LAB VALUE CHEAT SHEET

VITAL SIGNS BASAL METABOLIC PANEL (BMP) RENAL

• Blood pressure • Sodium: 135 – 145 mEq/L
• Calcium: 9 - 11 mg/dL
• Systolic: 120 mmHg • Potassium: 3.5 – 5.0 mEq/L
• Magnesium: 1.5 - 2.5 mg/dL
• Diastolic: 80 mmHG • Chloride: 95 - 105 mEq/L
• Phosphorus: 2.5 - 4.5 mg/dL
• Heart Rate: 60 - 100 BPM • Calcium: 9 - 11 mg/dL
• Specific gravity: 1.010 - 1.030
• Respirations: 12 - 20 Breaths per min • BUN: 7 - 20 mg/dL
• GFR: 90 - 120 mL/min/1.73 m2
• Oxygen: 95% - 100% • Creatinine: 0.6 – 1.2 mg/dL
• BUN: 7 - 20 mg/dL
• Temperature: 97.8 °F - 99 °F • Albumin: 3.4 - 5.4 g/dL
• Creatinine: 0.6 – 1.2 mg/dL
• Total protein: 6.2 - 8.2 g/dL

LIVER FUNCTION TEST (LFT) LIPID PANEL

• ALT: 7 - 56 U/L • Total cholesterol: <200 mg/dL ABG’S
• AST: 5 - 40 U/L • Triglyceride: <150 mg/dL
• PH: 7.35 - 7.45
• ALP: 40 - 120 U/L • LDL: <100 mg/dL → Bad cholesterol
• PaCO2: 35 - 45 mmHg
• Bilirubin: 0.1 - 1.2 mg/dL • HDL: >60/dL → Happy cholesterol
• PaO2: 80 - 100 mmHg
• HCO3: 22 - 26 mEq/L
HbA1c
Respiratory
REMEMBER
• Non-diabetic: 4 - 5.6% Opposite
PANCREAS ROME
Metabolic
• Pre-diabetic: 5.7 - 6.4%
• Diabetic: > 6.5% (GOAL for diabetic: < 6.5%) Equal
• Amylase: 30 - 110 U/L
• Lipase: 0 - 150 U/L

COMPLETE BLOOD COUNT ( CBC )

COAGs • WBC: 4,500 - 11,000 • Hemoglobin (Hgb)

Female: 12 - 16 g/dL Male: 13 - 18 g/dL
• RBC’s: 4.5 - 5.5
• PT: 10 - 13 sec • Hematocrit (HCT)
• PLT: 150,000 - 450,000
• PTT: 25 - 35 sec Female: 36% - 48% Male: 39% - 54%

• aPTT: 30 - 40 sec (heparin)

• INR
- NOT ON Warfarin < 1 sec OTHER
- ON Warfarin 2 - 3 sec
Measured • MAP: 70 - 100 mmHg
with Therapeutic Range Antidote
• ICP (intracranial pressure): 5 - 15 mmHg
HEPARIN aPTT 1.5 - 2.0 x normal “control” value Protamine Sulfate
• BMI: 18.5 - 24.9
WARFARIN PT/INR 1.5 - 2.0 x normal “control” value Vitamin K
• Glascow coma scale: Best = 15
*The higher these numbers = higher chance of bleeding Mild: 13-15 Moderate: 9-12 Severe: 3-8

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 LAB VALUE MEMORY TRICKS
SODIUM: 135 - 145 POTASSIUM: 3.5 - 5 PHOSPHORUS: 2.5 - 4.5

*Commit to memory! BANANAS: PHOR: 4

There are about 3-5 in every US: 2 (me + you = 2)
*don’t
bunch & you want them half forget
ripe (½) the .5
ELECTROLYTES

So, think 3.5 - 5.0

CALCIUM: 9 - 11 MAGNESIUM: 1.5 - 2.5 CHLORIDE: 95 -105

CALL 911 MAGnifying glass Think of a chlorinated pool that

you see 1.5 - 2.5 you want to go in when it’s
bigger than normal SUPER HOT: 95 - 105 °F
BLOOD COUNT (CBC)

• Hemoglobin (Hgb)
Female: 12 - 16 g/dL
COMPLETE

Male: 13 - 18 g/dL
• Hematocrit (HCT) 12 X 3 = 36
To remember HCT, (Female)
Female: 36% - 48% 16 X 3 = 48
multiply Hgb by 3
Male: 39% - 54% 13 X 3 = 39
(Male)
18 X 3 = 54

BUN: 7 - 20 mg/dL CREATININE: 0.6 – 1.2 mg/dL

BASAL METABOLIC
PANEL (BMP)

Think hamburger BUNs... This is the same value as

Hamburgers can cost anywhere LITHIUM’s therapeutic range (0.6 - 1.2 mmol/L)
from $7 - $20 dollars
Lithium is excreted almost solely by the kidneys...
And creatinine is a value that tests how well your kidneys filter

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 BLOOD TYPES
ANTIGENS:
Proteins that elicit immune response

Plasma → Identifies the cell

WBC’s → PLASMA ANTIBODIES

→
Protects body from “invaders” (think ANTI)

RBC’s Opposite of the type of antigen that is found

on the RBC

A B AB O
rsal rsal
Unive Unive
ENT R
RECIPI DONO

Antigen: A Antigen: B Antigen: A&B Antigen: NONE

Antibodies: B Antibodies: A Antibodies: NONE Antibodies: A&B

Recipient: A, O Recipient: B, O Recipient: ALL Recipient: O

Donor: A, AB Donor: B, AB Donor: AB Donor: ALL

Rh FACTOR
Has Rh on surface Can receive

Does not have Rh on surface Can receive

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 POTASSIUM IMBALANCE
Potassium imbalance plays a vital role in cell METABOLISM, and TRANSITION of
nerve impulses, the functioning of cardiac, lung, muscle tissues, & acid-base balance.
3.5 - 5 mEq/L

HYPERKALEMIA > 5 mEq/L HYPOKALEMIA < 3.5 mEq/L

✹ TIGHT & CONTRACTED ✹ Thready, weak, irregular pulse

✹ Orthostatic hypotension
M
SIGNS & SYMPTOMS

uscle cramps & weakness

✹ Shallow respirations
U rine abnormalities ✹ Anxiety, lethargy, confusion, coma

R espiratory distress ✹ Paresthesias

✹ Hyporeflexia
D ecreased cardiac contractility (↓HR, ↓BP)
✹ Hypoactive bowel sounds (constipation)
E CG changes
• Tall peaked T waves
✹ Nausea, vomiting, abdominal distention

R eflexes (↑ DTR ) • Flat P waves ✹ ECG changes

• Widened QRS complexes • ST depression
• Prolonged PR intervals • Shallow or inverted T wave
• Prominent U wave
✹ Medication
➥ Potassium-sparing diuretics (Spironolactone) ✹ Actual total body potassium loss
➥ Ace inhibitors ✹ Inadequate potassium intake
➥ NSAIDs ➥ Fasting, NPO
✹ Excessive potassium intake ✹ Movement of potassium from the
RISK FACTORS

(Example: rapid infusion of potassium-containing IV solutions) extracellular fluid to the intracellular fluid
✹ Kidney disease or those on Dialysis ➥ Alkalosis
➥ Decreased potassium excretion ➥ Hyperinsulinism
✹ Adrenal insufficiency (Addison’s disease) ✹ Dilution of serum potassium
➥ Water intoxication
✹ Tissue damage
➥ IV therapy with potassium-deficient solutions
✹ Acidosis
✹ Hyperuricemia
Potassium imbalance can cause cardiac dysrhythmias
✹ Hypercatabolism that can be life-threatening!

✹ Monitor EKG ✹ Oral potassium supplements

✹ Discontinue IV & PO potassium ✹ Liquid potassium chloride
MANAGEMENT

✹ Initiate a potassium-restricted diet ✹ Potassium-retaining diuretic

✹ Potassium-excreting diuretics ✹ Potassium is NEVER administered
✹ Prepare the client for dialysis by IV push, IM, or subcut routes.
✹ Prepare for administration: ➥ IV potassium is always diluted &
administered using an infusion device!
➥ IV calcium gluconate & IV sodium bicarb
✹ Avoid the use of salt substitutes or
other potassium-containing substances

Potassium & sodium = opposites Example: ↑ Na = ↓ K+

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 CALCIUM IMBALANCE
Calcium is found in the body’s cells, bones, and teeth. Needed for proper
functioning of the CARDIOVASCULAR, NEUROMUSCULAR, 9 - 11 mg/dL
ENDOCRINE systems, blood clotting & teeth formation

HYPERCALCEMIA > 11 mg/dL HYPOCALCEMIA < 9 mg/dL

C onvulsions

B one pain
A rrhythmias (dimished pulses)
SIGNS & SYMPTOMS

A rrhythmias T etany

C ardiac arrest (bounding pulses) S pasms & stridor

K idney stones GO NUMB ness in the fingers, face, & limbs

M uscle weakness ↓ (DTR) POSITIVE TROUSSEAU’S:

E xcessive urination
Carpal spasm caused by inflating a blood pressure cuff

CHVOSTEK’S SIGNS:
Contraction of facial muscles w/ light tap over the facial nerve.
Think “C” for Cheesy smile

✹ Increased calcium absorption

✹ Decreased calcium excretion ✹ Inhibition of calcium absorption from the GI tract
RISK FACTORS

✹ Kidney disease ✹ Increased calcium excretion

✹ Thiazide diuretics ➥ Kidney disease, diuretic phase
✹ Increased bone resorption of calcium ➥ Diarrhea & steatorrhea
➥ Hyperparathyroidism / Hyperthyroidism ➥ Wound drainage
➥ Malignancy ✹ Conditions that decrease
(bone destruction from metastatic tumors) the ionized fraction of calcium
✹ Hemoconcentration

✹ D/C IV or PO calcium ✹ Adm. calcium PO or IV

MANAGEMENT

✹ D/C Thiazide diuretics ➥ For IV, warm before & adm. slowly
✹ Administer phosphorus, calcitonin, ✹ Adm. aluminum hydroxide & Vit D
bisphosphonates, & prostaglandin ✹ Initiate seizure precautions
synthesis inhibitors (NSAIDs)
✹ 10% calcium (acute calcium deficit)
✹ Avoid foods high in calcium
✹ Consume foods high in calcium

A client with a calcium imbalance is at risk for a

pathological fracture. Move the client carefully and slowly

Calcium & phosphate = Inverse Example: ↑ Ca+ = ↓ Po4

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 MAGNESIUM IMBALANCE
1.5 - 2.5 mg/dL
Most of the magnesium found in the body is found in the bones. Regulates BP, blood
sugar, muscle contraction & nerve function.

HYPERMAGNESEMIA > 2.5 mg/dL HYPOMAGNESEMIA < 1.5 mg/dL

MEMORY TRICK: MAGNESIUM IS A SEDATIVE!

✹ LOW EVERYTHING AKA SEDATED ✹ HIGH EVERYTHING AKA NOT SEDATED

✹ Low energy (drowsiness / coma) ✹ High HR (tachycardia)
SIGNS & SYMPTOMS

✹ Low HR (bradycardia) ✹ High BP (hypertension)

✹ Low BP (hypotension) ✹ Increased deep tendon reflex (hyperreflexia)
✹ Low RR (bradypnea) REMEMB
✹ Shallow respirations
✹ ↓ Respirations (shallow) ER:
✹ Twitches, paresthesias Als o seen
in
✹ ↓ Bowel sounds hypoca
lcemia
✹ Tetany & seizures . Ca &
✹ ↓ DTR’s (deep tendon reflex) Mg rise
and fall
✹ Irritability & confusion
togeth
er!

POSITIVE TROUSSEAU’S:
Carpal spasm caused by inflating a blood pressure cuff

CHVOSTEK’S SIGNS:
Contraction of facial muscles w/ light tap over the facial nerve

✹ Insufficient magnesium intake

➥ Malnutrition/vomiting/diarrhea
✹ Increased magnesium intake
RISK FACTORS

➥ Malabsorption syndrome
➥ Magnesium-containing antacids (TUMS)
➥ Celiac & Chron’s disease
& laxatives
➥ Excessive adm. of magnesium IV ✹ Increased magnesium excretion
✹ Renal insufficiency ➥ Diuretics or chronic alcoholism
➥ ↓ renal excretion of Mg = ↑ Mg in the blood ✹ Intracellular movement of magnesium
✹ DKA (Diabetic Ketoacidosis) ➥ Hyperglycemia & Insulin adm.
➥ Sepsis

✹ Diuretics
MANAGEMENT

✹ IV adm. calcium chloride or calcium gluconate ✹ Magnesium sulfate IV or PO

✹ Restrict dietary intake of Mg containing foods ✹ Seizure precautions
✹ Avoid the use of laxatives & antacids ✹ Instruct the client to increase
containing magnesium magnesium-containing foods
✹ Hemodialysis

Magnesium & Calcium = SAME Example: ↑ Mg = ↑ Ca+

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 SODIUM IMBALANCE
135 - 145 mEq/L
Sodium is a major ELECTROLYTE found in ECF. Essential for acid-base, fluid balance,
active & passive transport mechanism, irritability & CONDUCTION of nerve-muscle tissue

HYPERNATREMIA > 145 mEq/L HYPONATREMIA < 135 mEq/L

HYPOVOLEMIC HYPONATREMIA: HYPERVOLEMIC HYPONATREMIA:

✹ BIG & BLOATED ↓ of fluid & sodium ↑ body water that is greater than Na+

F lushed skin
S tupor/coma L imp muscles (muscle weakness)
R estless, anxious, confused, irritable
SIGNS & SYMPTOMS

A norexia (nausea/vomitting) 0 rthostatic hypotension

I ncreased BP & fluid retention
L ethargy (weakness/fatigue) S eizures/headache
E dema (pitting)
T achycardia (thready pulse) S tomach cramping
D ecreased urine output (hyperactive bowels)

S kin flushed & dry

✹ Increased sodium excretion
A
5 d’s
gitation
➥ Diaphoresis (ex: high fever)
L ow-grade fever ➥ Diuretics
➥ Diarrhea & vomiting
T hirst (dry mucous membranes) ➥ Drains (NGT suction)
➥ Diuretics
(Thiazides & loop diuretics)
✹ Increased sodium intake ✹ SIADH
➥ Excess oral sodium ingestion ✹ Adrenal insufficient (adrenal crisis)
➥ Excess administration ✹ Inadequate sodium intake
of IV fluids w/ sodium ➥ Fasting, NPO, Low-salt diet
➥ Hypertonic IV fluids
RISK FACTORS

✹ Kidney disease
✹ LOSS OF FLUIDS!
✹ Heart failure
➥ Fever
➥ Watery diarrhea hemoconcentration
➥ Diabetes insipidus =
➥ Excessive diaphoresis Increased sodium!
➥ Infection ADMINISTER IV sodium chloride infusions
✹ Decreased sodium excretion (Only if due to hypovolemia)

➥ Kidney problems DIURETICS (If due to hypervolemia)

Hyponatremia → high fluids & low salt = hemodilution
Daily Weights
Where sodium goes, water FLOWS
Safety (orthostatic hypotension AKA risk for falls)
MANAGEMENT

✹ If due to fluid loss: Airway protection (NPO)

➥ Administer IV infusions Don’t give food to a lethargic, confused client
✹ If the cause is inadequate (INCREASED RISK FOR ASPIRATION)
renal excretion of sodium: Limit water intake
➥ Give diuretics that promote sodium loss Hypervolemic hyponatremia (high fluid & low salt)
✹ Restrict sodium & fluid intake as prescribed Teach to avoid a diet high in salt
(Canned food, packaged/processed meats, etc.)

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