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Appendix
C
C-1
Medical-Surgical Nursing
Is the value an expected abnormal nding? For example, creatinine is normally elevated in clients with renal failure. Is the value an unexpected abnormal nding? For example, elevated blood glucose levels in a client without diabetes may signal a disease. Is the value an unexpected normal nding? For example, a client with angina and probable myocardial infarction would be expected to have elevated isoenzymes. Normal levels may mean that the client has another cause of chest pain. Is the value an expected normal nding? For example, a healthy client should have a normal complete blood count. Use the analytic technique as a guide to determine when to call the physician. Remember, the laboratory only reports ndings; nurses help interpret their signicance. Appendix C summarizes the common laboratory diagnostic studies for use as a quick reference. A
C-1
C-2
Conventional Units
No hemolysis Total score 14 to 100
SI Units
No hemolysis Total score 14 to 100
4.6 to 6.2 1012/L 4.2 to 5.2 1012/L 4.5 to 5.1 1012/L 4.5 to 11.0 109/L Absolute 0/L 150 to 400 106/L 3000 to 5800 106/L 1500 to 3000 106/L 300 to 500 106/L 50 to 250 106/L 15 to 50 106/L 150 to 400 109/L 25 to 75 109/L
150 to 400/mm3 3000 to 5800/mm3 1500 to 3000/mm 300 to 500/mm3 50 to 250/mm3 15 to 50/mm3 150,000 to 400,000/mm3 25,000 to 75,000/mm3 (0.5% to 1.5% of erythrocytes)
3
Coagulation tests Bleeding time (template) Coagulation time (glass tubes) D-Dimer Factor VIII and other coagulation factors Fibrin split products (Thrombo-Welco test) Fibrinogen International normalized ratio (INR) Partial thromboplastin time (PTT) Partial thromboplastin time, activated (aPTT) Prothrombin time (PT) Coombs test Direct Indirect Corpuscular values of erythrocytes Mean corpuscular hemoglobin (MCH) Mean corpuscular volume (MCV) Mean corpuscular hemoglobin concentration (MCHC) Haptoglobin 26 to 34 pg/cell 80 to 96 m
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2.75 to 8.0 min 5 to 15 min < 0.5 g/ml 50% to 150% of normal < 10 g/ml 200 to 400 mg/dl 1.5 to 4.0 60 to 70 sec 30 to 40 sec 11.0 to 14.0 sec Negative Negative
2.75 to 8.0 min 5 to 15 min < 0.5 mg/L 0.5 to 1.5 of normal < 10 mg/L 2.0 to 4.0 g/L 60 to 70 sec 30 to 40 sec 11.0 to 14.0 sec Negative Negative 26 to 34 pg/cell 80 to 96 fL 320 to 360 g/L 0.20 to 1.65 g/L Table continued on following page
C-3
Conventional Units
SI Units
*For some procedures, reference values may vary, depending on the method used. Pagana, K. & Pagana, T. (2003). Mosbys diagnostic and laboratory test reference (6th ed.). St. Louis: Mosby.
C-4
Conventional Units
SI Units
C-5
Conventional Units
< 1 mg/dl 8.4 to 10.6 mg/dl 4.25 to 5.25 mg/dl
SI Units
< 10 mg/L 2.10 to 2.65 mmol/L 1.05 to 1.30 mmol/L
C-6
Conventional Units
SI Units
C-7
Conventional Units
< 2 mg/dl 3.0 to 4.5 mg/dl 3.5 to 5.0 mEq/L
SI Units
121 mol/L 1.0 to 1.5 mmol/L 3.5 to 5.0 mmol/L
*For some procedures, reference values may vary, depending on the method used. Pagana, K. & Pagana, T. (2003). Mosbys diagnostic and laboratory test reference (6th ed.). St. Louis: Mosby.
C-8
Conventional Units
Negative Negative 10 to 100 mg/24 hr 3 to 20 g/24 hr 1.3 to 7.0 mg/24 hr < 17 U/hr 0.01 to 0.04 Negative < 250 mg/24 hr < 10 g/24 hr < 100 g/24 hr 4 to 126 g/24 hr 0.1 to 1.6 mg/24 hr 110 to 250 mEq/24 hr 0 to 50 g/24 hr 10 to 100 g/24 hr 0 to 40 mg/24 hr 0 to 80 mg/24 hr 15 to 25 mg/kg/24 hr
SI Units
Negative Negative 0.15 to 1.5 mol/24 hr 8.3 to 55 nmol/24 hr 10 to 53 mol/24 hr < 17 U/hr 0.01 to 0.04 Negative < 6.3 nmol/24 hr < 55 nmol/24 hr < 590 nmol/24 hr 24 to 745 nmol/24 hr 0.5 to 8.1 mol/24 hr 110 to 250 nmol/24 hr 0 to 0.80 mol/24 hr 27.6 to 276 nmol/24 hr 0.0 to 0.30 mmol/24 hr 0.0 to 0.60 mmol/24 hr 0.130.22 mmol/kg/24 hr
Males Females Dehydroepiandrosterone Males Females Estrogens, total Males Females Glucose (as reducing substance) Hemoglobin and myoglobin, qualitative 17-Hydroxycorticosteroids Males Females 5-Hydroxyindoleacetic acid Qualitative Quantitative
110 to 150 ml/min/1.73 m2 105 to 132 ml/min/1.73 m2 0.2 to 2.0 mg/24 hr 0.2 to 1.8 mg/24 hr 4 to 25 g/24 hr 5 to 100 g/24 hr < 250 mg/24 hr Negative 3 to 9 mg/24 hr 2 to 8 mg/24 hr Negative 2 to 6 mg/24 hr
110 to 150 ml/min/1.73 m2 105 to 132 ml/min/1.73 m2 0.7 to 6.9 mol/24 hr 0.7 to 6.2 mol/24 hr 14 to 90 nmol/24 hr 18 to 360 nmol/24 hr < 250 mg/24 hr Negative 8.3 to 25 mol/24 hr 5.5 to 22 mol/24 hr Negative 10 to 31 mol/24 hr Table continued on following page
C-9
Conventional Units
SI Units
*For some procedures, reference values may vary, depending on the method used. Pagana, K. & Pagana, T. (2003). Mosbys diagnostic and laboratory test reference (6th ed.). St. Louis: Mosby.
C-10
SI Units
< 5 106/L All mononuclear Predominantly albumin 2.8 to 4.2 mmol/L (1.1 mmol/L less than serum) < 0.08 of total protein < 0.14 of total protein 0.3 to 0.6
All mononuclear Predominantly albumin 50 to 75 mg/dl (20 mg/dl less than serum) IgG Children < 14 yr Adults IgG index CSF/serum IgG ratio CSF/serum albumin ratio Oligoclonal banding on electrophoresis Pressure, opening Protein, total Absent 70 to 180 mm H2O 15 to 45 mg/dl < 8% of total protein < 14% of total protein 0.3 to 0.6
Modied from Conn, R. B., Borer, W. Z., & Snyder, J. W. (1997). Current diagnosis (9th ed., pp. 12351241). Philadelphia: W. B. Saunders; and data from Malarkey, L. M., & McMorrow, M. E. (2000). Nurses manual of laboratory tests and diagnostic procedures (2nd ed.). Philadelphia: W. B. Saunders.