Lab Values Podcast by NURSING.com (Nursing Podcast, normal lab values for nurses for NCLEX®) by NURSING.com (NRSNG‪)‬ Jon Haws RN: Critical Care Nurse & NCLEX Educator

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Objective: Determine the significance and clinical use of measuring Direct or Conjugated Bilirubin in clinical practice
 
Lab Test Name: Direct or Conjugated Bilirubin
 
Description: Bilirubin is a substance made when your body breaks down old red blood cells. This is a normal process. Bilirubin is also part of bile, which your liver makes to help digest the food you eat.
A small amount of bilirubin in your blood is normal.
Some bilirubin is bound to albumin in the blood. This type of bilirubin is called unconjugated, or indirect, bilirubin.
In the liver, bilirubin is changed into a form that your body can get rid of. This is called conjugated bilirubin or direct bilirubin. 
This bilirubin travels from the liver into the small intestine. A very small amount passes into your kidneys and is excreted in your urine. This bilirubin also gives urine its distinctive yellow color and contributes to the brown color of stool.
 
Indications: Newborns – immature liver has trouble clearing bilirubin and manifests as jaundice Investigate jaundice in adults Blockage of bile ducts- (liver or gallbladder) Detection of liver disease- particularly hepatitis Monitor progression of hepatitis Detect issues with RBC breakdown→hemolytic anemia Suspected drug toxicity- many medications are metabolized and cleared in the liver  
Normal Therapeutic Values: Normal – 0.0-0.2 mg/dL
Collection:
Plasma separator tube  
What would cause increased levels? Increased levels linked to:
Poor liver function or hepatitis Certain medications Hemolytic anemia Pregnancy Sepsis- poor perfusion Exercise TPN ETOH  
What would cause decreased levels? Studies are inconclusive regarding risk or association with disease process in the presence of a decreased bilirubin level.

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What is the Lab Name for Aspartate Aminotransferase (AST) Lab Values?

Aspartate Aminotransferase








What is the Lab Abbreviation for Aspartate Aminotransferase?

AST








What is Aspartate Aminotransferase in terms of Nursing Labs?

Aspartate aminotransferase (AST) is an enzyme primarily found in liver and heart cells and to a smaller extent, AST can also be found in the pancreas, kidneys, skeletal muscle, and brain. Levels of AST increase from cell death (necrosis) because the AST enzyme is released into the blood.








What is the Normal Range for Aspartate Aminotransferase?

12-37 U/L








What are the Indications for Aspartate Aminotransferase?

 
Monitor progression of: Liver disease Response to treatments. Monitor liver toxic medications  








What would cause Increased Levels of Aspartate Aminotransferase?

 
Liver disease Liver cancer Shock Congestive Heart Failure (CHF) Pericarditis Biliary tract obstruction Dermatomyositis Pancreatitis Muscular Dystrophy CVA Hemolytic anemia Delirium Tremens (DT)  








What would cause Decreased Levels of Aspartate Aminotransferase?

 
N/A

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What is the Lab Name for Amylase Lab Values?

Amylase
 








What is Amylase in terms of Nursing Labs?

Amylase is made in the pancreas. It is an enzyme that breaks down carbohydrates to allow our body to absorb it. Monitoring amylase levels can identify problems with the pancreas.
 








What is the Normal Range for Amylase?

0-130 U/L
 








What are the Indications for Amylase?

Diagnosing: Pancreatitis Pancreatic Duct Obstruction Macroamylasemia Trauma to Pancreas  








What would cause Increased Levels of Amylase?

Pancreatitis Pancreatic Cancer Pancreatic Cyst DKA Peritonitis Abdominal Trauma Duodenal Obstruction Mumps Alcohol use












 






What would cause Decreased Levels of Amylase?








Pancreatic Insufficiency Pancreatectomy Toxemia of Pregnancy Cystic Fibrosis Liver Disease

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What is the Lab Name for Ammonia (NH3) Lab Values?

Ammonia
 








What is the Lab Abbreviation for Ammonia?

NH3
 








What is Ammonia in terms of Nursing Labs?

Ammonia (NH3) is a byproduct created when protein is broken down. Ammonia is converted into urea in the liver, and urea is excreted by the kidneys. During liver disease, ammonia levels rise and can have a negative effect on the brain.
 








What is the Normal Range for Ammonia?

19-60 mcg/dL
 








What are the Indications for Ammonia?

Identifying liver disease Monitoring hepatic encephalopathy Evaluating effectiveness of treatment.  








What would cause Increased Levels of Ammonia?

Liver Failure Hepatic Coma (Hepatic Encephalopathy) Reye’s syndrome Total Parental Nutrition (TPN) Gastrointestinal Hemorrhage












 














What would cause Decreased Levels of Ammonia?

Some Antibiotics: Neomycin Hypertension

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  Objective: Determine the significance and clinical use of  alkaline phosphatase in clinical practice
 
Lab Test Name: Alkaline Phosphatase – ALP
 
Description: Measures amount of ALP in circulation
Located in several places in the body:
Liver Intestines Biliary tract Bones Placenta Different isoenzymes of ALP are used to determine:
Liver, bone, intestine and other cancers Bone turnover in postmenopausal women  
Indications: Evaluation of ALP:
Hepatobiliary disease Malignancies Bone disease Bone damage in renal patients  
Normal Therapeutic Values: Normal – 40-130 U/L
Collection:
 Plasma separator tube  
What would cause increased levels? Increased levels assessed in:
Liver disease Bone disease Pregnancy Amyloidosis Lung cancer Pancreatic cancer Congestive heart failure Ulcerative colitis Hodgkin’s disease Chronic renal failure Sarcoidosis  
What would cause decreased levels? Hypophosphatasia (spelling error on existing outline on NURSING.com) Anemia Kwashiorkor Cretinism Hypothyroidism Zinc or magnesium deficiency Scurvy

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What is the Lab Name for Albumin Lab Values?

Albumin
 








What is the Lab Abbreviation for Albumin?

alb
 








What is Albumin in terms of Nursing Labs?

Albumin is a transport protein in the blood. It helps maintain the oncotic pressure of the blood. Albumin levels will drop if synthesis is slowed, protein intake is inadequate, or there are increased losses. Albumin has a long half life, however, so levels are not a good indicator of acute illness.
 








What is the Normal Range for Albumin?

3.5 – 6.0 g/dL
 








What are the Indications for Albumin?

Evaluation of chronic illness Liver disease Nutritional status  
What would cause Increased Levels of Albumin?








Dehydration Hyper infusion Albumin  








What would cause Decreased Levels of Albumin?

Inadequate intake Liver disease Inflammation Chronic disease Losses (fistula, hemorrhage, kidney disease, burns) Over hydration Increased catabolism Congestive heart failure