Learn: new lab values

blood chemistry

used to assess wide range of conditions and the functions of body organs

sodium (Na+)

most abundant cation in the blood

- maintain osmotic pressure, acid-base balance, nerve impulses

sodium normal range

126-145 mEq/L

hyponatremia

low sodium

- weakness exhaustion, headache, tachycardia

hypernatremia

high sodium

- dehydration, increased aldosterone tremors, seizures, coma

potassium (K+)

maintain osmotic balance, along with sodium, acid base balance

- needed for proper nerve and muscle action

potassium normal range

3.5-5.0 mEq/L

hypokalemia

low potassium

- fatugie, depression, weakness

hyperkalemia

high potassium

- cardiac arrest, ventricular arrhythmias

chloride (Cl-)

maintains cellular integrity through osmotic pressure, acid-base balance, water balance

chloride normal range

98-106 mEq/L

Hypochloremia

low chloride

metabolic alkalosis, muscle spasms

Hyperchloremia

high chloride

minimal symptoms

sweat chloride measured in children suspected of CF

normal chloride level is 60-80

children with frequent lung infections and a sweat chloride level above 80 probably have CF

Calcium (Ca)

most abundant mineral in the body

involved in bone metabolism, protein absorption, muscle contraction, nerve impulses, cardiac function

calcium normal value

4.505.25 or 8.7-10.5 mg/dL

hypercalcemia

high calcium levels

- fatigue, depression, muscle weakness, vomiting, constipation

hypocalcemia

low calcium

muscle twitching, ECG changes, seizure, ab cramping, spasms

Magnesium (Mg)

4th most abundant mineral in the body

preserved normal muscle and nerve function, KEEPS HEART RHYTHM STEADY, bones strong

magnesium normal level

1.7-2.1 mEq/L

hypomagnesemia

low magnesium

- inadequate intake of magnesium

muscle weakness, irritability, ECG changes, delirium, seizures

hypermagnesemia

high magnesium

- caused by dehydration; EKG changes, increased K, cardiac arrest, resp. muscle paralysis

phosphorus

abundant element found in most tissues and cells

most found in bones , 15% found in blood

closely and inversely related to calcium

phosphorus normal range

1.2-2.3 mEq/L

hypophospatemia

low phosphate

caused by malnutrition, starvation

diaphragmatic weakness

hyperphosphatemia

high phosphate

minimal symptoms

bicarbonate

Regulated by kidneys

bicarb normal value

22-26 mEq/L

CO2

resp. exchange and part of the body's buffering system

CO2 normal range

35-45 mmHg

pts with COPD have

chronic hypercarbia (high CO2)

blood urea nitrogen BUN

nitrogen part of urea- end product of protein metabolism

BUN normal range

8-23 mg/dL

increased BUN

kidney damage, excessive protein intake

decreased BUN

poor diet, malabsorption

creatinine

waste product of muscle metabolism, reflection of the body's muscle mass

more specific for kidney failure than bun!

creatinine normal range

0.7-1.3 mg/dL

elevated creatinine

kidney disease

decreased creatinine

kidney damage, liver disease, pregnancy

total protein

protein involved with enzymes, hormones antibodies

reserve source of nutrition for body's tissues and muscles

protein normal range

6.0-8.5 g/dL

decreased protein

poor nutrition, malabsoprtion

increased protein

lupus, liver disease, chronic infections

albumin

helps with osmotic pressure regulation, nutrient transport, waste removal

albumin normal range

3.5-5.2 g/dL

increased albumin

not seen, primary dehydration

decreased albumin

poor diet, diarrhea

cholestrol

important in the systesis of steroid hormones

most synthesized through liver, some absorbed through diet

HDL

high density lipoproteins (healthy type of cholesterol)

LDL

low density lipoprotein (bad cholesterol)

cholestrol normal range

150-220 mg/dL

high cholestrol

diabetes, hypothyroidism, pregnancy

low cholestrol

depression, malnutrition

glucose

formed by digestion of carbs and the conversion of glycogen by liver

- primary source of energy

glucose normal range

70-139 mg/dL

elevated glucose

diabetes, steroid medications

decreased glucose

over production of insulin, liver disease

hematology

study of the blood and blood diseases

RBC

main function is to carry oxygen to tissue and transfer CO2

RBC normal range

4-6 million

hemoglobin Hgb

main transport of oxygen and COs in the blood

- important determinant of anemia

anemia

reduced the oxygen carrying capacity in th eblood

polycythemia

increases oxygen carrying capacity in the blood

Hgb normal range

12-16 gm%

hematocrit (Hct)

measurements of the percentage of RBCs in whole blood

Hct normal range

40-50%

WBC

fight infection, defend body by phagocytosis, transport and distribute antibodies in immune response

leukocytopenia

deficiency of white blood cells

leukocytosis

increased WBC count, body's response to infection

WBC count

5,000-10,000/mm3

neutrophils bands

immature cells, 0-6% wbc,

INCREASED with bacterial infection

segmented neutrophils

mature cells, normally 40-75% WBC

DECREASED with bacterial infection

eosinophils

0-6% total WBC

asthma and allergic reactions

basophils

0-1%

monocytes 2-10%

lymphocytes

20-45%

thrombocytes

platelets

platelet

smallest formed element of the blood

vital to coagulation to prevent excess bleeding

elevated platelets

dehydration

decreased platelets

immune system failure

platelet normal adult range

150-400,000 per mm3

higher range found in children

MCV (mean corpuscular volume)

actual size of RBC

- classifies anemias

87-103 cubic microns

thalassemia

inherited disease that can cause severe anemia

MCHC (mean corpuscular hemoglobin concentration)

measure of concentration of Hgb in an average RBC

normal is 32-36%

- useful assessing degree of anemia

clotting time normal value

up to 6 mins

activated partial thromboplastin time (APTT)

measured length of time required for plasma to form a fibrin clot

normal APTT time

25-39 seconds

USED FOR HEPARIN TERAPY

prothrombin time (PT)

similar to APTT, but used for monitoring WARFARIN therapy

normal bleeding 12-15 seconds

INR (international normalized ratio)

0.9-1.3

values of 5.0 indicate high likelihood for bleeding

values of 0.5 indicate tendency for clotting

legitimate sputum sample

numerous pus cells, few epithelial cells

sputum

clear- normal

mucoid- white; chronic bronchitis

yellow- WBC, bacterial infection

green- gram-neg, bronchiectasis, pseudomonas

brown/ dark- old blood

bright red- hemoptysis, TB

pink frothy- pulmonary edema

sputum culture

identify the bacteria present

sensitivity

identify what antibiotics will kill bacteria

gram stain

indentify gram postive vs. negative

acid fast stain

identify mycobacterium tuberculosis

culture, sensitivity, and gram stain can be done on...

blood, urine, pleural samples

troponin

specific to heart muscle, release into blood when injury to hear occurs

- peaks 4-6 hours after damage, remains elevated for a week

the higher the troponin level,

the greater the damage

creatine kinase normal range

20-220 U/L

SGOT

serum glutamic oxaloacetic transaminase

- found in high concentration in the heart

- found when injury occurs