Abnormal Function/Role Why is it Abnormal?

Implication
Labs
Chemistry
BUN (mg/dL) A blood urea nitrogen (BUN) test is used to determine how well your kidneys are working. It does this by measuring the amount of urea
nitrogen in the blood. Urea nitrogen is a waste product that's created in the liver when the body breaks down proteins.
Creatinine Creatinine is a waste product that comes from the normal wear and tear on muscles of the body. 
Serum (mg/dL)
Creatinine is a waste product that forms when creatine, which is found in your muscle, breaks down. Creatinine levels in the blood can
provide your doctor with information about how well your kidneys are working. Each kidney has millions of small blood-filtering units called
nephrons.
https://www.healthline.com/health/creatinine-blood

A creatinine test is a measure of how well your kidneys are performing their job of filtering waste from your blood.

Creatinine is a chemical compound left over from energy-producing processes in your muscles. Healthy kidneys filter creatinine out of the
blood. Creatinine exits your body as a waste product in urine.

A measurement of creatinine in your blood or urine provides clues to help your doctor determine how well the kidneys are working. An
increased level of creatinine may be a sign of poor kidney function.

https://www.mayoclinic.org/tests-procedures/creatinine-test/about/pac-20384646

Creatine is a chemical that your body uses to supply your muscles with energy. As you muscles use energy the tissue that makes up your
muscles breaks down. This natural breakdown of muscle tissue causes creatinine to be released into your bloodstream
https://my.clevelandclinic.org/health/diagnostics/16380-creatinine-clearance-test#:~:text=Creatinine%20is%20actually%20a%20waste,be
%20released%20into%20your%20bloodstream.

Glucose your body uses it for energy. As it travels through your bloodstream to your cells, it's called blood glucose or blood sugar. Insulin is a hormone that
(mg/dL) moves glucose from your blood. into the cells for energy and storage.
Your body is designed to keep the level of glucose in your blood constant. Beta cells in your pancreas monitor your blood sugar level every few
seconds. When your blood glucose rises after you eat, the beta cells release insulin into your bloodstream. Insulin acts like a key, unlocking
muscle, fat, and liver cells so glucose can get inside them.
 Alpha cells in the pancreas begin to produce a different hormone called glucagon. It signals the liver to break down stored glycogen and turn it
back into glucose.
https://www.webmd.com/diabetes/glucose-diabetes#:~:text=Glucose%20comes%20from%20the%20Greek,cells%20for%20energy%20and
%20storage
Bilirubin, direct Bilirubin is made during the normal process of breaking down red blood cells. It is a yellowish substance found in bile, a fluid in your liver. Excessive alcohol intake by the Elevated levels of Bilirubin
(mg/dL) This fluid helps digest food. A healthy liver moves most of the bilirubin from your body. If the liver is damaged, bilirubin can leak out into your patient lead to liver dysfunction that indicate liver damage.
blood. lead bilirubin build-up.

Bilirubin is a brownish yellow substance found in bile. It is produced when the liver breaks down old red blood cells. Bilirubin is then
removed from the body through the stool (feces) and gives stool its normal color.

Bilirubin circulates in the bloodstream in two forms:

Indirect (or unconjugated/Total) bilirubin.
This form doesn't dissolve in water. (It is insoluble.) Indirect bilirubin travels through the bloodstream to the liver, where it is changed
into a soluble form (direct or conjugated).
Direct (or conjugated) bilirubin.
Direct bilirubin dissolves in water. (It is soluble.) It's made by the liver from indirect bilirubin

As red blood cells age, they are broken down naturally in the body. Bilirubin is released from the destroyed red blood cells and passed on to
the liver. The liver releases the bilirubin in fluid called bile. If the liver is not functioning correctly, the bilirubin will not be properly released.
Therefore, if the bilirubin level is higher than expected, it may mean that the liver is not functioning correctly.
https://www.hepatitis.va.gov/hcv/patient/diagnosis/labtests-bilirubin.asp
Protein, total
(g/dL)
Albumin, (g/dL) Albumin carries substances such as hormones, medicines, and enzymes throughout your body. -May be caused by low protein Hypoalbuminemia may signal
Albumin is a protein made by your liver. Albumin helps keep fluid in your bloodstream so it doesn't leak into other tissues. intake as evidenced by the patient’s that there is a liver and kidney
eating very little for 3 days because problem.
of the pain, nausea, and vomiting
It is also a marker of inflammation.
The decrease of such proteins may May also implicate that there
Acute phase reactants (APR) are inflammation markers that exhibit significant changes in serum concentration during be used as markers of is an ongoing inflammation in
inflammation. These are also important mediators produced in the liver during acute and chronic inflammatory states. inflammation. the body (Hepatomegaly).

Negative acute phase reactants are downregulated, and their concentrations decrease during inflammation
Prealbumin Prealbumin, also called transthyretin, is the precursor to albumin. Inadequate protein intake in the diet Not getting enough protein in
(mg/dL) Measuring prealbumin can help clinicians detect short-term impairment of energy intake and the effectiveness of nutritional support efforts. as evidenced by the usual intake of the diet
https://journals.lww.com/nursing/Fulltext/2017/04000/Using_albumin_and_prealbumin_to_assess_nutritional.18.aspx the patient and not eating for 2
days
Prealbumin is a protein made in your liver. Prealbumin helps carry thyroid hormones and vitamin A through your bloodstream. It also helps
regulate how your body uses energy.

If your prealbumin levels are lower than normal, it may be a sign of malnutrition.
Malnutrition is a condition where your body does not get the calories, vitamins, and/or minerals needed for good health.

Alkaline ALP is an enzyme found in your bloodstream. It helps break down proteins in the body and exists in different forms, depending on where
Phosphatase it originates. Your liver is one of the main sources of ALP, but some is also made in your bones, intestines, pancreas, and kidneys.
(U/L)
ALP is often considered a liver enzyme because it’s primarily found in your liver. However, it also exists in the following places:

 Your bile duct.

 Your bones.
 Your kidneys.
 Your intestines.
 The placenta in pregnant people.

Abnormal levels of ALP in your blood can reflect damage to tissue or disruption of normal bodily processes
ALT (U/L) Alanine transaminase

-Old Name: SGPT = Serum Glutamic-Pyruvic Transaminase

an enzyme found mostly in the liver. When liver cells are damaged, they release ALT into the bloodstream
Your body uses ALT to break down food into energy. The function of ALT is to convert alanine into pyruvate, for cellular energy
production
AST (U/L) Aspartate aminotransferase
When your liver is damaged, it releases AST into your bloodstream
enzyme that helps metabolize amino acids
AST catalyzes a reaction between the amino acids aspartate and glutamate and is an important enzyme in amino acid metabolism.
CPK (U/L) Creatine phosphokinase (CPK) is an enzyme in the body. It is found mainly in the heart, brain, and skeletal muscle
When muscle tissue is damaged, CPK leaks into your blood.
Lactate Lactate dehydrogenase (also called lactic acid dehydrogenase, or LDH) is an enzyme found in almost all body tissues. It plays an
Dehydrogenase important role in cellular respiration, the process by which glucose (sugar) from food is converted into usable energy for our cells.
(U/L) Lactate dehydrogenase (LDH) is an enzyme required during the process of turning sugar into energy for your
cells. LDH is present in many kinds of organs and tissues throughout the body, including the liver, heart,
pancreas, kidneys, skeletal muscles, lymph tissue, and blood cells.
 Different LDH isoenzymes are found in different body tissues. The areas of highest concentration for each type of
isoenzyme are:

 LDH-1: heart and red blood cellsss

 LDH-2: heart and red blood cells
 LDH-3: lymph tissue, lungs, platelets, pancreas
 LDH-4: liver and skeletal muscle
 LDH-5: liver and skeletal muscle

HDL-C (mg/dL) HDL (high-density lipoprotein), or “good” cholesterol, absorbs cholesterol and carries it back to the liver.

Triglycerides Triglycerides are a type of fat (lipid) found in your blood.

(mg/dL)
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. Later, hormones release triglycerides for energy between meals.
If you regularly eat more calories than you burn, particularly from high-carbohydrate foods, you may have high triglycerides
(hypertriglyceridemia).

Coagulation
PT (sec) The prothrombin time, sometimes referred to as PT or pro time test, is a test to evaluate blood clotting.

Prothrombin is a protein produced by your liver. It is one of many factors in your blood that help it to clot appropriately.

The prothrombin time test may also be performed to evaluate you for liver disease. It is one of several tests used to screen people waiting
for liver transplants. That screening — known as the model for end-stage liver disease (MELD) — is a scoring system for assessing the
severity of chronic liver disease.

The average time range for blood to clot is about 10 to 13 seconds. A number higher than that range means it takes blood longer than
usual to clot. A number lower than that range means blood clots more quickly than normal.

Blood clotting, or coagulation, is an important process that prevents excessive bleeding when a blood vessel is injured. 
https://www.hematology.org/education/patients/blood-clots#:~:text=Blood%20clotting%2C%20or%20coagulation%2C%20is,a%20clot
%20over%20the%20injury.

This usually happens because the liver is not making the right amount of blood clotting proteins, so the clotting process takes longer. A high
PT usually means that there is serious liver damage or cirrhosis. A high PT may indicate there is a higher risk for internal bleeding from
the upper part of the GI tract (esophagus, stomach).
https://www.hepatitis.va.gov/hcv/patient/diagnosis/labtests-prothrombin-time.asp
 Fibrin is a tough protein substance that is arranged in long fibrous chains; it is formed from fibrinogen, a soluble protein that is produced by
the liver and found in blood plasma. When tissue damage results in bleeding, fibrinogen is converted at the wound into fibrin by the action of
thrombin, a clotting enzyme.
https://www.britannica.com/science/fibrin#:~:text=Fibrin%20is%20a%20tough%20protein,of%20thrombin%2C%20a%20clotting%20enzyme.

INR
PTT (sec)
Hematology
RBC Borderline mababa lamang 4.1 Can be caused by the blood loss
(x103/mm3) during her menstrual cycle &
internal bleeding (bruising &
Erythropoietin (EPO) is a glycoprotein hormone, naturally produced by the peritubular cells of the kidney, that stimulates red blood cell petechiae).
production. Renal cortex peritubular cells produce most EPO in the human body. PO2 directly regulates EPO production. The lower the
pO2, the greater the production of EPO.

NCBI yung source neto.

Erythropoietin (EPO) is a hormone that is produced predominantly by specialised cells called interstitial cells in the kidney. Once it is made, it acts
on red blood cells to protect them against destruction. At the same time it stimulates stem cells of the bone marrow to increase the production of
red blood cells.
Low RBC indicates that the
patient has anemia.

Hematocrit A hematocrit (he-MAT-uh-krit) test measures the proportion of red blood cells in your blood. Red blood cells carry oxygen throughout your It is caused by the low RBC.
(Hct, %)
body. Having too few or too many red blood cells can be a sign of certain diseases.

The hematocrit test, also known as a packed-cell volume (PCV) test

Hemoglobin Hemoglobin is essential for transferring oxygen in your blood from the lungs to the tissues. Inadequate Iron intake as
(Hgb, g/dL) evidenced by food history (pg.4)
Blood loss is the most common cause of iron deficiency.
 In menstruating women, genitourinary blood loss often accounts for increased iron requirements.  Another reason why she has low
iron is because of blood loss due to
Indicates that the patient has
her monthly menstruation. (There is
Iron-Deficiency Anemia.
an increased iron requirement for
women who have monthly
menstrual cycle)

Urinalysis
Protein (mg/dL) Proteins – which help build muscle and bone, regulate the amount of fluid in blood, combat infection and repair tissue – should remain in the Protein gets into the urine because Protenuria indicates kidney
blood. If proteins enter the urine they ultimately leave the body, which isn’t healthy. kidneys are not working properly damage.
due to damage.
Protein gets into the urine if the kidneys aren’t working properly. Normally, glomeruli, which are tiny loops of capillaries (blood vessels) in the
kidneys, filter waste products and excess water from the blood.

Glomeruli pass these substances, but not larger proteins and blood cells, into the urine. If smaller proteins sneak through the glomeruli,
 tubules (long, thin, hollow tubes in the kidneys) recapture those proteins and keep them in the body.

However, if the glomeruli or tubules are damaged, if there is a problem with the reabsorption process of the proteins, or if there is an
excessive protein load, the proteins will flow into the urine.

Bilirubin Excessive alcohol intake by the Elevated levels of Bilirubin

Urobilinogen Urobilinogen is a byproduct of bilirubin that is eventually eliminated through the stool and urine. Although urobilinogen is normally patient lead to liver dysfunction that and Urobilinogen indicate
(EU/dL) found in the urine, higher or lower levels may be a sign of a liver problem lead bilirubin build-up. liver damage.
Urobilinogen is a colorless pigment produced from the breakdown of bilirubin by gut bacteria. The majority of this compound is excreted in
feces, and a small amount is reabsorbed and excreted in the urine 
When bilirubin production increases because of red blood cell destruction (hemolysis) or liver disease, urobilinogen levels rise in the urine. 

Petechiae as seen in nursing assessment in pg.3 nursing assessment

Petechiae are formed when tiny blood vessels called capillaries break open. When these blood vessels break, blood leaks into your skin.