ANCC PMHNP LAB VALUES questions with complete solutions

T4, FREE THYROXINE correct answer: 0.8-2.8 Increased In Graves Decreased In Hypothyroidism TSH correct answer: 2- 10 mu/l Normal values can range from 0.4 - 4.0 mIU/L (milli-international units per liter), Calcium, Ca++ correct answer: 8.8-10.5 <7.0, tetany >11.0, hyperparathyroidism >13.5, hypercalcemic coma, metastatic cancer Sodium, Na+ correct answer: 135-148 mEq/L hypernatremia correct answer: dehydration hypovolemia diabetes insipidus eating too much salt gastroenteritis drugs such as adrenocorticosteroids, methyldopa, hydrazine, cough meds hyponatremia correct answer: drugs such as lithium, vasopressin, diuretics addisons renal disorder gi fluid loss Magnesium, Mg correct answer: 1.3 - 2.1 mEq/L lithium can increase hypomagnesemia correct answer: depression, confusion, irritability,nystagmus, tetany, convulsions, ataxia, increased reflexes, muscle weakness hypermagnesemia correct answer: N/V, respiratory depression, hypotension, depressed skeletal muscle contraction and nerve function, bradycardia Potassium, K+ correct answer: 3.5-5.1 mEq/L hyperkalemia correct answer: chronic marijuana use can elevate potassium Chloride, Cl correct answer: 98 - 106 passive transport through sodium major anion in the extracellular fluid Liver - ALT correct answer: 5 - 35 U/L - depakote can increase, safe to use up to 2 times normal limit Liver - AST correct answer: 5 - 40 U/L slight elevation can occur in DT's depakote can increase, safe to use up to 2 times normal limit Liver - GGT correct answer: 10 - 38 IU/L Thrombocytopenia correct answer: Platelet count normal = 150,000-450,000 if below - bone marrow doesn't make enough platelets. or bone marrow makes enough platelets, but the body destroys them or uses them up. or - The spleen holds on to too many platelets. The spleen is an organ that normally stores about one-third of the body's platelets. It also helps your body fight infection and remove unwanted cell material. can be caused by Valproate Neutropenia correct answer: A normal ANC is above 1,500 cells per microliter. An ANC less than 500 cells/µL is defined as neutropenia and significantly increases the risk of infection. Neutropenia is the condition of a low ANC, Clozapine - WBC => 3500 to initiate therapy, ANC MUST BE =>2000/mm, ck wbc/anc weekly x 6 months, then Q other week for 6 months; if stable then Q 4 weeks. after therapy test for at least 4 weeks, LIVER PANEL correct answer: ALP, AST, ASP, BILIRUBIN, ALBUMIN, TTL PROTEIN, CBC with WBC DIFFERENTIAL, PLATELET COUNT. FOR VALPROATE THERAPY - CK BASELINE AND MONTHLY FOR SEVERAL MONTHS CREATININE correct answer: 0.5-1.2 normal, kidney damage if elevated , athletes may be higher BUN correct answer: 10-20 mg/dL LITHIUM THERAPY correct answer: CREATININE/BUN, SERUM ELECTROLYTES, CBC W/WBC & DIFF, URINALYSIS, EKG, ck levels (post dose 12 hrs trough), after 4 days on med, then q 4-5 days during initial therapy