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Common Med Surg Lab Values

This document provides an overview of common medical laboratory values including: 1) ABG's, electrolytes, renal function, CBC, cardiac enzymes, and liver enzymes. Key values and their significance are defined. 2) Electrolyte abnormalities like hypernatremia, hypokalemia, and hyperkalemia are described along with their causes and treatment approaches. 3) Details are given for interpreting complete blood counts, cardiac enzymes, and renal and liver function markers. Normal ranges are provided throughout.

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1K views

Common Med Surg Lab Values

This document provides an overview of common medical laboratory values including: 1) ABG's, electrolytes, renal function, CBC, cardiac enzymes, and liver enzymes. Key values and their significance are defined. 2) Electrolyte abnormalities like hypernatremia, hypokalemia, and hyperkalemia are described along with their causes and treatment approaches. 3) Details are given for interpreting complete blood counts, cardiac enzymes, and renal and liver function markers. Normal ranges are provided throughout.

Uploaded by

ToMorrow
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Common Med-Surg Lab Values

ABG's *PH (acid) *HCO3 (bicarb) *PaCo2 (carbon dioxide) Electrolytes *Sodium and chloride *Potassium *Calcium/phosphate Renal Function *Blood urea nitrogen *Serum creatinine CBC (Complete blood count) *WBC *HGB/HCT *Platelets Cardiac enzymes *Ck *Ck-mb *Troponin *BNP Liver *Albumin *SGOT/SGPT *bilirubin

BUN/CR
Normal BUN/CR=10-15: 1 Blood urea nitrogen (10-20) *Byproduct of protein break down into nitrogen. Why would the level be high? *Bodys inability to eliminate nitrogen through nephrons Serum creatinine (0.8-1.2) *Best indicator for kidney function *lower is better Bun's high and dry Bun's low = wet

Complete blood count (CBC)


WBC (white blood cell) range (4,000-11,00) WBC < or = 500, neutropenia Function: kill organisms considered none self (foreign). Mnemonic-Never let monkey eats banana

Neutrophil-elevation (left shift) suggested acute bacterial infection Lymphocytes- fight infection (B-cells and T cells) Monocyte- elevation suggested of viral infection or parasite infection Eosinophil-elevation suggested of allergy nBasophil-elevation suggested of allergy

Red blood cell


RBC-produce in the bone marrow with the aid of erythropoietin (produce in the kidney) Hemoglobin (Hgb)-range male 14-16 and female 12-14...how many rbc if < or =7...blood transfusion Hematocrit-normal range 3x hemoglobin...how red is the blood Example Hgb is 9 and Hct is 27 What is the significant of not maintain 1:3 ratio? Example : if Hgb is 10 and Hct is 27 ..ratio<3 =Hemodilution (too much fluid). Example: if Hgb is 10 and Hct is 35...ratio >3 =dehydration Every unit RBC= increase Hgb by 1gm

Platelets
Normal range 150,000-450,000 Functions? *Aide in clotting *Fix damage blood vessels or endothelia What is the significant of having higher platelets? *Clots formation (DVT etc) What is the significant of having lower platelets? *Bruising or bleeding *Know as thrombocytopenia

Cardiac enzymes
CK-creatinine kinase *Byproduct of muscle breakdown. *Elevation signifies muscle injury (gen) *Peak 4-6 hours post injury/insult CK-MB *Specific to cardiac and brain injury if value is elevated Troponin *Sensitive lab value. *Elevation signifies cardiac muscles injury. *Peak 6 hours post injury BNP *measure the stretch of the ventricle. *The higher the values, the more stretch the ventricle is undergoing. *Use to determine CHF (high value)

prime electrolytes
Operating System of the PC is Marginal Osmolarity = 270-300 Sodium NA ECF = 135-145 Meq/L Potasium K ICF = 3.5 -5 Meq/L Calcium ECF = 8.5-10 Meq/L Magnesium ICF = 1.2-2.1 Meq/L

hypernatremia
Na level greater than (>145) significant: cause fluid shift from intracellular to intravascular and causes cellular dehydration (shrink) Causes: by dehydration, excessive sodium intake or DI (diabetic insipidus)-lack of ADH. S/S: confusion or seizure Treatments: what would you do if your blood is too salty? *Administer hypotonic solution *Increase po (water) intake *Give ADH (decrease urine production) and absorbed more water.

hypokalemia
Potassium is more intracellular than extracellular

Normal values- 3.5-5.0 Significant? *Aide with cardiac muscle contractility. Less potassium will cause irritability of the cell and causes arrhythmias. Causes: * loss of acid and gain in base *vomiting, diarrhea, Nasogastric lavage, excessive insulin usage. Treatments: *Potassium po/iv *How fast can you give IV= 10Meq/hr *PO < or = 40 Meq/time *for every 10 Meq Kcl, K^0.1 to 0.2 Diet high in potassium? What is diet high in potassium?

Liver enzymes
*Albumin (3.4-4.8 g/dL) *SGOT/SGPT (13-40 units/L, 10-40unit/L) *bilirubin (0.3-1.2 mg/dl)

Cardiac enzymes
*Ck (36-204 units/L) *Ck-mb (Less than 46%) *Troponin (detectable a few hours to 7 days after the onset of symptoms of myocardial damage. **Troponin I Less than 0.35 ng/mL **Troponin T Less than 0.20 mcg/L *BNP (Less than 100 pg/m)

CBC (Complete blood count)


*WBC (450011000 WBC/mm^3) *HGB (11.4-17.0 g/dL) *HCT (38-49 or 3x HGB) *Platelets (150,000450,000/mm^3)

Renal Function
*Blood urea nitrogen (1031 mg/dL) *Serum creatinine (0.61.2 mg/dL)

Electrolytes
Sodium/chloride Potassium Calcium/phosphate

hyperkalemia
Caused changes in electrical charge on the cell membrane and make the cell membrane more irritable Causes? *A gain in acid and a loss of base (Renal failure (absorb more hydrogen ion in the kidney) *Excessive blood glucose (diabetic ketoacidosis) *Excessive potassium supplement intake without diuretic Treatments to eliminate potassium? *Give kayexalate-bind with potassium and eliminate through feces. *Give insulin with D50 (dextrose)- insulin acts by binding with glucose and potassium and all three go into the cell- leaving less potassium in the blood stream. *Give sodium bicarbonate-acts by increasing blood pH. **As pH goes up, Potassium will come down. **Watch for s/s of volume overload and CHF *Diuretics *NaHCO3 (sodium bicarb)...binds to K *dialysis

ABG's
PH acid 7.4 alk +/- 0.05 HCo3 acid 24 alk +/-2 PaCo2 Alk 40 acid +/- 5 PaO2 (arterial) 60-100 SaO2 (O2 sat) > 91 ROME RO=Resp opposite ME= metabolic equal If Ph is in normal range= Com if HCO3 & PaCo2 point same dir = comp

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