LAB VALUES

17
LAB VALUES

LOW HIGH
GLUCOSE • Hypoglycemia is
commonly caused by
• Hyperglycemia can
be caused by
receiving too much diabetes, cushings
70 - 110 insulin, adrenal issues and pancreatitis
or malnutrition • > -350 = critical
• < 40 = critical

LOW HIGH
• Can be caused by • The kidneys
BICARBONATE damage to the reabsorb bicarbonate
kidneys and their elevating the pH in the
22-26 subsequent inability blood to compensate
to reabsorb HCO3 for acidosis
• HCO3 is a buffer and
stabilizer of pH

LOW HIGH
• Low pH is acidosis • Increased pH is
pH • Can be caused by alkalosis
an excess of CO2 in • It's caused by
7.35 - 7.45 the blood or by a loss
of HCO3 in the kidneys
excess HCO3 or a
decrease in CO2
• CO2 can decrease
d/t hyperventilation

LOW HIGH
BUN • BUN is a byproduct of
metabolism that indicates
• Increased BUN can
be caused by CHF a
renal function 61 bleed, hypovolemia,
8-25 + hydration kidney failure, pyelonephritis,
• Lower BUN can be caused heart attack, excess protein
by a low protein diet, liver in the GI tract or shock
failure and fluid overload
18
LAB VALUES

LOW HIGH
• Lower creatinine levels can be • Can suggest renal failure,
CREATININE caused by spinal cord injuries dehydration, rhabdomyolysis,
or abrupt declines in movement hyperthyroidism, muscular
0.6-1.5 because creatinine is released dystrophy, or an obstructed
by the kidney as a byproduct urinary tract
of metabolism

LOW HIGH
WBC • Neutropenia is typically caused • An elevated WBC count can
by bone marrow failure, viral be caused by infection, stress,
4300-10800 infection, chemotherapy, splenic inflammatory illnesses, or
insufficiency, and radiation leukemia

HEMOGLOBIN LOW HIGH

• Blood loss, anemia, bone • High altitude living, long-term
Male: 13-18% marrow suppression, leukemia,
and renal issues are common
smoking, tumors, polycythemia
vera, and erythropoietin use
Female: 12-16% causes of low Hgb can all cause it

HEMATOCRIT LOW HIGH

• Higher hematocrit levels • Hematocrit is usually directly

Male: 13-18% can be caused by dehydration,

blood loss, chemotherapy, or
proportional to hemoglobin
and should be 3xHgb
Female: 12-16% lead poisoning

19
LAB VALUES

LOW HIGH
ALT • Low ALT is normal and • It is a more specific test
indicates normal liver than AST.
13-69 function. • High ALT levels might be
an early sign of liver
disease.

LOW HIGH
AST • Low levels of AST in • High AST values may
the blood are typical indicate chronic-acute
5-40 and anticipated hepatitis, cirrhosis, or
other liver problems

LOW HIGH
ALBUMIN • Albumin levels in burns can also • Dehydration can result in
be reduced due to third spacing elevated albumin levels
3.4-5.0 • Because albumin is produced by due to a lack of water in
the liver, a low albumin level usually the blood
indicates liver disease or cirrhosis

LOW HIGH
TOTAL PROTEIN • Total protein levels might drop
due to liver illness, hemorrhaging,
• Chronic inflammation,
bone marrow diseases,
6.4 - 8.0 diarrhea, or vomiting hepatitis, and HIV can all
cause elevated total
protein levels

LOW HIGH
• Low platelets increase the • Platelet count increases
PLATELET patient's risk of bleeding and can can be induced by
be caused by DIC or aplastic myelogenous leukemia,
150k-350k anemia recent spleen resection,
or inflammation

20
 LAB VALUES

Vitals
Vital Signs Heart Rate Oxygen Saturation
Blood Pressure Bradycardia Normal
Systolic: 120 <60 BPM 95-100%
Diastolic: 80 Normal Mild Hypoxia
Oxygen Saturation: 97% 60-100 BPM 90-94%
Mean Arterial Pressure: 93 Tachycardia 100 BPM Moderate Hypoxia
Heart Rate: 60 86-89%
Severe Hypoxia
<86

Blood Pressure
Systolic Diastolic REMEMBER:

To avoid a misleading reading, make

Hypertension > 140 > 90 sure the BP cuff fits properly.
Pre-Hypertension 120-139 80-89
Too LARGE = False Low
Normal 100-120 60-79 Too SMALL = False High

Hypotension < 100 < 60

pulse Strength
Respirations Temperature
0 Pulse is absent
Rate Oral 1+ Diminished
- 12 to 20 breaths per minute 97.6-99.6°F / 35.5-37.5°C
2+ Normal
Assessment Rectal
3+ Full
- Rhythm 98.6-100.4°F / 36.6 - 38.0°C
4+ Bounding, Strong
Regular / Irregular Axillary
- Depth 96.6 - 98.6°F / 34.7 - 37.3°C
Normal, deep, shallow
Tachypneic: >20
Bradypneic: <12

21
 LAB VALUES
COAGs Basal Metabolic Liver Function
PT: 10 - 13 sec Panel (BMP) Test (LFT)
PTT: 25 - 35 sec Sodium: 135 - 145 mEq/L ALP: 40- 120 U/L
aPTT: 30 - 40 sec (heparin) Potassium: 3.5 - 5.0 mEq/L Bilirubin: 0.1 - 1.2 mg/dL
INR Chloride: 95 - 105 mEq/L
- NOT ON Warfarin < 1 sec Calcium: 9 - 11 mg/dL
- ON Warfarin 2 to 3 sec Albumin: 3.4 - 5.4 g/dL
Total protein: 6.2 - 8.2 g/dL

Lipid Panel Renal ABG's

Total Cholesterol: <200 mg/dL Calcium: 9 - 11 mg/dL PaCO3: 35 - 45 mmHg
Triglyceride: <150 mg/dL Magnesium: 1.5 - 2.5 mg/dL PaO2: 80 - 100 mmHg
LDL: <100 mg/dL (Bad Cholesterol) Specific gravity: 1.010 - 1.030 HCO3: 22 - 26 mEq/L
HDL: >60 mg/dL (Good Cholesterol) Phosphorus: 2.5 - 4.5 mg/dL
GFR: 90 - 120 mL/min

Complete Blood HbA1c Pancreas

Count (CBC) Non-diabetic: 4 - 5.6% Amylase: 30 - 110 U/L
Pre-diabetic: 5.7 - 6.4% Lipase: 0 - 150 U/LL
WBC: 4500 - 11000 / µL
Diabetic: >6.5%
RBC: 4.5 – 5.5 million/µL
PLT: 150000 - 450000/µL

Others...
MAP: 70 - 100 mmHg
Measured with
ICP (Intracranial Pressure):
5 - 15 mmHg
Therapeutic Range
BMI: 18.5 - 24.9
Heparin aPTT 1.5 - 2.0 x normal Protamine
Glascow coma scale:
"control" value Sulfate
- Best: 15
- Mild: 13 - 15 Warfarin INR 1.5 - 2.0 x normal Vitamin K
- Moderate: 9 - 12 "control" value
- Severe: 3 - 8

22
ARTERIAL BLOOD
GAS INTERPRETATION
Know your Laboratory Values
Determine whether the
issue is respiratory
Acidosis Therapeuti Antidote
c Range or metabolic in nature.
pH < 7.35 7.35 - 7.45 > 7.45
CO2 > 45 35-45 < 35 Alkalosis
HCO3 < 22 22-26 > 26 Respiratory
- pH is high and CO2 is low
Metabolic
- pH is high and HCO3 is high

Acidosis
Determine if it is an uncompensated,
Opposite
partially compensated, or fully compensated
- pH is low and CO2 is high
Equal
Uncompensated: If the pH is out of range and CO2 - pH is low and HCO3 is low
or HCO3 is in range
Partially Compensated: If CO2 and HCO3 are both
out of range and the pH is out of range
Fully Compensated: If pH is in range (7.35 - 7.45)

LABORATORY VALUES MEMORY TRICKS

Potassium (3.5-5) Phosphorus (2.5-4.5)

Bananas: Phos: 4 letters
-There are about 3-5 in • Us: 2 (me + you = 2)
every bunch and you
want them half ripe (1/2) Don't forget
So think 3.5 - 5.0 about the .5
23
LABORATORY VALUES MEMORY TRICKS

AST (9-40 U/L)

ALT (7-60 U/L)
(AST) School = 9AM - 4PM
Calcium (9-11) (ALT) Labor = 7AM - 6PM
Just call 911!!!

BUN (7-20mg/dL)
• Think of hamburger BUNs...
Chloride (95-105) Hamburgers can cost anywhere
Think of a from 7$ - 20$
chlorinated pool
that you want to go
in when it's SUPER
HOT!: 95-905°F

Sodium (135-145)
Creatine (0.6-1.2mg/dL)
Use the letters “od” in sodium to
This is the same value as LITHIUM's remember “odd” numbers.
therapeutic range (0.6-1.2 mmol/L) Lithium • The first 3 odd numbers are 1, 3,
is excreted almost solely by themkidneys and 5 add 10
and creatine is a value that tests how
well your kidneys filter 135 + 10 = 145

Glucose (70-100 mg/dL) Magnesium (1.5-2.5)

Energy gets Magnifying glass
you see 1.5-2.5 bigger
low at the age
than normal.
of 70-100
WOW! It looks
BIG!!!
24
NOTES

It never get easier, you just get stronger!