Week 8 Blog #2

Blog #2:

Week 8 February 22-28

Saturday, February 27, 2016
2p-10p 8 Hours Interned
Sunday, February 28, 2016
2p-10p 8 Hours Interned

Objective #2:
2.     Will verbally demonstrate knowledge of tests included in a CMP and CBC/diff including abnormalities, what disease process they might indicate and possible signs and symptoms that a patient might demonstrate given these values.

Signs and symptoms a patient may demonstrate to have these tests ordered in relation to abnormal values:

Liver Tests:

ALP- Test is ordered as part of the CMP which is for a general/annual medical exam or physical. The test is ordered when an individual shows particular signs and symptoms such as weakness, fatigue, loss of appetite, nausea, omitting, abdominal swelling, jaundice, dark urine, light colored stool, and pruritus. Signs and symptoms that the individual might have a bone marrow disorder which results in elevated ALP levels would be bone and/or joint pain, increased frequency of fractures, and deformed bones. 

ALT- Test is ordered as part of the CMP which is for a general/annual medical exam or physical. The test is ordered when an individual shows signs and symptoms like those seen in the ALP. Signs and symptoms include weakness, fatigue, loss of appetite, nausea, omitting, abdominal swelling, jaundice, dark urine, light colored stool, and pruritus. The test can also be ordered for people with in increased risk of liver disease or have liver damage. These people include persons who have a history of known or possible exposure to hepatitis viruses, heavy/chronic drinkers, have family members with a history of liver disease, take drugs that can damage the liver, and people who are overweight or have diabetes.

AST- Test is ordered as part of the CMP which is for a general/annual medical exam or physical. The test is ordered when an individual shows signs and symptoms like those seen in ALT and ALP. Signs and symptoms include weakness, fatigue, loss of appetite, nausea, omitting, abdominal swelling, jaundice, dark urine, light colored stool, and pruritus. And like with ALT,the test can also be ordered for people with in increased risk of liver disease or have liver damage. These people include persons who have a history of known or possible exposure to hepatitis viruses, heavy/chronic drinkers, have family members with a history of liver disease, take drugs that can damage the liver, and people who are overweight or have diabetes.

Bilirubin- Test is ordered as part of the CMP which is for a general/annual medical exam or physical. The test is ordered when an individual is exhibiting signs and symptoms such as jaundice, has a history of drinking excessive amounts of alcohol, has a suspected drug toxicity, has been exposed to the hepatitis-causing viruses, has dark/ amber colored urine, nausea, vomiting, abdominal pain and swelling, fatigue, and general malaise that often accompany chronic liver disease.

Week 8 Blog #1

Blog #1:

Week 8 February 22-28

Monday, February 22, 2016
4p-8p 4 Hours Interned

Objective #2:
2.     Will verbally demonstrate knowledge of tests included in a CMP and CBC/diff including abnormalities, what disease process they might indicate and possible signs and symptoms that a patient might demonstrate given these values.

Signs and symptoms a patient may demonstrate to have these tests ordered in relation to abnormal values:

Electrolytes:

Sodium- Test is ordered as part of the CMP which is for a general/annual medical exam or physical and when an individual has non-specific health complaints. Low sodium levels have signs and symptoms such as weakness, confusion, lethargy, and fatigue. High sodium levels have signs and symptoms such as thirst, dry mucous membranes, less frequent urination, muscle twitching, agitation, restlessness, acting irrationally, convulsions and possible coma. Another particular time to order this test is when an individual is dehydrated and is having trouble with balance. Routine sodium test are ordered in particular disorders such as high blood pressure, heart failure, and with liver and kidney diseases.

Potassium- Test is ordered as part of the CMP which is for a general/annual medical exam or physical and if they have a serious illness. Potassium tests will be ordered if an individual has kidney disease, cardiac arrhythmia, is taking diuretics or heart medications, and has high blood pressure. Regular potassium testing is done for individuals who have hypertension, diabetic ketoacidosis, kidney disease, and is receiving dialysis, diuretic therapy, or iv fluids. An individual with high potassium levels is seen in those who have kidney or addison disease, injury to tissue, infection, diabetes, dehydration, consumes too much from diet, and is taking certain drugs such as NSAIDs, ACE inhibitors, beta blockers, and potassium-sparing diuretics. An individual with low potassium levels is seen in those who have conn syndrome, diarrhea, vomiting, acetaminophen overdose, diabetes, and is taking drugs such as potassium-wasting diuretics, corticosteroids, bea-adrenergic agonists, certain antibiotics, and antifungal agents. 

Bicarbonate- Test is ordered as part of the CMP which is for a general/annual medical exam or physical. The test is ordered when an individual is demonstrating signs and symptoms of acidosis or alkalosis, prolonged vomiting and/or diarrhea, weakness, fatigue, and difficulty breathing. This test is also ordered to monitor treatment of certain problems such as high blood pressure, heart failure, and liver and kidney disease. Low CO2 levels are caused by Addison disease, chronic diarrhea, metabolic acidosis, respiratory alkalosis (hyperventilation), shock, kidney disease, methanol poisoning, and aspirin overdose. high CO2 levels are caused by prolonged vomiting and/or diarrhea, lung diseases, cushing and conn syndrome, and metabolic alkalosis. 

Chloride- Test is ordered as part of the CMP which is for a general/annual medical exam or physical. Like with CO2 the test is ordered when an individual is demonstrating signs and symptoms of acidosis or alkalosis, prolonged vomiting and/or diarrhea, weakness, fatigue, and difficulty breathing. The test is also ordered to monitor high blood pressure, heart failure, and liver and kidney disease. Increased levels of chloride can be seen when an individual is dehydrated, has cushing syndrome, and kidney disease. Elevated levels of chloride happen when too much base has been lost from the body, resulting in metabolic acidosis. Decreased chloride levels occurs with CHF, addison disease, emphysema, other chronic lung diseases, and prolonged vomitting and gastric suction. Decreased chloride levels happen when too much acid has been lost from the body, resulting in metabolic alkalosis.

Week 7 Blog #2

Blog #2:

Week 7 February 15-21

Friday, February 19, 2016

4p-8p 4 Hours Interned
Saturday, February 20, 2016

4p-8p 4 Hours Interned

Objective #2:
2.     Will verbally demonstrate knowledge of tests included in a CMP and CBC/diff including abnormalities, what disease process they might indicate and possible signs and symptoms that a patient might demonstrate given these values.

Signs and symptoms a patient may demonstrate to have these tests ordered in relation to abnormal values:

Proteins:

Albumin- Test is ordered as part of the CMP which is for a general/annual medical exam or physical. But will be ordered in particular if an individual has symptoms resulting from liver disorders such as jaundice, fatigue, or weight loss. Symptoms from nephrotic syndrome such as swelling around the eyes, belly, or legs can initiate the ordering of the test. Disorders and diseases in which the body can not properly absorb and digest proteins such as Crohns or celiac disease. If the individual is malnurished, the test will be ordered because the decreased albumin levels need to be elevated. And/or if the individual is dehydrated.

Total Protein- Test is ordered as part of the CMP which is for a general/annual medical exam or physical and get a general idea of the individuals nutritional status. Will be ordered in particular if an individual has some unexplained weight loss and if the individual is exhibiting signs and symptoms of edema or signs and symptoms that would imply liver, kidney, and bone marrow disorders. Low protein levels can suggest liver or kidney disorders by the two not being able to properly digest and absorb protein. This is common for individuals who are malnurished or have conditions that cause malabsorption such as celiac disease or IBD. High protein levels can be caused by chronic inflammation or infections such as HIV and viral hepatitis. High levels are also seen in bone marrow disorders like multiple myeloma.

Kidney Tests:

BUN- Test is ordered as part of the CMP which is for a general/annual medical exam or physical and to check if the kidneys are functioning properly. This is important when an ill person comes to the ER, is to be admitted to the hospital, and during hospital stay. Possible signs and symptoms increased BUN levels due to kidney function are, fatigue, lack of concentration and appetite, trouble sleeping, edema around the eyes, face, abdomen, wrists, thighs, and ankles, foamy urine that appears bloody or coffee-colored, decreased amount of urine, problems urinating, abnormal discharge, change in frequency of urination, mid-back pain (where the kidneys are located), and high blood pressure. A BUN test will be regularly ordered to individuals who have chronic diseases such as diabetes, CHF, heart attack, been diagnosed with kidney disease, during particular drug treatments that affect kidney function, and during dialysis.

Creatinine-  Test is ordered as part of the CMP which is for a general/annual medical exam or physical. Typically ordered when an individual is acutely ill and showing signs and symptoms of kidney dysfunction. Signs and symptoms of kidney dysfunction include the same signs and symptoms as seen in the BUN signs and symptoms listed above. The two test including urine albumin are taken together to determine how effectively the kidneys are functioning. 

Week 7 Blog #1

Blog #1:

Week 7 February 15-21

Monday, February 15, 2016
4p-8p 4 Hours Interned

Objective #2:
2.     Will verbally demonstrate knowledge of tests included in a CMP and CBC/diff including abnormalities, what disease process they might indicate and possible signs and symptoms that a patient might demonstrate given these values.

Signs and symptoms a patient may demonstrate to have these tests ordered in relation to abnormal values:

Glucose- Test is ordered as part of the CMP which is for a general/annual medical exam or physical. The glucose portion of the test is tested as a preventative measure and recommended screening in people age 45 or older with particular risk factors that could lead to diabetes. These risk factors are is the person is obese, has a relative with diabetes, a woman who delivered a baby over 9 pounds, woman with polycystic ovarian cancer, of a high risk ethnicity such as latino, african, asian, or native american, pacific islander, hypertension, low hdl cholesterol level or high triglyceride level, been previousily diagnosed as a prediabetic, and a history of CVD. Signs and symptoms a person may have hyperglycemia are increased thirst, fatigue, blurred vision, and slow-healing wounds or infections. Signs and symptoms an individual may have hypoglycemia are sweating, hunger, trembling, anxiety, confusion, and blurred vision.
Calcium- Test is ordered as part of the CMP which is for a general/annual medical exam or physical. Typically, individuals do not have high or low values of calcium, but the test will be ordered specifically if the individual is showing particular signs and symptoms or have particular diseases in which calcium needs to be monitored. Signs, symptoms, and diseases the individual may have include kidney and thyroid disease, parathyroid disorder, malabsorption, cancer, malnutrition. Hypercalcemia signs and symptoms will include fatigue weakness, loss of appetite, nausea, vomiting, constipation, abdominal pain, urinary frequency. Hypocalcemia signs and symptoms will include increased thirst, muscle cramps, and tingling fingers.

Week 6 Blog #2

Week 6 February 8-14
Friday, February 12, 2016
4p-8p 4 Hours Interned
Saturday, February 13, 2016
2p-10p 8 Hours Interned
Sunday, February 14, 2016
2p-10p 8 Hours Interned

Objective #2:

2.     Will verbally demonstrate knowledge of tests included in a CMP and CBC/diff including abnormalities, what disease process they might indicate and possible signs and symptoms that a patient might demonstrate given these values.

Sodium Normal Values: 135-145 mEq/L
Low Sodium Levels Signify- AKA hyponatremia. Low levels of sodium can be due to loosing too much from diarrhea, vomiting, excessive sweating, use of diuretics, kidney disease, Addison disease, drinking too much water, edema caused by heart failure, cirrhosis, nephrotic syndrome, malnutrition and other diseases and drugs related to anti-diuretic hormone (ADH). 
High Sodium Levels Signify- AKA hypernatremia. Almost always caused by loosing too much water from dehydration, too much sodium intake without drinking enough water, and Cushing syndrome caused by not enough ADH AKA diabetes insipidus.

Potassium Normal Values: 3.7-5.2 mEq/L
Low Potassium Levels Signify- AKA hyokalemia. Commonly caused by diuretics. Other drugs such as corticosteroids, beta-adrenergic-agonists and antagonists, antibiotics, and antifungal agents can lower potassium levels too. Other conditions such as diarrhea, conn syndrome, acetaminophen overdose, and in diabetics who do not regulate their condition well.
High Potassium Levels Signify- AKA hyperkalemia. Commonly caused from too much sodium intake from ones diet. Drugs such as NSAIDS, ACE inhibitors, beta blockers, ACE inhibitors, and potassium-sparing diuretics. Conditions such as kidney and addison disease, injury to tissue, infection, diabetes, and dehydration can all lead to increased potassium levels.

Bicarbonate Normal Values: 23-29 mEq/L
Low Bicarbonate Levels Signify- When C02 levels are low, it suggests the body is having trouble maintaining its acid-base balance. This is due to the body either failing to remove CO2 through the lungs and/or kidneys or a deficiency in potassium. Conditions showing low levels of CO2 are like addison and kidney disease, chronic diarrhea, respiratory alkalosis, metabolic acidosis, diabetic ketoacidosis, shock, ethylene glycol or methanol poisoning, and salicylate overdose.
High Bicarbonate Levels Signify- When C02 levels are high, like when they are low, it suggests the body is having trouble maintaining its acid-base balance. This is due to the body either failing to remove CO2 through the lungs and/or kidneys or a deficiency in potassium. Conditions showing high levels of CO2 are like cushing and conn syndrome, lung disease, prolonged vomiting or diarrhea, and metabolic alkalosis. 

ALP Normal Values: 44-147 IU/L
Low ALP Levels Signify- Low levels of ALP can be seen after blood transfusion or heart bypass surgery, deficiency in zinc, malnutrition, in Wilson disease, and in hypophosphatasia. 
High ALP Levels Signify- High levels of ALP signify that the liver has been damaged or a condition causing increased bone cell activity is going on. ALP is released when liver cells have been damaged or any condition that affects bone growth. High ALP levels are found in people with a form of liver disease, hepatitis, when bile ducts are blocked, liver cancer, Paget's disease, CHF, hodkin's lymphoma, ulcerative colitis, and particular bacterial infections. Temporary elevated ALP can be seen in pregnancy and when fractured bones are healing.

ALT Normal Values: 10-40 IU/L
Low ALT Levels Signify- Normal ALT levels are typically low, so there is no fret or further investigation needed if they are. An individual wants low ALT levels because otherwise, it indicates liver damage or disease
High ALT Levels Signify- High ALT levels indicate liver damage. The test is used in conjunction to the ALP test. Elevated ALT levels usually signify acute hepatitis, viral infection, as a result of toxic drug exposure to the liver, ischemia, obstruction to the bile ducts, cirrhosis, heart damage, alcohol abuse, liver tumors, and muscle injury. Many drugs, nonrecreational and prescribed, will elevate ALT levels due to causing damage to the liver.

AST Normal Values: 10-34 IU/L
Low AST Levels Signify- Normal AST levels are typically low, so there is no fret or further investigation needed if they are. An individual wants low AST levels because otherwise, it indicates liver disease or damage.
High AST Levels Signify- High AST levels is caused by acute hepatitis, viral infection, ischemia, cirrhosis, liver disease, alcoholic hepatitis, and heart attack. Temporary elevated levels can be seen in pregnancy when an injection of medicine has been administered into the muscle tissue, too much exercise, acute burns, surgery, and seizures. 

As you can see, ALP, ALT, and AST all have similar results pertaining to their values, this is because they are all evaluated in conjunction to one another. Their levels all become elevated under particular circumstances because they all work together and then are all compared against one another.

Week 6 Blog #1

Week 6 February 8-14
Monday, February 8, 2016
4p-8p 4 Hours Interned

Objective #2:

2.     Will verbally demonstrate knowledge of tests included in a CMP and CBC/diff including abnormalities, what disease process they might indicate and possible signs and symptoms that a patient might demonstrate given these values.

Albumin Normal Values: 3.5-5.5 g/dL
Low Albumin Levels Signify- A warning and indication that further investigation may be needed. Low albumin levels can reflect a temporary of more permanent condition. Low levels suggest liver disease. It can also reflect diseases in which the kidneys are not preventing albumin from leaking from the blood into the body, thus, not properly absorbing and digesting the protein. Lower levels of albumin can be a sign of kidney and liver disease. And can also occur or be noted in crohn's disease, low protein diets, celiac disease, and whipple disease.
High Albumin Levels Signify- Typically high levels of albumin signify dehydration and having a high protein diet. This is usually not a threat and can be easily reversed.

Total Protein Normal Values: 6.0-8.3 g/dL
Low Total Protein Levels Signify- Can suggest a liver or kidney disorder because proteins are not being properly digested or absorbed. this can be a result of malnutrition in particular diseases such as celiac and inflammatory bowel disease.
High Total Protein Levels Signify- Commonly seen as a result of chronic inflammation or with infections such as viral hepatitis or HIV. Some bone marrow disorders such as multiple myeloma can also result in elevated total protein values.

Bun Normal Values:6-10 mg/dL
Low BUN Levels Signify- Not common and a low BUN is usually not of much concern because the issue can resolve itself. If an individual has chronic low BUN levels it is due to severe liver disease, malnutrition, or over hydration. Also, a diet low in protein will result in low BUN levels.
High BUN Levels Signify- Increased Bun levels suggest impaired kidney function. This can be due to acute or chronic kidney disease, kidney damage, or kidney failure. It could also be a result of congestive heart failure, shock, stress, recent heart attack, obstruction of urine flow, and dehydration because these all result in a decreased blood flow to the kidneys. Also, diets high in protein will result in high BUN levels.

Creatinine Normal Values: 0.6-1.3 mg/dL
Low Creatinine Levels Signify- Not common. But when are chronically seen, is a result of decreased muscle mass.
High Creatinine Levels Signify- Suggests kidney disease or other conditions that affect kidney function. Other conditions include, damage or swelling of the blood vessels in the kidneys from infection or an autoimmune disease, bacterial infection in the kidneys, acute tubular necrosis, prostate disease, kidney stones, obstruction of the urinary tract, and reduced blood flow to the kidneys due to shock, dehydration, diabetes, and CHF.

Bilirubin Normal Values: 0.3-1.9 mg/dL
Low Bilirubin Levels Signify- Low levels if bilirubin is generally not of any concern, nor is it monitored. You don't bilirubin in your blood stream.
High Bilirubin Levels Signify- 2 types: unconjugated and conjugated bilirubin. Elevated unconjugated bilirubin levels are a result from hemolytic anemia, transfusion reaction, cirrhosis, and from an inherited condition known as Gilbert syndrome. Elevated levels of conjugated bilirubin are a result of viral hepatitis, drug reactions, and alcoholic liver disease. Elevated conjugated bilirubin levels can also occur when there is a blockage of the bile ducts such as with gallstones, tumors, and scarring of the bile ducts.

Just to distinguish the two types of bilirubin, here's their definitions:
Unconjugated bilirubin - when heme is released from hemoglobin, it is converted to unconjugated bilirubin, It is carried by proteins to the liver. Small amounts are present in the blood.
Conjugated Bilirubin - formed in the liver when sugars are attached to bilirubin. It enters the bile and passes from the liver to the small intestin and is eventually eliminated in the stool. Normally, conjugated bilirubin is not present in the blood.

Week 5 Blog #2

Blog #2:

Week 5 February 1-7

Friday, February 5, 2016

4p-8p 4 Hours Interned

Saturday, February 6, 2016

4p-8p 4 Hours Interned

Objective #2:

2.     Will verbally demonstrate knowledge of tests included in a CMP and CBC/diff including abnormalities, what disease process they might indicate and possible signs and symptoms that a patient might demonstrate given these values.

So as I said, this part of the blog is going to start getting kind of dry. I am now going to explain the abnormal tests values from the list above and what the abnormal values can potentially signify in relation to the disease process. I am going to break up the 14 tests over the next three blogs to keep on track with the timeframe of my biweekly blog requirements.

Glucose Normal Values: 70-100 mg/dL
Low Glucose Levels Signify- Also know as hypoglycemia, hypoglycemia can signify hypopituitarism, underactive thyroid gland, tumor in the pancreas, too little food, and liver or kidney disease.
High Glucose Levels Signify- Also known as hyperglycemia, hyperglycemia can signify an overactive throid gland, pancreatic cancer, swelling or inflammation of the pancreas, stress due to trauma, stroke, heart attack, or surgery, or have rare tumors such as pheochromocytoma, acromegalgy, cushing syndrome, and glucagonoma. High levels of glucose in the blood means you have impaired fasting glucose.

Calcium Normal Values: 8.5-10.2 mg/dL
Low Calcium Levels Signify- Also known as hypocalcemia, hypocalcemia can be caused by low levels of albumin, hypoparathyroidism, high levels of phosphate in the blood indicated by kidney failure, malnutrition from other diseases such as celiac disease, pancreatitis, and alcoholism, osteomalacia, and rickets.
High Calcium Levels Signify- Also known as hypercalcemia, hypercalemia can be caused by hyperparathyroidism, cancer, tuberculosis, and Paget's disease.

Next posts will have the following 12 tests and what their abnormal values can signify in relation to the disease process.

Week 5 Blog #1

Blog #1:

Week 5 February 1-7

Monday, February 1, 2016

4p-8p 4 Hours Interned

I’m apologizing in advance for my future blogs. Because now I am going to start blogging the specifics in regards to my goals, the blogs are going to be somewhat dry. Don’t now how exciting you can make values sound! Anyways, just a heads up!

Objective #2:
 2. Will verbally demonstrate knowledge of tests included in a CMP and CBC/diff including abnormalities, what disease process they might indicate and possible signs and symptoms that a patient might demonstrate given these values.

So here are the lab normal lab values for the components of the CMP test.

1.     Albumin

3.5-5.5 g/dL

Low values called: Hypoalbuminemia

High values called: Hyperalbuminemia

2.     Blood Urea Nitrogen (BUN)

6-10 mg/dL

Low values called: No specific name. Related to creatinine test.

High values called: No specific name. Related to creatinine test.

3.     Calcium

8.5-10.2 mg/dL

Low values called: Hypcalcemia

High values called: Hypercalcemia

4.     Carbon Dioxide (Bicarbonate)

23-29mEq/L

Low values called: No specific name. Related to pH and electrolyte levels.

High values called: No specific name. Related to pH and electrolyte levels.

5.     Chloride

96-106 mEq/L

Low values called: Hypochloremia

High values called: Hyperchoremia

6.     Creatinine

0.6-1.3 mg/dL

Low values called: No specific name. Related to BUN levels.

High values called: No specific name. Related to BUN levels.

7.     Glucose

70-100 mg/dL

Low values called: Hypoglycemia

High values called: Hyperglycemia

8.     Potassium

3.7-5.2 mEq/L

Low values called: Hypokalemia

High values called: Hyperkalemia

9.     Sodium

135-145 mEq/L

Low values called: Hyponatremia

High values called: Hypernatremia

10.  Total Bilirubin

0.3-1.9 mg/dL

Low values called:

High values called:

11.  Total Protein

6.0-8.3 g/dL

Low values called: No specific name. Related to albumin levels.

High values called: No specific name. Related to albumin levels.

12.  Alanine Aminotransferase (ALT)

10-40 IU/L

Low values called: No specific name. Related to ALP, total protein, and bilirubin levels.

High values called: No specific name. Related to ALP, total protein, and bilirubin levels.

13.  Alkaline Phosphatase (ALP)

44-147 IU/L

Low values called: No specific name. Related to bilirubin, AST, and ALT levels.

High values called: No specific name. Related to bilirubin, AST, and ALT levels.

14.  Aspartate Aminotransferase (AST)

10-34 IU/L

Low values called: No specific name. Related to ALP, total protein, and bilirubin levels.

High values called: No specific name. Related to ALP, total protein, and bilirubin levels.

           

Just note again that these tests are performed to determine an individuals kidney and liver function, electrolyte and acid/base levels, and blood sugar and blood protein levels. So for clarification these tests are to which functions:

Blood Sugar:

Glucose

Proteins:

Albumin

Total protein

Calcium – not a protein but bound to them in the blood. 

Electrolytes:

Sodium

Potassium

Bicarbonate (CO₂)

Chloride 

Kidney Tests:

BUN

Creatinine 

Liver Tests:

ALP

ALT

AST

Bilirubin