REFERENCE VALUES OR NORMAL VALUES GIVEN FOR ANY TEST SHOULD ONLY BE CONSIDERED? GUIDELINES

UTILIZING LAB VALUE RESULTS INTO NURSING PRACTICE HELPS PRIORTIZE CARE AND DEVELOP NURSING DIAGNOSES

THE LAB TEST THAT COUNTS ACTUAL NUMBERS OF DIFFERENT TYPES OF WBC’S IS: COMPLETE BLOOD COUNT WITH DIFFERENTIAL THE DIFFERENTIAL COUNTS THE WBC’S AND DEFINES THE NUMBER OF EACH TYPE OF WBC IN THE SAMPLE

CBC DIFFERENTIAL EOSINOPHILS BASOPHILS INCREASED LEVELS ON DIFFERENTIAL INDICATE ALLERGIC REACTIONS OR HYPERSENSITIVITIES

RBC’S NOMRAL THE VALUE FOR A PARTICULAR PATIENT IS 5.80 WHAT WOULD EXPLAIN THE INCREASE? INCREASED VALUE DUE TO: POLYCYTHEMIA VERA COPD W/HYPOXIA DEHYDRATION HIGH ALTITUDE

RBC’S; HEMOGLOBIN; HEMATOCRIT ARE ALL DECREASED IN ADULT WHAT CONDITION OR CONDITIONS WOULD CAUSE THESE VALUES TO BE LOWER THAN EXPECTED NORMALS? MALNUTRITION

CREATININE LEVEL INDICATOR OF GLOMERULAR FILTRATION NORMALS CRITICAL VALUE >7.4

IN THE WBC COUNT THE “BANDS” ARE? IMMATURE NEUTROPHILS OTHERWISE KNOWN AS IMMATURE WBC’S

24 HOUR URINE COLLECTION REQUIRES? DISCARD THE FIRST VOID OF THE DAY AND SET THAT HOUR AS THE BEGINNING OF THE 24 HOUR PERIOD. CONTINUE COLLECTING URINE INTO THE CONTAINER UNTIL 24 HOURS HAS PASSED.

WBC’S NORMALS 5, ,000 CRITICAL VALUE <2500 >30,000

HEMATOCRIT MONITORS FLUID IMBALANCES OR FLUID LEVEL TREATMENTS INCREASED: BURNS; CHF; COPD DECREASED: ANEMIA; BLOOD LOSS; FLUID RETENTION; NUTRITIONAL DEFICIT NORMAL MALE FEMALE CRITICAL VALUE <18 >54

HEMOGLOBIN MONITORS FLUID IMBALANCES OR FLUID LEVEL TREATMENTS INCREASED: BURNS; CHF; COPD DEHYDRATION DECREASED: ANEMIA; BLOOD LOSS; FLUID RETENTION; NUTRITIONAL DEFICIT NORMAL MALE FEMALE CRITICAL VALUE < 6.0 > 18.0

PLATELETS HELP FIGHT INFECTIONS; INVOLVED IN COAGULATION NORMAL VALUES: 100,000 TO 450,000 CRITICAL VALUE: < 50,000 > 1 MILLION

ERYTHROCYTE SEDIMENTATION RATE ESR DIAGNOSES INFLAMMATORY CONDITIONS NORMAL <50 Y/O 0-15 >50 Y/O 0-20

PARTIAL THROMBOPLASTIN TIME PTT EVALUATES HEPARIN THERAPY NORMAL SECONDS CRITICAL ALERT >70 SECONDS

PROTIME WITH INR PT INR EVALUATES COUMADIN THERAPY NORMAL SECONDS CRITICAL VALUE >27 SECONDS

pH of blood Normal range

RESPIRATORY ACIDOSIS Blood pH lower than 7.35 Pco2 higher than 45 HCO3 normal

RESPIRATORY ALKALOSIS BLOOD PH HIGHER THAN 7.45 Pc02 lower than 32 HCO3 normal

METABOLIC ACIDOSIS BLOOD PH LOWER THAN 7.35 PCO2 NORMAL HCO3 LOWER THAN 20

METABOLIC ALKALOSIS BLOOD PH HIGHER THAN 7.45 PCO2 NORMAL HCO3 HIGHER THAN 26

BLOOD GLUCOSE NORMALS FASTING CRITICAL VALUES: < 40 > 400

HEMOGLOBIN A1C NORMALS GOAL SHOULD BE UNDER 7 % ASSESSES LONG TERM GLYCEMIC CONTROL

TOTAL PROTEIN NORMAL VALUES NO CRITICAL VALUES

ALBUMIN NORMAL VALUES NO CRITICAL VALUES LOW VALUES PLACES PATIENT AT RISK FOR SKIN BREAKDOWN

DIGOXIN LEVELS NORMAL VALUE CRITICAL VALUE >2.5

DIGOXIN TOXICITY NAUSEA/VOMITING DIRRHEA ARRYTHMIAS HALOS OR YELLOWISH VISION CHANGES CHANGES TO LEVEL OF CONSCIOUSNESS

THYROID STIMULATING HORMONE (TSH) NORMAL ELEVATED VALUE INDICATES HYPO….. OR REPLACEMENT THERAPY NEEDS TO BE INCREASED DECREASED VALUE INDICATES HYPER…. OR THEARPY NEEDS TO BE DECREASED

AMYLASE NORMAL INCREASED VALUE IN PANCREATITIS ALCOHOLISM

LIPASE NORMAL VALUES 3-73 INCREASED VALUE: CHOLECYSTITIS PANCREATITIS

EVALUATES RENAL FUNCTION BUN AND CREATININE

BLOOD UREA NITROGEN EVALUATES RENAL FUNCTION NORMAL VALUES 7-18 OVER 60 Y/O 8-20 CLINICAL ALERTS >100

CREATININE EVALUATES RENAL FUNCTION NORMAL VALUES CLINICAL ALERT >7.4

AST OR ASPARTATE AMINOTRANSFERASE NORMALS MALE FEMALE ENZYME FOUND IN HIGH CONCENTRATIONS IN HEART MUSCLE; LIVER CELLS; SKELETAL MUSCLE; KIDNEYS; PANCREAS; AND BRAIN

ALT OR ALANINE AMINOTRANSFERASE NORMAL VALUES MALE FEMALE 7-35 ENZYME FOUND PRIMARILY IN LIVER, ALSO SMALL AMOUNT IN KIDNEY, HEART AND SKELETAL MUSCLES

AMMONIA NORMALS MALE FEMALE DETECTS LIVER DISORDERS AND SEVERITY

TOTAL BILIRUBIN NORMAL CRITICAL >15 BYPRODUCT OF HEME CATABOLISM FROM AGED RBC’S

ALKALINE PHOSPHATASE NORMAL ENZYME IN LIVER; BILE DUCTS; BONE CELLS; INTESTINE

CHOLESTEROL DESIRABLE VALUE <200 BORDERLINE VALUE HIGH VALUE >240

LOW DENSITY LIPOPROTEIN (LDL) OPTIMAL VALUE <139 BORDERLINE VALUE HIGH > 160

HIGH DENSITY LIOPROTEIN (HDL) MALE FEMALE OPTIMAL >40

C REACTIVE PROTEIN NORMALS 0 – 4.9 INCREASED WITH INFLAMMATORY DISORDERS

B-TYPE NATRIURETIC PEPTIDES (BNP) NORMAL VALUE <100 USEFUL INDICATOR OF CHF

HOMOCYSTEINE LEVELS NORMAL VALUE 4.6 – 11.2 ELEVATED IN CHF; CAD; FOLIC ACID DEFICENCY

MYOGLOBIN NORMAL VALUE 5-70 BEST INDICATOR OF ACUTE MYOCARDIAL INFARCTION

TROPONIN CRITICAL VALUE > 0.5 INITIAL SAMPLE ONLY BETTER INDICATOR OF CARDIAC DAMAGE AND TIMELINE OF MI

SODIUM HYPER OCCURS WITH EXCESSIVE WATER LOSS OR ABNORMAL RETENTION OF SODIUM HYPO OCCURS WITH INADEQUATE SODIUM RETENTION OR INADEQUATE INTAKE NORMAL CRITICAL VALUE <120 >160

POTASSIUM HYPO MALAISE, THIRST, ANOREXIA, WEAK PULSE, ECG CHANGES, LOW B/P; VOMITING HYPER IRRITABILITY; DIARRHEA; CRAMPS; DIFFICULTY SPEAKING; DYSRHYTHMIA; OLIGURIA NORMAL VALUES CRITICAL VALUES <2.5 >6.5

CHLORIDE INCREASED IN DEHYDRATION; ARF DECREASED IN SEVERE VOMITING CHF; OVER HYDRATION NORMAL VALUES: CRITICAL VALUES: <80 >115

CALCIUM INCREASED: EXCESSIVE CALCIUM INTAKE; HYPERPARATHYROIDISM; MALIGNANCY DECREASED: HYPOPARATHYROIDISM; MALABSORPTION; ACUTE PANCREATITIS; CRF NORMAL VALUES: CRITICAL VALUES: <7 >12

URINALYSIS pH SPECIFIC GRAVITY NORMAL 5-9 INCREASED IN ALKALOSIS DECREASED IN ACIDOSIS NORMAL INCREASED DEHYDRATION DIABETES CHF DECREASED DIURESIS EXCESS IV FLUIDS EXCESS HYDRATION IMPAIRED RENAL CONCENTRATING ABILITY

URINALYSIS LEUKOCYTES BACTERIA NORMAL VALUES NEGATIVE NONE SEEN IF PRESENT INDICATION OF INFECTION

URINALYSIS PROTEIN HEMOGLOBIN BILIRUBIN NITRATE NORMAL VALUES < 20 OR VERY LITTLE OTHERWISE NEGATIVE

URINALYSIS GLUCOSE KETONES NORMAL VALUES NEGATIVE IF PRESENT INDICATES DIABETES