Lab Values
This test is more specific for liver damage between AST and ALT
ALT
Which lab if elevated presents with:
AST
What can impact albumin levels?
Dehydration
Which test is included in a Comprehensive Metabolic Panel (CMP) but not a BMP?
total protein
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
Which test is ordered to assess the esophagus and stomach for structural abnormalities?
Barium Swallow
What are common indications of an elevated Bilirubin level?
hemolytic anemia, decreased liver function, gallbladder issues
Which condition is typically associated with elevated ALT levels?
hepatitis
Leukocyte esterase and nitrites that are positive in a urinalysis may indicate what?
A urinary tract infection (UTI)
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
Which organ regulates calcium levels in the body?
kidney
Low levels of Albumin in the blood can indicate this
Liver Disease
Which lab are bone fractures related to?
Alkaline Phosphatase
Why is a KUB ordered?
To identify obstructions or stones in the urinary tract
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
What is a common symptom associated with increased levels of bilirubin?
Jaundice
Hypocalcemia is associated with _____ levels in the blood?
low magnesium
Increase fluid intake before the test would be ordered for which test?
iodine-based contrast media before an IVP
Why does a patient with kidney failure have low calcium and high phosphate?
Phosphate builds up; high phosphate lowers calcium via reciprocal regulation.
Hypomagnesemia describes a serum magnesium below:
1.8 mg/dl
Which condition has tall, tented T waves on an ECG?
Hyperkalemia
Which low lab value has neurologic changes as a common symptom?
Hyponatremia
What is the primary dietary restriction necessary for a successful colonoscopy preparation?
Clear liquid diet
_________ helps determine:
Medication dosing
Need for nephrology referral
Monitoring the progression of kidney disease
GFR