lab values

What body system does creatinine tell you about?

Kidney function

What is the normal creatinine range?

0.6 – 1.2

Is elevated creatinine normally a high priority?

No — Level A

If patient with elevated creatinine is going for a dye study, what priority?

B – Monitor closely

What should you do for a patient with elevated creatinine going for contrast dye?

Watch kidney function, hydrate as ordered, notify provider if worsening

INR monitors what medication?

Warfarin (Coumadin)

What is therapeutic INR range?

2 – 3

INR of 4 or above is what priority?

C – Do something

What FOUR steps should the nurse take if INR = 4.5?

Hold Warfarin, assess for bleeding, prepare Vitamin K, notify provider

Potassium primarily affects what system?

Heart

Normal potassium range?

3.5 – 5.0

Potassium <3.5 level?

C

Actions for potassium <3.5?

Hold potassium-wasting meds, assess heart, give potassium, notify provider

Potassium 5–6 level?

C

Actions for potassium 5–6?

Hold potassium, assess heart, give insulin/Kayexalate, notify provider

Potassium >6 level?

D – Highest priority

Actions for potassium >6?

Hold potassium, assess heart, give insulin/Kayexalate, stay with patient, prepare emergency measures, notify provider

What does blood pH measure?

Acid–base balance

pH normal range?

7.35 – 7.45

pH in the 6s priority level?

D

Actions for pH in 6s?

Assess vitals, treat cause immediately, notify provider

What is BUN?

Nitrogen waste in blood

BUN normal range?

8 – 25

High BUN usually means what?

Dehydration

Priority level for high BUN?

B – Assess

Normal hemoglobin range?

12 – 18

Hgb 8–11 level?

B – Monitor

Hgb <8 level?

C – Do something

Actions for Hgb <8?

Assess for bleeding, prepare transfusion if ordered

Normal bicarb range?

22 – 26

Abnormal bicarb priority?

A – Not a priority alone

Normal CO₂ range?

35 – 45

CO₂ in 50s priority?

C

Actions for CO₂ in 50s?

Assess breathing, pursed-lip breathing, notify provider

CO₂ ≥ 60 priority?

D

Actions for CO₂ ≥ 60?

Prepare intubation/ventilation, call RT, stay with patient

Hct normal range?

36 – 54

High hematocrit usually means?

Dehydration

Priority level for high Hct?

B – Assess

Normal PaO₂?

78 – 100

PaO₂ 70–77 level?

C

Actions for PaO₂ 70–77?

Assess respirations, give oxygen, notify provider

PaO₂ <60 level?

D

Actions for PaO₂ <60?

Prepare intubation/vent, call RT, stay with patient

Normal SpO₂?

93 – 100

SpO₂ <93 priority?

C

Action for SpO₂ <93?

Give oxygen, assess patient

BNP indicates what?

CHF

High BNP priority?

B

Normal sodium range?

135 – 145

Abnormal sodium priority?

B

What to assess if sodium abnormal?

Mental status

Normal WBC range?

5,000 – 11,000

ANC must be above?

500

CD4 below 200 means what?

AIDS

Low counts priority?

C

Precautions for low WBC?

Neutropenic precautions

Normal platelet range?

150,000 – 400,000

Platelets <90,000 actions?

Bleeding precautions

Platelets <40,000 priority?

D

What are the 5 lab values that are always D priority?

Potassium >6, pH in the 6s, CO₂ ≥ 60, PaO₂ <60, Platelets <40,000