Lab Red - Normal: - Actual Hemoglobin: - Normal: -A direct male measure male

Values: Blood = count 4.66.2 of

Cheat Cells female red = 4.2-

Sheet (RBC): 5.2 corpuscles

= of

14-18 oxygen

g/dl

female capacity

= of

12-16 the

g/dl blood

carrying

Hematocrit : - Normal: -= Mean - Normal: Mean - Normal: -= % volume of Cell 27hemoglobin folate iron Cell Hemoglobin 31per Hemoglobin (MCH): 33 RBC deficiency deficiency Concentration): 35 Count: 0.5-2.5% indirect measure of of RBC RBC production male the males percentage = of Cell = 8096 39blood 49% that is female composed = of 3545% erythrocytes (MCV): = 8298

Volume female

* Increase: indicates * Decrease: indicates Mean - Normal: Reticulocyte - Normal: - An

Red - Normal: - Indicates

Blood variation iron

Cell in deficiency of

Distribution red anemia iron or

Width cell mixed

(RDW): 11-16% volume anemia anemia Count:

* Increase: indicates early Platelet - Normal: detection

- Note: increase in RDW occurs earlier than decrease in MCV therefore RDW is used for deficiency

140,000

440,000

* Low: worry * High: not White - Normal: * Increase: occur * Decreases: marrow Sodium - Normal: - Major Causes: contributory to cell * Hypernatremia: greater sodium during Blood

patient clinically Cell 3.4 infections suppression and

will

bleed significant (WBC):

physiologic and

10 stress

chemotherapy (Na):

136osmolality overload and in than or volume control of water

145 balance 145 depletion

Seen in: impaired thirst, inability to replace insensible losses, renal or GI loss S/sx: thirst, restlessness, irritability, lethargy, muscle twitching, seizures, hyper flexia, coma * Hyponatremia: 136 Causes: Occur nausea Potassium - Normal: - Regulated * Hypokalemia: less * Hyperkalemia: greater NOTE: Chloride - Normal: * Reduced: by * Increased: by Bicarbonate - Normal: 24metabolic metabolic or respiratory alkalosis acidosis (HCO3): 30 96False K than elevations are 5.0 seen in by than (panic hemolysis > of 3.5renal (K): 5.0 function 3.5 6) samples! (Cl): 106 in: true CHF, depletion diarrhea, and or or sweating, death. less dilutional thiazides

Symptoms: agitation, anorexia, apathy, disorientation, lethargy, muscle cramps and

- The test represents bicarbonate (the base form of the carbonic acid-bicarbonate buffer system) * Decreased: acidosis * Increased: alkalosis GLUCOSE: Normal: * causes: * mental causes: BUN: - Normal: - Panic Serum - Normal: - SCr is * Increase: Indicates worsening renal function 0.71.5 for in constant = > Creatinine adults patients and with 0.2normal 0.7 for kidney fasting, Blood 8100 insulin Urea include 70110 Hyperglycemia: diabetes Hypoglycemia: status administration Nitrogen 20 mg/dl (SCr): children function.

s/sx: increase thirst, increase urination and increased hunger (3Ps). May progress to coma

s/sx: sweating, hunger, anxiety, trembling, blurred vision, weakness, headache or altered

Total - Total - Albumin: o Related * Low: Cause: S/sx: Serum - Normal * peripheral protein:

Protein normal normal to liver edema, ascites, periorbital Calcium = Hypocalcemia: less =

and = liver 5.53.-

Albumin: 9.0 5 status dysfunction

edema

and

pulmonary

edema. (Ca):

8.5than

10.8 8.5

Causes: low serum proteins (most common), decreased intake, calcitonin, steroids, loop diuretics, high PO4, low Mg, hypoparathyroidism (common), renal failure, vitamin D deficiency (common), pancreatitis

 S/sx: fatigue, depression, memory loss, hallucinations and possible seizures or tetany Lead Early * supplements, hormone. Acute Increased Phosphate - Normal: Magnesium - Normal: - Primarily * Hypomagnesemia: less Alcoholism changes, may convulsions, lead psychosis, come eliminated 1.5by than to and than low cardiac the 2.6(>14.5) s/sx: risk nausea, vomiting, of dyspepsia digoxin and anorexia or death toxicity (PO4): 4.5 (Mg): 2.2 kidney 1.5 levels arrhythmia. 2.2 disease at 10-15 15 2-5 mEq/L mEq/L = = bradycardia, = flaccid respiratory flushing, distress sweating, and N/V, EKG low Ca paralysis, changes asystole. Phosphatase: ranges (most activity in (ALT from vary bones liver and and widely liver) dysfunction AST): Severe s/sx: lethargy, psychosis, cerebellar ataxia and possibly coma to: signs: finger MI, numbness, cardiac tingling, arrhytmias burning of and extremities than Pagets disease, sarcoidosis, and hypotension paresthias. 10.8 hyperthyroidism,

Hypercalcemia: more chronic immobilization,

Cause: malignancy or hyperparathyroidism (most common), excessive IV Ca salts, lithium, androgens, tamoxifen, estrogen, progesterone, excessive vit D or thyroid

Causes: excessive losses from GI tract (diarrhea or vomiting) or kidneys (diuretics). S/sx: weakness, muscle fasciculation with tremor, tetany, increased reflexes, personality * Hypermagnesemia: more Addisons S/sx: at over Alkaline - Normal: leukocytes

Caueses: incrased intake in the presence of renal dysfunction (common), hepatitis and

- Group of enzymes found in the liver, bones, small intestine, kidneys, placenta and * Increased: occurs Aminotransferases necrosis. - Increase: occurs after MI, muscle diseases and hemolysis.

- ALT and AST are measure indicators of liver disease. Sensitive to hepatic inflammation and

- Normal

ALT:

3-

30

Direct - Normal:

Bilirubin 0.1-0.3

(Conjugated): mg/d;

* Increase: associated with increases in other liver enzymes and reflect liver disease Urine: - Normal: * Foam: from - Side note: o Red-Orange: o Blue-Green: o Brown-Black: nitrofurantoin pH: - Normal: Protein - Normal: 0 content +1 or less 4.5[in than 150 8 urine]: mg/day Azo Cascara, should protein some Pyridium, dyes, chloroquine, or medications Elavil, be bile will rifampin, methylene iron salts, senna, clear acids change senna, blue, Flagyl, color in of yellow urine urine abuse and * Cloudy: results from urates (acid), phosphates (alkaline) or presence of RBC or WBC

phenothiazines. Clorets sulfonoamides

* Protein in urine: indication of hemolysis, high BP, UTI, fever, renal tubular damage, exercise, CHF, diabetic nephropathy, preeclampsia of pregnancy, multiple myeloma, nephrosis, Microscopic - Urine - Few, should if any, lupus analysis be sterile cells (no should nephritis of normal be and others. Urine: flora) found

- Significant bacteriuria is defined by an initial positive dipstick for leukocyte esterase or nitrites. If more than 1 or 2 species seen, contaminated specimen is likely.

ABG Ph 7.35 - 7.45 PCO2 35 45 mm Hg HCO3 22 27 mEq/ml PO2 80 100 mm Hg SaO2 93 100% RBC Male 4.5 - 6.2 million/ cubic mm Female 4.0 - 5.5 million/cubic mm WBC 4,300 - 10,800/ cubic mm Platelets 150,000 - 350,000/ cubic mm Hgb Male 14 - 16.5 g/dL Female 12 - 15 g/ dL Hct Male 42 - 52% Female 35 - 47% PT (Warfarin/ Coumadin) Male 9.6-11.8 secs Female 9.5-11.3 secs Should be 1.5 to 2 times the Normal PTT/ APTT (Heparin) 20-36 secs / 30-45 secs Should be 1.5 to 2.5 times the Normal INR 2 3 Standard Warfarin therapy 3 4.5 High dose Warfarin therapy 2-3 Atrial fibrillation, DVT and Pulmonary embolism 2.5-3.5 Prosthetic heart valves Bleeding Time 3 - 7 mins. 8 - 15mins (Saunders) Electrolytes K 3.5 - 5.1 mEq/ L Mg 1.6 - 2.6 mEq/ L Ph 2.7 - 4.5 mEq/ L Na 135 - 145 mEq/ L Cl 98-107 mEq/ L Ca 8.6 - 10 mg/dL

Potassium Chloride IT IS NEVER GIVEN BY IV PUSH, IM OR SUB Q With a dilution of not more than 1mEq/10ml Maximum infusion rate of 5-10 mEq/ hr NEVER to exceed 20 mEq/ hr at any circumstance Blood Sugar 70 110 mg/dL Glycosylated Hgb (glycohemoglobin) less than 7.5% Good 7.6 - 8.9% Fair greater than 9% Poor Vanillylmandelic Acid (VMA) 0.7 - 6.8 mg/24 hrs GFR 125 ml/min Creatinine 0.8 - 1 mg/dL 0.6-1.3 mg/dL (Saunders) BUN 10 20 mg/dL 8-25 mg/dL (Saunders) UO Adult: 30 cc/hr and 720 cc/24 hours Pedia: 2cc/ kg/ hr AST/ ALT 5-40 IU/L Ammonia 9-33 mol/L 35-65 mcg/ dl Albumin 3 - 5 g/dL Amylase 25-151 units/ L Lipase 10-140 units/ L Bilirubin (Total) less than 1.5 mg/ dL Pulmonary capillary mean wedge pressure 4-12 mmHg Central Venous Pressure 2-6 mmHg

Plasma Osmolality 280-300 mOsm/kg Serum Alcohol LEGAL .08 - .10 TOXIC! grater than 0.15 (50mg/100cc of blood) greater than 8%