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ONE ON ONE NCLEX LABS FOR NCLEX
Lab Normal
Critical
Values
What does lab
show?
What lab indicates if it goes high or low
Low
High
Glucose
70-110 mg/dL
50
400
Amount of glucose in blood
If the level is low patient is hypoglycemic If the level is high patient is hypoglycemic
Hemoglobin A1C
Good control 2.5-5.9% Fair control 6-8%
Poor control >8%
Mean of the glucose in the serum over the last 2-3 months
Helps show how controlled the client is on current regimen or helps diagnosis type two diabetics
Potassium
3.5-5.0 mEq/L
<2.5
>6.5
Amount of
Potassium in blood
If low, the muscles and nerves do not work effectively- weak to the point of respiratory depression
If high muscles and nerves can cause the heart to stop
Hemoglobin
Men 14-18 g/dL
Women 12-16 g/dL
<5
>20
Is the amount of
hemoglobin or
protein in blood
that carries 02
If low the patient will not be able to be active and do own care
If high could be the elevation of the client, polycythemia, heavy smoking etc
Hematocrit
Men 40-54%
Women 38-47%
<15
>60
Is the amount of red blood cells in blood
If low could be anemia of some kind If high sign of dehydration
WBC
5,000-10,000
<2,500
>30,00
Amount of White blood cells in the blood
Low
High sign of infection
Neutrophils
50-70%
WBC
Inflammation, tissue injury and infection
Segments
mature
50-60%
WBC
Bands immure
0-5%
WBC
Increase during a shift to the left when body needs more WBCs
Eosinophils
1-3%
WBC
Increase during Allergic and parasitic and decrease during higher levels of steroids
Basophils
0.4-1.0%
WBC
Increase during healing decrease during steroid use
Lymphocytes
25-35%
WBC
Elevate during chronic and viral infections
Monocytes
4-6%
WBC
Second defense against bacteria and foreign substances
ONE ON ONE NCLEX LABS FOR NCLEX
RBC
Men 4.7-6.1
million/mm3
Women 4.2-5.4
million/mm3
Show number of red blood cells in blood which is what
carries hemoglobin
Abnormal values indicated blood dyscrasias and anemia
ESR
Men 0-10 mm/hr
Women 0-20 mm/hr
Shows inflammation
Sodium
135-145 mEq/L
<120
>160
Amount of sodium in the blood
Increases with dehydration
Decreases with fluid excess
Platelets
150,000-400,00
<50,000
>1 million
Number of platelets in the blood
Decreased level occur with chemo, idiopathic thrombocytopenic purpura, most leukemias, uremia and some infections example mono
BUN
10-20 mg/dL
>100
End product of
protein metabolism Consists of nitrogen portion of urea
Increased with dehydration
Decreased with fluid excess
Creatinine
Men 0.6- 1.3 mg/dL Women 0.5-1.0 mg/dL
End product of
muscle creatine
metabolism, specific indicated of GFT
and renal status
Elevated levels indicate renal insufficiency or failure
Serum
Osmolality
280-296 mOsm/kg water
Reflects
concentration of
serum
Increased with dehydration
Decreased with fluid excess
PT
11.0-12.5 seconds
>20
Measures time
needed for
prothrombin to
form a fibrin clot via extrinsic
Low values indicate ineffective therapy High values indicate risk for bleeding
INR
1.3-2.0 without
Warfarin
Less than
therapeutic <2
Greater
than
therapeutic >3
Measures
effectiveness of oral anticoagulation
Therapeutic 2-3
Low values indicate ineffective therapy High values indicate risk for bleeding
ONE ON ONE NCLEX LABS FOR NCLEX
aPTT
20-36 seconds
>68
measures time
needed for
recalcified, citrated plasma to clot after adding activated
thromboplastin
reagent used for
heparin therapy
Low values indicate ineffective therapy High values indicate risk for bleeding or hemorrhage
Bleeding time
1-9 minutest
>15
Magnesium
1.3-2.1
<0.5
3.1
Amount of
magnesium in the blood
High indicated dehydration
Low indicated in fluid excess
Phosphorous
3.0-4.5
<1
Amount of
phosphorous in the blood
Albumin
3.5-5 g/dL
A plasma protein that maintains
oncotic pressure - keeps fluid in
vascular space
Decreased in malnourished states
Monitored as an indicator of nutritional status
Total protein
6.4-8.3 g/dL
Consists of
circulating albumins and goblins in blood
Decreased in malnutrition, low protein diet, GI disorders, severe liver disease chronic renal failure severe burns and water in toxification
Bilirubin
Total 0.3-1.0
Indirect 0.2-0.8 mom Direct 0.1-0.3 baby
>12
By product of
hemoglobin
breakdown
Elevated with jaundice and liver disease
Ammonia
10-80 mg/dL
End product of
nitrogen breakdown during protein
metabolism
Elevation in liver disease and possibly encephalopathy
ALT=SGPT
4-36 SI units
Primarily found in liver cells
Elevated with hepatitis or liver damage
ONE ON ONE NCLEX LABS FOR NCLEX
AST=SGOT
0-35 SI units
Mainly in heart
muscle and liver and some in
musculoskeletal
Rises following cellular injury and release of enzyme Rises after MI, & liver injury
Digoxin
0.5-2 ng/ml
>2.0
Lithium level
0.6-1.2 mEq/L
>1.5
ABG
Ph 7.35-7.45
Pa02 80-100 mm Hg PaC02 45-35 mmHg HC03 22-26
Sa02 94-100%
pH<7.25
C02<20
<15
>60
>40
75% or less
Determines which acid base imbalance the client is in
Total Cholesterol HDL
LDL
<200 mg/dL
Men 45-49
Women 50-59
60-180
Urinalysis
Alb
pH
WBC
Glucose
0-8 mg/dL
4.6-8.0
0-4
negative
Triiodothyronine T3
110.4-337.7 ng/dL
>337.7
If low the client has hypothyroidism
If high the client has hyperthyroidism
Thyroxine
T4
5-12 mxf/dL
>12
If low the client has hypothyroidism
If high the client has hyperthyroidism
Thyroxine Free
FT4
0.8-2.8 ng/dL
>2.8
If low the client has hypothyroidism
If high the client has hyperthyroidism
Heart labs
Troponin I
Less 0.35 ng/ml
>0.35
If high indicate heart injury such as MI
Troponin T
Less than 0.1 ng/mL
>0.1
If high indicate heart injury such as MI
CK MB
Males 2-6 ng/mL
Females 2-5 ng/mL
>6
If high indicate heart injury such as MI
Normal sinus rhythm
PR interval 0,18 seconds
QRS complex 0.06 seconds
P wave before each QRS and constant
It times are altered indicates dysrhythmias
Tonometry
10-21
Greater than 21
If done in the morning can be elevated and needs to be documented as such
Cerebral Spinal Fluid pressure
50- 175 mm H20
CD4 count
500- 1600 cells/L
Immune system problems with between 200 and 499
CD4 to CD8 ratio
1:2
Monitors the progression of HIV
Information taken from WebMD, Mayo Clinic, and Pearson’s Reviews and Rationales Comprehensive Review For NCLEX-RN
Labs for Diabetes Insipidus client
Hypernatremia (normal sodium 135-145)
Urine specific gravity low (normal 1.010 to 1.025)
Serum osmolality high (275 to 295)
Urine osmolality decreased (normal 300-1300)
Serum ADH levels decreased.
Lab cheat sheet for Addison’s and Cushing’s
Addison’s
Cushing’s
Low on cortisol
High on cortisol
Low on Blood sugar
High on blood sugar
Low on Sodium
High on sodium
High on potassium
Low on potassium
High on calcium
Low on calcium
To help remember labs affected mnemonic -----
C-Cat B-Bites S-spider P-picks up dead C-cold
The yellow part of the picture is the adrenal gland The adrenal gland is on top of the kidney
Most common pharmacology levels that You need to know
Drug
Therapeutic range
Digoxin
0.8 - 2.0 ng/ml
Gentamicin
5-10 mcg/ml
Lithium
0.8- 1.2 mEq/
Phenytoin
10-20 mcg/ml
Theophylline
10-20 mcg/ml
Tobramycin
5-10 mcg/ml
Diabetic Ketoacidosis labs
Blood glucose
>300 mg/dL
ketones
Positive at 1:2 dilution
Serum pH
<7.35- acidosis
Serum HC03
<15 mEq/L- metabolic
Sodium
Low normal or high
BUN
> 20 mg/dL elevated due to dehydration
Creatine
>1.5 elevated due to dehydration
Urine ketone
positive
Labs affected with Hypothyroidism and Hyperthyroidism
Hypothyroidism
Hyperthyroidism
Thyroid-stimulating hormone increased
Thyroid-stimulating hormone decreased
T3 decreased
T3 increased
T4 decreased
T4 increased
The pituitary is trying to tell the thyroid to do its job by sending TSH multiple times to get the thyroid to produce T3 & T4
The thyroid is more than doing its job. Has gone into overdrive on making T3 and T4 Producing too much!
