LAB VALUES Flashcards
What is a normal range of sodium?
135-145
What does a high sodium reflect?
- Diet affects this and IV fluid
- Vascular fluid deficient (increased concentration, free water loss)
- Diabetes insipidus
What does a low sodium reflect?
- Vascular fluid overload (decreased concentration)
- NG suction
- Burns (loss of serum)
- Diuretic administration
- Vomiting, diarrhea
What is a normal chloride?
98-106 mmol/l
What decreases Chloride?
- Decrease with NG
- Diet affects this and IV fluid
- Drugs that may lower serum chloride measurements include: Aldosterone, Bicarbonates, Certain diuretics
What increases chloride?
- Drugs that may increase serum chloride measurements include:
Acetazolamide, Ammonium chloride Androgens, Cortisone, Estrogen, Guanethidine, Methyldopa, (NSAIDs)
What is a normal potassium
3.5 - 5.0
What does a decrease in potassium reflect?
- Decrease with NG
- Diuretic administration
- Vascular fluid (increased and decreased concentrations)
- Insulin admin
- Alkalosis
- Ascites
What does an increase in potassium reflect?
- Increased with IV fluid administration with potassium added
- acidosis
- Infection
Meds
Acidosis
Cellular destruction - burns
Hypoaldosteronism
Increase of K+ intake
Nephrons broken
Excretion problems - kidneys
What is a normal CO2?
23-30 mmol/l
What does an increase in CO2 reflect?
- NG
- Breathing disorders,
- Cushing syndrome
- Hyperaldosteronism
- Vomiting
What does a decrease in CO2 reflect?
- Addison disease
- Diarrhea
- Ethylene glycol poisoning
- Ketoacidosis
- Kidney disease
- Lactic acidosis
- Metabolic acidosis
- Methanol poisoning
- Salicylate toxicity (such as aspirin overdose)
What does CO2 measure?
kidney’s ability to buffer
What is a normal range for BUN?
10-20 mg/dL
What does a high BUN reflect?
- moderate or heavy bleeding in the upper gastrointestinal tract (e.g. from ulcers).
- Enhanced metabolism of proteins will also increase urea production, as may be seen with high protein diets, patients on total parenteral nutrition, steroid use, burns, or fevers.
What does a low BUN reflect?
- liver problems
- malnutrition (insufficient dietary protein)
- excessive alcohol consumption.
- Overhydration from intravenous fluids
What is a normal creatinine range?
0.5-1.3 mg/dL
When do you see increases in creatinine?
A rise in blood creatinine level is observed only with marked damage to functioning nephrons
What is a normal glucose?
70 - 110
What are high levels of glucose associated with?
- Expect to high due to stress
- Increase in catecholamine response
- Administration of steroids
- Diabetes
What is a normal calcium range?
9 - 10.5 mg/dL
What are 3 things that affect calcium?
- Calcium varies with the level of serum albumin, a protein to which calcium is bound.
- Vitamin D is an important co- factor in the intestinal absorption of calcium
- Bone serves as an important storage point for calcium, as it contains 99% of the total body calcium.
What is a normal phosphorus range?
3.0 - 4.5 mg/dL
When do you see increased levels of phosphorus?
- Hypoparathyroidism
- renal failure
- bone metastasis
- hypocalcemia
- acidosis
- Rhabdomyolysis
- hemolytic anemia
When do you see decreased levels of phosphorus?
- Inadequate dietary ingestion
- chronic antacid ingestion
- hypercalcemia
- alcoholism
- vitamin D deficiency
- Alkalosis, gram- negative sepsis
- malnutrition
What is a normal range of magnesium?
1.3 - 2.1
What are increased levels of mag associated with?
- Dehydration
- Addison’s disease
- hyperparathyroidism
- hypothyroidism
- Kidney failure
- The use of medicine that contains magnesium, such as antacids and laxatives
What are decreased levels of mag associated with?
- Alcohol abuse or withdrawal
- diabetic ketoacidosis
- malabsorption problems in the intestines, such as sprue
- Infection and swelling of the pancreas (pancreatitis).
- Kidney disease.
- Long-term diarrhea.
- Not getting enough magnesium in the foods you eat.
- hypoparathyroidism
What is a normal albumin?
3.5 - 5.0
What are decreased levels of albumin associated with?
- When liver disease hepatocytes loose ability to produce albumin
- Overhydration
- Third-space losses
- inflammatory disease (burns, necrosis)
What 2 things does total protein measure?
albumin and globulin
what is a normal total protein
6.4 - 8.3 G/dL
What is a normal white blood cell count?
5 - 10.0x10 3 u
When do you see increases in WBC?
Increase is a response to acute infection and inflammation.
what is a normal RBC count?
4.2 - 6.1 mil/ul
When do you see an increased RBC count?
Increased in administration of EPO
When do you see a decreased RBC count?
- Decreased with bone metastasis
- hemorrhage
- anemia
- malnutrition
- Decreased when bone marrow focused on other cells
What 2 things affect HGB?
iron and protein
When do you see a decreased HGB?
- Decreased # RBC
- hemorrhage
- anemia
- malnutrition
What is a normal HCT?
37-52%
When do you see a decreased HCT?
- Dilutional anemia
- hemorrhage
- decrease EPO
- malnutrition
When do you see an increased HCT?
- Dehydration
2. fluid loss
When do you see a decrease in platelets?
- Aplastic anemia
- Cancer in the bone marrow, such as leukemia
- Cirrhosis (liver scarring)
- Folate deficiency
- HIT
- thrombocytopenic bleeding
- prolonged infection (sepsis)
(used platelets during surgery)
What is a range for PTT?
60 - 70 seconds
What is a normal aPTT?
30-40
When do you see an increased PTT, aPTT?
- Full Anticoagulant therapy (1.5 – 2 times control)
- (Intrinsic pathways activation)
- Heparin administration
- Liver failure (cirrhosis)
- DIC
When do you see a decreased PTT, aPTT?
- Extensive cancer (ovarian, pancreatic, colon)
What is a normal PT?
11 - 12.5 seconds
What affects PT?
- Warfarin (Coumadin) therapy
- Full Anticoagulant therapy (1.5 – 2 times control)
- Hepatocellular Disease (cirrhosis, hepatitis, and neoplastic invasive
prohepatocellular sysfuntion) - Biliary disease (obstruction)
- (extrinsic pathways activation)
- (Vitamin K deficiency, DIC, massive blood transfusions, salicylate
intoxication)
What is a normal INR?
0.8 - 1.1
What 3 things affect INR?
- Warfarin (Coumadin) therapy
- DIC
- Liver failure (cirrhosis)
What is a normal D-dimer?
<0.4 mcg/mL
When is the D-dimer increased?
when identifying intravascular clotting
What is a normal fibrinogen?
200 - 400 mg/dL
When do you see increased fibrinogen?
- Acute infections, Cancer, Coronary heart disease, myocardial infarction, Stroke
- DIC
- Inflammatory disorders (like rheumatoid arthritis and glomerulonephritis, a form of kidney disease)
- Trauma
- Cigarette smoking
- Peripheral artery disease
What is a normal neutrophil count?
55-70%
When do you see increases in neutrophils?
- bacterial infections
2. physiological stress
What are normal lymphocyte ranges?
20-40%
When do you see an increase in lymphocytes?
Viral infections
What is a normal monocyte range?
2 - 8%
What do monocytes act like?
Act as phagocytes in some inflammatory diseases
What is a normal range of eosinophils?
1-4%
When do you see an increase in eosinophils?
- allergic reactions
- hay fever asthma
- drug sensitivity
What is a normal range of basophils?
0.5 - 1%
What do basophils contain?
Contain heparin, histamines, and serotonin.
What do basophils analyze?
“mast cells” analyze allergic reactions