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Important lab values to know for the NCLEX
- Hemoglobin (Hgb)
- Normal range: 13 - 17
- Anemia: Hgb < 7. Typically transfuse with PRBCs < 7.
- White blood cell (WBC)
- Normal range: 4 - 10
- Neutropenia: WBC < 1. Could be from chemotherapy.
- Leukocytosis: WBC > 10. Indicative of infection.
- Platelets (Plt). Caution with blood thinners.
- Normal range: 150 - 450k
- Thrombocytopenia: Plt < 150k. Typically transfuse with platelets < 10k.
- Normal INR: < 1.1. For people being treated with anticoagulants, a normal therapeutic range is 2 - 3.
- Sodium (Na)
- Normal range: 135 - 145
- Hyponatremia: Na < 135. Treat with hypertonic saline such as 3% saline. Want slow gradual correction.
- Hypernatremia: Na > 145. Treat with fluid restriction or hypotonic saline such as 1/2NS.
- Potassium (K). Caution with diuretics.
- Normal range: 3.5 - 5
- Hypokalemia: K < 3.5. Treat with potassium supplementation.
- Hyperkalemia: K > 5. Treat with Kayexalate, or insulin.
- Glucose. Caution with diabetics, insulin administration.
- Normal range: ~ 70 - 130
- Hypoglycemia: < 70. Treat with IV D50 if comatose, or give juice and glucose tablets if stable.
- Hyperkalemia: > 140. Treat with insulin.
Elevated BUN and Cr are indicative of kidney failure.
- BUN: 7 - 20 mg/dL
- Creatinine (Cr): 0.7 - 1.3 mg/dL
Elevated cardiac enzymes are suspect for myocardial infarction (MI).
- Troponin: 0.04 - 0.39 ng/mL requires serial labs. Troponin > 0.4 is indicative of a MI.
- Normal CKMB: 5 - 25 IU/L. Elevated CKMB may indicate a MI.
- pH: 7.35 - 7.45. < 7.35 is acidosis, > 7.45 is alkalosis.
- pCO2: 35 - 45 mmHg
- Bicarb (HCO3): 22 - 28 mEq/L
- D-dimer: < 500 ng/mL. Elevated D-dimer is indicative of a pulmonary embolism (PE).
- Lactic acid: 0.5 - 1 mmol/L. A lactic acid > 2 is suggestive of sepsis.
- TSH: 0.4 to 4.0 mIU/L.
- T3: 75 -200 ng/dL
- Free T4: 0.8 -2.8 ng/dL. Elevated Free T4 can be hyperthyroid such as Graves’ Disease.
Most of the UA labs should be negative. If you see positive values for the following labs, think of a UTI:
- Leuk esterase
Elevated amylase and lipase are suggestive of pancreatitis.
- Normal Amylase: 23 - 85 units U/L.
- Normal Lipase: 0-160 U/L.