Labs Flashcards
what are the 4 priority levels used when studying these cards?
a: abnormal but not a priority, don’t need to do anything about it, can wait until the Dr discovers it
b: abnormal, concerned, monitor
c: critical, do something about it, inform Dr
d: highest priority
what is the best indicator of kidney fnxn
- creatinine
what are the 4 steps to do if a lab level is priority lvl C
1) hold (whatever is applicable to the lab)
2) focused assessment
3) prepare to give (whatever would help)
4) call appropriate HCP
what is the normal creatinine lvl
0.6-1.2
what priority lvl is an abnormal creatinine
A
increased creatinine indicates?
- kidney disease
what is normal INR lvl
in 2s-3s
a INR lvl > or equal to 4 is what priority lvl?
C
what do you do if the INR lvl is > or equal to 4
- hold warfarin
- focused assessment, assess for bleeding
- prepare vitamin K
- call HCP
what is a normal potassium lvl
3.5-5.3 (or 5, Mark says NCLEX uses 5.3)
a potassium lvl greater than 3.5 is what priority lvl?
C
what do you do if a potassium lvl is >3.5
1) hold anything with potassium
2) assess heart
3) prep kayexelate and regular insulin
4) call Dr
a potassium lvl > or equal to 6 is what priority lvl?
D
what do you do if a potassium lvl is > or equal to 6
1) hold anything with potassium
2) assess heart
3) prep kayexelate and regular insulin
4) call Dr.
- do this STAT, have multiple people involved, do not leave bedside
what is normal pH lvl
7.35-7.45
a pH lvl in the 6s is which priority lvl?
D
what do you do if a pH is in the 6s
1) assess VS
2) call Dr ASAP
(orders will be related to treating underlying cause)
what is a normal BUN lvl
8-25
if a BUN is increased, what do you assess for?
- dehydration
(dehydration is often a good guess with questions about imbalances if you aren’t sure)
what is a normal hgb
- general: 12-18
a hgb of 8-11 is what lvl of priority?
B
what do you do with a hgb of 8-11
- assess for anemia or malnutrition
a hgb <8 is what lvl of priority?
C
what do you do with a hgb of <8
1) assess for bleeding
2) prep to admin blood
3) call Dr
what is a normal bicarb lvl
22-26
an abnormal bicarb is what lvl of priority?
A
what is a normal CO2 lvl
- 35-45
a CO2 level in the 50s is which priority lvl?
C
what do you do with a CO2 in the 50s
1) assess resp status
2) prepare: pursed lip breathing
3) often don’t need to call (the pursed lip breathing often helps)
a CO2 lvl in the 60s is which priority lvl?
D (criteria for resp failure)
what do you do with a CO2 lvl in the 60s
1) assess resp status
2) prep to intubate and extubate
3) call RT first, then Dr
what is normal hct lvl
36-54
an increased hct lvl is which priority lvl?
B
what do you assess with an increased hct lvl
- dehydration
what is normal PO2 lvl
78-100 (via ABG)
a low PO2, in the 70-77 is which priority lvl?
C
what do you do with a PO2 lvl of 70-77
1) assess resp
2) O2
3) may not need to call (O2 often corrects it)
what lvl of priority is a PO2 in the 60s
D (criteria for resp failure)
what do you do with a PO2 lvl in the 60s
1) assess resp
2) prep to intubate and extubate
3) O2 on
3) call Dr
with hypoxia, what is the first sign? second?
- first = increased HR
- second = increased RR
what is a normal O2 sat lvl
- 93-100
an O2 sat <93% is which priority lvl?
C
what do you do if an SO2 <93%
1) assess
2) O2
an SO2 <95% in peds is which priority lvl?
bad (he didn’t give a lvl)
in what situation is an SO2 invalidated?
- with anemia –> causes it to be falsely high
what is the best indicator of CHF
BNP
what is a normal BNP lvl
<100
a BNP lvl >100 is which level of priority?
B
what should you do with a BNP level of >100
- monitor for CHF
what is a normal Na lvl
135-145
a high or low Na lvl is which priority lvl?
B
what do you do if there is a high Na lvl
- assess dehydration
what do you do if there is a low Na lvl
- assess for fluid overload
an abnormal Na lvl and change in LOC is which priority lvl?
C –> safety issue
what is a normal WBC lvl
5000-11 000
an abnormal WBC lvl is which priority lvl?
C
what is a normal absolute neutrophil count (ANC)
> 500
what is a normal CD4 lvl?
> 200
a CD4 <200 indicates? >20?
RELISTEN TO LECTURE
any abnormalities in WBC, ANC, or CD4 are which lvl of priority?
C
what do you do if there are any abnormalities in WBC, ANC, or CD4?
1) assess for infection
2) neutropenic precautions
study neutropenic precautions
relisten to plts
what is normal RBC lvl
4-6 million
an abnormal RBC lvl is which priority lvl?
B
what are the 5 abnormal lab lvls that are “D” priority?
- pH in 6s
- CO2 in 60s
- K+ in 6s
- SPO2 in 60s
- plt <40 000
