Week 1: Lab Values and Interpretation- Electrolyte Panel, BMP, CMP

What is it called with increased potassium

hyperkalemia

hyperkalemia causes

excess supplements, renal failure, metabolic acidosis, diabetic acidosis, blood transfusions

hyperkalemia presentation

muscle paralysis/weakness, muscle tenderness, paresthesia, dysrhythmia, bradycardia

what is it called with decreased potassium

hypokalemia

causes of hypokalemia

fluid overload, renal dysfunction, GI disorders, diuretics, alcoholism, hormone and endocrine disorders, cystic fibrosis.

hypokalemia presentation

extremity weakness, hyporeflexia, paresthesia, leg cramps, dysrhythmias, hypotension

clinical implications for BOTH hypo and hyperkalemia

increased risk for dysrhythmia and acute cardiac events (monitor vital signs and cardiac rhythm), watch strength and performance that may lead to flaccid paralysis

sodium

determinant of extracellular fluid volume

potassium

important for function of excitable cells (nerve, muscle, cardiac)

calcium

important for bone formation, cell division/growth, blood coagulation, neurotransmitter disease, muscle contractions

chloride

important for fluid balance and acid base status

phosphate

necessary for bone formation, acid base balance, storage, and transfer of energy

magnesium

important for BP control, bone strength, and heart rhythm

hyper- means

elevated

hypo- means

decreased

BMP means

basic metabolic panel

what is the bmp

8 specific lab tests that includes several electrolytes

what to pay attention to with BMP

time of results and timing of intervention

what 8 thinks are tested with BMP

calcium, carbon dioxide, chloride, creatinine, glucose, potassium, sodium, BUN

CMP stands for

comprehensive metabolic panel

What EXTRA is added into CMP

ALP, ALT, AST, bilirubin, albumin, total protein

normal male serum creatinine

0.6-1.2

normal female serum creatinine

0.5-1.1

elevated creatinine causes

renal disease, diabetic nephropathy, rhabdomyolysis, mm trauma, dehydration, meds, Urinary tract obsruction, polyomyositis, endocrine issues, exercise, heart failure

elevated creatinine presentation

edema, dyspnea, abdominal/back pain, myalgia, myopathy, arthralgia, fatigue, insomnia, headache, confusion, pruritis

elevated creatinine clinical implications

monitor for fatigue, vital signs, auscultate lungs, monitor pain, cognition

the higher the creatinine the ____ kidney function

worse

decreasing creatinine causes

debilitation, decreased mm mass

decreasing creatinine presentation

fatigue

decreasing creatinine clinical implications

monitor fatigue and vitals

what 2 things are tested for kidney function

blood urea nitrogen and serum creatinine

blood urea nitrogen (BUN)

nitrogen portion of urea, evaluates metabolic function of liver and excretory kidney function of urea

serum creatinine

catabolic product of creatine phosphokinase used in skeletal mm contraction, excreted by kidneys, measures GFR and renal function

fasting plasma glucose (FPG) test

measures blood sugar in fasting state

FPG adults

74-106

non fasting glucose test

mainly in those who are diabetics (2 hours after eating normally)

arterial blood gasses (ABGs) measure

acid base balance and oxygernation status

what are ABGs used to identify and monitor

acid-base disturbances, partial pressures of o2 and co2, assess response to med interventions

what are acid base disturbances compensations for

to normalize their pH and maintain homeostasis

where are ABGs drawn from

an artery (not vein)

pH measures

blood acidity

PaCO2 measures

effectiveness of alveolar ventilation

HCO3 measures

amount of bicarbonate dissolved in blood

PaO2 measures

pressure exerted by O2 dissolved in arterial blood in attempting to diffuse through pulmonary membrane

02 sat measures

oxyhemoglobin saturation, % of 02 carried by hemoglobin