PN104

Lab Name Hemoglobin A1C

Kim McCray
Why would the test be ordered? When first diagnosed with diabetes and then 2 to 4 times per year & to monitor the glucose control of diabetics over time What is it assessing? To monitor a persons diabetes and to aid in treatment decisions. determine how elevated their uncontrolled blood glucose levels have been Determine whether the TB is confined to the lungs (pulmonary) or has spread to organs outside the lungs (extrapulmonary)

Lab Names
Normal Value Range W 12.0-16.0 g/dl M 13.0-18.0 g/dl What can affect the results? Anemias, hemolysis, heparin therapy, thalassemia, long-term blood loss, chronic renal failure, hyperglycemia, alcohol ingestion Steroids & immunosuppres sant given within 4 to 6 wks, a skin test perform b4 incubation period, & test results read several days after designated time Certain drugs could cause false negatives and false positives Related Tests Glucose; Microalbumin; Microalbumin/creatinine ratio; Fructosamine

AFB smear and culture

To identify M. tuberculosis and determine the most effective antimicrobial agents to treat the infection

TB skin test, Bacterial wound culture

Albumin

When a person has symptoms of a liver disorder such as jaundice, fatigue, or weight loss, or symptoms of nephrotic syndrome such as swelling around the eyes, belly, or legs.

To evaluate liver function, along with a creatinine and BUN (Blood Urea Nitrogen) to evaluate kidney function, or along with a prealbumin to evaluate a person's nutritional status.

33- 52 g/L

Prealbumin, Microalbumin, Urinalysis, Liver panel

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Ammonia

Kim McCray
When adults experience mental changes, disorientation, sleepiness, or lapse into a coma, an ammonia level may be ordered to help evaluate the cause of the change in consciousness To help investigate the cause of changes in behavior and consciousness 10-50 umol//L

Lab Names
Failure to put blood Sample on ice, a high/low protein diet, exercise might increase plasma ammonia level, & certain antibiotics (neomycin & tetracycline) decrease ammonia level Narcotic drugs, IF fluids w/glucose, & contamination of the specimen w/saliva

Liver panel

Amylase

aPTT (PTT)

When a patient has symptoms of a pancreatic disorder, such as severe abdominal pain, fever, loss of appetite, or nausea. A urine amylase test may be ordered along with or following a blood amylase test. When someone has unexplained bleeding or clotting; when you are on unfractionated (standard) heparin anticoagulant therapy; sometimes as part of a presurgical screen

To assist in the diagnosis of acute pancreatitis and other health problems

25-125 units/liter

Lipase

To monitor heparin therapy, & to screen for clotting factor deficiencies

A clotted blood sample, & a test (collection) tube without an anticoagulant

Prothrombin Time (PT); Fibrinogen; Thrombin Time; Lupus Antibody; Activated Clotting Time (ACT); Coagulation Factors; Platelet Count; Heparin Anti-Xa

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Arterial Blood Gas

Kim McCray
If your doctor suspects that you have symptoms of an oxygen/carbon dioxide imbalance or an acid-base imbalance; symptoms include difficulty breathing, shortness of breath, or rapid breathing (hyperventilation); may also be tested to monitor the effectiveness of ongoing oxygen therapy (used when you have a condition that causes an acute or chronic oxygen shortage) and during certain surgeries to monitor your bloods oxygen and carbon dioxide levels To determine if you have an imbalance in the amount of oxygen gas (O2) or carbon dioxide gas (CO2) in your blood or an acid-base imbalance, which may indicate a respiratory (lung/breathing), metabolic, or kidney disorder pH pCO2 pO2 HCO3

Lab Names
7.35-7.45 35-45 mmHg 75-100 mmHg 22-26 mEq/L Improper handling of blood sample, hemolysis, narcotics/sedati ves, & inaccurate results can occur as a result of suctioning, changes in O2 therapy, ventilator use, & exposure to carbon monoxide or nitrate, & blood transfusion Electrolytes; CO2

Blood Type and Crossmatch

When you need to be transfused with blood or blood components or when you donate blood at a collection facility; pregnant women are tested to determine the risk of Rh incompatibility between the mother and fetus

Blood typing is used to determine your blood group and what type of blood or blood components you can safely receive

Previously received incompatible blood can make blood cross matching difficult

Direct antiglobulin test, Indirect antiglobulin test, Compatibility testing, Crossmatch, Antibody identification

BMP

The Basic Metabolic

To monitor

Comprehensive Metabolic

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Kim McCray
Panel (BMP) is a frequently ordered panel of tests that gives your doctor important information about the current status of your kidneys, blood sugar, and electrolyte and acid/base balance. If you have symptoms of heart failure, such as shortness of breath and fatigue, or if you are being treated for heart failure hospitalized patients and to monitor patients with some known conditions, such as hypertension and hypokalemia.

Lab Names
Panel

BNP

To help diagnose the presence and severity of heart failure

None known

Cardiac biomarkers At a Glance Test Sample The Test Common Questions Ask Us Links Phosphorus; Vitamin D; Parathyroid hormone (PTH); Magnesium; Albumin; Comprehensive metabolic panel (CMP)

Calcium

As part of a routine metabolic panel, in persons with kidney, bone, or nerve disease, or when symptoms of significantly increased or decreased calcium concentrations are present

To determine if the level of calcium in your blood is at normal levels

8.4 -10.6 mg/dl

Drugs, a diet low /high in calcium and Vitamin D, & IV saline solution can promote calcium loss

Carbamazepine

At regular intervals to monitor the drugs level; when indicated to detect low or excessive (potentially toxic) concentrations

To determine the concentration of carbamazepine in the blood and to maintain a therapeutic level

Drugs that a client is taking could increase/decrea se test results

Valproic acid; Carbamazepine-10,11 Epoxide; Phenytoin; Therapeutic Drug Monitoring; Emergency and Overdose Drug Testing

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CBC with differential

Kim McCray
If a patient is having symptoms such as fatigue or weakness or has an infection, inflammation, bruising, or bleeding, then the doctor may order a CBC to help diagnose the cause. To determine general health status and to screen for and monitor a variety of disorders, such as anemia , infection, and many other diseases

Lab Names
Blood smear; Hemoglobin; Hematocrit; Red blood cell (RBC) count; White blood cell (WBC) count; White blood cell differential count; Platelet count

CD4 & CD8

If youve been diagnosed with HIV, soon after you are first diagnosed to get a baseline assessment of your immune system; 2-8 weeks after starting anti-HIV therapy and then every three to four months if you continue therapy If you have chest pain or other signs and symptoms of a heart attack

To measure the strength of your immune system if you have been diagnosed with HIV infection; occasionally, it may be used with other conditions

None Known

HIV antibody; p24 antigen test; HIV viral load; HIV genotypic resistance testing; HIV phenotypic resistance testing

CK-MB

To determine if you have had a heart attack and whether certain clot-dissolving drugs are working To evaluate organ function and check for conditions such as diabetes, liver disease, and kidney disease.

IM injections, vigorous exercise, & trauma/surgical intervention

CK, Myoglobin; Troponin; Cardiac biomarkers

CMP

Gives your doctor important information about the current status of your kidneys, liver, and electrolyte and acid/base balance as well as of your blood

Basic Metabolic Panel

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Kim McCray
sugar and blood proteins When you have symptoms of a disease or condition that causes acute and/or chronic inappropriate blood clot formation such as: DVT (Deep Vein Thrombosis), PE (Pulmonary Embolism), or DIC (Disseminated Intravascular Coagulation), and to monitor the progress and treatment of DIC and other thrombotic conditions Soon after the start of digoxin therapy and at regular intervals to ensure that drug levels are within therapeutic range and are not low or at toxic concentrations

Lab Names

D-Dimer

To help diagnose or rule out thrombotic (blood clot-producing) diseases and conditions

Hemolysis of the blood specimen

Fibrin Degradation Products (FDP); Prothrombin Time (PT); Partial Thromboplastin Time (PTT); Fibrinogen; Platelet Count

Digoxin

To determine if the concentration of digoxin in your blood is at a therapeutic level or to detect toxic levels

Administering digoxin IM, a low serum potassium/magn esium, high serum calcium level, & hypothyroidism, severe heart disease, renal function abnormalities

Therapeutic drug monitoring; Emergency and Overdose Drug Testing; BUN; Creatinine; Creatinine clearance; Potassium

Electrolytes

As part of routine health screening, when your doctor suspects that you have an excess or deficit of one of the electrolytes (usually sodium or

To detect a problem with the body's fluid and electrolyte balance

Sodium, Potassium, Chloride, Bicarbonate (or total CO2), CMP, BMP

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Kim McCray
potassium), or if your doctor suspects an acid-base imbalance

Lab Names

Fecal Occult Blood

As part of a routine examination to screen for colon cancer

To screen for gastrointestinal bleeding, which may be an indicator of colon cancer

None Known

Glucose

Blood glucose: as part of a regular physical, when you have symptoms suggesting hyperglycemia or hypoglycemia, and during pregnancy; if you are diabetic, up to several times a day to monitor blood glucose levels The lipid profile is a group of tests that are often ordered together to determine risk of coronary heart disease.

To determine if your blood glucose level is within healthy ranges; to screen for, diagnose, and monitor hyperglycemia, hypoglycemia, diabetes, and pre-diabetes

Drugs such as cortisone, thiazide, & the loop diuretics, trauma which leads to stress, high doses of Vitamin C

Urinalysis; Insulin; CPeptide; A1c; Microalbumin

Lipid Profile

They are tests that have been shown to be good indicators of whether someone is likely to have a heart attack or stroke caused by blockage of blood vessels or hardening of the arteries (atherosclerosis).

Diet high in saturated fats/sugar & certain drugs

Cholesterol; HDL-C; LDL-C; Triglycerides; Direct LDL-C; VLDL-C; Cardiac Risk Assessment; Lp-PLA2

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Liver Panel

Kim McCray
If your doctor thinks you have signs or symptoms of liver damage, liver disease, bile duct blockage, hemolytic anemia, or a liverrelated metabolic problem When a diabetic has symptoms associated with DKA and may also be performed whenever there is the potential for DKA to develop, such as when a diabetic is sick or pregnant. When you have symptoms associated with ketoacidosis such as increased urination, excessive thirst, dehydration, loss of electrolytes, rapid breathing, shortness of breath, a fruitscent to the breath, nausea, vomiting, fatigue, confusion To detect, evaluate, and monitor liver disease or damage

Lab Names
Alanine aminotransferase (ALT), Alkaline phosphatase (ALP), Aspartate aminotransferase (AST), Bilirubin, Albumin, Total Protein

Ketones

To screen for, detect, and monitor diabetic ketoacidosis (DKA) in people with type 1 and sometimes type 2 diabetes

Contamination

Urine ketones; Blood gases; Glucose

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O&P

Kim McCray
When you have diarrhea that lasts more than a few days and/or have blood or mucus in your loose stools, especially if you have drunk unpurified water while camping or have traveled outside of the United States When a patient has a low sodium level; when a patient is taking mannitol; when a doctor suspects that a patient may have ingested a toxin such as methanol or ethylene glycol; when a patient is producing significantly increased or decreased amounts of urine; when a patient has chronic diarrhea To determine whether you have a parasite infecting your gastrointestinal tract and, if so, to identify them.

Lab Names
Urine, toilet paper, soap, disinfectants, antibiotics, antacids, barium, harsh laxatives, & hypertonic saline enemas (Fleet) Stool Culture, Giardia, Cryptosporidium, and Entamoeba histolytica antigen tests

Osmolality

To help evaluate the bodys water and electrolyte balance and to help investigate hyponatremia and increased or decreased urine production; to detect the ingestion of certain toxins (such as methanol); to monitor the effectiveness of treatment for conditions affecting osmolality; to help determine the cause of chronic diarrhea

275-295 mOsm/kg water

Diuretics & a high protein diet can cause urine hyperosmolality

BUN; Creatinine; Electrolytes; Glucose; Sodium; Emergency and Overdose Drug Testing; Osmotic gap; Osmolal gap

Phenytoin

At regular intervals to monitor, as needed

To determine phenytoin

Hemolysis of the blood

Therapeutic Drug Monitoring; Emergency and

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Kim McCray
to detect low or toxic concentrations concentration in the blood, to maintain a therapeutic level, and to detect phenytoin toxicity

Lab Names
specimen & drugs that increase serum phenytoin level Overdose Drug Testing

Platelet Count

As part of a routine complete blood count (CBC), during episodes of unexplained or prolonged bleeding, or to diagnose/monitor a bone marrow/blood disease When a man has symptoms suggestive of prostate cancer such as difficult, painful, and/or frequent urination; may also be ordered during and at regular intervals after prostate cancer treatment.

To diagnose a bleeding disorder or a bone marrow disease

Chemotherapy, X-ray therapy, & drugs

CBC; Platelet aggregation

PSA

To screen asymptomatic and symptomatic men for prostate cancer, to help determine the necessity for a biopsy of the prostate, to monitor the effectiveness of treatment for prostate cancer, and to detect recurrence of prostate cancer

Rectal/prostate examinations can increase serum PSA levels

Digital Rectal Exam (DRE); Tumor markers

PT & INR

If you are taking an anti-coagulant drug or if your doctor

To check how well bloodthinning

A clotted blood sample, a high fat diet, alcohol

Activated Clotting Time (ACT); Partial Thromboplastin Time (PTT);

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Kim McCray
suspects that you may have a bleeding disorder medications (anti-coagulants) are working to prevent blood clots; to help detect and diagnose a bleeding disorder

Lab Names
use, & leaving a blood sample at room temperature for several hours Prothrombin Consumption Time (PCT); Fibrinogen; Coagulation Factors; Platelet Count; Platelet Function Tests

PTT

When you have unexplained bleeding or blood clotting; when you are on unfractionated (standard) heparin anticoagulant therapy; sometimes as part of a presurgical screen

As part of an investigation of a bleeding or thrombotic episode; to monitor unfractionated (standard) heparin anticoagulant therapy

A clotted blood sample & a test (collection) tube without an anticoagulant

Prothrombin Time (PT); Fibrinogen; Thrombin Time; Lupus Antibody; Activated Clotting Time (ACT); Coagulation Factors; Platelet Count; Heparin Anti-Xa

Serum Iron

Stool Culture

When your doctor suspects that you may have too little or too much iron in your body When you have diarrhea that lasts more than a few days and/or have blood or mucus in your loose stools

To determine your blood iron level

75-175 ug/dL

To determine whether you have pathogenic bacteria in your gastrointestinal tract

Oral iron meds, recent blood transfusion, & hemolysis of the blood sample Contamination, antibiotics, sulfonamides, & urine in the stool collection

Ferritin; TIBC & UIBC, Transferrin; Hemoglobin; Hematocrit; CBC; Zinc protoporphyrin; Iron Tests O&P, Clostridium difficile toxin

T3 & T4

Usually ordered in response to an abnormal TSH test result or when a

To help evaluate thyroid gland function; to help diagnose

TSH; T4; Thyroid Antibodies

60-181 ng/mL

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Kim McCray
patient has symptoms of hyperor hypothyroidism; commonly performed on newborns hypothyroidism or hyperthyroidism; to screen for hypothyroidism in newborns

Lab Names

Troponin

Immediately and again at 4 to 6 hour intervals if you are having chest pain or other symptoms that may be due to a heart attack When a patient has symptoms of hyperor hypothyroidism and/or when a patient has an enlarged thyroid gland. It may be ordered at regular intervals to monitor the effectiveness of treatment when a patient is being treated for a known thyroid disorder. During a routine physical or when you have symptoms of a urinary tract infection, such as abdominal pain, back pain, frequent or painful urination; as part of a pregnancy checkup, a hospital admission, or a pre-

To determine if you have had a heart attack or injury to heart muscle

CK; CK-MB; Myoglobin; Cardiac biomarkers

TSH

To screen for and help diagnose thyroid disorders; to monitor treatment of hypothyroidism and hyperthyroidism

T4, T3, Thyroid Antibodies

Urinalysis

To screen for metabolic and kidney disorders and for urinary tract infections

5.0-9.0 1.001-1.035

Urine culture; Urine protein; BUN; Creatinine; Creatinine clearance; Microalbumin; eGFR

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Kim McCray
surgical work-up

Lab Names

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