Amalayse
• The blood test for amylase is used to diagnose pancreatitis (swelling of the pancreas) and other pancreatic diseases. The near-immediate rise of amylase at the beginning of a pancreatitis
attack, and its fall after about 2 days, helps to pinpoint this diagnosis.
Amylase is also used (to a lesser extent) in the diagnosis and follow-up of cancer of the
pancreas, ovaries, or lungs; gallbladder attack;
and mumps.
CBC
• The CBC is used as a broad screening
test to check for such disorders as anemia , infection, and many other diseases. It is actually a panel of tests that examines
different parts of the blood
• White blood cell (WBC) count is a count of the actual number of white blood cells per volume of blood. Both increases and decreases can be significant.
• White blood cell differential looks at the types of white blood cells present. There are five different types of
white blood cells, each with its own function in protecting us from infection. The differential classifies a person's white blood cells into each type: neutrophils (also known as segs, PMNs, grans), lymphocytes, monocytes,
eosinophils, and basophils
• Normal: 4.5 –11.0 x109
• Red blood cell (RBC) count is a count of the actual number of red blood cells per volume of blood. Both increases and
decreases can point to abnormal conditions
• Decreased with anemia
• Increased with dehydration or over-production
• Hemoglobin measures the amount of oxygen-carrying protein in the blood
• Normal value:
– Men: 14 – 18
– Women: 12 – 16
• Hematocrit measures the amount of space red blood cells take up in the blood. It is
reported as a percentage.
• Normal:
– Men: 40 --54%
– Women: 37 –47%
Platelets
• The platelet count is the number of platelets in a given volume of blood. Both increases and
decreases can point to abnormal conditions of excess bleeding or clotting. Mean platelet
volume (MPV) is a machine-calculated measurement of the average size of the platelets. New platelets are larger, and an
increased MPV occurs when increased numbers of platelets are being produced. MPV gives the doctor information about platelet production in the bone marrow.
• Normal: 130,000—400,000
• Erythrocyte Sedimentation rate tests how
:
quickly RBC’s settle in a test tube in one hour.
• Increased ESR indicative of inflammation
• Males younger than 50:0–15 millimeters per hour (mm/hr)
• Males 50 and older:0–20 mm/hr
• Females younger than 50:0–25 mm/hr
• Females 50 and older:0–30 mm/hr
Lytes
• Electrolytes are salts that conduct electricity and are found in the body fluid, tissue, and blood.
Examples are chloride, calcium, magnesium, sodium, and potassium. Sodium (Na+) is
concentrated in the extracellular fluid (ECF) and potassium (K+) is concentrated in the
intracellular fluid (ICF). Proper balance is
essential for muscle coordination, heart function, fluid absorption and excretion, nerve function,
and concentration.
Magnesium
• Magnesium is needed for more than 300 biochemical reactions in the body. It helps maintain normal muscle and nerve function, keeps heart rhythm steady, supports a healthy immune system, and keeps bones strong.
Magnesium also helps regulate blood sugar levels, promotes normal blood pressure, and is known to be involved in energy metabolism and protein synthesis . There is an increased interest in the role of magnesium in preventing and managing disorders such as
hypertension, cardiovascular disease, and diabetes.
Dietary magnesium is absorbed in the small intestines.
Magnesium is excreted through the kidneys.
Magnesium
• Normal: 1.8-2.4 mEq/L
• 40-60% stored in muscle and bone, 1/3 bound to plasma proteins
• Hypermangesemia: renal failure, excess intake (usually through antacids), adrenal insufficiency.
• Excess causes: skeletal smoot muscle
contraction, excess nerve function, loss of DTR, N/V, bradycardia, resp. distress
Magnesium
• Hypomagnesemia <1.5 mEq/L
• Malnutrition, malabsorption, renal tubular dysfunction, loop diuretics
• Causes: Behavioral changes, increased reflexes, muscle cramps, ataxia,
nystagmus, convulsions, tachycardia, hypotension
Potassium
• Normal 3.5 -5.5
• Kidneys are the most efficient regulator of potassium balance
• 98% of total body K+ is located in the cells
• Regulates muscle activity via maintenance of electrical conduction
• Regulates acid/base balance
• Required for deposition of glycogen and glucose in liver and skeletal muscle cells
Hypokalemia
Etiology: Diuretics, diarrhea, vomiting,
malnutrition, renal losses associated with
glycosuria, ketonuria, hyperaldosteronism. K+
shifts into cells with alkalosis insulin administration
S/S: confusion; rapid, weak, irregular pulse;
hypotension, anorexia, decreased reflexes,
muscle weakness, paresthesia, EKG changes
Hyperkalemia
• Causes: renal failure, cell damage from burns, injuries, chemotherapy, acidosis, DM
• S/S: Weakness, malaise, nausea, diarrhea, muscle irritability,
oliguria,bradycardia, EKG changes
Sodium
• Normal: 136-145
Sodium is the main cation (positive ion) that circulates in the body fluids outside the cells.
It is a critical component in blood pressure maintenance.
Sodium is also essential for the proper workings of nerves and muscles.
Hyponatremia
• Burns
• Vomiting and diarrhea
• Use of diuretics ("water pills"), especially of the type known as thiazide diuretics
• Certain kidney diseases
• Liver cirrhosis
• Congestive heart failure
• Syndrome of inappropriate antidiuretic hormone secretion (SIADH ,
• S/S: fatigue, headache, restlessness, nausea, muscle cramps, disorientation, coma, seizures, death
Hypernatremia
Findings Details
Cognitive dysfunction Lethargy, obtundation, confusion Abnormal speech
Irritability
Dehydration or volume-associated findings
Orthostatic blood pressure changes Tachycardia
• Risk factors for hypernatremia
– Age older than 65 years
– Mental or physical disability
– Hospitalization (intubation, impaired cognitive function)
– Residence in nursing home – Inadequate nursing care
– Urine concentrating defect (diabetes insipidus) – Solute diuresis (diabetes mellitus)
– Diuretic therapy
Calcium
• Normal 9-10.5
• Function: Promotes and regulates neuromuscular and enzyme activity, coagulation
Hypocalcemia
• Causes: parathyroid insufficiency,
hypomagnesemia, hyperphosphatemia, laxatives, malabsorption, malnutrition, diarrhea, vitamin D deficiency
• S/S: circumoral and peripheral
paresthesias, muscle twitching, facial spasm, muscle cramping, seizures, dysrhythmias
Hypercalcemia
• Hypercalcemia is a higher than normal level of calcium in the blood.
The most common cause is an overactive parathyroid gland
(hyperparathyroidism). The parathyroid glands, which are located below the thyroid gland, regulate calcium in your body.
• Other causes of hypercalcemia include:
• Certain medications, such as lithium or thiazide diuretics
• Certain cancers, including breast, lung and certain blood cancers
• Sarcoidosis, an inflammatory disorder
• Excessive intake of calcium or vitamin D supplements
• Familial hypocalciuric hypercalcemia, a genetic disorder
• Dialysis for chronic kidney failure
• Adrenal gland failure
• Overactive thyroid (hyperthyroidism)
Hypercalcemia
• Nausea/vomiting
• Excessive thirst
• Constipation
• Abdominal pain
• Muscle weakness
• Lethargy and fatigue
• Confusion
• May cause kidney stones and dysrhythmias
• Stain urine for stones
• Send stones to lab for analysis
Chloride
• Normal 98-106
• Functions: Varies inversely with
bicarbonate, maintain acid/base balance, associated with low Na+ and low K+ levels
Hyperchloremia
• Occurs when there is too much NA+ or too little bicarbonate
• No specific symptoms are associated with too much chloride
Hypochloremia
• Causes: Hyponatremia or elevated bicarbonate levels as in metabolic
alkalosis. May develop with vomiting and the loss of hydrochloric acid. Cystic
fibrosis is characterized by hypochloremia.
BUN
• Normal: 10-20mg/dL
• Reflects protein intake, liver function, kidney
excretory capacity. Elevation without concurrent creatinine elevation is indicative of dehydration
• Increases: renal disease, inadequate renal blood flow, urinary tract obstruction, protein catabolism as seen in burns and starvation.
• Decreases: severe liver failure, malnutrition, overhydration,
Creatinine
• Normal: <1.5 mg/dL
• Excreted by kidneys
• Increase: Renal disease, DKA, starvation, muscle disease, hyperthyroidism,
diuretics, barbiturates
BNP
• Brain Natriuretic peptide
• Regulates sodium excretion (natriuresis), diuresis, vasodilation leading to large
volume of dilute urine
BNP levels below 100 pg/mL indicate no heart failure BNP levels of 100-300 suggest heart failure is present BNP levels above 300 pg/mL indicate mild heart failure BNP levels above 600 pg/mL indicate moderate heart failure.
BNP levels above 900 pg/mL indicate severe heart failure.
CPK
• Creatinine phosphokinase
• An enzyme found in muscle tissue
• Elevated levels indicate muscle injury
• CK-MB elevations indicate cardiac muscle injury
• CK-MM—skeletal muscle
• CK-BB brain tissue
Troponin
• Troponin I: protein released by heart muscle is a specific marker for cardiac injury