Labs

Question 1

Specific Gravity

Answer 1

• High urine output → low specific gravity
• Low urine output → high specific graviry

Question 2

Creatinine (A category)

Answer 2

• Best indicator of kidney function
• 0.6-1.2 (serum)
  
  • If elevated, abnormal but not too worrisome (just means kidneys are failing)

Question 3

INR (+4 = C category)

Answer 3

• Monitors coumadin (warfarin) therapy
• 2-3
  
  • Increased = bleed risk
  • >4 is critical
    
    • hold all coumadin
    • Assess bleeding
    • Prepare to give Vitamin K
    • Call PCP

Question 4

Potassium

Answer 4

• 3.5-5.3
• For low (C category)
  
  • Assess heart
  • Prepare to give K+
  • Call PCP
• For mid - (5.4-5.9) (C category)
  
  • Hold potassium
  • Assess heart
  • Call PCP
• For high (6+) (D category)
  
  • Hold K+, assess heart, prepare Kayexalate/D5W
  • Call PCP

Question 5

pH

Answer 5

• 7.35-7.45
• Ph in 6s (D category)
  
  • Get vitals and call Dr.

Question 6

BUN (B category)

Answer 6

• 8-25 (“8 buns in the pack”)
• Elevated
  
  • Check for dehydration

Question 7

Hemoglobin

Answer 7

• 12-18
• For 8-11 (B category)
  
  • Monitor the patient
• For <8 (C category)
  
  • Assess bleeding, prepare for transfusion, call PCP

Question 8

Hct (B category)

Answer 8

• 36-54 (3x Hgb)
• If abnormal be concerned
• Assess for dehydration

Question 9

HCO3

Answer 9

• 22-26
• If out of range, abnormal but not worrisome

Question 10

CO2

Answer 10

• 35-45
• For CO2 in the 50s (C Category)
  
  • Assess respirations
  • Do pursed-lip breathing (blow out candle and exhale for longer periods)
  • Don’t give O2 (will increase CO2)
  • Does not apply to COPD
• For CO2 in the 60s (D Category)
  
  • Sign of respiratory failure
  • Assess respirations
  • Do pursed-lip breathing (decrease anxiety)
  • Prepare to intubate and ventilate
  • Call respiratory therapist
  • Call PCP

Question 11

PO2

Answer 11

• 78-100
• For 70-700 (C Category)
  
  • Sign of respiratory insufficiency
  • Assess respirations
  • Give Oxygen
• For <60s (D Category)
  
  • Sign of respiratory failure
  • Assess respirations
  • Give Oxygen
  • Prepare intubate and ventilate
  • Call respiratory therapist
  • Call PCP

Question 12

O2

Answer 12

• 93-100
• For <93
  
  • Assess respirations and give oxygen
• Anemia invalidates finger probe reading
  
  • falsely elevated
• Dye procedures cause high readings too

Question 13

BNP

Answer 13

• Good indicator of CHF
• 100
• For elevated #s (B category)
  
  • Continue to monitor

Question 14

Sodium

Answer 14

• 135-145
• Be concerned until there’s a change in the LOC (then becomes C Category)
• If high, assess for dehydration
• If low, assess for overload

Question 15

WBCs (C Categories)

Answer 15

• Total: 5000-11000
  
  • High WBC = leukocytosis
  • Low WBC = leukopenia, neutropenia, agranulocytosis, immunosuppression, bone marrow suppression
    
    • immunosuppressed, implement neutropenic precautions
• ANC: Above 500
  
  • immunosuppressed, implement neutropenic precautions
• CD4: Above 200 (<200 = AIDS)
  
  • immunosuppressed, implement neutropenic precautions

Question 16

Platelets

Answer 16

• 150,000-400,000
• For <90,000 (C Category)
  
  • Assess for bleeding
  • Implement bleeding precautions
• For <40,000 (D Category)
  
  • Assess for bleeding
  • Implement bleeding precautions
    *

Question 17

RBCs

Answer 17

• 4-6 million
• Abnormal are B category
• Monitor

Question 18

What are the 5 D Categories

Answer 18

• K+ >6
• pH in the 6s
• CO2 in the 60s
• PO2 <60s
• Platelets <40,000

Question 19

What are the Cs

Answer 19

• INR >4
• K+ low or 5.4-5.9
• BUN >30
• Hgb <8
• CO2 in the 50s
• PO2 70-77
• Na+ abnormal w/ change in LOC
• WBC <5000
• ANC <500
• CD4 <200
• Platelets <90,000