Ammonia (NH3) Lab Values
May 15, 2023•5 min
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Episode description
Overview
- Ammonia
- Normal Value Range
- Pathophysiology
- Special considerations
- Too High: Causes, Symptoms, Treatments
- Too Low: Causes, Symptoms, Treatments
- Normal value range
- 19-60 mcg/dL
- Pathophysiology
- Byproduct of protein metabolism
- Proteins → ammonia
- Ammonia → urea via the liver
- Urea excreted to the kidneys
- If ammonia is not converted to urea
- Ammonia ↑ in bloodstream
- Causes hepatic encephalopathy
- Neurotoxic
- ↓ Level of consciousness
- Confusion
- Altered mental status
- Refer to Neuro lesson 03.06 Encephalopathies
- Byproduct of protein metabolism
- Special considerations
- Sent in either green or lavender tube
- Typically sent on ice
- Discuss with facility lab or unit
- Elevations in ammonia
- Liver failure
- Treatment:
- Lactulose
- Ammonia binding agent
- Given PO or PR
- Ammonia excreted via stool
- Lactulose
- Treatment:
- Hepatic encephalopathy
- TPN
- GI hemorrhage
- Reye's syndrome
- Liver failure
- Decreased ammonia levels
- Antibiotics
- Assess patient's cognition and level of consciousness
- Assess patient's ability to swallow and protect airway
- Lactulose via rectal tube or PO if patient can tolerate oral medications and follow directions
- Lab Values
- Gastrointestinal/Liver Metabolism
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