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Glucose Levels
- Fasting 70 - 100
- Casual <200
- Critical <50 to 400
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Sx of low blood sugar
- Confusion
- Palpitations
- Shakiness
- Diaphoresis
- Hunger
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Sx of high blood sugar
- Frequent urination
- Increased thirst
- Blurred vision
- Fatigue
- Headache
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How to treat hypoglycemia
- It's best to avoid refined sugar. Instead:
- Nuts
- Peanut butter
- Whole wheat bread
- Cheese
- Fruit
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Hgb A1c
- Hemoglobin A1c
- Also called Glycosylated hemoglobin
- Measures how much glucose is stuck to RBC's
- It can also tell how well a pt's diabetes has been controlled in the last 2-3 months
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Hgb A1c normal range
4 - 5.9%
Ideal for diabetics is less than 7%
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Normal range for hemoglobin
Men: 14 - 18 g/dL
Women: 12 - 16 g/dL
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Why would hemoglobin be tested?
- Test or monitor anemia
- Also test or monitor for polycythemia vera, which is a slow growing blood cancer in which the bone marrow makes too many RBC, causing blood to be too thick
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What can make hemoglobin high?
- Can happen if living at higher altitude
- Smoking
- Polycythemia vera
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Recall hematocrit
Blood test that determines the percentage of RBC in the blood
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Normal ranges for hematocrit
Men 38 - 50%
Women 35 - 45%
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Why would hematocrit be ordered
Measures the proportion of RBC in the blood in order to diagnose certain diseases
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Hematocrit to hemoglobin ratio
three to one
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Normal range for platelets
150 K - 450 K
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Why would platelets be ordered
Monitor for formation of clots and risk for bleeding
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What if platelets are low
- Will have frequent bruising and/or bleeding
- Could be Thrombocytopenia, which is a condition where you don't have enough platelets.
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What if platelets are high
- Thrombocytosis (condition where your body produces too many platelets)
- Blood clot formation in legs and arms, can lead to MI or stroke
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Creatinine
- Is a chemical waste generated from muscle metabolism
- Is transported through bloodstream to kidneys, which filter out most of it and dispose of it
- Ordered to assess kidney function, done by blood test
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Creatinine values
0.5 - 1.5 mg/dL
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Sx of high creatinine
- feeling dehydrated
- fatigue
- edema
- SOB
- confusion
- N/V
*couldn't really find low s/s
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Recall BUN
- Blood urea nitrogen
- measures the amount of urea nitrogen in your blood
- reveals important info about how well your kidneys and liver are working
Don't by blood draw
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BUN value range
10 - 20 mg/dL
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Sx of low BUN
- Jaundice ~ liver failure
- N/V ~ liver aint working to break down protein
- Muscle aches ~
- Pain ~
- Diarrhea ~ "low on urea"
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Sx of high BUN
- High BP
- Fatigue but insomnia
- fog brain
- bone pain
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Total cholesterol
- <200 is desirable
- 200 - 239 mg/dL is borderline high
- 240 and above is high risk
Taken to identify pt's at risk for ateriosclerotic heart disease
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How do we test for pH
ABG blood test
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sx of low pH
- Acidosis, occurs when kidney's and lungs cant keep pH in balance
- *If you have a low pH, this means you have a high concentration of hydrogen (H+) ions
- Sx include:
- fatigue
- confusion
- SOB
- HA
- rapid, shallow breathing!
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sx of high pH
- Alkalosis*If your pH is high, you have a low concentration of hydrogen (H+) ions
- tremor
- muscle twitching, spasm
- numbness
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What is difference between PaO2 and SaO2
PaO2 is partial pressure of O2 in arterial blood in mmHg measurement.
SaO2 is arterial O2 that is saturated on RBC
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PaCO2
35 - 45 mm Hg
<35 is Alkaline
>45 is Acidic
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Recall what PaCO2 is
- Partial pressure of carbon dioxide in blood.
- Carbon dioxide is the respiratory parameter.
*Because CO2 will combine with water in blood and form carbonic acid, it is considered an acid.
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What happens when PaCo2 is high
- When PaCO2 levels are abnormally high (like COPD), pH drops which means it goes acidic
- Respiratory acidosis results
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What happens if PaCO2 is low?
- This can be triggered by hyperventilation for instance...
- Causes pH to rise cause your blowing off too much CO2, becoming alkaline
- Leads to respiratory alkalosis
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Normal range for HCO3
22 - 26 mEq/L
<22 is Acidic
>26 is Alkaline
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Recall what HCO3 is
- Bicarbonate, which is the alkaline substance in extracellular fluid
- It's the metabolic parameter
In the blood, HCO3 - slowly binds with free H + to reduce it's concentrations
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What if HCO3 levels increase?
- The pH will rise since HCO3 is an alkaline substance
- Metabolic alkalosis develops
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What is HCO3 levels decrease?
- The pH will drop (since HCO3 is alkaline) and will become acidic
- Metabolic acidosis develops
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What happens when the body compensates for an imbalance
- The body strives to maintain a normal pH
- Metabolic and respiratory processes must work together to keep hydrogen ion levels normal and stable
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To diagnose an acid-base imbalance, what three questions do you ask yourself?
- 1. Does the pH indicate acidosis or alkalosis?
- 2. Is the cause of the pH imbalance respiratory or metabolic?
- 3. Is there compensation for the imbalance?
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Causes of respiratory acidosis
- hypoventilation, may be related to:
- drug overdose
- airway obstruction
- COPD
- chest trauma
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Causes of respiratory alkalosis
- Hyperventilation, may be related to:
- anxiety
- high altitude
- Pregnancy
- Initial stage of PE
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Causes of metabolic acidosis
- DKA
- diarrhea
- renal failure
- shock
- sepsis
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Causes of metabolic alkalosis
- Prolonged vomiting
- Overuse of antacids
- Potassium-wasting diuretics
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