Normal Electrolyte Lab Values
- Potassium (K+)
- 3.5 to 5.0 mEq/L
- Calcium (Ca2+)
- 8.5 to 10.5 mg/dL
- Phosphate (PO43–)
- 2.5 to 4.5 mg/dL
- Magnesium (Mg2+)
- 1.5 to 2.5 mEq/L
- Sodium (Na+)
- 135 to 145 mEq/L
- Chloride (Cl–)
- 95 to 105 mEq/L
BUN (Blood Urea Nitrogen) Lab Values
pH - Blood and Urine Lab Value
- Blood
- 7.35 - 7.45
- Urine
- 4.0 - 8.0
Blood Acid-Base Control
- In a State of Acidemia
- Medullary Chemoreceptors Control Ventilation Rate
- Expulsion of CO2 through Lungs Increases pH
- Bicarbonate Reabsorption from the Kidney Increases pH
- Kidney Excretion of H+ Increases pH
Proximal Tubule
- Na+ Reabsorbed Via Active Transport
- Water Follows Na+
- Most Of Glucose Reabsorbed
- Most Of Amino Acids Reabsorbed
- Bicarbonate Exchanged For H+
- Drugs and Toxins Excreted
- Filtrate Osmolarity Same As Plasma
- Leads To Loop Of Henle
Loop of Henle
- Descending Limb
- Water Follows Na+
- Medullary Hypertonicity
- Increased Water Reabsorption
- Vasa Recta
- Na+ Reabsorbed Via Active Transport
- Ascending Limb
- Reabsorbs Na+, K+, Cl-
- Decreased Concentration of Filtrate
- Impermeable to Water
- Distal Tubule
Distal Tubule
- Hormonally Regulated
- Aldosterone Causes Na+ Reabsorption
- Na+ Reabsorbed Via Active Transport
- Water follows Na+
- Parathyroid Hormone Causes Ca2+ Reabsorption
- Leads to Collecting Duct
Collecting Duct
- Na+ Reabsorption
- Vasopressin Causes Water reabsorption
- Concentrates Filtrate
Metabolic Acidosis Interventions
- Raise Plasma pH > 7.20
- Treat Underlying Cause
- Sodium Bicarbonate
- Follow ABGs
- Continuously Monitor Patient
Metabolic Alkalosis
- Diuretic use
- Vomiting
- Antacid
- Hyperaldosteronism
Metabolic Alkalosis Interventions
- Treat Underlying Cause
- Stop Potassium (K+) Wasting Diuretics
- Spironolactone
- Acetazolamide
- IV Fluids
- Sodium Chloride
- Replace Potassium (K+)
- Monitor Respiratory Rate
- Monitor Heart Rate
- Seizure Precautions
Renal Calculi Assessment
- Hypercalcemia (Most Commonly)
- Flank Pain
- Radiates Toward Bladder
- Renal Colic
- Urinary Tract Infection
- Urinary Retention
- Hematuria
- Stone Recurrence
Renal Calculi Interventions
- Increase Fluid Intake
- Opioids
- NSAIDs
- Antibiotics
- Lithotripsy
- Surgical Stone Removal
- Identify Type CT-KUB
- Low Sodium Diet
Urinary Tract Infection Symptoms
- More Common in Elderly
- Most Common in Females and Babies
- Change in LOC
- Dehydration
- Fever
- Urgency
- Urethral Infection
- Burning
- Smelly Urine
- Dark Cloudy Urine
- Frequency of Urination
Pyelonephritis Assessment
- Ascending Urethral Bacteria
- Dysuria
- Fever
- Fatigue
- Flank Pain
- Costovertebral Tenderness
- Nausea and Vomiting
Pyelonephritis Interventions
- Urinalysis
- NSAIDs
- Antibiotics
- Increase Fluid Intake
- Avoid Catheterization
- Urosepsis
Chronic Kidney Disease Early Symptoms Assessment
- GFR < 60mL/min
- Accumulation of Waste Products
- General Malaise
- Hypertension
- Proteinuria
- Hyperkalemia
- Mineral and Bone Disorders
- Neuropathy
Chronic Kidney Disease Late Symptoms Assessment
- Metabolic Acidosis
- Severe Uremia
- Arrhythmias
- Edema
- CNS Depression
- Anemia
- Oliguria
- Pruritus
- End Stage Renal Disease (ESRD)
- GFR < 15mL/min
Chronic Kidney Disease Interventions
- Daily Weights
- Strict I/O
- Renal Diet
- Strict Medication Regimen
- Erythropoietin
- Manage Hyperkalemia
- Manage CKD-MBD
- Dialysis
- Kidney Transplant
Dialysis
- Hemodialysis
- Rapid Shifts of Fluid and Electrolytes
- Disequilibrium Syndrome
- Hypotension
- NO BP IN ARM with Shunt or Fistula
- Assess for Thrill and Bruit
- Peritoneal Dialysis
- Slow Process
- Peritonitis
- Loss of Protein
- Hyperglycemia
Indications for Urgent Dialysis (AEIOU)
- AEIOU Mnemonic
- Acidosis
- pH < 7.1
- Electrolyte Imbalances
- Symptomatic Hyperkalemia
- > 6.5 mEq/L
- Ingestion
- Overload (Volume)
- Uremia
- Encephalitis
- Pericarditis
Testes
- FSH Stimulates Sertoli Cells
- Inhibin B Release
- LH Stimulates Leydig Cells
- Leydig Cells Secrete Testosterone
- Testosterone Causes Male Development
Benign Prostatic Hyperplasia (BPH) Disease
- DHT-induced Growth Factors
- Common in Men > 50 Years Old
- Smooth, Symmetric, Firm Enlargement
- Affects Lateral and Middle (Periurethral) Gland
- Urethra Compression
- Increased Urinary Frequency
- Nocturia
- Dysuria
- Urinary Tract Infection
- Hydronephrosis