Nursing: Lab Values and Implications

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Urine Specific gravity
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1.010-1.030
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Sodium (Na)
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135-145 mEq/L Major intracellular cation, balance is between intake and renal excretion INCREASED (high intake, GI fluid loss, vomitting, sweating, dehydration) DECREASED- overhydration, renal insufficiency diuretic therapy, diarrhea
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Central Venous Pressure
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2-6 mmHg; 5-10 cmH2O
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Polyuria
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> 2000ml in 24 hours
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Oliguria
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100-400ml in 24 hours
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Anuria
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< 100 in 24 hours
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Magnesium
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1.5-2.5 mEq/L
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Calcium
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8.5 – 10.5 mg/dL evaluate parathyroid function & calcium metablolism. needed for muscle contractility, cardiac funciton, neural transmission and blood clotting. INCREASED- bone tumors, prolonged immobilizaiton, hyperparathyroidism DECREASED- inadequate intake, Vit D deviciency, renal failure, hypoparathyroidism NURSING IMPLICATIONS: assess intake of calcium & Vit D, renal function, cardiac function, CALCIUM CAN CAUSE CONSTIPATION
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Potassium
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3.5-5.0 mEq/L Balance is most inportant in maintaining membrane electric potential DECREASED- (diuretics, vomitting and diarhea,) INCREASED- (dehydration, renal failure, crush injury or burns, hemolysis) assess diet, cardiac function, diuretics, I&Os, kidney functioning
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pH
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7.35-7.45
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PaO2
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80-100 mmHg
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PaCO2
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35-45 mmHg
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HCO3
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22-26 mEq/L
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PTT (Partial Thromboplastin Time)
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normal = 20-35 seconds; on heparin therapy goal is 1.5 – 2.5 times this
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PT (Prothrombin Time, Pro-time)
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10 -13 seconds – refer to INR value
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INR
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1.0 norm without treatment; 2-3 for AFib, DVT & PE; 2.5-3.5 for prosthetic heart valves
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Serum Creatinine
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0.7 – 1.4 mg/dL
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Hematocrit Adult Male
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42-52%
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Hemoglobin Adult Male
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13-18 g/dL
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Hematocrit – Adult Female
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35-47%
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Hemoglobin – Adult Femail
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12-18 g/dL
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Glucose-fasting plasma
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65 – 115 mg/dL
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Glucose critical low
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< 50
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Glucose critical high
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> 400
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WBC
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ADULTS: 5,000 – 10,000/mm3 CHILDREN: 5,000 – 13,000/mm3 INCREASED? (infection, stress/trauma, dehydration, tissue necrosis)- check for signs of infection/ inflammation, antibiotics? DECREASED? (autoimmune disease, bone marrow dysfunction, vitamin deficiency)- protect from infection
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Blood Urea Nitrogen (BUN)
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10-20 mg/dL Blood urea nitrogen (BUN) measures the amount of urea nitrogen, a waste product of protein metabolism, in the blood. Urea is formed by the liver and carried by the blood to the kidneys for excretion. Because urea is cleared from the bloodstream by the kidneys, a test measuring how much urea nitrogen remains in the blood can be used as a test of renal function. INCREASED (aka azotemia) – elderly and in males – renal failure, dehydration, shock, stress, trauma, excessive protein intake DECREASED- liver failure, malnutrition, steroids, overhydration, pregnacy (due to increased plasma volume)
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Platelets
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150,000-400,000/mm3
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Red Blood Cells (RBC) – Adult Male
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female: 4.2-5.4 million/mm3 male: 4.7-6.1 million/mm3 INCREASED- (dehydration, congential heart disease, COPD)- VS? respriatory status? DECREASED- (blood loss, hemorrage, anemia, pregnancy, bone marrow depression, severe dehyrdation) – assess for blood loss, dietary deficiencies (protein or iron?)
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Digoxin Therapeutic Serum Level
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0.5-2 ng/ml
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Bleeding Time
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1.5-9.5 minutes
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Hemoglobin A1C
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Total cholesterol
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122-200 mg/dL
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High Density Lipoproteins (HDL) – Male
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35-70 mg/dL
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High Density Lipoproteins (HDL) – Female
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35-85 mg/dL
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Low Density Lipoproteins (LDL)
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160 mg/dL = too high time to treat
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Serum albumin
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3.5-5 g/dL
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Lithium Therapeutic Level
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.6-1.2 meq/L therapeutic
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Serum Ammonia (arterial)
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15-40 mcg/dL
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ALT/SGPT
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8-40 U/L
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AST/SGOT
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8-40 U/L
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Total serum protein
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6.0 – 8.0 g/dL
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Erythrocyte Sedimentation Rate (ESR) – Male
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0-15 mm/hr
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Erythrocyte Sedimentation Rate (ESR) – Female
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0-25 mm/hr 25 y/o
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Phosphorous
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2.5-4.5 mg/dL
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Intracranial Pressure (ICP)
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Glasgow Come Scale
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15 best score, 3 lowest score, 7 considered comatose
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Pulse Pressure
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Mean Arterial Pressure
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Chloride
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97-110 mmol/L
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Glucose Tolerance Test
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Fasting = 60-110 mm/dL, 1 hour = 190 mm/dL, 2 hours = 140 mm/dL, 3 hours = 125 mm/dL
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Serum Bilirubin Total
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0 – 0.9 mg/dL
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Serum Bilirubin Indirect
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0 – 0.3 mg/dL
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Lactate dehydrogenase (LDH)
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100 – 225 IU/L
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Alkaline Phosphatase
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50-150 units/L
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Serum Triglycerides
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100 – 200 mg/dL
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Creatine Kinase
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50-235 U/L = Male; 50-250 U/L = Female;0-70 U/L = Child
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Lithium – Therapeutic Level
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0.5-1.3 mEq/L
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Theophylline – Therapeutic Level
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10-20 mcg/mL
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phenytoin (Dilantin) – Therapeutic level
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10-20 mcg/mL
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acetaminophen (Tylenol)
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120-150 ng/dL
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magnesium sulphate
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4-7 mg/dL
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carbamazepine (Tegretol)
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5-12 mcg/mL
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amitriptyline (Elavil)
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120-150 ng/dL
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Urine pH (normal)
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4.5 – 8.0
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normal urine production/24 hr
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1,000 – 2,000
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normal/adequate fluid intake
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1,500 – 2,000 mL/day
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APTT (Activated Partial Thromboplastin Time)
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normal = 60 – 70 seconds; if on heparin therapy goal is 1.5 – 2.5 times norm
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Serum Creatine
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FEMALES- 0.5-1.1 MALES- 0.6-1.2 Creatinine is a waste product that is made when your body breaks down protein you eat and when muscles are injured/ totally excreted in kidney & directly proportional to renal excretory function INCREASED- due to renal failure (Reduced blood flow to the kidney due to shock, dehydration, congestive heart failure, atherosclerosis, or complications of diabetes), DECREASED- inadeuate protein, poor muscle mass.
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BLOOD GLUCOSE
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INCREASED- diabetes mellitus, acute stress, diuretic & steroid use, chronic renal failure DECREASED- insulin overdose, starvation NURSING IMPLICATIONS:assess BS, stress/surgery/meds, diet, activity, insulin HYPOGLYCEMIA shaking, sweating, anxiety, headache, slurred speech, confusion, hunger, pale HYPERGLYCEMIA= flushed, fatigue, headache, blurred vision, N & V, polyuria, polydyspia, polyphagie, fruity breath, coma
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Sodium (Na) – Value
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135-145 mEq/L
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Sodium (Na) – Description
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Major intracellular cation, balance is between intake and renal excretion
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Sodium (Na) – Increased
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(high intake, GI fluid loss, vomitting, sweating, dehydration)
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Sodium (NA) – Decreased
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overhydration, renal insufficiency diuretic therapy, diarrhea
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Calcium – Value
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8.5 – 10.5 mg/dL
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Calcium – Description
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needed for muscle contractility, cardiac funciton, neural transmission and blood clotting. Parathyroid function & metabolism of this substance should be evaluated.
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Calcium – Increased
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bone tumors, prolonged immobilizaiton, hyperparathyroidism
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Calcium – Decreased
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inadequate intake, Vit D deviciency, renal failure, hypoparathyroidism
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Calcium – Nursing implications
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Assess intake of calcium & Vit D, renal function, cardiac function. Constipation possible.

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