EP 224: Should I Become a a Nurse Practitioner?

EP 224: Should I Become a a Nurse Practitioner?

Becoming a Nurse Practitioner

Are you a registered nurse (RN) with a Bachelor of Science in Nursing (BSN) looking to take your career to the next level? If so, becoming a nurse practitioner (NP) might be the ideal path for you. In this blog post, we will explore the journey of becoming a nurse practitioner, comparing the different routes available, discussing the financial aspects, and highlighting the increased autonomy that comes with this advanced nursing role.

Exploring Specializations: Different Types of Nurse Practitioners

As a nurse practitioner, you have the opportunity to specialize in various areas of healthcare, tailoring your expertise to specific patient populations and healthcare needs. Here are some common types of nurse practitioners:

  • Family Nurse Practitioner (FNP): 
      1. FNPs provide primary care across the lifespan, from newborns to older adults. They diagnose and treat common acute and chronic conditions, offer preventive care, perform routine check-ups, and collaborate with other healthcare professionals to promote overall wellness.
  • Adult-Gerontology Nurse Practitioner (AGNP): 
      1. AGNPs specialize in the care of adults, including young adults, middle-aged adults, and older adults. They manage acute and chronic illnesses, conduct health assessments, and focus on health promotion, disease prevention, and management of age-related conditions.
  • Pediatric Nurse Practitioner (PNP): 
      1. PNPs focus on delivering primary care to infants, children, and adolescents. They provide well-child exams, immunizations, and developmental screenings, and manage common pediatric illnesses and conditions. PNPs play a crucial role in promoting children’s health and supporting families.
  • Psychiatric-Mental Health Nurse Practitioner (PMHNP): 
      1. PMHNPs specialize in mental health and psychiatric care across the lifespan. They assess, diagnose, and manage mental health disorders, prescribe medications, provide therapy, and collaborate with interdisciplinary teams to promote mental well-being.
  • Women’s Health Nurse Practitioner (WHNP): 
      1. WHNPs specialize in women’s health, including reproductive health, gynecological care, prenatal care, family planning, and menopausal management. They conduct screenings, offer health education, and provide comprehensive care to women throughout their lifespan.
  • Acute Care Nurse Practitioner (ACNP): 
      1. ACNPs are trained to manage acute and critical illnesses in various settings, such as emergency departments, intensive care units, and specialty clinics. They provide complex care, perform procedures, order and interpret diagnostic tests, and collaborate with other healthcare professionals in emergency situations.
  • Neonatal Nurse Practitioner (NNP): 
      1. NNPs specialize in the care of newborn infants, particularly those who are premature, critically ill, or have complex medical conditions. They provide comprehensive care, perform procedures, monitor growth and development, and support families in neonatal intensive care units (NICUs) and other neonatal settings.
  • Geriatric Nurse Practitioner (GNP): 
    1. GNPs focus on the specialized needs of older adults, including managing chronic illnesses, promoting healthy aging, and addressing age-related issues. They work in various settings, including long-term care facilities, assisted living centers, and geriatric clinics.

Different Routes to Becoming a Nurse Practitioner

Aspiring nurse practitioners have multiple paths to choose from based on their prior education and experience. The two main routes are:

  • Master of Science in Nursing (MSN): This is the most common and traditional path for becoming an NP. It typically requires two to three years of additional education beyond the BSN degree. MSN programs offer specialized tracks such as Family Nurse Practitioner (FNP), Adult-Gerontology Nurse Practitioner (AGNP), Pediatric Nurse Practitioner (PNP), and more.
  • Doctor of Nursing Practice (DNP): This is a terminal degree in nursing and provides the highest level of education for NPs. DNP programs typically take three to four years to complete, with an emphasis on advanced clinical skills, leadership, and evidence-based practice.

Financial Considerations

When considering the financial aspect of becoming a nurse practitioner, it’s important to factor in the cost of tuition and the potential pay increase. The average tuition for an MSN program ranges from $20,000 to $60,000, depending on the institution and location. On the other hand, DNP programs can cost between $30,000 and $100,000. While these figures may seem significant, it’s essential to remember that many nurses qualify for financial aid, scholarships, and loan forgiveness programs.

Pay Increase and Professional Growth

One of the most compelling reasons to pursue a career as a nurse practitioner is the potential for a substantial pay increase compared to an RN with a BSN. According to the Bureau of Labor Statistics, the median annual wage for nurse practitioners was between $115,890 and $135,677 significantly higher than the median wage for registered nurses. Moreover, NPs have greater opportunities for advancement, specialization, and leadership roles within the healthcare system.

Autonomy and Expanded Scope of Practice

Transitioning from an RN to an NP brings an increase in autonomy and a broader scope of practice. NPs are trained to assess, diagnose, and treat patients, order and interpret diagnostic tests, prescribe medications, and provide comprehensive care. While they work collaboratively with physicians, NPs often have more independence in managing patient care, particularly in primary care settings and underserved areas where access to physicians may be limited.

Duration of Schooling

The length of time required to become a nurse practitioner depends on the educational path chosen. MSN programs generally range from two to three years, while DNP programs typically require three to four years. It’s important to consider personal circumstances, such as work commitments and family obligations, when deciding which path is most feasible.

Conclusion

Becoming a nurse practitioner is an excellent way to advance your nursing career, enhance your earning potential, and gain more autonomy in patient care. Whether you choose the MSN or DNP route, embarking on this journey will provide you with the necessary skills and knowledge to make a lasting impact on the lives of your patients. By exploring the various types of nurse practitioners, you can find a specialized area that aligns with your passion and contributes to the health and well-being of individuals and communities. So, if you’re ready to embrace the challenges of an advanced nursing role and make a significant difference in the world of healthcare, becoming a nurse practitioner may be the right path for you.

Remember, your journey as a nurse practitioner is not just a step forward; it’s a leap toward making a significant difference in the lives of individuals and communities.

Watch the full episode: https://youtu.be/Ad4ffRlvIac

EP 223: Is Nursing Worth it

EP 223: Is Nursing Worth it

Is Nursing a Good Career Choice?

The short answer is yes for new nurses joining the field and current nurses. Nursing is still worth it and is a great career choice. It’s easy for us to look back and think, has nursing been the right choice? I’ll offer you some insight, everyone has those thoughts at some point in their career. Everyone eventually asks themselves the same question because the expectations don’t always meet the realities. What you thought you signed up for is there but with a lot of extras and long hard hours. No matter what field you enter you’re going to have to work hard to make something of it, there isn’t a perfect professional where you do everything you like. Nursing adds a very unique perspective to almost everything in life from relationships to finance. Below are some of the reasons I entered nursing and the benefits it brought me. 

Financial Benefits of Nursing

Nursing can bring you anywhere from $65,000 to $110,000 depending on state and experience. To be honest, that doesn’t seem like a lot but at the same time, it does. When you compare it to the median middle-class household income in the US is about $70,000, it is a very good career choice. The higher pay lies in staff nursing as it is in the highest demand and most abundant position. The most money in nursing is travel nursing but that requires moving around from place to place which is a little more stressful and harder. 

From a financial standpoint of you get your BSN or currently have it, you are in a good place in life. You are automatically positioned in the middle class right out of school and you have a really good cushion if you don’t make a series of bad choices. The financial beauty of nursing is you have a middle-class cushion, which means even if you don’t pursue anything else you will be well off but also if you do try something different and it doesn’t work out you can still fall back on nursing. 

Overtime and shift differentials

What’s really nice about nursing is that you get paid based on shifts and also hourly. Some jobs do have salaries but it doesn’t always equate to the time you put in. For nursing, the time you put in is the time you get paid for, you can view it as a pro or con but I see it as the best for nurses to get paid.

That being said, you can maximize your pay if you are ok with working the night or evening shift. It is a little rough but if you get used to it, you can make a couple hundred dollars more a week. Weekends are also paid more which is nice because you have to work every other. 

Overtime is always an option in nursing because in most places it it offered every day of the week This is nice because you can pick up whenever you want. If you want to make some more money you can pick up an extra day every month. In your typical job this would be hard because most have a 40hr week where it’s 9-5, but nurses have the luxury of 3×12 which makes for a long shift but also a longer week. You have about 4 days off, if you are complaining about money there is no reason you cannot pick up 1 or 2 days a month. 

One thing to watch out for is tax. You need to pay attention to how your income gets taxed because it might not be financially worth it to jump to the next tax bracket. Income tax levels can change every year so always keep an eye because it looks nice making more money but if a good chunk of that will be going to the taxman you’re better off spending time doing something else. As a nurse, you’re most likely going to get taxed at the 22% level and it would take you quite a bit of work to get to the 24% level and even more to get higher.

Job Security

Nursing is a healthcare field people will be getting sick forever. One financial benefit of this is that no matter where the economy goes no matter how many banks fail you will always have a job. No matter what happens you can always make an income. People will always be going to the hospital, people will always die, and people will always be born. In emergent times like we’ve seen over the last couple of years your job is in even higher demand. The unfortunate but positive thing is that nurses make more during emergencies. 

Career Advancement

There are a handful of administrator roles in nursing, nursing educator, assistant manager, and Clinical nurse specialist are just a few. They do require a graduate degree which has 2+ years of added school but it is worth it if you are trying to move up into a nurse leadership position. 

Nurse practitioners and Nurse anesthetists are also very popular fields to enter. They are the most-paid positions when it comes to being more hands-on in the clinical setting. With these careers, you are in over the $100,000 range when it comes to income. 

Going to school for an extra 2 to 3 years is worth it because it can bring you anywhere from $20,000 to$100,000 more a year. I understand this isn’t for everyone and it is completely fine if you just want to get your BSN. Regardless of what you choose, just having the BSN sets you up for success.

Watch the full episode

EP 222: Being a Male Nurse

EP 222: Being a Male Nurse

Men in Nursing

In recent years, the nursing profession has witnessed a notable shift in gender dynamics, with more men choosing to pursue careers in nursing. This increasing diversity brings new perspectives, challenges, and opportunities to the field. In this blog post, we will delve into the experiences of male nurses, shedding light on their unique journey, the benefits they bring to healthcare, and the obstacles they may encounter along the way.

The Rise of Male Nurses

Breaking free from long-standing stereotypes, more men are opting for nursing careers than ever before. Despite the historical perception of nursing as a female-dominated profession, men are drawn to the field for various reasons. These reasons include job stability, flexibility, the opportunity to make a difference in patient care, and the chance to challenge traditional gender roles.

The Impact of Gender Diversity in Nursing

The presence of male nurses contributes to a more balanced and diverse healthcare workforce, benefiting patients, colleagues, and the profession as a whole. Gender diversity in nursing brings unique perspectives, experiences, and skills, enriching the delivery of care. Male nurses often offer different approaches to patient interactions, collaboration, and problem-solving, fostering a more comprehensive and well-rounded healthcare environment.

Challenges Faced by Male Nurses

While progress has been made, male nurses may encounter various challenges throughout their careers. These challenges can stem from societal biases, misconceptions, and ingrained gender roles. Patient perceptions, acceptance from colleagues, and career advancement opportunities can be influenced by preconceived notions of what a nurse should look like or be. Overcoming these obstacles requires resilience, self-advocacy, and continuous efforts to promote inclusivity and gender equality.

Navigating Stereotypes and Patient Perceptions

Male nurses may face initial skepticism or surprise from patients who are accustomed to seeing female nurses. It is essential to actively dispel stereotypes and build trust by providing compassionate, skilled, and patient-centered care. By demonstrating expertise, empathy, and professionalism, male nurses can overcome initial biases and establish strong connections with their patients.

Emotional Balance and Leadership in Nursing

In the nursing profession, the ability to strike a balance between emotions and objectivity is essential for providing optimal patient care. While both men and women possess emotional intelligence, some argue that men’s perceived inclination toward being less emotional can offer unique advantages in certain nursing scenarios and leadership roles.

Emotional Resilience in Challenging Situations

Nursing can be emotionally demanding, with healthcare professionals often encountering distressing situations. Male nurses, who may be perceived as less emotional, can sometimes bring a sense of emotional stability to these high-pressure environments. Their ability to remain calm and composed during critical moments can help create a reassuring presence for patients, families, and colleagues.

Objective Decision-Making

Being less emotional does not mean lacking empathy or compassion. Instead, it can allow male nurses to approach decision-making with a heightened sense of objectivity. This ability to detach emotionally, when necessary, can facilitate clearer thinking and more balanced judgment in complex healthcare situations. It enables them to assess situations from multiple angles and make well-informed decisions that prioritize patient safety and well-being.

Leadership and Conflict Resolution

Leadership roles within nursing require individuals to navigate interpersonal dynamics, resolve conflicts, and make difficult decisions. Men, who may face societal expectations of being assertive and confident, can leverage these attributes to take on leadership responsibilities effectively. Their ability to remain level-headed in challenging situations and communicate with clarity can contribute to cohesive teamwork, effective problem-solving, and positive outcomes for both patients and healthcare teams.

Conclusion

The growing number of men in nursing is transforming the profession, offering fresh perspectives, challenges, and opportunities. While male nurses may encounter biases and stereotypes, they possess the resilience to navigate these hurdles. Their ability to provide emotional stability in demanding situations and make objective decisions contributes to excellent patient care. Furthermore, their leadership qualities foster effective teamwork and positive outcomes. Embracing the contributions of male nurses enhances diversity and fosters an inclusive healthcare environment for all.

Watch the full episode

EP 221: How ChatGPT Will Affect Nursing and Healthcare

EP 221: How ChatGPT Will Affect Nursing and Healthcare

How AI will affect nursing and Healthcare

Have you wondered how far can AI go? Or how useful can AI bots like ChatGPT be? Chatgbt has been on the rise, it surpassed 1 million users within 5 days of launch setting the record for quickest user growth. It surpassed online services like Instagram, Netflix, Facebook, Spotify, and Twitter it blew them out of the water as Instagram took second place with 2.5 months.

Currently, ChatGPT has over 100 million users and about 1 billion visits a day with 15% of its users being Americans. This isn’t just a national occurrence, but a global phenomenon. It’s only a matter of time before ChatGPT and other AI systems will start to have a big impact on healthcare. 

If you haven’t tried out ChatGPT I highly recommend you try it. ChatGPT is a Google search engine on steroids where you can ask the AI any question. You can have it write you a Haiku, proofread your paper, have a conversation, or even just look something up.

ChatGPT and Healthcare

What impact can this have on healthcare? Have you ever used doctor google? Chatbots have been shown they can generally answer medical questions and can generally pass medical exams most of the time. But people feel put of by putting their trust in software. One of the world’s most popular doctors with a random success rate. The redness on your skin can be either an irritation or straight-up cancer, doctor google is easy and convenient but most of the time it just doesn’t give you what you’re looking for when it comes to getting a quick idea of what your medical issue is. 

  • Every minute 70,000 inquiries get answered by dr google
  • 89% of people google their symptoms before asking their doctor
  • Google gets about 1 billion health questions a day
  • 40% of people use Google instead of a doctor

Often when you go see your doctor or go to the ED you get asked to explain what exactly happened and how you feel. What the medical professionals are trying to do is to get as much information as possible to make as best prediction about what is going on. The more you put in the search bar the better the results are going to be. 

Why ChatGPT is going to surpass Google

We live in a high pace society we thrive on speed. Whatever gets us what we want the quickest wins 99% of the time, we don’t like to wait. Let’s take a look at the history of the search. 

  • Before the telephone, if you wanted to find something out you’d have to look through an encyclopedia or newspaper, or have to know someone.
  • Once telephones became more common you were able to call specialists or people that may be able to answer your question from home.
    • We went from having to go to places to being able to ask from home.
  • Then came cellphones and internet search, meaning you can call anyone whenever and physically search the web for answers.
  • Now we have cellular internet and search engines meaning you can look up anything, anytime, and anywhere.

ChatGPT takes search to a whole new level. Instead of having to look through multiple Google recommendations to find what you are looking for, you are presented with the answer in the same window. If you want more information all you have to do is ask more expanding questions. It uses fewer clicks as it searches for you and gives you the best answer. It is the fastest way to get an answer to your question. 

Impact on nursing students

ChatGPT can be used as a resource for nursing students. It can answer questions, multiple choice, and regular responses. Multiple choice works better as there are options to choose from whereas asking general questions gives you multiple options and their rationale. Take it with a grain of salt because it does answer some basic questions wrong. It would be a better idea to use it more for rationale and explanations. 

ChatGPT’s Impact on Healthcare

Why do most people not like going to the doctor? The 2 main reasons are fear and embarrassment. People just do not like talking about their personal medical/health life.

  • The fear associated with the doctor’s office, hospitals, or medical procedures is one of the reasons people don’t go to the doctor. They may be reluctant to seek medical care or even routine procedures. They also fear that they might get hit with “bad news”.
  • Embarrassment is another reason people do not like to visit their doctor. People do not like to get asked direct questions about their bowel habits, sexual activity, or lifestyles. Some feel embarrassed about the physical and other exams. Some people have a history of trauma and it is hard for them to feel vulnerable. 

Fear and embarrassment are hard things to conquer. That is exactly why people would rather google what they are going through instead of seeking help from a doctor. 

There was a john hopkins study that compared the chatGPT medical responses to that of doctors. The results were very interesting. The questions that were asked were “Will the toothpick I swallowed kill me? How big a deal is the lump I got on my head after running into a metal bar?” 

  • 80% of the participants preferred the ChatGPS response over the doctors. The responses were accurate and of higher quality. 
  • They viewed ChatGPT as more empathetic and had a longer explanation.
    • For example, the chatbot’s answer to that toothpick question begins, “It’s natural to be concerned if you have ingested a foreign object, but in this case, it is highly unlikely that the toothpick you swallowed will cause you any serious harm.”
    • The real doctor wrote, “If you’ve surpassed 2-6 h, chances are they’ve passed into your intestines.”
    • The doctor went on to write 58 words in total, while the chatbot’s answer was more than three times as long at 191 words.
    • https://www.thebaltimorebanner.com/community/public-health/chatgpt-answers-medical-questions-X7TC7UUU5ZFWTIPCVTG4UZGDWM/ 

AI and diagnostics

AI algorithms are currently being used to help lead diagnosis and treatment. AI algorithms can analyze medical images like xrays, ultrasounds, CT scans, and MRIs and help identify and diagnose diseases more accurately and quickly. 

You have an algorithm and software that can almost instantaneously compare what is going on in an image to all the different possibilities. Instead of having to rely on multiple physicians, using AI speeds up the process. You have all the ideas to cross reference to what is seen in the image compared to a handful of brains in the room. Something to consider is the accuracy of these AI systems. Remember people have off days, they miss certain thinkings, fatigue is a factor, and all other flaws that make us human. These are computing machines. They are more consistent than humans. 

There is a downfall of it “looking outside the box” but for standard diagnoses that are easier to spot AI can be very helpful. Even when it comes to more rare types of issues the Power of AI can help with the results

Watch the full episode: https://youtu.be/Cl5IAd65NAI

EP 201: Lab Values to Know as a Nurse

EP 201: Lab Values to Know as a Nurse

Lab Values to Know as a Nurse

What are the lab values to know as a nurse? Lab values and what they show could mean so many things. They are used to determine the patient’s overall well-being and health and on nurses to base their care plan.

Different factors affect the patient’s lab values result, but the most common factors affecting it are the patient’s age, race, gender, medical history, and presence of any underlying conditions. Knowing and understanding lab values is essential in your nursing career.

There are different lab values to know as a nurse. In this episode, we will talk about all the different labs we look at in the hospital. We will go over their normal values, what they signify, and what can happen if they are out of their normal range.

This will be a good refresher episode for everyone who deals with labs and a great one for any nursing students because these are the labs you’ll need to know to pass some of your classes and the NCLEX.

Electrolytes

Potassium K+

  • Potassium is one of the most important minerals in the body. It helps regulate fluid balance, muscle contractions, and nerve signals. 
  • Normal level: 3.5-5 mEq/L
    • Hyperkalemia signs: heart arrhythmias, numbness, and tingling, breathing problems
    • Hypokalemia signs: muscle weakness, fatigue, heart arrhythmias
  • Clinical problem
    • Increased level: Acute renal failure, Crushed/burn injury, acidosis 
    • Decreased level: vomiting/diarrhea, dehydration, malnutrition, gastric suction, Diuretics 

Sodium Na+ 

  • Sodium plays a key role in your body. It helps maintain normal blood pressure, supports the work of your nerves and muscles, and regulates your body’s fluid balance.
  • Normal level: 135-145 mEq/L
    • Hypernatremia signs: lethargy, myoclonic jerks, confusion, nystagmus, tachycardia
    • Hyponatremia  signs: nausea and vomiting, lethargy, seizure, neurological deficits
  • Clinical problem
    • Increased level: Dehydration, severe vomiting, diarrhea, Heart failure, hepatic failure, Cushing’s disease 
    • Decreased level: vomiting, diarrhea, gastric solution, D5W, SIADH,

Calcium Ca+ 

  • It is a mineral that is necessary for life. In addition to building bones and keeping them healthy, calcium enables our blood to clot, our muscles to contract, and our heart to beat. About 99% of the calcium in our bodies is in our bones and teeth.
  • Normal level: 8.5 to 10.2 mg/dL
    • Hypercalcemia signs: bone pain, muscle weakness, excessive thirst, lethargy, nausea
    • Hypocalcemia signs: numbness and tingling in digits, muscle cramps, wheezing, fatigue
  • Clinical problem
    • Increased level: Hyperparathyroidism, malignant neoplasm of bone, lung, breast, kidney, multiple myeloma, and prolonged immobilization. 
    • Decreased level: Diarrhea, malabsorption of calcium, Hypoparathyroidism

Chloride CI- 

  • Chloride is one of the essential electrolytes in the blood. It helps keep the amount of fluid inside and outside of your cells in balance. It also helps maintain proper blood volume, blood pressure, and pH of your body fluids.
  • Normal level: 95-105 mEq/L
    • Hyperchloremia signs: diarrhea, vomiting, fatigue, dry mucous membrane
    • Hypochloremia signs: diarrhea, vomiting, weakness, dehydration
  • Clinical problem
    • Increased level: Dehydration, hypernatremia, head injury, metabolic acidosis.  
    • Decreased level: Vomiting, gastric suction, diarrhea, hypokalemia. 

Magnesium Mg+

  • It helps to maintain normal nerve and muscle function, supports a healthy immune system, keeps the heartbeat steady, and helps bones remain strong. It also helps adjust blood glucose levels. It aids in the production of energy and protein.
  • Normal level: 1.5-2 mEq/L
    • Hypermagnesemia: diminished deep tendon reflexes, flushing, headache, nausea, drowsiness.
    • Hypomagnesemia: muscle weakness, twitches, or tremors; irritability, insomnia, drowsiness
  • Clinical problem
    • Increased level: Severe dehydration, renal failure, leukemia
    • Decreased level: Protein malnutrition, malabsorption, cirrhosis of the liver, alcoholism, hypokalemia

Phosphorus 

  • It is a mineral that makes up 1% of a person’s total body weight. It is the second most abundant mineral in the body. It is present in every cell of the body. Most of the phosphorus in the body is found in the bones and teeth.
  • Normal level: 2.5-4.5 mg/dl
    • Hyperphosphatemia signs: osteoporosis, cardiovascular disease
    • Hypophosphatemia signs: changes in mental state, bone pain/fragility, fatigue, weight loss, weakness
  • Clinical problem
    • Increased level: Renal failure, hypocalcemia, hypoparathyroidism 
    • Decreased level: starvation, hypercalcemia, hypomagnesemia, chronic alcoholism

Ammonia

  • Ammonia is a waste product made by your body during protein digestion.
  • Normal level: 15-50 μmol/L
    • Hyperammonemia signs: Lethargy (ETOH Pt), rapid or heavy breathing, Altered mental status 
  • Clinical problems
    • Increased level: Hepatic failure, High protein diet with liver failure, acidosis. 

Uric acid 

  • It is a chemical created when the body breaks down substances called purines.
  • Purines are usually produced in the body and are also found in some foods and drinks.
  • Normal level 0.18-0.48 mmol/L
    • High signs: Joint pain, joint stiffness, redness, and swelling. 
  • Clinical problems
    • Increased level: Gout, alcoholism, severe eclampsia, renal failure

Creatinine

  • Creatinine is a waste product produced by muscles from the breakdown of a compound called creatine. It is removed from the body by the kidneys.
  • Normal level 0.8-1.3 mg/dL
    • High signs: Nausea, muscle cramps, vomiting, fatigue, HTN
  • Clinical problem
    • Increased level: Hypothyroidism, CKD, intense exercise, dehydration 
    • Decreased level: Renal impairment, hyperthyroidism, ALS

BUN 

  • BUN is the end product of protein metabolism and is excreted by the kidneys
  • Normal level 8-21 mg/dL
    • High signs: Frequent urination, itching, muscle cramps, fatigue. 
  • Clinical problem
    • Increased level: Dehydration, GI bleeding, prerenal failure, Acute MI, sepsis, shock
    • Decreased level:  Severe liver damage, overhydration, malnutrition

Specific Gravity

  • A urine-specific gravity test compares the density of urine to the density of water. This quick test can help determine how well your kidneys dilute your urine.
  • Normal level 1.010-1.030 
    • High signs: Dehydration, Diabetes, Proteinuria, SIADH
    • Low signs: Polydipsia, Diabetes Insipidus, Diuretics, early stages of CKD

LDH 

  • Lactic dehydrogenase (LDH) is an intracellular enzyme in nearly all metabolizing cells, with the highest concentration in the heart, skeletal muscle, liver, kidney, brain, and RBCs.
  • Normal level 50-150 U/L
    • Increased level: Acute MI, P.E, Sepsis, shock, CVA, sickle cell.

Hematology

RBC 

  • The reticulocyte count is an indicator of bone marrow activity
  • Normal level 4.5-5.0 million
    • Increased level: sickle cell, hemolytic anemia, leukemias 
    • Decreased level: Anemia, radiation therapy, post hemorrhage, cirrhosis of the liver (alcohol suppresses reticulocytes)

WBC 

  • White blood count, part of a complete blood count, is composed of 5 types of WBCs 
  • Normal level 5,000-10,000
    • Increased level: Acute infection, Inflammatory diseases (RA, gout), Tissue damage (acute MI, burns)
    • Decreased level: leukemias, immunosuppressive agents

Plt 

    • Platelets (thrombocytes) are essential elements in the blood that promote coagulation.
  • Normal level 200,000-400,000
    • Increased level: Polycythemia vera, trauma, acute blood loss, Metastatic carcinoma
    • Decreased level: Multiple myeloma, Anemias, Leukemias, liver disease, lupus, DIC, Cirrhosis 

Hgb 

  • Hemoglobin responsible for the transportation of oxygen
  • Normal level 
    • male 13-17 g/dL
    • female 12-15 g/dL
  • Increased level: Dehydration, polycythemia, COPD, HF, severe burns
  • Decreased level: Anemias, Hemorrhage, cirrhosis of the liver, Leukemias, Hodgkin’s disease, kidney disease

Hematocrit 

  • The hematocrit is a ratio of the volume of red blood cells to the volume of all these components, called whole blood. The value is expressed as a percentage or fraction.
  • Normal level Male 40%-52% Female 36%-47%
    • Increased level: Dehydration/hypovolemia, severe diarrhea, diabetic acidosis, burns.
    • Decreased level: Acute blood loss, anemias, RA, lupus, CKD, cirrhosis

PTT 

  • Partial thromboplastin time (PTT) is a blood test that looks at how long it takes for blood to clot. It can help tell if you have a bleeding problem or if your blood doesn’t clot properly.
  • Normal level 25-35 sec.  If on Heparin 1.5-2.5x normal
    • Increased level: Hemophilia, cirrhosis, vitamin k deficiency, Von Willebrand disease, DIC. 

PT 

  • Prothrombin Time. It is synthesized by the liver and is an inactive precursor in the clotting process.  
  • Normal level 11- 14 sec
    • Increased level: Liver disease, Clotting factor issues (Factor 2 deficiency), Heart failure, leukemias
    • Decreased level: Thrombophlebitis, MI, P.E 

INR 

  • The international normalized ratio (INR) is a laboratory measurement of how long it takes blood to form a clot. It is made to monitor patients receiving warfarin. 
  • Normal level 0.9-1.2 If on Coumadin 1.5 – 3

Reticulocytes

  • Reticulocytes are immature red blood cells (RBCs).
  • Normal range  0.5-1.5%

Neutrophils 

  • Are the most numerous circulating WBCs, respond mainly to inflammation & tissue injury.
  • Normal range 2-8 x 10^9/L

Bands 

  • Basophils increase during the healing process
  • Basophils are white blood cells that defend your body from allergens. Basophils release histamine
  • Normal Range < 1 x 10^9/L

Lymphocytes 

  • Increased during chronic and viral infections
  • Normal range 1-4 x 10^9/L

Monocytes 

  • The second line of defense. More extensive and more substantial than neutrophils can ingest large particles and debris.
  • Normal range 0.2-0.8 x 10^9/L

Eosinophils 

  • Increase during allergic and parasitic conditions 
  • Normal level < 0.5 x 10^9/L

HBA1C 

  • The hemoglobin A1c test tells you your average blood sugar level over the past 2 to 3 months. It’s also called HbA1c, glycated hemoglobin test, and glycohemoglobin.
  • Normal level <6.5%

Glucose 

  • Simple sugar is used as an energy source and is stored as glycogen in the liver and skeletal muscles.
  • Normal level 70-110 mg/dL
    • Increased level: DM, Diabetic acidosis, adrenal gland hyperfunction (Cushing’s) 
    • Decreased level: Hypoglycemia, malnutrition

Gastrointestinal

Bilirubin

  • Bilirubin is formed from the breakdown of hemoglobin by the reticuloendothelial system and is carried in the plasma to the liver. Bilirubin (unconjugated or indirect) is bound to serum albumin and transferred to the liver, which is conjugated to glucuronate by glucoronyl transferase. Conjugated (direct) bilirubin is excreted into the bile.
  • Normal level 
    • Direct Bilirubin 0-6 µmol/L 
    • Total Bilirubin 2-20 µmol/L
  • Increased level: Obstructive jaundice caused by stones, hepatitis, cirrhosis, liver cancer
  • Decreased level: Iron-deficiency anemia. 

Albumin 

  • Albumin is a protein made by your liver. Albumin helps keep fluid in your bloodstream so it doesn’t leak into other tissues. It also carries various substances throughout your body, including hormones, vitamins, and enzymes.
  • Normal level 35-50 g/L
    • Increased level: Dehydration, severe vomiting, severe diarrhea 
    • Decreased level: Cirrhosis of the liver, acute liver failure, severe burns, severe malnutrition, preeclampsia, renal disorders, prolonged immobilization. 

ALT/AST

  • ALT/AST is an enzyme found primarily in the liver cells and is effective in diagnosing hepatocellular destruction.
  • Normal level 5-30 U/L
  • Increased level: Acute (viral) hepatitis and liver necrosis (Drug or chemical toxicity).

Amylase 

  • Amylase is an enzyme derived from the pancreas, the salivary glands, and the liver. Its function is to change starch to sugar. 
  • Normal level: 30-125 U/L
  • Increased level: Acute pancreatitis, obstruction of the pancreatic duct, acute cholecystitis, diabetic acidosis, diabetes mellitus, renal failure. 

Lipase 

  • Lipase, an enzyme secreted by the pancreas, aids in digesting fats. Appears in the bloodstream following damage to the pancreas. 
  • Normal level: 10-150 U/L
  • Increased level: Acute and chronic pancreatitis, cancer of the pancreas, and obstructions. 

Hormones

Hydroxyprogesterone 

  • IHydroxyprogesterone is a hormone made by the adrenal glands, two glands on top of the kidneys. A 17-OHP test is used for Hydroxyprogesterone levels to help diagnose a rare genetic disorder called congenital adrenal hyperplasia.
  • Normal level: 0.2-1 mg/L

Adrenocorticotropic ACTH 

  • Adrenocorticotropic hormone (ACTH) is made in the pituitary gland. It is needed for your adrenal glands to work properly and help your body react to stress. ACTH stimulates the release of another hormone called cortisol from the adrenal gland’s cortex (outer part).
  • Normal level: 4.5-20 pmol/
  • Increased level: Addison’s disease, Stress, pituitary neoplasm, pregnancy. 
  • Congenital adrenal hyperplasia (CAH) refers to a group of genetic disorders that affect the adrenal glands, a pair of walnut-sized organs above the kidneys. The adrenal glands produce essential hormones, including Cortisol, which regulates the body’s response to illness or stress.

TSH 

  • Thyroid-stimulating hormone is a pituitary hormone that stimulates the thyroid gland to produce thyroxine (T3), and triiodothyronine (T4)  which stimulates the metabolism of almost every tissue in the body.
  • Normal level: 0.5-5 mIU/L
  • Increased level: Hypothyroidism, acute thyroiditis, viral hepatitis, myasthenia gravis, preeclampsia
  • Decreased level: Hyperthyroidism

Thyroxine

  • Serum T4 levels are commonly used to measure thyroid hormone concentration and the function of the thyroid gland. 
  • So, if your T3 and T4 levels are too low, the pituitary gland will release more TSH. If they’re too high, the gland will release less TSH — but this give-and-take system only works if everything functions properly.
  • Normal level:
    • Free T3 0.2-0.5 ng/dL
    • Free T4 10-20 pmol/L
    • Total T4 4.9-11.7 mg/dL
    • Total T3 0.7-1.5 ng/dL
  • Increased level: Hyperthyroidism, acute thyroiditis, myasthenia gravis, preeclampsia
  • Decreased level: Hypothyroidism, Protein malnutrition.

Follicle-stimulating hormone 

  • FSH, a gonadotropic hormone produced and controlled by the pituitary gland, stimulates the growth and maturation of the ovarian follicle to produce estrogen in females and promote spermatogenesis in males. 
  • Normal level:
    • (FSH) 1-10 IU/L (M/F) 
    • 5-25 IU/L (ovulation) 
    • 30-110 IU/L (postmenopause)
  • Increased level: Gonadal failure such as menopause, Pituitary tumor, Turner’s syndrome, Klinefelter’s syndrome 
  • Decreased level: Neoplasms of the ovaries, testes, adrenal: polycystic ovarian disease, hypopituitarism; anorexia nervosa. 

Growth Hormone 

  • Human growth hormone (hGH), a hormone from the anterior pituitary gland, regulates the growth of bone and tissue. 
  • Normal level: (fasting) 0-5 ng/m
  • Increased level: Gigantism (children), Acromegaly (adults), major surgery. 
  • Decreased level: dwarfism in children, hypopituitarism

Progesterone 

  • It is secreted by the corpus luteum, a temporary endocrine gland that the female body produces after ovulation during the second half of the menstrual cycle.
  • Normal level 70-280 ng/dL
  • Increased level: Ovulation, pregnancy, ovarian cysts, tumors of the ovary or adrenal gland. 
  • Decreased level: Gonadal dysfunction, luteum deficiency, threatened abortion, placental failure.

Prolactin 

  • It is a hormone produced by your pituitary gland, which sits at the bottom of the brain. Prolactin causes breasts to grow and develop and causes milk to be made after a baby is born. 
  • Normal level: < 14 ng/mL
  • Increased level: Pregnancy, breastfeeding, pituitary tumor, amenorrhea, hypothalamic disorder, endometriosis, chronic renal failure, Addison’s disease.
  • Decreased level: Postpartum pituitary infarction

Testosterone (male):  

  • Testosterone is the primary male sex hormone and an anabolic steroid. In male humans, testosterone plays a crucial role in developing male reproductive tissues such as the testes and prostate and promoting secondary sexual characteristics such as increased muscle and bone mass and body hair growth.
  • Normal level: 10-25 nmol/L
  • Increased level: Adrenal hyperplasia or tumor, polycystic ovaries in females
  • Decreased level: Testicular hypofunction, Klinefelter’s syndrome (primary hypogonadism), Alcoholism, hypopituitarism

Lipids

LDL 

  • LDL stands for low-density lipoproteins. It is sometimes called the “bad” cholesterol because a high LDL level leads to a buildup of cholesterol in your arteries.
  • Normal level: 85-125 mg/dL
  • Saturated fat and cholesterol in your food make your blood cholesterol level rise.

HDL 

  • HDL stands for high-density lipoproteins. It is sometimes called the “good” cholesterol because it carries cholesterol from other parts of your body to your liver. Your liver then removes the cholesterol from your body.
  • Normal level: 40-80 mg/dL

Triglycerides 

  • Triglycerides are a type of fat (lipid) found in your blood. When you eat, your body converts any calories it doesn’t need to use right away into triglycerides. The triglycerides are stored in your fat cells.
  • Normal level: 50-150 mg/dL
  • Increased level: Hyperlipoproteinemia, acute MI, Hypertension, cerebral thrombosis, hypothyroidism
  • Decreased level; Hyperthyroidism, hyperparathyroidism, and protein malnutrition.

Total chol 

  • A measure of the total amount of cholesterol in your blood. It includes low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol.
  • Normal level: 3-5.5 mmol/L

Cardiac Markers

Creatine kinase

  • Creatine kinase is an enzyme found in the heart, brain, skeletal muscle, and other tissues. Increased amounts of CK are released into the blood when there is muscle damage. 
  • Normal level:  25-200 U/L
  • Increased level: exercise and inflammation of muscles, called myositis, and myopathies such as muscular dystrophy. Rhabdomyolysis.

Troponin 

  • Troponins are a group of proteins found in skeletal and heart (cardiac) muscle fibers that regulate muscular contraction—used for cardiac disease diagnosis of acute MI.
  • Normal level: 0-0.4 ng/mL
  • Increased level: MI, myocardial damage

C-reactive protein 

  • It is produced in the liver in response to tissue injury and inflammation. 
  • Normal level < 5 mg/L
  • Increased level: Chronic infections, cardiovascular and peripheral disease, acute MI, Stroke, inflammatory bowel disease, RA, Lupus, bacterial meningitis.

D-dimer 

  • D-dimer is a fibrin degradation product, a small protein fragment in the blood after a blood clot is degraded by fibrinolysis.
  • Normal level: < 500 ng/mL
  • Increased level: DIC, P.E, Thrombosis, COVID 

BNP

  • Brain Natriuretic peptide is a neurohormone secretion primarily in the cardiac ventricles and will increase in response to volume expansion and pressure overload.
  • Normal level:  < 100 pg/ml
  • Increased level: Heart failure, Left ventricular hypertrophy, myocarditis, AMI, Renal failure, prolonged systemic hypertension.

Tumor Markers 

Alpha-fetoprotein 

  • Serum alpha-fetoprotein (AFP), a screening test, is usually done between 16 and 20 weeks gestation to determine the probability of twins or to detect low birth weight or severe birth defects, such as neural-tube defects. 
  • Normal level: 0-44 ng/mL
  • Increased level: Cirrhosis of the liver, hepatitis, Spina bifida, Fetal death, fetal distress, Turner’s syndrome
  • Decreased level: Down’s syndrome, absence of pregnancy

HCG 

  • Human chorionic gonadotropin is a hormone produced by cells that surround a growing embryo, which eventually forms the placenta after implantation. The presence of hCG is detected in some pregnancy tests. Appears in the blood and urine 14-26 days after conception.
  • Normal level: <5 IU/I
  • Increased level: Pregnancy, Chorionepithelioma of pregnancy is a malignant tumor originating in connection with pregnancy. 
  • Decreased level: Nonpregnant, dead fetus, postpartum (3-4 days)

CA 19-9

  • Cancer Tumor Markers (CA 19-9) is a cancer antigen in diagnosing pancreatic, hepatobiliary, gastric, and colorectal cancer. 
  • Normal level: <40 U/mL
  • Decreased levels = Effective response to treatment, benign disease
    • There are also different tumor markers. You won’t need to know all of these, but we thought we should include them. 
    • CA 15-3: Metastatic breast cancer, ovarian, lung, pancreas, cirrhosis, colon cancer.
    • CA-27.29: Recurrence of breast cancer
    • CA 50: Gastrointestinal tumor, biliary tract tumors
    • CA 125: Ovarian breast cancer, uterine tumors, pancreas, breast, colon, lung, cirrhosis, pancreatitis.  

CEA 

  • Carcinoembryonic antigen (CEA) has been found in the gi epithelium of embryos and has been extracted from tumors in the adult gastrointestinal tract. 
  • Normal level: <4 ug/L
  • Increased level: GI tract (esophagus, stomach, small and large intestine, rectum cancer), leukemia, Ulcerative colitis. 

PAP 

  • Prostatic acid phosphatase (PAP) originates in the prostate and usually is present in small amounts in the blood. 
  • Normal level: 0-3 U/dL
  • Increased level: prostate cancer, testicular cancer, leukemia, and non-Hodgkin’s lymphoma.

 

PSA 

  • Prostate-specific antigen (PSA) is always present in low concentrations in the blood of adult males.
  • Normal level: <4 ug/L
  • Increased level: Prostate cancer

Vitamins 

Folate 

  • Folate is one of the B vitamins needed to make red and white blood cells in the bone marrow, convert carbohydrates into energy, and produce DNA and RNA.
  • Normal level: 7-36 nmol/L
  • Increased level: Pernicious anemia (is a deficiency in red blood cells caused by lack of vitamin B12)
  • Decreased level: Folic acid anemia, vitamin b6 deficiency anemia, malnutrition, malabsorption syndrome (small intestine), pregnancy, liver disease.

Vitamin A 

  • It is a Fat-soluble vitamin absorbed from the intestine in the presence of lipase and bile. Vitamin A moves to the liver and is then stored in the body as retinol.
  • Vitamin A is vital for normal vision, the immune system, reproduction, and growth and development.
  • Normal level: 30-65 µg/dL
  • Increased level: Hypervitaminosis, Chronic kidney disease
  • Decreased level: Night blindness, liver, intestinal, or pancreatic disease, chronic infections, cystic fibrosis, protein malnutrition, malabsorption, celiac disease

Vitamin B6

  • Vitamin B6, also known as pyridoxine, is a water-soluble vitamin your body needs for several functions. It’s significant to protein, fat, and carbohydrate metabolism and the creation of red blood cells and neurotransmitters.
  • Normal level: 5-30 ng/mL
  • Decreased level: Malnutrition, chronic alcoholism, gestational diabetes, pregnancy, lactation, small bowel inflammatory disease, renal failure.

Vitamin B12 

  • Vitamin B12 is a nutrient that helps keep the body’s nerve and blood cells healthy and helps make DNA, the genetic material in all cells. Vitamin B12 also helps prevent a type of anemia.
  • Normal level: 130-700 ng/L
  • Decreased level: Pernicious anemia, malabsorption syndrome, liver diseases, hypothyroidism (myxedema), pancreatic insufficiency, Crohn’s disease.
  • Increased level: Acute hepatitis, leukemia.

Vitamin C 

  • Ascorbic acid is a water-soluble vitamin important for forming collagen and certain amino acids for wound healing and withstanding stress, injury, and infection. 
  • Normal level: 0.4-1.5 mg/dL
  • Decreased levels: Scurvy, malabsorption, pregnancy, cancer, and severe burns. 

Vitamin D

  • Vitamin D is a fat-soluble vitamin occurring from exposure to the ultraviolet rays of sunlight and is absorbed in the presence of bile and stored in the liver. Vitamin D helps regulate the amount of calcium and phosphate in the body. These nutrients are needed to keep bones, teeth, and muscles healthy. 
  • Normal level:  5-75 ng/mL
  • Decreased level: Malabsorption, cirrhosis of the liver, rickets, osteomalacia, hypoparathyroidism, celiac disease, inflammatory bowel disease

Miscellaneous

Rheumatoid Factor

  • RF factor is a screening test used to detect antibodies (Igm, IgG, or Ig)
  • Normal level:  <25 IU/ml
  • Increased level: Rheumatoid arthritis, lupus, tuberculosis, leukemia

ESR 

  • An erythrocyte sedimentation rate (ESR) is a type of blood test that measures how quickly erythrocytes (red blood cells) settle in unclotted blood in millimeters per hour. 
  • It can show if you have inflammation in your body.
  • Normal level: >2 mm/h
  • Increased level: RA, rheumatic fever, AMI, Hodgkin’s disease, multiple myeloma, bacterial endocarditis, gout, hepatitis
  • Decreased level: Polycythemia vera, heart failure, sickle-cell anemias, factor V deficiency

ACE 

  • The ACE test measures the level of angiotensin-converting enzyme (ACE) in the blood.
  • Normal level: 20-50 µmol/L
  • Increased level: Sarcoidosis, Diabetes Mellitus, hypothyroidism, Respiratory distress syndrome
  • Decreased level: Therapy for sarcoidosis, diabetes mellitus, hypothyroidism

Lead

  • Found in lead-based paint, unglazed pottery, batteries, leaded gasoline
  • Normal level: < 25 IU/ml 
  • Higher levels can damage the kidneys and nervous system.

Refresh your memory and relearn the lab values by watching the full episode here 👇👇👇

TIMESTAMPS:

00:00 Introduction
01:21 About the episode
02:35 Electrolytes Potassium K+
Sodium Na+
Calcium Ca+
Chloride CI-
Magnesium Mg+
Phosphorus
Ammonia Uric acid
Creatinine
BUN
Specific Gravity
Lactic Dehydrogenase (LDH)
17:02 Hematology
RBC
WBC
Platelets (thrombocytes)
Hemoglobin (Hgb)
Hematocrit
Partial thromboplastin time (PTT)
Prothrombin Time (PT)
International Normalised Ratio (INR)
Reticulocytes
Neutrophils Bands
Lymphocytes
Monocytes
Eosinophils
HBA1C
Glucose
27:25 Gastrointestinal
Bilirubin
Albumin
ALT/AST
Amylase Lipase
30:40 Hormones
Hydroxyprogesterone
Adrenocorticotropic ACTH
Thyroid-Stimulating Hormone (TSH)
Thyroxine Follicle-Stimulating Hormone (FSH)
Human Growth Hormone (hGH)
Progesterone
Prolactin
Testosterone
36:57 Lipids Low-Density Lipoproteins (LDL)
High-Density Lipoproteins (HDL)
Triglycerides Total Cholesterol
39:11 Cardiac Markers
Creatine kinase
Troponin
C-Reactive Protein
D-Dimer
Brain Natriuretic Peptide (BNP)
41:56 Tumor Markers
Alpha-Fetoprotein (AFP)
CA 19-9 Carcinoembryonic Antigen (CEA)
Prostatic Acid Phosphatase (PAP)
Prostate-Specific Antigen (PSA)
44:15 Vitamins
Folate
Vitamin A
Vitamin B6
Vitamin B12
Vitamin C
Vitamin D
48:12 Miscellaneous
Rheumatoid Factor (RF)
Erythrocyte Sedimentation Rate (ESR)
Angiotensin-Converting Enzyme (ACE)
Lead