Blood Chemistery (Chem 20 Panel)
Test:
Sodium
Potassium
Normal Value
135-145 mEq/L
3.5-5.0 mEq/L
Interpretation
↓vomiting, diuretics, excessive admin of
dextrose and water, prolonged low
sodium diet, excessive water intake
↑tube feedings, diarrhea,
hyperventilation, diabetes insipidus, OTC
drugs s/a Alka-Settzer, near drowning in
salt water, inadequate H2O ingestion
↓vomiting, gastric suction, diuretics,
steroids, inadequate intake
↑renal failure, K+ supplements, burns,
crushing injuries
Chloride
CO2
BUN
Creatinine
Creatinine Clearance
100-110
34-45 mm/Hg
10-20 mg/dL
0.7-1.4 mg/dL
1.42- 2.08 mL/min
( 125 ml/min )
Glucose
Serum Calcium
70-110
8.6-10.2
↑ As levels rise renal function worsens
Estimates glomerular filtration rate
(GFR) of kidney
Lower levels indicate renal insufficiency
↓Hypoparathyroidism, pancreatitis, renal
failure, steroids, loop diuretics,
inadequate intake, post thyroid surgery
↑malignant neoplastic diseases,
hyuperparathyroidism, excessive intake,
carbonate antacids (TUMS)
Ionized Serum Calcium
Phosphorous
Magnesium
4.5-5.1
2.3- 4.7
1.3-2.3 mEq/L
↓ alcoholism, GI suction, diarrhea,
intestinal fistuals, abuse of diuretics or
laxitives
↑renal failure, excessive Mg admin
(antacids, cathartics)
May cause ventricular dysrhythmias,
EKG changes
Serum Bilirubin direct
0.1-0.4 mg/dL
Abnormal liver and gall bladder
disorders e.g., with jaundice
*Direct bilirubin ↑ in obstruction
Total Bilirubin
0.3-1 mg/dL
Protein studies Serum albumin
3.5-5.5 g/dL
Detect presence of bilirubin due
to hemolytic or liver disease
Proteins are produced by the
liver
Levels ↓ with hepatic disease
*severely ↓ albumin causes
edema!
(AST) Aspartate
aminotransferase
(ALT ) Alanine aminotransferase
Alkaline Phosphate
10 – 40 units
↑ liver disease, hepatitis
10- 40 units
50- 120 units/L
LDL
90 – 176 units /L
Blood Ammonia
15-45 mcg/dL
Amylase
6-160 U/dL
Lipase
< 200 U/d/L
↑ liver disease, hepatitis
Evaluates liver function,
NPO 8-12 hrs prior
Blood draw usually part of liver
panel
Used to manage Paget’s disease
and osteoporosis
With damage to liver enzymes
are released into the
bloodstream
The liver converts ammonia to
urea with liver disease ammonia
levels ↑
Diagnose pancreatitis and acute
cholecystitis
NPO 8 -12 hr prior to test
Diagnose acute/chronic
pancreatitis, biliary obstruction,
hepatitis, cirrhosis
Total Protein
Albumin
Uric Acid
6.7-7.7
3.5-5.5
Anti-nuclear antibodies ANA
↓ Nutritional Deficit
Blood draw - Used to detect
Gout
Blood test used to screen for
autoimmune disease such as
systemic Lupus, Sjogren’s ,
scleroderma
Complete Blood Count (CBC)
Test:
White Blood Cells (WBC)
Normal Value:
Adult: 4500 - 11,000 /mm3
Child: 5000 – 13000 / mm3
Red Blood Cells
M: 4.6 – 6.2 million/mm3
F: 4.2 – 5.4 million/ mm3
C: 3.2 – 5.2 million / mm3
M: 13 – 18 g/dL
F: 12 – 16 g/dL
C: 11 – 12.5 g/dL
Hemoglobin (HGB)
Interpretation:
↑ infection, inflammation,
malignancies s/s lymphoma,
leukemia, (e.g. UTI WBC in
urine)
↓ leucopenia, bone marrow
suppression, chronic disease,
leukemia
Anemia, hemorrhage, blood loss
Measures the O2 carrying
capacity of RBC
↓ Anemia, hemorrhage,
hemodilution, ↓O2, fatigue,
weakness
M: 42% - 52%
F: 35% - 47%
C: 35% - 45%
↓ HCT – blood loss
↓O2, fatigue, weakness
150,000- 450,000 / mm3
Used to diagnose hemorrhagic
diseases such as
Thrombocytopenia
Test:
Bleeding Time
Normal Value:
1.5- 9.5 minutes
Partial thromboplastin time (PTT)
20-40 seconds
Or
(1.5-2.5 x control)
e.g. Patient PTT = 250 sec
(control = 38 sec) would indicate
clotting!!!
10-16 seconds
Interpretation:
Duration of bleeding after
standardized skin incision
3+7=10 (HEPARIN)
Monitors effectiveness of
Heparin
Hematocrit (HCT)
MCV
MCHC
RDW
Platelets (PLT)
Neutrophil %
Bands %
Lymphocyte %
Monocyte %
Eosinophil %
Basophil %
Coagulation Studies
Prothrombin time (PT)
International normalized ratio
(INR)
Sedimentation Rate (ESR)
1.0
2-3 for therapy in arterial
fibrillation, DVT, & PE
2.5-3.5 for therapy in prosthetic
heart valve
M: 15- 20
F: 25 – 30
*Test that measures how long it
takes blood to clott
2 + 8 = 10 (COUMADIN) Monitors
effectiveness of Coumadin
Monitors the effectiveness of an
Warfarin/Coumadin therapy
therapy
Speed at which RBCs settle in
well mixed venous blood
↑ Indicates inflammation, fatigue,
weakness
Miscellaneous Test:
Test:
Troponin I
Troponin II
Creatine Kinase (CK)
Normal Value:
Interpretation:
MB bands present heart muscle
damage
Used to diagnose MI
Detected 3-5 hrs post MI
A1C
Glucose tolerance test
4% - 6%
Fasting 60-110 mg/dL
1 hr – 190 mg/dL
2 hr 140 mg/dL
3 hr 125 mg/dL
3 month review of glucose
Determines the ability of the
body to secrete insulin in
response to Hypoglycemia
Total Cholesterol
150-200 mg/dL
Low Density Lipoproteins (LDL)
100-160 mg / dL
High- Density Lipoproteins (HDL)
M: 35-70 mg/dL
F: 35- 85 mg / dL
100- 200 mg/dL
1.010 – 1.030
Determines the risk for
athlerosclerosis
Depends on risk factors in pt has
increased risk s/a CAD LOL <100
required
Delermines if elevated
cholesterol is due to HDL or LDL
Determines elevated cholesterol
levels caused by HDL or LDL
Detect risk for atherosclerosis
< 1.010 FVO
Decreased concentration of
solutes in urine
-renal failure, pylonephritis,
diabetes insipidus, acute tubular
necrosis , nephritis, excessive
intake of fluids FVO, polydipsia
Triglycerides
Specific Gravity
>1.030 concentrated FVD
Increased concentration of
solutes in urine
-dehydration, diarrhea, emesis,
excessive sweating, heart failure,
SIADH
As a patient looses edema fluid
the urine specific gravity will ↓
pH of Urine
FSerum Osmolality
TSH
T3
T4
4.5- 8
275-295
↑ Hypothyroidism
↓Hyperthyroidism
↓Hypothyroidism
↑Hyperthyroidism
↓Hypothyroidism
↑Hyperthyroidism
Arterial Blood Gas (ABG)
Test:
pH
Normal Value:
7.35
– 7.45
PaCO2
35– 45 mm/Hg
HCO3
22-26 mEq/L
Metabolic Alkalosis
Metobolic Acidosis
Respiratory Alkalosis
Respiratory Acidosis
PaO2
SaO2
pH ↑ CO2↑ HCO3↑
pH ↓ CO2↓ HCO3 ↓
pH ↑ CO2 ↓ HCO3 ↓
pH ↓ CO2 ↑ HCO3 ↑
85 – 95 mm/Hg
95% - 99%
pH Urine
pH Gastric aspirate
4.5- 8
5.0 -7.5
Interpretation:
< 7.35 Acidosis
>7.45 Alkalosis
>45 Respiratory Acidosis
< 35 Respiratory Alkalosis
< 22 Metabolic Acidosis
>26 Metabolic Alkalosis
< 5 overly acidic ↑ ulcer risk
(e.g. patient with burn! Need to
report to HCP if pH 5)
Therapeutic Range
Test:
Digoxin
Normal Range:
0.5-2 ng/mL
Phenytoin
Theophylline
Lithium
10-20
10-20
1 – 1.5 mEq/L
Interpretation:
Low K+ increases risk of toxicity
*assess HR prior to admin
HR<60 HOLD
Check serum levels 2-3 times wk
when therapy starts then monthly
while on maintenance
● Causes ↓ Na Hyponatremia
Tylenol
Toxic > 4000 mg/day or 4g/day
Pressure Reading:
Test:
Central Venous Pressure (CVP)
Normal Range:
Interpretation:
3-12 mm Hg in H20
It reflects RIGHT-SIDED filling
pressures. It is primarily used to
monitor fluid volume status
IF normal may indicate desired
response to fluid replacement!
Blood Pressure
Mean Arterial Pressure (MAP)
120/80 – 120-139/ 80-89
⮚
65
Newborn:
Respiratory Rate RR
Blood Glucose
BP
Temp
30 – 60 / min
40 – 69
60-80/ 40-50
Should not be less than 97.6 or
36.5