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44 Cards in this Set
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Sodium
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135 to 145 mEq/L
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Hyponatremia Causes
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Increased sodium excretion: excessive diaphoresis, diuretics, vomiting, diarrhea, wound drainage esp GI, renal disease, decreased aldosterone secretion
Inadequate sodium intake: NPO, low-salt diet Dilution of serium sodium: renal failure, freshwater drowning, syndrome of inappriorate ADH secretion, hyperglycemia, CHF, excessive ingestion of hypotonic fluids/irrigation with hypotonic fluids |
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Hypernatremia Causes
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Decreased sodium excretion: corticosteriods, Cushing's syndrome, renal failure, hyperaldosteronism
Increased sodium intake: excessive oral sodium ingestion/sodium IV fluids Decreased water intake: NPO Increased water loss: fever, hyperventilation, infection, increased metabolism rate, excessive diaphoresis, watery diarrhea, diabetes insipidus |
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Potassium
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3.5 to 5.1 mEq/L
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Hypokalemia Causes
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Actual total body potassium loss: excessive use of meds ie diuretics/corticosteriods, increased secretion of aldosterone, vomiting, diarrhea, wound drainage, prolonged NG suction, excessive diaphoresis, renal disease impairing reabsorption of potassium
Inadequate potassium intake: NPO Movement of potassium from the extracellular fluid to the intracellular fluid: alkalosis, hyperinsulinism Dilution of serum potassium: water intoxication, potassium-poor IV fluids |
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Hyperkalemia Causes
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Excessive potassium intake: overingestion of potassium-containing foods/meds
Decreased potassium excretion: potassium-sparing diuretics, renal failure, adrenal insufficiency ie Addison's disease Movement of potassium from the intracellular fluid to the extracellular fluid: tissue damage, acidosis, hyperuricemia, hypercatabolism |
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Calcium
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8.6 to 10.0 mg/dL
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Hypocalcemia Causes
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Inhibition of calcium absorption from the GI tract: inadequate oral intake of calcium, lactose intolerance, malabsorption syndromes ie celiac or Crohn's disease, inadequate intake of vitamin D, end-stage renal disease
Increased calcium excretion: renal failure, polyuric phase, diarrhea, steatorrhea, wound drainage Conditions that decrease the ionized fraction of calcium: hyperproteinemia, alkalosis, meds ie calcium chelators/binders, acute pancreatitis, hyperphospatemia, immobility, removal/destruction of parathyroid glands |
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Hypercalcemia Causes
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Increased calcium absorption: excessive oral intake of calcium/vitamin D
Decreased calcium excretion: renal failure, use of thiazide diuretics Increased bone resorption of calcium: hyperparathyroidism, hyperthyroidism, malignancy, immobility, glucocorticoids Hemoconcentration: dehydration, lithium use, adrenal insufficiency |
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Magnesium
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1.6 to 2.6 mg/dL
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Hypomagnesemia Causes
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Insufficient magnesium intake: malnutrition/starvation, vomiting, diarrhea, malabsorption syndrome, Celiac/Crohn's disease
Increased magnesium secretion: Meds ie diuretics, chronic alcoholism Intracellular movement of magnesium: hyperglycemia, insulin administration, sepsis |
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Hypermagnesemia Causes
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Increased magnesium intake: magnesium-containing antacids/laxatives, excessive administration of IV magnesium
Decreased renal excretion of magnesium from renal insufficiency |
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pH
CO2 HCO3 O2 |
Acidosis 7.35 to 7.45 Alkalosis
Alkalosis 35 to 45 mEq/L Acidosis Acidosis 22 to 26 mm Hg Alkalosis 80 to 100 mm Hg |
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Respiratory Acidosis Causes
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Primary defects in the function of lungs or changes in respiratory patterns
Any condition that causes obstruction of the airway or depresses the respiratory system Asthma, atelectasis, brain trauma, bronchiectasis, bronchitis, CNS depressants, emphysema, hypoventilation, pulmonary edema, pneumonia, pulmonary emboli |
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Respiratory Alkalosis Causes
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Conditions that overstimulate the respiratory system
Fever, hyperventilation, hypoxia, hysteria, overventilation by mechanical ventilators, pain |
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Metabolic Acidosis Causes
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DM, DKA, excessive ingestion of aspirin, high-fat diet, insufficient metabolism of carbs, malnutrition, renal insufficiency/failure, severe diarrhea
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Metabolic Alkalosis Causes
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Results from dysfunction of metabolism causing increased amount of available base solution in blood or decreased available acids in blood
Diuretics, excessive vomiting or GI suctioning, hyperaldosteronism, ingestion of and/or infusion of excess sodium bicarbonate, massive transfusion of whole blood |
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Activated Partial Thromboplastin Time
(aPTT) |
20 to 30 seconds
Evaluates how well the coagulation sequence is functioning by measuring the amount of time it takes for recalcified citrated plasma to clot after PT added Monitors heparin therapy Screen for coagulation disorders |
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Prothrombin Time
(PT) |
Male: 9.6 to 11.8 seconds
Female: 9.5 to 11.3 seconds Measures the amount of time it takes for clot formation Monitors warfarin (Coumadin) therapy response Screens for dysfunction of extrinsic clotting system from liver disease, vitamin K deficiency, or disseminated intravascular coagulation |
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International Normalized Ratio
(INR) |
Standard warfarin therapy: 2.0 to 3.0
High-dose warfarin therapy: 3.0 to 4.5 Measures the effects of oral coagulants |
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Platelet Count
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150,000 to 400,000 cells/mm3
Produced by bone marrow to function in hemostasis Functions in hemostatic plug formation, clot retraction, and coagulation factor activation |
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Hemoglobin
(Hgb) |
Male:14 to 16.5 g/dL
Female: 12 to 15 g/dL Main componenet of erythrocytes and is the carrier for transporting oxygen and carbon dioxide Identifies anemia |
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Hematocrit
(Hct) |
Male: 42% to 52%
Female: 35% to 47% Represents RBC mass Important in measuring anemia or polycythemia |
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Red Blood Cell Count
(RBC) |
Male: 4.5 to 6.2 million/uL
Female: 4.0 to 5.5 million/uL Aids in diagnosing anemias and blood dyscrasias, also evaluates body's ability to produce RBCs in sufficient numbers Functions in hemoglobin transport resulting in oxygen being delivered to the body tissues Formed by red bone marrow, 120 day life span, removed from blood via liver, spleen, and bone marrow |
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Serum Iron
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Male: 65 to 175 mcg/dL
Female: 50 to 170 mcg/dL Aids in diagnosing anemias and hemolytic disorders Found in hemoglobin, acts as carrier of oxygen from lungs to tissues and carbon dioxide return to lungs |
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Creatine Kinase
(CK) |
26 tp 174 units/L
Levels rise within 6 hours of muscle damage, peaks at 18 hours, returns to normal in 2 to 3 days Detects myocardial or skeletal muscle damage, and CNS damage Found in muscle and brain tissue and reflects tissue catabolism resulting from cell trauma CK-MB: Cardiac Muscle: 0% to 5% of total CK-MM: Skeletal Muscle: 95% to 100% of total CK-BB: Brain tissue: 0% |
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Lactate Dehydrogenase
(LDH) |
140 to 280 units/L
Level rises about 24 hours after MI, peaks in 40 to 72 hours, returns to normal within 7 to 14 days LDH1: 14% to 26% LDH2: 29% to 39% LDH isoenzymes affected by acute MI are LDH1 and LDH2 LDH flip is when LDH1 is higher than LDH2, helps diagnose MI |
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Troponins
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Troponin I: <0.6 ng/mL; >1.5 indicates MI
Troponin T: >0.1 to 0.2 ng/mL indicates MI Regulatory protein found in striated (cardiac/skeletal) muscle and increased amounts released into bloodstream ehn infarction causes damage to myocardium Levels elevate as early as 3 hours after myocardial injury, TI levels remain elevated for 7 to 10 days, TT for 10 to 14 days |
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Albumin
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3.4 to 5 g/dL
Main plasma protein of blood: maintains oncotic pressure, transports bilirubin, fatty acids, meds, hormones, and other substances insoluble in water Increased with dehydration, diarrhea, metastatic carcinoma Decreased with acute infections, ascites, alcoholism Presence of albumin/protien in urine indicates abnormal renal function |
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Ammonia
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35 to 65 mg/dL
Byproduct of protein catabolism (most created by bacteria acting of proteins present in the gut) Elevated levels result from hepatic dysfunction, may lead to encephalopathy |
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Amylase
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25 to 151 units/L
Enzyme produced by pancreas and salivary glands, aids in digestion of complex carbs, excreted by kidneys Increased with acute pancreatitis, levels start rising 3 to 6 hours after onset, peaks at 24 hours, returns to normal in 2 to 3 days |
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Lipase
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10 to 140 units/L
Pancreatic enzyme converts fats and triglycerides into fatty acids and glycerol Increased in pancreatic disorders, elevations may not occur until 24 to 36 hours after onset, remain elevated for 14 days |
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Bilirubin
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Direct/conjugated: 0 to 0.3 mg/dL
Indirect/unconjugated: 0.1 to 1.0 mg/dL Total: lower than 1.5 mg/dL Produced by liver, spleen, bone marrow, and a byproduct of hemoglobin breakdown Increase with jaundice, direct/indirect levels help to differentiate the cause of jaundice |
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Lipids
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Cholesterol: 140 to 199 mg/dL
Low-density lipoproteins (LDL): <130 mg/dL High-density lipoproteins (HDL): 30 to 70 mg/dL Triglycerides: <200 mg/dL Cholesterol is in all body tissues and major component of LDL, brain/nerve cells, cell membranes, and some gallbladder stones Increased cholesterol, LDL, triglyceride levels place client at risk for CAD HDL protects against risk for CAD |
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Protein
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6.0 to 8.0 g/dL
Increased in Addison's disease, autoimmune collagen disorders, chronic infection, Crohn's disease Decreased in edema, cirrhosis, burns, severe hepatic disease Reflects total amount of albumin and globulins in plasma Regulates osmotic pressure and coagulation factors for hemostasis, enzymes, hormones, tissue growth/repair, and pH buffers |
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Uric Acid
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Male: 4.5 to 8 mg/dL
Female: 2.5 to 6.2 mg/dL Is formed as purines adenine and guanine, are metabolized continuously during formation and degradation of DNA and RNA, also formed from metabolism of dietary purines Elevated amounts of uric acid deposit in joints and soft tissue cause gout Increased cellular turnover and slowed renal excretion of uric acid may cause hyperuricemia elevated levels of urinary uric acid precipitate into urate stones in kidneys |
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Fasting Blood Glucose
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70 to 110 mg/dL
Aids in diagnosing DM and hypoglycemia Glucose is main source of cellular energy and essential for brain and erythrocyte function |
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Glucose Tolerance Test
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Baseline fasting: 70 to 110 mg/dL
30-min fasting: 110 to 170 mg/dL 60-min fasting: 120 to 170 mg/dL 90-min fasting: 100 to 140 mg/dL 120-min fasting: 70 to 120 mg/dL Aids in diagnosing DM If levels peak at higher than normal at 1 and 2 hours after glucose intake and slower than normal to return to fasting levels, then DM is confirmed |
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Glycosylated Hemoglobin
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Diabetics with
Good control: 7% or lower Fair control: 7% to 8% Poor control: >8% Is blood glucose bound to hemoglobin Hemoglobin A1C is reflection of how well blood glucose levels are controlled over past 3 to 4 months |
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Serum Creatinine
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0.6 to 1.3 mg/dL
Indicator of renal function Increased levels indicate slowing of glomerular filtration rate |
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Blood Urea Nitrogen
(BUN) |
8 to 25 mg/dL
Elevated levels indicate a slowing of glomerular filtration rate, due to acute or chronic kidney disease, damage, or failure. decreased blood flow to the kidneys r/t CHF, shock, stress, recent heart attack, severe burns, to conditions that cause obstruction of urine flow, dehydration May be elevated when there is excessive protein breakdown (catabolism), significantly increased protein in the diet, or gastrointestinal bleeding Low BUN levels are not common, seen in severe liver disease, malnutrition, and overhydration |
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Thyroid Studies
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Thyroid-stimulating hormone (TSH): 0.2 to 5.4 microunits/mL
Thyroxine (T4): 5.0 to 12.0 mcg/dL Thyroxine, free (FT4): 0.8 to 2.4 ng/dL Triiodothryonine (T3): 80 to 230 ng/dL Thyroid disorder diagnosis |
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White Blood Count
(WBC) |
4,500 to 11,000 cells/mm3
Neutrophils: 1800 to 7800 cells/mm3 Bands: 0 to 700 cells/mm3 Eosinophils: 0 to 450 cells/mm3 Basophils: 0 to 200 cells/mm3 Lymphocytes: 1000 to 4800 cells/mm3 Monocytes: 0 to 800 cells/mm3 Assesses leukocyte distribution Function in the immune defense system of body |
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White Blood Count
(WBC) Shifts to Left/Right |
"Shift to the Left": increased number of immature neutrophils is present in blood; with low WBC count indicates recovery from bone marrow depression or infectionwhere demand for neutrophils in tissue is higher than capacity of bone marrow to release into circulation; with high WBC indicates increased release of neutrophils by bone marrow as response to overwhelming infection/inflammation
"Shift to the Right": cells have more than usual number of nuclear segments; found in liver disease, Down syndrome, megaloblastic and pernicious anemia |
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