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Lab Values

Nursing

QuestionAnswer
Red Blood Cells (RBC's) Actual count of red corpucles Normal male = 4.6 - 6.2 Normal female = 4.2 - 5.2
Hemoglobin - HGB A direct measure of oxygen carrying capacity of the blood Normal male = 14 - 18 g/dl Normal female = 12 - 16 g/dl
Mean Cell Volume MCV - indicates the size of the RBC Normal male = 80 - 96 Normal female = 82 - 98 decrease may ID iron deficiency anemia & thalassemia increase may ID pernicious anemia & folic acid anemai
Mean Cell Hemoglobin per RBC MCH - indicates the weight of hemoglobin in RBC regardless of the size Normal 27 - 33 increase ID folate deficiency decrease ID iron deficiency
Mean Cell Hemoglobin Concentration MCHC indicates the hemoglobin concentration per unit of RBC's Normal 31 - 35 Decrease ID hypochromic anemia
Reticulocyte Count An indirect measure of RBC production Normal 0.5 - 2.5% of RBC
Red Blood Cell Distribution Width RDW is the size width differences of RBC's Indicates variation in red cell volume Normal 11 - 16% Increase ID iron deficiency anemia or mixed anemia Note: increase in RDW occurs earlier than decrease in MCV therefore RDW is used for early detection of iron deficiency anemia
Platelets Normal 140,000 - 450,000 Low - worry patient will bleed High - not clinically significant
White Blood Cell (WBC) Leukocytes Normal 4.5 - 10 or 4500 to 10,000 Newborn 9000 - 30,000 2 years 6000 - 17,000 10 years 4500 - 13,500 Increase called leukocytosis; occur during infections & physiologic stress Decrease called leukopenia; marrow suppression & chemotherapy
Neutrophils are the most circulating WBC & they respond more rapidly to the inflammatory & tissue sites than other types of WCB Normal 2500 - 8000
Lymphocytes Normal 1000 - 4000 Increase occurs in chronic & viral infections Severe= chronic lymphocytic leukemia Decrease in # during excess adrenocortical hormone or steroid therapy
BUN serum Blood Urea Nitrogen To detect a renal disorder or dehydration associated with increased levels Normal 5 - 25 Panic = > 100
Creatinine To diagnose renal function Normal 0.5 - 1.5 Decrease pregnancy & eclampsia Increase Acute & chronic renal failure shock lupus & more
Creatine clearance to detect renal dysfunction & to monitor renal function Normal 85 - 135
Total Protein & Albumin R/T Liver status Total protein normal = 5.5 - 9.0 Albumin = 3.5 - 5.0 Low cause liver dysfunction S/SX peripheal edema ascites periorbital edema pulmonary edema
Potassium (K) regulated by renal function Normal 3.5 - 5.0 hypokalemia less than 3.5 hyperkalemia greater than 5.0 (panic >6.0) note false K elevations are seen in hemolysis of samples
Urinalysis Specific Gravity Normal 1.010 - 1.030
Urine normal should be clear yellow cloudy results from urates (acid) phopsphates (alkaline) or presence of RBC or WBC foam from protein or bile acids in urine
Urine & Meds red orange - pyridium rifampin senna phenothiazines blue green - azo dyes elavil methylene blue clorets abuse brown black - cascara chloroquine senna iron salts flagyl sulfonoasmides & nitrofurantoin
pH Normal 4.5 - 8
Protein content in urine Normal 0 - +1 or less than 150 mg/day Protein in urine ID of hemolysis high BP UTI fever renal tubular damage exercise CHF diabetic nephropathy preeclampsia of pregnancy multiple myeloma nephrosis lupus nephritis & others
Microscopic analysis of Urine urine should be sterile ( no normal flora) few if any cells should be found significant bacteriuria is defined by an inital positive dipstick for leukocyte esterase or nitrites
Sodium (Na) major contributory to cell osmolality and in control of water balance Normal 135 - 145
Hypernatremia > 145cause sodium overload Or volume depletion seen in impaired thirst inability to replace insensible losses renal or GI loss
Hyponatremia <135 < 135 cause true depletion or dilutinal occurs in CHF diarrhea sweating thiazides S/SX agitation anorexia apathy disorientation lethargy muscle cramps & nausea
Calcium Normal 8.5 - 10.8
Hypocalcemia <8.5 causes law serum proteins decreased intake calcitonin steroid loop diuretic high PO4 low Mg hypoparathyroidism renal failure vitamin D deficiency pancreatitis
Hypercalcemia >10.8 cause malignancy or hyperparathyroidism excessive IV Ca salts supplements chronic immobilizaiton Paget disease sarcoidosis hyperthyroidism lithium androgens tamoxifen estrogen progesterone excessive vit D or thyroid hormone increased risk of dig to
Phosphate - PO4 Normal 2.6 - 4.5
Magnesium Normal 1.5 - 2.2 Critical <0.5 or >3 primarily eliminated by the kidney
Hypomagnesemia Less than 1.5 Cause excessive loss from GI tract (D&V) or kidneys (diuretics)- Alcoholism may lead to low levels
Hypermagnesemia more than 2.2 cause- renal dysfunction, hepatitis & addison disese
Alkaline Phosphatese normal - ranges vary widely - increase occurs in liver dysfunction group of enzymes found in the liver bones small intestines kidneys placenta & leukocytes ( most activity from bones & liver)
Aminotransferases ALT and AST Normal ALT 3 - 30 AST 8 -38 ALT & AST are measure indicators of liver disease. Increased occurs after MI muscle diseases and hemolysis
Direct Bilirubin - Conjugated Normal 0.1 - 0.3 mg/d increased associated with increase in other liver enzymes and reflect liver disease
Chloride Normal 95 -105 reduced by metabolic alkalosis increased by metabolic or respiratory acidosis
Bicarbonate - HCO3 Normal 22 - 26 the test represents bicarbonate - the base of the carbonice acid bicarbonate buffer system decrease- acidosis & increase alkalosis
pH 7.35 - 7.45 increased alkaline decreased acid
PCO2 Normal 35 - 34 increased acid decreased alkaline
PO2 normal 80 -100
O2 saturation 96 - 100
Metabolic Alkalosis increased ph & PC02 & HC03
Metabolic Acidosis decreased pH & PC02 & HC03
Respiratory Alkalosis decreased pH & HC03 increased PC02
Respiratory Acidosis increase pH decrease PC02 & HC03
Phosphate Normal 3.0 - 4.5
Chorionic villi biopsy - CVB normal finding - normal fetal cells 3 - 11 or 2 -8
Hemocrit - HCT 36 - 45
Erythrocyte sedimentation rate - ESR Blood SED Rate 0 - 20
PTT 20 - 45 seconds Max 112 seconds Therapeutic 1.5 - 2.5
PT/INR Pro Time International Normalized Ratio 10 - 45 seconds
Bilirubin 0.1 - 1.0
Digoxin 0.5 - 2 toxic > 2.5
Dilantin 10 - 20 toxic > 30
Theophylline 10 - 20 toxic > 20
Lithium 0.5 - 1.2
Tylenol Toxic > 4000 mg/day
Glycosylated Hemoglobin A1C 3 month review of Glucose
Glucose Normal 70 -110
Hyperglycemia S/SX increase thirst, urination & hunger may progress to coma cause include diabetes
Hypoglycemia S/SX sweating hunger anxiety trembling blurred vision weakness headache or altered mental status cause - fasting or insulin adminstration
Serum Osmolarity 285 - 295
Created by: hrhfal