Labs
CBC
WBC: 4-10k
WBC: inc = infection, dec = sepsis, autoimmune
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Neutrophils: inc = Bacterial infection (Antibiotic, fluids, rest); dec = sepsis/cancer
Lymphocytes: inc = Viral infection (Tylenol, fluids, rest); dec = autoimmune
Eosinophils: inc = allergies, parasitic infection
Basophils: inc = Chronic conditions (RA/UA), Allergies
Monocytes: inc = Cancer, Leukemia; dec = repeated can be bone marrow
RBC: 4-6mil
RBC: inc = dehydration; dec = anemia
HGB (Hemoglobin): 11-15
The # of RBC; inc = dehydration; dec = fluid retention
HCT (Hematocrit): 36-48
The % of RBC; inc = dehydration; dec = fluid overload, bleeding, cancer
Platelets: 150-450k
Inc = anemia, inflammation; dec = sepsis, cirrhosis
COAGS
PT: 11-16 Seconds
INR: Therapeutic Range: 2-3
PTT: 25-35 Seconds
PT & INR: Important w/ Coumadin (Antidote: Vit K)
INR: <2 = Thicker the blood (risk of clotting);
>3 = Thinner the blood (risk of hemorrhage = HOLD COAG)
PTT: Important w/ Heparin (Antidote: Protamine Sulfate)
U/A
PH: 5-8
Specific Gravity: 1.001-1.030
↑ with dehydration
Electrolytes
Sodium (Na): 135-145
inc = elevated BP; dec = weak, N/V, muscle ache, AMS; seizures with both
Magnesium (Mg): 1.6-2.4 (Remember 2)
Controls Ventricle; inc = renal failure; ↓ = Torsade de Pointes (Fatal vent condition)
Potassium (K): 3.5-5.0 (Antidote for high potassium = Kayexalate)
Controls Electrical Activity of Heart; inc/dec = arrhythmias
Calcium (Ca): 8.8-10
Controls Contractility of Heart or SA Node; inc = afib (Calcium Channel Blockers given); dec = arrhythmias
Glucose: 70-99 (inc = 100-125 = PreDM, 126+ DM; dec = hypoglycemia) Note: steroids can cause false high
HGB A1C: 4-6.5
↑ # Indicated diabetes; 6 avg 120 BG/day over last 3 months
Renal
BUN (Blood Urea Nitrogen): 8-23 inc = dehydration, impaired kidney func, CHF; dec = malnutrition, liver disease
GFR (Glomerular Filtration Rate): ↑90= Normal ↓60= Chronic Renal Disease ↓15= Acute Renal Failure
Creatinine: 0.5-1.2 ↑2= No Contrast Dye given d/t kidney failure
Cardiac
Troponin: ↓0.01
Inc directly related to MI/cardiac injury; takes 4-6 hours to become elevated
BNP: ↓500
Inc directly related to CHF, dialysis noncompliant
Liver
AST& ALT: 10-40
↑ the # = the worse the liver function; AMS
CRP: 0-5 ↑ The #= More inflammation
Made in the liver and shows inflammation; >3 normal, inc = sepsis, predisposition for CAD
Bilirubin: 0.3 - 1.9 inc = liver disease, blocked duct, causes jaundice
AGB’s
PH: 7.35-7.45 inc = alkalotic, dec = acidic
Co2: 35-45 inc/dec= impaired gas exchange
O2: 80-100 dec = impaired gas exchange
HCO3 (Bicarb): 22-26 shows you metabolism vs renal issues
Pancreas
Amylase: 25-85 inc = pancreatitis r/t alcoholism primarily; cancer, stone blockage, ARDS
Lipase: 13-60 inc = pancreatitis r/t alcoholism primarily; cancer, stone blockage, ARDS
Albumin: 3.5-5 Overall Nutrition; inc = dehydration, dec = malnutrition
Lactic Acid: 0.5-22 ↑4 = Sepsis=ICU
Procalcitonin: 0-0.5, 0.5-2 localized infection, ↑2 = Sepsis or Severe Inflam (R/O: sepsis vs bact/viral infect)
ESR (sed rate): 0-26 mm/hr shows infection, inflame, cancer, autoimmune dis
Scales
Braden: 15-20 ↓15= Risk for skin breakdown
Morse: 0-24 ↑The #= more risk for fall
Glasgow Coma Scale GCS: 3-15 (↓8 = intubate); Measures eye, motor and verbal responses
Pressure Ulcer Staging
1: red, painful area that doesn’t blanche but no skin disruption yet
2: skin blisters, open sore, red and irritated around border
3: crater, may see fat layer/fascia
4: damage to muscle/bone/tendon/joints
IV’s
14(orange)
16
18
20
22
24
Trauma
Surgery
Normal
Normal
Elderly
Peds
Rapid Blood
Rapid Blood
Routine Blood
Routine Blood
X
X
HTN Med Classes/Actions
ACE Inhibitors (PRIL) = blocks angiotensin 1 from becoming angiotensin 2 which prev systemic and renal
vasoconstriction and the release of aldosterone; first drug of choice d/t not elevating HR; “ace cough”
and 1st dose syncope
Calcium Channel Blockers (PINE) = relaxes arterial smooth muscle and dec HR; controls SA node/
“Pacemaker”; need: BP or Apical Pulse (hold: if HR under 60)
Beta Blockers (OLOL) = dec cardiac workload, inc efficiency, vasodilation; need: apical pulse (hold: if HR
under 60)
Cardiac (Ejection Fraction AKA EF: 55+ normal, 40-55 dysfunction, 30-39 failure)
PR=Atrial Depolarization
QRS=Ventricle Depolarization
SP=Ventricle Repolarization