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Napa Valley College Associate Degree Program in Nursing Lab Values & Diagnostic Test Results Signifigence/Trend of Lab

Test Name of Test Normal Range Na is a major cation of ECF and has a water retaining effect. It is part of the NA/K pump. Its functions are to maintain body fluid, conduction of neuromuscular impulses, and enzyme activity K is a major ICF cation. It is part of the NA/K pump. The ECF/ICF ratio of K is the major factor in resting membrane potential of nerve and muscle cells and effects neuromuscular and cardiac function K has a narrow range and 8090% is excreted in the urnine, so it needs to monitored closely. When there is tissue breakdown K leaves the cells and enters the ECF, in there is adequat reanal fucntion it is excreted if not levels rise. High: Acute renal failure, metabolic acidosis, oliguria, anuria High/Drugs: Diuretics (K sparing), antibiotics, K Cl 3.6-5.3 mmol 98-107 mmol Cl is and ECF anion important in mainatining body water balance and acid base balance. CO2 determines metabolic acid-base abnormalites. If CO2 is low HCO3 is lost resulting in metabolic acidosis. If CO2 is high HCO3 is retained resulting in metabolic alkalosis. Observe S/S Hyperkalemia: Bradycardia, abd cramps, oliguria, anuria, tingling, twitching, numbness Renal function: UOP should be 25ml/hr or 600 ml/day; less may cause hyperkalemia Report: >5.0; restriction may be needed, and Kayexelate may be needed. If administering Kayexelate; Observe S/S Hypokalemia > 7.0 may cause cardiac arrest

Nursing Actions

Na

134-144 mmol

CO2

22-30 mmol

diabetic acidosis. blood clotting.55 mmol 1. carpopedal spasm. Ca. binds with phosphorus. sasms of larynx. Low: dyrythmias Protein malnutrition.With hypomanesemia there will usually be fully correct until Mg levels are corrected. IV soultions Renal: Mg is excreted by kidneys. formation of teeth and bones. It has a calcium. lack of intake. P is the principal ICF anion and is important in Low: Check serum levels of phospphorus. enzymes needed for carbohydrate and protein generalized spacticity. Low: Starvation.Ca functions to transmit nerve impulses. pain in muscle and bone hyperparathyroidism. causes rapid precipitation. anorexia. Teach: Foods rich in phosphorus: meats. EKG: A flat or inverted T wave may indicate hypomagnesemia or hypokalemia IV Mg: Administer slowly to prevent flushed feeling. pegnancy Ca Mg 2. Mg is needed for Observe for S/S Hypomagnesemia: Teteny. milk. saspmodic contractions Observe for positive Chvosteks's and Trousseau's signs Observe when client is recieving citrated blood. and hypokalemia is present K supplementation will protein. NG suctioning. burns. Mg activates many Twitching. chronic renal failure/phophate retention. Magnesium influences use of k. chronic alcholholism.6 meq/L Low: Observe for S/S of teteny/hypocalcemia: muscular twitching. anorexia. may prevent ionization Digoxin: Hypercalcemia enhances Dig toxicity: N/V. diarrhea. myocardial contraction. Low: Malabsorption. bradycaardia Administer IV Ca gluconate slowlly with D5W not NS. vomiting. Na. not take: Antacids with aluminum hydroxide. laxative abuse. Assess when without Mg. Both are decrease phophorus. almonds Do dec=ficiency. . Aborbed in small intestine and excreted by the Low: Check serum K. Ca. Observe S/S Hypophosphatemia: Anorexia. tremors. dehydration. It has a reciprocal realtionship to phosphorus and both are regulated by PTH. and magnesium. enzyme activity for energy transfer. chronic diarrhea. paresthesia. regulated by PTH. High: Monitor: UOP. Vit D whole grain cereal. chronic infections. malabsorption. facial spasmss. Restlessness. neuromuscular activity.5-2. alchoholism.13-2. hypomagnesemia. hypercalcemia. pacreatitis. hypoparathyroidism. and muscle contraction. glucose IV. and Mg. effective UOP >750 ml/day will decrease MG levels. If kidneys. Ca antagonizes the sedative effect of Mg. confusion. toxicity: N/V. bradycardia hyperaldosteronism. IV Ca gluconatae should be available to prevent hypermagnesemia. chirrosis of Digoxin: Hypomagnesemia enhances Dig liver. alchoholism. hypokalemia. tremors. hypoparathryoidism.7-2. sodium promotes Ca loss. metabolism. Ca should not be given with solution containing bicarbonate. cont. malabsorption. a k and Ca defecit. Elevated calcum can recriprocal realtionship to calcium.5 meq Phos 1. bowel resection giving MG supplementation complications.

GI bleed. Low: Anemia. CHF. weakness. .Gluc BUN 70-110 mg/dl 5-25 mg/dl Glucose is stored as glycogen is liver or skeltsl muscle. renal failure. dry MM. DM. It is not influenced by diet or fluid intake. It is monitored to detect renal disorder or dehydration. salicylates Cr is a by product of muscle catabolism.50 mg/dl GFR 90-120 Hgb F: 12-15 g/dl M: 13. In renal disease both BUN and Cr will be elevated VS and UOP: Q8 hours S/S Dehydration: Poor turgor. Hct measures concentration of RBC in blood. ASA. decrease UOP<25 ml/h S/S Overhydration: Renal disorder. AMI. sulfonamides. It is excreted by the kidneys and is a more specific indicator of renal function than BUN. Low/Drugs: PCN. dyspnea at rest. In renal disease both BUN and Cr will be elevated High diet: Limit beef/poultry Cr 0. lithium. AMI. malnutrition. propranolol. methyldopa. decreased BP. JVD. licorice High/Drugs: Diuretics. sepsis. High: Acute/chronic renal failure. Observe S/S Shock: Vs changes. chloramphenicol . weakness. anemias. lithium Estimates how much blood passes throught the filters in the kidneys each minute. chirosis of liver. Glucagon is neede to convert glycogen to glucose.5-1. weight gain I &O's High: Compare to BUN. tachypnea. kidney disease. Increased P and RR. morphine. Promote energy conservation and safety. Compare with Hgb. kidney disease. antibiotics.tachycardia. Promote energy conservation and safety. Oler people will have lower GFR rate because is decreases with age. High: Dehydration. chronic renal failure.5-18 g/dl Hct F: 36-46% M: 40-54% Encourage nutrition. Dyspnea. tachycardia. Low: Acute blood loss. diabetic neuropathy. ascorbic acid. high protein intake. methyldopa. excess IV fluids Low/Drugs: Antibiotics. Insulin is needed to transport glucose into cells. dyspnea at rest. vitamin B/C Observe S/S Anemia: Dizziness. peripheral edema. Encourage nutrition. Low: >60 for 3 months or more indicated chronic renal faillure Hgb is the iron protein of RBC that is the 02 carrier. shcok. Observe S/S Anemia: Dizziness. puffy eyelids. diet High/Drugs: Antibiotics. BUN is an end product of protein metabolism. defficiencies tachycardia. Compare with Hct. sulfonamides High: Compare with Cr.

diet low in foods with nitrogen. Also very likey long immobilization too. poor diet. malnutrition. High levels are found after MI and in liver disease. malnutrition.Plt 150. Used to detect hepatocellular destruction Low: Vit B6 defficiency(beriberi). proetein-losing enteropathies. sulfonamides. Used to measure liver or bone disorder. Malabsorption. It Teach: Foods rich in protein is important in maintaining vascular fluid levels in the vessels by oncotic pressure. Decreases with cause fluid shifts and edema. aplastic anemia. and had a ruptured bladder and rectal hematoma. Vit B6 defficiency(beriberi). coagulation. prolonged immobilization . reanal disorders. malabsorption Low/Drugs: PCN. petechiae. Severe diarrhea Enzyme produced mainly in liver and bone.0 g/dl Ast 8-38 Montior platelet count with bleeding episodes. Most likely due to poor nutrition and blood loss. Severe diarrhea Enzyme in liver cells. Low: Pregnancy. Often compared with ALT. High levels are associated with clotting. liver. Low assess: Peripheral ascites/edema Alb is a plasma protein synthesized by the liver. Teach: Clent to avoid injury Low: Idiopathic thrombocytopenic purpura. pancreas. diet low in foods with nitrogen. poor diet. ulcerative colitis. ALT 10-35 Alk Phos 42-136 . kidneys. uremia Low/Drugs: ASA. Plts are the blood component that promotes Observe S/S Bleeding: Purpura. Enzyme found in heart muscle. skeletal muscle.5-5. sever malnutriton . Low levels are associated with hematemesis. sulfonamides. kidney disease. Low: Chirrhosis of liver. kidney and placenta.00ul Alb 3.000-400. ASA. has ALZ. acute liver failure. severe burns. liver disease. ascorbic acid Client is elderly. Fever. Heparin. Fever. diabetic ketoacidosis. also in intestine. reactal bleeding bleeding. diuretics. Malabsorption.

chlorpromazine. sulfonamides. epinepherine. hydantoin derivatives. resperine Monitor anticoagulation therapies. lithium Monitors RBC count. sulfonamides. Hold per MD Observe S/S Bleeding: Purpura. Overhydration High assess: VS. Record and report Vitamin K per MD. HA Chronic S/S: Cracked corners of mouth. chronic infection Assess S/S Iron deficiency Anemia: Fatigue. mithramycin. ASA. procainamide. High: Acute infection High/Drugs: Asa. hematemesis. S/S infection: Fever. antibiotics. leukocytoiss Teach: Some medications can cause agranulocytoiss or leukopenia Leukopenia: Avoid contacts with contagious persons due to reduced resistance to colds or infections RBC F: 4. numbness/tinbling extremeties Teach: Client to eat foods rich in iron: Liver.8 Product of breakdown of Hgb carried to liver and excreted in bile. when PT is>40 Teach: No self medicate. Milk/antacids interfere with absorption.0 10-13 sec Pt is a precusor to clotting process. Low: Hemorrhage. anemia. dyspnea on exertion. Take with meals. tachcardia. methyldopa.3-10. RR. renal insufficiency. red meats.2 mg/dl WBC 4. chronic infection.1-1. antibiotics.0 60-70 sec 200-400 mg/dl . PT M: 4. pallor.Tbili 0. leukemias. potassium iodide. pheytoin. dyphagia. factor deficiencies. WBC's are part of the body's defense mechanism an respond to infection. heparin. CHF Increase/Prolonged/Drugs: Anticoagulants. Measures clotting ability.0-3.0-5. many OTC drugs may effect anticogulants INR PTT Fibrinogen 2.0 Low assess: Blood loss. iron-fortified breads Iron supplements: Teach client stools may be dark. freen vegetables.6-6. Increase/Prolonged: Liver disease. petechiae. chronic renal failure. allopurinol. smooth tounge. reactal bleeding. gold compounds. difitalis. Used to monitor biliruben levels assocaited with jaundice and to measure liver disorder. chlordiazepoxide. triamerene. increased pulse.

sulfonamides. reanal disorders. Also very likey long immobilization too.1-0.5 ng/ml . ASA. edema. Follow up with MD. Used to diagnose HF High: HF. malabsorption Low/Drugs: PCN. Acute MI. renal failure Protein enzymes in heart and skeletal muscle released to blood stream 1-3 hours after onset of MI symptoms. has ALZ. More specific to acardiac injury that CPK-MB Low assess: Peripheral ascites/edema Teach: Foods rich in protein BNP <100 pg/ml High assess S/S HF: Dyspnea. L ventricular hypertrophy. and had a ruptured bladder and rectal hematoma. prolonged immobilization . cough. Most likely due to poor nutrition and blood loss.Alb 3. ascorbic acid Client is elderly. acute liver failure. proetein-losing enteropathies. Take medications as prescribed. Decreases with cause fluid shifts and edema. sever malnutriton . Neurohormone in cardiac ventricles increases in response to volume exapnsion and pressure overload. ulcerative colitis. Within normal limits-Continue to monitor Troponin I 0. severe burns.0 g/dl Alb is a plasma protein synthesized by the liver. Early rejection of transplants. myocarditis.5-5. Low: Chirrhosis of liver. It is important in maintaining vascular fluid levels in the vessels by oncotic pressure. edema Teach: Report increased SOB. cough.