BNP
Troponin(TNI/TNT)
CK-MB/CPK-MB
ABG(Arterial Blood Gas)
More ABG
UA(Urinalysis Profile)
More UA
100
What does BNP stand for?
Brain Natriuretic Peptide
(hormone in the "downstairs" or "pumping chambers" of the heart)
100
What is the normal value for TNT?
<0.1ng/mL
100
What does CK-MB/CPK-MB stand for?
creatinine phosokinase muscle brain
100
What is the purpose of an ABG?
To measure the acidity (pH), levels of oxygen and carbon dioxide in the blood from an artery.
100
What is the normal values for PaCO2?
PaCO2: 35-45mm Hg
100
What is the purpose of this test?
To determine the presence of infection.
100
- Color – Yellow (pale to dark/straw)
- Clarity/turbidity – Clear
- pH – 4.9.
- Specific gravity – 1.015.
- Protein - 0
- Glucose - Present.
- Ketones – Present.
- Microscopic Analysis - very few
- Nitrites – Negative.
What values are concerning and what might they indicate?
Glucose present - uncontrolled diabetes, kidney disease
Ketones present - uncontrolled diabetes, alcoholism, low CHO diet
200
What is the purpose of this test?
To measure the amount of the BNP hormone in the blood and assess for heart failure.
200
What is the normal value for Troponin and TNI?
< 0.03ng/mL
200
What is the normal value?
<3%-6% of total CK
200
What are the components of an ABG?
PaO2, PaCO2, pH, HCO3, SO2, O2, BE
*Peter Picked a Pepper and Has Shortness Of Breath
200
What is the normal values for pH?
pH: 7.35-7.45
200
What is the normal value for pH?
4.6-8.0
200
- Color – Yellow (pale to dark/straw)
- Clarity/turbidity – Clear.
- pH – 4.3.
- Specific gravity – 1.053.
- Glucose - None.
- Ketones – None.
- Microscopic Analysis - very few
- Nitrites – Negative.
What values are concerning and what might they indicate?
The pH is low=metabolic or respiratory acidosis
Specific gravity is high=dehydration, diuretic use and kidney disease.
300
Normal Value?
<100 pcg/mL
300
A high value of troponin in the blood is indicative of?
Heart muscle injury
300
A high value of CK-MB in the blood is indicative of?
Heart muscle damage caused by heart attack.
*Same as Troponin
300
What is the normal values for PaO2?
PaO2: 80-100mm Hg
300
What is the normal values for HCO3?
HCO3: 22-26 mEq/L
300
Which parts of this test do we want to see none or very few?
*For 300 extra points tell me what happens if these are present in the urine.
Protein-0-8
*kidney damage, HTN pregnancy, infection
Glucose-none
*uncontrolled diabetes, kidney disease
Ketones-none
*uncontrolled diabetes, alcoholism, low CHO diet
Microscopic Analysis-very few RBCs/WBCs
*UTI
Nitrates-none
*UTI
300
- Color – Yellow (pale to dark/straw)
- Clarity/turbidity – Clear
- pH – 9.3.
- Specific gravity – 1.002.
- Glucose - None.
- Ketones – None.
- Microscopic Analysis - very few
- Nitrites – Negative.
What values are concerning and what might they indicate?
The pH is high=metabolic or respiratory alkalosis
Specific gravity is low=overhydration, sugar or protein present
400
High value BNP is indicative of?
CHF
Heart failure and increased pressure/fluid in the heart.
400
When will you see this elevation in the blood?
4-6 hours after a heart attack
At the highest level 12-24 hours after heart attack
400
What is one difference between Troponin and CK-MB?
Troponin=protein
CK-MB=enzyme
*both have same effects of high values and are used for the same purpose
400
What are the normal values for SO2(O2 sat) and O2 content(O2CT)?
SO2(O2 sat): 95%-100%
O2 content(O2CT): 15-22mL/100mL blood
400
What is the normal value for BE (base excess)?
BE (base excess): -2 to +2 mEq/L
400
What is the normal value for specific gravity and what are the high and low values indicative of?
Normal: 1.005-1.030
High: dehydration, diuretic use, kidney disease
Low: overhydration, sugar or protein present
400
- Color – Amber
- Clarity/turbidity –Sediment
- pH – 4.8.
- Specific gravity – 1.053.
- Protein - 7
- Glucose - None.
- Ketones – None.
- Microscopic Analysis - Many
- Nitrites – Present.
What values are concerning and what might they indicate?
The color, clarity, microscopic analysis, nitrates and protein are all out of range and are indicative of an infection, more specifically, a UTI.
500
A 74 year old female presents to the ER with complaints of dyspnea, persistent cough, and unable to sleep at night due to difficulty breathing. On assessment, you note crackles throughout the lung fields, respiratory rate of 25, and an oxygen saturation of 90% on room air. Which of the following lab results confirm your suspicions of heart failure?
- A. K+ 5.6
- B. BNP 820
- C. BUN 9
- D. Troponin <0.02
B. BNP 820
500
A client arrives in the emergency department complaining of chest pain that began 4 hours ago. A troponin T blood specimen is obtained and the results indicate a level of 0.6 ng/mL. The nurse determines that this result indicates which finding?
A high level that indicates heart muscle injury occurred.
500
Of Troponin and CK-MB which one has a higher sensitivity and should be used first if both are available when testing for acute MI?
*Think of their values.
Troponin
500
A patient is on continuous BiPap and has arterial blood gases (ABGs) drawn. Select ALL the abnormal results:
- A. pH 7.20
- B. PaCO2 48
- C. HCO3 25
- D. PaO2 80
- E. SO2: (O2 sat): 93%
- F. O2 content (O2CT): 17mL/100mL blood
- G. BE (base excess): -1.5 Eq/L
A- pH=low
B- PaCO2=high
E- SO2=low
G- BE=low
500
A patient has the following arterial blood gases (ABGs). How do you interpret these results:
pH 7.38, HCO3 24, and PCO2 38
Normal
500
A nurse cares for a client with a urine specific gravity of 1.040. Which action should the nurse take?
a. Obtain a urine culture and sensitivity.
b. Place the client on restricted fluids.
c. Assess the clients creatinine level.
d. Increase the clients fluid intake.
D
Normal specific gravity for urine is 1.005 to 1.030. A high specific gravity can occur with dehydration, diuretic use, and kidney disease.
Increasing the clients fluid intake would be a beneficial intervention.
Assessing the creatinine or obtaining a urine culture would not provide data necessary for the nurse to make a clinical decision.
500
- Color – Yellow (pale to dark/straw)
- Clarity/turbidity – Clear
- pH – 6.2.
- Specific gravity – 1.013.
- Glucose - None.
- Ketones – None.
- Microscopic Analysis - very few
- Nitrites – Negative.
What values are concerning and what might they indicate?
None, this is some good pee!