Episodi
-
Normal
135-145 mEq/L
Monitor: Extracellular osmolality Electrolyte imbalance
Indications
Description
Sodium (Na+) is the most abundant cation in extracellular fluid. Sodium aids in osmotic pressure, renal retention and excretion of water, acid-base balance, regulation of other cations and anions in the body. Sodium plays a role in blood pressure regulation and stimulation of neuromuscular reactions. Sodium and water have a direct relationship; water follows salt.
Cushing Syndrome Hyperaldosteronism Dehydration Burn injury Azotemia (elevated nitrogen) Lactic acidosis (LA) Fever/excessive sweating Excessive IV fluids containing sodium Diabetes Insipidus Osmotic diuresis
What would cause increased levels?
Congestive Heart Failure (CHF) Syndrome of Inappropriate Antidiuretic Hormone (SIADH) Cystic Fibrosis Diuretic use Metabolic acidosis Addison’s Disease Nephrotic Syndrome Vomiting Diarrhea Ascites Excessive Antidiuretic Hormone(ADH) Liver failure
What would cause decreased levels? -
Episodi mancanti?
-
Normal
3.5 - 5.0 mEq/L
Evaluate: Electrolyte imbalances Cardiac arrhythmias Monitor patients who are: Acidotic Receiving diuretic therapy
Indications
DescriptionPotassium (K+) is the most abundant intracellular cation and plays a vital role in the transmission of electrical impulses in cardiac and skeletal muscle. It plays a role in acid base equilibrium. In states of acidosis hydrogen will enter the cell which will force potassium out of the cell. A 0.1 decrease in pH will cause a 0.5 increase in K+.
Renal failure Hypoaldosteronism Addison’s disease Injury to tissues Diabetes Mellitus (DM) Ketoacidosis Hyperventilation Acidosis Infection Dehydration Burns
What would cause increased levels?
Hyperaldosteronism Excess insulin Alkalosis Diarrhea Vomiting Cystic Fibrosis Cushing Syndrome
What would cause decreased levels? -
Normal
25 - 35 seconds
Detection of coagulation disorders Evaluate response to Heparin (PT for Coumadin) Preoperative assessment
Indications
DescriptionPartial Thromboplastin Time (PTT)evaluates the function of factors I, II, V, VIII, IX, X, XI, and XII. PTT represents the amount of time required for a fibrin clot to form. Monitors therapeutic ranges for people taking Heparin.
Disseminated Intravascular Coagulation (DIC) Clotting Factor Deficiencies: Hypofibrinogenemia Von Willebrand Disease Hemophilia Liver disease: Cirrhosis Vitamin K deficiency Polycythemia Dialysis
What would cause increased levels?
N/A
What would cause decreased levels? -
Normal
95 - 100%
Determine respiratory status Part of Arterial Blood Gas (ABG) testing
Indications
Description
Oxygen saturation (SaO2) is a measurement of the percentage of how much hemoglobin is saturated with oxygen. Oxygen is transported in the blood in two ways: oxygen dissolved in blood plasma (pO2) and oxygen bound to hemoglobin (SaO2). About 97% of oxygen is bound to hemoglobin while 3% is dissolved in plasma. SaO2 and pO2 have direct relationships, if one is decreased so is the other. The relationship between oxygen saturation (SaO2) and partial pressure
O2 (PaO2) is referred to as the oxyhemoglobin (HbO2) dissociation curve. SaO2 of about 90% is associated with PaO2 of about 60 mmHg.
Polycythemia Increased inspired O2 Hyperventilation
What would cause increased levels?
Anemia’s Hypoventilation Bronchospasm Mucus plugs Atelectasis Pneumothorax Pulmonary edema Adult respiratory distress syndrome
What would cause decreased levels? -
Normal
261 – 280 mOsm/kg
Monitor: Electrolyte balance Acid-Base balance Hydration Evaluate function of antidiuretic hormone.
IndicationsDescription
Osmolality is a measure of the particles in solution. The size, shape, and charge of the particles do not impact the osmolalityWhat would cause increased levels?
Dehydration Azotemia Hypercalcemia Hyperglycemic Hyperosmolar Nonketotic State (HHNS) Hypernatremia Diabetes Insipidus Hyperglycemia Mannitol therapy Uremia Severe pyelonephritis Shock KetosisWhat would cause decreased levels?
Hyponatremia Syndrome of Inappropriate Antidiuretic Hormone (SIADH) Overhydration -
Normal
1.6 – 2.6 mg/dL
Monitor: Renal failure Chronic alcoholism Cardiac arrhythmias
Indications
Description
Magnesium (Mg) is a cation necessary for protein synthesis, nucleic acid synthesis, muscle contraction, ATP (adenosine triphosphate) use, nerve impulse conduction, and blood clotting. Magnesium affects the absorption of sodium, calcium, phosphorus, potassium.What would cause increased levels?
Renal insufficiency Uncontrolled Diabetes Mellitus (DM) Addison Disease Dehydration Hypothyroidism Overuse of antacids Tissue traumaWhat would cause decreased levels?
Alcoholism Diabetic acidosis Renal failure: Glomerulonephritis Hypercalcemia Malnutrition Malabsorption Hypoparathyroidism Diarrhea -
Normal
0.3 -2.6 mmol/L
Determine cause of acidosis Evaluate tissue oxygenation
Indications
Description
Lactate (Lactic Acid) is a byproduct of anaerobic metabolism. Normally, the tissues use aerobic metabolism to breakdown glucose for energy and the byproduct is CO2 and H2O which we excrete through our kidneys and exhalation. However, if the tissues are starved of oxygen (hypoxic), they use anaerobic metabolism. This can be compounded if the liver is also hypoxic causing the liver to be unable to clear the lactic acid.What would cause increased levels?
Shock Sepsis Tissue ischemia Carbon monoxide poisoning Lactic acidosis Diabetes Mellitus (DM) Heart failure Pulmonary edema Strenuous exerciseWhat would cause decreased levels?
N/A -
Normal
0.8 - 1.2
Therapeutic Levels of Warfarin 2.0 – 3.5
Evaluate therapeutic doses of Warfarin Identify patients at higher risk for bleeding Identify cause of: Bleeding Deficiencies
Indications
Description
International normalized ratio(INR) takes results from a prothrombin time test and standardizes it regardless of collection method.What would cause increased levels?
Disseminated Intravascular Coagulation (DIC) Liver disease Vitamin K deficiency WarfarinWhat would cause decreased levels?
Too much vitamin K Estrogen containing medications such as birth control -
Normal
>60 optimal mg/dL
Monitor risks of heart disease
IndicationsDescription
Cholesterol is transported via lipoproteins. There are multiple types of lipoproteins and they each have slightly different functions: high-density lipoprotein (HDL), low-density lipoprotein (LDL) very low-density lipoprotein (VLDL). HDL cholesterol is considered the good cholesterol because it travels through the blood picking up extra cholesterol and taking it back to the liver.What would cause increased levels?
Familial HDL Lipoproteinemia Exercise Unsaturated fats: Mono- Poly- HypothyroidWhat would cause decreased levels?
Metabolic Syndrome Hepatocellular disease: Hepatitis Cirrhosis Hypoproteinemia: Nephrotic Syndrome Malnutrition Smoking High saturated and trans fat diets Excess body weight Hyperthyroid -
Normal
5.6-7.5 % of total Hgb
Assess control of blood sugars over a several month time frame Diagnose Diabetes Mellitus (DM)
Indications
DescriptionGlycosylated Hemoglobin (HbA1c) is the combination of glucose and hemoglobin. When glucose is elevated in the blood the amount of glycosylated hemoglobin increases proportionally. A red blood cells lifespan is about 4 months, so you can get an idea of blood sugar control over the last several months.
Poorly controlled Diabetes Mellitus(DM) Non-Diabetic Hyperglycemia: Stress Cushing Syndrome Pheochromocytoma Corticosteroid Therapy
What would cause increased levels?
Renal failure Blood loss Hemolytic anemia Sickle cell anemia
What would cause decreased levels? -
Normal
2 - 20 ng/mL
Diagnose megaloblastic anemia Monitor effects of long-term Total Parenteral Nutrition (TPN) Identify Folate Deficiency
IndicationsDescription
Folic acid is an essential water soluble B vitamin. It is stored in the liver and is an important part of Red Blood Cell (RBC) and White Blood Cell (WBC) function, DNA replication, and cell division.
Excess folate intake
What would cause increased levels?
Vitamin B12 deficiency Pernicious anemia Hemolytic anemia Celiac Disease or Crohn Disease Inflammatory Bowel Disease (IBS) Alcoholism Malnutrition
What would cause decreased levels? -
Normal
20-300 ng/mL
Diagnosing: Iron-deficiency anemiaH emochromatosis Monitor: Iron levels
Indications
DescriptionFerritin is a protein that stores iron. It is formed in the liver spleen and bone marrow. Ferritin in the blood is usually proportional to stored ferritin. Ferritin is a more sensitive and specific test for identifying iron-deficiency anemia, however, it is usually measured in conjunction with total iron binding capacity and iron.
Inflammation Alcoholic liver disease Multiple blood transfusions Hemochromatosis
What would cause increased levels?What would cause decreased levels?
Long term Gastrointestinal(GI) bleeding Iron-deficiency anemia Heavy menstrual bleeding -
Normal
96-108 mEq/LIndications
Identify Acid-Base ImbalanceDescription
Chloride (Cl-), an anion found in the blood, works together with sodium to help maintain oncotic pressure and water balance in the body. Chloride is inversely related to bicarbonate levels in the blood. Chloride is also part of hydrochloric acid (HCL) which is utilized in the stomach to breakdown food. When red blood cells (RBCs) take up CO2 they take up chloride as well. The negative ion bicarbonate then leaves the red blood cell so that the electrical charge is maintained. Extra chloride is excreted into the urine by the kidneys.
What would cause increased levels?
Dehydration Acute Renal Failure Cushing Disease Metabolic Acidosis Respiratory Alkalosis.What would cause decreased levels?
Congestive Heart Failure (CHF) Water intoxication Burns Metabolic Alkalosis Respiratory Acidosis Addison Disease Salt-losing Nephritis Excessive sweating Diarrhea Vomiting -
Normal
8.4-10.2 mg/dL
Identify problems with: Parathyroid Neuromuscular functions Diseases that affect bone Effectiveness of treatments.
IndicationsDescription
Calcium (Ca+), a positive ion in the body, is necessary for neuromuscular processes, bone mineralization, and hormonal secretion. The parathyroid gland and vitamin D are responsible for calcium regulation in the body. In the blood, about half of calcium travels in ion form, the other half is bound to proteins like albumin. When albumin levels are low, calcium levels will appear lower. Calcium has an important relationship with phosphorus: they are inversely proportional.
What would cause increased levels?
Cancers: Breast, lung, and multiple myeloma are the most common Hyperparathyroidism Acidosis Renal transplant Sarcoidosis Vitamin D toxicity DehydrationWhat would cause decreased levels?
Malnutrition Cirrhosis Chronic Renal Failure Hypoparathyroidism Alkalosis Hypomagnesemia Hypoalbuminemia Hyperphosphatemia Malabsorption Alcoholism Osteomalacia Vitamin D deficiency -
Normal
12-37 U/L
Monitor progression of: Liver disease Response to treatments. Monitor liver toxic medications
IndicationsDescription
Aspartate Aminotransferase (AST) is an enzyme primarily found in liver and heart cells, and to a smaller extent, AST can also be found in the pancreas, kidneys, skeletal muscle, and brain. Levels of AST increase from cell death (necrosis) because the AST enzyme is released into the blood.What would cause increased levels?
Liver disease Liver cancer Shock Congestive Heart Failure (CHF) Pericarditis Biliary tract obstruction Dermatomyositis Pancreatitis Muscular Dystrophy CVA Hemolytic anemia Delirium Tremens (DT)
N/A
What would cause decreased levels? -
Normal
0-130 U/LIndications
Diagnosing: Pancreatitis Pancreatic Duct Obstruction Macroamylasemia Trauma to PancreasDescription
Amylase is made in the pancreas. It is an enzyme that breaks down carbohydrates to allow our body to absorb it. Monitoring amylase levels can help identify problems with the pancreas.What would cause increased levels?
Pancreatitis Pancreatic Cancer Pancreatic Cyst DKA Peritonitis Abdominal Trauma Duodenal Obstruction Mumps Alcohol useWhat would cause decreased levels?
Pancreatic Insufficiency Pancreatectomy Toxemia of Pregnancy Cystic Fibrosis Liver Disease -
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Normal
30-40 seconds
Identifying congenital deficiencies in clotting Monitoring heparin therapeutic levels (PT for warfarin) Monitoring effects of: Liver Disease Protein Deficiency Fat malabsorption on clotting
IndicationsDescription
Activated Partial Thromboplastin Time (aPTT) is a test that measures the amount
of time it takes for a fibrin clot to form after reagents have been added to the
specimen. It is useful in diagnosing clotting disorders. In conjunction with PT it can
be used to differentiate the specific factor that may be missing.What would cause increased (Prolonged) levels?
Vitamin K Deficiency Disseminated Intravascular Coagulation (DIC) Hemodialysis Patients Afibrinogenemia Polycythemia Liver disease Von Willebrand Disease.What would cause decreased levels?
N/A - Mostra di più
