Laboratory Values *This list is based on current values listed by ATI and is likely not comprehensive. But it is a good place to start. Add on as you go through nursing school. *Values listed are blood values, unless otherwise specified. These are adult values. 1. Electrolytes and Glucose Electrolyte Sodium, Na+ Normal range 136-145 mEq/L Potassium, K+ Chloride, Cl- 3.5-5.0 mEq/L 98-106 mEq/L Calcium, Ca2+ 9-10.5 mg/dL Phosphorous, P Magnesium, Mg2+ 2.5-4.5 mg/dL 1.3-2.1 mg/dL Glucose measures Fasting blood glucose <100 mg/dL Glycosylated hemoglobin (HbA1c) 5-7% 2. Hematology Complete blood count (CBC) Component RBCs (erythrocytes) Hct (hematocrit) Hb (hemoglobin) MCH (mean corpuscular Hb) MCV (mean corpuscular volume) Normal range Females: 4.2-5.4 x 106 cells/uL Males: 4.7-6.1 x 106 cells/uL Females: 37-47% Males: 42-52% Females: 12-16 g/dL Males: 14-18 g/dL 27-31 pg/cell 80-95 fL Platelets 150,000-400,000 cells/mm3 WBCs (leukocytes) 5,000-10,000 cells/mm3 Iron (not part of CBC) Females: 60-160 mcg/dL Males: 80-180 mcg/dL Interpretation of findings High: erythrocytosis, polycythemia, severe dehydration Low: anemia, hemorrhage, renal disease High: erythrocytosis, COPD, severe dehydration Low: anemia, hemorrhage, renal disease High: erythrocytosis, COPD, severe dehydration Low: anemia, hemorrhage, renal disease High: megaloblastic anemia Low: iron deficiency anemia High: megaloblastic anemia Low: iron deficiency anemia High: malignancy, polycythemia, rheumatoid arthritis Low: splenomegaly, hemorrhage, leukemia High: infection, inflammation Low: immunosuppression, autoimmune disease High: liver disorder, lead toxicity Low: iron deficiency anemia, chronic blood loss 1 What is a CBC? The complete blood count (CBC) is a group of tests that evaluate the cells that circulate in blood, including red blood cells (RBCs), white blood cells (WBCs), and platelets (PLTs). The CBC detect a variety of diseases and conditions, such as infections, anemia and leukemia. Laboratory measure PTT (prothrombin time) PT (partial thromboplastin time) INR Clotting and Inflammation Normal range Interpretation of findings Increased: vitamin K deficiency, DIC, liver 30-40 seconds disease, heparin therapy Decreased: extensive cancer 11-12.5 seconds Same as PTT 0.78-1.1 Elevated: warfarin therapy Positive: DIC, malignancy Negative: rule out PE or DVT High: acute inflammation/infection, heart disease D-dimer <0.4 mcg/dL Fibrinogen 200-400 mg/dL 3. Respiratory Arterial blood gas (ABG). An arterial blood gas (ABG) sample reports the status of oxygenation and acid‑base balance of the blood. (often done by respiratory therapist) An ABG measures the following: • pH: amount of free hydrogen ions in the arterial blood (H+) • PaO2: partial pressure of oxygen • PaCO2: partial pressure of carbon dioxide • HCO3¯ : concentration of bicarbonate in arterial blood Normal Values 7.35 – 7.45 pH PO 80-100 mmHg 2 PCO 2 35 – 45 mmHg HCO 3 21-28 mEq/L 4. Cardiovascular Lipids Type Total cholesterol LDL Desired Value <200 mg/dL <130 mg/dL Purpose Screening for heart disease ‘bad cholesterol’ – transports cholesterol from cells to liver 2 Triglycerides HDL Females: 35-135 mg/dL Males: 40-160 mg/dL Females: >55 mg/dL Males: >45 mg/dL Higher levels associated with increased heart disease risk ‘good’ cholesterol – protects from heart disease by transporting cholesterol from cells to liver Cardiac enzymes Type Expected range (normal) CK MB 30-170 units/L Troponin T <0.1 ng/mL Timing after myocardial injury First detected 3-6 hours after injury. Remains elevated 2-3 days First detected 2-3 hours after injury. Remains elevated 1014 days 5. Gastrointestinal and hepatobiliary Blood test Liver enzymes Normal range Aspartate aminotransferase (AST) Alanine aminotransferase (ALT) Alkaline phosphatase (ALP) Other liver tests 0-35 units/L 4-36 units/L 30-120 units/L Total bilirubin 0.3-1 mg/dL Direct (conjugated) bilirubin Indirect (unconjugated) bilirubin Albumin Total protein (albumin + globulin) Ammonia Lactate dehydrogenase (LDH) 0.1-0.3 mg/dL 0.2-0.8 mg/dL 3.5-5 g/dL 6 – 8.3 g/dL 10-80 mcg/dL 140 – 280 U/L Interpretation of findings Elevated in hepatitis or cirrhosis Same as above Elevated with liver damage Elevated with altered liver function, bile duct obstruction Same as above Same as above Decreased in liver disease Decreased in liver disease Elevated in liver disease Elevated in tissue damage from anemia, liver disease, lung disease, infections Pancreatic enzymes Amylase Lipase 30-220 units/L 0-160 units/L Elevated in pancreatitis Same as above 6. Renal Measure Blood urea nitrogen (BUN) Creatinine (Cr) Glomerular filtration rate (GFR) Urinalysis Normal Range 8-20 mg/dL 0.6-1.2 mg/dL >90 ml/min Interpretation of Findings High: renal impairment, dehydration High: renal impairment Low: decreased renal function Urinary output Specific gravity Normal urine pH 30 ml/hr 1.005-1.030 4.5 – 8.0 Low: renal injury or impairment High: dehydration Usual values are 6.0 – 7.5 3 7. MIscellanous Blood test Ethanol Normal range < 50 mg/dL or 0.05% Interpretation of findings Individual is not considered intoxicated 0.08% ethanol level – alcohol limit for drivers 4