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SURGERY PREPARING FOR SURGERY

Chem 7: Blood Chemistry Tests


What Do Your Basic Metabolic Panel Test Results Mean?
By Jennifer Whitlock, RN, MSN, FNP-C
Updated December 31, 2016

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Blood Chemistry Tests


Blood chemistry tests are often ordered prior to surgery or a procedure to
examine the general health of a patient. This blood test, commonly referred to as
a Chem 7 because it looks at 7 different substances found in the blood, is one of
several tests that are routinely performed after surgery to make sure the patient
is well in the days following surgery.

The blood is drawn from a vein, or if a special IV is present, it can be drawn from
the IV without a stick.

Your doctor may have this blood test done several days prior to the procedure or
it may be drawn immediately prior to your surgery.

Please keep in mind that there are many reasons that the results this test may be
higher or lower than normal. It is important to consult with your physician
regarding the results, as there are many factors that can contribute to results
that do not fall within the normal range.

This test is known by multiple names including a SMAC7, Sequential Multi-


Channel Analysis with Computer 7, Metabolic Panel, Basic Metabolic Panel (BMP)
and Metabolic 7, but most medical professionals refer to it as a chem 7 or BMP. A
comprehensive metabolic panel is similar to a BMP but includes additional tests.

BMP Results Vary Based on Where You Live


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The results of the chem 7 are different depending on the country where the test
BMP Results Vary Based on Where You Live
The results of the chem 7 are different depending on the country where the test
is done. The first set of results listed is for the United States, which may vary
slightly between labs.

The additional results listed are for metric based countries, designated
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"international". The vast majority of countries use the metric system
(international) for test results.

Understanding Blood Chemistry Results:

Blood Urea Nitrogen (BUN)


BUN is a measure of kidney function. A high level may indicate that the
kidneys are functioning less than normal.

Normal Values: 8-25mg/100ml (USA)2.9-8.9 mmol/L (International)

Carbon Dioxide (CO2)


This test measures the amount of carbon dioxide in the blood. Most carbon Advertisement

dioxide is present in the form of bicarbonate, which is regulated by the lungs


and kidneys. The test result is an indication of how well the kidneys, and
sometimes the lungs, are managing the bicarbonate level in the blood.

Normal Values: 24-30 mEq/L (USA) 24-30 mmol/L (International)

Creatinine
Creatinine is produced by the body during the process of normal muscle
breakdown. High levels may indicate kidney impairment, low blood pressure,
high blood pressure or another condition. Some medications can also cause a
higher than normal level of blood creatinine. Low levels may be caused by late
stage muscular dystrophy, myasthenia gravis and over hydration.

Normal Values:

Men: 0.2-0.5 mg/dl (USA) 15-40 umol/L (International)

Women: 0.3-0.9mg/dl (USA) 25-70 umol/L (International)

Glucose Advertisement

This test shows the level of glucose in the blood. High levels of glucose can
indicate the presence of diabetes or another endocrine disorder. Keep in mind
that some medications and the timing of the test in relation to meals can
radically alter the results. Do not assume that your results indicate a problem
until you have consulted with your physician.

Normal Values: 70-110 mg/ml (USA) 3.9-5.6 mmol/L (International)

Serum Chloride (Cl)


This test shows the level of chloride in the blood. Chloride binds with
electrolytes including potassium and sodium in the blood and plays a role in
maintaining the proper pH of the blood. Chloride levels can vary widely if the Advertisement
patient is dehydrated or overly hydrated, if the kidneys are not functioning
properly. Heart failure and endocrine problems can also contribute to
abnormal chloride results.

Normal Values: 100-106 mEq/L (USA) 100-106 mmol/L (International)

Serum Potassium (K)


This test shows the level of potassium in the blood. Potassium plays an
important role in muscle contractions and cell function. Both high and low
levels of potassium can cause problems with the rhythm of the heart so it is
important to monitor the level of potassium after surgery. Patients who are
taking diuretics regularly may require regular blood tests to monitor
potassium levels, as some diuretics cause the kidneys to excrete too much
potassium.
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potassium levels, as some diuretics cause the kidneys to excrete too much
potassium.

Normal Values: 3.5-5 mEq/L (USA) 3.5-5 mmol/L (International)

Serum Sodium (Na)


This portion of the test shows the amount of sodium present in the blood. The
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kidneys work to excrete any excess sodium that is ingested in food and
beverages. Sodium levels fluctuate with dehydration or over-hydration, the
food and beverages consumed, diarrhea, endocrine disorders, water retention
(various causes), trauma and bleeding.

Normal Values: 135-145 mEq/L (USA) 3.5-5 mmol/L

More Common Tests Before & After Surgery

Sources:

Chem7. Medline Plus. National Institutes of Health


http://www.nlm.nih.gov/medlineplus/ency/article/003462.htm
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