Lab Values
What is ALT
This test is more specific for liver damage between AST and ALT
AST
Which lab if elevated presents with:
Dehydration
What can impact albumin levels?
total protein
Which test is included in a Comprehensive Metabolic Panel (CMP) but not a BMP?
Suzie Smith 32 y/o F
5’5” 170#
History: Hypertension, Diabetes Mellitus
ETOH : states occasionally in social situations
Smoking: states occasional vaping
Meds: none
Social: Married 4 yr., 0 children Employed as a waitress at a busy restaurant
Nursing Notes
Date: Day 1 Time 0800 Suzie states she is feeling tired for the last few weeks and has no energy. She states she can sometimes feel her heart beating fast and has had episodes of nausea and diarrhea. She states she drove herself to the emergency room today after being dizzy and fell. She states she has no injuries from the fall. Admitted to the medical-surgical unit for observation and diagnostic testing.
Date: Day 2 Time 1300 Suzie states she is feeling exhausted. Nursing assessment: patient with increased bouts of confusion. At times A & O x 4, other times thinks she is at home and asking staff “where is my cat?” Urine output decreased and dark yellow.
Orders DAY 1 • Basic metabolic panel (BMP) • Liver function tests (LFT) • Comprehensive metabolic panels (CMP) • ECG • Bedrest
Question: Urinalysis interpretation
Her Urinalysis was just posted to her chart.
pH 9.2
Protein Trace
Glucose Negative
Ketones Positive
Leukocyte esterase Increased
Specific Gravity 2.2
Blood positive
Based on the results of the Specific Gravity, you know that some causes of an increase would include:
(Specific Gravity Normal Range: 1.002-1.035) dehydration, impaired blood flow to the kidneys, glucosuria, or use of Contrast media
Barium swallow
Which test is ordered to assess the esophagus and stomach for structural abnormalities?
hemolytic anemia, decreased liver function, gallbladder issues
What are common indications of an elevated Bilirubin level?
Hepatitis
Which condition is typically associated with elevated ALT levels?
A urinary tract infection (UTI)
Leukocyte esterase and nitrites that are positive in a urinalysis may indicate what?
Results are back and Suzie's ECG shows Tall Tented T Waves. Which lab do you, as the clinician, think should be ordered next?
serum potassium
kidney
Which organ regulates calcium levels in the body?
Low levels of Albumin in the blood can indicate this
What is Liver Disease
Alkaline Phosphatase
Which lab are bone fractures related to?
To identify obstructions or stones in the urinary tract
Why is a KUB ordered?
A patient with chronic diarrhea has the following lab results:
Why does the patient have low potassium?
High sodium levels can cause potassium to shift out of cells and be excreted in urine, leading to hypokalemia. Chronic diarrhea exacerbates potassium loss.
The ______________test shows whether electrolytes are out of balance or if the blood is too acidic or not acidic enough. It is also the measurement of the gap between cation (Na+ and K+) and anion (Cl− and HCO3−) levels.
Anion Gap
Jaundice
What is a common symptom associated with increased levels of bilirubin?
low magnesium
Hypocalcemia is associated with _____ levels in the blood?
iodine-based contrast media before an IVP
Increase fluid intake before the test would be ordered for which test?
Phosphate builds up; high phosphate lowers calcium via reciprocal regulation.
Why does a patient with kidney failure have low calcium and high phosphate?
1.8 mg/dl
Hypomagnesemia describes a serum magnesium below:
Hyperkalemia
Which condition has tall tented T waves on an ECG?
Hyponatremia
Which low lab value has neurologic changes as a common symptom?
Clear liquid diet
What is the primary dietary restriction necessary for a successful colonoscopy preparation?
_________ helps determine:
Medication dosing
Need for nephrology referral
Monitoring the progression of kidney disease
What is GFR