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HCC Fluids & Labs

Serum Osmolality Range 275-295 mOsm/kg. How "thick" the blood is.
Red Blood Cell Count Females 4-5 million/cubic mm, Males 4.5-6 million/cubic mm
Hemoglobin (Hgb/Hb) Females 12-16 g/dl, Males 13.5-18 g/dl. LESS THAN 12 = ANEMIA
Hematocrit (Hct) Females 38-47%, Males 40-54%
White Blood Cell Count (Total) 4,000-11,000/microliter, <4,000 = LEUKOPENIA
Shift to the Right Increase in Segs. Mature Neutrophils.
Shift to the Left Increase in Bands. Immature WBC's being thrown out = appendicitis.
Platelet Count 150,000-400,000 mm3. Essential for clotting. <150,000 = THROMBOCYTOPENIA, BLEEDING, OR VIT. K DEFICIENCY
Prothrombin Time (PT/Protime) 12-15 seconds, PROLONGED C THROMBOCYTOPENIA, BLEEDING, AND VIT. K DEFICIENCY. time for plasma to clot after animal tissue factor is added. looking for common pathways in clotting.
International Normalized Ratio (INR) 0.8-1.2, PROLONGED C THROMBOCYTOPENIA, BLEEDING, AND VIT. K DEFICIENCY.When client is on anticoagulants 2-3 is desired range. 2.5-3.5 for artificial valves. CLOT DETECTION
Bilirubin 0.3-1.2 mg/dL, ELEVATED C CIRRHOSIS. Used by liver to make bile. Increased levels in anemia-jaundice.
Mean Corpuscular Volume (MCV) 80-94. GREATER THAN 100 = ANEMIA. Microcytic/Macrocytic. Measures avg size of individual RBC's. GREAT
Mean Corpuscular Hemoglobin Concentration (MCHC) 32-36. Hypochromic/Hyperchromic. Portion(%) of each cell perfused with hemoglobin.
Mean Corpuscular Hemoglobin (MCH) 26-34. Microcytic/Hypochromic. Amt or mass(wt.) of Hgb in one RBC. Smaller = Less color
Reticulotye Count 1.5-2.5%. Folic Acid Deficiency...I'll add more to this after reviewing the lecture recording.
pH 7.35-7.45
PaCO2 35-45 mmHg
PaO2 80-95 mmHg
Oxygen Saturation(Sats) 95-100%
HCO3 22-26 mEq/L
Specific Gravity 1.005-1.030 (amt. of particles iin urine)
FBS Fasting Blood Sugar. 70-110
Temperature 97.6-99.6. 98.6 degrees F is norm. 36.2-37.6 degrees C
Pulse 60-100 bpm
Respirations 12-20
Blood Pressure 100-120 systolic over 60-80 diastolic. Average 110/70
Blood Enzymes Show up when tissue of an organ have been damaged. (liver damage = liver enzymes)
White Blood Cell Differential (Diff) Neutrophils, Lymphocytes, Monocytes, Eosinophils, Basophils.
Never Let Monkeys Eat Bananas 60, 30, 6, 3, 1 Neutrophils 50-70%, Lymphocytes 20-40%, Monocytes 4-8%, Eosinophils 2-4%, Basophils 0-2%.
Neutrophils 50-70%. First line defense, contain enzymes to fight pathogens. Increase=bacterial infection, decrease=viral infection.
Lymphocytes 20-40%. Increased in infection or extreme physical exertion. Produce antibodies to fight antigens.
Monocytes 4-8%. Evolve into macrophages and release substances that stimulate other cells of the immune system into action.
Eosinophils 0-4%. High in allergic reactions.
Basophils 0-2%. Contain (and can release) histamine and serotonin.
Na+ Sodium 135-145 mEq/L. Major Cation outside cell.
F.R.I.E.D. Hypernatremia. Fever, Restless, Increased fluid retention, Edema, Decreased urin output.
M.O.D.E.L. Hypernatremia. Meds/Meals, Osmotic diuretics, Diabetes insipidus, Excessive H20 loss, Low H20 intake.
K+ 3.5-5 mEq/L. Major Cation inside cell. Sources: bananas, dark green leafy, raisins, potatoes, dried beef.
M.A.C.H.I.N.E. Hyperkalemia. Medications(ACE inhibitors, NSAIDs), Acidosis(metabolic and respiratory, Cellular destruction, Hyperaldosteronism, Intake(excessive), Nephrons(renal failure), Excretion(impaired).
M.U.R.D.E.R. Hyperkalemia. Muscle weakness, Urine(olg/anuria), Respiratory distress, Decreased cardiac contract, ECG changes, Reflexes changes.
Cl- Chloride. 95-110 mEq/L. Major anion outside cell.
HPO4- Phosphate. 2.5-4.5 mg/dL.
Ca++ Calcium. 8.5-10.5 mg/dL.
C.A.T.S. Hypocalcemia. Convulsions/confusion, Arrhythmias, Tetany, Spasms.
Mg++ Magnesium. 1.5-2.4 mEq/L.
Acid Base Balance Too many H+ ions = more acid. pH decreased = H+ increased, pH increased = less H+.
Alkalosis >7.45 pH
Acidosis <7.35 pH
Respiratory Alkalosis Hyperventilation, pulmonary disease, vent settings too high/fast, high altitudes.
Respiratory Acidosis Most common acid-base imbalance. When ventilation is depressed CO2(acid) is retained. Over sedation, brain stem trauma, immobility, resp. muscle paralysis, narcotics.
Metabolic Alkalosis Too much base and H+ concentration is lost. Steroid use, NG suctioning, prolonged vomiting, thiazide diuretic use.
Metabolic Acidosis When acid accumulates or bicarb is lost. Impaired kidney function, severe diarrhea, shock, ketoacidosis, liver failure, salicylate toxicity, starvation.
Blood Glucose 70-110 mg/dL in adults. 70-120 mg/dL in elder adult. HYPOGLYCEMIA MAY BE SEEN WITH HYPOALBUMINURIA AND NUTRITIONAL DEFICIENCIES.
BUN Blood Urea Nitrogen. 8-21 mg/dL
Creatinine 0.5-1.1 mg/dL Females, 0.6-1.2 mg/dL Males
Intracellular Fluid inside the cell
Extracellular Fluid outside the cell
Protein 6-8 g/dL, LOW IN HYPOALBUMINURIA AND NUTRITIONAL DEFICIENCIES. The major colloid in the vascular system contributing to the total osmotic pressure.
Diffusion The movement of molecules from an area of high concentration. Occurs with liquids, gases, and solids.
Osmosis The movement of water between two compartments seperated by a membrane permeable to water but not to a solute.
Isotonic Fluids with the same osmolality as the cell interior.
Hypotonic Solutions in which the solutes are less concentrated than the cells.
Hypertonic Solutions in which the solutes are more concentrated than the cells.
Oncotic Pressure Osmotic pressure exerted by colloids in a solution. The major colloid in the vascular system contributing to the total osmotic pressure is protein.
First Spacing The normal distribution of fluid in the ICF and ECF compartments.
Second Spacing An abnormal accumulation of interstitial fluid.
Third Spacing When fluid accumulates in a portion of the body from which it is not easily exchanged with the rest of the ECF. 3rd spaced fluid is trapped and essentially unavailable for functional use. (ascites, peritonitis, and edema)
Diuretic Increases excretion of water from the body.
Hypothalamic Regulation A body fluid deficit or increase in plasma osmolality is sensed by osmoreceptors in the hypothalamus, which in turn stimulates thirst and antidiuretic hormone (ADH) release.
ADH The distal tubules and collecting ducts in the kidneys respond to ADH by becoming more permeable to water so water is reabsorbed.
Glucocorticoids (cortisol) Primarily have an anti-inflammatory effect and increase serum glucose levels.
Mineralcorticoids (aldosterone) Enhance sodium retention and potassium excretion
Insensible Water Loss Invisible vaporization from the lungs and skin, assists in regulating body temperature. Normally, about 900 mL per day is lost.
H2O deficiency HYPERNATREMIA (dehydration=less water=serum sodium level appears higher).
Na+ deficiency HYPONATREMIA
H2O excess HYPONATREMIA (more water=serum sodium level appears lower)
AST Aspartate Aminotransferase 35-140, INCREASED C CIRRHOSIS
ALT Alanine Aminotransferase 10-60, INCREASED C CIRRHOSIS
ALP Alkaline Phosphatase 42-128 units/L
Created by: mande747