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NCLEX Review (by M.K.) > LAB VALUES > Flashcards

LAB VALUES Flashcards

1
Q

What is the normal value of CREATININE

A

0.6 to 1.2

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2
Q

What lab value monitors coumadin…. Also reflects PT (or Prothrombin time)

A

2 to 3

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3
Q

What lab value of INR do we consider critical?

What do we do?

A

When it is 4 or above

Action to take in following order … Hold Coumadin ! —> Focus Assessment for bleeding ! —> Prepare to give vit K ! —> Call HCP

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4
Q

When do we consider Potassium level “critical”

When is it HIGHEST PRIORITY

A

If lower tha 3.5
If higher than 5.3

Dangerous when over 6

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5
Q

What is low potassium level?

What do we do?

A

Lower than 3.5

Action to take in the following order … Nothing to hold ! Assess heart
(EKG) ! Prepare to give K+ ! Call HCP

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6
Q

What is high potassium level?

What do we do?

A

A high potassium level is 5.4-5.9

—> Action to take in the following order … Hold K+ !
—> Assess heart (EKG) !
—> Prepare to give Insulin/Kayexelate !
—> Call HCP

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7
Q

What is very high Potassium level?

What to do?

A

6 more more

Action to take in the following order …
—> Hold K+ !
—> Assess heart (EKG) !
—> Prepare to give Insulin/Kayexelate STAT !
—> Call HCP, stay with pt

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8
Q

What value of pH is highest priority?

A

If pH is in the 6s

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9
Q

What is the normal BUN level

What does it mean if elevate? What to assess? What to do

A

Normal level is 8 to 25

Assess dehydration

Action to take …
—> Nothing to hold !
—> Assess for dehydration !
—> Prepare IV fluid !
—> Call HCP

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10
Q

What is the nomal Hemoglobin level?
What is considered low Hgb level?
What is considered critical level of Hemoglobin?

A

Normal: 12-18
Low: 8-11
Critical: <8

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11
Q

What is considered a critically low Hemoglobin level?

In critical hemoglobin level, what do we do?

A

Less than 8

Action to take in level C,
—> nothign to hold
—> assess for bleeding/anemia/malnutrition
—> Prepare blood
—> Call HCP

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12
Q

What is the normal BICARBONATE(HCO3) LEVEL?

A

22 to 26

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13
Q

What is considered Level C “critical” CO2 level?

What is the course of action>?

A

CO2 level C is if in the 50s

Nothinbg to hold
—> Assess for breathing
—> Ask pt to perform purse-lipped breathing
—> Call HCP
(***this lab value does not apply to COPD patients)

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14
Q

What is considered Level D “top priority” lab value of CO2

What is the course of action

A

If CO2 level is in the 60s

Action to take for a Level D … Nothing to hold !
—> Prepare to intubate/ventilate !
—> Call (Respiratory therapy ! HCP), do not leave pt

o This is respiratory failure

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15
Q

What are the 5 priority pts based on their lab values

A

K+ >6
PH in the 6s
CO2 in the 60s
PO2 <60
Platelets <40,000

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16
Q

Neutropenic Precautions

A

Strict handwahsing
Vital q4 hrs
Dedicated stethoscope, BP cuff
Reverse/protective isolatiom
Shower
BID with microbial soap
Avoid crowds
Limit staff/visitors
No fresh flowers/potted plants
No raw fruits/veggies/undercooked meat
No water ptcher standing for over 15 minutes
Check WBC daily
No indwelling catheters
Do not reuse sups or disposable plates

17
Q

Normal RBC value

A

4-6 million

18
Q

What is the normal value of Platelet (PLT)

When is it considered Level C “critical”?
Whenis it considered Level D “highest priority”?

A

PLT

Normal: 150,000-450,000
Level C: <90,000
Level D: <40,000

19
Q

It is the lab value we look at in HIV, AIDS patients

A

CD4

20
Q

CD4 normal level:

CD4 in HIV patients: >200 but <500
CD4 levels in AIDS: <200
When is it considered Level C “critical”: <200

What is the action we take for cd4 (WBC and ANC?)?

A

Normal level: > 200

CD4 in HIV patients:
CD4 levels in AIDS:
When is it considered Level C “critical”:

Action for WBC, ANC and CD4 … Assess and put on pt neutropenic precautions
o Refer to neutropenic precautions below

21
Q

What is the normal ANC (Absolute neutrophil count)?

When is it considered Level C “critical”? What do we do

A

Normal ANC: >500

Level C “critical”: <500
When it is <500, Action for WBC, ANC and CD4 … Assess and put on pt neutropenic precautions

22
Q

What is the normal WBC count?

When is it considered Level C “critical”? What do we do?

A

Normal WB: 4,000-11,000

Level C is <4,000, We assess and put pt on neutropenic precautions

23
Q

What is the normal Sodium (Na) level?

When is it considered Level B “Abnormal”? What do we do
When is it considered Level C “critical”?

A

Normal Sodium level: 135-145

Level B if abnormal.
Action to take for a Level B… Nothing to hold —>

24
Q

What are the 5 priority pts based on their lab values

A
  1. K+ >6
  2. PH in the 6s
  3. CO2 in the 60s
  4. PO2 <60
  5. Platelets <40,000
25
Q

What is thenormal value of phosphorus

A

3.0-4.5 mg/dL

26
Q

What are causes of hyperphosphatemia

A
  1. Excessive dietary intake of phosphorus
  2. Tumor lysis syndrome (a solid tumor bursts open thenr eleases its contents)
  3. Renal failure
  4. HYpoparathyroidism -> Hypocalcemia -> Hyperphosphatemia
27
Q

What are signs of hypophosphatemia

A
28
Q

What are the causes of hypophosphatemia

A

Malnuitrition
Alcoholism (impais GI tract to absorb nutrients)
TPN
Hyperparathyroidism -> hypercalcemia -> hypophosphatemia

29
Q

The nurse is caring for a client with a phosphorus level of 5.0 mg/dL. They know that whoch of the following are possible causes of this condition? SATA
A. Tumor lysis syndrome
B. Hypoparathyroidism
C, Hypercaldemia
D. Renal failure
E. Superior Vena Cava syndrome

A

A. Correct
B. Hypoparathyroidism causes hypocalcemia = hyperphosphatemia
D. Kidneys don’t work well and phosphorus builds up

30
Q

Normal # of Magnesium

A

1.6-2.6 mg/dL

31
Q

Stored in the bones and cartilage
Plays a major role in skeletal muscle contraction
Important for ATP formation
Activates vitamins
Necessary for cellular growth
Id directly related to calcium

A

Magnesium (Mg)

32
Q

What cause hypermagnesemia

A

Excessive dietary intake
Too many magnesium containing medications
Over-correction of hypomagsesemia
Renal failure

33
Q

What does hypermagnesemia look like

A

Neuromuscular: weakness, shallow breathing, slowed reflexes, decreasewd deep tendon reflexes
Cardiovascular: bradycardia, hypotension, vasodilation (fluthed, feel warm)
Neuro: drowsy, lethargy, coma

34
Q

What is the treatment for hypermagnesemia?

A

Calcium gluconate
Dialysis
Loop diuretics
Treat the cause / hold any fluids containing Mag

35
Q

What are causes of maypomagnesemia

A

Alcoholism
Malnutrition
Malabsorption
Hypoparathyroidism
Hypocalcemia
Diarrhea

36
Q

What are S/Sx or Hypomagnesemia

A

CV: Torsades de pointes***
Neuromuscular: numbness, tingling, cramping, tetany, seizures, increased deep tendon reflexes
Neuro: psychosis, confusion
GI: nausea, vomiting, abd cramps, anorexia

37
Q

What lab changes causes TORSADE DE POINTES?

What is the treatment?

A

Hypomagnesemia

TX: IV PUSH MAGNESIUM, or PO Magnesium hydroxide
Monitor cardiac rhythm
Treat the cause

38
Q

The nurse is caring for a client with a serum magnesium level of 3.2 mg/dL. They know that which of the following have caused this electrolyte abnormality? SATA
a. Renal failure b. ALcoholism c. Anorexia d. Diarrhea e. Malnutrition

A

A.

NCLEX Review (by M.K.) (21 decks)

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