V.

SERUM GASTROINTESTINAL STUDIES

SERUM
NORMAL VALUE GASTROINTESTINAL FUNCTION NURSING CONSIDERATION
STUDIES
3.4–5 g/dl *Albumin Presence in urine means abnormal Perform a venipuncture from an
renal function extremity that does not have an IV
infusion
4.5–13 King Armstrong Alkaline Phosphate Level rises during liver disease, *Hepatotoxic medication
units/dl bile obstruction performed within 12 hours before
specimen collection can cause a
falsely elevated values
35–65 mg/dl Ammonia Elevated levels resulting from Place specimen in ice and
hepatic dysfunction may lead to transport to laboratory
encephalopathy immediately

*Venous ammonia levels are NOT

reliable indicator of hepatic coma
25–151 units/L *Amylase Acute pancreatitis a. on the lab form, list the
medications that the client
has taken during the
previous 24 hours before the
test
b. note that many medications
may cause false-positive or
false-negative results
c. results are invalidated if the
specimen was obtained less
than 72 hours after
cholecystography with
radiopaque dyes.
10-140 units/L Lipase Pancreatic disorder
Total: <1.5 mg/dl *Bilirubin  with any type of jaundice Note that results will be elevated
with the ingestion of alcohol or the
 administration of morphine sulfate,
theophylline, ascorbic acid or
aspirin
Lipids a. oral contraceptives may
increase the lipid level
140–199 mg/dl a. Cholesterol
b. instruct client to abstain
b. Triglycerides from foods and fluid, except
1. LDL for water, for 12 to 14 hours
2. HDL and from alcohol for 24
<130 mg/dl hours before the test
c. Phospholipid
30–70 mg/dl s

c. instruct the client to

completely avoid high
<200 mg/dl cholesterol foods the
evening meal before the test
6–8 g/dl Protein  with Addison’s disease,
autoimmune collagen disorders,
chronic infection, and Crohn’s
disease

with burns, cirrhosis, edema,

severe hepatic disease
Male: 4.5–8 mg/dl Uric Acid * Conditions of increased cellular
turnover, as well as slowed renal
Female: 2.5–6.2 mg/dl excretion of uric acid, may cause
hyperuricemia
IV. SERUM ENZYMES AND CARDIAC MARKERS
*Troponins a. Troponin is a regulatory
protein found in striated
muscle (skeletal and
<0.6 ng/ml Troponin I – myocardial)
elevated for 7 – 10 b. Increased amounts of
>1.5 ng/ml  indicates MI days troponins are released into
the bloodstream when an
infarction causes damage to
>0.1–0.2 ng/ml  indicates the myocardium
Troponin T –
MI elevated for 10-14
days
<90 mcg/l indicates MI *Myoglobin a. It is an oxygen-binding a. the level can rise as early as
protein found in striated 2 hours after a MI, with a
muscle (skeletal and rapid decline in the level
cardiac) muscle that after 7 hours
releases oxygen at very low b. because the myoglobin level
tensions is not cardiac specific and
b. Any injury to skeletal muscle rises and falls so rapidly, its
will cause myoglobin release use in dx MI may be limited
into the blood

26-174 units/L Creatinine kinase

Isoenzymes

a. 0% to 5% a. CK-MB
b. 95% to 100% b. CK-MM
c. 0% c. CK-BB
140-28- units/L Lactate *Presence of an LDH flip (when
dehydrogenase LDH1 is higher than LDH2) is
helpful in dx a myocardial
infarction
II. COAGULATION STUDIES
20-36 seconds * aPTT Used to monitor heparin therapy *Do not draw samples from an arm
and screen for coagulation into which heparin is infusing
disorders
*PT Monitor response to warfarin *Provide direct pressure to the
(coumadine) therapy venipuncture site for 3-5 mins if a
9.6-11.8 seconds male coagulation defect is present
9.5-11.3 seconds female *Diets high in green leafy
vegetables can increase the
absorption of vitamin K, which
*INR shortens the PT

2-3 standard warfarin *a PT longer than 30 sec places the

client at risk for bleeding
3-4.5 high-dose warfarin
8-15 minutes Clotting time *the client should not receive
heparin therapy for 3 hours before
specimen collection because the
heparin therapy will affect the
result
150,000-400,000 cells/mm3 *Platelet count *Bleeding precautions should be
instituted in patients with low
platelet count
III. ERYTHROCYTE STUDIES
0-30 mm/hr depending on ESR
age of client
Hemoglobin a. main component of
erythrocytes and serves as
the vehicle for transporting
oxygen and carbon dioxide
14-16.5 d/dl a. Male
b. Female b. helpful in identifying anemia
12-15 g/dl
 c. hematocrit represents red
blood cell mass and is
important measurement in
the identification of anemia
Hematocrit
or polycythemia

a. Male
b. Female
42%-52%

35%-45%
Iron

65-175 mcg/dl a. Male

b. Female
50-170 mcg/dl
RBC *Fasting is not required

4.5-6.2 million/ul a. Male

b. Female
4.0-5.5 million/ul
VII. GLUCOSE STUDIES
70-110 mg/dl Fasting Blood *instruct a client with diabetes
Glucose mellitus to withhold morning
insulin or oral hypoglycemic
medication until after the blood is
drawn
Glucose Tolerance
Test
0.6-1.3 mg/dl *Serum Creatinine Elevated levels indicate a slowing Instruct the client to avoid
of glomerular filtration rate excessive exercise for 8 hours and
excessive red meat intake for 24
hours before the test
8-25 mg/dl *Blood urea Creatinine and urea nitrogen levels
nitrogen should be analyzed when renal
function is evaluated
*VIII. ELEMENTS
8.6-10 mg/dl *Calcium aids in blood clotting by
converting prothrombin to
thrombin
1.6-2.6 mg/dl *Magnesium Magnesium is needed in the
blood-clotting mechanism,
regulates neuromuscular activity,
metabolism of calcium
2.7-4.5 mg/dl Phosphorus

IX. THYROID STUDIES

0.2-5.4 microunits/ml TSH
X. WHITE BLOOD CELL COUNT
4,500-11,000 cells/mm3 WBC Assess leukocyte distribution “shift to the left” means that an
increased number of immature
neutrophils is present in the blood

“shift to the right” means that cells

have more than the usual number
of nuclear segments; found in liver,
Down syndrome, or megaloblastic
 anemia
XI. HEPATITIS TESTING
XII. HIV and AIDS TESTING