What Are Abnormal Lab Values?
Mean Cell Hemoglobin (MCH): Normal: pg/cell - = % volume of hemoglobin per RBC - = Hgb / RBC * Increase: indicates folate deficiency * Decrease: indicates iron deficiency Mean Cell Hemoglobin Concentration): Normal: g/dL - = Hgb / Hct * Decrease: indicates iron deficiency Reticulocyte Count: Normal: % of RBC. Apr 08, · Normal and Abnormal Lab Values for Glycosylated Hemoglobin. 7% or lower (good control of diabetes) 7% to 8% (fair control of diabetes) Higher than 8 % (poor control of diabetes).
The numbers used as a basis for comparison are the result of large numbers of tests done on healthy people over a period of years. Often testing can reveal abnormal lab values that are the first clue to hidden problems in a person who feels fine.
Other times, abnormal lab values are a clue that the person needs to make an important lifestyle change, such as when there are high cholesterol or triglyceride vales. Making changes to diet and exercise can help bring values that are outside of the normal range back into the range of what are considered acceptable numbers.
The specific laboratory tests used on a person generally depend on what the physician is looking for. Not all tests are ordered in all situations. Abnormal lab values in any of these areas can signify potentially serious problems and require further investigation.
In some cases, such as for people over a certain age, very specific tests are ordered to look for signs that might indicate cancer, thyroid problems, heart trouble, liver problems, or anemia.
If abnormal lab values are found in any of these areas, a more thorough investigation is usually begun immediately, how to pin up curly hair poor lab test results can sometimes indicate the impending failure of an organ or the presence of cancer. X-rays and other what abnormal lab values mean tests typically follow up indications of organ problems, with the ultimate hope of resolving any problems before they become too serious, thus restoring normal function to the body.
Please enter the following code:. Login: Forgot password?
Feb 02, · If your GFR falls below 30 you will need to see a kidney disease specialist (called a nephrologist). A GFR below 15 indicates that you need to start a treatment for kidney failure. Your kidney disease specialist will speak to you about treatments for kidney failure, such as . Apr 22, · When the Hgb and Hct values fall too low, it’s called anemia (uh-NEE-me-uh). Platelets (Plts) Platelets help control bleeding. You may bruise or bleed easily when your platelet levels are low. The risk of bleeding goes up when platelet levels drop below 20, What a low number may mean. Viral infections, lupus, leukemia, chemotherapy, pernicious anemia (due to vitamin B12 deficiency) What a high number may mean. Leukemia, myeloproliferative disorders (which cause blood cells to grow abnormally in bone marrow), inflammatory conditions.
Getting familiar with and interpreting laboratory values can be intimidating, particularly to new nurses. Complete blood count is one of the most basic laboratory examinations to assess the overall health status of a patient. It can help diagnose infections, autoimmune disorders, anemia, and other blood diseases. High Level: Dehydration, cigarette smoking, congenital heart disease, pulmonary fibrosis, renal cell carcinoma, polycythemia vera. Low Level: Bleeding, anemia, malnutrition, overhydration, hemolysis, erythropoietin deficiency, leukemia, multiple myeloma, porphyria, thalassemia, sickle cell anemia.
Drugs that may decrease RBC count: Quinidine, hydantoins, chloramphenicol, chemotherapeutic drugs. Hemoglobin is the protein component of red blood cells. It makes the blood look bright red as it is made with iron. High hemoglobin levels are usually present among people living in high altitude levels and among smokers. On the other hand, low hemoglobin levels may be present in a variety of blood diseases, like sickle cell disease and thalassemia.
High Level: Dehydration, cigarette smoking, polycythemia vera, tumors, erythropoietin abuse, lung diseases, blood doping. Drugs that may decrease hemoglobin: Aspirin, antibiotics, sulfonamides, trimethadione, anti-neoplastic drugs, indomethacin, doxapram, rifampin, and primaquine. Hematocrit is also known as packed cell volume or PCV. It reflects the volume percentage of red blood cells in the whole blood. The result is dependent on the size, structure, and total number of red blood cells.
Determining hematocrit is helpful in diagnosing and assessing blood diseases, nutritional deficiencies, and hydration status. High Level: Dehydration, hypoxia, cigarette smoking, polycythemia vera, tumors, erythropoietin abuse, lung diseases, blood doping, erythrocytosis, cor pulmonale.
Platelets are also known as thrombocytes. They circulate in the bloodstream and bind together to form a clot over any damaged blood vessel. Determining platelet count is vital in assessing patients for tendencies of bleeding and thrombosis.
High Level: Cancer, allergic reactions, polycythemia vera, recent spleen removal, chronic myelogenous leukemia, inflammation, secondary thombocytosis.
Low Level: Viral infection, aplastic anemia, leukemia, alcoholism, vitamin B12 and folic acid deficiency, systemic lupus erythematosus, hemolytic uremic condition, HELLP syndrome, disseminated intravascular coagulopathy, vasculitis, sepsis, splenic sequestration, cirrhosis.
Drugs that may increase platelet: Romiplostim, steroids, human IgG, immunosuppressants. Drugs that may decrease platelet: Aspirin, hydroxyurea, anagrelide, chemotherapeutic drugs, statins, ranitidine, quinidine, tetracycline, vancomycin, valproic acid, sulfonamides, phenytoin, piperacillin, penicillin, pentoxifylline, omeprazole, nitroglycerin. White blood cells, also known as leukocytes, defend the body against infections and other foreign bodies. In general, there are five types of white blood cells— neutrophils, lymphocytes, monocytes, eosinophils, and basophils.
High Level: Infections, cigarette smoking, leukemia, inflammatory diseases, tissue damage, severe physical or mental stress. Low Level: Autoimmune disorders, bone marrow deficiencies, viral diseases, liver problems, spleen problems, severe bacterial infections, radiation therapy.
Drugs that may increase white blood cells: Corticosteroids, heparin, beta-adrenergic agonists, epinephrine, granulocyte colony-stimulating factor, lithium. Drugs that may decrease white blood cells: Diuretics, chemotherapeutic drugs, histamine-2 blockers, captopril, anticonvulsants, antibiotics, antithyroid drugs, quinidine, chlorpromazine, terbinafine, clozapine, sulfonamides, ticlopidine. Urinalysis is usually done as part of routine diagnostic examinations.
A standard urinalysis involves three stages— visual exam, dipstick test and microscopic exam. In a visual examination, a urine sample is inspected for color, cloudiness, and odor. The presence of bacteria can also affect its appearance:. The dipstick urine test is done by dipping a plastic strip into the urine sample. This strip has partitions impregnated by different chemicals that correspond to certain substances present in the urine, so abnormalities will be detected. Once the strip is dipped into the urine, there will be some changes in the color of the partitions.
The following are the chemical tests usually included in reagent strips:. The pH level of the urine is related to the acid-base balance maintained by the body. Therefore, consumption of acidic or basic foods, as well as the occurrence of any condition in the body that produces acids or bases, will directly affect the pH of the urine. In some circumstances, too acidic or basic urine produces crystals. When this phenomenon happens inside the kidney, kidney stones can develop.
Specific gravity reflects how concentrated the urine is. It can measure the proportion of solutes present in the urine when compared to pure water. Determining specific gravity is useful when you want to detect a particular substance in the urine sample. For example, if you suspect that a patient secretes small amounts of protein in the urine, the first morning-void urine is the best sample because it has high specific gravity and appears concentrated.
Albumin is usually the first type of protein compound excreted in the urine whenever there is a kidney problem. Other types of protein compounds are not detectable in dipstick test and can be measured through a different urine protein test.
Conditions that usually produce high amounts of protein in the urine include preeclampsia, multiple myeloma, inflammation, urinary tract injuries, malignancies and other disorders that destroy red blood cells.
Glucose should not be present in the urine. However, in some circumstances, the renal threshold allows the excretion of glucose in the urine when the blood glucose levels are too high.
The conditions that can cause glucosuria are pregnancy, diabetes mellitus, liver diseases and hormonal disorders. Like glucose, ketones should not be present in the urine. Ketones are by-products of fat metabolism and they form whenever there is not enough carbohydrate present for energy production.
Ketones also form when insulin levels are not enough to initiate carbohydrate metabolism so the body just uses fat in order to produce the energy needed for daily activities. Other conditions that produce ketones in the urine are diabetes mellitus, frequent vomiting, strenuous exercise, and high protein diet.
The presence of blood in the urine is called hematuria and this usually happens when there is an injury in the urinary tract. Other conditions that may induce hematuria include cigarette smoking, strenuous exercise, kidney problems, and trauma. Leukocyte esterase is the enzyme produced by white blood cells. Normally, there are white blood cells present in the urine, but they are so few that there is no leukocyte esterase detectable in dipstick test.
On the other hand, when there are many white blood cells present in the urine, the leukocyte esterase level elevates and it could be detected in strips. White blood cells in the urine increase in response to urinary tract infections. Bilirubin, a part of bile, is the yellow fluid secreted into the intestines to aid in digestion.
It should not be present in a normal urine sample but once detected, it can reflect the presence of liver diseases. High urobilinogen levels in the urine can signify liver diseases and other conditions that can cause RBC destruction.
For people with liver problems and obvious signs of liver dysfunction, the absence of urobilinogen may indicate the presence of a hepatic or biliary obstruction. However, the detection of nitrite in the urine is not used as a sole basis for the determination of UTI as some people can still have UTI with a negative nitrite result.
In microscopic examination, the urine sample is centrifuged so sediments will settle at the bottom and the clear part can be discarded. Few drops of this centrifuged urine will be examined under a microscope. The sediments observed under the microscope are measured in terms of per lower power field LPF or per high power field HPF.
The following are the entities measured in a microscopic examination:. RBCs are present in the urine sample of a person with severe urinary tract infection, renal disorders, urinary tract injuries and inflammation. It can also reflect an improper collection of urine specimen e. Urine contaminated by blood from menstruation or hemorrhoids. Elevated WBCs in the urine is a sign of an infection or inflammation of the urinary tract.
It can also reflect improper urine sample collection as in the case of urine specimen contaminated by vaginal secretions. In a normal urine specimen, there are few epithelial cells that can be seen under microscopic examination. However, in cases of severe urinary tract infection, inflammation and malignancies, there will be an increased number of epithelial cells in the urine. An elevated number of epithelial cells can also signify an improper collection of the urine specimen, especially if it is not collected using the midstream-catch technique.
A normal urine sample is ideally sterile and free from microorganisms. However, in cases of urinary tract infection and improper urine collection, bacteria, yeast, and trichomonads can be found under microscopic examination. Results should be correlated clinically as these microorganisms are also present externally in the genitals. Casts are cylindrically shaped particles formed from the coagulated protein secreted by renal cells.
Examples include fatty casts, granular cast, and waxy casts among others. Examples of casts that are not typically present in the urine include leucine, cystine, and tyrosine. These casts may signify malignancies and abnormal metabolic processes. Potassium is critical in nerve and muscle function because it communicates impulses. The movement of nutrients into the cell and the transport of waste products out of the cell are also mediated by potassium. Whenever potassium levels are increased or decreased, the heart rhythms are affected as signified by EKG changes.
Low Level: Anorexia nervosa, malnutrition, diarrhea, vomiting, poorly managed diabetes, hyperaldosteronism. Drugs that may decrease potassium: Amphotericin B, gentamicin, carbenicillin, corticosteroids, beta-adrenergic agonists, potassium-wasting diuretics.
Sodium reflects a part of renal function as kidneys are responsible for eliminating it from the body. It also plays a part in motor and nerve function. Patients are tested for serum sodium levels in cases of dehydration, edema, abnormal blood pressure levels, and changes in motor functions. High Level: Cushing syndrome, diabetes insipidus, excessive fluid loss, malnutrition, dehydration. Drugs that may increase sodium: NSAIDs, laxatives, birth control pills, corticosteroids, and lithium.
Together with sodium, potassium and carbon dioxide, chloride maintains the normal acid-base balance of the body through balancing body fluids. Abnormal changes in serum chloride levels is usually an indicator of metabolic changes in the body. High Level: Diarrhea, metabolic acidosis, compensated respiratory alkalosis, renal tubular acidosis, bromide poisoning, kidney diseases, Cushing syndrome, hyperventilation.