3 - Lab Tests and Values

What is a reference range?

A set of values that includes upper and lower limits of a lab test based on a group of healthy people

What is complete blood count (CBC)?

• One of the most basic lab examinations to determine the status of a pt’s health

• Can dx infections, autoimmune disorders, anemia, and other blood diseases

• Consists of RBC, Hgb, Hct, PLT, and WBC

What is white blood cell count (WBC)?

• Normal range: 4,000-10,000 mm3

• Defend against infections and foreign bodies

• If inc, indicated an infection

• If dec, indicates susceptibility to infection/compromised immune system

Besides infections, what are some causes for high WBC?

• Cigarettes

• Leukemia

• Inflammatory diseases

• Tissue damage

• Physical/mental stress

• Cancer

Besides infection, what are some causes for low WBC?

• Autoimmune disorders

• Bone marrow deficiencies

• Viral diseases

• Liver or spleen problems

• Bacteria infections

• Radiation therapy

• Cancer

What is red blood cell count (RBC)?

• Primary function is to carry oxygen in the bloodstream

• If dec, anemia

• If inc, tendency to from clots or blockage

What s the normal red blood cell count range?

• Male: 4.5-6.2 million/mm3

• Female: 4-5.5 million/mm3

What are factors that cause high RBC levels?

• Dehydration

• Cigarettes

• Congential heart diseae

• Pulmonary fibrosis

• Renal cell carcinoma

• Polycythemia vera

What are factors that cause low RBC levels?

• Bleeding

• Anemia

• Malnutrition

• Overhydration

• Hemolysis

• Leukemia

• Multiple myeloma

• Sickle cell anemia

What is hemoglobin (HGB)?

• Iron-based pigment that binds and transports O2 in the blood (component of RBC)

• If dec, will have anemia, low energy, and inc risk of developing a pressure ulcer

• If inc, may live in a high altitude or smoker

• Inc by: blood doping, smoking, dehydration, polycythemia vera

• Dec by: nutritional deficiency, blood loss, sickle cell anemia, bone marrow suppression

What is the normal HGB level?

• Male: 13-18 g/dL

• Female: 12-16 g/dL

What is hematocrit (HCT?

• Measure of the volume of percentage of RBCs your body is making

• If inc, blood viscosity is inc and inc chance to impede blood in tissue

• If dec, there will be anemia, fatigue listlessness, and poor wound healing

What is the normal HCT range?

• Male: 40-52%

• Female: 37-48%

• Factors that inc high count: dehydration, hypoxia, cigarettes, lung disease, cor pulmonale

• Factors that dec low count: overhydration, nutritional deficiencies, Hodgkin’s lymphoma, chemo

What are platelets?

• Circulate in the bloodstream and bind together to form a clot over a damaged blood vessel

• If inc, indicates infection b/c bone marrow has inc in production

• If dec, there will be inc bleeding

What is the normal platelet range?

• 150-450 thou/uL

• Factors that inc: cancer allergic reactions, polycythemia vera, splen removal

• Factors that dec: viral infection, aplastic anemia, leukemia, alcoholism, lack of B12 and folic acid

What is blood glucose?

• Normal level is necessary for wound healing and dec damage to nerve, circulatory system, etc.

• If high, indicates infection

• If above 190, indicates dec WBC

What is the normal blood glucose range?

80-120 mg/dL

What is hemoglobin A1C?

Test that shows the average blood glucose for 3 months

What is a normal hemoglobin A1C range?

• Good - 2.5-5.9

• Fair - 6-8

• Over 8 is considered poor control

What is albumin?

• A protein made by the liver that keeps fluid from leaking out of the blood vessels, nourishes tissues, and transports hormones, vitamins, drugs, and substances like calcium throughout the body

• Used to evaluate liver or renal function and nutritional status

• If dec, could have excessive wound drainage, liver disease, inflammation, shock, malnutrition, nephritic syndrome, Crohn’s disease, celiac disease

• If inc, it could have dehydration

What is pre-albumin?

• Will give info on recent diet history and is an indicator of malnutrition or at increased risk of malnutrition

• Factors that can cause high pre-albumin: Hodgkin’s lymphoma, kidney problems, pregnancy

• Factors that can cause low pre-albumin: malnutrition, liver problems, cancer, zinc, deficiency

What is normal pre-albumin level?

20-40 mg/dL

What is sodium (NA)

• Plays a part in kidney function as the kidneys eliminate sodium from the body and stabilizes blood pressure, and needed for motor and nerve function

• If increased, may cause edema

• If decreased, may be dehydrated, low blood pressure, and changes in motor function

What are factors that affect NA levels?

• Factors that can cause high Na levels: Cushing syndrome, diabetes insipidus, excessive fluid loss, malnutrition, dehydration

• Factors that can cause low Na levels: Addison’s disease, renal diseases, cirrhosis, heart failure, severe vomiting and diarrhea, diuretic medications, dehydration

What is a normal NA level?

135-145 mEq/L

What is potassium?

• It is a mineral in your blood that is critical in nerve and muscle function

• It’s needed to communicate impulses, move nutrients into cells and transport waste out of cells

• If too high or too low, it affects the heart rhythms

• Increased with severe burns, acidosis

What are factors that affect potassium?

• Factors that can cause high K levels: Infection, dehydration, Addison’s disease, injury to tissue, diabetes, acute or chronic kidney failure

• Factors that can cause low K levels: Anorexia nervosa, malnutrition, diarrhea, vomiting, poorly managed diabetes

What is the normal potassium level?

3.5-5 mEg/L

What is erythrocyte sedimentation rate (ESR)?

• Used to help detect inflammation associated with conditions such as infections, cancers, and autoimmune diseases

• It’s the relationship of RBC to plasma

• If inc, there is an infection or inflammation but does not identify where

• If dec, could have polycythemia, leukocytosis, sickle cell anemia, or some protein abnormalities

What is normal ESR range?

0-20 mm/hr

What is prothrombin time (PT) and international normalized ratio (INR)?

• It is a blood test that measures how long it takes blood to clot.

• A PT test evaluates the coagulation factors VII, X, V, II, and I (fibrinogen).

• Most of the time, results are given as an INR (international normalized ratio)

What is normal INR range?

• 11 - 13.5 sec (INR of 0.8 – 1.1)

• If you are taking blood thinners to prevent blood clots, usually will try to keep INR between 2.0 and 3.0 which is an effective therapeutic range

• If INR is higher than normal, then blood is thinner and clotting too slow

• If INR is lower than normal, then blood is thicker and is clotting too quickly

What are factors that affect INR?

Bleeding disorders, disseminated intravascular coagulation, liver disease, low vitamin K

What is partial thromboplastin time (PTT)?

• It is a blood test that measures the time it takes your blood to clot.

• The PTT is used to evaluate the coagulation factors XII, XI, IX, VIII, X, V, II (prothrombin), and I (fibrinogen)

• Partial thromboplastin time (PTT) and prothrombin time (PT) are often done at the same time

What is the normal PTT range?

25 – 35 sec

What is the relationship of PT to PTT?

Look at chart in PPT

What is total cholesterol?

• A fat-like substance found in your blood.

• It is the total of HDL, LDL, and lipids

• If increased, may increase your chance of having heart and circulation problems

• Good level is below 200

What is normal total cholesterol range?

3.5-5.5 mmol/L

What is high density lipoproteins (HDL) cholesterol?

• A type of "good" cholesterol that protects your heart

• Normal range: above 40

What are low density lipoproteins (LDL) cholesterol?

• A type of "bad" cholesterol

• If increased LDL level may increase your chance of having heart and circulation problems

• Normal range: below 100

What are triglycerides?

• A type of fat found in your blood created by the foods you eat.

• A high level along with high levels of total and LDL cholesterol may increase your chance of heart and circulation problems

What is the normal triglyceride range?

• 50-150 mg/dL

• 150-199 = mildy high

• 200-499 = high

• 500 or higher - very high

What is pH?

• Related to the acid-base balance maintained by the body.

• If too acidic or basic, urine produces crystals inside the kidney and can develop stones

What is normal pH level?

4.5 - 8

What is blood urea nitrogen (BUN)?

• Urea nitrogen is a normal waste product in your blood that comes from the breakdown of protein from the foods you eat and from your body metabolism

• It is normally removed from your blood by your kidneys, but when kidney function slows down,the level rises.

• It increases when you eat more protein

• It decreases when you eat less protein

What are factors that affect BUN levels?

• Factors that can cause high levels: Hypovolemia, excessive protein levels in the gastrointestinal tract, CHF,GI bleed, MI, urinary tract obstruction, pyelonephritis, kidney failure, shock.

• Factors that can cause low levels: Low protein diet, malnutrition, liver failure, fluid overload.