Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Adult Health I > Rischer Chapter 6: Fluid and electrolyte content > Flashcards

Rischer Chapter 6: Fluid and electrolyte content Flashcards

1
Q 
Basic Metabolic Panel (BMP)/Chemistries
ALWAYS RELEVANT (5)
A
  1. sodium
  2. potassium
  3. glucose
  4. Creatinine
  5. Glomerular filtration rate (GFR)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Potassium

A
  1. 5-5.0 mEq/L
    - essential to normal cardiac electrical conduction
    - tends to deplete more quickly with loop diuretic usage than magnesium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Sodium

A

135-145 mEq/L

  • foundational fluid balance electrolyte
  • fluid volume deficit due to dehydration –> sodium elevated
  • fluid volume excess –> sodium low
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Glucose

A

fasting: 70-110 mg/dL
- required fuel for metabolism
- elevated levels post-op can increase risk of infection/sepsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Creatinine
and
Glomerular filtration rate (GFR)

A

creatinine: 0.6-1.2 mg/dL
GFR: >60 mL/minute
-gold standard for kidney function and adequacy of renal perfusion
-elevated creatinine can indicate damage to fragile capillary membrane screen of the glomerulus, allowing protein and glucose to pass through

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q 
CBC 
ALWAYS RELEVANT (4)
A
  1. WBC
  2. Neutrophils
  3. Hemoglobin
  4. Platelet count
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

WBC

A

4500-11,000/mm^3

-correlated with the presence of inflammation or infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Neutrophils

A

50-70%

  • correlated with the presence of inflammation or infections
  • most common leukocyte (first responder to any bacterial infection within several hours)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Hemoglobin

A
  • male: 13.5-17.5 g/dL
  • female: 12.0 -16.0 g/dL
  • determines anemia or acute/chronic blood loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Platelet count

A

150-450 x 103/ microliter

  • relevant when there is concern for anemia or blood loss or patient is on heparin
  • watch for thrombocytopenia in heparin patients
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q 
Cardiac 
ALWAYS RELEVANT (3)
A
  1. troponin
  2. CPK-MB
  3. BNP (B-natriuretic peptide)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

troponin

A

<0.4 ng/mL

  • ordered to rule out MI
  • can take up to 6 hours after attack to elevate
  • labs always ordered every 6-8 hours x3
  • can be slightly elevated and positive in heart failure and unstable angina
  • patients with renal disease (usually CKD III-IV) are unable to clear troponin by kidneys and will have baseline low positive (track the trending for theses patients)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

CPK-MB

A

<5%

  • specific iso-enzyme for cardiac muscle
  • confirms presence of MI
  • used to confirm troponin based MI diagnosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

BNP

A

<100 ng/L

  • neurohormone secreted by myocytes in the ventricles
  • compensates for overstressed ventricles by being a vasodilator and diuretic
  • elevated in heart failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q 
Coagulation 
ALWAYS RELEVANT (1)
A
  1. PT/INR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

PT/INR

A
  1. 9 - 1.1 nmol/L
    - therapeutic: 2-3 nmol/L
    - measures time for firm fibrin clot to form and measures clotting cascade
    - dependent on vitamin K synthesis from the liver
    - elevated in liver disease (unless on warfarin/Coumadin to achieve therapeutic goal of INR 2-3)
    - extremely important for patients on warfarin!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q 
Misc Chemistries 
ALWAYS RELEVANT (2)
A
  1. Magnesium

2. Lactate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Magnesium

A
  1. 6 -2.0 mEq/L
    - essential to normal cardiac electrical conduction
    - too high or low –> can predispose to rhythm changes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Lactate

A
  1. 5-2.2 mmol/L
    - trend with any shock state (especially sepsis)
    - elevated level –> higher likelihood of death
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Basic Metabolic Panel (BMP)/Chemistries

SITUATIONAL (5)

A
  1. chloride
  2. CO2
  3. Anion Gap
  4. Calcium
  5. BUN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Chloride

A

95-105 mEq/L

-Relevant if NG suction or frequent vomiting is present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

CO2

A

22-28 mEq/L

-actually reflecting the amount of bicarbonate (HCO3-)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Anion Gap (AG)

A

7-16 mEq/L

  • difference between primary measured cations (Na+ and K+) and primary measured anions (Cl- and HCO3-) in serum
  • relevant to acid base concerns typically seen in renal failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Calcium

A
  1. 4-10.2 mg/dL
    - relevant with renal failure and ETOH abuse
    - Hypocalcemia can occur in the case of low albumin
    - Hypercalcemia can be seen with cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

BUN

A

7-25 mg/dl

  • relevant to renal failure (important to trend with creatinine) but can be elevated for other reasons
  • elevated with dehydration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Misc Chemistries

SITUATIONAL

A
  1. Phosphorous
  2. Ionized calcium
  3. amylase
  4. lipase
  5. ammonia
27
Q

Phosphorous

A
  1. 5 -4.5 mg/dl
    - 85% stored in bone
    - primary intracellular anion
    - responsible for cellular metabolism and formation of bones and teeth
    - relevant to renal failure
    - will be increased due to decreased renal excretion
28
Q

Ionized calcium

A
  1. 05-1.46 mmol/L
    - Represents Ca++ that is metabolically avaliable compared to serum Ca++ that is more generalized
    - More accurate value for determining calcium
29
Q

Amylase

A

25-125 U/l

  • digestive enzyme to break down complex carbs
  • primarily formed in pancreas
  • will leak into circulation with pancreatic inflammation
  • Relevant with pancreatitis/cholecystitis and obstruction of common bile duct
30
Q

Lipase

A

3-73 units/L
-Glycoprotein produced primarily in pancreas to break down fats
-will leak into circulation with pancreatic inflammation
Relevant with pancreatitis/cholecystitis and obstruction of common bile duct

31
Q

Ammonia

A

20-100mcg/dL

  • comes from 2 sources
    1. deamination of amino acids during protein metabolism
    2. degradation of proteins by colon bacteria
  • liver converts ammonia in the portal blood to urea (excreted by kidneys)
  • High ammonia when liver function is impaired
  • potentially toxic to the CNS and causes confusion and altered mental status
  • contributing factor to hepatic encephalopathy in end-stage liver disease
32
Q

CBC

SITUATIONAL

A
  1. Hematocrit

2. RBCs

33
Q

Hematocrit

A

male 39-49%
female 35-45%
-elevation can confirm fluid volume deficit (will be elevated)

34
Q

RBCs

A

male: 4.3-5.7 x10^8/microliter
female: 3.8-5.1 x10^8/microliter
- not as relevant as hemoglobin for anemia and blood loss

35
Q

WBC Differential

SITUATIONAL

A
  1. Band forms
  2. Lymphoctyes
  3. Monocytes
  4. Eosinophils
  5. Basophils
36
Q

Band forms

A

3-5%

  • immature neutrophils
  • elevated in sepsis
  • > 8 is a “shift to the left” = impending sepsis
37
Q

Lymphocytes

A

23-33%

-relevant when there is known or suspected VIRAL infection

38
Q

Monocytes

A

3-7%

  • phagocytes that are similar to neutrophils but less prevalent
  • not as relevant as neutrophils
39
Q

Eosinophils

A

1-3%

-elevated with parasitic infection or allergic response

40
Q

Basophils

A

0-1%

  • -phagocytes that are similar to neutrophils but less prevalent
  • not as relevant as neutrophils
41
Q 
Liver Panel (LFT)
SITUATIONAL / RELEVANT when patient has GI or liver problem
A
  1. albumin
  2. total bilirubin
  3. alkaline phosphatase
  4. ALT
  5. AST
42
Q

Albumin

A
  • 3.5-5.5 g/dL
  • Large colloid plasma protein made by the liver
  • low in malnutrition
  • can be contributing factor to ascites or edema
43
Q

Total bilirubin

A
  1. 1 - 1.0 // 0.0 -0.3 mg/dL
    - direct // indirect
    - broken down byproduct of heme protein in RBCs
    - Relevant to liver disease
44
Q

Alkaline phosphate

A

male: 38-126 U/l
female: 70-230 U/l
- nonspecific hepatic iso-enzyme that has large concentration in liver
- not as helpful as ALT and AST for primary liver disease

45
Q

ALT

A

8-20 U/L

  • relevant with any primary liver disease
  • enzyme found in liver
  • released into circulation when liver cells are damaged
  • higher specificity to liver than AST
46
Q

AST

A

8-20 U/L

  • relevant with any primary liver disease
  • enzyme found in liver
  • released into circulation when liver cells are damaged
47
Q

Urinalysis

SITUATIONAL

A
  1. color
  2. clarity
  3. specific gravity
  4. protein
  5. glucose
  6. ketones
  7. bilirubin
  8. blood
  9. nitrite
  10. LET (leukocyte esterase)
48
Q

Color

A

yellow

  • clear to pale yellow with aggressive diuresis
  • orange due to bilirubin in urine with liver disease
  • dark amber with dehydration or fluid volume deficit
49
Q

Clarity

A

clear

-cloudy/containing sediment –> patient may have UTI

50
Q

Specific gravity

A
  1. 015 - 1.030
    - measures kidney’s ability to concentrate or dilute urine in relation to plasma
    - increased with dehydration
    - decreased with diuresis
51
Q

Protein

A

negative

  • relevant when positive in any patient with renal disease
  • active young adolescent females can have higher protein in urine (1st void of day should be used)
52
Q

Glucose

A

negative

  • relevant if diabetic
  • degree of presence in urine reflects poorly controlled diabetes
  • glucose should be filtered by glomerulus –> reflects kidney damage
53
Q

Ketones

A

negative

  • ketones are formed from metabolism of fatty acids
  • most commonly seen in diabetic ketoacidosis (DKA) and dehydration
54
Q

Bilirubin

A

negative

-may be positive with liver disease

55
Q

Blood

A

negative

-will typically be positive if patient has UTI or renal calculi

56
Q

Nitrite

A

negative

  • to rule out UTI (must be assessed with LET and WBC - nitrite by itself is not a predictable indicator of urinary infection)
  • positive indicates presence of gram-negative bacteria in urinary tract (ie e. coli)
57
Q

LET (leukocyte esterase)

A

negative

  • enzyme that is present if WBCs are in the urine
  • to rule out UTI (must be assessed with nitrite and WBC - LET by itself is not a predictable indicator of urinary infection)
58
Q

Urinalysis Micro

SITUATIONAL

A
  1. RBC
  2. WBC
  3. Bacteria
  4. Epithelia
59
Q

RBC

A

<5

-must be noted if UTI or renal calculi (correlates with severity)

60
Q

WBC

A

<5

  • GOLD STANDARD for UTI if patient is symptomatic
  • *many clinicians will even diagnose UTI at <5 if there are symptoms
  • amount indicates severity
61
Q

bacteria

A

negative

-does not consistently correlate to presence of infection

62
Q

Epithelial

A

negative

-skin cells are present (not particularly relevant?)

63
Q

Cardiac

SITUATIONAL

A
  1. CPK total
64
Q

CPK total

A

male: 38-174 U/I
female: 26-140 U/I
- enzyme found in muscle fibers of body
- used as a ratio to MB to identify if the ratio of CPK : (CPK - MB) is clinically significant and positive for a MI

Adult Health I (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions