Sodium controls which types of cells?
Brain cells and skeletal muscle cells.
Abnormal sodium levels cause which symptoms?
Symptoms from brain cell and skeletal muscle dysfunction:
- decreased level of consciousness (↓ LOC)
- seizures
- muscle twitching
- headaches
Potassium controls which types of cells?
Heart and skeletal muscle cells.
Abnormal potassium levels cause which symptoms?
Symptoms from heart and skeletal muscle dysfunction:
- heart dysrhythmias
- muscle weakness and cramps
- muscle numbness and tingling (paresthesia)
Magnesium and Calcium controls which types of cells?
Skeletal and heart muscle cells, and cells for nerve function.
What is the function of white blood cells (WBCs)?
To fight infection.
What does an increased and decreased white blood cell (WBC) count indicate?
- Decreased WBC: the client is immunosuppressed (risk for infection)
- Increased WBC: the client has an active infection
Define:
Neutropenia and Leukopenia
Leukopenia and neutropenia both indicate ↓ WBCs.
What is the function of RBCs?
To carry oxygen to all the organs.
Erythrocyte is another name for RBC (red blood cells).
What does a decreased red blood cell count (RBC) indicate?
Anemia: the body doesn’t have enough oxygen causing fatigue and weakness.
Define:
Hemoglobin
A protein on RBCs that carries oxygen.
RBC = red blood cell
Define:
Hematocrit
The proportion of RBCs in the blood.
RBC = red blood cell
What do both hemoglobin and hematocrit indicate?
Both indicate how much blood and oxygen the client has.
Hemoglobin and hematocrit are commonly referred to as “H and H”.
What does a decreased hemoglobin and hematocrit most commonly indicate?
anemia or bleeding
There is not enough oxygen or RBCs due to bleeding. RBC = red blood cell.
What does an increased hemoglobin and hematocrit most commonly indicate?
dehydration
The volume of fluid in the blood is decreased making the red portion of the blood look more concentrated.
What is the function of platelets?
For the blood to clot properly.
Define:
Thrombocytopenia
Indicates low platelets.
This can cause an increased risk of bleeding.
What is blood urea nitrogen (BUN) and what does an increased level indicate?
BUN is the waste product of protein breakdown in the liver excreted by the kidneys.
An increased BUN may or may not indicate a kidney problem because other conditions can increase the BUN.
What is creatinine and what does an increased level indicate?
Creatinine is the breakdown product of muscle and other proteins that are excreted by the kidneys.
Any increase in creatinine indicates a kidney problem.
What is the glomerular filtration rate (GFR)?
GFR is how much urine gets filtered through the kidneys:
- It is controlled by blood pressure
- It is the best way to measure kidney function
Define:
Bilirubin
The breakdown product of old red blood cells and is secreted in bile by the liver.
It causes the yellow color in urine and stool.
What does an increased bilirubin indicate?
Can indicate liver damage or liver disease.
What is ALT, AST, ALP and what does an increased level indicate?
ALT, AST, and ALP are enzymes released by the liver when there is inflammation.
ALP can also be elevated with bone disorders.
Define:
Cholesterol
Fat in the body. It is needed to build healthy cells, but an increased level can increase the risk of heart disease and stroke.
What are high-density lipoproteins (HDL) and low-density lipoproteins (LDL)?
HDL and LDL are types of cholesterol:
- HDL is the “Happy” or good cholesterol
- LDL is the bad cholesterol
What is ammonia in regards to the liver?
A waste product of proteins.
The liver helps the body get rid of ammonia by turning it into urea and disposing of it by the kidneys (see BUN).
What is albumin and what are its 3 main functions?
A protein made by the liver.
Functions of albumin/proteins:
- prevents fluids from leaking out of the vascular space
- transports substances throughout the body
- nourishes tissues
What are the most common reasons an albumin/protein level is decreased?
- malnutrition: not eating enough protein
- liver disease: the liver can’t make proteins
- kidney disease: kidneys are damaged and can’t hold onto the proteins and are excreted
What are the blood coagulation labs?
- aPTT (activated partial thromboplastin time)
- PTT (partial thromboplastin time)
- PT (prothrombin time)
- INR (international normalized ratio)
These labs refer to bleeding time. The higher the number the more likely the client will bleed. Depending on the situation, a higher number (called therapeutic) is desired to prevent blood clots.
What is amylase and lipase?
Enzymes released by the pancreas when there is inflammation.
An increased level indicates pancreatitis.
What is hemoglobin A1c?
It’s also called HbA1c or glycated hemoglobin test.
The average level of blood sugar over the past 2 to 3 months.
It indicates how well the client has controlled their blood sugar.
What is BNP and what does an increased level indicate?
An enzyme released by the heart when it is stretched due to too much fluid in the heart.
An increased brain natriuretic peptide (BNP) means worsening heart failure.
What is troponin and what does an increased level indicate?
(Immediate Complication)
A protein released by the heart during a myocardial infarction (heart attack).
It is the best indicator of a heart attack.
What is CK/CPK and what does an increased level indicate?
CK/CPK (creatine kinase) is an enzyme released by the heart during a myocardial infarction.
It can also be raised with muscle damage from other reasons.
What is uric acid and what are elevated levels caused by?
The breakdown of purines found in foods or old cells.
Elevated levels are caused by:
- kidney disorder: cannot eliminate uric acid efficiently
- tumor lysis syndrome: breakdown of old cells from chemotherapy releases uric acid into the blood
What can a high uric acid level cause?
Gout
The high uric acid causes inflammation in the joints, especially the big toe.
What is a D-dimer lab?
Indicates the presence of a blood clot.
What are the thyroid labs?
- TSH (thyroid-stimulating hormone)
- T3 (triiodothyronine)
- T4 (thyroxine)
Which direction do the labs go with hypothyroidism?
- ↓T3 and ↓T4
- ↑TSH
T3 and T4 are decreased so the body compensates by making more TSH.
Which direction do the labs go with hyperthyroidism?
- ↑T3 and ↑T4
- ↓TSH
T3 and T4 are elevated so the body compensates by making less TSH.
When caring for a client, why is looking at several lab values for the same test better than just looking at one single value?
Looking at several values of the same lab test can indicate if the client is improving or getting worse by recognizing trends.
What is a complete blood count (CBC)?
A blood lab test where all the hematology labs are included as one test.
- WBC (white blood cells)
- RBC (red blood cells)
- Hgb (hemoglobin)
- Hct (hematocrit)
- platelets
What is a basic metabolic panel (BMP)?
A set of labs that includes electrolytes and kidney function:
- sodium
- chloride
- potassium
- carbon dioxide (CO2)
- blood glucose
- BUN
- creatinine
What is a complete metabolic panel (CMP)?
A set of labs that includes everything in a BMP (electrolytes and kidney labs) in addition to the liver labs:
- bilirubin
- protein
- ALT, AST, and ALP
Define:
Pancytopenia
Low blood counts of RBCs, WBCs, and platelets.
RBC = red blood cell
WBC = white blood cell
Sepsis/septic
(Immediate Complication)
A systemic infection - an infection throughout the entire body.
A high temperature can indicate sepsis.
Define:
Penia
Indicates low or deficient.
It is a common ending to many different labs.
What are the renal labs?
- creatinine
- BUN (blood urea nitrogen)
- GFR (glomerular filtration rate)
What are the common liver labs?
- ALT, AST, and ALP
- bilirubin
- albumin
- protein
- ammonia
What are the common cardiac labs?
- troponins
- BNP (B-type natriuretic peptide)
- CK (Creatine kinase)
What are the common pancreas labs?
- amylase
- lipase
- hemoglobin A1C
- blood sugar
What are the different types of white blood cells and what types of infections do each target?
- neutrophils: bacterial infections
- lymphocytes: viral infections
- monocytes: severe infections
- eosinophils: parasite infections
- basophils: parasite infections
Why is each client vital sign important to measure in nursing?
- Temp: to check for infection and dehydration
- RR: to check for respiratory problems
- HR: to check for irregular heart rhythm, tachycardia or bradycardia
- BP: to check for fluid volume issues such as fluid volume overload or fluid volume deficit
- O2: to check for decreased oxygen level
Define:
Hypertension and Hypotension
- Hypotension: Blood pressure < 90/60
- Hypertension: Blood pressure > 120/80
Hypoxic/hypoxia
(Immediate Complication)
pulse oximetry reading < 95%
Define:
Bradycardia and Tachycardia
- Bradycardia: heart rate < 60
- Tachycardia: heart rate > 100
Define
Febrile and Afebrile
- Febrile: a temperature above normal
- Afebrile: temperature is within normal limits
What does mean arterial pressure (MAP) measure?
The average pressure in systemic cardiac circulation.
at least 60 to maintain perfusion
How is mean arterial pressure (MAP) measured?
MAP = systolic blood pressure + 2(diastolic blood pressure) / 3
Ex: 120 + 2(80) / 3 = 93.3
What does cardiac output (CO) measure?
How much blood the heart pumps out.
How is cardiac output calculated?
Cardiac output = heart rate x stroke volume (L/min)
average is 4-7 L/min
