BIood sampIe NormaI Clinical Significance

Arterial Blood
Gases (ABG)
PaO2 = 80-100
mm Hg
PaCO2 = 35-45
mm Hg
pH = 7.35-7.45
HCO3 = 22-26
mEq/l
SaO2 = 95-99%
!anic VaIues for ABGs
PaO2: < 40
PaCO2: < 20 or > 70
pH: < 7.2 or > 7.6
HCO3: < 10 or > 40
SaO2: < 60%
See more information regarding CO2 Retention.
Degrees of poxia:
mild: PaO2 of 60-80 mm
mod: PaO2 of 40-60 mm
severe: PaO2 < 40 mm
Hematocrit
(Hct)
Female: 36-46%
Male: 42-52%
Low values = Anemia: monitor for fatigue, dyspnea,
tachycardia, tachypnea
RBC / Whole Blood = ___ %
Hemoglobin
(Hgb)
Female: 12-15
g/dl
Male: 14-17 g/dl
Low values = Anemia: monitor for fatigue, dyspnea,
tachycardia, tachypnea
Chemotherapy: < 10 -- hold aerobic exercise
RBC Count Female: 4 -5.5
million/mm3
Male: 4.5 - 6.2
million/mm3
Low values = Anemia: monitor for fatigue, dyspnea,
tachycardia, tachypnea
High values: n COPD, may indicate !oIc9emia, a
compensation for pulmonary dysfunction that makes
blood thicker, and increases risk of CVA, etc.
%otal WBC
Count
5,000 - 10,000
/mm3
> 10,000 indicates systemic infection (more than just
local colonization)
Chemotherapy :
< 5,000: use reverse isolation, see patient in room,
careful hygiene, hold aerobic exercise
Platelets,
%hrombocytes
200,000 -
500,000 /mm3
Chemotherapy:
O 30,000 50,000: avoid resisted exercise, risk of
internal hemorrhage, ambulation OK
O < 30,000: bedside, gentle AROM
O < 20,000: consult with physician or nurse before
activity
Sed Rate,
Erythrocyte
Sedimentation
Rate (ESR)
Female: 1-25
mm/hr
Male: 0-17 mm/hr
Bad if elevated.
Used to diagnose, or follow the course of inflammatory
diseases, e.g. rheumatic conditions
Alternative calculation of normal value:
Female: (age + 10) / 2
Male: age / 2
Creatinine Female: 0.6 -
1.2 mg/dl
Male: 0.5 - 1.1
mg/dl

Elderly values are
lower because of
reduced muscle
mass
Renal function measure: ig vaIues are bad.
May indicate nephropathy, end stage renal d.
Can occur in brittle diabetics also.
Potassium (K) 3.5 - 5.0 mEq/l ow (pokaIemia) secondary to: vomiting, diarrhea,
sweating, or use of loop diuretics e.g. Lasix,
furosemide. Also increases the risk of digitalis toxicity.
ResuI9 of low K: ventricular arrhythmias
ig (perkaIemia) secondary to: overuse of K
supplements, renal or endocrine problem.
ResuI9 of high K: ventricular arrhythmias, asystole
Calcium (Ca) 8.2 -10.2 mg/dl ow (pocaIcemia): secondary to: abuse of
laxatives, renal failure, low dietary calcium or Vit. D
intake, excessive magnesium intake.
ResuI9 of low Ca: osteoporosis, muscle spasms /
tetany, calcium deposits in tissue; cardiac arrhythmia,
asystole
ig (percaIcemia): secondary to: immobilization,
metastatic bone CA; overuse of antacids containing
calcium
ResuI9 of high Ca:
thirst; polyuria; renal stones; decreased muscle tone
and D%Rs; tachycardia; cardiac arrhythmia, asystole
Sodium (Na) 136 -145 mEq/l ow (pona9remia) secondary to: fluid loss from
diarrhea, vomiting, diaphoresis, diuretic use.
ResuI9 of low Na: postural hypotension, abdominal
cramps, headache, fatigue, weakness
ig (perna9remia) secondary to: dehydration, high
salt intake, poor renal function
ResuI9 of high Na: edema, tachycardia
iabe9es
Fas9ing BIood GIucose (FBG)
GIucose eveI ndica9ion
70 to 99 mg/dL Normal fasting glucose
100 to 125 mg/dL
mpaired fasting glucose (pre-diabetes)
Contributes to the diagnosis of Metabolic Syndrome
>126 mg/dL Diabetes

raI GIucose ToIerance Tes9 (GTT)
(Sample drawn 2 hours after a 75-gram glucose drink)
GIucose eveI ndica9ion
< 140 mg/dL Normal glucose tolerance
140 to 200 mg/dL
mpaired glucose tolerance (pre-diabetes)
Contributes to the diagnosis of Metabolic Syndrome
> 200 mg/dL Diabetes
onversion 9ooI for Blood Glucose to HBA1c
ar9 with comparative values for HBA1c & Blood Glucose
Glycosylated
Hemoglobin
BA1c, or A1c
- 6%
is normal
Lab work done at the doctor's office, that gives
an average of the last 3 month's blood
glucose.
%he goal for diabe9ic patients it to keep 9e
vaIue < 7%

!uImonar Func9ion Tes9 (!FT) resuI9s: ! & R

FV FEV1 FEV1 / FV
!
Decreased.
Mild: 65-80% of predicted
Mod: 50-65% of predicted
Severe: < 50% of predicted
Decreased.
Mild: 65-80% of predicted
Mod: 50-65% of predicted
Severe: < 50% of predicted
Decreased.
Mild: 65-80% of predicted
Mod: 50-65% of predicted
Severe: < 50% of predicted
R
Decreased.
Mild: 65-80% of predicted
Mod: 50-65% of predicted
Severe: < 50% of predicted
Decreased.
Mild: 65-80% of predicted
Mod: 50-65% of predicted
Severe: < 50% of predicted
Normal or increased.
80-100% of predicted


BP - liIespan values
Vital signs - pediatric values
/:9',:08 $B! B!
NormaI < 120 < 80
!reper9ension 120-139 80-89
TN - $9age 1 140-159 90-99
TN - $9age 2 > 160 > 100

- According to the Seventh Report of the Joint National Committee on Detection, Education, and
%reatment of High Blood Pressure (JNCV). 2003


Ejec9ion Frac9ion (EF), defines degrees of heart failure:
O 55 normal
O -55 mild LV dysIunction
O - moderate LV dysIunction
O severe LV dysIunction
Ottawa Cardiovascular Centre. (2. Congestive Heart Failure Survival Kit. Continuing Medical Implementation Inc. Retrieved 7-2-2.
http://www.cvtoolbox.com/downloads/CHFSurvivalKit.pdI

CHF is quantified by an echocardiogram (US) reading of eIeva9ed EDV (End Diastolic Volume and
decreased SV (Stroke Volume)


Reuma9ic diseases and tests with which they may be strongly associated:
Bartlett, S. (2006). Clinical Care in the Rheumatic Diseases. (3rd ed.). Association of Rheumatology
Health Professionals. American College of Rheumatology. Atlanta : ARHP
Rheumatoid factor (RF)
RA -70%, Sjogrens -90% (p.44-5)
Antinuclear Antibodies: ANA (Fluorescent ANA =
FANA)
SLE - 99% (p.45)
HLA B27: Human Leukocyte Antigens
AS - 90%, Reiters - 80% (p.178)
ESR Erythrocyte Sedimentation Rate & CRP (C-
reactive protein)
RA and Polymyalgia Rheumatica
Most useful as serial measurements to
track the course of the disease, especially
when in active inflammation (p.48)
Uric Acid Crystals (synovial aspiration)
Gout or pseudogout (p.44)
WBC levels
O Most indicative of Gout (synovial
aspiration)
O Normal in RA, but can be
elevated during inflammatory
phase (p.47-48).
O Leukopenia and other
hematologic disorders can occur
in SLE (p.188)

BM calculator
BM table
Underweight < 18.5
Normal
weight
18.5 - 2.9
Overweight 25 - 29.9
Obesity 30
Morbid
Obesity
0

VO2 Max / 3.5 = ME%s


AnkIe BraciaI ndex (AB):
Clinical application: decisions about use of compression, and use of sharp debridement.
Prognostic for wound healing.
Ankle SBP / Brachial SBP
Must have a doppler US to hear SBP at the dorsalis pedis artery. Cuff goes around
calf).
For normal persons, leg SBP is higher than brachial SBP.
0.9 -
1.2
Normal
0.7 -
0.9
Mild arterial disease (intermittent
claudication pain)
0.5 -
0.7
Moderate arterial disease (claudication
pain at rest)
< 0.5
Severe arterial disease (risk of
gangrene)
Falsely high values that are 1.2 may indicate arteriosclerosis (diabetes), because the
vessels are calcified and non-compressible by the BP cuff. Referral for other testing
would be appropriate.