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NEUROLOGICAL SYSTEM

INTERCRANIAL PRESSURE (ICP): 10-15 mmHg

GLASCOW COMA SCALE (GCS):


o Best possible: 15
o Less than 8 severe head injury, Coma
o 9-12 moderate head injury
o greater than 13 minor head trauma

CEREBRAL PERFUSION PRESSURE (CPP): Maintain above 70-80 mmHg


o :
o

INTRAOCULAR PRESSURE (IOP): 10-21 mmHg


o : Glaucoma
o

CARDIOVASCULAR SYSTEM
Normal values of Hemodynamic Readings:

Central venous pressure (CVP): 1-8 mmHg


o
o

Pulmonary artery systolic (PAS): 15-26 mmHg


o
o

Pulmonary Artery Diastolic (PAD): 5-15 mmHg

o
o

Pulmonary Artery Wedge Pressure (PAWP): 4-12 mmHg


o
o

Cardiac Output (CO): 4-6 l/min


o
o

Mixed Venous Oxygen Saturation (SvO2): 60-80%


o
o

Sufficient ventricular functioN


o Ejection fraction greater than 40-50%
o Heart Failure ejection fraction below 40%

CARDIAC ENZYMES
Creatine Kinase MB Isoenzyme (CK-MB)
o 0% of total CK (30-170 units/L)
o More sensitive to myocardium
o Elevated levels three days
o First detectable follow myocardial injury 4-6 hrs
o
o

TROPONIN T: <0.2 ng/L


o Elevated levels 14-21 days
o First detectable 3-5 hours following MYOCARDIAL INJURY
o
o

TROPONIN I: <0.03 ng/L


o ELEVATED LEVELS 7-10 days
o First detectable 3 hours following MI
o
o

MYOGLOBIN: <90 MCG/L

o
o
o
o

ELEVATED 24 hours
First detectable 2 hours following mi

CHOLESTEROL
o <200 mg/dl
o screening test for heart disease
o
o

HDL Good cholesterol


o Females: 35-80 mg/dl
o Males: 35-65 mg/dl
o Produced by liver

LDL Bad cholesterol


o <130 mg/dl
o Can be up to 70% total cholesterol

Triglycerides
o <150 mg/dl
o Evaluating test for arthrosclerosis

GASTROINTESTINAL SYSTEM

Asparte aminotransferase (AST): 5-40 units/:


o : hepatitis, cirrhosis
o

ALANINE AMINOTRANSFERASE (ALT):


o 8-20 units/l
o 3-35 iu/l
o : hepatitis, cirrhosis
o

alkaline phosphatase (ALP)


o 42-128 units/l

o 30-85 iu/l
o : Liver damage
o

Amylase: 56-90 IU/L


o : Pancreatitis
o

lipase: 0-110 units/l


o : Pancreatitis
o

Total bilirubin: 0-10 mg/dl


o : Altered liver function, bile duct obstruction, or other hepatobiliary
disorder
o

Direct (conjugated) bilirubin: 0.3 mg/dl


o : Altered liver function, bile duct obstruction, or other hepatobiliary
disorder
o

indirect (conjugated) bilirubin: 0.1-1.0 mg/dl


o : Altered liver function, bile duct obstruction, or other hepatobiliary
disorder
o

Albumin: 3.5-5.0 g/dl


o
o : Hepatic disease

Alphafetoprotein <40 mcg/L


o : Liver cancer
o

Ammonia: 15-110 mg/dl


o : Liver Disease
o

SERUM BUN: 10-20 mg/dl


o
o

creatinine

o
o
o
o

M: 0.6-1.2 mg/dl
F: 0.5-1.1 mg/L

Creatinine clearance
o M: 90-139 ml/min/m2
o F: 80-125 ml/min/m2
o
o
24 hour urine creatinine clearance: 80-140 ml/min

RESPIRATORY SYSTEM

INTEGUMENTARY SYSTEM

MUSCULOSKELETAL SYSTEM

HEMATOLOGICAL SYSTEM

BLOOD TYPE
A
B
AB
O

BLOOD
ANTIGEN
A
B
AB
NONE

COMPATIBILITY
ANTIBODIES
AGAINST
B
A
NONE
A, B

ARTERIAL BLOOD GASES (ABGS):


PH: 7.35-7.45
o Amount of free hydrogen ions in arterial blood
Pac02: 80-100 mmhg
o Partial pressure of O2
PaCo2: 35-45 mmHg
o Partial Pressure of CO2
HCO3-: 22-26 mEq/L
o Concentration of Bicarbonate in arterial blood
SaO2: 95-100%
o <90% Hypoxemia

ELECTROLYTES
Sodium: 136-145 meq/L
o

COMPATIBLE
WITH
A, O
B, O
A, B, AB, O
O

Potassium: 3.5-5.0 meq/L


o
o

Chloride: 98-106 meq/L


o
o

Calcium: 9.0-10.5 Mg/DL


o
o

Magnesium: 1.3-2.1 meq/L


o
o

Phosphorus: 3.5-4.5 mg/dl


o
o

Blood diagnostic Procedures

Serum RBC
o M: 4.7-6.1 mil/ul
o F: 4.2-5.4 mil/ul
o :
o : Anemia

SERUM WBC: 5, 000-10,000/uL


o : Infection
o : Immunosuppresion

MCV: 80-95 mm3


o : Microlytic (large) cells, Possible Anemia
o : Microlytic (small) cells, Possible Iron Deficiency Anemia

MCH: 27-31 pg/cell


o Same as above; except MCH measures amount of hgb by weight per rbc

TIBC: 250-460 mcg/dl


o : Iron deficiency
o : Anemia, Hemolysis, Hemorrhage

Iron
o
o
o
o

M: 80-180 mcg/dl
F: 60-160 mcg/dl
: Hemochromatosis, iron excess, liver disorder, megoblastic anemia
: Iron deficiency anemia, hemorrhage

Platelets
o 150,000-400,000 mm3
o : malignancy or polycthemia vera
o : Autoimmune disease, bone marrow suppression, enlarged spleen

Hemoglobin (hgb)
o M: 14-18 g/dl
o F: 12-16 g/Dl
o :
o :

Hematocrit (Hct)
o M: 42-52%
o F: 37-47%
o
o

PT: 11-12.5s
o 85-100%; 1:1 CLIENT CONTROL RATIO
o : EVIDENCE OF DEFICIENCY OR CLOTTING
o : Evidence of Vit K Excess

aPTT: 1.5-2 times normal range of 30-40s


o (desired range for anticoagulants)
o measures intrinsic clotting factors

o monitored for heparin therapy


o Hemophilia, DIC, Liver Disease
o

INR: 2-3 on Warfarin therapy


o Measures mean of PT
o Monitored for warfarin (Coumadin) therapy
o
o

D-Dimer:
o
o
o
o
o

0.43-2.33 mcg/ml
0-250 ng/dl
measures hypercoagulability of blood
: Clot formation

FIBRINOGEN LEVELS: 170-340 mg/dl


o Reflects available fibrogen for clotting
o
o : decreased ability to clot

Fibrin degradation products: <10mcg/ml


o Monitors efficacy of meds for dic
o : Clot dissolving activity (fibrinolysis) occuring
o

Absolute neutrophil count (ANC):


o <2,000/mm3: Increased risk of infection
o <500/mm3: severe infection

White Blood Cells

Neutrophils: 55-75%
o : acute bacterial infections, fungal infections
o : sepsis, radiation therapy, aplitic anemia, chemotherapy, influenza

lymphocytes (t cells & B cells): 20-40%


o T lymphocytes: cell mediated immunity
o B lymphocytes: humoral immunity

o : Chronic bacterial or viral infection, viruses (mononucleosis, mumps,


measles), bacteria (hepatitis), lymphocytic leukemia, multiple myelomA
o : leukemia, sepsis

monocytes 2-8%
o : chronic inflammation, protozoal infections, tb, viral infections
(mononucleosis, mumps, measles)
o : corticosteroids

Eosinophils: 1-4%
o : allergic reaction, parasitic infections, chronic inflammation, hodgkins
o : Stress, corticosteroids
Basophils: 0.5-1.1%
o : leukemia
o : acute allergic/hypersensitivity, hyperthyroidism
HIV
o Stage 1
Cd4 & T lymphocyte count 500 cells/meq/l or more
Cd4 & t lymphocyte % of total lymphocytes 29 or more
o Stage 2
1 or more infections of stage 3
Cd4 & T lymphocyte count 200-499 cells/meq/l
Cd4 & t lymphocyte % of total lymphocytes 14-28

o Stage 3 (AIDS)
Candidiasis of esophagus, bronchi, trachea, or lungs
Cd4 & T lymphocyte count less than 200 cells/meq/l
Cd4 & t lymphocyte % of total lymphocytes less than 14

URINARY SYSTEM

Serum ADH: 0-4.7 pg/ML


o : SIADH
o
o patient education:
fast & avoid stress 12 hrs prior to test
some meds may interfere with test
blood is drawn and transported to lab within 10 mins

Urine electrolytes & Osmolarity


o Urine sodium: 75-200 meq/day

o Urine potassium: 26-123 meq/day (intake dependent)


o Urine chloride: 110-250 meq/24 hour
o Urine osmolarity: 250-900 mosm/kg

Urine specific gravity: 1.003-1.030


o A increase in urine output and an increase in urine specific gravity occur as
a result of excess adh production
o Usually performed in lab, but can be done on a clinical unit using calibrated
hydrometer or temperature compensated refractometer
o
o

Plasma cortisol
o Test varies according to time of day. Since has diurnal pattern, increased
levels are present early in the morning, and lowest levels occur around
midnight, or 3-5 hrs after onset of sleep
o
o

Salivary cortisol
o <2.0 ng/ml
o Typical value at midnight
o
o

Urinary cortisol
o : hypercortisolism
o

Serum acth
o Typically early morning values are from 25-200 pg/ml
o Early evening values 0-50 pg/ml
o : addisons
o : Cushings
o
ACth stimulation test
o If no increase in cortisol occurs after acth administration, test is + for
addisons or hypocortisolism
o
o

REPRODUCTIVE SYSTEM

PSA: 2-4 ng/ml


o : Prostatic cancer
o
ENDOCRINE SYSTEM

Fasting blood glucose: <110 mg/dl


o Test done to determine patients bgm when no fluids or foods (other than
water) have been consumed for past 8 hours
o Ensure patient has fasted 8 hours prior to blood draw
o Antidiabetic meds postponed until Q level drawn

Oral glucose tolerance test: <140 mg/dl


o Test done to determine patients ability to metabolize a standard amount of
glucose
o Patient must consume balanced diet for 3 days prior to test and fast for the
10-12 hours prior to test
o Fasting bgm is drawn at the start
o Bgm levels drawn at 30 mins for 2 hours
o Assess for hypoglycemia

Glycosylated hemoglobin (Hba1c) j


o 5% or less absence of DM
o 5.7-6.4% prediabetes mellitus
o 6.5 or greater DM
o **Best indicator of average bgm levels for past 120 days
o
o

T3: 70-205 ng/dl


o Low and high levels each indicate hypothyroidism and hyperthyroidism
o More indicative than T4 of hyperthyroidism
o
o

T4: 4.0-12.0 mcg/dl


o Low and high levels each indicate hypothyroidism and hyperthyroidism
o
o

TSH: 0.4-6.15 microunits/ml


o Stimulates release of thyroid hormone by the anterior pituitary gland
o
o

TRH
o Relative to baseline
o
o

RAIU
o
o
o
o
o

35% of injected amount of radioactive iodine (123I)


measures amount of 123 I absorbed by thyroid gland
patients with hyperthyroidism absorb high amounts (>35%) of 123 I