Labs

Question 1

For every 0.1 change in pH, K will change by _________

Answer 1

0.6 in OPPOSITE direction

Question 2

For every 10mEq/L change in HCO3, pH will change ________

Answer 2

0.15 in the SAME direction

Question 3

For every 10mmHg change in CO2, pH will change ________

Answer 3

0.08 in OPPOSITE direction

Question 4

Sodium Normals

Answer 4

135-145
- determines osmotic pressure
- dominant extra cellular cation

Question 5

Hyponatremia

Answer 5

<135 mEq/L
Causes: vomiting/diarrhea, volume overload, loss of water (SIADH)

Question 6

Hypernatremia

Answer 6

> 145
Causes: sweating, diarrhea, Cushing’s syndrome, DI

Question 7

Potassium Normals

Answer 7

3.4-5.0 mEq/L
- regulated by kidneys
- in acidosis, H shifts K out of cells causing increase in labs

Question 8

Hyperkalemia

Answer 8

> 5 mEq/L
Symptoms: slow wide V tach (QRS), peaked T waves, tachycardia
Treatment: Ca gluconate, glucose, insulin, alb

Question 9

Hypokalemia

Answer 9

<3.5 mEq/L
Symptoms: hypotension, vent arrhythmias, cardiac arrest
** prominent U waves, T waves flat/inverted
Treatment:
- give K

Question 10

Calcium Normals

Answer 10

8.5-10.5
- muscular contraction, excitability, coagulation

Question 11

Hypocalcemia

Answer 11

Cramping, tingling, AMS
Causes: diarrhea, renal failure, alkalosis
- reciprocal relationship with phosphorous

Question 12

Hypercalcemia

Answer 12

Pain, N/V, AMS, polyuria, polydipsia
Causes: renal impairment, decreased phos

Question 13

Chvostek’s Sign

Answer 13

Hypocalcemia/Hyperphosphatemia
- touching side of cheek causes draw up of cheek/lip

Question 14

Trousseau’s Sign

Answer 14

Hypocalcemia/Hyperphosphatemia
- hand flexed to forearm (during BP)

Question 15

Magnesium

Answer 15

1.5-2.5
Hypo: torsades, tremors
Hyper: AMS, decreased RR, decreased DTR, decreased BP

Question 16

Chloride

Answer 16

95-105
- follows Na and water
- deficiency in Cl = decrease K and vice versa

Question 17

Creatinine

Answer 17

0.6-1.2
- waste product of muscle metabolism
Increase: shock, rhabdo, dehydration
Decrease: pregnancy

Question 18

BUN

Answer 18

6-23
- measures glomerular function
- is a urea waste product of liver
Increase: renal failure, hypovolemia, CHF, dehydration
Decrease: liver failure, malnutrition, excessive IVF

Question 19

Anion Gap

Answer 19

Uncorrected: 9-12
K corrected: 16-20
- measurement between cation and anion

Question 20

Betahydroxybutyrate (BHB)

Answer 20

0.4-0.5
- predominate ketone body at onset of DKA

Question 21

BNP

Answer 21

<100
- secreted by cardiomyocytes based on vetricular stretch

Question 22

Troponin

Answer 22

<0.4
- protein essential for muscle contraction
- calcium binding site
-increases after injury

Question 23

Creatine Kinase (CK)

Answer 23

0-3
- enzyme in cardiac and some skeletal muscles
- normally undetected

Question 24

Serum Osmolality

Answer 24

275-305 (double Na norm)
Increase: dehydration, DI, hyperglycemia, hypernatremia
Decrease: SIADH, hyponatremia, overhydration

Question 25

Urine Specific Gravity

Answer 25

1.005-1.030 - identifies urine concentration Increase: SIADH Decrease: DI (dilutional)

Question 26

Hypoparathyroidism can cause:

Answer 26

hypocalcemia

Question 27

DIC lab values

Answer 27

decreased platelets, decreased fibrinogen, prolonged PT/PTT

Question 28

Sickle cell crisis triggers

Answer 28

Stress, cold, poor fluid intake

Question 29

Excessive NG suction can cause:

Answer 29

metabolic alkalosis

Question 30

What lab value is utilized to evaluate GFR?

Answer 30

urine Cr

Question 31

What lab abnormality causes peaked T waves?

Answer 31

Hyperkalemia

Question 32

What lab abnormality causes prominent U wave?

Answer 32

Hypokalemia