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What does Hemoglobin do?
- – The essential oxygen carrier of the blood
- – A protein used by RBC’s to distribute oxygen to other tissues and cells in the body
What are the Lab value ranges for Hemoglobin?
- Remember "15" as a normal value
- Ranges Adult
- Male 14.0 - 17.4 g/dl
- Female 12.0 -16.0 g/dl
- Pediatric 11.0 - 16.0 g/dl
- Neonate 10.7 – 17.1 g/dl
What does Hematocrit do?
- – The percentage of red blood cells (RBC) in a volume of whole blood
- – Refers to the amount of blood that is occupied by RBC’s
- • It’s like chocolate milk: how much of it is chocolate and how much of it is milk
Normal Values for Hematocrit?
- Ranges Adult
- Male 39% - 49%
- Female 34% - 44%
- Pediatric 32% - 45%
- Neonate 33% - 55%
Normal Range for WBC count
- – Adult 4,000 - 10,000 (cell/mcl) **
- – Pediatric 5,000 - 10,000 (cell/mcl)
Red Blood Cell Count
- Ranges Adult -5**
- Male 4.2- 5.6M/ul
- Female 3.8– 5.1M/ul
- Pediatric 3.5– 5.0M/ul
- Neonate 3.3– 5.5M/ul
What are Neutorphils?
- • Main defender of the body against
- – Infection
- – Antigens
- • High levels may indicate an active infection
Normal Neutorphil values
- • Should account for anywhere between 38% and 80% of the WBC count
- • Ranges
- Adult 50% - 75% **
- Pediatric 30% - 60%
- High levels are found in allergic reactions
- • Ranges 0% - 1%
- Produces the anti-inflammatory protein histamine
- Ranges 1% - 5%
- Bear the major responsibility for carrying out the activity of the immune system
- Adult 15% - 40%
- Responsible for removal of debris
- • Ranges 2% - 6%
Which Electrolytes are on a Chem 7 Blood screen?
- • Sodium
- • Potassium
- • Chloride
- • Bicarbonate
- • Magnesium
- • Phosphorus
- • Calcium
What role do Electrolytes have?
- • Involved in metabolic activities
- • Essential to the normal function of all cells
- • Positively and negatively charged molecules
- – Called ions
- • Intracellular
- • Extracellular(Interstitial)
- • In the bloodstream
- • In other fluids throughout the body
Which electrolytes are found more abundently inside of Cells?
Which electrolytes are found more abundently Outside of Cells?
Sodium and chloride
Normal Sodium (Na) levels
Ranges 135 - 145 mEq/L
What does Sodium do?
- The major extracellular cation and osmotically active solute
- • Major functions are
- –Water balance
- – Transmission of nerve impulses
- • Deficits lead to neurological changes
How is Sodum eliminated from the body?
What is Hypernatremia?
- Increased sodium level caused by
- • Water excess - Diuetics/ Diarrhea
- • Sodium loss
- – Manifestations
- • Confusions
- • Seizure
How do you treat Hypernatremia?
- • Diluting the sodium
- • Promoting excretion
- • Consider fluids (D5W)
- • Consider diuretics
- – Avoid rapid rehydration with hypotonic fluids
- • Can cause fluid shifts
What does Potassium (K) do?
- The principle cation in intracellular fluid
- Plays a crucial role in the formation of electrical impulses in nerves and muscle
What is considered in abnormally high Potassium levels?
- High level is above 5.0
- Broken cells would cause falsely elevate potassium levels
- – Referred to as hyperkalemia
- – DKA
- – Metabolic Acidosis
- – Uremia
- – Iatrogenic
- • Hemolysis
- It is considered severe over 8.0
- • Widening of the QRS complex
- • Bradycardia
- • Eventually, ventricular standstill
What is in a Potassium Cocktail?
- • Calcium Chloride – Acts as a cardiotonic
- • Sodium Bicarbonate- forces K back into the cells.
- • D50 – Counter acts the effect of Insulin
- • Insulin – Forces potassium back into the cell
- – Can also be given if the patient is showing signs of
- impending arrest
What is Hypokalemia?
Low serum potassium is referred to as hypokalemia and occurs when the serum potassium level falls below 3.5
How is Hypokalemia treated?
- • Treatment consists of replacing K+ with KCL.
- • NEVER push IV
Normal Potassium(K) ranges
Ranges 3.5- 5.0mEq/L
- A negatively charged ion found primarily in extracellular fluid.
- • Ranges 95 - 110mEq/L
Magnesium (Mag)- Causes of deficits
- Magnesium deficits MUST be corrected before it is possible to correct the potassium deficit.
- Diuretics, diarrhea and alcoholism are 3 very common causes of magnesium depletion.
- Over ½ of the total body stores are located in bone and less than 1% is in plasma.
Complications of hypermagnesemia are
Complete heart block can be seen at serum levels of 7.5 mEq/L and respiratory depression and coma can occur at serum levels of 10mEq/L.
Normal Magnesium range is
1.3– 2.2 mEq/L
Normal Bicarb levels
22- 26 mEq/L
What is Anion Gap
- The equivalence of cations in a solution always balances the equivalents of anions.
- [Na + K] - [Cl + HCO3] = anion gap
Normal values for the Anion Gap are
- < 12
- (>12 is Metabolic Acidosis)
60- 120 mg/dl
Blood Urea Nitrogen (BUN)
- • Ranges 10- 20 mg/dl
- – Elevated
- • Renal Failure
- • Dehydration
- • GI Bleed
- •Low- Protein deficiency
- The most important indicator of glomerular filtration rate and is a by/product of normal muscle metabolism.
- Ranges 0.6mg/dl – 1.2mg/dl
Cardiac Enzymes (CK/MB values)
- CK Adult Male 96– 140U/L
- MB Adult Male 0% - 5 %
- • Troponin I < .01
- • Troponin T < .01
- intracellular storage site for oxygen.
- • Ranges Male < 90ng/ml
B-type natriuretic peptide (BNP)
- Commonly used to assisst in the diagnosis and monitoring of Congestive Heart Failure
- Normal value: < 100
Prothrombin Time (PT)
- • The PT is used to monitor Coumadin therapy.
- • Ranges 11 sec - 13 sec
Partial Thromboplastin Time (PTT)
- • The PTT is used to monitor heparin therapy
- Ranges 30 sec – 45 sec
- Ranges 130 – 400 k/mcl
- Thrombocytopenia is the term used for a low platelet count.