HCC Fluids & Labs
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| Serum Osmolality Range | 275-295 mOsm/kg. How "thick" the blood is.
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| Red Blood Cell Count | Females 4-5 million/cubic mm, Males 4.5-6 million/cubic mm
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| Hemoglobin (Hgb/Hb) | Females 12-16 g/dl, Males 13.5-18 g/dl. LESS THAN 12 = ANEMIA
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| Hematocrit (Hct) | Females 38-47%, Males 40-54%
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| White Blood Cell Count (Total) | 4,000-11,000/microliter, <4,000 = LEUKOPENIA
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| Shift to the Right | Increase in Segs. Mature Neutrophils.
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| Shift to the Left | Increase in Bands. Immature WBC's being thrown out = appendicitis.
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| Platelet Count | 150,000-400,000 mm3. Essential for clotting. <150,000 = THROMBOCYTOPENIA, BLEEDING, OR VIT. K DEFICIENCY
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| 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.
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| 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
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| Bilirubin | 0.3-1.2 mg/dL, ELEVATED C CIRRHOSIS. Used by liver to make bile. Increased levels in anemia-jaundice.
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| Mean Corpuscular Volume (MCV) | 80-94. GREATER THAN 100 = ANEMIA. Microcytic/Macrocytic. Measures avg size of individual RBC's. GREAT
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| Mean Corpuscular Hemoglobin Concentration (MCHC) | 32-36. Hypochromic/Hyperchromic. Portion(%) of each cell perfused with hemoglobin.
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| Mean Corpuscular Hemoglobin (MCH) | 26-34. Microcytic/Hypochromic. Amt or mass(wt.) of Hgb in one RBC. Smaller = Less color
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| Reticulotye Count | 1.5-2.5%. Folic Acid Deficiency...I'll add more to this after reviewing the lecture recording.
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| pH | 7.35-7.45
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| PaCO2 | 35-45 mmHg
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| PaO2 | 80-95 mmHg
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| Oxygen Saturation(Sats) | 95-100%
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| HCO3 | 22-26 mEq/L
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| Specific Gravity | 1.005-1.030 (amt. of particles iin urine)
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| FBS | Fasting Blood Sugar. 70-110
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| Temperature | 97.6-99.6. 98.6 degrees F is norm. 36.2-37.6 degrees C
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| Pulse | 60-100 bpm
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| Respirations | 12-20
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| Blood Pressure | 100-120 systolic over 60-80 diastolic. Average 110/70
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| Blood Enzymes | Show up when tissue of an organ have been damaged. (liver damage = liver enzymes)
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| White Blood Cell Differential (Diff) | Neutrophils, Lymphocytes, Monocytes, Eosinophils, Basophils.
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| 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%.
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| Neutrophils | 50-70%. First line defense, contain enzymes to fight pathogens. Increase=bacterial infection, decrease=viral infection.
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| Lymphocytes | 20-40%. Increased in infection or extreme physical exertion. Produce antibodies to fight antigens.
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| Monocytes | 4-8%. Evolve into macrophages and release substances that stimulate other cells of the immune system into action.
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| Eosinophils | 0-4%. High in allergic reactions.
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| Basophils | 0-2%. Contain (and can release) histamine and serotonin.
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| Na+ | Sodium 135-145 mEq/L. Major Cation outside cell.
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| F.R.I.E.D. | Hypernatremia. Fever, Restless, Increased fluid retention, Edema, Decreased urin output.
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| M.O.D.E.L. | Hypernatremia. Meds/Meals, Osmotic diuretics, Diabetes insipidus, Excessive H20 loss, Low H20 intake.
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| K+ | 3.5-5 mEq/L. Major Cation inside cell. Sources: bananas, dark green leafy, raisins, potatoes, dried beef.
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| 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).
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| M.U.R.D.E.R. | Hyperkalemia. Muscle weakness, Urine(olg/anuria), Respiratory distress, Decreased cardiac contract, ECG changes, Reflexes changes.
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| Cl- | Chloride. 95-110 mEq/L. Major anion outside cell.
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| HPO4- | Phosphate. 2.5-4.5 mg/dL.
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| Ca++ | Calcium. 8.5-10.5 mg/dL.
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| C.A.T.S. | Hypocalcemia. Convulsions/confusion, Arrhythmias, Tetany, Spasms.
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| Mg++ | Magnesium. 1.5-2.4 mEq/L.
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| Acid Base Balance | Too many H+ ions = more acid. pH decreased = H+ increased, pH increased = less H+.
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| Alkalosis | >7.45 pH
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| Acidosis | <7.35 pH
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| Respiratory Alkalosis | Hyperventilation, pulmonary disease, vent settings too high/fast, high altitudes.
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| 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.
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| Metabolic Alkalosis | Too much base and H+ concentration is lost. Steroid use, NG suctioning, prolonged vomiting, thiazide diuretic use.
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| Metabolic Acidosis | When acid accumulates or bicarb is lost. Impaired kidney function, severe diarrhea, shock, ketoacidosis, liver failure, salicylate toxicity, starvation.
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| Blood Glucose | 70-110 mg/dL in adults. 70-120 mg/dL in elder adult. HYPOGLYCEMIA MAY BE SEEN WITH HYPOALBUMINURIA AND NUTRITIONAL DEFICIENCIES.
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| Albumin (Alb) | 3.5-5 g/dL, LOW C HYPOALBUMINURIA AND NUTRITIONAL DEFICIENCIES.
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| BUN | Blood Urea Nitrogen. 8-21 mg/dL
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| Creatinine | 0.5-1.1 mg/dL Females, 0.6-1.2 mg/dL Males
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| Intracellular | Fluid inside the cell
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| Extracellular | Fluid outside the cell
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| Protein | 6-8 g/dL, LOW IN HYPOALBUMINURIA AND NUTRITIONAL DEFICIENCIES. The major colloid in the vascular system contributing to the total osmotic pressure.
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| Diffusion | The movement of molecules from an area of high concentration. Occurs with liquids, gases, and solids.
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| Osmosis | The movement of water between two compartments seperated by a membrane permeable to water but not to a solute.
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| Isotonic | Fluids with the same osmolality as the cell interior.
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| Hypotonic | Solutions in which the solutes are less concentrated than the cells.
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| Hypertonic | Solutions in which the solutes are more concentrated than the cells.
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| 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.
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| First Spacing | The normal distribution of fluid in the ICF and ECF compartments.
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| Second Spacing | An abnormal accumulation of interstitial fluid.
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| 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)
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| Diuretic | Increases excretion of water from the body.
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| 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.
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| ADH | The distal tubules and collecting ducts in the kidneys respond to ADH by becoming more permeable to water so water is reabsorbed.
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| Glucocorticoids (cortisol) | Primarily have an anti-inflammatory effect and increase serum glucose levels.
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| Mineralcorticoids (aldosterone) | Enhance sodium retention and potassium excretion
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| Insensible Water Loss | Invisible vaporization from the lungs and skin, assists in regulating body temperature. Normally, about 900 mL per day is lost.
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| H2O deficiency | HYPERNATREMIA (dehydration=less water=serum sodium level appears higher).
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| Na+ deficiency | HYPONATREMIA
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| H2O excess | HYPONATREMIA (more water=serum sodium level appears lower)
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| Na+ excess | HYPERNATREMIA
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| Vitamin B12 | 100-700 pg/mL, <100pg/mL = THROMBOCYTOPENIA, BLEEDING, AND VIT. K DEFICIENCY.
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| Folic Acid | 2-20 ng/mL, DECREASED C THROMBOCYTOPENIA, BLEEDING, AND VIT. K DEFICIENCY.
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| AST Aspartate Aminotransferase | 35-140, INCREASED C CIRRHOSIS
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| ALT Alanine Aminotransferase | 10-60, INCREASED C CIRRHOSIS
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| Ammonia | 9-33 umol/L, ELEVATED C HEPATIC ENCEPHALOPATHY
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| Triglycerides | 40-160 mg/dL, ELEVATED C HYPOALBUMINURIA AND NUTRITIONAL DEFICIENCIES.
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| ALP Alkaline Phosphatase | 42-128 units/L
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