- Blood Glucose - Acid/Base balance - Kidney Function - Electrolyte Imbalance -Blood Proteins -Liver function

Lab Values Lecture Flashcards by Jarrett Evans

BMP are tests for (4)

Blood Glucose
Acid/Base balance
Kidney function
Electrolyte imbalance

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CMP tests for (6)

Blood Glucose
Acid/Base balance
Kidney Function
Electrolyte Imbalance
-Blood Proteins
-Liver function

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Glucose
What is the normal range?
What was this blood test measure

70-110 mg/dL
Direct measurement of blood glucose level

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What does Glycosylated Hemoglobin A1c test for?
What is the range for:
Normal-
Good-
Fair-
Poor-

The average blood glucose level for the last 3 months. The test monitors the treatment of diabetes
Normal: 4-5.9%
Good: <7%
Fair: 8-9%
Poor: >9%

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Sodium (Na+)
Normal Range? (sODDium)
What is special about sodium?

135-145 mEq/L
Major cation in the extracellular space

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Potassium (K+)
Normal Range? (Bananas)
Why is Potassium important? (2)

3.5-5.1 mEq/L
K+ is important to cardiac function
Major cation within the cell

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Chloride(Cl-)
Normal range? (Hot Tub)
What is important to know about Cl- (2)

98-109 mEq/L
Major extracellular anion
Usually follows N+ (Sodium Chloride Table Salt)

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Bicarbonate (HCO3-)
What is the normal range?
What is the critical value?
What is the role of bicarbonate?

20-30 mEq/L
<6mEq/L
Major role in acid/base balance

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Calcium (Ca2+)
What is the normal range?
What is calcium important for

7.6-10.4 mg/dL
Parathyroid function, calcium metabolism

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What does CBC mean? what do CBC test for? (9)

CBC: Complete Blood Count
Hgb: O2 carrying protein
Hct: Packed volume of RBCs, % of total volume
MCV: Cell size (normocytic, macro and micro)
MCH: Amount of Hgb per cell
MCHC: Hgb/Hct per 100mL/RBCs
RDW: Red cell distribution width
Platelet: # of plt. per cc/blood
WBC: # of white cells per mL/blood

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Erythrocyte Count (RBC)
What is the function of the RBC?
What is the Normal Range?

RBC count: the number of circulating RBCs in 1mm3 of blood
Carry oxygen
Contain Hemoglobin molecules
3.89-5.40M/uL

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RBC Indices: (4)

MCV: 80-95 fL
RDW: 11-14.5%
MCH: 27-31 pg
MCHC: 32-36 g/dL

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RBC,HgB,Hct all have common high and lows, what are they? (4)(14)

High: congenital heart disease, severe chronic obstructive pulmonary disease, polycythemia vera, severe dehydration
Low: anemia, hemoglobinopathy, cirrhosis, hemolytic anemia, hemorrhage, dietary deficiency, bone marrow failure, prosthetic valves, renal disease, normal pregnancy, rheumatoid arthritis, lymphoma, leukemia, Hodgkin disease

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What does hemoglobin (Hgb or Hb) measure?
What is the normal range? (What is the lifespan of globins?)
In depth description of what patient?

Measurements of the total Hemoglobin in the blood.
Normal Range: 12-16g/dL
Anemic patients

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Hematocrit (Hct) measures what?
Normal Range:
Critical Values:

-Indirect measurement of RBC number and volume (% of blood made up by RBC)
-Part of routine testing and anemia eval.
-Normal: 37.0%-47.0%
Critical values <15% or >60%

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What affects Hct values?

-Gender and Age
-Specifically, Women have lower Hct and continues to lower with age.

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Anemia: (5)

-Decrease in number of RBC’s (erythrocytes)
-Impaired RBC production
-Blood loss
-RBC destruction
-Combination of all 3

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Platelet Count (Thrombocytes)
What does this measure and formed where?
Platelet function?
Normal Count:

-Actual count of the number of platelets (thrombocytes) per cubic milliliter of blood
-Formed in the bone marrow
- Platelets form clots
Normal Count: 150,000

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High platelet count is called
and their counts:(2)
Low platelet count is called
and their counts:

H: Thrombocytosis
Counts >1 million = risk of clotting
Counts >600,000 = potential for problems
L: Thrombocytopenia
Counts below 50,000 = significant bleeding

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Do NOT give your patient Lovenox or Enoxaparin if their Platelet count is?

100,000
these are both anti-platelet medications.

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Total WBC’s (leukocytes) measures? (3)
Normal Range:

-Measurement of total WBC count
-Part of routine testing on CBC
-White cell differential count
percentage of each type of leukocyte present in the specimen
Normal Range: 3.6-10.8K/uL

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Phosphorus (P)
What is the normal range?
What is the role of phosphorus

3.0-4.5 m/DL
Assists in the interpretation of parathyroid and calcium abnormalites

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High WBC count is called?
Low WBC count is called?

H: Leukocytosis (Infection, inflammation , sepsis, trauma)
L: Leukopenia (Bone marrow failure, chemo, radiation, overwhelming infection and autoimmune disease)

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Magnesium (Mg-)
What is the normal range?
Where is it found? (MagKNEEium)
What is the role of Mg?

1.3-2.1 mEq/L
Found intracellularly, around half of it in the bone
Important in calcium metabolism and closely tied to calcium levels

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Measurement of Each WBC type in the blood is called? Normal Values of each? (5)

WBC Differential Neutrophils: 50-70% Lymphocytes: 20-40% Monocytes: 2-8% Eosinophils: 1-4% Basophils : 0.5-1.0%

Leukocytosis: Lymphocytosis: Left Shift:

1. abnormally large number of leukocytes WBC > 10,000 cells/mL3 2. form of actual or relative leukocytosis due to increase in numbers of lymphocytes 3. increase in the number of immature neutrophils (bands/stabs) found in the blood

Total protein Normal range? (Protein goal) What does it measure? (3)

6.4-8.3 g/dL Combination of pre-albumin, albumin, and globiuns

If your patient is Hyperglycemic and you administer insulin, you need to make sure they do what?

Eat within 15 minutes to balance them out.

If your patient is Hypoglycemic what can you give them non-pharmacologically to fix this? (4)

orange juice, regular soda, glucagon tablets, iv glucagon

What is all included in the hepatic function test (7)

-Albumin -AST -Alk phos -ALT -Bili total -Direct Bili -Ammonia

Amylase checks what? Normal Range:

Pancreas Function: Pancreatic test helpful in evaluation of abdominal pain Normal Range: <130 u/L

High Amylase can indicate? (4) Low Amylase can indicate? (2)

H: many abdominal diagnoses, DKA, various cancers, salivary gland inflammation L: hepatic necrosis, advanced chronic pancreatitis

What is the function of Lipase? Normal Range:

-Enzyme secreted by pancreas into small intestines -Helps break down triglycerides into fatty acids -Highly specific for pancreatic diseases Normal Range: <160 u/L

Albumin What is the normal range What is albumin (2) What is the function of Albumin?(2) What does the level of albumin reflect?(2)

3.5-5.0 mg/dL A protein formed and synthesized with the liver and Compromised 60% of total proteins in blood Regulates osmotic pressure and transports blood, hormones, enzymes, and drugs. Hepatic function and nutritional state

High Lipase count can indicate? (3) Low Lipase count can indicate? (1)

H: acute pancreatitis, early pancreatic cancer, perforated ulcer L: acute severe pancreatitis

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

30-120 u/L Detect and monitor diseases of liver and bone

Clotting Factors Assess Normal Bleeding and Coumadin Therapy: PT and INR.

PT (protime): 11.0-13.0 seconds Critical value: > 20 seconds INR (International Normalized Ratio): 0.8-1.5 secs (without Coumadin) Critical value: > 5.5 seconds

Clotting Factors Asses Heparin Therapy: PTT

PTT (Partial Thromboplastin TIme): 30-45 seconds

Alanine Aminotransferase (ALT) What is the normal range? Where is it found? Why would it be in the bloodstream? What is it used it detect?

4-36 u/L The liver Injury or disease to the liver parenchyma Used to identify and monitor hepatocellular disease

Peak and Trough: Trough: Peak:

Trough: level 30 min prior to dose; if results OK then give medication Peak: level 1 1/2 hrs after IVPB infusion complete

Stool Testing can include: (3)

1. Fecal Occult Blood Test (FOBT) 2. C – diff 3. Culture & Sensitivity

Aspartate Aminotransderase (AST) What is the normal range Where is AST found in high contrations Why would AST be in the blood stream?

0-35 u/L In within highly metabolic tissues (Liver, muscle cells(Heart and muscle cells)) Disease/ injury to one of the tissues

Bilirubin What is the normal range What is Bilirubin? Where is it found? What are the parts to Bilirubin (2)? Which patients would need this test?

.3-1.0 mg/dL The end product of RBC metabolism components of the bile Conjugated (Direct) and unconjugated (Indirect) bilirubin Patients with hemolytic anemia and newborns with jaundice

Unconjugated Bilirubin What is the normal range? What is it measure?

.02-.08 mg/dL Levels of indirect bilirubin in blood

Conjugated Bilirubin What is the normal range? What does this measure?

.1-.3 mg/dL Level of direct bilirubin in the blood

What are used to evaluate kidney functions (2)

BUN and Creatinine

Blood urea Nitrogen (BUN) What is the normal range? What organs can we evaluate with BUN (2) What is BUN

10-20 mg/dL Kidney and liver function End product of protein metabolism

Creatinine Normal range? What is the critical value? What does this measure?

.5-1.1 mg/dL >4 mg/dL A direct measure of renal function

Should there be Nitrites in the urine?

Can there be protein in the urine?

Only in very small amounts 0-8 mg/dL

Should there be ketones in the urine

Should there be bilirubin in the urine?

Should there be crystals in the urine

Should there be glucose in the urine?

Should there be WBC in the urine

Only in very small amounts

Should there be RBC in the urine

In very small amounts

Is urine acidic or basic

It can be both

Should there be bacteria in the urine

What must be done with 24 hr urine collections

Discard the 1st void Put on ice/Refrigerate

What must be done with 24hour urine collection

discard the 1st void Put on ice/refrigerate

When does the time start on 24 hour urine collection

After the discarded urine

What does urinary protein measure?

Kidney function

What blood collection device should you NOT connect to a blood culture bottle?

Vacu-Holder (The beads in the blood culture bottle could get lodged into the pt’s body)

What is not used for Kidney function

GFR