Cause/Effect Pt Assesment

Question 1

HYPOnatremia - low sodium

Answer 1

DILUTION due to cirrhosis/nephrosis, CHF

DEPLETION due to diarrhea, intravascular fluid loss
hypoaldosteronism, cystic fibrosis, APAP, carbamazepine, thiazide diuretics, NSAIDs

Question 2

HYPERnatremia - high sodium

Answer 2

Diabetes insipidous (irregular ADH)
water deficiency (initiates thirst mechanisms), high degree burns

Question 3

HYPOkalemia

Answer 3

alkalosis due to V/D, malnutrition, hepatic failure, thiazides and diuretics
ENHANCES EFFECTS OF DIGOXIN

Question 4

HYPERkalemia

Answer 4

decreased renal excretion, ACE inhibitors, K sparing diuretics (spironolactone, inspra)

Question 5

HYPOchloremia

Answer 5

V/D, thiazides and loop diuretics

Question 6

HYPERchloremia

Answer 6

dehydration, hyperventilation, acidosis, NSAIDs, saline infusion

Question 7

Low CO2

Answer 7

acute renal failure, hyperventilation, and is a sign of acidosis

Question 8

High CO2

Answer 8

vomiting and sodium bicarb

Question 9

Hypocalcemia

Answer 9

hypoPTH, decreased vitamin D, furosemide, calcitonin, low albumin can cause Ca to appear falsely low

Question 10

Hypercalcemia

Answer 10

hyperPTH, malignancies, Paget’s disease

Question 11

Hypophosphatemia

Answer 11

hyperPTH, Aluminum overdose, malnourishment

Question 12

Hyperphosphatemia

Answer 12

renal failure, increased vitamin D, hypoPTH, hypocalcemia

Question 13

Hypoglycemia

Answer 13

Addison’s Disease, high insulin level, insufficient intake

Question 14

Hyperglycemia

Answer 14

acute stress, infection, liver disease, Cushings, diabetes

Question 15

reduced BUN

Answer 15

over hydration, liver dysfunction, chloramphenicol

Question 16

increased BUN

Answer 16

high protein intake, increased protein breakdown, GI bleed, dehydration, kidney failure, corticosteroids, tetracyclines, methotrexate, amino glycosides, lithium

Question 17

BUN vs SCr

Answer 17

BUN excreted almost entirely by the kidneys, good maker for renal function not as good as SCr

SCr EXCELLENT marker for renal function

Question 18

reduced SCr

Answer 18

muscle atrophy, muscle loss due to age/immobility

Question 19

increased SCr

Answer 19

renal dysfunction, rapid muscle breakdown, dehydration, aminoglycosides, vancomycin

Question 20

Creatinine Clearance

Answer 20

method of estimating GFR, 24 hr urine collection, or calculate using SCr

Question 21

Urinalysis

Answer 21

no protein, no glucose, high pH, specific gravity correlates with osmolality

Question 22

hypouricemia

Answer 22

rare - not a problem

Question 23

hyperuricemia

Answer 23

overproduction or under excretion by kidneys

Question 24

Lactate Dehydrogenase

Answer 24

1&2 heart - increased possible MI

5 liver/muscle

Question 25

CK-MB

Answer 25

elevated indicates possible MI, 4-8 hrs to increase, 12-24 hrs to peak

Question 26

Troponin cTnI

Answer 26

Gold standard for diagnosing MI
cTnI > 0.4 - 2 = possible MI
cTnI > 2 = MI

Question 27

TSH

Answer 27

increased levels used to diagnose HYPOthyroidism

Question 28

T3 T4

Answer 28

Hyperthyroidism

Question 29

Left shift

Answer 29

bands (immature neutrophils) increase; segs do not

Question 30

Right shift

Answer 30

segs (mature neitrophils) increase; bands do not

caused by liver disease, hemoylsis, anemia

Question 31

INR

Answer 31

gold standard in prothrombin internationally

Question 32

Anemia diagnosis

Answer 32

RBC, Hgb, Hct, MCV, MCHC

Question 33

Liver function

Answer 33

bilirubin, AST, ALT, GGT, alk phos

Question 34

Heart disease

Answer 34

CK-MB, cTnI, AST, LDH

Question 35

Kidney function

Answer 35

SCr, BUN, calculated CrCl, urinalysis