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61 Cards in this Set

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Chem Panel

Glucose
60 - 110 mg/dL
Caloric energy source
Chem Panel

Total bilirubin
<1.0 mg/dL
breakdown product of hemoglobin
Chem Panel

Total protein
6.0-7.7 g/dL
Chem Panel

Albumin
3.5-5.0 g/dL
responsible for oncotic pressure & binding
Chem Panel

Alkaline phosphatase (AP or ALP)
20-120 IU/L
enzyme related to bone growth & hepatic function
Chem Panel

Blood urea nitrogen (BUN)
8-30 mg/dL
end product of protein metabolism
Chem Panel

Uric acid
male=4-8 mg/dL
female=2.6-7 mg/dL
end product of purine metabolism
Chem Panel

Creatinine (Cr)
<1.5 mg/dL
by product of muscle catabolism
Chem Panel

Aspartate aminotransferase (AST)
<42 IU/L
transfer of amino groups

enzyme related to skeletal muscles and liver function
Chem Panel

Alanine aminotransferase (ALT)
<30 IU/L
transer of amino groups

enzyme related to liver function
Chem Panel

Cholesterol
<200 mg/dL

major plasma lipid needed for hormone synthesis
Chem Panel

Lactate dehydrogenase (LDH)
100-225 IU/L

– catalyzes pyruvate to lactate in glycolysis
– enzyme related to muscle & liver function (LDH5)
Chem Panel

Calcium
8.4-10.2 mg/dL

2.1 - 2.6 mmol/L

– essential mineral
Chem Panel

Phosphate
2.6-4.5 mg/dL

0.84 - 1.45 mmol/L

– essential mineral
Chem Panel

Magnesium
1.5-2.2 meq/L

0.6 - 0.95 mmol/L

– essential mineral
Hematology Survey Complete blood count (CBC)

Hematocrit (Hct)
male=41-50%

female=36-46%
Hematology Survey Complete blood count (CBC)

Hemoglobin (Hgb)
males=13-17 gm/dL

female=12-15 gm/dl
Hematology Survey Complete blood count (CBC)

Red blood cells (RBC)
males=4.5-5.8 K/mm3
female=4.0-5.0 K/mm3
Hematology Survey Complete blood count (CBC)

RBC Indices

– Reticulocytes
0.5 - 2.5% RBC’s
RBC Indices

MCV
80-100 fl
RBC Indices

MCH
26-34 pg/cell
RBC Indices

MCHC%
31-37 g/dL
Hematology Survey

White blood cells (WBC)
4-9 K/mm3
WBC Differential

Segs
45-75%
WBC Differential

Monocytes
2-6%
WBC Differential

Bands
<5%
WBC Differential

Eosinophils
0-4%
WBC Differential

Lymphocytes
20-40%
WBC Differential

Basophils
0-1%
Hematology Survey

Platelet (Plts)
120-420 K/mm^3
Serum Electrolytes:
Sodium
136-145 meq/L
Serum Electrolytes:
Chloride
96-105 meq/L
Serum Electrolytes:
Potassium
3.5-5.0 meq/L
Serum Electrolytes:
Bicarbonate
24 - 30 meq/L
Fluid Compartments
60% of Total Body Weight
ICF = 40% of TBW
ECF = 20% of TBW
ISF = 15% of TBW
Plasma = 5% of TBW
Daily Fluid Requirements
35 mL/kg per day

1500 mL/m^2 per day
Acid Base Values

HCO3/PCO2 Ratio
Normal 20:1

<20:1 - pH < 7.35 acidosis
>20:1 - pH > 7.45 alkalosis
Acid Base Values

pH
7.4 (7.35-7.45)
Acid Base Values

PO2
80-100 mmHg
Acid Base Values

PCO2
35-45 mmHg
Acid Base Values

HCO3
22-26 meq/L
Anion Gap
AG = Na - (Cl + HCO3)

Normal: 3-11
Acid Base Values

Urine pH
pH 5-7
Metabolic Acidosis Tx

Acetazolamide dose
250-500 mg x 1-2
Chronic Metabolic Acidosis Tx

Bicarb dose
Loading Dose: 22-24 meq/L

Maintenance Dose: 1-3 meq/kg/day (2 gm/day max 6 gm per day)

Wasting: 10-15 meq/kg/day
BUN:Cr Ration
Normal 15-20:1

Increase: intravascular depletion
Decrease: intrinsic renal damage, dec protein intake, hepatic cirrhosis
Measured Creatine Clearance Equation
CrCl = (Ucr X Vol) / (Scr x T)
ARF Urine Output

Nonoliguric
UO > 450 mL/day
ARF Urine Output

Oliguric
UO 50-450 mL/day
ARF Urine Output

Anuric
UO < 50 mL/day
Urinalysis

Proteinuria
> 150 mg per day

A glomerular problem
ARF Diuretic Tx

Mannitol
12.5 - 25 gm IV may repeat 1X
ARF Diuretic Tx

Furosemide
80 mg IV

If no response, 400 mg IV
ARF Diuretic Tx

Furosemide + distal tubule diuretic
Chlorthiazide 500 mg IV (not w/ CrCl < 25 mL/min)

Metolazone 10 mg PO q12h (works w/ low GFR)
Staging CKD

Stage 1
Kidney Damage w/ normal or increased GFR (>90 mL/min/1.73m^2)

Structural damage-proteiuria
Staging CKD

Stage 2
Kidney damage w/ mild decrease in GFR (60-89 ml/min/1.73 m^2)
Staging CKD

Stage 3
Moderate decrease in GFR (30-59 ml/min/1.73 m^2)

Symptoms are present and beginning effects of anemia and hyperPTH
Staging CKD

Stage 4
Severe decrease in GFR (15-29 mL/min/1.73 m^2)

Uremia,electrolyte and acid/base disorder
Staging CKD

Stage 5
Kidney Failure ESRD (< 25 mL/min/1.73 m2)

Requires renal transplant or dialysis
Glycemic Control

HgbA1c
Normal < 6%

Diabetic Target <7%
Anemia of CKD (any stage)

Hgb
Male: Hgb < 13.5 g/dL
Female: Hgb < 12 g/dL

Target: 11 >= 11.0 g/dL