Med Surg Lab values

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saturn1212
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Med Surg Lab values
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2013-10-27 23:01:45
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Lab values Med surg nur 243
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  1. A1C
    • A1C: Identifies avg plasma glucose concentration over prolonged periods of time (3 months).
    • Normal: 4.0-5.5%
    • Causes of increase poorly controlled diabetes gestational diabetes
    • Causes of decrease hemorrhage chronic renal failure hemolytic anemia pregnancy related anemia
  2. Alanine Aminotransferase (ALT):
    • ALT: Assess liver function related to liver disease &/ or damage.
    • Normal: Female= 7-35, Male= 10-40
    • Causes of increase Acetaminophen toxicity Alcohol hepatitis Acute pancreatitis Liver cancer/ failure severe burns MI shock muscular dystrophy biliary obstruction recent muscle injury
    • causes of decrease vit B6 deficiency
  3. Amylase:
    • Amylase: assist in diagnosis & eval of the treatment modalities used for pancreatitis
    • Normal: 30-110
    • Causes of increase acute appendicitis, pancreatitis, & cholecystitis Aortic aneurysm burns and traumatic shock alcoholism mumps biliary tract disease pancreatic cancer common bile duct obstruction/ stones diabetic ketoacidosis Abd trauma
    • Causes of decrease Severe hepatic disease Pancreatectomy Pancreatic insufficiency
  4. aPTT
    • Activated Partial Thromboplastin Time (aPTT): assist in assessing coagulation disorders & monitor the effectiveness of therapeutic interventions
    • Normal: 25-35 secs (CV>70)
    • Causes of increase circulating anticoagulants Factor deficiencies Liver disease Heparin Lupus Warfarin therapy Vit K deficiency
    • Causes of decrease Antihistamines Digitalis Tetracycline Inflammatory States Elevated factor
  5. Albumin
    • Albumin: to assess liver or kidney function & nutritional status
    • Normal: 3.2-5
    • Causes of increase Dehydration Shock hemoconcentration
    • Causes of decrease Malabsorption Malnutrition CHF Acute & Chronic liver disease Thyroid dysfunction Inflammation and chronic diseases burns hemorrhage over hydration
  6. Anion Gap
    • Anion Gap: to assess the difference between cations and anions in the blood. Only Na, Cl, & HCO3
    • Normal: 8-16 (CV: <8 or >16)
    • Causes of increase Diabetic ketoacidosis ETOH ischemia uremia salicylates lactic acidosis
    • Causes of decrease Excess IV saline Hemorrhage Liver disease nephrotic syndrome lithium toxicity
  7. HCO3
    • HCO3: Used to detect, evaluate, & monitor electrolyte imbalance
    • Norm: 22-26 (CV:<15 or >40)
    • Causes of increase Comp resp acidosis Vomitting Cushing's disease diuretics Metabolic alk
    • Causes of decrease Chronic diarrhea Comp resp alkalosis Ketoacidosis Meta acidosis salicylate toxicity Vol overload renal failure
  8. PaCO2
    • PaCO2: used to assess resp function
    • Norm: 35-45 (CV: <20 or >60)
    • Causes of increase ETOH Barbituates Benzos MG resp acidosis resp failure
    • Causes of decrease Chronic hyperventilation Incorrect ventilator Liver disease Resp alkosis sepsis
  9. O2 SAT
    • O2 Sat: measures how much O2 the blood is carrying as a percentage of max potential carrying capacity
    • Normal: 96-100%
    • Causes of increase alcoholism airway obstruction asthma barbituates COPD congenital heart disease MG PNA pulm embolism
  10. pH
    • pH: measure of balance of acids & bases in the blood
    • Normal: 7.35-7.45 (CV: <7.25 or >7.55)
    • Causes of increase Metabolic alk Resp Alkalosis
    • Causes of decrease Meta acidosis Resp acidosis
  11. AST
    • Aspartate Aminotransferase (AST): enzyme associated with liver cell damage
    • Normal: <35
    • Causes of increase Acute viral hepatitis Alcohol hepatitis Erythromycin Liver abscess liver disease Liver cancer MI
    • Causes of decrease Vit B6 deficiency
  12. BUN
    • Blood Urea Nitrogen (BUN): Assess renal function & monitor effectiveness of therapeutic interventions such as hemodialysis.
    • Normal: 8-21 (CV>100)
    • Causes of Increase Acute renal failure CHF Decreased renal perfusion ketoacidosis hypovolemia GI bleed DM Shock Urinary tract obstruction
    • Causes of decrease Malabsorption Low-protein/ high-carb diet pregnancy severe liver disease inadequate dietary protein
  13. BNP
    • B-type natriuretic peptide (BNP): assist in diagnosing CHF
    • Normal: <100
    • Causes increase Cardiac inflammation Cirrhosis MI HF Left Ventricular hypertrophy renal failure pulm HTN ventricular dysfunction
  14. Ionized Ca
    • Ionized Calcium: Investigate conditions related to alt levels of ionized calicum.
    • Normal: 4.6-5.2 (CV: <3.2 or >6.2)
    • Causes of increase Alkalosis Bone cancer chronic renal failure Vit D toxicity
    • Causes of decrease acidosis alcoholism chronic renal failure Mg+ deficiency Vit D deficiency
  15. Creatine Kinase & Isoenzymes (CK-MB)
    • Creatine Kinase & Isoenzymes (CK-MB): marker for cardiac ischemia
    • Normal: 55-170
    • Causes of increase ETOH muscle trauma MI myocarditis RA CVA tetanus
    • Causes of decrease sedentary lifestyle small stature
  16. Creatnine
    • Creatnine: Assess kidney function in renal failure
    • Normal: 0.61-1.21
    • Causes of increase CHF dehydration renal disease renal failure shock renal calculi
    • Causes of decrease decreased muscle mass liver disease pregnancy hyperthyroidism
  17. D-Dimer
    • D-Dimer: assist in diagnosing a diffuse state of hypercoagulation
    • Normal: <250 Causes of increase Arterial or Venous thrombosis DVT DIC Pre-eclampsia Pregnancy PE recent sx thrombolytic or fibrinolytic therapy 2nd fibrinolysis
  18. eGFR
    • Glomerulaar Filtration Rate (eGFR): vol of fluid filtered thru the renal glomerular capillaries into the Bowman's capsule per unit time.
    • Normal: 60
    • Causes of increase early DM acromegaly high CO infection hypothyroidism
    • Causes of decrease shock renal failure CHF decreased renal perfusion dehydration hemorrhage
  19. Fasting blood glucose
    • Fasting blood glucose: assist in dx or assess of DM
    • Normal: 65-100 (CV: <50 or >125)
    • Causes of increase pancreatitis DM glucocorticoids stress
    • Causes of decrease Adrenal insufficiency ETOH malignancy malnutrition sepsis hypoglycemia hypothyroidism
  20. Hematocrit
    • Hematocrit: amt of blood vol occupied by RBCs
    • Normal: 36-52
    • Causes of increase burns congenital heart disease CHF COPD dehydration diarrhea hypoxia shock vomiting
    • Causes of decrease anemia hemodilution hemolytic anemia liver disease malnutrition leukemia hemorrhage
  21. Hemoglobin
    • Hemoglobin: iron-containing O2 transport in blood
    • Normal: 13.5-17.5 (CV<5 or >20)
    • Causes of increase Burns COPD CHF dehydration shock vomiting diarrhea hypoxia,
    • Causes of decrease anemia renal disease hemodilution leukemia pregnancy liver disease hemorrhage hyperthyroidism
  22. HDL
    • High-density cholesterol (HDL): assess risk & monitor for CAD
    • Normal: 45-90 (CV<40)
    • Causes of increase Exercise Insulin Estrogen therapy
    • Causes of decrease Beta-blockers renal failure smoking DM diuretics hypothyroidism liver disease mod alcoholism obesity oral BC post MI stress
  23. Chloride
    • Chloride: Found mostly in ECF & is essential for maintaining acid/base balance, transmit nerve impulses & reg fluid in & out of cells.
    • Normal: 97-107 (CV<80 or >115)
    • Causes of increase diarrhea dehydration overuse of NS renal failure resp acidosis
    • Causes of decrease adrenal insufficiency HCO3 Cushing's syndrome diabetic ketoacidosis diuretics diaphoresis renal failure vomiting glucocorticoids
  24. Ketones
    • Ketones: produced when liver metabolizes fatty acids as a last resort for energy.
    • Normal: <5
    • Causes of increase Anorexia DM type 1 hyperthyroidism malnutrition prolonged hypoglycemia prolonged vomiting starvation
  25. Lipase
    • Lipase: pancreatic enzyme that digest fat into fatty acids
    • Normal: <160
    • Causes of increase Pancreatitis Cholecystitis Crohn's disease cystic fibrosis DM Liver disease Pancreatic cancer, duct obstruction, or pseudocyst Renal failure
    • Causes of decrease Pancreatic dysfunction
  26. LDL
    • Low-density Cholesterol (LDL): responsible for transporting hydrophobic lipids such as cholesterol and triglycerides thru the bloodstream
    • Normal: <100 (CV >160 for no risk factors, >130 for CAD risk factors)
    • Causes of increase Anabolic steroids Cholestasis Chronic renal failure DM hypothyroidism poor diet pregnancy hypercholesterolemia
    • Causes of decrease chronic illness
  27. Mg
    • Magnesium: evaluation of kidneys, DM, and GI disorders
    • Normal: 1.8-3.0 (<1 or >5)
    • Causes of increase Addison's disease ASA dehydration hypothyroidism lithium renal failure hyperparathyroidism Mg containing laxatives
    • Causes of decrease Albuterol ETOH diabetic ketoacidosis diarrhea diuretics malnutrition starvation malabsorption hypoparathyroidism
  28. Total Cholesterol
    • Total Cholesterol: acts to maintain cell membrane's fluidity
    • Normal: <200 (CV> 240)
    • Causes of increase cirrhosis corticosteroids Cushing's syndrome hyperlipidemia hypothyroidism poorly controlled DM pregnancy
    • Causes of decrease acute hepatitis cirrhosis hyperthyroidism malabsorption malnutrition sepsis
  29. Ph
    • Phosphorus: Buffering agent in cells
    • Normal: 2.5-4.5 (CV <1)
    • Causes of increase Bone cancer diarrhea diuretics hypocalcemia renal failure vit D toxicity hyper/ hypoparathyroidism Causes of decrease ETOH DM diarrhea hypercalcemia hypokalemia hypomagnesemia Vit D deficiency Oral BC hypothyroidism rickets
  30. Platelet
    • Platelet: Plays big role in hemostasis
    • Normal: 150-400 (CV <50 or >999)
    • Causes of increase Acute blood loss anemia cancer infection iron deficiency pre-eclampsia thrombocythemia
    • Causes of decrease ETOH anemia blood transfusion chemotherapy DIC HIT HIV leukemia uremia Plavix
  31. K+
    • Potassium: control muscle contraction (especially in heart), nerve impulses, and acid-base balance
    • Normal: 3.5-5.0 (CV <3 or >6)
    • Causes of increase ACE inhibitors acidosis renal failure Addison's disease dehydration ARBS Beta-blockers DM NSAIDs infection
    • Causes of decrease Ascites Burns Cushing's syndrome diarrhea diuretics hyperaldosteronism insulin metabolic alkalosis salicylates vomiting
  32. PT/INR
    • PT/INR: measures extrinsic pathway of coagulation to determine clotting tendency of blood.
    • Normal: 0.9-1.2 (CV>4)
    • Causes of increase DIC Hepatitis Liver disease Vit K deficiency Warfarin therapy
  33. RBC count
    • Red Blood Cell Count: Measures how many red blood cells are present in bloodstream to deliver O2 to the tissues thru the circulatory system.
    • Normal: 4.3-5.9
    • Causes of increase Congenital heart disease Dehydration High Altitude Hypoxia Malignancy Pulm fibrosis
    • Causes of decrease ETOH Allopurinol Anemia Chemotherapy renal failure hemodilution hemolysis hemorrhage malnutrition liver disease leukemia
  34. Na+
    • Sodium: Measures amount of essential electrolyte that helps with blood volume regulation, BP, fluid balance, nerve impulse conduction, muscle contraction, and acid-base balance
    • Normal: 135-145 (CV <120 or >155)
    • Causes of increase Cushing's syndrome dehydration DM excessive diaphoresis oral BC hypertonic saline pregnancy vomiting
    • Causes of decrease ACE inhibitors AIDS adrenal insufficiency CHF cirrhosis diarrhea heavy sweating hypothyroidism malnutrition NG suctioning thiazide diuretics vomiting, water intoxication
  35. Specific Gravity
    • Specific Gravity: measures urine concentration
    • Normal: 1.010-1.030
    • Causes of increase CHF dehydration fasting shock
    • Causes of decrease excessive fluid intake renal failure
  36. TSH
    • Thyroid Stimulating Hormone (TSH): hormone that regulates endocrine function of thyroid gland
    • Normal: 0.35-5.5
    • Causes of increase Cretinism pituitary adenoma primary hypothyroidism recovery phase of acute illness thyroid hormone resistance
    • Causes of decrease Acute illness glucocorticoids Grave's disease hyperthyroidism hypopituitarism levodopa
  37. Free T4
    • Free T4: Measures amt of total thyroxine that is not attached to anything. This hormone functions to increase CO, HR, RR, sympathetic activity and brain development
    • Normal: 0.9-2.4
    • Causes of increase Acute & chronic thyroiditis Amiodarone Beta-blockers Grave's disease hyperthyroidism Goiter iodine- induced hyperthyroidism
    • Causes of decrease Cretinism hypothyroidism malnutrition
  38. Triglycerides
    • Triglyceride: Major form of lipids in body
    • Normal: 70-150
    • Causes of increase ETOH beta-blockers renal failure cigarette smoking cirrhosis corticosteroids DM diuretics hypothyroidism obesity oral BC stress
    • Causes of decrease hyperthyroidism liver disease malabsorption malnutrition
  39. T3
    • Triodothyronine (T3): thyroid hormone that affects almost every physiological process in the body, including growth and development, metabolism, body temp, HR.
    • Normal: 60-171
    • Causes of increase Estrogen therapy Grave's disease hyperthyroidism liver disease oral BC pregnancy T4 therapy
    • Causes of decrease Anabolic steroids chronic disease glucocorticoids hypoglycemia lithium malnutrition oral BC
  40. Troponin
    • Troponin I: proteins of cardiac muscle that provide the most specificity for cardiac injury
    • Normal: <0.04
    • Causes of increase cardiac surgery cardiac trauma CHF dilated cardiomyopathy MI myocarditis unstable angina prolonged SVT
  41. CO2
    • CO2 (venous): used to assess resp function
    • Normal: 35-45 (CV <20 or >60)
    • Causes of increase ETOH Barbituates Benzos Guillian-Barre syndrome MG resp acidosis resp failure
    • Causes of decrease chronic hyperventilation liver disease incorrect ventilator settings resp alkalosis sepsis
  42. Uric Acid
    • Uric Acid: created when the body braks down purine nucleotides.
    • Normal: 2.5-7.8
    • Causes of increase ETOH chemotherapy gout leukemia low-dose aspirin menopause radiation therapy renal failure thiazide diuretics
    • Causes of decrease Allopurinol liver disease high dose aspirin
  43. WBC
    • WBC: cells of the immune system involved in defending the body against both infectious disease and foreign materials.
    • Normal: <0.5 or >50
    • Causes of increase Anemia autoimmune systemic disease burns cancer inflammatory disease infection leukemia severe stress
    • Causes of decrease anemia bone marrow failure ETOH glucocorticoids hypersplenism liver disease sepsis SLE vit B12 deficiencies

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