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Labs Flashcards

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1
Q

Components of ABG’s

A

pH
PaCo2 -partial pressure of carbon dioxide
PaO2- partial pressure of oxygen
SO2-oxygen saturation
HCO3- bicarbonate
BE- base excess

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2
Q

Normal range pH &
What does it mean

A

7.35-7.45

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3
Q

Normal range PaCO2 &
What does it mean

A

35-45 mm Hg

shows adequacy of gas exchange between alveoli and external environment (alveolar ventilation)
hypoventilation (damaged alveoli, as in COPD) PaCO2 is elevated causing respiratory acidosis

hyperventilation= PaCO2 is decreased, causing respiratory alkalosis

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4
Q

PaO2- Normal range

A

75-100 mmHg (partial pressure Oxegen)

indicates the amount of O2 present to bind with hemoglobin

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5
Q

SO2

A

Oxygen Saturation

94-100%

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6
Q

HCO3

A

Bicarbonate

22-26 mEq/L

Deficit indicates metabolic acidosis
Increased indicates metabolic alkalosis

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7
Q

Intracellular Electrolytes

A

Cations: K+, Na+, Mg2+
Anions: Cl- HCO3-, PO4 3-

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8
Q

What does Sodium do in the body?

A

Where sodium goes, fluid flows.
Major cation in the ECF
Maintains blood volume and Blood pressure
regulated by ADH (add da H20)
- aldosterone holds back salt to keep water
Works with K+

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9
Q

Hypernatremia, What is it? What causes it?

A

-high serum sodium
Caused by:
-inadequate water intake
-excess water loss
-(rarely) Sodium gain
-diarrhea, diabetes related
osmotic diuresis
- increased insensible water loss
fever, heatstroke,
hyperventilation
Sodium is main ECF osmolality, so hypernatremia can cause hyperosmolality

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10
Q

Clinical manifestation and Nursing management of hypernatremia

A

-water shifts out of cell into ECF due to high osmolarity of ECF
-causes dehydration and shrinking of cells, which can cause dehydration of brain cells, resulting in change in metal status,

Symptoms of decreased ECF volume:
-drowsiness, restlessness, confusion, seizures, coma
- diarrhea
-intense thirst, dry swollen tounge,
postural hypotension
- increased pulse, weakness muscle crams

Symptoms with Normal or increased ECF volume:
-agitations restlessness, twitching, siezures
-edema
-intense thirst
-weight gain, increased BP

Nursing Management:
-if primary water deficit: fluid replacement orally or IV with d5w

-If problem is sodium excess or intravascular depletion: IV fluids like .9% NS,
- or if sodium excess not from water loss, Na excretion through diuretics, and restrict dietary sodium intake

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11
Q

Hyponatremia, causes

A

low serum sodium
excess sodium loss:
- diarrhea
-vomiting
-primary adrenal insufficiency
-diuretics
-NG suctions

Inadequate sodium intake
- fasting diets

excess water gain:
-misuse of sodium free fluids, hypotonic fluids

water excess in relation to sodium

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12
Q

Signs/symptoms of Hyponatremia

A

Decreased EFC volume
- apprehension, irritability
-confusion
-cold clammy skin
-postural hypotnesion
-inreased pulse, thready pulse

With normal or increased ECF volume
- apathy headache
-confusion
-muscle spasms, seizures, coma
-nausea vomiting, diarrhea
-weight gain, increased BP

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13
Q

Hyperkalemia causes, Excessive potassium intake

A

-Excessive or rapid IV administration
-potassium containing drugs
-Renal Failure
-Low aldosterone
-potassium containing slat substitute

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14
Q

hyperkalemia causes, Shift of potassium out of cells

A

-acidosis
-intense exercise
-tissue catabolism (crush injuries, sepsis, burns, fever)
-tumor lysis syndrome

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15
Q

What does Potassium do?

A

King Potassium, king of action and contraction. 3.5-5.0
Especially in the heart, keeping cells polarized through Na K+ channel

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16
Q

hyperkalemia causes, failure to eliminate postassium

A

adrenal insufficiency
meds: Angiotensin II receptor blockers, ACE inhibitors, Heparin, Potassium sparing diuretics, NSAIDS
Renal disease

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17
Q

Hyperkalemia clinical manifestations

A

Heart:
ECG Tall T waves and ST Elevation
hypotension bradycardia
irregular pulse

GI:
cramping diarrhea, vomiting
Hyperactive bowel sounds

Neuromuscular
increased DTR
paralysis and paesthesia (tingling)
confusion
fatigue irritability
muscle weakness

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18
Q

Causes of hypokalemia

A

Below 3.0
Fluid/electrolyte loss
D’s
Diarrhea, Diuretics, Diet, DKA, alDosterone

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19
Q

Symptoms of Hypokalemia

A

Heart
- low and slow pump
- flat T waves, ST depression, presence of U wave
-
Neuromuscular
- Shallow respirations= most deadly!
- Decreased DTR
-cramps and paralysis

GI:
- constipation
- hypoactive bowel sounds
- paralytic illeus= priority because causes risk of small bowel obstruciton

20
Q

Sodium imbalances values

A

Hypernatremia: > 145 mEq/L

Hyponatremia <136 mEq/L

21
Q

hyperkalemia EKG changes

A

-loss of p waves
- prolong PR interval
ST segment depressions
-Widening QRS
-Tall, peaked T wave
- Vfib

22
Q

Hypokalemia causes, potassium loss

A

Dialysis
diaphoresis
GI losses: diarrhea, Vomiting, fistulas, NG suction, ileostomy drainage
renal losses: diuretics, hyperaldosteronism, magnesium depletion

23
Q

Hypokalemia Shift into cells

A

-alkalosis
increased epinephrine, up stress
increased insulin release
insulin therapy

24
Q

hypokalemia from lack of potassium intake

A

diet low in K+
failure to include potassium in IV fluids if NPO
Starvation

25
Q

hypokalemia, clinical manifestations

A

constipations, nasusea
fatigue, hyperglycemia
irregular, weak pulse
muscles soft, flabby
muscle weakness, leg vramps
decreased feflexes
shallow respirations

26
Q

Hypokalemia, EKG changes

A

peaked P wave
prolonged QTS
ST segment depression
Flattened T wave
Presence of U wave
Ventricular dysrhythmias
1st and 2nd degree heart block

27
Q

calcium imbalances lab values

A

hypercalcemia > 10.5
Hypocalcemia< 9.0
Normal range 9-10.5

28
Q

hypercalcemia: causes

A

Causes:
-2/3 caused by hyperparathyroidism= high PTH
-cancers cause remaining 1/3
Excess calcium comes from pulling Ca out of bone

29
Q

Hypercalcemia clinical manifestations

A

-Increased bone pain, fractures
-fatigue lethargy, ca acts like sedative
-severe muscle weakness
-depressed reflexes
-kidney stones
-polyuria and dehydration

30
Q

Hypercalcemia EKG changes

A
  • short ST segment
    -Short QT intervla
    -Ventricular dysrhythmias
31
Q

hypercalcemia treatment

A

Mild: stop meds related to hypercalcemia, diet low in Ca, increase weight bearing activity, adequate hydration, drink 3000-4000 ml fluid daily.

Severe: IV isotonic saline, bisphosphonate, and calcitonin. But be careful of impaired renal function, as these pt’s cannot excrete excess fluid. Bisphosphonates- pamidronate, zoledronic acid, gold standard for treating hypercalcemia

32
Q

hypocalcemia: Causes

A

Results from any condition with PTH deficiency, ie hypoparathyroidism high blood pH which causes calcium to bind to protein decreasing ionized Ca, increased nerve excitability due to low calcium lowering threshold for activating sodium channels,

33
Q

Potassium Lab Range

A

3.5/5 mEq/L

34
Q

Total Calcium Lab value range

A

9.0-10.5 mg/dL

35
Q

Magnesium Lab value Ranges

A

1.3-2.1 mg/dL

36
Q

What does Magnesium do in the body?

A

1.3-2.1 mg/dL
Magnum Magnesium keeps law and order in the body’s muscles- by protein synthesis, nerve function, and blood sugar control

Stimulates parathyroid hormone- which regulates calcium levels- Required for Calcium and Vit D absorption

Obtained in diet through spinach almonds and yogurt

37
Q

What does Calcium do in the body?

A

9.0- 10.5 mEq/L
99% found in bones
3 strong B’s:
Strong Bones
strong blood- clotting factors
strong Beets

regulated by PTH (parathyroid hormone)- increases calcium in blood
Calcitonin Hormone- decreases blood calcium by putting in bone
Calcitrol- controls release of calcitonin

38
Q

What does phosphate do in the body?

A

3.0-4.5 mEq/L
Enemies with calcium- always work inversely
obtained from meat, poultry, fish, nuts, beans, and dairy
Main function is to help bone and teeth formation and repair cell tissue

Regulated by all things that regulate Calcium, PTH- because they are inversely related

39
Q

What does Chloride do in the body?

A

98-106
follows sodium around
absorbed with salt
helps sodium maintain BP and blood volume

40
Q

Normal WBC range?

A

5,000-10,000/mm3

41
Q

Hemoglobin men and women

A

Men 14-18 g/100L
Women 12-16 g/100 L

42
Q

Hematocrit lab range

A

Men 42-52%
Women 36-44%

43
Q

Platelet lab range

A

150,000-400,000/mm3

44
Q

RBC’s lab range

A

Men 4.7-6.1 million/mm3
Women 4.2-5.4 million/mm3

45
Q

PT INR normal and therapeutic range and which thinner is it used for?

A

Warfarin (war-K-IN) - measured with INR and Vit K is antidote
Normal INR- 0.7-1.8
Therapeutic INE 2-3

46
Q

PTT normal and Therapeutic. What thinner does it check

A

Heparin (remember hePTT)
Normal- 30-40 sec
Therapeutic 1.5-2 times normal values

47
Q

Digoxin labs

A

.5–2.0 mg/ml

Nursing (10 decks)

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