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Flashcards in Lab Studies Deck (19):
1

ABG Normal Values

pH 7.35-7.45

CO2 35-45

HCO3 22-26

PaO2 80-100

BE -2 to 2

SaO2 > 95%

2

Base Excess

Normal -2 to 2
> 4 is an indicator for potential need for blood transfusion
> -19 correlates with a negative outcome

3

Base Excess Replacement Formula

0.1 x (-BE) x patient weight in kg = Bicarb needed (mEq)

4

CO2 Regulation

  • diffusion into circulation --> pulmonary capillaries
  • Capillary/alveolar membrane --> alevoli
  • CO moves blood to tissues
  • CO2 regulation is a function of minute volume

5

Anion Gap Equation

(Na+) - (Cl- + HCO3-)

Normal anion gap is 12 +/- 4

6

Metabolic Alkalosis

pH > 7.35 and Bicarb > 26

  • Usually result of H+, K+, Na+, Cl- loss
  • Causes: vomiting, NG tube suctioning, diuretics, steroids, antacid poisoning
  • Treat underlying cause

7

Metabolic Acidosis

pH < 7.35 and Bicarb < 22

  • #1 cause is lactic acidosis
  • Ketoacidosis
  • Treat underlying cause

8

Respiratory Alkalosis

pH > 7.35 and CO2 < 35

  • Result of alveolar hyperventilation
  • Often caused by ASA poisoning (stimulates resp. center), or hyperthermia, hypermetabolic states
  • Check Vt then f if on a vent

9

Respiratory Acidosis

pH < 7.35 and CO2 > 45

  • Result of failure to remove CO2
  • Chest wall injury, CNS depression, lung injury

10

Anion Gap Causes

  • Methanol
  • Uremia
  • DKA
  • Propylene Glycol
  • Isoniazid (INH/Iron
  • Lactate
  • Ethylene Glycol
  • Salicylates

11

Anion Gap Acidosis Treatment

Ventilation/secure airway, find cause, if pH < 7.0 consider bicarb based on severity.

12

BMP Values

Na+ - 135-145 mEq/L
K+ - 3.5-5 mEq/L
Cl- - 95-105 mEq/L
CO2 - 22-26 mEq/L
BUN - 6-24 mg/dL
Cr - 0.7-1.4 mg/dL
Glucose - 80-120 mg/dL

13

CBC Values

HGB/HCT - 15/45
PLT - 150k-450k
WBC - 5k-10k

14

Albumin

Primary serum protein, prodcued by the liver, maintains colloid osmotic pressure.

15

Coag Panel

PT - 11sec (Extrinsic Pathway)
PTT - 21-35sec (Intrinsic Pathway)
INR - 1.0 (International Normalized Ratio)

16

Heparin/LMWH

  • Affects the intrinsic pathway
  • OD treated with protamine sulfate

17

Coumadin

  • Affects the extrinsic pathway, clinically monitored by measuring INR
  • Therapeutic INR typically 3-4
  • Overdose treated with vitamin K

18

Urine Output

  • Infant - 2cc/kg/hr
  • Child - 1cc/kg/hr
  • Adult - 0.5cc/kg/hr

19

Osmolarity

  • Measure of solute concentration
  • Normal serum osmolarity 280-295 mOsm/L
  • Increases with dehyration
  • Decreases with overhydration