Osmolality Lab Values
Normal 261 – 280 mOsm/kg Indications Monitor: Electrolyte balance Acid-Base balance Hydration Evaluate function of antidiuretic hormone. Description Osmolality is a measure of the particles in solution. The size, shape, and charge of the particles do not impact the osmolality What would cause increased levels? Dehydration Azotemia Hypercalcemia Hyperglycemic Hyperosmolar Nonketotic State (HHNS) Hypernatremia Diabetes Insipidus Hyperglycemia Mannitol therapy Uremia Severe pyelonephritis Shock Ketosis What would cause decreased levels? Hyponatremia Syndrome of Inappropriate Antidiuretic Hormone (SIADH) Overhydration
Magnesium (Mg) Lab Values
Normal 1.6 – 2.6 mg/dL Indications Monitor: Renal failure Chronic alcoholism Cardiac arrhythmias Description Magnesium (Mg) is a cation necessary for protein synthesis, nucleic acid synthesis, muscle contraction, ATP (adenosine triphosphate) use, nerve impulse conduction, and blood clotting. Magnesium affects the absorption of sodium, calcium, phosphorus, potassium. What would cause increased levels? Renal insufficiency Uncontrolled Diabetes Mellitus (DM) Addison Disease Dehydration Hypothyroidism Overuse of antacids Tissue trauma What would cause decreased levels? Alcoholism Diabetic acidosis Renal failure: Glomerulonephritis Hypercalcemia Malnutrition Malabsorption Hypoparathyroidism Diarrhea
Low Density Lipoprotein (LDL) Lab Values
NormalIndications Useful in determining risk of cardiovascular disease. Description Cholesterol is transported via lipoproteins. There are multiple types of lipoproteins and they each have slightly different functions: high-density lipoprotein (HDL), low-density lipoprotein, LDL, and very low-density lipoprotein (VLDL). LDL cholesterol is considered bad cholesterol because as it travels through the blood, it deposits cholesterol into the lining of blood vessels, causing atherosclerosis and an increase in cardiovascular disease. What would cause increased levels? Diet high in saturated fats Nephrotic Syndrome Alcoholism Chronic liver disease: Hepatitis Cirrhosis Hypothyroidism Cushing’s Syndrome What would cause decreased levels? Regular physical activity Hyperthyroidism Hypoproteinemia: Malabsorption Severe burns Malnutrition
Lactic Acid Lab Values
Normal 0.3 -2.6 mmol/L Indications Determine cause of acidosis Evaluate tissue oxygenation Description Lactate (Lactic Acid) is a byproduct of anaerobic metabolism. Normally, the tissues use aerobic metabolism to breakdown glucose for energy and the byproduct is CO2 and H2O which we excrete through our kidneys and exhalation. However, if the tissues are starved of oxygen (hypoxic), they use anaerobic metabolism. This can be compounded if the liver is also hypoxic causing the liver to be unable to clear the lactic acid. What would cause increased levels? Shock Sepsis Tissue ischemia Carbon monoxide poisoning Lactic acidosis Diabetes Mellitus (DM) Heart failure Pulmonary edema Strenuous exercise What would cause decreased levels? N/A
International Normalized Ratio (INR) Lab Values
Normal 0.8 - 1.2 Therapeutic Levels of Warfarin 2.0 – 3.5 Indications Evaluate therapeutic doses of Warfarin Identify patients at higher risk for bleeding Identify cause of: Bleeding Deficiencies Description International normalized ratio(INR) takes results from a prothrombin time test and standardizes it regardless of collection method. What would cause increased levels? Disseminated Intravascular Coagulation (DIC) Liver disease Vitamin K deficiency Warfarin What would cause decreased levels? Too much vitamin K Estrogen containing medications such as birth control