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Objective:

Determine the significance and clinical use of  Thyroid Stimulating Hormone in clinical practice

 

Lab Test Name:

Thyroid Stimulating Hormone

 

Description:

Thyroid Stimulating Hormone (TSH) is released from the anterior pituitary in response to low levels of thyroid hormone. 

TSH stimulates the thyroid gland to release thyroid hormones

• Triiodothyronine (T3) 
• Thyroxine (T4)
• T3 and T4 have an inverse relationship with TSH

 

Indications:

Aids to diagnose:

• Hyperthyroidism
• Hypothyroidism
• Anterior pituitary function

Monitor: 

• Thyroid replacement therapy

  Normal Therapeutic Values:

Normal – 

2-10 mU/L

Collection:

•  Plasma separator tube

 

What would cause increased levels?

TSH levels increase in the following conditions:

• Hypothyroidism
• Thyroidectomy
• Thyroid dysfunction
• Thyroiditis
• Thyroid Agenesis
• Large doses of iodine
• Pituitary TSH-secreting tumor

 

What would cause decreased levels?

Recall the inverse relationship between TSH and T3/T4 labs, and how the negative feedback loop works with these hormones.

TSH levels decrease in the following conditions:

• Anterior pituitary hypofunction- If the pituitary isn’t secreting TSH, the level will be low.
• Hyperthyroidism- If there is a large amount of thyroid hormone circulating, the feedback system relays the info upstream and less TSH is released. 

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What is the Lab Name for Sodium (Na+) Lab Values?

Sodium

 

What is the Lab Abbreviation for Sodium?

Na+

 

What is Sodium in terms of Nursing Labs?

Sodium (Na+) is the most abundant cation in extracellular fluid. Sodium aids in osmotic pressure, renal retention and excretion of water, acid-base balance, regulation of other cations and anions in the body, plays a role in blood pressure regulation, and stimulation of neuromuscular reactions. Sodium and water have a direct relationship; Water follows salt.

 

What is the Normal Range for Sodium?

135-145 mEq/L

 

What are the Indications for Sodium?

• Monitor:
  • Extracellular osmolality
  • Electrolyte balance

  What would cause Increased Levels of Sodium?

• Cushing Syndrome
• Hyperaldosteronism
• Dehydration
• Burn injury
• Azotemia (elevated nitrogen)
• Lactic acidosis (LA)
• Fever/excessive sweating
• Excessive IV fluids containing sodium
• Diabetes Insipidus
• Osmotic diuresis

  What would cause Decreased Levels of Sodium?

• Congestive Heart Failure (CHF)
• Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
• Cystic Fibrosis
• Diuretic use
• Metabolic acidosis
• Addison Disease
• Nephrotic Syndrome
• Vomiting
• Diarrhea
• Ascites
• Excessive Antidiuretic Hormone(ADH)
• Liver failure

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What is the Lab Name for Red Blood Cell (RBC) Lab Values?

Red Blood Cell

 

What is the Lab Abbreviation for Red Blood Cell?

RBC

 

What is Red Blood Cell in terms of Nursing Labs?

Red Blood Cells (RBCs) contain hemoglobin which is responsible for oxygen transport throughout the body. RBCs are primarily produced in the bone marrow, they have a life span of 120 days and are destroyed in the spleen and liver. RBC production is regulated by erythropoietin (EPO) which is produced and released from the kidneys.

 

What is the Normal Range for Red Blood Cell?

Male: 4.5 – 5.5 x106/cells/mm3 Female: 4.0 – 4.9 x106/cells/mm3

 

What are the Indications for Red Blood Cell?

• Identify:
  • Anemia
  • Blood loss

  What would cause Increased Levels of Red Blood Cell?

• Dehydration
• Polycythemia Vera
• Chronic Obstructive Pulmonary Disease (COPD)
• High altitude
• Congenital heart disease
• CorPulmonale
• Pulmonary fibrosis
• Thalassemia trait

  What would cause Decreased Levels of Red Blood Cell?

• Chemotherapy
• Anemia
• Hemorrhage
• Hemolysis
• Hemoglobinopathy
• Advanced cancer
• Leukemia
• Lymphoma
• Pernicious anemia
• Rheumatoid disease
• Organ failure
• Bone marrow failure
• Hypervolemia
• Pregnancy

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Objective:

Determine the significance and clinical use of Prostate Specific Antigen in clinical practice

 

Lab Test Name:

Prostate Specific Antigen – PSA

 

Description:

Measurement of PSA in the bloodstream

Used to diagnose and assess prostate health, size and function.

 

Indications:

Evaluate:

• Enlarged prostate when prostate cancer is suspected
• Stage cancer
• Effectiveness of treatments

 

Normal Therapeutic Values:

Normal – 

• Male: < 4 ng/mL 
• Female: < 0.5 ng/mL

Collection:

•  Serum Separator Tube

  What would cause increased levels?

Increased:

• Benign Prostatic Hypertrophy (BPH)
• Prostate cancer
• Prostatitis
• Urinary retention

  What would cause decreased levels?

Decreased:

• Long-term use of NSAIDs- explained in part by the anti-inflammatory effect of these medications
• Thiazides- reduces bioavailable testosterone, associated with resulting in functional hypogonadism
• Statins- cholesterol plays a role in synthesis of androgen, which affects the size of the prostate
• 5-alpha-reductase inhibitors- due to the effect on prostate size.

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What is the Lab Name for Potassium (K+) Lab Values?

Potassium

 

What is the Lab Abbreviation for Potassium?

K+

 

What is Potassium in terms of Nursing Labs?

Potassium (K+) is the most abundant intracellular cation and plays a vital role in the transmission of electrical impulses in cardiac and skeletal muscle. It plays a role in acid base equilibrium. In states of acidosis hydrogen with enter the cell as this happens it will force potassium out of the cell, a 0.1 decrease in pH will cause a 0.5 increase in K+.

 

What is the Normal Range for Potassium?

3.5 – 5.0 mEq/L

 

What are the Indications for Potassium?

• Evaluate:
  • Electrolyte imbalances
  • Cardiac arrhythmias
• Monitor patients who are:
  • Acidotic
  • Receiving diuretic therapyw

 

What would cause Increased Levels of Potassium?

• Renal failure
• Hypoaldosteronism
• Addison disease
• Injury to tissues
• Diabetes Mellitus (DM)
• Ketoacidosis
• Hyperventilation
• Acidosis
• Infection
• Dehydration
• Burns

 

What would cause Decreased Levels of Potassium?

• Hyperaldosteronism
• Excess insulin
• Alkalosis
• Diarrhea
• Vomiting
• Cystic Fibrosis
• Cushing Syndrome

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What is the Lab Name for Platelets (PLT) Lab Values?

Platelets

 

What is the Lab Abbreviation for Platelets?

(PLT)

 

What is Platelets in terms of Nursing Labs?

Platelets (PLT) play a role in coagulation, hemostasis, and thrombus formation. Platelets are the smallest blood cell, damaged vessels send out signals that result in platelets traveling to the area and becoming “active”.

 

What is the Normal Range for Platelets?

100,000 – 450,000 cells/mcL

 

What are the Indications for Platelets?

• Determine clotting vs bleeding disorders

 

What would cause Increased Levels of Platelets?

• Malignancy
• Polycythemia Vera
• Postsplenectomy syndrome
• Rheumatoid Arthritis (RA)
• Iron-deficiency anemia
• Hemolytic anemia
• Tuberculosis
• Birth control

  What would cause Decreased Levels of Platelets?

• Idiopathic Thrombocytopenia (ITP)
• Inherited thrombocytopenia disorders:
  • Wiskott-Aldrich Syndrome
  • Bernard-Soulier Syndrome
  • Zieve Syndrome
• Infection:
  • Hepatitis
  • Human Immunodeficiency Virus (HIV)
  • Measles
  • Sepsis
• Hypersplenism
• Hemorrhage
• Leukemia
• Lymphoma
• Drug Therapy:
  • Aspirin
  • Ibuprofen
  • Sulfa antibiotics
  • Hydralazine
  • Thiazide diuretics
• Systemic Lupus Erythematosus (SLE)
• Hemolytic anemia’s

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What is the Lab Name for Partial Thromboplastin Time (PTT) Lab Values?

Partial Thromboplastin Time

 

What is the Lab Abbreviation for Partial Thromboplastin Time?

PTT

 

What is Partial Thromboplastin Time in terms of Nursing Labs?

Partial Thromboplastin Time (PTT)evaluates the function of factors I, II, V, VIII, IX, X, XI, and XII. PTT represents the amount of time required for a fibrin clot to form. Monitors therapeutic ranges for people taking Heparin.

 

What is the Normal Range for Partial Thromboplastin Time?

25 – 35 seconds

 

What are the Indications for Partial Thromboplastin Time?

• Detection of coagulation disorders
• Evaluate response to Heparin (PT for Coumadin)
• Preoperative assessment

  What would cause Increased Levels of Partial Thromboplastin Time?

• Disseminated Intravascular Coagulation (DIC)
• Clotting Factor Deficiencies:
  • Hypofibrinogenemia
  • Von Willebrand Disease
  • Hemophillia
• Liver disease:
  • Cirrhosis
• Vitamin K deficiency
• Polycythemia
• Dialysis

  What would cause Decreased Levels of Partial Thromboplastin Time?

N/A

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What is the Lab Name for Oxygen Saturation (SaO2) Lab Values?

Oxygen Saturation

 

What is the Lab Abbreviation for Oxygen Saturation?

SaO2

 

What is Oxygen Saturation in terms of Nursing Labs?

Oxygen saturation (SaO2) is a measurement of the percentage of how much hemoglobin is saturated with oxygen. Oxygen is transported in the blood in two ways: oxygen dissolved in blood plasma (pO2) and oxygen bound to hemoglobin (SaO2). About 97% of oxygen is bound to hemoglobin while 3% is dissolved in plasma. SaO2 and pO2 have direct relationships, if one is decreased so is the other. The relationship between oxygen saturation (SaO2) and partial pressure O2 (PaO2) is referred to as the oxyhemoglobin (HbO2) dissociation curve. SaO2 of about 90% is associated with PaO2 of about 60 mmHg. For more information on PaO2, SaO2 and oxyhemoglobin dissociation curve visit this link HERE.

 

What is the Normal Range for Oxygen Saturation?

95 – 100%

 

What are the Indications for Oxygen Saturation?

• Determine respiratory status
• Part of Arterial Blood Gas (ABG) testing

 

What would cause Increased Levels of Oxygen Saturation?

• Polycythemia
• Increased inspired O2
• Hyperventilation

  What would cause Decreased Levels of Oxygen Saturation?

• Anemia’s
• Hypoventilation
• Bronchospasm
• Mucus plugs
• Atelectasis
• Pneumothorax
• Pulmonary edema
• Adult respiratory distress syndrome

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What is the Lab Name for Osmolality Lab Values?

Osmolality

 

What is Osmolality in terms of Nursing Labs?

Osmolality is a measure of the particles in solution. The size, shape, and charge of the particles do not impact the osmolality

 

What is the Normal Range for Osmolality?

261 – 280 mOsm/kg

 

What are the Indications for Osmolality?

• Monitor:
  • Electrolyte balance
  • Acid-Base balance
  • Hydration
• Evaluate function of antidiuretic hormone.

 

What would cause Increased Levels of Osmolality?

• Dehydration
• Azotemia
• Hypercalcemia
• Hyperosmolar Hyperglycemia Syndrome (HHS)
• Hypernatremia
• Diabetes Insipidus
• Hyperglycemia
• Mannitol therapy
• Uremia
• Severe pyelonephritis
• Shock
• Ketosis

 

 

What would cause Decreased Levels of Osmolality?

• Hyponatremia
• Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
• Overhydration

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  What is the Lab Name for Creatinine (Cr) Lab Values?

Magnesium

 

What is the Lab Abbreviation for Creatinine?

Mg

 

What is Creatinine in terms of Nursing Labs?

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 is the Normal Range for Magnesium?

1.6 - 2.6mg/dL

 

What are the Indications for Magnesium?

• Monitor:
  • Renal failure
  • Chronic alcoholism
  • Cardiac arrhythmias

  What would cause Increased Levels of Magnesium?

• Renal insufficiency
• Uncontrolled Diabetes Mellitus (DM)
• Addison Disease
• Dehydration
• Hypothyroidism
• Overuse of antacids
• Tissue trauma

 

What would cause Decreased Levels of Magnesium?

• Alcoholism
• Diabetic acidosis
• Renal failure:
  • Glomerulonephritis
• Hypercalcemia
• Malnutrition
• Malabsorption
• Hypoparathyroidism
• Diarrhea