1. Labs - BMP Panel & Electrolytes .pdf

Labs BMP Panel & Electrolytes BMP Basic Metabolic Panel Sodium (Na+) Swells the body Potassium (K+) Potassium pumps the heart muscles Na...

Labs BMP Panel & Electrolytes BMP Basic Metabolic Panel Sodium (Na+) Swells the body Potassium (K+) Potassium pumps the heart muscles Na Cl BUN Chloride (Cl-) Helps to maintain acid base balance CO2 Helps to maintain acid base pH balance (too much can (Carbon Dioxide) HCO3 put the body in Acidosis) Memory trick: Carbon DiACID Pushes the body into an alkalotic state Glucose (Bicarbonate) Memory trick: Bicarb Base 2 labs for 2 kidneys. High BUN over 20, usually means K CO2/ HCO3 Cr BUN & Creatinine dehydration. Creatinine over 1.3 = Bad Kidney (kidney injury) 70 - 110 Normal Glucose Hyperglycemia (over 120) usually clients with uncontrolled diabetes, Hypoglycemia (60 or less) brain will DIE! Very deadly Electrolytes Labs Treatment K+ 3.5 - 5.0 mEq/L Hyperkalemia Hypokalemia P P P PHARMACOLOGY FOR HIGH K+ Potassium IV (Normal 3.5-5.0) NCLEX TIP 1. IV Calcium Gluconate = Dysrhythmias 1. First Action = Heart monitor Potassium Priority Pumps the heart 2. IV 50% Dextrose + Regular INsulin 2. Never push = DEATH LAB: High or Low 3. Kayexalate (polystyrene sulfonate) 3. Only 10-20 mEq MAX per HOUR Potassium (K+) 4. Dialysis IV!!! (IV Pump) 3.5-5.0 (normal) Potassium 4. Slow infusion (if arm burns) RITY K+ PRIO Common NCLEX Question HIGH Potassium (5.0+) LOW Potassium (Below 3.5) HIGH Pump LOW Pump Patient with chronic kidney disease missed 3 dialysis End stage renal disease… potassium 7.2, BUN 35, sessions… potassium level of 8.1 … creatinine of 3.8, and urine output of 300 ml in 24 Peaked T waves, ST elevation Flat T wave, ST depress, U wave wide QRS complexes, heart rate of 58 & lethargy. hours. Which order is the PRIORITY? Which order should the nurse implement first? 1. IV Regular insulin R & 50% Dextrose 1. IV 50% Dextrose & regular insulin 2. IV loop diuretic 2. Sodium polystyrene sulfonate O2 3. Dialysis 3. Hemodialysis 4. Put in for vacation time? 4. IV calcium gluconate Normal ST elevation ST Depression Na 135 - 145 mEq/L Ca 9.0 - 10.5 mEq/L Mg+ 1.3 - 2.1 mEq/L S S C C M M Sodium Swells the body with FLUID Calcium Contracts the muscles Magnesium Mellows the muscles Sodium Calcium Magnesium Na+ Ca Mg+ Ca 9.0 - 10.5 mEq/L Mg+ 1.3 - 2.1 mEq/L Low calcium Diarrhea Low magnesium Na 135 - 145 mEq/L 2 dance moves: T&C Torsades De Pointes & V Fib! NCLEX TIP T - Trousseau's Hyperreflexia Low Sodium - Low & Slow Twerking arm when BP cuff on C - Chvostek’s Increased DTR Cheek smile when stroking face “Mental Status change” = PRIORITY Seizures & Coma HIGH magnesium HIGH Calcium Decreased DTR Respiratory Arrest Stones, moans & groans Kidney Stones Hyporeflexia Constipation HIGH sodium = Big & Bloated Torsades de pointes Edema (swollen body) T C Increased muscle tone Trousseau's Chvostek’s Twerking arm when BP cuff on Cheek smile when stroking face Flushed “red & rosy” skin Ventricular Fibrillation