ABGs, Understanding Basic Lab Results

Question 1

Purpose of Understanding Basic Laboratory Tests

Answer 1

1. establishing diagnosis
2. rule out clinical problem (eliminate presence of disease)
3. monitor course of illness and response to treatment
4. check prognosis
5. screen for disease
6. check drug therapeutic level and toxicity

Question 2

Nursing Responsibilities

Answer 2

• Know and understand laboratory tests
• Maintain Universal Precautions
• Educate patients
• Identify patients
• Follow guidelines/protocols for specimen collections and reporting.
• Know supplies/equipment (esp. if nurse is drawing blood from central line)
• Know interfering factors
• Monitor results
• Report abnormal results (maintain privacy)
• Documentation

Question 3

Basic Chemistry Panel

Answer 3

• sodium (Na)
• potassium (K)
• chloride (Cl)
• CO2
• Blood Urea Nitrogen (BUN)
• Creatine

Question 4

Indications: Chemistry Panel

Answer 4

• Cardiac, Respiratory, GI, Renal, Endocrine, Metabolic, &/or Neuro diseases
• Burns
• Electrolyte imbalances/abnormalities
• Acid-Base balance status
• Malnutrition
• Hydration status (dehydration)
• Effects of drug therapy
• Pre-op
• Baseline assessment

Question 5

CBC and Differential

Answer 5

• RBC Count
• Hemoglobin
• Hematocrit
• RBC indices
• WBC count and differentials
• Platelet count

Question 6

Indications: CBC w/ diff.

Answer 6

• Hematologic (blood) disorders
• Cardiac, Renal, Liver, or Lung diseases
• Neoplasm (cancer)
• Leukemia
• Infection
• Autoimmune diseases or immunologic abnormality
• Malabsorption syndromes
• Dietary deficiency
• Dehydration
• Pre-op & post-op
• Baseline assessment
• Blood loss
• Pregnancy
• Monitor response to chemo (evaluate undesired reactions to drugs)

Question 7

Liver Panel, Liver Functions Tests (LFTs)

Answer 7

• Bilirubin
• AST (Aspartate Aminotransferase)
• ALT (Alanine Aminotransferase)
• GGT (Gamma-Glutamyl Transpeptidse)
• 5’ Nucleotidase
• ALP (Alkaline Phosphatase)

Question 8

Indications: LFTs

Answer 8

• Liver disease
• Hepatic tumor, necrosis, or ischemia
• Hepatoxic drugs, ETOH use
• Drugs for cholesterol or hyperlipidemia
• Trauma
• Obstructive jaundice
• Gallbladder or Pancreatic disease
• Pregnancy
• Preop
• Baseline data

Question 9

Lipid Panel, Lipid Profile

Answer 9

Patient must be FASTING!

• Cholesterol
• HDL
• LDL
• VLDL
• Triglycerides

Question 10

Indications: Lipid Panel

Answer 10

• Family history of hypertriglyceridemia
• Hyperlipidemias
• Cardiac disorders (also used to evaluate risk for cardiac disease)
• Renal Failure
• Diabetes Mellitus
• High fat or high carbohydrate diet
• Malabsorption syndrome
• Thyroid disorders
• Malnutrition

Question 11

Coagulation Panel

Answer 11

• PT (protime)
• PTT (partial thromboplastin time)
• Bleeding Time
• Platelet Count (see CBC)

Question 12

Indications: Coag Panel

Answer 12

• Monitor drug effects (heparin, warfarin)
• Drug overdoses (anticoagulants, antiinflammatories)
• Embolism
• Bleeding or Clotting disorders
• Vit. K deficiency
• Bleeding disorders
• Renal or Liver disorder (cirrhosis)
• Bone marrow failure
• Massive blood transfusion

Question 13

Other Tests

Answer 13

• thyroid panel
• renal panel, renal function tests
• UA (urinalysis)

Question 14

Urinalysis (UA)

Answer 14

Appearance
Color
pH
Protein
Specific Gravity (SG)
Leukocyte esterase
Nitrites
Bilirubin
Casts
Glucose
WBC

Question 15

Acid-Base Disorders

Answer 15

-must maintain homeostasis

Question 16

hydrogen ions (H+)

Answer 16

determine acidity of body fluids

Question 17

acids

Answer 17

release H+ in solution

Question 18

bases (alkaline)

Answer 18

accept H+ in solution

Question 19

pH

Answer 19

measured hydrogen concentration in solution

Question 20

H+ and pH have an

Answer 20

inverse relationship

Question 21

If you increase H+, how does that affect pH?

Answer 21

pH falls (acidic)

Question 22

If you decrease H+, how does that affect pH?

Answer 22

pH rises (alkaline or basic)

Question 23

Regulation of Acid-Base Balance

Answer 23

maintains pH of body within normal range

Question 24

Buffer Systems effect on regulation of acid-base balance

Answer 24

buffers are substances that prevent changes in pH by removing or release H+

Question 25

Respiratory System effect on regulation of acid-base balance

Answer 25

regulates carbon acid in body by eliminating or retaining CO2.

Question 26

Renal System effect on regulation of acid-base balance

Answer 26

excess acids removed by kidneys, they also bicarbonate ions.

Question 27

(ABGs) arterial blood is used because

Answer 27

it reflects acid-base balance in body than venous blood

Question 28

(ABGs) Arterial blood provides

Answer 28

information about the effectiveness of lungs in oxygenating blood

Question 29

What elements are measured in ABGs?

Answer 29

pH, PaCO2, HCO3, PaO2

Question 30

ABGs

Answer 30

Arterial blood gas

Question 31

Normal ABGs: pH

Answer 31

7.35-7.45

Question 32

Normal ABGs: PaCO2

Answer 32

35-45 mm Hg

Question 33

Normal ABGs: PaO2

Answer 33

80-100 mm Hg

Question 34

Normal ABGs: HCO3

Answer 34

22-26 mEq/L