Adult/Elderly

3.5-5 g/dL

Children

Premature: 3-4.2 g/dL

Newborn: 3.5-5.4 g/dL

Infant: 4.4-5.4 g/dL

Child 4-5.9 g/dL

Indications: used to evaluate and monitor the disease course in patients with cancer, intestinal or renal protein wasting states, immune disorders, liver dysfunction, impaired nutrition, and chronic edema (Pg 441)

Alanine

Aminotransferase (ALT)

Adults

4-36 units/L 

may be 2x that in infants, may be elevated in African Americans, elderly and males, (pg 38)

Adults

10-80 mcg/dL

Child

40-80 mcg/dL

Newborns

90-150 mcg/dL

Indications: liver diseases

Aspartate

Aminotransferase (AST)

Age                                     Value in units/dL

0-5 days                                35-140

<3 yrs                                   15-60

3-6 yrs                                  15-50

6-12 yrs                                 10-50

12-18 yrs                               10-40

Adults                                    0-35

increased in elderly

Indications: hepatocellular disease

Adult

30-220 units/dL

Newborns

6-65 units/dL

 Critical Value: 3 x upper limit

Indication: pancreatitis, ectopic pregnancy, etc. 

Normal

30-120 units/L (slightly higher in children and elderly)

most sensitive indicator of metastisis to liver, 

Adult

.3-1 mg/dL

Newborn

1-12 mg/dL

Critical Value: Adult 12 mg/dL; Newborn >15 

(pg 131)

Age                                          Amount mg/dL

<10 days                                    7.6-10.4

10 days-2 yrs.                             9-10.6

child                                           8.8-10.8

adult                                          9-10.5 

Older adults have lower levels

Critical values: <6 or >13 

Indications: used to evaluate parathyroid function, renal function problems, and cancers

pg 148

Age                                         Amount mg/dL

Adult                                         <200

Child                                         120-200

Newborn                                    53-135

Infant                                        70-175

Indications: used to evaluate risk of coronary heart disease

p166

Age                                         Amount in mg/dL

adult

female                                     .5-1.1

male                                        .6-1.2

Adolescents                               .5-1

child                                         .3-.7

infant                                       .2-.4

newborn                                   .3-1.2

Critical Values >4

pg.204

Erythrocyte 

Sedimentation Rate

Age                                        Amount in mm/hr

Adult                               

female                                      </= 20

male                                         </= 15

child                                          </= 10

Newborn                                     0-2

Indications: used to diagnose conditions associated with inflammation, tissue necrosis, infarct and malignancies

pg 234

Fibrinigin

Range

Adult 200-400 mg/dL

Newborn 125-300 mg/dL

Critical value: <100

can lead to spontaneous bleeding

Age                                      Amount in mg/dL

premi                                    20-60

Neonate                                30-60

Infant                                   40-90

Child <2                                60-100

Child >2 - Adult                  Fast 70-110

                                       Casual </= 200

Critical Values

Age                                       Amount

Adult                                  

Male                                      <50 or >400

Female                                 <40 or >400

Infant                                   <40

Newborn                              <30 or >300

pg 267

Glucose

Tolerance Test

Range

Fasting < 110 mg/dL

30 min < 200 mg/dL

1 hr     < 200 mg/dL

2 hrs    < 140

3 hrs    70-115

4 hrs    70-115

urine negative

pg 275

Hemeglobin

A1C

Range

Nondiabetic                      4-5.9%

Good Diabetic control         <7%

Fair Control                      8-9%

Poor Control                     >9%

pg 280

Age                                        Range in %

Adult

Male                                        42-52

Female                                    37-47

Pregnant Female                       33

Elderly                                     Values decrease

Child

Newborn                                  44-64

2-8 weeks                                39-59

2-6 months                              35-50

6 months - 1 year                     29-43

1-6 years                                 30-40

6-18 years                               32-44

Critical Values: <15 or >60 %

Indications:Indirect measure of RBC number and volume.  

pg 295

Hemoglobin

Age                                        Rate in g/dL

Adult

Male                                        14-18

Female                                    12-16

Pregnant Female                       >11 

Elderly                                    Values decrease

Child

Newborn                                 14-24

0-2 weeks                               12-20

2-6 months                             10-17

6 months-1year                       9.5-14

1-6 years                                9.5-14

6-18 years                              10-15.5

Critical Values: <5 or >20 g/dL

Indications: measures RBC 

pg 299

HIV

Viral Load

Normal findings show undetectable load

Ranges for HIV pos 

% develop AIDS                    Load (RNA copies)

  5.4                                       <500

16.6                                        500-3000

31.7                                        3100-10000

55.2                                        10001-30000

80                                           >30000 

Pg 316

Lactic

Dehydrogenase

Age                                   Range in units/L

Newborn                             160-450

Infant                                 100-250

Child                                   60-170

Adult/elderly                        100-190

Indications: An intercellular enzyme used to support diagnosis of injury or disease involving the heart, liver, RBC, kidneys, skeletal muscle, brain and lungs.

Normal Findings

0-160 units/L

Indications

Evaluates pancreatic function

p354

Range

Adult 1.3-2.1 mEq/L

Child 1.4-1.7 mEq/L

Newborn 1.4-2 mEq/L

Critical Values: <.5 or >3 mEq/L

Indications: This test is used to identify magnesium levels.

Increased levels indicate renal insufficiency, Addison disease leads to increased aldosterone which increases Mg excretion, Mg antacids , hypothyroidis, major transfusion. Symptoms: lethargy, nausea and vomiting, and slurred speech.

Decreased levels: Malnutrition, malabsorption, hypoparathyroidism leads to decreased Ca absorb therefore decreased Mg absorb, alcoholism increases excretion, chronic renal tubular disease because Mg is reabsorbed in renal tubules, diabetic acidosis treatment causes Mg to fall. Symptoms: weakness, irritability, tetany, EKG changes, delirium and convulsions.

pg 368

Parathyroid

Hormone

Normal Levels: 10-65 pg/mL

Indications: PTH is measured to assist in the evaluation of hypercalcemia or hypocalcemia.  It is routinely monitored in patients with chronic renal failure.

Partial

Thromboplastin Time

Normal 

aPTT 30-40 seconds

PTT 60-70 seconds

Patients receiving anticoagulant therapy: 1.5-2.5 times control value in seconds.

Critical Value: aPPT >70 sec. PPT >100 sec.

Indications: The PTT test is used to assess the intrinsic system and the common pathway of clot formation.  It is also used to monitor heparin therapy.

Phosphate

and

Phosphorus

Age                                       Range in mg/dL

Adult                                      3-4.5 

Elderly                                    values decrease 

Child                                       4.5-6.5

Newborn                                 4.3-9.3

Critical Value: <1 mg/dL

Indications: Investigate parathyroid and calcium abnormalities.  

pg 406

Platelet

Aggregation

Normal Findings

Vary with platelet agonist used

Indications: This test is a measure of platelet function and aids in the evaluation of bleeding disorders

Platelet

Count

Age                                      Amount in mm^3

Adult/elderly                          150,000-400,000

Child                                     150,000-400,000

Infant                                   200,000- 475,000

Premature Infants                  100,000-300,000

Newborns                              150,000-300,000

Critical Values: 9,000 or >1 million/mm^3

Indications: Performed on patients who develop patechiae, spontaneous bleeding, increasingly heavy menses, or thrombocytopenia.  It is used to monitor the course of the disease or therapy for thrombocytopenia or bone marrow failure

pg 416

Mean

Platelet Volume

Normal Findings

7.4-10.4 fL

Indications: this test is helpful in the evaluation of platelet disorders especially thrombocytopenia

pg 419

Potassium

Age                                       Range in mEq/L

Adult/edlerly                            3.5-5

Child                                      3.4-4.7

Infant                                    4.1-5.3

Newborn                                3.9-5.9

Critical Values: Adult <2.5 or >6.5 and Newborn <2.5 or >8

Indications: an important electrolyte for cardiac function, monitored in patients who take diuretics or heart medications.

Causes of Increased Levels: dietary intake, IV intake, acute or chronic renal failure because K excretion is decreased, addison disease, hypoaldosteronism, aldosterone-inhibiting diuretics (aldosterone enhances K excretion), crush injury, hemolysis, transfusion, infection, acidosis (H+ is driven into the cell and K is driven out), and dehydration. Symptoms: irritability, N/V, intestinal colic, diarrhea, changes in EKG  (peaked T waves, widened QRS, and depressed ST).

Causes of Decreased Levels:  dietary intake, IV intake, burns, GI disorders (diarrhea, vomiting, villous adnomas), diuretics (increase K excretion), hyperaldosteronism (aldosterone enhances K excretion), Cushing syndrome (aldosterone like effect), renal tubular acidosis (increased K excretion), licorice ingestion, alkalosis ( H+ ions are driven out of cells and K is driven in), Insulin administration (glucose and K are driven into cells), glucose administration, ascites (reduced blood flow stimulates secretion of aldosterone), renal artery stenosis (same as above), Cystic Fibrosis (K is secreted in sweat), trauma, surgery, burns. Symptoms: decreased contractility of smooth, skeletal and cardiac muscle, weakness, paralysis, hyporeflexia, ileus, increased cardiac sensitivity to digoxin, cardiac arrhythmias, flattened T waves and prominent U waves.

Protein C

Protein S

Normal Findings

Protein S: 60-130 % of normal activity

Protein C: 70-150 % of normal activity

(Protein C decreased in elderly and females

Indications:  Part of evaluation of patients with coagulation disorders.

Protein

(albumin)

Age                                      Range in g/dL

Adult

    Total Protein:                       6.4-8.3

    Albumin:                             3.5-5

    Globulin:                             2.3-3.4

Children

    Total Protein   

      Premature infant                4.2-7.6

      Newborn                           4.6-7.4

      Infant                               6-6.7

      Child                                 6.2-8

    Albumin

      Premature infant                3-4.2

      Newborn                           3.5-5.4

      Infant                               4.4-5.4

      Child                                 4-5.9

Indications: Used to diagnose, evaluate and monitor the disease course in patients with cancer, intestinal/renal protein wasting states, immune disorders, liver dysfunction, impaired nutrition, and chronic edematous states.  

pg441

Prothrombin Time 

(INR)

Normal Findings

11-12.5 seconds (85-100%)

Full anticoagulant therapy: > 1.5-2 times control value (20-30%)

INR .8-1.1

Critical Values: >20 sec. INR > 5.5

Indications: The PT is used to evaluate the adequacy of the extrinsic system and common pathway in the clotting mechanism.

pg 448

Red Blood

Cell Count (RBC)

Age                                      Range in 10^6/uL

Adult/Elderly 

    Male                                  4.7-6.1

    Female                              4.2-5.4

Child

   2-8 weeks                           4-6

   2-6 months                         3.5-5.5

   6 months - 1 year                3.5-5.2

   1-6 years                           4-5.5

   6-18 years                         4-5.5

Newborn                               4.8-7.1

Indications: closely related to H and H 

pg 455

Age                                       Range in mEq/L

Adult/elderly                            136-145

Child                                       136-145

Infant                                     134-150

Newborn                                 134-144

Critical Values: <120 or >160

Indications: monitor fluid and electrolyte levels

Causes of Hypernatremia: increased intake via diet or IV, decreased Na loss due to cushing syndrome (corticosteroids act like aldosterone) and hyperaldosteronism, excess free body water loss due to GI loss, sweating, thermal burns, dieabetes insipidus, osmotic diuresis (high Na concentration. Symptoms: dry mucous membranes, thirst, agitation, restlessness, hyperreflexia, mania and convulsions

Causes of Hyponatremia:Decreased Na intake via diet or IV, increased Na loss due to addison disease (aldosterone and corticosteroid levels are inadequate so Na is not reabsorbed and is excreted), diarrhea, vomiting, nasogastric aspiration, intraluminal bowel loss (ileus or bowel obstruction), diuretic, chronic renal insufficiency (kidney loses its reabsorptive ability), Large volume aspiration of pleural or peritoneal fluid (drowning -- leads to dilution of Na), increased free body water via excessive intake, hyperglycemia, Congestiv Heart Failure, peripheral edema, ascites, pleural effusion, intraluminal bowel loss (ileus or obstruction), syndrome of inappropriate or ectopic secretion of ADH (ADH prevents excretion of free water leads to dilution. Symptoms: weakness, confusion, lethargy, stupor, coma

pg479

Thyroid Stimulating

Hormone

Normal Findings

Adult 2-10 uUnit/mL

Newborn 3-18 uUnit/mL

Indications: this test is used to diagnose hypothyroidism and to differentiate it from secondary or tertiary hypothyroidism

pg 497

Age                                  Range in mcg/dL

1-3 days                            11-22

1-2 weeks                          10-16

1-4 months                        8-16

1-5 years                           7-15

5-10 years                         6-13

10-15 years                       5-12

Adult Male                         4-12

Adult Female                     5-12

Adult >60 years                 5-11

Critical Values: Adult <2 mcg/dL if myxedema coma possible; >20 mcg/dL if thyroid storm possible; Newborn: <7 mcg/dL

Indications: Assess thyroid function, used to diagnose thyroid function and to monitor replacement and suppressive therapy.  

Triiodothryonine

Age                                       Range ng/dL

1-3 days                                 100-174

1-11 months                           105-245

1-5 years                                105-270

6-10 years                              95-240

11-15 years                            80-215

16-20 years                            80-215

20-50 years                            70-205

>50 years                              40-180

Indications: used to evaluate thyroid function, particularly in hyperthyroidism, also used ot monitor thyroid replacement and suppressive therapy.

pg 524

Troponins

Normal

Cardiac troponin T: <.2 ng/mL

Cardiac troponin I: <.03 ng/mL

Indications:  used in patients with chest pain to determine if the pain is caused by cardiac ischemia.  specific indicator of cardiac muscle injury and can be used to indicate risk of future cardiac events.

pg 530

White Blood Cell Count

With Differential

Normal Findings

Total 

Adult/child >2 yrs 5000-10000/mm^3

Child</=2 yrs 6200-17000/mm^3

Newborn 9000-30000/mm^3

cell                   %                   per mm^3

neutrophils      55-70                2500-8000

lymphocytes    20-40                1000-4000

monocytes       2-8                   100-700

eosinophils       1-4                   50-500

basophils         .5-1                  25-100

Critical Values: WBCs <2500 or >30000/mm^3

Indications: evaluate patients with infection, neoplasm, allergy or immunosuppression.