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Common laboratory tests: Interpretation and Nursing ImplicationsNURS 325Basic Metabolic PanelLab valueReference range*Interpretation and Nursing ImplicationsSodium 135-145 mEq/LHyponatremia: Strict I/O, daily weights, monitor for GI symptoms (anorexia, nausea, vomiting, abdominal cramping) and CNS symptoms (lethargy, confusion, muscletwitching, seizures). Avoid giving large water supplements. Seizure precautions when hyponatremia is severe.Depending on cause, treatments include isotonic IV fluids, avoid diuretics, fluid restriction, hypertonic saline (severe cases).Hypernatremia:Strict I/O, daily weights, and monitor for changes in behavior such as restlessness, lethargy, and disorientation. Look for excessive thirst and elevated body temperature. Provide sufficient water intake.Depending on cause, treatments include fluid replacement (oral or IV).Potassium3.6-5.0 mEq/LHypokalemiacan be life-threatening. For patients taking digoxin, assess for hypokalemia, which potentiates the action of digitalis. Patients with hypokalemia are at risk of cardiac arrhythmias. Monitor patients for muscle cramps and weakness, paresthesias, fatigue, anorexia, decreased bowel motility, and an irregular heartbeat. To prevent hypokalemia, educate patients about abuse of laxatives and diuretics. If giving IV potassium supplementation, administer per facility policy (e.g. no more than 10 meq/hr) and monitor IV site closely. If giving oral supplementation, give with food, do not crush extended release caps/tabs, and dilute liquid potassium as directed. Potassium is renally cleared, so check to make sure that patient has adequate urine output and creatinine clearance (at least 30 mL/min) before repleting. Hyperkalemiacan be life-threatening. Monitor patients for arrhythmias, irritability, paresthesias, and anxiety, as well as GI symptoms such as nausea and intestinal colic. Avoid giving patients with renal insufficiency potassium-sparing diuretics, potassium supplements, or salt substitutes. Patients on ACE inhibitors should avoid potassium supplements.Treatment is usually needed when the patient is symptomatic. Treatments may include Sodium polystyrene sulfonate (Kaexylate)—removes potassium via GI tract, IV insulin (temporarily shifts insulin into the cell), albuterol (temporarily shifts insulin into the cell), IV calcium chloride or gluconate (protects the myocardium from the harmful effects of hyperkalemia).CO2 (Total CO₂)23-29 mEq/L or mmol/L*Note: This is not the same as carbon dioxide on the ABG! Total CO2 content includes the serum bicarbonate as well as available forms of carbon dioxide (i.e., dissolved CO2 and carbonic acid). Serum bicarbonate comprises about 95% of the total CO2 so this test on a chemistry panel can be used to evaluate acid-base balanceHigh levelsindicate metabolic alkalosisLow levelsindicate metabolic acidosisBUN (Blood Urea Nitrogen)6-20 mg/dL (2.1 – 7.1 mmol/L)Measures the concentration of urea in the blood. Urea concentration is regulated by renal excretionIncreased levelsmay be due to dehydration and/or renal impairment. A less common cause is GI bleeding due to digestion of protein in the