ELECTROLYTES:
Na 135-145meq/L
Mg 1.5-2.5meq/L Urine: 6-8.5meq/day (Critical <8.5 or >3)
K. 3.5-5.5meq/L (NB: 3.5-6 Infant: 4-5.5) Urine: 25-125meq/day
Cl 97-107meq/L
P 2.5-4.5mg/dL
Ca 4.5-5meq/L or 9-11mg/dL Urine: Total: 22-29 meq/L (<250mg/day)
KCl: never given by IV push,IM,SQ
Dilution: <1meq/10ml
Max. infusion rate: 5-10meq/hr
NEVER exceed 20meq/hr
Electrolytes Regulator: kidney, endocrine, GI
ABG:
Ph 7.35-7.45
PCO2 35-45 mmHg
HCO3 22-26meq/L
PaO2 80-100%
SaO2 >95% (Arterial)
CVP 2-6mmHg/3-12 (>12 hypervolemia <3 hypovolemia)
CBC:
RBC 4-5.5mil/mm3
Hgb 12-18G/dL (g/100ml) ) F: 12-16 M:14-18
Glycosylated Hgb (HbA1C) 4-6% (Poor: >9)
Hct 35-50% (>50 Fluid overload <35 Dehydration)
Erythrocyte Sedimentation Rate (ESR) <20 mm/hr
Reticulocyte Count .5-2.5% 25-75k
WBC 4-11k/mm3 5-10
Mean Corpuscular Volume (MCV) 80-100 76-100 cu um
Mean Corpuscular Hgb (MCH) 26-34 27-32pg/cell
Concentration (MCHC) 31-37% 32-36hgb/
CHEMISTRY:
Glucose 70-110mg/dl Inc: DM Dec: BM
2hrs Postprandial: Up to 140mg/dl
BUN 7-22mg/dl 5-25 Kaplan
Serum Creatinine .5-1.5mg/dl (Saunders) Older Adult: <2
Urine Creatinine 500-2000mg/day
Creatinine Clearance. 75-125ml/min
Spec. Gravity 1.010-1.030
Uric Acid 3.5-7.5mg/dl or 2.5-8.5
Urea (Serum) 20-40mg/dl
Bilirubin <1mg/dl Conjugated(Direct): <.4
Pyruvate (Pyruvic Acid) .3-.9mg/dl
Transferrin Serum 188-341 mg/dl
Transferrin Saturation 20-50%
Triglyceride 35-160mg/dl
HDL >60mg/dl
LDL <75 or 77.3/140 or >50% reduction
Total Cholesterol <200mg/dl (120-200)
Globulin 2-3.5g/dl
Albumin 3.5-5.5g/dl Inc: Bact. Meningitis
CHON 6-8g/dl Urine: <150 mg/day(10-150) Inc: BM, Polio, GBS, MS
Ammonia (NH3) 15-70mcg/dl
Prostate Spec Antigen(PSA) <4ng/ml
Serum Alcohol 0mg/dl Intoxication >.1
TOXIC: >.15 (50mg/100cc of blood)
ADH 1-5pg/ml
Amylase 25-150 U/L
Lipase 10-150 U/L
Alkaline Phosphatase 33-160 U/L
Phosphatase,Prostatic (Acid) 0-3 U-L
Phosphate 3-4.5mg/dl
Alanine/Aspartate Aminotransferase (AST/ALT) 5-40 U/L
Gamma Glutamyl Transferase (GGT) 5-60 U/L
Alkaline Phosphatase (ALP serum) 35-100 U/L
Serum Osmolality 280-300 mOsm/kg water
CARDIAC ENZYMES:
CKMB (Heart) <4% <3ng/ml Most Spec.
Troponin <.4ng/ml Best indicator of MI
Troponin T <.01 ng/ml
Total CK 38-120 ng/ml
CK-Index M. 0-3
CPK 20-230U/L 10-120mcg/L
CK Isoenzymes <5MB
CK Isoenzyme in brain (CKBB) 0%
CKMM (Skeletal Muscle) 96-100
INR (Intl Normalized Ratio) 2-3
Bleeding time 8-15 Saunders <9mins
Clotting time 5-15mins
Platelet 150-450k/mcL
Standard Warfarin therapy. 2-3
High dose Warfarin therapy 3-4.5
Prosthetic heart valves 2.5-3.5
Plasminogen. 75-140%
Fibrinogen 175-400mg/dl
Thrombin Time 14-17secs
ANTI-COAGULANT:
Heparin/Lovenox/Dalteparin (Partial Thromboplastin Time/APTT) 30-60 Max-112 SQ/IV
Antidote: Protamine Sulfate
Coumadin (Na Warfarin/PT) 10-12secs 10-14 Oral
Antidote: Vit K
1.5-2 times the normal
URINALYSIS:
Volume 1-2L/day Normal: 1500cc/day Minimum: 600cc/day
30cc/hr or 720cc/day Pedia: 2cc/kg/hr
Spec Gravity 1.002-1.030
Ph 5-8
Casts 1-2 per high power field
DIFFIRENTIAL COUNT:
Segmented neutrophils 45-75% 2500-8k
Band forms 0-5% (Left shift >8%)
Basophils 0-3 (0 - 0.75%)
Eosinophils 0-3/0-8
Monocytes 3-11 (3 - 7%)
Lymphocytes 15-45 (25 - 33%)
Blood Volume 8.5-9% of Total Body Weight
CO <5% of Total Hgb
CD4 Cell Count 500-1500 cells/uL
Ceruloplasmin 15-60mg/dl
MATERNITY:
FHR 120-160bpm
Variability 6-10bpm
FHT 20wks
Quickening 16wks
Fundal Height 24-34wks
Contractions 2-5mins apart
Amniotic Fluid 500-1200ml Duration <90sec Intensity <100mmHg
Blood Loss Vaginal birth: 200-300ml CS:'500cc Hemorrhage:'500
AVA V: Oxygenated blood
APGAR Appearance, Pulses, Grimace, Activity, Reflexes
(Done at 1&5mins)
(0-absent, 1-decreased, 2-strongly positive)
Sperm Count 20-150
MEDICATIONS:
Digoxin .5-2 ng/ml (Toxic 2.5)
Li .6-1.2meq/L (Toxic 1.5)
Dilantin/Theophylline 10-20mcg/dl (Toxic >30)
Tylenol Toxic >4000mg/day Antidote: Mucomist
Carbamazipine Therapeutic 5-12
Insulin: Regular
Onset 30-60 min
Peak 2-4hr
Duration 5-7hr
NPH 1-3 hr onset, 6-12 hr peak and 18-24 duration
Lispro-fast acting and to eat right away, don’t mix
HHNKS: Glucose >800, no ketones, acidosis
Cerebral Spinal Fluid (CSF):
CSF Glucose 50-80 ng/dl
CSF Protein 15-45 mg/dl
CSF RBCs 0/?l
CSF WBCs 0-3/?
-IV FLUIDS:
Isotonic PLR, D5W, .9 NaCl, PNM
Hypotonic .45 NaCl, .3 NaCl?
Hypertonic 3% NaCl?, D10-15W, D5LR, D5NM
VITAL SIGNS:
BP <120/80mmHg
PR 70-100bpm
RR 12-20bpm
Temp 98.6F 36.5-37.5C
Hypothermia: <35C
RULE OF 9s (TBSA):
Head 9%
Arms 18%
Body 36%
Legs 36%
Genetalia 1%
Body Mass Index (BMI):
Underweight <18.8kg/m
Normal. 18.5-24.9
Overweight 25-29.9
Obesity class I 30-34.9
Obesity class II 35-39.9
Obesity class III (extreme, morbid) >40
HORMONES:
Aldosterone (Normal Na Diet Adult) 19-34 mcg/dl
Testosterone M: 275-1000ng/dl F: 23-75 Pregnant: 38-1900
Serum Testosterone M: 300-1000ng/dl F: <62
Cortisol serum 8am: 5-25ng/dl 6-23 4pm:3-7ng/dl
Total T4 (TT4) 5.5-12.3ng/ml
Free Thyroxine (T4 Free). .6-2ng/dl
Thyroxine serum 4.5-12mg/dl
Total T3 (TT3) 60-200ng/ml
Free T3 2.3-4.2pg/ml
Triiodothyronine (T3 free serum) 230-620 pg/dl
Growth Hormone <10ng/ml
Progesterone F (mid-luteal) 4.5-25.2 ng/ml M .3-1ng/ml
Renin Activity Normal Na Diet .5-4ng/ml
Prolactin (PRL) 0-14 ng/ml <30
Serum Alpha-Fetoprotein (AFP) 0-44 ng/ml
Thyroxine-binding Globulin (TBG). 12-30mg/L
Resin T3 Uptake (RT3U) 25-35%
Calcitonin M <14pg/ml F <6.5
Glucagon 50-200pg/ml
Estrogen F(Premenopausal) 50-450pg/ml M <55
Parathyroid Hormone (PTH) 11-54pg/ml
Adrenocorticotrophic Hormone (ACTH) 6-100 pg/ml
Glucose-6-Phosphate Dehydrogenase (G6PD) 5-1U/g Hb
Follicle-Stimulating Hormone (FSH) 1-12 U/L
Insulin 5-25 uU/L
Luteinizing Hormone F (Premeno):<76 IU/L Follicular:2-10
Mid-cycle/Postmeno: 15-65 Luteal:1-12
TRH 5-25mlu/ml
Thyroid Stimulating Hormone (TSH) .3-6U/ml
Radioactive Iodine Uptake(RAIU) 10-35% (24hr)
17-Hydroxycorticosteroid (17-OHCS) <4 mg/day
VITAMINS & MINERALS:
Ferritin 15-300ng/ml
Folate 2-20ng/dl
Fe 60-170mcg/dl
Total Fe-binding Capacity (TIBC) 240- 460 mcg/dl
Vit E 5-20mcg/ml
Vit B6 5-24ng/ml
Vit D3 (Cholecalciferol) 24-40 ng/ml
Vit A 30-95mcg/dl
Zinc 60-130 ng/dl
Pb <40ng/dl
Co 70-150ng/dl
Lactic Dehydrogenase 50-150 U/L
Transferrin > 200 mg/dl
Lactid Acid 4.5-20mg/dl
Acetoacetate <3mg/dl
Pyruvic Acid .3-.9 mg/dl
Ascorbic Acid .2-2mg/dl
B-Hydroxybutyrate <2.8 mg/dl
Vit B12 (Cyanocobalamin) 100-800pg/ml
1.25-Dihydroxy-Cholecalciferol 24-65pg/ml
25-Hydroxy-Cholecalciferol 10-55pg/ml
Zinc 70-102 umol/L
GFR 125ml/mil
Vanellylmandelic Acid (VMA) <10/day
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