Lab Values

Hemoglobin norms

Males: 14-18 g/dL

Females: 12-16 g/dL

Anemia

Hemoglobin < 5 g/dL

Ploycythemia

Hemoglobin > 20 g/dL

Hematocrit norms

Males: 42-52%

Females: 37-47%

Causes of polycythemia

Severe dehydration, congenital heart disease, erythrocytosis, burns, eclampsia, living in high altitudes, hypoxia due to chronic pulmonary conditions

Polycythemia presentation

Fatigue, HA, dizziness, visual changes, TIA, dysrhythmia, bruising, bleeding

Causes of anemia

Blood loss/hemorrhage, vitamin B12 and iron deficiency, bone marrow suppression, oncologic conditions, metabolic disorders, medications

Anemia presentation

pallor, tachycardia, orthostatic hypotension, dysrhythmia, impaired endurance and activity tolerance

White blood cell norms

5,000-10,000 mm

Leukocytosis

WBC > 30,000 mm

Leukocytosis causes

Infection, inflammation, bone marrow disease, immune system disorder, severe stress/pain

Leukocytosis presentation

Fever, fatigue, bleeding, bruising, frequent infections

Leukopenia

WBC < 2,500 mm

Leukopenia causes

Chemotherapy, radiation therapy, marrow infiltrative diseases, infections, dietary deficiency, autoimmune disease

Leukopenia presentation

Frequent/persistent infections, inflammation or ulcers in/around mouth, HA, stiff neck, sore throat, fever/chills, night sweats

Platelets norms

150,000-400,000 mm

Thrombocytosis/thrombocythemia

Platelets > 1 million

Thrombocytosis/thrombocythemia causes

Cancer, splenectomy, acute/chronic inflammation, strenuous exercise, iron-deficiency anemia, polycythemia vera

Thrombocytosis/thrombocythemia presentation

HA, dizziness, weakness, chest pain, tingling in hands/feet

Thrombocytopenia

Platelets < 50,000 mm

Thrombocytopenia causes

Blood loss/hemorrhage, damage to developing blood cells, diseases that lead to reduced platelet count

Thrombocytopenia presentation

Petechiae (type of bruising), ecchymosis, oral bleeding, hematuria (blood in urine), epistaxis (nose bleed)

Plasma D-Dimer norms

< 250 ng/mL or < 0.4 mcg/mL

Activated partial thromboplastin time norms

30-40 seconds

Increased Activated partial thromboplastin time causes

Inherited clotting factor deficiency. inherited deficiency of prothrombin/fibrinogen/factor V/factor X, acquired inhibitor of prothrombin/fibrinogen/factor V/factor X, disseminated intravascular coagulation, liver disease, hypofibrinogenemia, anticoagulation therapy, vitamin K deficiency

Increased Activated partial thromboplastin time causes

Increased bleeding tendency, bruising, oozing from wounds, mucosal bleeding

Prothrombin time norms

11.0-12.5 seconds

Increased prothrombin time causes

Alcohol, anticoagulation therapy, liver disease, bile duct obstruction, vitamin K deficiency, inherited factor VII deficiency, disseminated intravasculaar coagulation, ingerited deficiency of prothrombin/fibrinogen/factor V/factor X, acquired inhibitor of prothrombin/fibrinogen/factor V/factor X

Increased prothrombin presentation

increased bleeding tendency, bruising, oozing from wounds, mucosal bleeding

Increased prothrombin

20 seconds

Increased activated partial thromboplastin time

>70 seconds

International normalized ratio (INR) norms

0.8-1.1

Increased INR

>5.5

Increased INR causes

Alcohol, anticoagulation therapy, liver disease, bile duct obstruction, vitamin K deficiency, hereditary factor deficiency

Increased INR presentation

Increased bleeding tendency, bruising, oozing from wounds, mucosal bleeding

Sodium norms

136-145 mEq/L

Hypernatremia

Sodium > 160 mEq/L

Hypernatremia causes

Hypovolemia, sodium overload, endocrine disorders

Hypernatremia presentation

Thirst, confusion, irritability, hyperreflexia, seizure, coma, tachycardia, hypotension, oliguria

Hyponatremia

Sodium < 120 mEq/L

Hyponatremia causes

Hypervolemia and hypovolemia, severe GI loss, dehydration, diuretics, renal or hepatic disease, GI disorders, hypotonic IV administration

Hyponatremia presentation

HA, lethargy, hyporeflexia, seizure, coma, orthostatic hypotension, pitting edema, confusion, weakness, nausea

Potassium norms

3.5-5.0 mEq/L

Hyperkalemia

Potassium > 6.5 mEq/L

Hyperkalemia causes

Excess K supplementation, renal failure, metabolic acidosis, diabetic acidosis, blood transfusion

Hyperkalemia presentation

Muscle weakness or paralysis, muscle tenderness, paresthesia, dysrhythmia, bradycardia

Hypokalemia

Potassium < 2.5 mEq/L

Hypokalemia causes

Fluid overload, renal dysfunction, GI disorders, diuretics, alcoholism, hormonal and endocrine disorders, cystic fibrosis

Hypokalemia presentation

Extremity weakness, hyporeflexia, paresthesia, leg cramps, dysrhythmia, hypotension

Calcium norms

9-10.5 mg/dL

Hypercalcemia

Calcium > 13 mg/dL

Hypercalcemia causes

Excessive release of calcium into blood, dehydration, endocrine and hormonal disorders, GI disorders, excessive vitamin D, supplements/antacids, cancer, immobilization

Hypercalcemia presentation

Hyporeflexia, muscle weakness, ventricular dysrhythmia, lethargy, constipation, nausea/vomiting, bone pain

Hypocalcemia

Calcium < 6 mg/dL

Hypocalcemia causes

Chronic kidney disease, sepsis, malnutrition, malabsorption, pancreatitis, laxative use

Hypocalcemia presentation

Confusion, muscle cramps, hyperreflexia, dysrhythmia, paresthesia, agitation, seizure, fatigue

Magnesium norms

1.3-2.1 mEq/L

Hypermagnesemia

Magnesium > 3 mEq/L

Hypermagnesemia causes

renal failure, oliguria, increased magnesium intake, endocrine disorders, diabetic ketoacidosis

Hypermagnesemia presentation

Nausea/vomiting, hyporeflexia, hypotonia, somnolence, bradycardia, dysrhythmia, hypotension, respiratory depression

Hypomagnesemia

Magnesium < 0.5 mEq/L

Hypomegnesemia causes

Malnutrition, malabsorption, chronic alcohol use, diuretics, chronic renal disease, diabetic acidosis

Hypomagnesemia presentation

Hypertonia, hyperreflexia, tremors, muscle cramping, seizures, apathy, nystagmus, dysrhythmias

Glucose norms

74-106 mg/dL

Hyperglycemia

Glucose > 400 mg/dL

Hyperglycemia causes

Diabetes, acute stress response, cushing syndrome, cystic fibrosis, chronic kidney disease, IV fluids, acute pancreatitis, medications

Hypoglycemia

Glucose < 50 mg/dL

Hypoglycemia causes

Excess insulin, hypopituitarism, hypothyroidism, Addison’s disease, malnutrition, alcoholism

Hypoglycemia presentation

Perspiration, weakness, pallor, nervousness, seizure, lethargy, irritability, tachycardia, palpitation, altered mental status, hunger, HA, shaking, blurred vision, loss of consciousness

Troponins norms

Cardiac troponin T: < 0.1 ng/mL

Cardiac troponin I: < 0.03 ng/mL

High-sensitivity cardiac troponin: women < 14 ng/L, men < 22 ng/L

Increased troponin causes

Myocardial injury, myocardial infarction

Natriuretic peptides norms

BNP: < 100 pg/mL

NT-pro-BNP: < 300 pg/mL

Increased natriuretic peptides

>400 pg/mL

Increased natriuretic peptides causes

Heart failure, myocardial infarction, systemic HTN, cor pulmonale, heart transplant rejection

pH norms

7.35-7.45

PaCO2 norms

35-45 mmHg

HCO3 norms

21-28 mEq/L

PaO2 norms

80-100 mmHg

Respiratory alkalosis

pH increases, PaCO2 decreases, HCO3 normal

Respiratory alkalosis causes

Hyperventilation, salicylates

Respiratory alkalosis presentation

Lightheaded, dyspnea, paresthesia, chest tightness, seizure

Respiratory acidosis

pH decreases, PaCO2 increases, HCO3 normal

Respiratory acidosis causes

Respiratory depression, pulmonary disease (pneumonia, COPD, cystic fibrosis, asthma)

Respiratory acidosis presentation

Anxiety, confusion, fatigue/lethargy, tachypnea, coma, seizure

Metabolic alkalosis

pH increases, PaCO2 normal, HCO3 increases

Metabolic alkalosis causes

Sodium bicarbonate overdose, prolonged vomiting, nasogastric drainage, cystic fibrosis

Metabolic alkalosis presentation

Confusion, delirium, dysrhythmias, hypotension, muscle cramping

Metabolic acidosis

pH decreases, PaCO2 normal, HCO3 decreases

Metabolic acidosis causes

Diabetes, shock, renal failure, intestinal fistula

Metabolic acidosis presentation

Dyspnea, fatigue, nausea/vomiting, tachyarrhythmias, hypotension