✨ 精选课程 · 第5课，共8课 · 90 sec

你必须在睡梦中也能背出的实验室数值

The Lab Values You Must Recite in Your Sleep

🧪 许多题目会给出一个实验室数值，旁边却没有正常范围，即使案例资料中显示了范围，熟记范围也能节省时间。以下是最能决定最多题目答案的数值。

🧪 Many questions give a lab value with no normal range beside it, and even when a case exhibit shows one, knowing the range cold saves time. Here are the ones that decide the most questions.

💡 核心要点

把这些背得滚瓜烂熟。每一道包含数字的题目都假设你已经会了。

Know these cold. Every question that includes a number assumes you do.

🧠 为什么重要

钠135到145 mEq/L。钾3.5到5.0 mEq/L。钙（总）9到10.5 mg/dL。镁1.5到2.5 mEq/L。葡萄糖70到99 mg/dL，空腹。BUN 10到20 mg/dL。肌酐0.6到1.2 mg/dL。血红蛋白12到16 g/dL为女性，14到18 g/dL为男性。血小板150,000到400,000/mm3。白细胞5,000到10,000/mm3。使用warfarin时INR为2到3，适用于大多数适应证（某些机械瓣膜需要更高）；使用heparin时aPTT为对照值的1.5到2.5倍。Digoxin 0.5到2.0 ng/mL。Lithium 0.6到1.2 mEq/L。Phenytoin 10到20 mcg/mL。大多数成人糖尿病患者的A1c低于7%；pH为7.35到7.45，PaCO2为35到45 mm Hg，HCO3为22到26 mEq/L。

Sodium 135 to 145 mEq/L. Potassium 3.5 to 5.0 mEq/L. Calcium (total) 9 to 10.5 mg/dL. Magnesium 1.5 to 2.5 mEq/L. Glucose 70 to 99 mg/dL fasting. BUN 10 to 20 mg/dL. Creatinine 0.6 to 1.2 mg/dL. Hemoglobin 12 to 16 g/dL women, 14 to 18 g/dL men. Platelets 150,000 to 400,000/mm3. White cells 5,000 to 10,000/mm3. INR 2 to 3 on warfarin for most indications (higher for some mechanical valves). aPTT 1.5 to 2.5 times control on heparin. Digoxin 0.5 to 2.0 ng/mL. Lithium 0.6 to 1.2 mEq/L. Phenytoin 10 to 20 mcg/mL. A1c under 7% for most adults with diabetes. pH 7.35 to 7.45, PaCO2 35 to 45 mm Hg, HCO3 22 to 26 mEq/L.

🏥 真实场景

📝 把它们写在索引卡上。在每个红灯前读它，坚持一周。考试当天，一道题说“钾3.1”，而你在读完句子之前大脑就说“低，注意U波和digoxin”。那种反应比任何策略都更有价值。

📝 Write them on an index card. Read it at every red light for a week. On exam day, a question says 'potassium 3.1' and your brain says 'low, watch for U waves and digoxin' before you finish the sentence. That reflex is worth more than any strategy.

📌 要点总结

电解质：Na 135–145，K 3.5–5.0，Ca 9–10.5，Mg 1.5–2.5Electrolytes: Na 135–145, K 3.5–5.0, Ca 9–10.5, Mg 1.5–2.5
肾脏：BUN 10–20，肌酐0.6–1.2；血液：Hgb 12–16（女性），14–18（男性），血小板150–400k，白细胞5–10kKidney: BUN 10–20, creatinine 0.6–1.2; blood: Hgb 12–16 (women), 14–18 (men), platelets 150–400k, WBC 5–10k
药物：digoxin 0.5–2.0，lithium 0.6–1.2，phenytoin 10–20；使用warfarin时INR 2–3Drugs: digoxin 0.5–2.0, lithium 0.6–1.2, phenytoin 10–20; INR 2–3 on warfarin

✅ 自我测试

哪个数值在正常范围之外？Which value is outside the normal range?

钾5.8 mEq/LPotassium 5.8 mEq/L
钠140 mEq/LSodium 140 mEq/L
钙9.6 mg/dLCalcium 9.6 mg/dL
镁2.0 mEq/LMagnesium 2.0 mEq/L

答案: A · 钾5.8 mEq/L

钾高于5.0就是高钾血症；其他数值都正常。作为备选的镁值在正常范围内，不是题目所问的异常值。

Potassium above 5.0 is hyperkalemia; the other values are normal. The magnesium level offered as the alternative is within the normal range and is not the abnormal value the question asks for.

一位服用lithium的患者，其水平为1.9 mEq/L，护士应如何解读？A client taking lithium has a level of 1.9 mEq/L. How should the nurse interpret this?

低于治疗范围Below the therapeutic range
高于治疗范围Above the therapeutic range
在治疗范围内Therapeutic
在急性躁狂治疗范围内Within the acute-mania therapeutic range

答案: B · 高于治疗范围

维持范围是0.6到1.2 mEq/L，急性躁狂的治疗上限约为1.5。1.9的水平有毒性，所以应暂停给药，通知医疗提供者，并评估粗大震颤、呕吐、腹泻、共济失调和意识混乱。

The maintenance range is 0.6 to 1.2 mEq/L, and acute mania is treated up to about 1.5. A level of 1.9 is toxic, so hold the dose, notify the provider, and assess for coarse tremor, vomiting, diarrhea, ataxia and confusion.

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