1
Q
What is a normal range of sodium?
A
135-145
2
Q
What does a high sodium reflect?
A
- Diet affects this and IV fluid
- Vascular fluid deficient (increased concentration, free water loss)
- Diabetes insipidus
3
Q
What does a low sodium reflect?
A
- Vascular fluid overload (decreased concentration)
- NG suction
- Burns (loss of serum)
- Diuretic administration
- Vomiting, diarrhea
4
Q
What is a normal chloride?
A
98-106 mmol/l
5
Q
What decreases Chloride?
A
- Decrease with NG
- Diet affects this and IV fluid
- Drugs that may lower serum chloride measurements include: Aldosterone, Bicarbonates, Certain diuretics
6
Q
What increases chloride?
A
- Drugs that may increase serum chloride measurements include:
Acetazolamide, Ammonium chloride Androgens, Cortisone, Estrogen, Guanethidine, Methyldopa, (NSAIDs)
7
Q
What is a normal potassium
A
3.5 - 5.0
8
Q
What does a decrease in potassium reflect?
A
- Decrease with NG
- Diuretic administration
- Vascular fluid (increased and decreased concentrations)
- Insulin admin
- Alkalosis
- Ascites
9
Q
What does an increase in potassium reflect?
A
- Increased with IV fluid administration with potassium added
- acidosis
- Infection
Meds
Acidosis
Cellular destruction - burns
Hypoaldosteronism
Increase of K+ intake
Nephrons broken
Excretion problems - kidneys
10
Q
What is a normal CO2?
A
23-30 mmol/l
11
Q
What does an increase in CO2 reflect?
A
- NG
- Breathing disorders,
- Cushing syndrome
- Hyperaldosteronism
- Vomiting
12
Q
What does a decrease in CO2 reflect?
A
- Addison disease
- Diarrhea
- Ethylene glycol poisoning
- Ketoacidosis
- Kidney disease
- Lactic acidosis
- Metabolic acidosis
- Methanol poisoning
- Salicylate toxicity (such as aspirin overdose)
13
Q
What does CO2 measure?
A
kidney’s ability to buffer
14
Q
What is a normal range for BUN?
A
10-20 mg/dL
15
Q
What does a high BUN reflect?
A
- moderate or heavy bleeding in the upper gastrointestinal tract (e.g. from ulcers).
- Enhanced metabolism of proteins will also increase urea production, as may be seen with high protein diets, patients on total parenteral nutrition, steroid use, burns, or fevers.
16
Q
What does a low BUN reflect?
A
- liver problems
- malnutrition (insufficient dietary protein)
- excessive alcohol consumption.
- Overhydration from intravenous fluids
17
Q
What is a normal creatinine range?
A
0.5-1.3 mg/dL
18
Q
When do you see increases in creatinine?
A
A rise in blood creatinine level is observed only with marked damage to functioning nephrons
19
Q
What is a normal glucose?
A
70 - 110
20
Q
What are high levels of glucose associated with?
A
- Expect to high due to stress
- Increase in catecholamine response
- Administration of steroids
- Diabetes
21
Q
What is a normal calcium range?
A
9 - 10.5 mg/dL
22
Q
What are 3 things that affect calcium?
A
- Calcium varies with the level of serum albumin, a protein to which calcium is bound.
- Vitamin D is an important co- factor in the intestinal absorption of calcium
- Bone serves as an important storage point for calcium, as it contains 99% of the total body calcium.
23
Q
What is a normal phosphorus range?
A
3.0 - 4.5 mg/dL
24
Q
When do you see increased levels of phosphorus?
A
- Hypoparathyroidism
- renal failure
- bone metastasis
- hypocalcemia
- acidosis
- Rhabdomyolysis
- hemolytic anemia
25
When do you see decreased levels of phosphorus?
1. Inadequate dietary ingestion
2. chronic antacid ingestion
3. hypercalcemia
4. alcoholism
5. vitamin D deficiency
6. Alkalosis, gram- negative sepsis
7. malnutrition
26
What is a normal range of magnesium?
1.3 - 2.1
27
What are increased levels of mag associated with?
1. Dehydration
2. Addison's disease
3. hyperparathyroidism
4. hypothyroidism
5. Kidney failure
6. The use of medicine that contains magnesium, such as antacids and laxatives
28
What are decreased levels of mag associated with?
1. Alcohol abuse or withdrawal
2. diabetic ketoacidosis
3. malabsorption problems in the intestines, such as sprue
4. Infection and swelling of the pancreas (pancreatitis).
5. Kidney disease.
6. Long-term diarrhea.
7. Not getting enough magnesium in the foods you eat.
8. hypoparathyroidism
29
What is a normal albumin?
3.5 - 5.0
30
What are decreased levels of albumin associated with?
1. When liver disease hepatocytes loose ability to produce albumin
2. Overhydration
3. Third-space losses
4. inflammatory disease (burns, necrosis)
31
What 2 things does total protein measure?
albumin and globulin
32
what is a normal total protein
6.4 - 8.3 G/dL
33
What is a normal white blood cell count?
5 - 10.0x10 3 u
34
When do you see increases in WBC?
Increase is a response to acute infection and inflammation.
35
what is a normal RBC count?
4.2 - 6.1 mil/ul
36
When do you see an increased RBC count?
Increased in administration of EPO
37
When do you see a decreased RBC count?
1. Decreased with bone metastasis
2. hemorrhage
3. anemia
4. malnutrition
5. Decreased when bone marrow focused on other cells
38
What 2 things affect HGB?
iron and protein
39
When do you see a decreased HGB?
1. Decreased # RBC
2. hemorrhage
3. anemia
4. malnutrition
40
What is a normal HCT?
37-52%
41
When do you see a decreased HCT?
1. Dilutional anemia
2. hemorrhage
3. decrease EPO
4. malnutrition
42
When do you see an increased HCT?
1. Dehydration
| 2. fluid loss
43
When do you see a decrease in platelets?
1. Aplastic anemia
2. Cancer in the bone marrow, such as leukemia
3. Cirrhosis (liver scarring)
3. Folate deficiency
4. HIT
5. thrombocytopenic bleeding
6. prolonged infection (sepsis)
(used platelets during surgery)
44
What is a range for PTT?
60 - 70 seconds
45
What is a normal aPTT?
30-40
46
When do you see an increased PTT, aPTT?
1. Full Anticoagulant therapy (1.5 – 2 times control)
2. (Intrinsic pathways activation)
3. Heparin administration
4. Liver failure (cirrhosis)
5. DIC
47
When do you see a decreased PTT, aPTT?
1. Extensive cancer (ovarian, pancreatic, colon)
48
What is a normal PT?
11 - 12.5 seconds
49
What affects PT?
1. Warfarin (Coumadin) therapy
2. Full Anticoagulant therapy (1.5 – 2 times control)
3. Hepatocellular Disease (cirrhosis, hepatitis, and neoplastic invasive
prohepatocellular sysfuntion)
4. Biliary disease (obstruction)
5. (extrinsic pathways activation)
6. (Vitamin K deficiency, DIC, massive blood transfusions, salicylate
intoxication)
50
What is a normal INR?
0.8 - 1.1
51
What 3 things affect INR?
1. Warfarin (Coumadin) therapy
2. DIC
3. Liver failure (cirrhosis)
52
What is a normal D-dimer?
<0.4 mcg/mL
53
When is the D-dimer increased?
when identifying intravascular clotting
54
What is a normal fibrinogen?
200 - 400 mg/dL
55
When do you see increased fibrinogen?
1. Acute infections, Cancer, Coronary heart disease, myocardial infarction, Stroke
2. DIC
3. Inflammatory disorders (like rheumatoid arthritis and glomerulonephritis, a form of kidney disease)
4. Trauma
5. Cigarette smoking
6. Peripheral artery disease
56
What is a normal neutrophil count?
55-70%
57
When do you see increases in neutrophils?
1. bacterial infections
| 2. physiological stress
58
What are normal lymphocyte ranges?
20-40%
59
When do you see an increase in lymphocytes?
Viral infections
60
What is a normal monocyte range?
2 - 8%
61
What do monocytes act like?
Act as phagocytes in some inflammatory diseases
62
What is a normal range of eosinophils?
1-4%
63
When do you see an increase in eosinophils?
1. allergic reactions
2. hay fever asthma
3. drug sensitivity
64
What is a normal range of basophils?
0.5 - 1%
65
What do basophils contain?
Contain heparin, histamines, and serotonin.
66
What do basophils analyze?
“mast cells” analyze allergic reactions
