hLab Value AHS Reference Range

ABGs
pH Low – indicates acidosis
7.35 – 7.45 -overproduction of acid that builds up in the blood
-an excessive loss of bicarbonate from the blood (metabolic acidosis)
-buildup of carbon dioxide in the blood that results from poor lung function or
depressed breathing
S&S = confusion, tachycardia, headache, vomiting, SOB, fatigue, seizures
High – indicates alkalosis
-characterized by the buildup of excess base or alkali in the body
-caused by an overabundance of bicarbonate in the blood
-loss of acid from the blood (metabolic alkalosis)
-low level of carbon dioxide in the blood that results from rapid or deep
breathing
S&S = confusion, muscle twitching, numbness in the face, hands, or feet,
N&V, low K and calcium
PaCO2 -partial pressure of carbon dioxide in arterial blood
35 – 45 mmHg Low – respiratory alkalosis, secondary metabolic acidosis
-can be caused by hypoxia, anxiety, pregnancy, PE (hyperventilation)
S&S = chest pain, dyspnea, tetany, paresthesia, dizziness, seizures
High – respiratory acidosis
-can be caused by COPD, asthma, smoking, neurological conditions that
impact breathing (hypoventilation)
S&S = SOB, headache, confusion, fatigue, depression, seizures
PaO2 -partial pressure of oxygen in arterial blood
70 - 90 mmHg Low – caused by the inability of the lungs to properly oxygenate blood due
to hypoventilation, impaired diffusion, pulmonary shunting
S&S = headache, dyspnea, tachycardia, confusion, cyanosis
High – indicates increased oxygen levels of inhaled air or increased
pulmonary blood flow with ventilation-perfusion inequality
HCO3 (bicarb) -concentration of bicarbonate in arterial blood
20 – 27 mmol/L Low – metabolic acidosis
-can be caused by diarrhea, kidney disease, liver failure, diabetes
S&S = increased HR, headache, confusion, fatigue, loss of appetite, N&V
Treatment = sodium bicarbonate, IV fluids and insulin
High – metabolic alkalosis
-caused by loss of acid through vomiting and dehydration, diuretic use, and
hypokalemia
S&S = muscle twitch, tetany, light-headedness, confusion, nausea, vomiting,
numbness or tingling in face, hands, or feet
Treatment = electrolyte replacement, saline, hydrochloric acid
Lactate High – hyperlactatemia
Less than 2 -caused by increased lactate production from respiratory muscles
mmol/L -indicates impaired tissue oxygenation, sepsis, dehydration, anemia, liver
disease/damage
S&S = muscle ache, rapid breathing, nausea, stomach pain
Treatment = IV fluids, oxygen therapy
Electrolytes
Sodium -required for conducting nerve impulses, contraction and relaxation of
135 – 145 mmol/L muscles, and maintain the proper balance of water and minerals
Low – hyponatremia
-common causes include diuretics, vomiting, diarrhea, congestive heart
failure, renal and liver disease
 S&S = nausea, vomiting, decreased energy, confusion
Treatment = hypertonic NS 3%
High – hypernatremia
-results from water depletion, dehydration, diarrhea, kidney dysfunction
S&S = excessive thirst, fatigue, confusion, muscle weakness
Treatment = D5W, dialysis
Potassium -helps nerves to function and muscles to contract, heartbeat to stay regular,
3.5 – 5.0 mmol/L and move nutrients into cells and waste products out of cells
Low – hypokalemia
-caused by alcohol use (excessive), chronic kidney disease, DKA, diarrhea,
diuretics (water retention relievers), excessive laxative use, excessive
sweating, folic acid deficiency
S&S = thready, weak, irregular pulse, muscle weakness, nausea, vomiting,
constipation, leg cramps
Treatment = oral or IV potassium replacement
High – hyperkalemia
-caused by acute kidney disease, high potassium diet, dehydration
S&S = heart palpitations, chest pain, decreased blood pressure and resp
rate
Treatment = diuretics, kayexalate, dialysis

Chloride -helps to regulate the amount of fluid and types of nutrients going in and out
98 – 112 mmol/L of the cells, maintains proper pH levels, stimulates stomach acid needed for
digestion, stimulates the action of nerve and muscle cells, and facilitates the
flow of oxygen and carbon dioxide within cells
Low – hypochloremia
-caused by excess use of loop diuretics, nasogastric suction, or vomiting
-metabolic alkalosis is usually present with hypochloremia
S&S = dehydration, weakness, fatigue, difficulty breathing
Treatment = IV NS
High – hyperchloremia
-caused by conditions like diarrhea or kidney disease, certain medications,
fever (sweating), dehydration or eating too much salt
S&S = fluid retention, increased BP, irregular HR, muscle weakness,
seizures, confusion
Treatment = sodium bicarbonate, dialysis, IV fluids
Calcium -needed for muscles to move and for nerves to carry messages between
1.15 – 1.30 your brain and every part of your body, helps blood vessels move blood
mmol/L throughout your body and helps release hormones that affect many functions
Low – hypocalcemia
-causes include cirrhosis, nephrosis, malnutrition, burns, chronic illness, and
sepsis
S&S = Muscle spasms, tetany, seizures, tingling of lips, tongue, hands and
feet
Treatment = IV Calcium gluconate (vit D helps absorb calcium)
High – hypercalcemia
-caused by hyperparathyroidism and increased oral intake
-severe cases can be an endocrine emergency and cause severe
neurological, cardiac, and renal issues
S&S = Muscle weakness, fatigue, nausea, vomiting, frequent urination, bone
pain, excessive thirst
Treatment = IV fluids and diuretics, calcitonin, bisphosphonates, prednisone
Phosphate -needed for regulation of gene transcription, activation of enzymes,
0.7 – 1.5 mEq/L maintenance of normal pH in extracellular fluid, and intracellular energy
storage
Low – hypophosphatemia
-caused by inadequate phosphate intake, increased phosphate excretion,
and shift from extracellular phosphate into the intracellular space
S&S = Muscle weakness, fatigue, decreased appetite, confusion, bone pain
Treatment = oral or IV phosphate replacement
High – hyperphosphatemia
-caused by kidney failure, high oral intake, increased renal reabsorption,
vitamin D intoxication
S&S = muscle cramps, numbness or tingling around the mouth, rash, itchy
skin, bone pain
Treatment = Calcium carbonate, calcium acetate, Sevelamer
Magnesium -needed for regulating muscle and nerve function, blood sugar levels, and
1.4 – 1.9 mEq/L blood pressure and making protein, bone, and DNA
Low – hypomagnesemia
-caused by chronic diseases including diabetes, hypertension, coronary
heart disease, and osteoporosis, alcohol use disorder, GI losses, renal
losses, and medications such as diuretics, antibiotics, cortisone, and
painkillers
S&S = Nausea, dizziness, confusion, weakness, tremors, tetany, abnormal
eye movements
Treatment = oral or IV magnesium replacement
High – hypermagnesemia
-caused by alcoholism, malnourishment, PPIs, hypothyroidism, kidney
disease, renal failure, lithium therapy
S&S = Confusion, fatigue, headache, constipation, decreased reflexes,
shortness of breath
Treatment = IV loop diuretics, dialysis, IV calcium gluconate
Osmolality -indicates the concentration of all the particles dissolved in body fluid
280 – 300 -can be impacted by dehydration, hypo/hypernatremia, and kidney damage
mosm/kg Low – can indicate excess fluid intake, hyponatremia, paraneoplastic
syndromes, and syndrome of inappropriate ADH secretion
High – can indicate dehydrate, diabetes insipidus, head trauma, stroke,
hyperglycemia, hypernatremia, uremia, and alcohol poisoning
Anion gap -anion gap blood test is a way to check the acid-base balance (pH balance)
4 – 16 Low -can indicate alkalosis, low level of albumin, kidney disease, heart
disease, liver disease, and some types of cancer
High -can indicate acidosis caused by dehydration, diarrhea, kidney
disease, DKA, and certain medications
Kidney Function
Creatinine -it is a by-product of normal muscle function and can indicate kidney function
40 – 100 umol/L Low – can be caused by low body mass, chronic kidney disease, reduced
kidney function, fluid overload or malnutrition
S&S = weakness, low tolerance of exercise, frailness
High – indicate impair kidney function such as infection, obstruction, or
failure, high protein intake, heart disease, diabetes
S&S = edema, changes in urination, N&V, SOB, muscle cramps, decreased
appetite, chest pain
Urea -kidneys filter urea and remove other waste products from your blood
3-9 mmol/L Low – can be caused by low-protein diet, pregnancy, malnutrition, or severe
liver damage
High – can indicate kidney injury or disease, dehydration, or heart failure
eGFR -blood test measures how much blood your kidneys filter each minute
>60 Low – indicates kidney dysfunction or failure, levels below 15 may require a
kidney transplant
High – healthy kidney function is indicated by levels over 60
Liver Function
Tests
ALT -found mainly in the liver, but also in smaller amounts in the kidneys, heart,
(alanine muscles, and pancreas
aminotransferase) Low – can indicate vit B6 deficiency or chronic kidney disease
Less than 70 u/L High – sign of liver injury or disease
S&S = stomach pain, fatigue, dark urine, jaundice, itch, N&V
AST -an enzyme that’s found in your liver, heart, pancreas, muscles and other
(aspartate tissues in your body
aminotransferase) Low – may indicate vit B6 deficiency, kidney disease
Less than 55 u/L High – can indicate hepatitis, cirrhosis, mono, liver failure, or fatty liver
S&S = N&V, fatigue, weakness, abdo pain and swelling, jaundice, edema
Total Bilirubin -waste by-product of normal process of breaking down old RBC and
<20 umol/L excreted through the liver
High – indicates liver damage or disease, or bile duct obstruction due to
cirrhosis, gallstones, and pancreatitis
S&S = jaundice, bloating, N&V, confusion, fatigue
Lipase -an enzyme of the pancreas that helps to digest fats
10 to 140 U/L Low – can indicate damage to the pancreas cells in conditions such as
cystic fibrosis and chronic pancreatitis
High – can indicate issues with the pancreas, kidney failure, cirrhosis, or
bowel problems
S&S = excessive thirst, fatigue, frequent urination, weight loss
ALP -an enzyme found in several tissues throughout the body, but primarily in the
(Alkaline liver, bile duct and bone
phosphatase) Low – can be caused by lack of zinc, malnutrition, pernicious anemia,
35-145 U/L thyroid disease, Wilson disease or hypophosphatasia
High - caused by liver problems, such as hepatitis, blockage of the bile ducts
(obstructive jaundice), gallstones, cirrhosis, liver cancer, or cancer that has
spread (metastasized) to the liver from another part of the body
S&S = itch, weight loss, N&V, weakness, jaundice, abdo swelling and pain
CRP -protein that is made by the liver that is released in times of inflammation
(c-reactive High – caused by inflammation from diseases, infections, and cancers. Can
protein) also be caused by obesity, lack of exercise, smoking, diabetes
Less than 0.3 Medications that work as anti-inflammatories can cause decreased levels
mg/dL
Cardiac
High Sensitivity -troponin is a protein of the heart muscle
Troponin High – indication of myocardial injury or heart attack and severe coronary
<14 ng/L artery disease
(critical >53 ng/L)
proBNP -certain type of hormone in your blood called a B-type natriuretic peptide that
less than 300 ng/L indicates how well the heart is functioning
High – indication of heart failure and that the heart is not pumping effectively
S&S = fatigue, swelling in abdomen, legs, and feet, coughing, difficulty
breathing, loss of appetite, nausea
CBC & D
Hgb -protein contained in red blood cells that is responsible for delivery of oxygen
 120 – 160 g/L to the tissues
Low – can be caused by aplastic anemia, cancer, medications, chronic
kidney disease, cirrhosis, Hodgkins disease, RA, hypothyroidism, IBD, iron
deficiency anemia, and active bleeding
High – can be caused by chronically low O2 levels (COPD and smoking),
bone marrow diseases, cancer, heart disease and can lead to complications
such as blood clots
Hct -percentage by volume of red cells in your blood
0.36 – 0.48 (%) Low – can be caused by ulcers, colon cancer, trauma, internal bleeding,
severe dehydration
High – can be caused by bone marrow disease, congenital heart disease,
high altitude, low O2 levels, dehydration, right-sided heart failure
RBC Low – decreased production, increased destruction, bleeding, malnutrition,
4 – 5.6 m/uL deficiencies in iron, B12, and folic acid, and kidney disease
High – can indicate dehydration, heart disease, smoking, kidney disease
WBC Low – indicates an immunocompromised state, can be caused by leukemia,
4 – 11 K/uL lymphoma, myeloma, and autoimmune disorders
High – indicates infection, allergy, inflammatory disease, leukemia, or tissue
damage (burns or surgery)
Platelets Low – (Thrombocytopenia), can be caused by TTP (clotting disorder) and
150 – 400 K/uL DIC, infections, heavy alcohol use, viral infections, pregnancy, liver disease,
blood cancers
S&S = bruising, abnormal bleeding, fatigue, blood in urine or stool
High – can indicate an autoimmune disease, cancer, trauma, infection or
iron deficiency
S&S = nosebleeds, bleeding from gums, blood in stool, headache,
weakness, chest pain
Neutrophils Low – (neutropenia) can occur with infection, chemotherapy, bone marrow
2.0 – 9.0 (%) disorders, vit B12 and folate deficiency, and autoimmune diseases
High – (neutrophilia) indicates that the body is stress from infection,
inflammation or vigorous exercise, or overproduction with neoplams
Misc.
Glucose Low – caused by too much insulin, alcohol use, hot weather, inadequate
3.3 – 11 mmol/L nutritional intake
S&S = tachycardia, shaking, sweating, dizziness, hunger, confusion
High – can be caused by stress, illness, eating too much, lack of exercise,
dehydration, improper use of diabetes medication
S&S = thirst, dry mouth, blurred vision, recurrent infections, increased
urination, headache, fatigue
D-dimer -protein fragment from the breakdown of a blood clot
Less than 0.50 High – indicates the presence of a blood clot or a blood clotting problem,
can also be seen with surgery, trauma, heart attack, cancer, or liver disease

Acid – Base Imbalances

Respiratory Acidosis pH = low -hypoventilation
HCO3 = high -rapid, shallow respirations
PaCo2 = high -decreased BP
-dyspnea, headache
-hyperkalemia and dysrhythmias
Caused by decreased -drowsiness and decreased LOC
respiratory stimuli, COPD,
pneumonia, atelectasis
Respiratory Alkalosis pH = high -hyperventilation
HCO3 = low -tachycardia
PaCo2 = low -decreased or normal BP
-numbness and tingling of
extremities
Caused by hyperventilation or -deep, rapid breathing
mechanical ventilation -confusion & lethargy
Metabolic Acidosis pH = low -headache and changes in LOC
HCO3 = low -hyperkalemia
PaCo2 = low -nausea, vomiting, diarrhea
-muscle twitching, warm, flushed
Caused by DKA, diarrhea, renal skin
failure, and shock
Metabolic Alkalosis pH = high -restlessness and lethargy
HCO3 = high -dysrhythmias and tachycardia
PaCo2 = high -compensatory hypoventilation
-confusion, decreased LOC
Caused by vomiting, excessive -hypokalemia
GI suction, diuretics