Metabolic Panel Explained: Basic (BMP) & Comprehensive Metabolic Panel (CMP) Lab Values for Nurses

Summary

In this educational video, Sarah Threats Turner discusses the importance of understanding the metabolic lab panel, which includes the BMP and CMP, for nurses. She explains that these tests assess electrolytes, renal, and liver functions, and highlights the significance of recognizing normal ranges and abnormal values. Turner also covers the causes of these variations and provides insights into conditions like hypoglycemia, hypercalcemia, and liver diseases, emphasizing the role of the parathyroid gland and the impact of medications on electrolyte levels.

Takeaways

• 🧬 The metabolic panel is a common blood test that assesses electrolytes, renal function, and liver function.
• 🔍 There are two types of metabolic panels: the Basic Metabolic Panel (BMP) and the Comprehensive Metabolic Panel (CMP), with the latter including liver function tests.
• 🩸 Blood samples for metabolic panels are collected through a vein in the arm and sent to a lab for analysis.
• 📊 A BMP includes tests for glucose, calcium, sodium, chloride, potassium, carbon dioxide, BUN, and creatinine.
• 📈 The CMP, in addition to BMP tests, assesses liver function through ALP, AST, ALT, bilirubin, total protein, albumin, and globulin.
• 🚨 Abnormal values in the metabolic panel can indicate conditions such as diabetes, kidney disease, liver disease, and electrolyte imbalances.
• 🍬 Glucose levels are key indicators of blood sugar; hypoglycemia is less than 70 mg/dL, and hyperglycemia is higher than the normal range.
• 🦴 Calcium levels are regulated by the parathyroid gland and vitamin D intake, with abnormalities potentially leading to hypocalcemia or hypercalcemia.
• 💧 Sodium levels are crucial for electrolyte balance, with hyponatremia occurring below 135-140 mEq/L and hypernatremia being excessively high.
• 🌀 Potassium is a critical electrolyte with levels between 3.5 to 5 mEq/L, and abnormalities can be caused by diuretics, corticosteroids, and renal failure.
• 🌪 Carbon dioxide levels affect the body's acid-base balance, with low levels indicating acidosis and high levels potentially due to respiratory issues.
• 📉 Liver function tests in the CMP, such as ALP, AST, and ALT, can indicate liver or bone diseases if results are abnormally high.

Q & A

What is the main topic of Sarah Threats Turner's video?

The main topic of the video is the metabolic lab panel, which includes the BMP and the CMP, and how it is used in assessing a patient's health, particularly focusing on electrolytes, renal function, and liver function.

What does a metabolic panel test for?

A metabolic panel tests for electrolytes, renal function, and liver function. It can be ordered as a Basic Metabolic Panel (BMP) or a Comprehensive Metabolic Panel (CMP), with the latter including additional liver function tests.

What is the difference between a BMP and a CMP?

A BMP focuses on electrolytes and renal function, while a CMP includes all the tests of a BMP plus additional liver function tests such as ALP, AST, ALT, bilirubin, total protein, albumin, and globulin.

What are the normal reference ranges for glucose in the blood?

The normal reference range for glucose is about 70 to 100 milligrams per deciliter for a fasting patient, and up to 125 milligrams per deciliter if the patient has not been fasting.

What conditions can cause abnormal glucose levels in the blood?

Hypoglycemia (low glucose) can be caused by too much insulin or oral diabetic medication, while hyperglycemia (high glucose) can be due to poorly managed diabetes, certain medications like corticosteroids, or other factors that increase blood glucose.

What is the normal blood level range for calcium?

The normal blood level range for calcium is about 8.5 to 10.5 milligrams per deciliter.

Why is potassium a critical electrolyte to monitor?

Potassium is critical to monitor because it has a narrow normal range and can be affected by many factors, including medications, disease processes, and diet. Abnormal potassium levels can affect the toxicity of certain drugs and impact the heart and other muscles.

What does the term 'anion gap' refer to in the context of a metabolic panel?

The anion gap refers to the difference between the positively and negatively charged electrolytes in the blood, calculated from sodium, chloride, and bicarbonate (from CO2). A high anion gap may indicate metabolic acidosis.

What does an elevated BUN (Blood Urea Nitrogen) level suggest about a patient's kidney function?

An elevated BUN level suggests that the kidneys are under stress or not functioning well, as it indicates a higher amount of urea nitrogen in the blood, which should normally be filtered out by healthy kidneys.

Why is creatinine an important indicator of kidney function?

Creatinine is an important indicator of kidney function because it is a waste product from muscle that should be filtered out by the kidneys and excreted in urine. High levels of creatinine in the blood can indicate kidney stress or failure.

How does the metabolic panel assess liver function?

The metabolic panel assesses liver function through the CMP, which includes tests for ALP, AST, ALT, bilirubin, total protein, albumin, and globulin. Abnormal levels of these components can indicate liver disease or dysfunction.

What is the significance of albumin levels in the blood?

Albumin levels are significant because they play a crucial role in regulating oncotic pressure within blood vessels. Low albumin levels can lead to fluid leakage from the vessels, causing swelling, while high levels may indicate liver problems or immune disorders.