

A

> 6.1 mEq/L

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14
Q

When is glucose considered critically low?

A

< 40 mg/dL

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15
Q

When is glucose considered critically high?

A

> 450 mg/dL

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16
Q

What is the normal range for total protein?

A

6.4 - 8.3 mg/dL

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17
Q

What is the normal range for albumin?

A

3.5 - 5.0 g/dL

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18
Q

What is the normal range for bilirubin?

A

0.3 - 1.0 mg/dL

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19
Q

What is the normal range for Alkaline Phosphatase (ALP)?

A

30 - 120 units/L

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20
Q

What is the normal range for Aspartate Aminotransferase (AST)?

A

0 - 35 units/L

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21
Q

What is the normal range for Alanine Aminotransferase (ALT)?

A

4 - 36 units/L

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22
Q

What is the normal range for White Blood Cells (WBC)?

A

5,000 - 10,000/mm^3
or
5 - 10 x 10^9/L

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23
Q

What is the normal range for Red Blood Cells (RBC)?

A

4.2 - 6.1 x 10^12/L

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24
Q

What is the normal range for Hemoglobin (Hgb)?

A

12.0 - 18.0 g/dL

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25
Q

What is the normal range for Hematocrit (Hct)?

A

37% - 52%

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26
Q

What is the normal range for Platelets?

A

150.000 - 400,000/mm^3
or
150 - 400 x 10^9/L

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27
Q

What is the normal range for Partial Thromboplastin Time (PTT)?

A

60 - 70 seconds

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28
Q

What is the normal range for Prothrombin Time (PT)?

A

11 - 12.5 seconds

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29
Q

What is the normal range for International Normalized Ratio (INR)?

A

0.8 - 1.1

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30
Q

What is the therapeutic range for Internation Normalized Ratio (INR)?

A

2.0 - 3.0

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31
Q

What is the normal value for High Density Lipoprotein (HDL)?

A

> 45 mg/dL

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32
Q

What is the normal value for Low Density Lipoprotein (LDL)?

A

< 130 mg/dL

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33
Q

What is the normal range for Triglycerides?

A

40 - 160 mg/dL

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34
Q

What is the normal value for Total Cholesterol?

A

< 200 mg/dL

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35
Q

What is the normal range for magnesium?

A

1.6 - 2.6 mEq/L

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36
Q

What is the normal range for phosphorus?

A

3.0 - 4.5 mg/dL

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37
Q

What is the normal range for Hemoglobin A1C (Hgb A1C)?

A

4 - 6%

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38
Q

What is the normal range for Ammonia?

A

10 - 80 mcg/dL

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39
Q

What is the normal value for Troponin?

A

< 0.017 ng/mL

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40
Q

What is the normal range for BNP?

A

< 100 pg/mL

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41
Q

What is the normal range for Digoxin?

A

0.8 - 2.0 ng/mL

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42
Q

What is the normal value for D-Dimer?

A

< 500 ng/mL

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43
Q

What is the normal value for Erythrocyte Sedimentation Rate (ESR)?

A

< 20 mm/hr

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44
Q

What is the normal value for C-Reactive Protein (CRP)?

A

< 10 mg/dL

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45
Q

What is the normal value for Creatinine Clearance?

A

~ (about) 120 mL/min

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46
Q

When are White Blood Cells (WBCs) considered critically high?

A

> 40,000 mm^3

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47
Q

When are White Blood Cells (WBCs) considered critically low?

A

< 2,000 mm^3

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48
Q

What labs are included in a lipid panel?

A

HDL
LDL
Total Cholesterol
Triglycerides

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49
Q

What labs are included in a Basic Metabolic Panel (BMP)?

A 
Sodium
Potassium
Chloride
Total CO2
Glucose
Blood Urea Nitrogen (BUN)
Creatinine
eGFR
Total Calcium
Anion Gap
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50
Q

What labs are included in a Complete Metabolic Panel (CMP)?

A 
All labs from a BMP: 
Sodium
Potassium
Chloride
Total CO2
Glucose
Blood Urea Nitrogen (BUN)
Creatinine
eGFR
Total Calcium
Anion Gap
And then labs to evaluate how well the liver is working:
ALP
AST
ALT
Total Protein
Albumin
Bilirubin
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51
Q

What labs are included in a Complete Blood Count (CBC)?

A 
White Blood Cells
Red Blood Cells
Hemoglobin
Hematocrit
Platelet Count
52
Q

What labs are included in a Complete Blood Count with Differential (CBC w/ Diff)?

A 
All labs from a CBC: 
White Blood Cells
Red Blood Cells
Hemoglobin
Hematocrit
Platelet Count
And then labs to analyze white blood cell production:
Neutrophils
Lymphocytes
Monocytes
Eosinophils
Basophils
53
Q

What labs will tell the provider how the liver is functioning?

A 
AST
ALT
ALP
Total Protein
Albumin
Bilirubin
Ammonia (This is usually tested only with known liver malfunction)
54
Q

List all the electrolytes we’ve learned about thus far

A 
Sodium
Potassium
Chloride
Calcium
Magnesium
Phosphorus
55
Q

If the glucose results higher than normal, the first thing the nurse should do is…

A

Assess the patient!

56
Q

If the glucose results higher than normal, the second thing the nurse should do is…

A

After assessing the patient, inquire about the patient’s dietary habits for the day. Have they eaten recently?

57
Q

Signs and symptoms of hyperglycemia are?

A 
Increased thirst (polydipsia)
Increased urination (polyuria)
Increased hunger (polyphagia)
Hot, dry skin

If a patient exhibits these s/s, the nurse should suspect hyperglycemia is possible; check the blood glucose

58
Q

Signs and symptoms of hypoglycemia are?

A 
Fatigue
Weakness
Headache
Hunger
Clammy, cool skin
Shakiness
Irritability

If a patient exhibits these s/s, the nurse should suspect hypoglycemia is possible; check the blood glucose

59
Q

What will kill the patient first, a critically high or critically low glucose?

A

Critically low!

Brain requires glucose for energy. Without glucose, the brain will shut down and the body will go into a coma (life threatening!)

60
Q

Which blood glucose requires attention from the nures first:
Blood Glucose of 68 mg/dL
Blood Glucose of 800 mg/dL

A

Blood Glucose of 68 mg/dL

Even though this blood glucose is not critically low yet, it is lower than desired range. A low blood sugar must be corrected so it does not keep dropping. Remember: the brain requires glucose for energy. Without glucose, the brain will shut down and the body will go into a coma (life threatening!)

A blood glucose of 800 mg/dL is critically high and concerning, but it is not the priority when another patient is hypoglycemic!

61
Q

If the BUN is acutely elevated and the patient does not have any known kidney disease, what may be the patients issue?

A

The patient may be dehydrated.

62
Q

Which electrolytes assist in cardiac and smooth muscle function?

A

Potassium
Calcium
Sodium

63
Q

If the bilirubin is > 1.0 mg/dL, what clinical manifestation might the patient present with?

A

Jaundice.

Yellow tinted skin and sclera

64
Q

What is the role of albumin?

A

Keep fluid from leaking out of the blood vessels
Nourish tissues
Promote wound healing
Transport substances throughout the body (because it’s a protein!)

65
Q

If AST, ALT and ALP are elevated, what does the nurse suspect?

A

Impaired/decreased liver function

66
Q

If albumin is decreased, what organ could be malfunctioning?

A

Liver

The liver synthesizes/makes albumin. If the liver isn’t working properly, it cannot make the albumin!

67
Q

If albumin is elevated, what could be the issue?

A

Dehydration

68
Q

What are causes of a decreased albumin level?

A

Liver malfunction
Fluid volume overload
Malnutrition (i.e. alcoholics)

69
Q

If the total protein level is decreased, what are possible causes?

A

Liver impairment
Fluid volume overload
Malnutrition (i.e. alcoholics)

70
Q

What is the medical term for White Blood Cells?

A

Leukocytes

71
Q

What is the medical term for Red Blood Cells?

A

Erythrocytes

72
Q

When are White Blood Cells most commonly elevated?

A

During an acute bacterial infection

73
Q

How long does a Red Blood Cell typically live for?

A

120 days

74
Q

What does Hemoglobin (Hgb) measure?

A

The amount of oxygen carried within the blood

75
Q

What does Hematocrit (Hct) measure?

A

The percentage of total blood volume made up by red blood cells

76
Q

What unit is Hematocrit (Hct) measured in?

A

percentage (%)

77
Q

What is the medical term used when RBCs, Hct and Hgb are elevated?

A

Erythrocytosis

78
Q

What is the medical term used when RBCs, Hct and Hgb are decreased?

A

Erythropenia

79
Q

What is the most common cause of erythrocytosis?

A

Dehydration

Fluid volume within the vessels decreases, but the RBCs, Hgb and Hct do not decrease. This makes it appear as though there is more RBCs, Hgb and Hct available.

80
Q

What are causes of erythrocytosis?

A

Dehydration
Chronic Obstructive Pulmonary Disease (COPD)
Living at high altitudes

81
Q

What are causes of erythropenia?

A 
Hemorrhage (blood loss) from a trauma or internal bleeding
Fluid volume overload
Nutritional deficiencies
Kidney/Renal Disease
Anemia
82
Q

What is the medical term for platelets?

A

Thrombocytes

83
Q

What is the medical term for elevated platelet count?

A

Thrombocytosis

84
Q

What is the medical term for decreased platelet count?

A

Thrombocytopenia

85
Q

If a patient experiences a trauma and they have lost a lot of blood (hemorrhaging), what labs within the CBC will be decreased?

A

RBC
Hgb
Hct
Platelets

86
Q

If a provider wanted to analyze the “break down” of the WBC, what test would be ordered?

A

CBC with differential

87
Q

What is it called when a patient is experiencing an acute bacterial infection and neutrophils are being produced rapidly?

A

Shift to the left

Occurs during an acute bacterial infection, neutrophils are stimulated and rapidly produced. They enter circulation early to fight off the infection.

88
Q

What is the medical term for critically low WBCs?

A

Neutropenia

89
Q

What type of precautions need to be put into place if a patient has WBCs <2,000

A

The patient is neutropenic and neutropenic precautions need to be put in place

Everyone except the patient must wear a mask when around patient to protect patient from their germs

90
Q

If a patient is taking the medication Warfarin (Coumadin) what lab value(s) will the nurse monitor? Will the nurse expect these lab values to be higher or lower than normal range?

A

Monitor PT and INR

Both values will be elevated above normal range while patient is on this medication.

PT will be prolonged, meaning the time it takes for the blood to clot will be longer

INR will ideally be elevated to therapeutic range (2.0-3.0) while on this medication

91
Q

If a patient is taking the medication Heparin what lab value(s) will the nurse monitor? Will the nurse expect these lab values to be higher or lower than normal range?

A

Monitor PTT

PTT will be elevated above normal range while the patient is on Heparin. PTT will be prolonged, meaning the time it takes for the blood to clot will be longer

92
Q

If the patient’s PT, INR, and/or PTT are elevated, what is the patient at risk for?

A

Bleeding

93
Q

If a provider wants to see how well the glucose has been controlled over the past two to three months, what lab will be ordered?

A

Hemoglobin A1C

94
Q

A Hemoglobin A1C less than what number is ideal for a patient with Diabetes Mellitus?

A

< 7 %

95
Q

If a Hemoglobin A1C is > 9 %, what does the provider know?

A

The blood glucose has been very poorly controlled over the past two to three months

96
Q

If a patient has a glucose level of 80 mg/dL but a Hemoglobin A1C of 14%, will they have s/s of hyperglycemia?

A

No. Glucose level is within range so s/s should not be present.

97
Q

If a patient experiences tissue hypoxia, what lab will be elevated?

A

Lactic Acid/Lactate

98
Q

If ammonia levels are high, what organ is malfunctioning?

A

Liver

The liver must break ammonia down into BUN so it can be excreted by the kidneys. If the liver isn’t working properly, it will not be able to break the ammonia down.

99
Q

If ammonia levels are high, what is the nurse’s priority action for the patient?

A

Maintaining safety

100
Q

The patient is at risk for coronary artery disease and atherosclerosis when what lipid panel labs are elevated?

A

LDL
Triglycerides
Total Cholesterol

101
Q

If a patient has a d-dimer level above 500, what does the nurse suspect?

A

Possible blood clot

102
Q

If the patient has a d-dimer level above 500 and complains of left lower extremity pain, what diagnostic test should be ordered?

A

An ultrasound. Quickest test to view blood flow in the lower extremity. Determine if blood clot present

103
Q

If the patient has a d-dimer level above 500 and complains of chest pain and shortness of breath, what diagnostic test should be ordered?

A

A CTA Scan of the Chest. Need to visualize the blood vessels of the lungs to determine if these is a blood clot present.

Ultrasound cannot be performed because it cannot visualize the blood vessels of the lungs, they are too deep within the body.

104
Q

What labs assess kidney function?

What lab is the most accurate indicator of kidney function?

A

Creatinine Clearance/Glomerular Filtration Rate *most accurate indicator of kidney function!)
eGFR
Creatinine
Blood Urea Nitrogen

105
Q

If liver function was impaired, what liver function tests would be elevated and what liver function tests would be decreased?

A

Elevated:
AST, ALT, ALP, Bilirubin, Ammonia

Decreased:
Albumin, Total Protein

106
Q

What labs assess pancreatic function?

A

Amylase

Lipase

107
Q

What labs identify the amount of inflammation present within the body? (I.e. what are the inflammatory marker labs?)

A

Erythrocyte Sedimentation Rate (ESR)

C-Reactive Protein (CRP)

108
Q

If the patient has an acute bacterial infection, what labs will be elevated?

A

WBCs
ESR
CRP

109
Q

If a patient is scheduled to receive a CT Scan with contrast, what must the nurse ask?

A

Allergies to contrast dye or shellfish

110
Q

What is the difference between a CT Scan and a CTA Scan?

A

A CT scan shows the body/organs/tissues in a 3D image.

A CTA scan shows the body/organs/tissues in a 3D image and also shows blood flow through vessels.

111
Q

What does an x-ray show images of?

A

Bones
Heart
Lungs
Joints

112
Q

What diagnostic machine(s) are portable?

A

Ultrasound

X-Ray

113
Q

If a female of child bearing age is having an x-ray or CT scan, what must be ruled out?

A

Pregnancy

114
Q

If a CT scan with intravenous contrast is ordered, function of what organ must be assessed first?

A

Function of the kidneys.

Kidneys must be working appropriately in order to receive intravenous contrast. They need to excrete the material.

115
Q

If a MRI is being obtained, what must the nurse do with the patient before the test is started? What does the nurse have to do for his/herself

A

MRI Checklist
Remove all metal, doesn’t matter what area of the body is being scanned
Patient must be in a gown only
Educate the patient

Nurse must remove all metal off of his/her body before going into the MRI room

116
Q

If the provider wants to see blood flow through vessels/organs, what diagnostic imaging test would be ordered?

A

CT Angiogram (CTA)

117
Q

What must the patient remove before an x-ray?

A

All metal around/close to the area being x-rayed

Put patient in a gown (better safe than sorry!)

118
Q

What are the benefits of an ultrasound test?

A

It is quick, easy and painless.

No rule out testing needs to be performed before hand. Machine is portable, it can come to the patient.

119
Q

Brain Natriuretic Peptide (BNP) is an important lab to monitor the severity of what disease?

A

Chronic Heart Failure

120
Q

Troponin is an important lab to monitor during what time?

A

Acute cardiac injury

121
Q

A normal level for a troponin lab is what?

A

< 0.017 ng/mL

122
Q

A normal level for a Brain Natriuretic Peptide (BNP) lab is what?

A

< 100 pg/mL

123
Q

If Brain Natriuretic Peptide (BNP) is greater than 400 pg/mL, what disease is likely to exist in the patient?

A

Heart failure

124
Q

Other than a troponin, what elevation of what lab can show injury to cardiac muscle?

A

Creatine Kinase MB (CK-MB)

125
Q

What is the normal range for amylase?

A

60-120 units/mL

126
Q

What is the normal range for lipase?

A

0-160 units/mL

MedSurg Nursing; N1110 (15 decks)

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