Laboratory Values

Question 1

K+

Answer 1

3.5-5

Regulated by the kidneys

Question 2

Hyperkalemia

Answer 2

Peaked T-Waves
Arrythmias

Question 3

Hypokalemia

Answer 3

Respiratory Arrest/Distress
Lethargy
Decreased muscle strength, tetany
T-wave flattening
U Waves

Question 4

CL-

Answer 4

95-105

Question 5

Serum Bicarbonate

Answer 5

23-30
Total amount of C02, carried in the form of HC03

Question 6

BUN

Answer 6

4.5-11

Question 6

Creatinine

Answer 6

0.6-1.4

Question 7

Calcium

Answer 7

8.8-10.4

Essential for blood coagulation, endocrine and neuro function

Question 8

Hypocalcemia

Answer 8

Muscle Cramps/Spasms
Seizures
Coarse Hair, Brittle Nails
Pruritus (itching)

Question 9

Hypercalcemia

Answer 9

Cardiac Arrythmias
Hypotonia
Paresis/Weakness

Question 10

Alkaline Phosphatase

Answer 10

44-147

Enzyme found in bones, liver, and kidneys

Crucial component in the breakdown of proteins

Elevated with liver damage/bile duct blockage

Question 11

Albumin

Answer 11

3.5-5.5

Protein produced by the liver

Critical in maintaining oncontic pressure in blood vessels

Hypoalbunemia - liver or kidney disease, fluid overload/accumulation Malnutrition/Inflammatory conditions

Hyperalbuminemia - Dehydrated, liver or kidney disease, inflammatory

Question 12

ALT

Answer 12

10-35

Enzyme in the liver - Breakdown amino acids

Elevated - Liver damage/injury

Question 13

AST

Answer 13

10-35

Found in liver and heart

Released in the bloodstream with tissue damage. Consider MI as well as liver damage.

Question 14

Serum Osmolality

Answer 14

275-295

Amount of solute in the serum part of the blood

Regulates with ADH

Question 15

Urine Specific Gravity

Answer 15

1.005-1.030

Measurement of the concentration of urine

SIADH - Too much ADH - body holds onto volume… creates high concentration urine

Question 16

SIADH

Answer 16

Too much release of ADH. Causes dilutional state. Creates high urine specific gravity with **low serum osmolality. **

Question 17

Diabetes Insipidus

Answer 17

To little ADH. Creates a dry state. Too much fluid loss.

low urine specific gravity with high serum osmolality

Question 18

Troponin

Answer 18

Essential for muscle contraction.

Calcium binding site.

Will not rise until 3-4 hours after onset of MI, and will peak at 12 hours.

Question 19

CK-MB

Answer 19

0-0.3

Creatine Kinase - Muscle Brain

Compare to total CK
if relative index is above >2.5-3.0.. likely indicates cardiac damage.

Question 20

proBNP

Answer 20

Secreted by cardiomycoytes based on ventricular stretch

Marker in CHF patients

Question 21

Beta-Hydroxybutyrate

Answer 21

0.4-0.5

Allow early onset of DKA

Question 22

Magnesium

Answer 22

1.5-2.5

Low mg++ usually seen in deficits in Ca+ or K+

Cleared by kidneys

Hypermagnesemia - Renal failure?

Loss of deep tendon reflexes

Hypomagnesemia -

Associated with hypokalemia or hypocalcemia. Neuromuscular irritability and mood changes.

Question 23

Phosphorus

Answer 23

3.0-4.5

Mineral and strength to bone.

Strong reciprocal relationship between phosphorus and calcium.

Hyper - tetany, seizures

Question 24

Chvostek’s Sign Test question

Answer 24

Touching the cheek and having the cheek rise.

Sign of hypocalcemia/hyperphosphatemia

Question 25

Treousseau Sign Test question

Answer 25

Blood pressure cough on an arm and pump it up. Arm and hand will flex up towards arm.

Indication of hypocalcemia.