NCLEX Lab Values 2018


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Important lab values to know for the NCLEX

CBC

  • 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.

Coagulation

  • Normal INR: < 1.1. For people being treated with anticoagulants, a normal therapeutic range is 2 - 3.

Electrolytes

  • 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.

Kidney Function

Elevated BUN and Cr are indicative of kidney failure.

Normal range:

  • BUN: 7 - 20 mg/dL
  • Creatinine (Cr): 0.7 - 1.3 mg/dL

Cardiac Enzymes

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.

ABGs

  • pH: 7.35 - 7.45. < 7.35 is acidosis, > 7.45 is alkalosis.
  • pCO2: 35 - 45 mmHg
  • Bicarb (HCO3): 22 - 28 mEq/L

Respiratory

  • D-dimer: < 500 ng/mL. Elevated D-dimer is indicative of a pulmonary embolism (PE).

Sepsis

  • Lactic acid: 0.5 - 1 mmol/L. A lactic acid > 2 is suggestive of sepsis.

Thyroid Hormones

  • 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.

Urine analysis

Most of the UA labs should be negative. If you see positive values for the following labs, think of a UTI:

  • Leuk esterase
  • Nitrates
  • Bacteria
  • WBCs
  • RBCs

Gastrointestinal

Elevated amylase and lipase are suggestive of pancreatitis.

  • Normal Amylase: 23 - 85 units U/L.
  • Normal Lipase: 0-160 U/L.