Labs

Question 1

CBC is what color tube?

Answer 1

Lavender

Question 2

Normal WBC

Answer 2

4,000 - 11,000

Question 3

Normal Hg (male and female) gm/dl

Answer 3

Male: 13.5 - 18 gm/dl
Female: 12-16 gm/dl

Question 4

Normal Platelets

Answer 4

150,000 - 400,000

Question 5

Normal Hct (male and female)

Answer 5

Male: 40-54%
Female: 38-47%

Question 6

In CBC differential, and increase in bands > 10% (shift to the left) indicates…

Answer 6

Acute Infection

Question 7

Normal PT (factors I, II, V, VI, X)

Answer 7

11 - 16 seconds

Question 8

Normal PTT (factors I, II, V, VIII to XII)

Answer 8

25 - 35 seconds

Question 9

Normal INR

Answer 9

0.6 - 1.7

Question 10

INR for pts on Coumadin for AFib/DVT

Answer 10

2 - 3

Question 11

INR for pts on Coumadin for mechanical heart valves/PE

Answer 11

2.5 - 3.5

Question 12

SMA, BMP, Chemistry is what color tube?

Answer 12

Red

Question 13

Normal Na range

Answer 13

135 - 145 mEq/l

Question 14

Normal Cl range

Answer 14

95 - 105 mEq/l

Question 15

Normal K+ range

Answer 15

3.5 - 5.0 mEq/l

Question 16

Normal CO2 range (chemistries)

Answer 16

22 - 26 mEq/l

Question 17

Normal BUN range

Answer 17

10 - 30 mg/dl

Question 18

Normal Cr range

Answer 18

0.6 - 1.5 mg/dl

Question 19

Normal glucose

Answer 19

70 - 110 mg/dl

Question 20

Normal Mg

Answer 20

1.5 - 2.5 mEq/dl

Question 21

Normal Ca (Ionized)

Answer 21

4.5 - 5.6 mg/dL

Question 22

Normal PO4 (Phosphate)

Answer 22

4.5 - 5.6 mg/dl

Question 23

Normal Total Serum Ca

Answer 23

8.5 - 11.0 mg/dL

Question 24

Normal Albumin

Answer 24

3.5 - 5.0 gm/dL

Question 25

If you have a low Albumin level, what else should you check and why?

Answer 25

Calcium - Calcium is protein bound - Low levels also indicate risk for toxicity for protein-bound drugs (such as Coumadin, Ca channel blockers)

Question 26

Normal GFR

Answer 26

85 - 135 ml/min

Question 27

Estimated Cr Cl Formula

Answer 27

[(140 – age) X weight in Kg] / (72 x serum creatinine) | - For Females: (X 0.85)

Question 28

Normal BUN : Cr ratio

Answer 28

10: 1 to 15:1 | - remember this is just a guide, ASSESS and treat based on cause of renal failure and baseline

Question 29

An increased BUN : Cr ratio (wide ratio) indicates

Answer 29

Pre-Renal Failure ( > 20 : 1) - kidney cells are still able to remove Cr from the body but the BUN accumulates due to decreased perfusion, increased protein catabolism, and slow GFR (resulting in increased reabsorption) - an increase in BUN without a corresponding increase in Cr could be due to dehydration

Question 30

A decreased BUN : Cr ratio (narrow) indicates

Answer 30

Intra Renal Failure ( < 20 : 1) - increase in creatinine - no significant increase in BUN - all end-stage renal disease ends up in intra-renal BUN : Cr pattern

Question 31

How many liters/day for a renal patient on fluid restriction?

Answer 31

1 - 1.5 liters/day

Question 32

What kind of fluids should not be used for IVPB in renal patients?

Answer 32

NS

Question 33

3 main treatments for Hyperkalemia

Answer 33

- Kayexalate (sodium polysterene sulfonate)exchanges Na for K in the bowels --> expect osmotic diarrhea - IV Glucose (D50) + IV insulin - 10% Calcium Gluconate stabilizes cardiac cell membrane potential --> prevents Vtach or Vfib

Question 34

Is Mg elevated or decreased in Renal Failure?

Answer 34

Increased due to diminished excretion

Question 35

Hypomagensium is often seen with

Answer 35

Hypokalemia

Question 36

Phosphorus is inversely related to what mineral...

Answer 36

Calcium

Question 37

Phosphorus is elevated or decreased in Renal Failure?

Answer 37

Increased due to diminished excretion

Question 38

2 Meds to LOWER phosphorus

Answer 38

- Phoslo (Calcium Acetate) - Renagel (Sevelamer) - phosphate binder * TAKE WITH MEALS

Question 39

Increase in PTH serve to...

Answer 39

Increase renal phosphorus excretion (secondary hyperparathyroidism)

Question 40

Is Ca elevated or decreased in Renal Failure?

Answer 40

Decreased because of decreased absorption of Ca related to the deficiency of metabolically active Vitamin D (produced by normal kidney) - leads to osteodystrophy - renal patients may complain of cramps and muscle twitching

Question 41

Ionized vs total serum Ca

Answer 41

- Total measures the protein-bound Ca in the serum. If the patient has LOW albumin, the Total Serum Ca level will also be low (although the Ionized may be normal) - Ionized is Ca that is unbound to the albumin

Question 42

Normal Uric Acid range (male and female)

Answer 42

Male: 4.5 - 6.5 mg/dl Female: 2.5 - 5.5 mg/dl

Question 43

Lactic Acid normal range

Answer 43

0.7 - 2.2 mmol/L

Question 44

Lactic Acid > 4.0 is...

Answer 44

Diagnostic criteria for severe sepsis

Question 45

Normal BNP

Answer 45

< 100

Question 46

BNP diagnostic of CHF

Answer 46

> 500

Question 47

WBC increase implication

Answer 47

Risk for sepsis

Question 48

WBC decrease implication

Answer 48

Risk for infection | - neutropenic precautions

Question 49

Do steroids increase or decrease WBC?

Answer 49

Both - decrease WBC but then your body thinks you're going immunosuppressed so produces more WBC

Question 50

How could Hgb be falsely elevated? Falsely low?

Answer 50

Elevated: Dehydration, hemoconcentration Low: hemodilution

Question 51

Hgb increase implication

Answer 51

Risk for clotting, DVT

Question 52

Hgb decrease implication

Answer 52

Diminished perfusion, bleeding - transfusion?, source of blood loss, are they going to OR?

Question 53

Hgb could decrease due to Anemia of ____ _______

Answer 53

Anemia of chronic inflammation

Question 54

Stop Heparin if platelets are....

Answer 54

< 100,000

Question 55

Don't let patient go to OR if....

Answer 55

platelets < 100,000 or PT > 1.5

Question 56

What can increase/prolong PT

Answer 56

- Liver Failure, cirrhosis - Vitamin K deficiency - Clotting factors I, II, V, VI, and X deficiency (hemophilia) - DIC - Coumadin

Question 57

Renal CO2 range

Answer 57

20-40 meq/l

Question 58

Low renal CO2

Answer 58

< 20 | Metabolic Acidosis