Alkaline Phosphatase (ALK PHOS) Lab Values

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Abby Rose
BSN,RN
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Outline

Objective:

Determine the significance and clinical use of  alkaline phosphatase in clinical practice

 

Lab Test Name:

Alkaline Phosphatase – ALP

 

Description:

Measures amount of ALP in circulation

Located in several places in the body:

  • Liver
  • Intestines
  • Biliary tract
  • Bones
  • Placenta

Different isoenzymes of ALP are used to determine:

  • Liver, bone, intestine and other cancers
  • Bone turnover in postmenopausal women

 

Indications:

Evaluation of ALP:

  • Hepatobiliary disease
  • Malignancies
  • Bone disease
  • Bone damage in renal patients

 

Normal Therapeutic Values:

Normal – 40-130 U/L

Collection:

  •  Plasma separator tube

 

What would cause increased levels?

Increased levels assessed in:

  • Liver disease
  • Bone disease
  • Pregnancy
  • Amyloidosis
  • Lung cancer
  • Pancreatic cancer
  • Congestive heart failure
  • Ulcerative colitis
  • Hodgkin’s disease
  • Chronic renal failure
  • Sarcoidosis

 

What would cause decreased levels?

  • Hypophosphatasia (spelling error on existing outline on NURSING.com)
  • Anemia
  • Kwashiorkor
  • Cretinism
  • Hypothyroidism
  • Zinc or magnesium deficiency
  • Scurvy

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Transcript

Hey everyone, Abby, here from nursing.com. In this lesson, we’re going to discuss alkaline phosphatase. It’s abbreviated as ALP. It’s one of the liver enzymes and the liver function tests. We’ll talk about its normal value and things that might cause it to be increased or decreased. Let’s dive in!

Alkaline phosphatase is a lab value that measures the amount of ALP in circulation. Alkaline phosphatase is produced in the GI system, in the bones, and even in the placenta. We see it located in several places in the body, including the biliary tract, and measurement of this lab can help us determine if there’s the presence of liver, bone, intestinal, or even lung cancer. It also is used to differentiate between whether or not osteoporosis is present in a postmenopausal woman. So, what do you think some clinical indications would be? Who do you think we might see in their clinical presentation needing this lab? Yes. If you thought jaundice, because we talked liver, you are right. Evaluation of ALP is necessary in the presence of hepatobiliary disease, malignancies like we talked about with certain cancers, bone disease, and even those that have bone damage who are also renal patients. Normal therapeutic value is between 40 and 130 units per liter. It’s collected in a plasma separator tube. You’ll see it here if you use the lab skeletons at the bottom. I like to call it ALK Phos. That’s how we’ve seen it used in practice. Lab values will be increased in the presence of liver disease, bone disease, pregnancy, various cancers, chronic kidney disease and ulcerative colitis. We’ve talked about that, right? Liver, oh boy, liver, bone, and the GI system. It will be decreased with a condition called hypophosphatasia. It’s a pretty rare disorder. It can also be decreased in anemia or cretinism, hypothyroidism, nutrient deficiencies, and scurvy. Okay? 

 

Linchpins for this lesson are that this is an enzyme and, the ALP is an enzyme and this lab measures the quantity of it in the blood. A normal value is between 40 and 130 units per liter. We’ll see an increase in this value in certain cancers and during pregnancy. Hypophosphatasia can be present when lab values are greatly decreased, otherwise it’s kind of rare. 

 

You did great on this lesson everybody. This wraps it up. We love you guys and remember, you can do this! Now, go out and be your best self today and as always, happy nursing!

 

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Concepts Covered:

  • Acute & Chronic Renal Disorders
  • Oncology Disorders
  • Urinary Disorders
  • Renal Disorders
  • Noninfectious Respiratory Disorder
  • Central Nervous System Disorders – Brain
  • Upper GI Disorders
  • Disorders of Pancreas
  • Male Reproductive Disorders
  • Cardiac Disorders
  • Vascular Disorders
  • Immunological Disorders
  • Shock

Study Plan Lessons

Acute Kidney Injury Case Study (60 min)
Acute Renal (Kidney) Module Intro
Alkaline Phosphatase (ALK PHOS) Lab Values
Causes of Renal Calculi Nursing Mnemonic (Patients Complain of Pain and Difficulty Urinating)
Chronic Renal (Kidney) Module Intro
Continuous Renal Replacement Therapy (CRRT, dialysis)
Dialysis & Other Renal Points
Disease Specific Medications
Encephalopathy (Hypoxic-ischemic, Metabolic, Infectious, Hepatic) for Progressive Care Certified Nurse (PCCN)
End-Stage Renal Disease (ESRD) for Progressive Care Certified Nurse (PCCN)
Enteral & Parenteral Nutrition (Diet, TPN)
Hemodialysis (Renal Dialysis)
Hypertonic Solutions (IV solutions)
Intake and Output (I&O)
Intrarenal Causes of Acute Kidney Injury Nursing Mnemonic (TONIC)
Kidney Cancer
Levofloxacin (Levaquin) Nursing Considerations
Lisinopril (Prinivil) Nursing Considerations
Metabolic & Endocrine Module Intro
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic/Endocrine Course Introduction
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of Glomerulonephritis
Nursing Care and Pathophysiology of Hypertension (HTN)
Nursing Care and Pathophysiology of Nephrotic Syndrome
Nursing Care and Pathophysiology of Renal Calculi (Kidney Stones)
Nursing Care and Pathophysiology of Urinary Tract Infection (UTI)
Nursing Care Plan (NCP) for Acute Kidney Injury
Nursing Care Plan (NCP) for Benign Prostatic Hyperplasia (BPH)
Nursing Care Plan (NCP) for Bladder Cancer
Nursing Care Plan (NCP) for Chronic Kidney Disease
Nursing Care Plan (NCP) for Encephalopathy
Nursing Care Plan (NCP) for Glomerulonephritis
Nursing Care Plan (NCP) for Hypovolemic Shock
Nursing Care Plan (NCP) for Kidney Cancer
Nursing Care Plan (NCP) for Nephrotic Syndrome
Nursing Care Plan (NCP) for Renal Calculi
Nursing Care Plan (NCP) for Urinary Tract Infection (UTI)
Nursing Case Study for Acute Kidney Injury
Nutrition (Diet) in Disease
Phenazopyridine (Pyridium) Nursing Considerations
Protein in Urine Lab Values
Renal (Kidney) Failure Labs
Renal Failure- Acute Kidney Injury (AKI), Chronic Kidney Disease (CKD) for Progressive Care Certified Nurse (PCCN)
Symptoms of Nephrotic Syndrome Nursing Mnemonic (NAPHROTIC)
Trimethoprim-Sulfamethoxazole (Bactrim) Nursing Considerations
Urinary Retention for Certified Emergency Nursing (CEN)
Who Needs Dialysis Nursing Mnemonic (AEIOU)
Vasopressin (Pitressin) Nursing Considerations