values and labs Flashcards
PH normal values
7.35-7.45
PaO2 values
80-100
PaCO3
35-45
HCO3
22-26
O2 sat
95-100%
potassium value
3.5-5.1
how is K maintained in the body? How is it regulated
by the NA-K pump.
Regulated by ALDOSTERONE in the kidneys
What is K needed for?
needed for normal cardiac function, neuro function, and muscle contraction.
How does aldosterone work?
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
Hyperkalemia: What is it caused by? what can it lead to?
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.
Treatment for Hyperkalemia
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
K protocol (Kayexalate)
binds to K and gets pooped out
HYPOkalemia: what is it caused by? WHat can it lead to? How to treat?
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.
What happens when you administer K too fast?
It can cause cardiac arrest. In fact, K is one of the ingredients used during lethal injection to stop the heart.
The relationship between K supplements and loop and thiazide diuretics.
K is excreted from the kidneys along with water. K supplements should be given when administering loop and thiazide diuretics.
sodium normal levels
136-145
How is NA regulated? What does NA do?
by the NA-K pump. Maintains fluid balance in the intravascular and interstitial spaces.
HyperNA: what does it cause? what is it CB? What does it effect?
excess H2O loss. Cells shrink.
CB V+D or low H2O intake.
Neuro status changes such as confusion, lethargy, irritablity, or seizures.
treatment of HYPERNA
hypotonic IV solution
HYPOnatermia: what causes it? what happens to the cells? manifestations?
too much H2O or too much hypotonic IV solution.
Cells swell.
can cause neuro symptoms like headache, confusion, seizures, and coma
treatment of HYPO NA
limit fluids or if extreme, give hypertonic IV gradually to increase NA level
Phosphate level
2.5-4
OR
0.80-1.50
Phosphate: where is it stored? what is it used for? how is it excreted and absorbed?
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.
HyperPH: caused by? symptoms? treatment?
CB kidney disease or crush injuries.
symptoms are usually asymptomatic but HYPOCA symptoms might show.
TX: less PH, PH- binder meds, or hemodialysis
HypoPH: caused by? symptoms?
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.
Magnesium levels
1.5-2.4
OR
0.75-0.95 (*)
Magnesium: what is it used for? where is it stored?
essential for normal cardiac, nerve, muscle, and immune system functioning.
most of it is stored in bones, and ICF
HYPER MG: caused by? what can it lead to? treatment?
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
HYPO MG: caused by? symptoms? treatment?
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
Calcium levels
8.6-10.2
OR 2.25-2.75
calcium: where is it stored and regulated? what is it used for? what is it relationship with pth?
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.
HYPER CA: caused by? leads to? treatment?
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
HYPO CA: caused by? leads to?
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
hypoCA signs: the names and what they do
- chvosteks- involuntary twitching of facial muscles when the facial nerve is tapped
- Trousseaus- a hand spasm is caused by inflating a BP cuff to a level above systolic pressure for 3 minutes.
The phosphorus and CA relationship
PH is inversely related to CA, an abnormally high PH level as seen with renal failure can also rresult in hypocalcemia
Hemoglobin: what does it do in the body? low or high levels?
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
white blood cells: what do they do in the body? low and high levels?
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
hematocrit: what does it test? high and low levels?
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
hemoglobin levels
123- 174 g/L
WBC levels
4-10 x10 (9)L
Hematocrit levels
0.37-0.52
RBCs level
4.7-5.14 X1012/L
RBC: what does it measure? low and high levels?
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
platelets: high and low levels
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.
Platelet levels
130-400 x10(9)/L
Blood gases: why is it needed?
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
isotonic solutions
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
hypotonic
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.
Hypertonic
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
what isotonic fluids are used for
Fluid resuscitation for hemorrhaging, severe vomiting, diarrhea, GI suctioning losses, wound drainage, mild hyponatremia, or blood transfusions.
what isotonic fluids are used for
Fluid resuscitation for hemorrhaging, severe vomiting, diarrhea, GI suctioning losses, wound drainage, mild hyponatremia, or blood transfusions.
according to the American diabetes association, what is the goal of therapy for clients with type 2 diabetes?
a glycosylated hemoglobin less than 7%.
if there is more CO2 in the lungs, that means there is more— in the body. what can cause this?
acid. “carbondiACID”.
It can be caused by intoxication, overdose, or head injury.
what happens if you are breathing out too much like in hyperventilation?
It can be caused by intoxication, overdose, or head injury.
how do the kidneys control acid/base?
Kidneys control H ions and HCO3. They do this by either getting rid of ACID in urine or retaining BASE in the kidneys.
with acid/base, what happens when you vomit too much?
When you vomit, you become ALKALOTIC because you vomit all of the acid OUT. This is the same with NG stomach aspiration.
with acid/base, what happens when you have renal failure, diarrhea, and DKA?
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.
describe what is happening in resp acidosis. what causes it?
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.
resp alkalosis, what is happening and what causes it? how can you fix it?
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.
resp alkalosis, what is happening and what causes it? how can you fix it?
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.
what meds cause the K to drop in the body?
Diuretics “thiazides”
Chloride and its relationship with bicarb and sodium
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
Potassium and sodiums relationships
if you have a high sodium level, you will have a low level of K. High potassium level will mean low levels of sodium.
Main concern with abnormal K values?
Muscle contraction and nerve impulses.
What medications causes HYPOkalemia?
Loop diuretics, corticosteroids, and too much insulin (moves the K into the cell)
Cushings relationship to low K in blood
too much cortisol which DROPS the K and increases the NA. (cortisol is the direct cause to hypokalemia)
Burn patients relationship with potassium?
The K will move out of the cell into the bloodstream.
Renal patients and potassium
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.
Magnesium and calcium relationship
if CA levels are low, MG is also low.
Respiratory acidosis is caused by:
underelimination of H+ ions. Can be caused by resp depression, poor chest expansion, obstruction…
Respiratory alkalosis is caused by
hyper ventilation, excess intake of bicarb, prolonged vomiting, gastric suctioning, and diuretics.
INR
gives you the thickness of the blood
- lower level= thicker blood
- higher level= thinner blood
BUN
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…
CREATINE
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
PTH
influences bone reabsorption, CA reabsorption and also PH regulation
ATRIAL NATRIURETIC PEPTIDE (ANP)
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
chronic pancreatitis
increase in amylase, bilirubin, and alkaline p’tase
lab changes in parathyroid dysfunction
CA, PO4, PTH and urine changes (cAMP)
cardiac biomarkers
CK, CK-MB, protein (myoglobin, troponin)
HEART FAILURE PROMPT DX
BNP
URINALYSIS AND STOOL FOR LIVER FAILURE
UROBILINOGEN (measured over 24 hours)
PT
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
PTT
28-38 seconds
monitors effectiveness of heparin
thrombin time
14- 16 seconds
ADH (antidiuretic hormone)
Controls the amount of fluid leaving the bodyy in urine which promotes reabsorption of H2O into the blood
CL levels
85-115
most important thing to remember with abnormal potassium values
can cause arrythmias
what can happen with chloride abnormal levels
imbalances can affect the strength of myocardial contraction and impulse
tetany will be seen with what imbalance?
hyperactive reflexes seen with low levels.
RBC breakdown produces…
Bilirubin as a byproduct= jaundice
