Lab Values - Just a Good Overall Review of Labs (Found on Brainscape) Flashcards
What is the normal range for potassium?
3.5 - 5.0 mEq/L
What is the normal range for sodium?
135 - 145 mEq/L
What is the normal range for glucose?
70 - 110 mg/dL
What is the normal range for creatinine?
0.5 - 1.2 mg/dL
What is the normal range for blood urea nitrogen?
10 - 20 mg/dL
When is sodium considered critically low?
< 120 mEq/L
When is sodium considered critically high?
> 160mEq/L
When is potassium considered critically low?
< 3.0 mEq/L
When is potassium considered critically high?
> 6.0 mEq/L
When is glucose considered critically low?
< 40 mg/dL
When is glucose considered critically high?
> 450 mg/dL
What is the normal range for albumin?
3.5 - 5.0 g/dL
What is the normal range for White Blood Cells (WBC)?
5,000 - 10,000/mm^3
What is the normal range for Hemoglobin (Hgb)?
female = 12.0 - 16.0 g/dL male = 14.0 - 18.0 g/dL
What is the normal range for Hematocrit (Hct)?
female = 37-47% male = 42-52%
What is the normal range for Platelets?
150.000 - 400,000/mm^3
What is the normal range for Partial Thromboplastin Time (PTT)?
60 - 70 seconds
What is the normal range for Prothrombin Time (PT)?
11 - 12.5 seconds
What is the normal range for International Normalized Ratio (INR)?
0.8 - 1.1
What is the therapeutic range for International Normalized Ratio (INR)?
Depends on why on warfarin
What is the normal value for Total Cholesterol?
< 200 mg/dL
What is the normal range for Hemoglobin A1C (Hgb A1C)?
4 - 6%
What is the normal range for serum Digoxin?
0.8 - 2.0 ng/mL
What labs are included in a lipid panel?
HDL
LDL
Total Cholesterol
Triglycerides
What labs are included in a Basic Metabolic Panel (BMP)?
Sodium Potassium Chloride Total CO2 Glucose Blood Urea Nitrogen (BUN) Creatinine eGFR Total Calcium Anion Gap
What labs are included in a Complete Metabolic Panel (CMP)?
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
What labs are included in a Complete Blood Count (CBC)?
White Blood Cells Red Blood Cells Hemoglobin Hematocrit Platelet Count
What labs are included in a Complete Blood Count with Differential (CBC w/ Diff)?
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
What labs will tell the provider how the liver is functioning?
AST ALT ALP Total Protein Albumin Bilirubin Ammonia (This is usually tested only with known liver malfunction)
If the glucose results higher than normal, the first thing the nurse should do is…
Assess the patient!
What will kill the patient first, a critically high or critically low glucose?
Critically low!
Brain requires glucose for energy. Without glucose, the brain will shut down and the body will go into a coma (life threatening!)
If the BUN is acutely elevated and the patient does not have any known kidney disease, what may be the patients issue?
Patient may be dehydrated, have a GI bleed, or on high-nitrogen diet/tube feedings.
What is the role of serum albumin?
Keep fluid from leaking out of the blood vessels
Nourish tissues
Promote wound healing
Transport substances throughout the body (because it’s a protein!)
If AST, ALT and ALP are elevated, what does the nurse suspect?
Impaired/decreased liver function
If the bilirubin is > 1.0 mg/dL, what clinical manifestation might the patient present with?
Jaundice.
Yellow tinted skin and sclera
Which electrolytes assist in cardiac and smooth muscle function?
Potassium
Calcium
Sodium
If albumin is decreased, what organ could be malfunctioning?
Liver
The liver synthesizes/makes albumin. If the liver isn’t working properly, it cannot make the albumin!
What is the medical term for White Blood Cells?
Leukocytes
What is the medical term for Red Blood Cells?
Erythrocytes
When are White Blood Cells most commonly elevated?
During an acute bacterial infection
How long does a Red Blood Cell typically live for?
120 days
What does Hemoglobin (Hgb) measure?
The amount of oxygen carried within the blood
What does Hematocrit (Hct) measure?
The percentage of total blood volume made up by red blood cells
What unit is Hematocrit (Hct) measured in?
percentage (%)
What is the most common cause of erythrocytosis (elevated H&H)?
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. We call it a “false high”.
What are causes of erythrocytosis (elevated H&H)?
Dehydration
Chronic Obstructive Pulmonary Disease (COPD)
Living at high altitudes
Polycythemia vera
What are most common causes of low H&H?
Hemorrhage (blood loss) from a trauma or internal bleeding Fluid volume overload Nutritional deficiencies Kidney/Renal Disease Anemia
What is the medical term for elevated platelet count?
Thrombocytosis
What is the medical term for decreased platelet count?
Thrombocytopenia
If a provider wanted to analyze the “break down” of the WBC, what test would be ordered?
CBC with differential
What is it called when a patient is experiencing an acute bacterial infection and neutrophils are being produced rapidly?
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
What is the medical term for critically low neutrophils (which we know fight bacterial infection)?
Neutropenia
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?
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; acceptable range may vary slightly - depending on WHY the patient is on warfarin
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?
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
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?
Hemoglobin A1C
A Hemoglobin A1C less than what number is ideal for a patient with Diabetes Mellitus?
< 7 %
If a patient has a glucose level of 80 mg/dL but a Hemoglobin A1C of 14%, will they have s/s of hyperglycemia?
No. Glucose level is within range so s/s should not be present.
If ammonia levels are high, what is the nurse’s priority action for the patient?
Maintaining safety
What labs assess kidney function?
What lab is the most accurate indicator of kidney function?
Creatinine Clearance/Glomerular Filtration Rate *most accurate indicator of kidney function!)
eGFR
Creatinine
Blood Urea Nitrogen
If liver function was impaired, what liver function tests would be elevated and what liver function tests would be decreased?
Elevated:
AST, ALT, ALP, Bilirubin, Ammonia
Decreased:
Albumin, Total Protein
What labs assess pancreatic function?
Amylase
Lipase
What labs identify the amount of inflammation present within the body? (I.e. what are the inflammatory marker labs?)
Erythrocyte Sedimentation Rate (ESR)
C-Reactive Protein (CRP)
If a patient is scheduled to receive a CT Scan with contrast, what must the nurse ask?
Allergies to contrast dye or shellfish
If a CT scan with intravenous contrast is ordered, function of what organ must be assessed first?
Function of the kidneys.
Kidneys must be working appropriately in order to receive intravenous contrast. They need to excrete the material.
Brain Natriuretic Peptide (BNP) is an important lab to monitor the severity of what disease?
Chronic Heart Failure
Troponin is an important lab to monitor during what time?
Acute cardiac injury