When would you have U waves? (Looks like elongated T waves)
Hypokalemia
Normal lab values BMP
BMP
Na+ 135-145
K+ 3.5-5
Cl 95-105
BUN 4.5-11
Cr 0.6-1.4
Gluc 60-110
BHB
0.4-0.5
Primary ketone body at the onset to dka, primary identification of dka
Mg
1.5-2.5
Low mg usually seen w low ca and k
Magnesium loss in icu pt:
Urine lose, GI loss, medications/abx, nutrition, stress response
Phosphorus
3-4.5
Bone health
Reciprocal relationship w Ca++
Causes tetany, sz, hypotension
Ca
8.8-10.2
Kidney disease always have low Ca.
HYPO: dysphasia hypotension seizure muscle weakness
HYPER: Confusion hypotonia paresis volume depletion short QT interval
Chvostk’s Sign
Touch the cheek and it will draw the cheek and lip up. Sign of low Ca
Trousseau Sign
Sign of muscular excitability. BP cuff on the arm, the hand will flex up towards the BP cuff
Hypocalcemia
Normal labs CBC
RBC 4.2-5.4
Hgb 12-16
HCT 37-47 (3X hgb)
MCC 80-95 (low- iron deficiency)
MCH 23-31 (amt of hgb per RBC)
RDW 11-15% (size of RBC)
Platelets 150-400
WBC 4500- 11,000
(Components of wbc’s: neitrophils, lymphocytes, monocytes, eosinophils, basophils- Never let monkey eat bananas
Coag
INR 0.8-1.2 (how long it takes the blood to clot compared to the standard rate. Evaluating effects of blood thinning meds: Coumadin
PT 10-14 how long it takes plasma to clot
PTT 25-35 specific to Heparin. Measures functioning of intrusive and common clotting pathways
Ammonia <40
Serum Osmolality
275-295. Amount of solute i the serum part of the blood. Maintains proper fluid in our body.
High- diabetes (lack of adh, body drops fluid, we’re hemoconcentrated)
Low- SIADH. Indicates diluted state, holding onto vol
Urine spec gravity
1.005- 1.030
Low is more diluted in our urine. Diabetes.
High more concentrated.
SIADH- high spec gravity, holding on to fluid not peeing, your pee is concentrated. Remember they have low serum osmolality
Troponin
0.04
Starts after hour 3 of heart injury and will peak at hour 12
CK-MB
0-0.3
Found in cardiac muscle and skeletal muscle. Compare it to the CK ratio (relative index) is > 2.5-3 lively indicates cardiac damage
proBNP
<100 pg/ml
Secreted by cardiomyocytes based on ventricular stretch
Used as a marker in CHF patients
Which of the following patients would you anticipate being at the highest risk of developing hypernatremia?
A) 56-year-old male with cancer of the lung and SIADH
B) 26 year-old male with acute diarrhea and vomiting
C) 48 year-old female with bacterial pneumonia, fever and diaphoresis
D) 73-year-old female with CHF taking loop diuretics 
C
You have administered three units of PRBCs. Your patient initial hemoglobin and her was 5 and 18. You would expect their H&H to increase to.
A) hgb 8 hct 27
B) hgb 6 hct 21
C) hgb 8 hct 24
D) hgb 7 & hct 24
A
Hgb increases 1 with every prbc and Hct increases 3 with every prbc
You have a nine-year-old female patient. Her current hematocrit is 59 sodium is 158 and chloride is 121. What is the most likely cause of these findings?
A) normal findings in a pediatric patient
B) dehydration
C) acute renal failure
D) fluid overload
B
A patient would likely require PRBC transfusion at what Hgb level?
<9
<10
< 7
< 8
<7
Chvostek’s sign is associated with which electrolyte abnormality?
Hyponatremia
hypokalemia
hypocalcemia
hypophosphatemia 
Hypocalcemia
Neutrophils 45-75%
Purpose is to destroy and ingest BACTERIA, FUNGI
Eosinophils 0-7%
Allergic reaction and inflammatory
Lymphocytes 18-45%
Fight viral infection
Monocytes 1-10%
Phagocytic cells remove foreign material, clean up at end of viral or bacterial process
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