Lab Values Flashcards
What is the normal range for potassium?
3.5 - 5.0 mEq/L
What is the normal range for sodium?
136 - 145 mEq/L
What is the normal range for calcium?
9.0 - 10.5 mg/dL
What is the normal range for glucose?
70 - 100 mg/dL
What is the normal range for creatinine?
0.6 - 1.2 mg/dL
What is the normal range for blood urea nitrogen?
10 - 20 mg/dL
What is the normal range for chloride?
98 - 106 mEq/L
What is the normal range for total CO2 (Carbon Dioxide Content)?
23 - 30 mEq/L
What is the normal value for estimated Glomerular Filtration Rate (eGFR)?
> 60 mL/min
When is sodium considered critically low?
< 120 mEq/L
When is sodium considered critically high?
> 160mEq/L
When is potassium considered critically low?
< 3.0 mEq/L
When is potassium considered critically high?
> 6.1 mEq/L
When is glucose considered critically low?
< 40 mg/dL
When is glucose considered critically high?
> 450 mg/dL
What is the normal range for total protein?
6.4 - 8.3 mg/dL
What is the normal range for albumin?
3.5 - 5.0 g/dL
What is the normal range for bilirubin?
0.3 - 1.0 mg/dL
What is the normal range for Alkaline Phosphatase (ALP)?
30 - 120 units/L
What is the normal range for Aspartate Aminotransferase (AST)?
0 - 35 units/L
What is the normal range for Alanine Aminotransferase (ALT)?
4 - 36 units/L
What is the normal range for White Blood Cells (WBC)?
5,000 - 10,000/mm^3
or
5 - 10 x 10^9/L
What is the normal range for Red Blood Cells (RBC)?
4.2 - 6.1 x 10^12/L
What is the normal range for Hemoglobin (Hgb)?
12.0 - 18.0 g/dL
What is the normal range for Hematocrit (Hct)?
37% - 52%
What is the normal range for Platelets?
150.000 - 400,000/mm^3
or
150 - 400 x 10^9/L
What is the normal range for Partial Thromboplastin Time (PTT)?
60 - 70 seconds
What is the normal range for Prothrombin Time (PT)?
11 - 12.5 seconds
What is the normal range for International Normalized Ratio (INR)?
0.8 - 1.1
What is the therapeutic range for Internation Normalized Ratio (INR)?
2.0 - 3.0
What is the normal value for High Density Lipoprotein (HDL)?
> 45 mg/dL
What is the normal value for Low Density Lipoprotein (LDL)?
< 130 mg/dL
What is the normal range for Triglycerides?
40 - 160 mg/dL
What is the normal value for Total Cholesterol?
< 200 mg/dL
What is the normal range for magnesium?
1.6 - 2.6 mEq/L
What is the normal range for phosphorus?
3.0 - 4.5 mg/dL
What is the normal range for Hemoglobin A1C (Hgb A1C)?
4 - 6%
What is the normal range for Ammonia?
10 - 80 mcg/dL
What is the normal value for Troponin?
< 0.017 ng/mL
What is the normal range for BNP?
< 100 pg/mL
What is the normal range for Digoxin?
0.8 - 2.0 ng/mL
What is the normal value for D-Dimer?
< 500 ng/mL
What is the normal value for Erythrocyte Sedimentation Rate (ESR)?
< 20 mm/hr
What is the normal value for C-Reactive Protein (CRP)?
< 10 mg/dL
What is the normal value for Creatinine Clearance?
~ (about) 120 mL/min
When are White Blood Cells (WBCs) considered critically high?
> 40,000 mm^3
When are White Blood Cells (WBCs) considered critically low?
< 2,000 mm^3
What labs are included in a lipid panel?
HDL
LDL
Total Cholesterol
Triglycerides
What labs are included in a Basic Metabolic Panel (BMP)?
Sodium Potassium Chloride Total CO2 Glucose Blood Urea Nitrogen (BUN) Creatinine eGFR Total Calcium Anion Gap
What labs are included in a Complete Metabolic Panel (CMP)?
All labs from a BMP: Sodium Potassium Chloride Total CO2 Glucose Blood Urea Nitrogen (BUN) Creatinine eGFR Total Calcium Anion Gap
And then labs to evaluate how well the liver is working: ALP AST ALT Total Protein Albumin Bilirubin
What labs are included in a Complete Blood Count (CBC)?
White Blood Cells Red Blood Cells Hemoglobin Hematocrit Platelet Count
What labs are included in a Complete Blood Count with Differential (CBC w/ Diff)?
All labs from a CBC: White Blood Cells Red Blood Cells Hemoglobin Hematocrit Platelet Count
And then labs to analyze white blood cell production: Neutrophils Lymphocytes Monocytes Eosinophils Basophils
What labs will tell the provider how the liver is functioning?
AST ALT ALP Total Protein Albumin Bilirubin Ammonia (This is usually tested only with known liver malfunction)
List all the electrolytes we’ve learned about thus far
Sodium Potassium Chloride Calcium Magnesium Phosphorus
If the glucose results higher than normal, the first thing the nurse should do is…
Assess the patient!
If the glucose results higher than normal, the second thing the nurse should do is…
After assessing the patient, inquire about the patient’s dietary habits for the day. Have they eaten recently?
Signs and symptoms of hyperglycemia are?
Increased thirst (polydipsia) Increased urination (polyuria) Increased hunger (polyphagia) Hot, dry skin
If a patient exhibits these s/s, the nurse should suspect hyperglycemia is possible; check the blood glucose
Signs and symptoms of hypoglycemia are?
Fatigue Weakness Headache Hunger Clammy, cool skin Shakiness Irritability
If a patient exhibits these s/s, the nurse should suspect hypoglycemia is possible; check the blood glucose
What will kill the patient first, a critically high or critically low glucose?
Critically low!
Brain requires glucose for energy. Without glucose, the brain will shut down and the body will go into a coma (life threatening!)
Which blood glucose requires attention from the nures first:
Blood Glucose of 68 mg/dL
Blood Glucose of 800 mg/dL
Blood Glucose of 68 mg/dL
Even though this blood glucose is not critically low yet, it is lower than desired range. A low blood sugar must be corrected so it does not keep dropping. Remember: the brain requires glucose for energy. Without glucose, the brain will shut down and the body will go into a coma (life threatening!)
A blood glucose of 800 mg/dL is critically high and concerning, but it is not the priority when another patient is hypoglycemic!
If the BUN is acutely elevated and the patient does not have any known kidney disease, what may be the patients issue?
The patient may be dehydrated.
Which electrolytes assist in cardiac and smooth muscle function?
Potassium
Calcium
Sodium
If the bilirubin is > 1.0 mg/dL, what clinical manifestation might the patient present with?
Jaundice.
Yellow tinted skin and sclera
What is the role of albumin?
Keep fluid from leaking out of the blood vessels
Nourish tissues
Promote wound healing
Transport substances throughout the body (because it’s a protein!)
If AST, ALT and ALP are elevated, what does the nurse suspect?
Impaired/decreased liver function
If albumin is decreased, what organ could be malfunctioning?
Liver
The liver synthesizes/makes albumin. If the liver isn’t working properly, it cannot make the albumin!
If albumin is elevated, what could be the issue?
Dehydration
What are causes of a decreased albumin level?
Liver malfunction
Fluid volume overload
Malnutrition (i.e. alcoholics)
If the total protein level is decreased, what are possible causes?
Liver impairment
Fluid volume overload
Malnutrition (i.e. alcoholics)
What is the medical term for White Blood Cells?
Leukocytes
What is the medical term for Red Blood Cells?
Erythrocytes
When are White Blood Cells most commonly elevated?
During an acute bacterial infection
How long does a Red Blood Cell typically live for?
120 days
What does Hemoglobin (Hgb) measure?
The amount of oxygen carried within the blood
What does Hematocrit (Hct) measure?
The percentage of total blood volume made up by red blood cells
What unit is Hematocrit (Hct) measured in?
percentage (%)
What is the medical term used when RBCs, Hct and Hgb are elevated?
Erythrocytosis
What is the medical term used when RBCs, Hct and Hgb are decreased?
Erythropenia
What is the most common cause of erythrocytosis?
Dehydration
Fluid volume within the vessels decreases, but the RBCs, Hgb and Hct do not decrease. This makes it appear as though there is more RBCs, Hgb and Hct available.
What are causes of erythrocytosis?
Dehydration
Chronic Obstructive Pulmonary Disease (COPD)
Living at high altitudes
What are causes of erythropenia?
Hemorrhage (blood loss) from a trauma or internal bleeding Fluid volume overload Nutritional deficiencies Kidney/Renal Disease Anemia
What is the medical term for platelets?
Thrombocytes
What is the medical term for elevated platelet count?
Thrombocytosis
What is the medical term for decreased platelet count?
Thrombocytopenia
If a patient experiences a trauma and they have lost a lot of blood (hemorrhaging), what labs within the CBC will be decreased?
RBC
Hgb
Hct
Platelets
If a provider wanted to analyze the “break down” of the WBC, what test would be ordered?
CBC with differential
What is it called when a patient is experiencing an acute bacterial infection and neutrophils are being produced rapidly?
Shift to the left
Occurs during an acute bacterial infection, neutrophils are stimulated and rapidly produced. They enter circulation early to fight off the infection.
What is the medical term for critically low WBCs?
Neutropenia
What type of precautions need to be put into place if a patient has WBCs <2,000
The patient is neutropenic and neutropenic precautions need to be put in place
Everyone except the patient must wear a mask when around patient to protect patient from their germs
If a patient is taking the medication Warfarin (Coumadin) what lab value(s) will the nurse monitor? Will the nurse expect these lab values to be higher or lower than normal range?
Monitor PT and INR
Both values will be elevated above normal range while patient is on this medication.
PT will be prolonged, meaning the time it takes for the blood to clot will be longer
INR will ideally be elevated to therapeutic range (2.0-3.0) while on this medication
If a patient is taking the medication Heparin what lab value(s) will the nurse monitor? Will the nurse expect these lab values to be higher or lower than normal range?
Monitor PTT
PTT will be elevated above normal range while the patient is on Heparin. PTT will be prolonged, meaning the time it takes for the blood to clot will be longer
If the patient’s PT, INR, and/or PTT are elevated, what is the patient at risk for?
Bleeding
If a provider wants to see how well the glucose has been controlled over the past two to three months, what lab will be ordered?
Hemoglobin A1C
A Hemoglobin A1C less than what number is ideal for a patient with Diabetes Mellitus?
< 7 %
If a Hemoglobin A1C is > 9 %, what does the provider know?
The blood glucose has been very poorly controlled over the past two to three months
If a patient has a glucose level of 80 mg/dL but a Hemoglobin A1C of 14%, will they have s/s of hyperglycemia?
No. Glucose level is within range so s/s should not be present.
If a patient experiences tissue hypoxia, what lab will be elevated?
Lactic Acid/Lactate
If ammonia levels are high, what organ is malfunctioning?
Liver
The liver must break ammonia down into BUN so it can be excreted by the kidneys. If the liver isn’t working properly, it will not be able to break the ammonia down.
If ammonia levels are high, what is the nurse’s priority action for the patient?
Maintaining safety
The patient is at risk for coronary artery disease and atherosclerosis when what lipid panel labs are elevated?
LDL
Triglycerides
Total Cholesterol
If a patient has a d-dimer level above 500, what does the nurse suspect?
Possible blood clot
If the patient has a d-dimer level above 500 and complains of left lower extremity pain, what diagnostic test should be ordered?
An ultrasound. Quickest test to view blood flow in the lower extremity. Determine if blood clot present
If the patient has a d-dimer level above 500 and complains of chest pain and shortness of breath, what diagnostic test should be ordered?
A CTA Scan of the Chest. Need to visualize the blood vessels of the lungs to determine if these is a blood clot present.
Ultrasound cannot be performed because it cannot visualize the blood vessels of the lungs, they are too deep within the body.
What labs assess kidney function?
What lab is the most accurate indicator of kidney function?
Creatinine Clearance/Glomerular Filtration Rate *most accurate indicator of kidney function!)
eGFR
Creatinine
Blood Urea Nitrogen
If liver function was impaired, what liver function tests would be elevated and what liver function tests would be decreased?
Elevated:
AST, ALT, ALP, Bilirubin, Ammonia
Decreased:
Albumin, Total Protein
What labs assess pancreatic function?
Amylase
Lipase
What labs identify the amount of inflammation present within the body? (I.e. what are the inflammatory marker labs?)
Erythrocyte Sedimentation Rate (ESR)
C-Reactive Protein (CRP)
If the patient has an acute bacterial infection, what labs will be elevated?
WBCs
ESR
CRP
If a patient is scheduled to receive a CT Scan with contrast, what must the nurse ask?
Allergies to contrast dye or shellfish
What is the difference between a CT Scan and a CTA Scan?
A CT scan shows the body/organs/tissues in a 3D image.
A CTA scan shows the body/organs/tissues in a 3D image and also shows blood flow through vessels.
What does an x-ray show images of?
Bones
Heart
Lungs
Joints
What diagnostic machine(s) are portable?
Ultrasound
X-Ray
If a female of child bearing age is having an x-ray or CT scan, what must be ruled out?
Pregnancy
If a CT scan with intravenous contrast is ordered, function of what organ must be assessed first?
Function of the kidneys.
Kidneys must be working appropriately in order to receive intravenous contrast. They need to excrete the material.
If a MRI is being obtained, what must the nurse do with the patient before the test is started? What does the nurse have to do for his/herself
MRI Checklist
Remove all metal, doesn’t matter what area of the body is being scanned
Patient must be in a gown only
Educate the patient
Nurse must remove all metal off of his/her body before going into the MRI room
If the provider wants to see blood flow through vessels/organs, what diagnostic imaging test would be ordered?
CT Angiogram (CTA)
What must the patient remove before an x-ray?
All metal around/close to the area being x-rayed
Put patient in a gown (better safe than sorry!)
What are the benefits of an ultrasound test?
It is quick, easy and painless.
No rule out testing needs to be performed before hand. Machine is portable, it can come to the patient.
Brain Natriuretic Peptide (BNP) is an important lab to monitor the severity of what disease?
Chronic Heart Failure
Troponin is an important lab to monitor during what time?
Acute cardiac injury
A normal level for a troponin lab is what?
< 0.017 ng/mL
A normal level for a Brain Natriuretic Peptide (BNP) lab is what?
< 100 pg/mL
If Brain Natriuretic Peptide (BNP) is greater than 400 pg/mL, what disease is likely to exist in the patient?
Heart failure
Other than a troponin, what elevation of what lab can show injury to cardiac muscle?
Creatine Kinase MB (CK-MB)
What is the normal range for amylase?
60-120 units/mL
What is the normal range for lipase?
0-160 units/mL
