NCLEX Lab Values

Sodium: 135-145 Hyponatremia: Nausea, muscle cramps, increased ICP, confusion, convulsions. Treat with LR or 0.9%NaCl and water restrictions Hypernatremia: weakness, disorientation, hallucinations, hypotension and tachycardia. Treat with hypotonic solutions (D5W, 0.3% or 0.45%NaCl) Potassium: 3.5-5.5 Hypokalemia: Muscle weakness, paresthesias, dysrhythmias, increased sensitivity to digitalis. Hyperkalemia: EKG changes, dysrhythmia, cardiac arrest, muscle weakness, paralysis. Treat with Kayexalate (can cause diarrhea), emergency situations calcium gluconate, regular insulin, and dialysis. Calcium: 9-11 Hypocalcemia: Tetany, Trousseaus sign- inflate BP cuff on upper arm= carpal spasms. Chvosteks sign- tap facial nerve= twitching of facial muscle. Treat with calcium gluconate, seizure precaution, caution with digitalis patients, phosphate binding antiacids, calcitriol, Vit D. Hypercalcemia: sedation effect, muscle weakness, abdominal pain and distention, depressed deep tendon reflexes. Treat with Calcitonin, Lasix, prevent development of renal calculi, may be caused by hyperparathyroidism. Magnesium: 1.5-2.5 **Magnesium acts as a depressant Hypomagnesium: increased neuromuscular irritability, tremors, tetany, seizures, dysrhythmia, dysphagia. Treat with increase Mg (green veggies, nuts, bananas, oranges, peanut butter, chocolate.) Magnesium sulfate, keep self inflating breathing bag

and monitor respirations, test ability to swallow before PO fluids. Hypermagnesium: Depresses CNS, depresses cardiac impulses, hypotension, facial flushing, muscle weakness, absent deep tendon reflexes, shallow respirations. EMERGENCY, treat with iv calcium gluconate, support ventilation, (Mag Sulfate antidote is Calcium Gluconate) Platelets 150,000-450,000 = risk for bleeding Ptt 30-60 seconds = Bleeding time, check when giving heparin. Antidote for heparin is protamine sulfate INR 2-3 = check when giving Coumadin, antidote is Vitamin K. WBC 5,000-11,000 = risk for infection RBC 4.5-6.0 million <4.5 decreased oxygen carrying capacity, air hunger Hematocrit 35-45% <35% dehydration >45% fluid overload Hemoglobin 12-16 <12= anemia BUN 7-20 renal function Creatinine 0.5-1.5 renal function Quickening 16 weeks fetal heart tones 20 weeks fetal heart rate 120-160 Lithium 1.0-1.5 Signs of overdose: vomiting, diarrhea, drowsiness, muscular weakness, ataxia. Dilantin 10-20 anticonvulsant, pink sweat and urine, IV=cardiac arrest, never mix with other drugs or dextrose Digoxin 0.5-2.0 Low potassium increases risk of toxicity, antidote=digabind Tylenol antidote is Mucomyst Insulin: Reg 30-60 min onset, 2-4 hr peak and 5-7 duration NPH 1-3 hr onset, 6-12 hr peak and 18-24 duration Lispro-fast acting and to eat right away, dont mix

pH 7.35-7.45 below=acidic above=alkalosis PaCO2 35-45 =respiratory and ventilation PaO2 80-100% = oxygenation HCO3 22-26 = metabolic and renal function 5 P's with fractures: pain, pallor, pulselessness, paresthesia and paralysis Fetal Heart strips: VEAL CHOP (Variable is cord, early is head, accelerations is ok and late is placental insuffenciency) starve a gastric ulcer, feed a duo ulcer 200-300 ml blood loss with vaginal birth, 500 ml with c-section, over is hemorrhage Urine specific gravity: 1.010-1.030 Diabetes Insipidus: ADH, UO (dehydration), urine specific gravity, serum sodium Syndrome of Inappropriate ADH: ADH, UO urine specific gravity, serum sodium HHNKS: glucose > 800, no ketones, acidosis LDL: optimal <139. Bad cholesterol AST: 10-40 Liver function ALT: 5-35 Liver function Serum albumin: 3.5-5.5 muscle strength and tone CVP: nl 3-12. >12: hypervolemia, <3: hypovolemia Isotonic: 0.9% NaCl, LR, D5W Hypotonic: 0.45% NaCal Hypertonic: D10-15W, 3% NaCl 60mg=1grain Carbamazepine: therapeutic 5-12 24-34wks: fundal height correlates with wks gestation No grapefruit juice: cyclosporine, carbamazepine, buspar, zocor, verapamil OD benzodiazepines antidote: flumazenil (romazicon) 24 hour old jaundice is abnormal, normal is over 24 hrs old PR Interval is 0.12-0.20

QRS Complex is 0.04-0.12 Addison's (AD-Aldosterone Deficiency) disease- sodium and potassium, hypoglycemia Urine output, Hypotension +, Hypovolumia, dehydration and CO. Cushings Adrenal hypersecretion of glucocorticoids. sodium potassium and Calicum, HYPERGLYCEMIA. Risk for infection and osteoporosis Pheochromocytoma - Hypertension is a hallmark. @ 20 weeks of gestation - fundus is @ umbilicus. Neutrophil count - 1800 - 7800; indicate +/- of infection
CK (creatine kinase) CK-MB (cardiac CK isoenzyme) CK-MM (skeletal muscle CK isoenzyme) CK-BB (brain CK isoenzyme) LDH1 (lactate dehydrogenase isoenzyme) LDH2 (lactate dehydrogenase isoenzyme) LDH3 (lactate dehydrogenase isoenzyme) LDH4 (lactate dehydrogenase isoenzyme) LDH4 (lactate dehydrogenase isoenzyme) Troponin I (normal) Troponin I (myocardial infarction) 26 to 147 (units/l) 0 to 5 (% of total) 95 to 100 (% of total) 0 (% of total) 14 to 26 (%) 29 to 39 (%) 20 to 26 (%) 8 to 16% 6 to 16 (%) less than 0.6 (ng/ml) greater than 1.5 (ng/ml)

TroponinT (myocardial infarction) Myoglobin (normal) Myoglobin (myocardial infarction)

greater than 0.1 to 0.2 (ng/ml) less than 90 (mcg/L) greater than 90 (mcg/L)

BNP less than 100 more than 100 CHF