Chemical Blood Tests: Basic Metabolic Panel Terminology

Chemical Blood Tests: Basic Metabolic Panel Terminology
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Lesson Transcript
Instructor: Adrianne Baron

Adrianne has taught high school and college biology and has a master's degree in cancer biology.

This lesson covers the various parts of the basic metabolic panel chemical blood test. We will discuss normal ranges and terms associated with abnormal ranges.

Blood Tests

You will likely find yourself thinking more about blood now that you are entering the healthcare field. There are many different properties in blood. There are physical features, such as the shape of blood cells, and chemical features, such as pH, which is the acidity or alkalinity of a substance.

We assess the various properties of blood to gain an understanding of what is going on in a person's body. There are three main categories of blood tests: blood counts, physical blood tests, and chemical blood tests.

There are a pretty good number of chemicals present in the blood, so we have several tests that we use to assess them. We're going to explore our most comprehensive chemical test now. While we do, keep in mind that normal value ranges can vary depending on the lab performing the test.

Basic Metabolic Panel

A basic metabolic panel is a test that checks the levels of seven different chemicals in the blood. Let's look at each of the chemicals and their normal ranges in the blood:

BUN stands for blood urea nitrogen. This part of the basic metabolic panel checks the amount of urea, a nitrogen waste product, in the bloodstream. The normal range is anywhere from 7-20mg/dL.

When the levels are below normal, this could mean that the patient eats a low protein diet, has liver failure, or is suffering from malnutrition. If the levels are higher than normal, it could mean the patient is dehydrated, in shock, or has GI tract bleeding, kidney failure or congestive heart failure.

The next chemical tested during a basic metabolic panel is carbon dioxide or CO2. You probably learned at some point in time that carbon dioxide is the waste product of respiration that is carried on the surface of red blood cells. The level of carbon dioxide in the blood should fall between 20-30 mmol/L.

A patient with carbon dioxide below this level could be experiencing ketoacidosis, metabolic acidosis, lactic acidosis, diarrhea, or kidney disease. Carbon dioxide above normal levels could indicate that a person is experiencing vomiting, breathing disorders, or an excessive release of the hormone aldosterone.

Creatinine is another chemical tested in the basic metabolic panel. This chemical is a waste product created when your muscles contract. The level we expect to see in the blood is .6 - 1.1 mg/dL for females and .7 - 1.3 mg/dL for males. That makes sense considering males usually have more muscle than females.

Abnormal results usually indicate problems with either the kidneys or the muscles. This is because the muscles create the chemical, and the kidneys get rid of it. If the levels are low, then the person likely has muscle problems. If the levels are high, they may have kidney problems or something could be blocking the urinary tract and preventing the kidneys from clearing creatinine from the blood.

The blood glucose levels are also checked in this test. You are likely more familiar with the term blood sugar, rather than blood glucose. These are the same thing. We get glucose from the foods we eat, and it is the energy source for the cells in our body. How much we consume and how much our cells use should be in balance. The acceptable range for blood glucose is 70 to 100 mg/dL if the test is a fasting blood glucose and 64-124 mg/dL if the test is a random blood glucose.

You, like most people, probably already know that blood sugar levels are related to diabetes mellitus. If the level is slightly higher, this could mean a patient is pre-diabetic. If it is significantly higher, then the patient is diabetic.

High blood glucose, or hyperglycemia, could also indicate problems in the pancreas, such as pancreatitis or pancreatic cancer. Hypoglycemia, or low blood glucose, could mean the patient has kidney or liver disease, tumors in the pancreas, sluggish thyroid, or a decrease in release of pituitary gland hormones.

During a metabolic panel, there are some electrolytes tested as well. Electrolytes are chemical ions that carry an electrical charge. They are found in the serum portion of blood, which is the part of blood that has no cells. Electrolytes are key to allowing the heart and other muscles to contract, enabling the nerves to send signals and maintaining homeostasis.

The first electrolyte measured is serum chloride or the chloride levels in the blood serum. The normal range is 96-106 mEq/L. We use the term hyperchloremia to mean higher-than-normal serum chloride and the term hypochloremia to mean lower-than-normal chloride.

Hypochloremia might mean that a patient is dehydrated, has congestive heart failure, has excessive release of the hormone aldosterone, or is in metabolic alkalosis. Hyperchloremia could indicate a patient is in metabolic acidosis, has diarrhea, is experiencing kidney tubule acidosis, or has bromide poisoning.

The potassium levels in the serum, or serum potassium, is the next part of the metabolic panel. It is expected that a patient's potassium levels will fall between 3.7 - 5.2 mEq/L. Changes from the normal range for potassium might mean that trouble is looming in the heart and kidneys. Remember that the kidneys are key in determining blood pressure and that heart conditions affect the kidneys since they filter the blood.

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