Bedside Laboratory Interpretation T3

Home > Preview

The flashcards below were created by user thom.mccusker@gmail.com on FreezingBlue Flashcards.


  1. Limitations of Lab Values
    • 1. Single point in time
    • 2. "Lab" errors
    • a. Hemolyzed specimen
    • b. Wrong collection tube
  2. Context of values
    • Abnormal: acute vs chronic (i.e. Anemia)
    • (normal may not necessarily excluded disease)
  3. Sodium
    • Major extracellular cation
    • a. Gradient
    • b. Depolarization
    • Sodium and water clearances tied together
    • 135-145mEq/L
  4. Correcting Sodium
    • Must correct volume status prior to correcting sodium
    • - Fluid restriction vs administration
    • -NSS cvs D5W (free water)
    • Cardiac and CNS issues
  5. Sodium Metabolism
    • 1. ADH (atidiuretic hormone)/vasopressin
    • * Release stimulated
    • - by hypotension
    • - increased plasma osmolarity
    • - stress hormones
  6. Potassium
    1. Major intracellular cation


    • 3.5-5.0 mEq/L
    • 2. "Reverse" gradient
    • a. Maintain depolarization
    • b. Involved in repolarization
    • 3. Cardiac and muscular effects
  7. Potassium (chronic vs acute)
    • 1. Chronic vs acute renal failure
    • a. Tolerance of severe hyperkalemia
    • b. Arrhythmia (vvfib/vtach)
    • 2. Hypokalemia
    • a. Arrhythmias
    • b. Important in cardiac patients
    • c. Must correct hypomag
  8. Magnesium
    • 1. Enzymes depend on it at cellular level
    • 1.8-2.6 mg/ml
    • Source: dietary
    • Clearance (70% renal filtering, rest protein bound)
    • Kidneys preferentiallly retain Mg over K
  9. Chloride
    • - 98-106 mEq/L
    • - renal clearance
    • - tied to sodium clearance
    • usuallly passive (anions move with cations)
  10. Chloride is lost with significant _______ and _____ ______ .
    • Vomiting
    • NGT suctioning
  11. Chloride increases with ___ ________ .
    NSS administration
  12. Bicarbonate
    • 1. 23-28 mEq/L
    • 2. Base buffer system
    • 3. HCO3- + H+ -> H2CO3 -> H2O and CO2
  13. BUN
    • 8-20 mg/dl 
    • Nitrogen (from ammonia from liver) combined with carbon, hydrogen and oxygen and others
  14. Creatinine
    • 0.7-1.3 mg/dl
    • Protein metabolism
    • Measure of GFR
  15. Calcium
    • 2.2-2.6 Moller/L (9-10.5 mg/dl)
    • 1. Balance: calcitonin and PTH
    • 2. Hypocalcemia
    • A. Tetany (intermittent muscle spasm)
    • B. Chvosteks and Trousseau tests
    • 3. Hypercalcemia
    • A. Diureses
    • B. Stones, groans, bones, psychic overtones
  16. Complete Blood Count
    • WBC
    • HGB
    • HCT
    • Platelets
  17. WBC
    3.5-10.5 cells/mcl
  18. HGB (Hb)
    • Males 13.5-17.5 g/dL
    • Females 12.0 15.5 g/dL
  19. HCT
    • Males 38-50%
    • Females 35-44%
  20. Platelets
    150k-450k cells/mcl
  21. Troponin (CTNI)
    • ~ 0.04 ng/ml
    • (set at 99th percentile)
    • Assay dependent
    • - 3-4 hours from initial infarct
    • - peak 24 hours
    • Rechecking Q6 hours
    • (normal does not R/O ACS)
  22. Beta Natriuretic Peptide (BNP)
    • < 100 pg/ml "normal"
    • Some correlation to severity of heart failure.
    • Nesiritide(natrecor) Hormone that can treat CHF that's getting worse.
  23. Ph
    • Arterial 
    • 7.35-7.45
    • Venous
    • 7.3-7.5
    • ~.03 more acidosis in venous blood
    • Greater variation when further from "normal"
  24. PCO2
    • Arterial
    • 35-45
    • Venous
    • 42-48
  25. PO2
    • Arterial
    • 80-100
    • Venous
    • 35-45
  26. HCO3
    • Arterial
    • 22-28
    • Venous
    • 24-30
  27. ABG/VBG Interpretation
    • 1. Look at pH 1st: acidosis vs alkalotic 
    • 2. Look at PCO2
    • a. Could have combo metabolic
    • b. Can only have single respiratory 
    • c. Could have metabolic and respiratory
  28. Primary Respiratory Disorder
    (ABG/VBG Interpretation)
    • 1. Increase in PCO2 causes acidosis
    • 2. Acute
    • Increase in PCO2 by 10 decrease in pH by .08
    • 3. Chronic (CO2 retainers)
    • Increase in PCO2 by 10 decrease in pH by only .03 (less acidosis since "buffered"
  29. Anion Gap
    • AG = Na - (Cl + HCO3)
    • Reflects unmeasured anions - proteins/albumin
  30. High Anion Gap Acidosis
    • Acidosis fro addition of unmeasured anions
    • 1. Methanol/metformin
    • 2. Uremia
    • 3. DKA
    • 4. Paraldehyde
    • 5. Iron
    • 6. Lactic Acidosis 
    • 7. Ethylene Glycol
    • 8. Salicylates
  31. Normal Gap Acidosis
    • 1. Usually addition of chloride (normal saline)
    • 2. Loss of bicarbonate (diarrhea)

Card Set Information

Author:
thom.mccusker@gmail.com
ID:
333491
Filename:
Bedside Laboratory Interpretation T3
Updated:
2017-08-14 01:37:08
Tags:
Labs
Folders:
T3
Description:
Bedside Laboratory Interpretation Temple Transport Team
Show Answers:

Home > Flashcards > Print Preview