laboratory valu

8/7/2019 Laboratory Valu

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NURSING SCIENCESLABORATORY VALUES

PYRAMID POINTS Explain purpose of test to client Obtain informed consent if required Inform client of specific test preparation Initiate standard (universal) or other precautions as necessary

Maintain asepsis Instruct client in post-test procedures and need for follow-up Note if the laboratory value is abnormal Monitor for signs and symptoms which will occur as a result of the abnormality Report the significant results to the physician Initiate prescribed interventions based on the laboratory results Document the effectiveness of interventions and follow-up laboratory studies

SELECTING A VENIPUNCTURE SITE Use distal aspects of the vein first Avoid scars and lesions or a vein with an intravenous (IV) infusion in place

SELECTING A VENIPUNCTURE SITEPYRAMID ABBREVIATIONS

g/dl - gram per deciliter g/dl - microgram per deciliter mg/dl - milligram per deciliter mEq/L - milliequivalent per liter U/L - units per liter mm/hour - millimeter per hour IU/L - International unit per liter g/ml - microgram per milliliter ng/ml - nanogram per milliliter U/ml - microunit per milliliter ml/kg -milliliter per kilogram

ELECTROLYTES NORMAL ADULT ELECTROLYTE VALUES

SODIUM

136-145 mEq/L POTASSIUM

3.5-5.1 mEq/L CHLORIDE

98-107 mEq/L BICARBONATE (VENOUS)

22-29 mEq/L

ELECTROLYTES SERUM SODIUM (NA)

Description NA is a major cation of extracellular fluid NA maintains osmotic pressures and acid-base balance and transmits nerve impulses

NA is absorbed from the small intestine and excreted in urine in amounts dependent on dietary intake Minimum daily requirement of NA is 15 mEq Value

135-145 mEq/L Nursing Considerations

Do not draw during hemodialysis Drawing blood samples proximal to IV infusion of sodium chloride will falsely elevate results

ELECTROLYTES SERUM POTASSIUM (K)

Description K is a major intracellular cation


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K regulates cellular water balance, electrical conduction in muscle cells, and acid-base balance The body obtains K through dietary ingestion, and the kidneys either preserve or excrete K depending

upon cellular need

K levels are used to evaluate cardiac dysrhythmias, renal dysfunction, mental confusion, GI distress, andIV replacement therapy

ELECTROLYTES SERUM POTASSIUM (K) (contd)

Value

3.5-5.1 mEq/L Nursing Considerations

Do not draw during hemodialysis Use of a tourniquet and pumping the hand prior to venous sampling can increase the value Do not draw from a site where an IV infusion exists If the client is receiving K, note this on the laboratory form Clients with elevated WBC counts and platelet counts may have falsely elevated K levels

ELECTROLYTES SERUM CHLORIDE

Description Chloride is a hydrochloric acid salt that is the most abundant body anion in the extracellular fluid Chloride functions in counterbalancing cations such as sodium, and acts as a buffer during O

2and CO

2

exchange in red blood cells

Chloride aids in digestion, osmotic pressure, and water balance

ELECTROLYTES SERUM CHLORIDE (contd)

Value 98-107 mEq/L

Nursing Considerations Do not draw during hemodialysis Draw from an extremity that does not have saline infusing into it Do not allow client to clench/unclench hand prior to blood draw Any condition accompanied by prolonged vomiting and/or diarrhea will alter levels

COAGULATION STUDIES ACTIVATED PARTIAL THROMBOPLASTIN TIME (APTT)

Description Evaluates how well the coagulation sequence is functioning by measuring the amount of time it takes forrecalcified, citrated plasma to clot after partial thromboplastin is added to it

Screens for deficiencies and inhibitors of all coagulation factors except VII and XIII Most commonly used to monitor heparin therapy and screen for coagulation disorders

COAGULATION STUDIES ACTIVATED PARTIAL THROMBOPLASTIN TIME (APTT) (contd)

Value 20-36 seconds depending on the type of activator used

Nursing Considerations If client is on intermittent heparin therapy, draw sample 1 hour prior to next scheduled dose Do not draw samples during hemodialysis Do not draw samples from an arm where heparin is infusing

Transport specimen to lab immediately If value is prolonged, initiate bleeding precautions

COAGULATION STUDIES PROTHROMBIN TIME (PT) AND INTERNATIONAL NORMALIZED RATIO (INR)

Description Prothrombin is a vitamin K dependent glycoprotein produced by the liver that is necessary for firm fibrin

clot formation

Each laboratory establishes a normal value or control based on the method used to perform the test (PT)

COAGULATION STUDIES PROTHROMBIN TIME (PT) AND INTERNATIONAL NORMALIZED RATIO (INR) (contd)

Description


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The PT measures the amount of time it takes for clot formation and is used to monitor response toCoumadin therapy or to screen for dysfunction involving the extrinsic system resulting from liver disease,vitamin K deficiency, or DIC

A PT value within 2 seconds (plus or minus) of the control is considered normal The INR standardizes the PT ratio and is calculated by raising the observed PT ratio to the power of the

International Sensitivity Index specific to the thromboplastin reagent used


Values Normal PT is 9.6-11.8 seconds (adult male) and 9.5-11.3 seconds (adult female) INR of 2.0-3.0 for standard Coumadin therapy INR of 3.0-4.5 for high dose Coumadin therapy


Nursing Considerations Blood for a baseline PT should be drawn before starting anticoagulation therapy Do not draw during hemodialysis Note time of collection on laboratory form Provide direct pressure to the site for 3 to 5 minutes if a coagulation defect is present


Nursing Considerations Concurrent therapy with heparin can lengthen PT for up to 5 hours after dosing Diets high in green leafy vegetables can increase the absorption of vitamin K, which shortens the PT A PT greater than 30 seconds places the client at risk for hemorrhage Oral anticoagulation therapy usually maintains the PT at 1.5-2 times the laboratory control value

COAGULATION STUDIES CLOTTING TIME

Description Measures the time required for the interaction of all factors involved in the clotting process

Value 8-15 minutes

Nursing Considerations The client should not receive heparin therapy for 3 hours prior to specimen collection The test result is prolonged by any anticoagulant therapy, test tube agitation, or higher temperature

changes

COAGULATION STUDIES PLATELET COUNT

Description Platelets function in hemostatic plug formation, clot retraction, and coagulation factor activation Platelets are produced by the bone marrow to function in hemostasis

Value 150,000-400,000 cells/l

Nursing Considerations Do not draw specimen during hemodialysis Monitor site for bleeding in clients with known thrombocytopenia High altitudes, chronic cold weather, and exercise increase platelet counts Bleeding precautions should be instituted in clients with a low platelet count

SERUM GASTROINTESTINAL (GI) STUDIES ALBUMIN

Description Albumin is the major plasma protein of blood Albumin maintains oncotic pressure and transports bilirubin, fatty acids, medications, hormones, and

other substances that are insoluble in water

Value 3.4-5 g/dl

Nursing Considerations


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Draw from an extremity that does not have an IV infusing into it

SERUM GASTROINTESTINAL (GI) STUDIES ALKALINE PHOSPHATASE

Description Alkaline phosphatase is an enzyme normally found in bone, liver, intestine, and placenta The level rises during periods of bone growth, liver disease, and bile duct obstruction

Value 4.5-13 King-Armstrong units/dl

Nursing Considerations Client may be requested to fast 10-12 hours prior to test Hepatotoxic medications administered within 12 hours prior to specimen collection invalidates the test Do not draw during hemodialysis Transport specimen to lab immediately

SERUM GASTROINTESTINAL (GI) STUDIES AMMONIA

Description Ammonia is a waste product from nitrogen breakdown during protein metabolism Ammonia is metabolized by the liver and excreted by the kidneys as urea Elevated levels due to hepatic dysfunction may lead to encephalopathy Not a reliable indicator of hepatic coma

Value 15-45 g/dl

Nursing Considerations Instruct client to fast, except for water, and refrain from smoking for 8-10 hours Do not draw during hemodialysis Place specimen in an ice water bath Transport to laboratory immediately

SERUM GASTROINTESTINAL (GI) STUDIES AMYLASE

Description Amylase is an enzyme produced by the pancreas and salivary glands that aids in the digestion of complex

carbohydrates

Amylase is excreted by the kidneys In acute pancreatitis, amylase level starts rising at least 2 hours after the onset, peaks at about 24 hours,

and returns to normal in 2-3 days after the onset

Normal serum amylase may occur in pancreatitis, especially chronic pancreatitis

SERUM GASTROINTESTINAL (GI) STUDIES AMYLASE (contd)

Value 50-180 Somogyi U/dl in the adult, and 20-160 Somogyi U/dl in the older adult

Nursing Considerations List medications that the client has taken 24 hours prior to the test on the laboratory form Identify medications which may cause false positive or negative results Results are invalidated if specimen obtained less than 72 hours after cholecystography with radiopaque

dyes

SERUM GASTROINTESTINAL (GI) STUDIES

BILIRUBIN Description Bilirubin is produced by the liver, spleen, and bone marrow and is also a by-product of hemoglobin

breakdown

Total bilirubin levels can be broken down into direct bilirubin, which is primarily excreted via the intestinaltract, and indirect bilirubin, which circulates primarily in the blood stream

Total bilirubin levels rise with any type of jaundice, whereas direct and indirect levels rise depending onthe etiology of the jaundice

SERUM GASTROINTESTINAL (GI) STUDIES BILIRUBIN (contd)

Values


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Bilirubin, direct: 0-0.3 mg/dl Bilirubin, indirect: 0.1-1.0 mg/dl Bilirubin, total: less than 1.5 mg/dl

Nursing Considerations Do not draw during hemodialysis Instruct client to eat a diet low in yellow foods such as carrots, yams, yellow beans, and pumpkins 3-4

days before sampling

Instruct client to fast for 4 hours before sampling

Note that results will be elevated with the use of alcohol, morphine, theophylline, ascorbic acid, andaspirin

Note that results are invalidated if the client received a radioactive scan within 24 hours prior to the test

SERUM GASTROINTESTINAL (GI) STUDIES CHOLESTEROL, TOTAL

Description Cholesterol is present in all body tissues and is a major component of low-density lipoproteins (LDL),

brain and nerve cells, cell membranes, and some gallstones

Value 120-200 mg/dl

Nursing Considerations Instruct client to fast from foods and fluid, except for water, for 12-14 hours and from alcohol for 24 hours

prior to the test

Instruct client that the evening meal prior to the test should be free of high cholesterol foods Cholesterol levels tend to decrease temporarily with major illness or surgery

SERUM GASTROINTESTINAL (GI) STUDIES LIPASE

Description Lipase is a pancreatic enzyme that changes fats and triglycerides into fatty acids and glycerol In acute pancreatitis, serum lipase begins to increase in 2-6 hours, peaks at 12-30 hours, and remains

elevated, but slowly decreases for 2-4 days

Value 31-186 U/L

Nursing Considerations Endoscopic retrograde cholangiopancreatography (ERCP) may increase lipase activity Traumatic venipuncture can inhibit lipase activity

SERUM GASTROINTESTINAL (GI) STUDIES LIPIDS, TOTAL

Description Blood lipids consist of cholesterol, triglycerides, and phospholipids A lipid profile helps determine the risk factors in coronary artery disease

Value 400-800 mg/dl

Nursing Considerations Instruct client to fast from food and fluids for 12 hours prior to the test Oral contraceptives may increase the levels of lipids in the serum

SERUM GASTROINTESTINAL (GI) STUDIES TRIGLYCERIDES

Description

Triglycerides comprise a major part of very low-density lipoproteins (VLDL) and a small part of low-density lipoproteins (LDL)

Triglycerides are synthesized in the liver from fatty acids, protein and glucose, and are obtained from thediet

Values Normal range: 10-190 mg/dl Borderline high: 200-400 mg/dl High: 400-1000 mg/dl Very high: greater than 1000 mg/dl

Nursing Considerations Instruct client to fast for 12 hours prior to the test


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Instruct client to avoid alcohol and refined carbohydrates for 3 days prior to the test

SERUM GASTROINTESTINAL (GI) STUDIES PROTEIN

Description Reflects the total amount of albumin and globulins in the serum Protein regulates osmotic pressure and comprises coagulation factors for hemostasis, enzymes,

hormones, tissue growth and repair, and pH buffers

Value 6.0-8.0 g/dl

Nursing Considerations Do not draw during hemodialysis Do not draw in an extremity with an IV infusion Instruct client to avoid a high fat diet for 8 hours prior to the test

SERUM GASTROINTESTINAL (GI) STUDIES URIC ACID

Description Uric acid is formed as the purines adenine and guanine, and it is continuously metabolized during the

formation and degradation of DNA and RNA, and from the metabolism of dietary purines

Elevated amounts deposit in joints and soft tissue and cause gout Conditions of fast cell turnover as well as slowed renal excretion of uric acid may cause uricemia Elevated amounts of urinary uric acid precipitate into urate stones in the kidneys

SERUM GASTROINTESTINAL (GI) STUDIES URIC ACID (contd)

Values Male: 4.5-8 ng/dl Female: 2.5-6.2 ng/dl

Nursing Considerations Instruct client to fast for 8 hours prior to test Aminophylline, caffeine, and vitamin C may cause falsely elevated results

GLUCOSE STUDIES FASTING BLOOD GLUCOSE

Description Glucose is a monosaccharide found in fruits and is formed from the digestion of carbohydrates and the

conversion of glycogen by the liver

Glucose is the bodys main source of cellular energy and is essential for brain and erythrocyte function FBS levels are used to help diagnose diabetes mellitus and hypoglycemia

GLUCOSE STUDIES NORMAL ADULT GLUCOSE VALUES

Glucose, fasting 70-105 mg/dl Glucose monitoring 60-110 mg/dl (capillary blood) Glucose tolerance test, oral Baseline fasting 70-105 mg/dl 30

minute fasting 110-170 mg/dl 60 minute fasting 120-170 mg/dl 90 minutefasting 100-140 mg/dl 120 minute fasting 70-120 mg/dl Glucose, 2 hour postprandial < 140 mg/dl

GLUCOSE STUDIES FASTING BLOOD GLUCOSE

Nursing Considerations

Instruct client to fast for 8-12 hours prior to test Instruct diabetic client to withhold morning insulin or oral hypoglycemic medication until after the blood is

drawn

GLUCOSE STUDIES GLUCOSE TOLERANCE TEST (GTT)

Description Aids in the diagnosis of diabetes mellitus If the glucose levels peak at higher than normal at 1 and 2 hours after injection or ingestion of glucose,

and are slower than normal to return to fasting levels, then diabetes mellitus is confirmed

GLUCOSE STUDIES


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GLUCOSE TOLERANCE TEST (GTT) (contd) Nursing Considerations

Instruct client to eat a high carbohydrate (200-300 g) diet for 3 days before the test Instruct client to avoid alcohol, coffee, and smoking for 36 hours before testing Instruct client to fast for 10-16 hours prior to the test Instruct client to avoid strenuous exercise for 8 hours before and after the test Instruct diabetic client to withhold morning insulin or oral hypoglycemic medication Instruct client that test will take 3-5 hours, requires intravenous or oral administration of glucose and

multiple blood samples

GLUCOSE STUDIES GLYCOSYLATED HEMOGLOBIN

Description Glycosylated hemoglobin is blood glucose bound to hemoglobin Hb A1c (a glycosated hemoglobin A) is a reflection of how well blood glucose levels have been controlled

for up to the prior 4 months

Hyperglycemia in diabetics is usually a cause of an increase in Hb A1c

GLUCOSE STUDIES GLYCOSYLATED HEMOGLOBIN (contd)

Values Values are expressed as percentage of total hemoglobin Diabetic with good control: 7.5-11.4%

Diabetic with moderate control: 11.5-15% Diabetic with poor control: greater than 15%

Nursing Consideration Fasting is not required

RENAL FUNCTION STUDIES SERUM CREATININE

Description A very specific indicator of renal function, revealing the balance between creatinine formation and

excretion

Increased levels indicate a slowing of the glomerular filtration rate Value

0.6-1.3 mg/dl Nursing Considerations

Do not draw during hemodialysis Instruct client to avoid excessive exercise for 8 hours and avoid excessive red meat intake for 24 hours

before the test

RENAL FUNCTION STUDIES BLOOD UREA NITROGEN (BUN)

Description Urea nitrogen is the nitrogen portion of urea, a substance formed in the liver through an enzymatic protein

breakdown process

Urea is normally freely filtered through the renal glomeruli with a small amount reabsorbed in the tubulesand the remaining excreted in the urine

Elevated values may be a result of either prerenal, renal, or postrenal causes Value

5-20 mg/dl

Nursing Considerations Do not draw during hemodialysis Both creatinine levels and urea nitrogen levels should be analyzed when evaluating renal function

SERUM ENZYMES CREATINE PHOSPHOKINASE

Description Creatine kinase is an enzyme found in muscle and brain tissue and reflects tissue catabolism due to cell

trauma

The test is performed to detect myocardial or skeletal muscle damage or central nervous system damage Isoenzymes include CK-BB (brain), CK-MB (heart), and CK-MM (muscle) CK-BB is found mainly in brain tissue, CK-MB is found mainly in cardiac muscle, and CK-MM is found


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mainly in skeletal muscle

SERUM ENZYMES CREATINE PHOSPHOKINASE (contd)

Values Creatine phosphokinase-MM: 5-70 U/L Creatine phosphokinase-MB: 0-7 U/L Creatine phosphokinase-BB: 0.3 U/L

Nursing Considerations If the test is for skeletal muscle evaluation, instruct client to avoid strenuous physical activity for 24 hours

prior to the test

Instruct client to avoid ingestion of alcohol for 24 hours prior to the test Invasive procedures and IM injections may falsely elevate CK levels

SERUM ENZYMES LACTATE DEHYDROGENASE (LD OR LDH)

Description The isoenzymes that are particularly affected with acute myocardial infarction are LDH1 and LDH2 This enzyme begins to elevate approximately 24 hours after myocardial infarction and peaks in 48-72

hours; thereafter, it returns to normal, usually within 7-14 days

The presence of an LD flip (when LD1 is greater than LD2), is helpful in diagnosing an MI

SERUM ENZYMES NORMAL ADULT LACTATE DEHYDROGENASE

Lactate dehydrogenase 70-200 IU/L Lactate dehydrogenase isoenzymes LDH1 14-26%

LDH2 29-39% LDH3 20-26%LDH4 8-16% LDH5 6-16%

SERUM ENZYMES LACTATE DEHYDROGENASE (LD OR LDH)

Nursing Considerations LDH isoenzymes should be interpreted in view of the clinical findings Testing should be repeated on 3 consecutive days

ERYTHROCYTE STUDIES ERYTHROCYTE SEDIMENTATION RATE

Description

The rate at which erythrocytes settle out of anticoagulated blood in 1 hour Not diagnostic of any particular disease but indicates that a disease process is ongoing Value

0-30 mm/hour depending on age Nursing Consideration

Fasting is not necessary but a fatty meal may cause plasma alterations

ERYTHROCYTE STUDIES HEMOGLOBIN AND HEMATOCRIT

Description Hemoglobin is the main component of erythrocytes and serves as the vehicle for the transportation of

oxygen and carbon dioxide

Hemoglobin determinations are important in determining anemia Hematocrit determines red blood cell mass and is an important measurement in the determination of

anemia or polycythemia

ERYTHROCYTE STUDIES NORMAL ADULT HEMOGLOBIN AND HEMATOCRIT LEVELS

Hemoglobin Male 14-16.5 g/dl Female 12-15 g/dl

Hematocrit Male 42-52% Female 35-47%

ERYTHROCYTE STUDIES HEMOGLOBIN AND HEMATOCRIT


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Nursing Consideration Fasting is not required

ERYTHROCYTE STUDIES SERUM IRON

Description Iron is mostly found in hemoglobin Iron acts as a carrier of oxygen from the lungs to the tissues and indirectly aids in return of carbon

dioxide to the lungs

Aids in diagnosing anemias and hemolytic disorders Value

Male: 65-175 g/dl Female: 50-170 g/dl

Nursing Considerations Do not draw during hemodialysis Level will be increased if client has ingested iron prior to test

ERYTHROCYTE STUDIES RED BLOOD (RBC) CELL COUNT

Description RBCs function in hemoglobin transport which results in delivery of oxygen to the body tissues RBCs are formed by red bone marrow, have a life span of 120 days and are removed from the blood by the

liver, spleen and bone marrow

Aids in diagnosing anemias and blood dyscrasias Evaluates the bodys ability to produce red blood cells in sufficient numbers

Values Female: 4-5.5 million/l Male: 4.5-6.2 million/l

Nursing Consideration Do not draw during hemodialysis

ELEMENTS CALCIUM

Description A cation that is absorbed into the bloodstream from dietary sources and functions in bone formation,

nerve impulse transmission, contraction of myocardial and skeletal muscles

Aids in blood clotting by converting prothrombin to thrombin

Value 8.6-10.2 mg/dl or 4.5-5.5 mEq/L

Nursing Considerations Do not draw during hemodialysis Instruct client to eat a diet with normal calcium levels (800 mg/day) for 3 days before test Instruct client that fasting may be required for 8 hours prior to the test

ELEMENTS MAGNESIUM

Description Used as an index to determine metabolic activity and renal function Magnesium is needed in the blood clotting mechanism, regulates neuromuscular activity, acts as a co-

factor that modifies the activity of many enzymes, and has an effect on the metabolism of calcium

ELEMENTS MAGNESIUM (contd)

Value 1.5-2.3 mEq/L or 1.8-2.6 mg/dl

Nursing Considerations Do not draw during hemodialysis Prolonged use of magnesium products will cause falsely increased levels especially if renal damage is

present

Prolonged IV or TPN therapy, blood transfusions, or prolonged NG suctioning may cause falselydecreased results

ELEMENTS


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PHOSPHORUS Description

Phosphorus is important in bone formation, energy storage and release, urinary acid base buffering, andcarbohydrate metabolism

High concentrations of phosphorus are stored in bone and skeletal muscle Phosphorus is absorbed from food and excreted by the kidneys

Value 2.5-4.5 mg/dl or 1.8-2.6 mEq/L

Nursing Considerations Do not draw during hemodialysis Instruct client to fast prior to the test

THYROID STUDIES Description

Performed if a thyroid disorder is suspected Helpful to differentiate primary thyroid disease from secondary causes and from abnormalities in

thyroxin-binding globulin levels

Values Thyroid stimulating hormone (Thyrotropin; TSH): 0.2-5.4 U/ml Thyroxine (T4): 5.0-12.0 g/dl Thyroxine, free (FT4): 0.8-2.4 ng/dl Triiodothyronine (T3): 80-230 ng/dl

Nursing Consideration Test results are invalid if client had undergone a radionuclide scan within 7 days prior to the test

WHITE BLOOD CELLS Description

White blood cells function in the bodys immune defense system The WBC count assesses each leukocyte distribution

Value 4500-11,000/l

WHITE BLOOD CELLS NORMAL ADULT WHITE BLOOD CELL DIFFERENTIAL

Neutrophils 56% or 1800-7800 /l Bands 3% or 0-700 /l Eosinophils 2.7% or 0-450 /l

Basophils 0.3% or 0-200 /l Lymphocytes 34% or 1000-4800 /l Monocytes 4% or 0-800 /l

WHITE BLOOD CELLS Nursing Considerations

A shift to the left means there is an increased number of immature neutrophils in the peripheral blood A low total WBC count with a left shift indicates a recovery from bone marrow depression or an

infection of such intensity that the demand for neutrophils in the tissue is greater than the capacity ofthe bone marrow to release them in the circulation

A high total WBC count with a left shift indicates an increased release of neutrophils by the bonemarrow in response to an overwhelming infection or inflammation

A shift to the right means cells have more than the usual number of nuclear segments; found in liverdisease, Downs syndrome, or megaloblastic and pernicious anemia

HEPATITIS TESTS Description

Tests include Radioimmune assay (RIA) and enzyme-linked immunosorbent assay (ELISA) Serologic tests for specific hepatitis virus markers assist in defining the specific type of hepatitis

HEPATITIS TESTS Values

The presence of IgM antibody to hepatitis A virus (IgM anti-HAV) and the total antibody to hepatitis Avirus (total anti-HAV) identifies the disease

Detection of core antigen (HBcAg), envelope antigen (HBeAg), and surface antigen (HBsAg), or theircorresponding antibodies, constitutes hepatitis B assessment


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Hepatitis C is confirmed by the presence of antibodies to hepatitis C (anti-HCV) Serologic HDV determination is made by detection of the hepatitis D antigen (HDAg) early in the course

of the infection and by detection of anti-HDV antibody (anti-HDV) in the later disease stages

Hepatitis E virus (HEV) is serologically distinct

HEPATITIS TESTS Nursing Consideration

If using RAI technique, the injection of radionuclides within 1 week prior to the test may falsely elevateresults

AIDS TESTING Description

Detects HIV, types 1 and 2 (HIV-1/2), that cause AIDS Tests used to determine the presence of antibodies to HIV-1 include ELISA, Western blot (WB) and

indirect fluorescent antibody (IFA)

A single reactive ELISA test by itself cannot be used to diagnose AIDS and should be repeated induplicate with the same blood sample; if repeatedly reactive, follow-up tests using WB or IFA should bedone

A positive WB or IFA is considered confirmatory for HIV A positive ELISA that fails to be confirmed by WB or IFA should not be considered negative and repeat

testing should take place in 3-6 months

AIDS TESTING Nursing Considerations

Maintain issues of confidentiality surrounding HIV testing Follow prescribed state regulations and protocols related to reporting positive test results

NORMAL ADULT VALUES: URINE TESTS NAME OF TEST AND VALUE

Chloride 110-250 mEq/24 hours

Magnesium 7.3-12.2 mg/dl/24 hours

Potassium 25-125 mEq/24 hours

Protein 40-150 mg/24 hours

Sodium

40-220 mEq/24 hours Uric acid

250-750 mg/24 hours pH

4.5-7.8 Specific gravity

1.016 and 1.022

THERAPEUTIC SERUM MEDICATION LEVELS MEDICATION AND THERAPEUTIC RANGE

Acetaminophen (Tylenol)10-20 g/ml Amikacin (Amikin) 25-30 g/ml Amitriptyline (Elavil) 120-150 ng/ml Carbamazepine (Tegretol) 5-12 g/ml

Chloramphenicol (Chloromycetin) 10-20 g/ml Desipramine (Norpramin) 150-300 ng/ml Digitoxin (Crystodigin) 15-25 ng/ml Digoxin (Lanoxin) 0.5-2.0 ng/ml Disopyramide (Norpace) 2-5 g/ml Ethosuximide (Zarontin) 40-100 g/ml Gentamicin (Garamycin) 5-10 g/ml Imipramine (Tofranil) 150-300 ng/ml Lidocaine (Xylocaine) 1.5-5.0 g/ml

THERAPEUTIC SERUM MEDICATION LEVELS


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MEDICATION AND THERAPEUTIC RANGE (contd) Lithium (Lithobid) 0.5-1.3 mEq/L Magnesium sulfate 4-7 mg/dl Nortriptyline (Aventyl) 50-150 ng/ml Phenobarbital (Luminal) 10-30 g/ml Phenytoin (Dilantin) 10-20 g/ml Primidone (Mysoline) 5-20 g/ml Procainamide (Pronestyl) 4-10 g/ml

Propranolol (Inderal) 50-100 ng/ml Quinidine (Quinaglute, Cardioquin) 2-5 g/ml Salicylate 100-250 g/ml Theophylline (Aminophylline, Theo-Dur) 10-20 g/ml Tobramycin (Nebcin) 5-10 g/ml Valproic acid (Depakene)50-100 g/ml

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