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Values AND Markers - notes
Nursing Process Ii (Broward College)
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VALUES AND MARKERS
Hematology Values
 HEMATOCRIT (HCT)
 Normal Adult Female Range: 37 – 47%
Optimal Adult Female Reading: 42%
Normal Adult Male Range 40 – 54%
Optimal Adult Male Reading: 47
Normal Newborn Range: 50 – 62%
Optimal Newborn Reading: 56
 HEMOGLOBIN (HGB)
 Normal Adult Female Range: 12 – 16 g/dl
Optimal Adult Female Reading: 14 g/dl
Normal Adult Male Range: 14 – 18 g/dl
Optimal Adult Male Reading: 16 g/dl
Normal Newborn Range: 14 – 20 g/dl
Optimal Newborn Reading: 17 g/dl
 MCH (Mean Corpuscular Hemoglobin)
 Normal Adult Range: 27 – 33 pg
Optimal Adult Reading: 30
 MCV (Mean Corpuscular Volume)
 Normal Adult Range: 80 – 100 f
Optimal Adult Reading: 90
Higher ranges are found in newborns and infants
 MCHC (Mean Corpuscular Hemoglobin Concentration)
 Normal Adult Range: 32 – 36 %
Optimal Adult Reading: 34
Higher ranges are found in newborns and infants
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R.B.C. (Red Blood Cell Count)
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Normal Adult Female Range: 3.9 – 5.2 mill/mcl
Optimal Adult Female Reading: 4.55
Normal Adult Male Range: 4.2 – 5.6 mill/mcl
Optimal Adult Male Reading: 4.9
Lower ranges are found in Children, newborns and infants
W.B.C. (White Blood Cell Count)
 Normal Adult Range: 3.8 – 10.8 thous/mcl
Optimal Adult Reading: 7.3
Higher ranges are found in children, newborns and infants.
PLATELET COUNT
 Normal Adult Range: 130 – 400 thous/mcl
Optimal Adult Reading: 265
Higher ranges are found in children, newborns and infants
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NEUTROPHILS and NEUTROPHIL COUNT – this is the main
defender of the body against infection and antigens. High
levels may indicate an active infection.
 Normal Adult Range: 48 – 73 %
Optimal Adult Reading: 60.5
Normal Children’s Range: 30 – 60 %
Optimal Children’s Reading: 45
LYMPHOCYTES and LYMPHOCYTE COUNT – Elevated levels
may indicate an active viral infections such as measles,
rubella, chickenpox, or infectious mononucleosis.
 Normal Adult Range: 18 – 48 %
Optimal Adult Reading: 33
Normal Children’s Range: 25 – 50 %
Optimal Children’s Reading: 37.5
MONOCYTES and MONOCYTE COUNT – Elevated levels are
seen in tissue breakdown or chronic infections, carcinomas,
leukemia (monocytic) or lymphomas.
 Normal Adult Range: 0 – 9 %
Optimal Adult Reading: 4.5
EOSINOPHILS and EOSINOPHIL COUNT – Elevated levels may
indicate an allergic reactions or parasites.
 Normal Adult Range: 0 – 5 %
Optimal Adult Reading: 2.5
BASOPHILS and BASOPHIL COUNT – Basophilic activity is not
fully understood but it is known to carry histamine, heparin
and serotonin. High levels are found in allergic reactions.
 Normal Adult Range: 0 – 2 %
Optimal Adult Reading: 1
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Electrolyte Values
 SODIUM – Sodium is the most abundant cation in the blood
and its chief base. It functions in the body to maintain
osmotic pressure, acid-base balance and to transmit nerve
impulses. Very Low value: seizure and Neurologic Sx.
 Normal Adult Range: 135-146 mEq/L
Optimal Adult Reading: 140.5
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POTASSIUM – Potassium is the major intracellular cation.
Very low value: Cardiac arythemia.
Normal Range: 3.5 – 5.5 mEq/L
Optimal Adult Reading: 4.5
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CHLORIDE – Elevated levels are related to acidosis as well as
too much water crossing the cell membrane. Decreased
levels with decreased serum albumin may indicate water
deficiency crossing the cell membrane (edema).
Normal Adult Range: 95-112 mEq/L
Optimal Adult Reading: 103
CO2 (Carbon Dioxide) – The CO2 level is related to the
respiratory exchange of carbon dioxide in the lungs and is
part of the bodies buffering system. Generally when used
with the other electrolytes, it is a good indicator of acidosis
and alkalinity.
Normal Adult Range: 22-32 mEq/L
Optimal Adult Reading: 27
Normal Childrens Range – 20 – 28 mEq/L
Optimal Childrens Reading: 24
CALCIUM – involved in bone metabolism, protein absorption,
fat transfer muscular contraction, transmission of nerve
impulses, blood clotting and cardiac function. Regulated by
parathyroid.
Normal Adult Range: 8.5-10.3 mEq/dl
Optimal Adult Reading: 9.4
PHOSPHORUS – Generally inverse with Calcium.
Normal Adult Range: 2.5 – 4.5 mEq/dl
Optimal Adult Reading: 3.5
Normal Childrens Range: 3 – 6 mEq/dl
Optimal Childrens Range: 4.5
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ANION GAP (Sodium + Potassium – CO2 + Chloride) – An
increased measurement is associated with metabolic
acidosis due to the overproduction of acids (a state of
alkalinity is in effect). Decreased levels may indicate
metabolic alkalosis due to the overproduction of alkaloids (a
state of acidosis is in effect).
Normal Adult Range: 4 – 14 (calculated)
Optimal Adult Reading: 9
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CALCIUM/PHOSPHORUS Ratio
Normal Adult Range: 2.3 – 3.3 (calculated)
Optimal Adult Reading: 2.8
Normal Children’s range: 1.3 – 3.3 (calculated)
Optimal Children’s Reading: 2.3
SODIUM/POTASSIUM
Normal Adult Range: 26 – 38 (calculated)
Optimal Adult Reading: 32
Hepatic Enzymes
 AST (Serum Glutamic-Oxalocetic Transaminase – SGOT )
– found primarily in the liver, heart, kidney, pancreas, and
muscles. Seen in tissue damage, especially heart and live
 Normal Adult Range: 0 – 42 U/L
Optimal Adult Reading: 21
 Normal Adult Range: 0 – 48 U/L
Optimal Adult Reading: 24
 Normal Adult Range: 20 – 125 U/L
Optimal Adult Reading: 72.5
Normal Childrens Range: 40 – 400 U/L
Optimal Childrens Reading: 220
 Normal Adult Female Range: 0 – 45 U/L
Optimal Female Reading: 22.5
Normal Adult Male Range: 0 – 65 U/L
Optimal Male Reading: 32.5
 Normal Adult Range: 0 – 250 U/L
Optimal Adult Reading: 125
 Normal Adult Range 0 – 1.3 mg/dl
Optimal Adult Reading: .65
 ALT (Serum Glutamic-Pyruvic Transaminase – SGPT)
– Decreased SGPT in combination with increased cholesterol
levels is seen in cases of a congested liver. We also see
increased levels in mononucleosis, alcoholism, liver damage,
kidney infection, chemical pollutants or myocardial
infarction
 ALKALINE PHOSPHATASE – Used extensively as a tumor
marker it is also present in bone injury, pregnancy, or
skeletal growth (elevated readings. Low levels are
sometimes found in hypoadrenia, protein deficiency,
malnutrition and a number of vitamin deficiencies
 GGT (Gamma-Glutamyl Transpeptidase) – Elevated levels
may be found in liver disease, alcoholism, bile-duct
obstruction, cholangitis, drug abuse, and in some cases
excessive magnesium ingestion. Decreased levels can be
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found in hypothyroidism, hypothalamic malfunction and low
levels of magnesium.
LDH (Lactic Acid Dehydrogenase) – Increases are usually
found in cellular death and/or leakage from the cell or in
some cases it can be useful in confirming myocardial or
pulmonary infarction (only in relation to other tests).
Decreased levels of the enzyme may be seen in cases of
malnutrition, hypoglycemia, adrenal exhaustion or low
tissue or organ activity.
BILIRUBIN, TOTAL – Elevated in liver disease, mononucleosis,
hemolytic anemia, low levels of exposure to the sun, and
toxic effects to some drugs, decreased levels are seen in
people with an inefficient liver, excessive fat digestion, and
possibly a diet low in nitrogen bearing foods
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Renal Related
 B.U.N. (Blood Urea Nitrogen) – Increases can be caused by
excessive protein intake, kidney damage, certain drugs, low
fluid intake, intestinal bleeding, exercise or heart failure.
Decreased levels may be due to a poor diet, malabsorption,
liver damage or low nitrogen intake.
 Normal Adult Range: 7 – 25 mg/dl
Optimal Adult Reading: 16
 Normal Adult Range: .7 – 1.4 mg/dl
Optimal Adult Reading: 1.05
 Normal Adult Female Range: 2.5 – 7.5 mg/dl
Optimal Adult Female Reading: 5.0
Normal Adult Male Range: 3.5 – 7.5 mg/dl
Optimal Adult Male Reading:5.5
 Normal Adult Range: 6 -25 (calculated)
Optimal Adult Reading: 15.5
 CREATININE – Low levels are sometimes seen in kidney
damage, protein starvation, liver disease or pregnancy.
Elevated levels are sometimes seen in kidney disease due to
the kidneys job of excreting creatinine, muscle
degeneration, and some drugs involved in impairment of
kidney function.
 URIC ACID – High levels are noted in gout, infections, kidney
disease, alcoholism, high protein diets, and with toxemia in
pregnancy. Low levels may be indicative of kidney disease,
malabsorption, poor diet, liver damage or an overly acid
kidney.
 BUN/CREATININE – This calculation is a good measurement of
kidney and liver function.
Protein
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PROTEIN, TOTAL – Decreased levels may be due to poor
nutrition, liver disease, malabsorption, diarrhea, or severe
burns. Increased levels are seen in lupus, liver disease,
chronic infections, alcoholism, leukemia, tuberculosis
amongst many others.
Normal Adult Range: 6.0 -8.5 g/dl
Optimal Adult Reading: 7.25
Normal Adult Range: 3.2 – 5.0 g/dl
Optimal Adult Reading: 4.1
Normal Adult Range: 2.2 – 4.2 g/dl (calculated)
Optimal Adult Reading: 3.2
Normal Adult Range: 0.8 – 2.0 (calculated)
Optimal Adult Reading: 1.9
ALBUMIN – major constituent of serum protein (usually over
50%). High levels are seen in liver disease(rarely) , shock,
dehydration, or multiple myeloma. Lower levels are seen in
poor diets, diarrhea, fever, infection, liver disease,
inadequate iron intake, third-degree burns and edemas or
hypocalcemia
GLOBULIN – Globulins have many diverse functions such as,
the carrier of some hormones, lipids, metals, and
antibodies(IgA, IgG, IgM, and IgE). Elevated levels are seen
with chronic infections, liver disease, rheumatoid arthritis,
myelomas, and lupus are present, . Lower levels in immune
compromised patients, poor dietary habits, malabsorption
and liver or kidney disease.
A/G RATIO (Albumin/Globulin Ratio)
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Lipids
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CHOLESTEROL – High density lipoproteins (HDL) is desired as
opposed to the low density lipoproteins (LDL), two types of
cholesterol. Elevated cholesterol has been seen in
artherosclerosis, diabetes, hypothyroidism and pregnancy.
Low levels are seen in depression, malnutrition, liver
insufficiency, malignancies, anemia and infection.
Normal Adult Range: 120 – 240 mg/dl
Optimal Adult Reading: 180
Normal Adult Range: 62 – 130 mg/dl
Optimal Adult Reading: 81 mg/dl
Normal Adult Range: 35 – 135 mg/dl
Optimal Adult Reading: +85 mg/dl
Normal Adult Range: 0 – 200 mg/dl
Optimal Adult Reading: 100
Normal Adult Range: 1 – 6
Optimal Adult Reading: 3.5
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LDL (Low Density Lipoprotein) – studies correlate the
association between high levels of LDL and arterial
artherosclerosis
 HDL (High Density Lipoprotein) – A high level of HDL is an
indication of a healthy metabolic system if there is no sign
of liver disease or intoxication.
 TRIGLYCERIDES – Increased levels may be present in
artherosclerosis, hypothyroidism, liver disease, pancreatitis,
myocardial infarction, metabolic disorders, toxemia, and
nephrotic syndrome. Decreased levels may be present in
chronic obstructive pulmonary disease, brain infarction,
hyperthyroidism, malnutrition, and malabsorption.
 CHOLESTEROL/LDL RATIO
Thyroid
 THYROXINE (T4) – Increased levels are found in
hyperthyroidism, acute thyroiditis, and hepatitis. Low levels
can be found in Cretinism, hypothyroidism, cirrhosis,
malnutrition, and chronic thyroiditis.
 Normal Adult Range: 4 – 12 ug/dl
Optimal Adult Reading: 8 ug/dl
 Normal Adult Range: 27 – 47%
Optimal Adult Reading: 37 %
 Normal Adult Range: 4 – 12
Optimal Adult Reading: 8
 Normal Adult Range: .5 – 6 milU/L
 AACE (2003) target level: 0.3 to 3.04
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T3-UPTAKE – Increased levels are found in hyperthyroidism,
severe liver disease, metastatic malignancy, and pulmonary
insufficiency. Decreased levels are found in hypothyroidism,
normal pregnancy, and hyperestrogenis status.
FREE T4 INDEX (T7)
THYROID-STIMULATING HORMONE (TSH) – produced by the
anterior pituitary gland, causes the release and distribution
of stored thyroid hormones. When T4 and T3 are too high,
TSH secretion decreases, when T4 and T3 are low, TSH
secretion increases.
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Cardiac
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Creatine phosphokinase (CK) – Levels rise 4 to 8 hours after
an acute MI, peaking at 16 to 30 hours and returning to
baseline within 4 days
25-200 U/L
32-150 U/L
< 12 IU/L if total CK is <400 IU/L
<3.5% of total CK if total CK is >400 IU/L
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140-280 U/L
LDH-1 18%-33%
LDH-2 28%-40%
10-42 U/L
<1
< 0.4
CK-MB CK isoenzyme – It begins to increase 6 to 10 hours
after an acute MI, peaks in 24 hours, and remains elevated
for up to 72 hours.
 (LDH) Lactate dehydrogenase – Total LDH will begin to rise 2
to 5 days after an MI; the elevation can last 10 days.
 LDH-1 and LDH-2 LDH isoenzymes – Compare LDH 1 and LDH
2 levels. Normally, the LDH-1 value will be less than the LDH2. In the acute MI, however, the LDH 2 remains constant,
while LDH 1 rises. When the LDH 1 is higher than LDH 2, the
LDH is said to be flipped, which is highly suggestive of an
MI. A flipped pattern appears 12-24 hours post MI and
persists for 48 hours.
 SGOT – will begin to rise in 8-12 hours and peak in 18-30
hours
 Myoglobin – early and sensitive diagnosis of myocardial
infarction in the emergency department This small heme
protein becomes abnormal within 1 to 2 hours of necrosis,
peaks in 4-8 hours, and drops to normal in about 12 hours.
 Troponin Complex – Peaks in 10-24 hours, begins to fall off
after 1-2 weeks.
Table of Cardiac markers
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Serum Markers of
Myocardial Injury
Detected
Peak
Falls
Myoglobin
1-3
1-8
12-18
CK/CK-MB
3-8
12-16
24-48
MB Isoforms
1-6
4-8
12-48
Troponin Complex
3-6
10-24
cTnI: 5-9 days
cTnT: 7-14 days
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