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Nursing Lab Values (Common with details)
Terms in this set (71)
3.5 - 5 g / dL
Albumin is a transport protein in the blood. It helps maintain the oncotic pressure of the blood. Albumin levels will drop if synthesis is slowed, protein intake is inadequate, or there are increased losses. Albumin has a long half life, however, so levels are not a good indicator of acute illness. Evaluates chronic illness, liver disease, or nutritional status.
↑ - dehydration
↓ - liver disease, hemorrhage, kidney disease, CHF
Alkaline Phosphatase (ALP)
40 to 120 U / L
Varies based on location: liver, bone, serum, gender
Alkaline phosphatase (ALP) is located in several places in the body: liver, intestines, biliary tract, bones, placenta. Different isoenzymes of ALP can be used to determine different disorders: liver, bone, intestine, certain cancers. It can also be used to determine bone turnover in postmenopausal women.
↑ - liver disease, pregnancy, lung cancer, CHF, chronic renal failure
↓ - hypophosphatasia, anemia, kwashiorkor, hypothyroidism, zinc or magnesium deficiency
Aspartate Aminotransferase (AST)
5 to 35 IU / L
Found in heart, liver, skeletal muscle
Not as specific a marker as ALT for liver injury
AST / ALT > 2 indicates chronic alcoholism
↑ - liver disease, pancreatitis, CHF, biliary tract obs
↓ - CVA, delirium tremens, pericarditis, cirrhosis
Alanine Aminotransferase (ALT)
3 to 25 IU / L
Found in heart, liver, and skeletal muscle. Much more specific marker of liver injury than AST
↑ - cirrhosis, pre-eclampsia, burns, pancreatitis, MI, infections (mononucleosis)
↓ - pyridoxal phosphate deficiency
20 to 60 ug / dL
Ammonia is a byproduct created when protein is broken down. Ammonia is converted into urea in the liver, and urea is excreted by the kidneys. ↑ levels have a negative effect on the brain.
↑ - GI hemorrhage, liver failure, reye's syndrome, TPN
30 to 110 U/L
Amylase is made in the pancreas. It is an enzyme that breaks down carbohydrate to allow our body to absorb it.
↑ - alcoholism, pancreatitis, DKA, pericarditis, , gastric resection, pancreatic cancer
↓ - cystic fibrosis, liver disease, pancreatectomy
Base Excess, Arterial (BE)
-2 to +2 mEq / L
↑ - metabolic alkalosis, low K+, Cushing's Syndrome, vomiting
↓ - metabolic acidosis, DKA, Addison's disease, renal failure, diarhea
22 to 26 mEq / L
Bicarbonate needs to be 20 times carbonic acid to maintain balance in the blood.
↑ - anoxia, respiratory acidosis, metabolic alkalosis
↓ - hypocapnia, respiratory alkalosis, metabolic acidosis
Bilirubin, Direct (Conjugated)
< 0.3 mg / dL
Bilirubin is a byproduct of red blood cell breakdown. Bilirubin is transported to the liver where it is conjugated. It then goes to the intestines to be excreted. Direct bilirubin is a measure of conjugated bilirubin. If you subtract direct bilirubin from total bilirubin you can determine the amount of unconjugated bilirubin. If unconjugated bilirubin is elevated that is specific to liver disease.
↑ - Elevated destruction of RBCs, liver problems
< 1.2 mg / dL
One of the by-products of red blood cell breakdown is bilirubin. Bilirubin is made in the bone marrow, liver, or spleen and is transported by albumin to the liver. In the liver bilirubin is conjugated. In the small intestine conjugated bilirubin is eventually excreted in the feces as urobilin. Excess bilirubin causes a yellowing of the skin and the whites of the eyes called jaundice.
↑ - newborn jaundice, pernicious anemia, liver tumors, alcoholism, cholesytitis, cirrhosis, hepatitis, hypothyroidism
Blood Urea Nitrogen (BUN)
8 to 20 mg / dL
When protein is broken down ammonia is formed. Ammonia is converted to urea in the liver and is eventually excreted in the kidneys. Blood urea nitrogen (BUN) measures the amount of urea in the blood.
↑ - renal failure, CHF, DM, GI bleed, dehydration, ketoacidosis
↓ - liver failure, over-hydration, inadequate protein intake, pregnancy
Brain Type Natriuretic Peptide (BNP)
< 100 pg / mL
Brain natriuretic peptide (BNP) is a hormone. It is made by the heart and indicates how hard the heart is working. When levels are increased it indicates that the heart is working too hard --> CHF
↑ - CHF
C-Reactive Protein (CRP)
< 1 mg / dL
C-reactive protein (CRP) is made in the liver in response to inflammation. CRP helps practitioners identify inflammation and when it has resolved. CRP is a good indicator because it increases quickly in the inflammatory response, and drops when inflammation resolves.
↑ - bacterial infection, crohn's disease, rheumatoid arthritis, MI, lupus, pregnancy
8.4 to 10.2 mg / dL
Other than a major component of bone, Calcium also participates in muscle contraction. In the blood about 45% of Calcium travels in ion form, 40% is bound to proteins like albumin, 15% bound to anions like bicarbonate, lactate, etc. When albumin levels are low, Calcium levels will appear lower. Calcium has an important relationship with Phosphorus: they are inversely proportional.
↑ - cancers (lymphoma, leukemia, bone), acidosis, hyperparathyroidism, pheochromocytoma, polycythemia vera
↓ - malnutrition, cirrhosis, hypoparathyroidism, alkalosis, chronic renal failure, magnesium deficiency, alcoholism, hypoalbunemia
97 to 107 mEq / L
Chloride (Cl¯) is an anion found in the blood. Sodium and chloride help maintain oncotic pressure and water balance in the body. Chloride is inversely related to bicarbonate levels in the blood.
↑ - dehydration, acute renal failure, Cushing's disease, hyperparathyroidism, metabolic acidosis, respiratory alkalosis.
↓ - CHF, overhydration, water intoxication, burns, metabolic alkalosis, Addison's disease, diarrhea, vomiting, fistula.
< 200 mg / dL
Cholesterol is primarily synthesized in the liver and intestines. It is transported via lipoproteins. There are multiple types of lipoproteins and they each have slightly different functions: high-density lipoprotein (HDL), low-density lipoprotein, LDL, very low-density lipoprotein (VLDL).
↑ - myeloma, burns, pernicious anemia, thalassemia, malabsorption, malnutrition, liver disease, polycythemia vera, COPD, hyperthyroidism
↓ - Gout, obesity, high fat diet, pregnancy, nephrotic syndrome, alcoholism, anorexia, ischemic heart disease
0.5 to 1.2 mg / dL
Creatinine is a byproduct of creatine metabolism, and it is excreted in the kidneys. Creatinine is created in proportion to muscle mass and usually stays stable. Identifies muscular disorders or renal disease.
↑ - Gigantism, dehydration, shock, renal disease, acromegaly, CHF, hyperparathyroidism
↓ - loss of muscle mass, inadequate protein intake, pregnancy, liver disease, muscular dystrophy
Male: 97 to 137 ml/min
Female: 88 to 128 ml/min
Urine and blood levels are compared to determine creatinine clearance from the blood. Used to determine kidney damage in renal disease, glomerular function, effectiveness of treatment.
↑ - DM, exercise, renal disease, TB, acromegaly, gigantism, CHF, polycystic kidney disease, dehydration, hypothyroidism
↓ - glomerulonephritis, paralysis, vegetarian diet, anemia, leukemia, muscle wasting, hyperparathyroidism
Creatine Kinase (CK)
Male: 20 - 200 U / L
Female: 20 - 180 U / L
Creatine Kinase enzyme is found in heart and skeletal muscle and to a lesser extent brain. When damage is done to these types of tissue CK is released into the blood. There are three isoenzymes, and depending on which one is elevated this lab value can help one determine timing, location, extent of damage. The three isoenzymes are CK-MB (cardiac), CK-MM (skeletal), and CK-BB (brain).
↑ - alcoholism, CHF, delirium tremens, hypothyroidism, MI, PE, reye's syndrome, surgery, tachycardia, tetanus
↓ - small stature, sedentary lifestyle
Creatinine Kinase - MB (CK-MB)
Male: < 6.7 ng / mL
Female: < 3.8 ng / mL
If CK-MB is elevated 3 times more than CK this indicates damage to heart muscle.
↑ - heart ischemia, surgery, trauma, kidney failure
≤ 250 ng / mL
D-dimer is a compound formed when two identical fibrin molecules combine. Cross-linkages do not occur between fibrinogen molecules. D-dimer levels are elevated in the setting of clot breakdown, but will be even higher in the setting of DIC. Identifies DIC and rule out pulmonary embolism, DVT, or stroke.
↑ - surgery, trauma, infection, liver disease, cancer, pregnancy, DVT, DIC, cardiac disease
Erythrocyte Sedimentation Rate (ESR)
0 to 20 mm / hr
The erythrocyte sedimentation rate (ESR) test measures sedimentation of red blood cells. The inflammatory process affects proteins in the blood which causes red blood cells to stick together and settle out of liquid. Normal blood has very little settling, but during the inflammatory process the ESR is elevated. Identifies inflammation which assists in diagnosing cancer, infection, and autoimmune.
↑ - MI, anemia, cancers, systemic lupus erythromatosus, Crohn's disease, endocarditis, infection, nephritis, multiple myeloma, pregnancy, PE, rheumatoid arthritis, TB
↓ - CHF, sickle cell anemia, polycythemia
20 to 300 ng / mL
Ferritin is the storage form of Iron. Some is stored in body tissue, some circulates in the blood. It is formed in the liver spleen and bone marrow. Ferritin in the blood is usually proportional to stored ferritin. Ferritin is a more sensitive and specific test for identifying iron-deficiency anemia, however, it is usually measured in conjunction with total iron binding capacity and iron.
↑ - inflammation, breast cancer, hemolytic anemia, fasting, hemochromatosis, liver disease, hyperthyroidism, alcoholism, Hodgkin's disease, infection, leukemia
↓ - dialysis, iron-deficiency anemia
< 2 ng / mL
Folate is an essential water soluble vitamin. It is stored in the liver and is an important part of RBC and WBC function, DNA replication, and cell division.
↑ - Vitamin B12 deficiency, excess folate intake, pernicious anemia
↓ - malnutrition, hemolytic anemias, scurvy, liver disease, Crohn's disease, megaloblastic anemia, neoplasm, alcoholism, pregnancy, ulcerative colitis, whipple's disease
Glomerular Filtration Rate
90 to 120 mL / min
Glomerular filtration rate (GFR) is an estimate of blood flow through the kidneys. There are different equations used to estimate the GFR. A GFR <60 ml mL/min/1.73 m2 for over 3 months indicates chronic kidney disease. A GFR < 15 mL/min/1.73 m2 indicates kidney failure.
↓ - kidney disease, kidney failure
70 to 110 mg / dL
Glucose is a sugar molecule that is a component of carbohydrates. In the body sugar is stored as glycogen in liver and muscle. Pancreas releases glucagon when serum glucose levels are low.
↑ - stress (cortisol), pancreatitis, stroke, Cushing's syndrome, DM, renal disease, Vitamin B1 deficiency
↓ - hypothyroidism, Addison's disease, starvation, post-gastrectomy
Glucose Tolerance Test (GTT)
2 hour: < 140 mg / dL
The glucose tolerance test (GTT) is a measure of glucose metabolism after a specific amount of glucose intake. A fasting blood sugar is taken and then a 75 gram carbohydrate drink is taken. Blood sugars are measured 1 hour, 2 hour, and 3 hour post-prandial. Blood sugars over 126 mg/dL fasting or >200 mg/dL after 2 hours indicate a problem in glucose metabolism.
↑ - Impaired glucose metabolism
Glycosolated Hemoglobin (HgbA1c or A1c)
5.5 % to 7.5 %
Glycosylated hemoglobin (Hgb A1c) is the combination of sugar in the blood (glucose) and hemoglobin. When glucose is elevated in the blood the amount of glycosylated hemoglobin increases proportionally. A red blood cells lifespan is about 4 months, so you can get an idea of blood sugar control over the last several months.
↑ - DM
↓ - Renal failure, blood loss, pregnancy, hemolytic anemia
Growth Hormone (GH)
Male: < 5 ng / mL
Female: < 10 ng/ mL
Growth hormone is secreted by the anterior pituitary. Growth hormone helps regulate sleep and growth throughout childhood. Growth hormone stimulates protein production and lipid and glucose metabolism.
↑ - cirrhosis, acromegaly, exercise, hyperpituitarism, gigantism, malnutrition, anorexia nervosa, DM, renal failure, stress
↓ - dwarfism, hypopituitarism
Male: 41% to 50%
Female: 36% to 46%
Hematocrit is the percentage of the blood that is made up of packed red blood cells. A hematocrit level of 40% indicates that there are 40 mL packed red blood cells in 100mL of blood.
↑ - erythrocytosis, polycythemia, shock, dehydration
↓ - anemia, blood loss, bone marrow hyperplasia, severe burns
Male: 13.5 to 16.5 g / dL
Female: 12.0 to 15.0 g / dL
Hemoglobin is the main protein in red blood cells. It binds to and transports oxygen in the blood, and can also carry carbon dioxide. Hemoglobin is an iron containing compound, And iron-deficiency can affect hemoglobin's ability to carry oxygen.
↑ - burns, COPD, CHF, dehydration, erythrocytosis, high altitudes, polycythemia vera
↓ - hemolytic disorders, nutrition deficiency, fluid retention, anemias, Hodgkin's disease, hemorrhage, leukemia, carcinoma, lymphoma, pregnancy
High Density Lipoprotein (HDL)
< 60 mg / dL
Cholesterol is transported via lipoproteins. There are multiple types of lipoproteins and they each have slightly different functions: high-density lipoprotein (HDL), low-density lipoprotein, LDL, very low-density lipoprotein (VLDL). HDL cholesterol is considered the good cholesterol as it travels through the blood picking up extra cholesterol and taking it back to the liver. HDL cholesterol is beneficial, and lower levels indicate increased risk for heart disease.
↑ - Exercise, mono and poly unsaturated fats
↓ - smoking, high saturated and trans fat diet, excess body weight
Low Density Lipoprotein (LDL)
< 100 mg / dL
Useful in determining risk of cardiovascular disease.
↑ - diet high in saturated fats
↓ - regular physical activity
< 150 mg / dL
Evaluate for elevated triglycerides, estimate risk for atherosclerotic heart disease and stroke. Triglycerides are required to provide energy during the metabolic process, excess triglycerides are stored in adipose tissue
↑ - MI, alcoholism, anorexia nervosa, cirrhosis, HTN, nephrotic syndrome, obesity, renal failure, pancreatitis, stress
↓ - COPD, liver disease, hyperthyroidism, malnutrition, malabsorption
0.54 to 2.3 mg / L
Homocysteine is an amino acid in the body that can be synthesized from the amino acid methionine. Homocysteine requires vitamin B12 and Folate to break it down. Excess homocysteine can damage blood vessels, impact clotting, and increase risk of plaque formation. Identifies enzyme deficiencies that cause homocystinuria, evaluate risk of cardiovascular disease or venous thrombosis.
↑ - Chronic renal failure, folic acid deficiency, homocystinuria, Vitamin B12 deficiency, CAD
International Normalized Ratio (INR)
0.8 to 1.2
International normalized ratio (INR) takes results from a prothrombin time test and standardizes it regardless of collection method. Evaluates therapeutic doses of anticoagulants, identify patients at higher risk for bleeding, identify cause of bleeding, and deficiencies
↑ - DIC, hereditary, liver disease, vitamin K deficiency, SLE, drug therapy (coumadin)
↓ - enteritis, ovarian hyperfunction
50 to 175 ug / dL
Iron is an element that is an important component of hemoglobin in red blood cells. Hemoglobin transports oxygen from the lungs to all the cells of the body. Most of the iron in the body is in hemoglobin, but some iron is in myoglobin and some is stored in the liver, bone marrow, and spleen. The storage form of iron is ferritin. Iron is transported in the blood by a protein called transferrin.
↑ - hemolytic anemia, iron poisoning, acute leukemia, Vitamin B6 deficiency, acute liver disease, aplastic anemia, nephritis, thalassemia, pernicious anemia, lead toxicity
↓ - Infection, carcinoma, blood loss, hypothyroidism, iron-deficiency anemia, nephrosis, protein malnutrition
Lactate Dehydrogenase (LDH)
88 to 230 U / L
The blood level of LDH is a general indicator of tissue and cellular damage. The level of LDH may also rise in other types of body fluids (e.g., cerebrospinal fluid, pleural fluid, etc.) in the presence of certain diseases.
Venous: 0.5 to 2.2 mEq / L
Arterial: 0.5 to 1.6 mEq / L
Lactate is a byproduct of carbohydrate metabolism. Lactate is broken down by the liver. During intense exercise pyruvate is converted to lactate to provide a little extra energy when there is not enough oxygen present. If the liver doesn't properly breakdown lactate that can lead to increased levels.
↑ - DM, heart failure, PE, reye's syndrome, shock, hemorrhage
< 95 U / L
Diagnose pancreatitis, diagnose pancreatic cancer
Lipase is an enzyme created in the pancreas. It travels to the intestines where it aids in the breakdown of fats. If damage occurs to certain parts of the pancreas lipase is released into the bloodstream.
↑ - Cholecystitis, pancreatic duct obs, pancreatic cyst, pancreatitis, renal failure
1.4 to 2.4 mEq / L
Magnesium is a cation necessary for protein synthesis, nucleic acid synthesis, muscle contraction, ADP (adenosine diphosphate) use, nerve impulse conduction, and blood clotting. Magnesium affects the absorption of sodium, calcium, phosphorus, potassium. Monitors for renal failure, chronic alcoholism, cardiac arrhythmias.
↑ - Addison's disease, adrenocorticol insufficiency, dehydration, hypothyroidism, SLE, overuse of antacids, tissue trauma
↓ - alcoholism, glomerulonephritis, hypercalcemia, hypoparathyroidism, pancreatitis, pregnancy, diarrhea
Mean Corpuscular Volume (MCV)
80 to 100 fL
Mean corpuscular volume (MCV) is the average of the volume of red blood cells. It is helpful in differentiating between different types of anemia.
↑ - alcoholism, liver disease, pernicious anemia, Vitamin B12 anemia, folate anemia
↓ - iron deficiency anemia, thalassemia
< 80 ng / mL
Myoglobin is a protein in skeletal and cardiac muscle that binds oxygen. When damage is done to heart and skeletal muscle, myoglobin is released into the blood.
↑ - heart surgery, exercise, cocaine use, MI, muscular dystrophy, shock, renal failure
↓ - myasthenia gravis, rheumatoid arthritis
270 to 300 mOsm / kg (L)
Osmolality is a measure of the particles in solution. The size, shape, and charge of the particles do not impact the osmolality. Monitor electrolyte balance and acid-base balance, monitor hydration, evaluate function of ADH.
↑ - dehydration, azotemia, hypercalcemia, diabetic ketoacidosis, hypernatremia, DI
↓ - adrenocorticoid insufficiency, hyponatremia, SIADH
Oxygen Saturation, Arterial (SaO₂)
95% to 100%
Oxygen is transported in the blood in two ways. Oxygen dissolved in blood plasma (pO2) and oxygen bound to hemoglobin (SaO2). About 97% of oxygen is bound to hemoglobin while 3% is dissolved in plasma. There is a relationship between saturation and partial pressure referred to the oxyhemoglobin dissociation curve. SaO2 of about 90% is associated with PO2 of about 60 mmHg.
Partial Pressure CO₂, Arterial (PCO₂)
35 to 45 mmHg
part of the ABG reflects the amount of CO2 dissolved in the blood. pCO2 is an indirect measure of gas exchange within the lungs.
↑ - CO2 retention (pulmonary edema, COPD)
↓ - hyperventilation, hypoxia, anxiety, pregnancy, PE
Partial Pressure O₂, Arterial (PO₂)
80 to 100 mmHg
Part of an ABG to determine respiratory status. Oxygen is transported in the blood in two ways. Oxygen dissolved in blood plasma (pO2) and oxygen bound to hemoglobin (SaO2). About 97% of oxygen is bound to hemoglobin while 3% is dissolved in plasma. There is a relationship between saturation and partial pressure referred to the oxyhemoglobin dissociation curve. SaO2 of about 90% is associated with PO2 of about 60 mmHg
↑ - polycythemia
↓ - anemia, cardiac decompensation, COPD, restrictive pulmonary disease, hypoventilation
Prothrombin Time (PT)
11 to 14 seconds (2 - 3 INR for therapeutic Coumadin levels)
Vitamin K is the antidote to too much Coumadin
Evaluate therapeutic doses of anticoagulants, identify patients at higher risk for bleeding, identify cause of bleeding, and deficiencies. Time it takes for a fibrin clot to form. Prothrombin is produced by the liver and is dependent on vitamin K.
↑ - DIC, hereditary factors, liver disease, vitamin K deficiency, SLE, drug therapy
↓ - enteritis, ovarian hyperfunction
Partial Thromboplastin Time (PTT)
25 to 35 seconds
Protamine Sulfate is the antidote to Heparin
Detection of coagulation disorders, evaluate response to anticoagulation medication (Heparin), preoperative assessment. Partial Thromboplastin Time (PTT) evaluates the function of factors XII, XI, IX, VII, V, X, II, and I, represents the amount of time required for a fibrin clot to form.
↑ - DIC, liver disease, vitamin K deficiency, polycythemia, dialysis, Von Willebrand's disease
Activated Partial Thromboplastin Time (aPTT)
25 to 39 seconds
APPT is a test that measures the amount of time it takes for a fibrin clot to form after reagents have been added to the specimen
↑ - DIC, liver disease, vitamin K deficiency, polycythemia, dialysis, Von Willebrand's disease
7.35 to 7.45
Reflects the amount of free H+ ions in the body
↑ - metabolic alkalosis, respiratory alkalosis
↓ - metabolic acidosis, respiratory acidosis
Phosphorus / Phosphate (PO₄)
3.0 to 4.5 mg / dL
Diagnosing hyperparathyroidism, evaluation of renal failure. Phosphorus is a major intracellular anion playing a vital role in cellular metabolism. it makes up the phospholipid bilayer of the cell membrane, and is crucial in the formation of bones and teeth. Calcium and phosphorus share an inverse relationship
↑ - Excess Vitamin D, DKA, lactic acidosis, renal failure (PO4 excreted by kidneys), PE, respiratory acidosis, hypocalcemia, acromegaly
↓ - hyperalimentation, hyperinsulinism, hyperparathyroidism, hypokalemia, hypercalcemia, alkalosis, vomiting & diarrhea, malnutrition, osteomalacia
100,000 - 450,000 cells / mcL
Determine clotting vs bleeding disorders, part of a basic screening exam. Platelets play a role in coagulation, hemostasis, and thrombus formation. Platelets are the smallest blood cell, damaged vessels send out signals that result in platelets traveling to the area and becoming "active".
↑ - infection, polycythemia vera (bone marrow disorder), RA, cirrhosis, pancreatitis, trauma
↓ - aplastic anemia, alocholism, medication, inherited, lymphoma, hemorrhage, DIC, ITP, radiation, dialysis
3.5 to 5.5 mEq / L
Evaluate electrolyte imbalances, useful in evaluating cardiac arrhythmias, useful when patient is receiving diuretic therapy, useful with acidotic patients. Potassium is the most abundant intracellular cation and plays a vital role in the transmission of electrical impulses in cardiac and skeletal muscle. It plays a role in acid base equilibrium. In states of acidosis hydrogen will enter the cell as this happens it will force potassium out of the cell, a 0.1 decrease in pH will cause a 0.5 increase in K+.
↑ - acidosis, renal failure, diet, dialysis, burns, Addison's disease, ketoacidosis, trauma, hyperventilation, uremia
↓ - CHF, alkalosis, hyperaldosteronism, toxic shock syndrome, malabsorption, excess insulin, Cushing's disease
19 to 38 mg / dL
Helpful in evaluating nutritional status. Protein produced by the liver, short half-life (2 days) making it a good indicator of protein status and malnutrition.
↑ - steroid therapy, alcholism
↓ - malnutrition, chronic illness, inflammatory process, trauma, liver disease
Prostate Specific Antigen (PSA)
Male: < 4 ng / mL
Female: < 0.5 ng / mL
Utilized to evaluate enlarged prostate when prostate cancer is suspected, stage cancer, evaluate effectiveness of treatments. PSA produced by prostate when used in conjunction with digital exam this test is helpful in diagnosing and assessing prostate abnormalities.
↑ - BPH, prostate cancer, urinary retention
6 to 8 g / dL
Diagnosing myeloma, lymphoma, macroglobulinemia, amyloidosis, evaluate kidney function. Protein is an important contributor of energy in our diet. Protein has many numerous functions in the body.
↑ - UTI, nephrotic syndrome, exercise, diabetic nephropathy, sickle cell disease
Red Blood Cell (RBC)
Male: 4.5 - 5.5 x 10⁶ / cells / mm³
Female: 4.0 - 4.9 x 10⁶ / cells / mm³
Helpful in identifying anemia, determine blood loss, part of the CBC and useful in a general physical exam. Red blood cells (RBCs) contain hemoglobin which is responsible for oxygen transport throughout the body. RBCs are primarily produced in the bone marrow, they have a life span of 120 days and are destroyed in the spleen and liver. RBC production is regulated by erythropoietin which is produced and released from the kidneys.
↑ - dehydration, polycythemia vera, COPD, bone marrow failure
↓ - chemotherapy, anemia, hemorrhage, leukemia, organ failure, hypervolemia, pregnancy
Red Cell Distribution Width (RDW)
Useful in the diagnosis of anemia. Red blood cell distribution width (RDW) is a measurement of the variation of RBC cell size amongst the entire population of RBCs. Used with other red cell indices to determine cause of anemia.
↑ - Anemia
135 to 145 mEq / L
Sodium (Na) is the most abundant cation in extracellular fluid. Sodium aids in osmotic pressure, renal retention and excretion of water, acid-base balance, regulation of other cations and anions in the body, plays a role in blood pressure regulation, and stimulation of neuromuscular reactions. Generally speaking elevated sodium levels are often due to relative deficit of free water.
↑ - Cushing's disease, dehydration, burns, azotemia, vomiting, lactic acidosis, fever, diarrhea, diabetes
↓ - CHF, cystic fibrosis, diuretics, metabolic acidosis, Addison's disease, nephrotic syndrome, excessive ADH, liver failure
Total Iron Binding Capacity (TIBC)
250 to 460 ug / dL
Assess cause of anemia and whether anemia is associated with iron deficiency or another cause, assess iron metabolism and storage. Total iron binding capacity is essentially a measure to determine if a patient has too much or too little iron in the body and how well iron is being transported
↑ - liver disease, iron deficiency anemia, pregnancy
↓ - infection, cirrhosis, protein depletion, renal disease
Troponin I (cTnI)
< 0.35 ng / mL
Evaluating damage to heart muscle, diagnose an MI. Troponins are proteins that initiate contraction of muscle fibers. Troponin I is specific to heart muscle. Troponins stays elevated for a week after muscle damage then returns to normal.
↑ - heart damage, MI
White Blood Cell (WBC)
5,000 to 10,000 cells / mcL
White blood cells demonstrate the body's response or ability to respond to an infectious process. White blood cells are created in the bone marrow, their primary function is to defend the body against infection. There are various types of WBCs which have different shapes and functions.
↑ - leukocytosis, emotional stress, transfusion reaction, infection, Cushing's disease, leukemia (unnatural rise in immature WBCs)
↓ - radiation, SLE, anemia, rheumatoid arthritis, viral infection
Specific Gravity (urine)
1.001 - 1.035
Specific gravity, in the context of clinical pathology, is a urinalysis parameter commonly used in the evaluation of kidney function and can aid in the diagnosis of various renal diseases.
↑ - dehydration, diarrhea, vomiting, UTI, glucosuria, renal artery stenosis, hepatorenal syndrome, decreased blood flow to the kidney, SIADH - more solutes in urine
↓ - renal failure, pyelonephritis, DI, acute tubular necrosis, interstitial nephritis, and excessive fluid intake
Digoxin (therapeutic range)
0.8 to 2.0 ng/ml
Lithium (therapeutic range)
0.6 to 1.2 mEq / L
Phenytoin / Dilantin (therapeutic range)
10 to 20 mcg / mL
Theophylline / Aminophyllin (therapeutic range)
10 to 20 mcg / mL
Valproic Acid / Depakote (therapeutic range)
50 to 100 mcg / mL
Vancomycin trough level
10 to 20 mcg / mL
Vancomycin peak level
30 to 40 mcg / mL
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