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values and labs Flashcards

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1
Q

PH normal values

A

7.35-7.45

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2
Q

PaO2 values

A

80-100

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3
Q

PaCO3

A

35-45

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4
Q

HCO3

A

22-26

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5
Q

O2 sat

A

95-100%

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6
Q

potassium value

A

3.5-5.1

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7
Q

how is K maintained in the body? How is it regulated

A

by the NA-K pump.
Regulated by ALDOSTERONE in the kidneys

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8
Q

What is K needed for?

A

needed for normal cardiac function, neuro function, and muscle contraction.

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9
Q

How does aldosterone work?

A

causes reabsorption of sodium and excretion of potassium in the distal tubule of the kidneys. In response to potassium levels rising or sodium levels falling in the bloodstream, the adrenal cortex releases aldosterone and targets the kidneys. In response, the kidneys excrete potassium and reabsorb sodium.

aka responsible of reabsorp. of both NA and H2O

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10
Q

Hyperkalemia: What is it caused by? what can it lead to?

A

CB kidney failure, metabolic acidosis, or K sparing diuretics.
Can lead to irritability, cramping, D, and ECG issues. At extreme levels, it can cause dysrhytmias and cardiac arrest.

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11
Q

Treatment for Hyperkalemia

A

give less K, start K protocol, insulin admin to push K into cells to prevent excess K from affecting cardiac muscle, or if extreme: hemodialysis

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12
Q

K protocol (Kayexalate)

A

binds to K and gets pooped out

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13
Q

HYPOkalemia: what is it caused by? WHat can it lead to? How to treat?

A

CB V+D, K-wasting diuretics, insulin use, and low K in diet. Can lead to weakness, arrhythmias, lethargy, and a thready pulse.
Treatment: increase K in diet, or IV K.

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14
Q

What happens when you administer K too fast?

A

It can cause cardiac arrest. In fact, K is one of the ingredients used during lethal injection to stop the heart.

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15
Q

The relationship between K supplements and loop and thiazide diuretics.

A

K is excreted from the kidneys along with water. K supplements should be given when administering loop and thiazide diuretics.

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16
Q

sodium normal levels

A

136-145

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17
Q

How is NA regulated? What does NA do?

A

by the NA-K pump. Maintains fluid balance in the intravascular and interstitial spaces.

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18
Q

HyperNA: what does it cause? what is it CB? What does it effect?

A

excess H2O loss. Cells shrink.
CB V+D or low H2O intake.
Neuro status changes such as confusion, lethargy, irritablity, or seizures.

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19
Q

treatment of HYPERNA

A

hypotonic IV solution

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20
Q

HYPOnatermia: what causes it? what happens to the cells? manifestations?

A

too much H2O or too much hypotonic IV solution.

Cells swell.

can cause neuro symptoms like headache, confusion, seizures, and coma

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21
Q

treatment of HYPO NA

A

limit fluids or if extreme, give hypertonic IV gradually to increase NA level

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22
Q

Phosphate level

A

2.5-4
OR
0.80-1.50

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23
Q

Phosphate: where is it stored? what is it used for? how is it excreted and absorbed?

A

stored in the bones and the ICF

it is important in energy metabolism, RNA and DNA formation, nerve function, muscle contraction, and for bone, teeth, and membrane building and repair.

It is excreted by the kidneys and absorbed by the intestines.

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24
Q

HyperPH: caused by? symptoms? treatment?

A

CB kidney disease or crush injuries.

symptoms are usually asymptomatic but HYPOCA symptoms might show.

TX: less PH, PH- binder meds, or hemodialysis

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25
Q

HypoPH: caused by? symptoms?

A

CB ETOH abuse, burns, diuretic use, resp alka., DKA, and stravation.

usually asymptomatic but in severe cases can cause muscle weakness, anorexia, or neuro issues like seizures.

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26
Q

Magnesium levels

A

1.5-2.4
OR
0.75-0.95 (*)

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27
Q

Magnesium: what is it used for? where is it stored?

A

essential for normal cardiac, nerve, muscle, and immune system functioning.

most of it is stored in bones, and ICF

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28
Q

HYPER MG: caused by? what can it lead to? treatment?

A

CB renal failure, too much MG, lax/ antacis

can lead to bradycardia, weak and thready pulse, lethargy, tremors, low reflexes, muscle weakness, and cardiac arrest

treatment: increase fluids, stop MG meds, or later on hemodialysis

CA gluconate can reduce the cardiac effects of hyper MG

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29
Q

HYPO MG: caused by? symptoms? treatment?

A

caused by low MG in diet, loop diuretics, ETOH abuse

leads to V, lethargy, weakness, leg cramps, tremor, dysrhythmias, tetany

treatment: increase MG in diet

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30
Q

Calcium levels

A

8.6-10.2
OR 2.25-2.75

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31
Q

calcium: where is it stored and regulated? what is it used for? what is it relationship with pth?

A

mainly stored in bones. regulated by the PTH in response to low calcium levels in the blood. Ca excretion and reabsorption are regulated by the PTH. As PTH is secreted in response to low calcium levels in the blood, CA is reabsorbed in both the kidneys and the intestine and released from the bones to increase serum calcium levels.

activity causes CA to move into bones where as immobility causes the release of CA from the bones, which causes them to be weak.

important for bone and teeth structure, nerve transmission, and muscle contraction.

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32
Q

HYPER CA: caused by? leads to? treatment?

A

CB immboilization which allows CA to leak out of bones and into serum. cancers can cause it to leak. hyperparathyroism or tumors can cause too much PTH secretion which causes too much CA.

leads to GI and MSK issues like N+V, constipation, too much urination, and skeletal muscle weakness

treatment is to lower CA in the diet, supplement with PH, hemodialysis, or SX removal of thyroid

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33
Q

HYPO CA: caused by? leads to?

A

hypoparathyroidism where not enought PTH is excreted and causes a decrease in reabsorption of CA and decrease release of CA from the bones.

can lead to MSK and nervous issues. Numbness and tingling, muscle cramps, and tetany

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34
Q

hypoCA signs: the names and what they do

A
  1. chvosteks- involuntary twitching of facial muscles when the facial nerve is tapped
  2. Trousseaus- a hand spasm is caused by inflating a BP cuff to a level above systolic pressure for 3 minutes.
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35
Q

The phosphorus and CA relationship

A

PH is inversely related to CA, an abnormally high PH level as seen with renal failure can also rresult in hypocalcemia

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36
Q

Hemoglobin: what does it do in the body? low or high levels?

A

majority of O2 molecules are transported throughout the body by attaching to hemoglobin within RBCs. Each hemoglobin protein is capable of carrying four O2 molecules.
When all four hemoglobin structures contain an oxygen molecule, its “saturated”

low levels mean anemia
high levels mean low levels of O2 in blood, live in high altitudes, or smoke

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37
Q

white blood cells: what do they do in the body? low and high levels?

A

fight infection and defend the body through a process called phagocytosis in which the leukocytes encapsulate and destroy foreign organisms. WBCs also produce, transport, and distribute antibodies as part of the immune response to a foreign substance.

WBC count can help diagnose infections, inflammation, and other health conditions that affect WBCs

Leukopenia AKA Low levels can be caused my autoimmune disorders, infection, malnutrition

Leukocytosis AKA high levels mean fighting an infection/ inflammation

38
Q

hematocrit: what does it test? high and low levels?

A

detects anemia and other health conditions. measures the proportion of red blood cells in your blood

low hematocrit means insufficient supply of healthy RBCs (anemia)

high levels can mean dehydration or disease-producing too much

39
Q

hemoglobin levels

A

123- 174 g/L

40
Q

WBC levels

A

4-10 x10 (9)L

41
Q

Hematocrit levels

A

0.37-0.52

42
Q

RBCs level

A

4.7-5.14 X1012/L

43
Q

RBC: what does it measure? low and high levels?

A

measures the number the RBCs which carry oxygen. Can diagnose anemia and other diseases.

A low RBC count could also indicate a Vit B6, B12, or folate deficiency.

high count can be a sign of dehydration, heart disease, and other diseases

44
Q

platelets: high and low levels

A

lower levels AKA thrombocytopenia causes you too bleed too much. might be a sign of certain cancers or infections.

higher levels AKA thrombocytosis causes blood clots to form.

45
Q

Platelet levels

A

130-400 x10(9)/L

46
Q

Blood gases: why is it needed?

A

essential to proper body functioning. the kidneys and lungs work together to correct slight imbalances as they occur. the kidneys compensate for the lungs and vice versa

47
Q

isotonic solutions

A

they have a similar concentration as blood.
for example. NS 0.9% is similar to blood so it stays in the ICF and osmosis does not cause fluid movement between compartments.
it can raise BP but can cause excessive fluid volume

48
Q

hypotonic

A

it has a lower concentration of dissolved solutes than blood.

NA 4.5% results in decreased concentration of dissolved solutes in the blood as compared to the intracellular space. this imbalance causes osmotic movement of water from the intravascular compartment into the intracellular space.

BUT if too much fluid moves out of the intravascular compartment into the cells. cerebral edema can happen.
AND possibly cause worsening hypovolemia and hypotension if too much fluid moves into the cells and out of intravascular space.

49
Q

Hypertonic

A

higher concentration of dissolved particles than blood.

fluids like NACL 3% can cause an increase concentration of dissolved solutes in the intravascular space compared to the cells. this causes the osmotic movement of water out of the cells into the intravascular space to dilute the solutes in the blood.

ALWAYS ASSESS for signs of hypervolemia like high BP and breathing difficulties

50
Q

what isotonic fluids are used for

A

Fluid resuscitation for hemorrhaging, severe vomiting, diarrhea, GI suctioning losses, wound drainage, mild hyponatremia, or blood transfusions.

51
Q

what isotonic fluids are used for

A

Fluid resuscitation for hemorrhaging, severe vomiting, diarrhea, GI suctioning losses, wound drainage, mild hyponatremia, or blood transfusions.

52
Q

according to the American diabetes association, what is the goal of therapy for clients with type 2 diabetes?

A

a glycosylated hemoglobin less than 7%.

53
Q

if there is more CO2 in the lungs, that means there is more— in the body. what can cause this?

A

acid. “carbondiACID”.

It can be caused by intoxication, overdose, or head injury.

54
Q

what happens if you are breathing out too much like in hyperventilation?

A

It can be caused by intoxication, overdose, or head injury.

55
Q

how do the kidneys control acid/base?

A

Kidneys control H ions and HCO3. They do this by either getting rid of ACID in urine or retaining BASE in the kidneys.

56
Q

with acid/base, what happens when you vomit too much?

A

When you vomit, you become ALKALOTIC because you vomit all of the acid OUT. This is the same with NG stomach aspiration.

57
Q

with acid/base, what happens when you have renal failure, diarrhea, and DKA?

A

When you have renal failure, your kidneys retain ACID (H ions). Which makes the body go into ACIDOSIS. If you have diarrhea, you are pooping out all of the BASE out of the body. You go into ACIDOSIS. In DKA, (acidosis is in the name) what happens in DKA is that the patient will experience Kussmaul respirations (rapid ventilation) to breathe out the acids.

58
Q

describe what is happening in resp acidosis. what causes it?

A

low and slow RR. (sloooow in acidooosis). It is retaining too much acid by slow breathing. CB sleep apnea (airway blockage), head trauma, post op from anesthesia, pneumonia (the thick mucus impairs gas exchange making blood more acidic), and COPD or asthma attack.

CNS depressants, ETOH, benzos, can cause RESP ACIDOSIS.

59
Q

resp alkalosis, what is happening and what causes it? how can you fix it?

A

fast RR. Panting too fast from panic attack or hyperventilation. ACID levels the body and leaves it in ALKALOSIS. To retain the acid, breathe into a bag.

59
Q

resp alkalosis, what is happening and what causes it? how can you fix it?

A

fast RR. Panting too fast from panic attack or hyperventilation. ACID levels the body and leaves it in ALKALOSIS. To retain the acid, breathe into a bag.

60
Q

what meds cause the K to drop in the body?

A

Diuretics “thiazides”

61
Q

Chloride and its relationship with bicarb and sodium

A

If there is hypercholeremia, you will have sodium increase. BUT will have a lower level of BICAR B. Bicarb and chloride have an opposite relationship

62
Q

Potassium and sodiums relationships

A

if you have a high sodium level, you will have a low level of K. High potassium level will mean low levels of sodium.

63
Q

Main concern with abnormal K values?

A

Muscle contraction and nerve impulses.

64
Q

What medications causes HYPOkalemia?

A

Loop diuretics, corticosteroids, and too much insulin (moves the K into the cell)

65
Q

Cushings relationship to low K in blood

A

too much cortisol which DROPS the K and increases the NA. (cortisol is the direct cause to hypokalemia)

66
Q

Burn patients relationship with potassium?

A

The K will move out of the cell into the bloodstream.

67
Q

Renal patients and potassium

A

elevated BUN and creatine. You will also see K increase. often they will need dialysis to bring it down. The kidneys are failing so they cant remove excess K.

68
Q

Magnesium and calcium relationship

A

if CA levels are low, MG is also low.

69
Q

Respiratory acidosis is caused by:

A

underelimination of H+ ions. Can be caused by resp depression, poor chest expansion, obstruction…

70
Q

Respiratory alkalosis is caused by

A

hyper ventilation, excess intake of bicarb, prolonged vomiting, gastric suctioning, and diuretics.

71
Q

INR

A

gives you the thickness of the blood
- lower level= thicker blood
- higher level= thinner blood

72
Q

BUN

A

3.6-7.2 mmol/L

made of UREA which is the end product of the metabolism of protein by the LIVER.

Factors that increase BUN include decreased renal function, GI bleed, dehydration, increased protein intake and fever.

low BUN levels can be from end stage liver disease, low protein diet, starvation…

73
Q

CREATINE

A

60-130 mmol/L

End product of muscle metabolism. better indicator of renal function than BUN because it does not vary with protein intake and metabolic states

74
Q

PTH

A

influences bone reabsorption, CA reabsorption and also PH regulation

75
Q

ATRIAL NATRIURETIC PEPTIDE (ANP)

A

the action of ANP is the direct opposite of the renin- angiotensin system.

ANP decreases BP and volume

aka it decreases the workload of the heart by regulating fluids, NA, and K

76
Q

chronic pancreatitis

A

increase in amylase, bilirubin, and alkaline p’tase

77
Q

lab changes in parathyroid dysfunction

A

CA, PO4, PTH and urine changes (cAMP)

78
Q

cardiac biomarkers

A

CK, CK-MB, protein (myoglobin, troponin)

79
Q

HEART FAILURE PROMPT DX

A

BNP

80
Q

URINALYSIS AND STOOL FOR LIVER FAILURE

A

UROBILINOGEN (measured over 24 hours)

81
Q

PT

A

10-13 seconds
produced by the liver, shows how fast blood clots

assess the effect of warfarin

prolonged clotting time would suggest a bleeding tendency

82
Q

PTT

A

28-38 seconds
monitors effectiveness of heparin

83
Q

thrombin time

A

14- 16 seconds

84
Q

ADH (antidiuretic hormone)

A

Controls the amount of fluid leaving the bodyy in urine which promotes reabsorption of H2O into the blood

85
Q

CL levels

A

85-115

86
Q

most important thing to remember with abnormal potassium values

A

can cause arrythmias

87
Q

what can happen with chloride abnormal levels

A

imbalances can affect the strength of myocardial contraction and impulse

88
Q

tetany will be seen with what imbalance?

A

hyperactive reflexes seen with low levels.

89
Q

RBC breakdown produces…

A

Bilirubin as a byproduct= jaundice

NCLEX (6 decks)

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