DIAGNOSTIC

TEST
Miss Shivangi R Mistry
M.Sc.Nursing
Hemoglobin
This is a protein in the blood cells which carries the
oxygen to the different organs.
Hemoglobin is made up of four protein molecules
(globulin chains) that are connected together.
The normal adult hemoglobin (abbreviated Hb or
Hgb) molecule contains two alpha-globulin chains and
two beta-globulin chains.
Normal hemoglobin level:
• In males: 13.0-18.0 g/dL
• In females: 11.5-16.5 g/dL
Hematocrit
Proportion of red blood cells to the fluid component
or the plasma of the blood. The hematocrit (Ht or Hct)
is expressed as a percentage. For example, a hematocrit
of 35% means that there are 35 milliliters of red blood
cells in 100 mL of blood.
Normal hematocrit level:
• In males 45%
• In females 40%
High Hematocrit Level
The hematocrit levels are increased in the following
conditions:
Increased risk of Dengue Shock Syndrome (DSS)
Polycythemia vera
Chronic obstructive pulmonary disease (COPD)
Erythropoietin (EPO) or Erythropoietin use
Dehydration
Capillary leak syndrome
 Sleep apnea
Anabolic steroids use
Low Hematocrit Level
The hematocrit levels are reduced in the following
conditions:
• Anemia
• Pregnancy
• High altitude living
• Nutritional deficiency of iron, vitamin B,, or folate
• Kidney disease
• Bone marrow disease
Leukemia, lymphoma or multiple myeloma
 Platelet
This component of blood helps in clotting of the blood
Platelets are tiny blood cells that help the body in forming
clots to stop bleeding.
If one of the blood vessels gets damaged, it sends out signals
to the platelets. The platelets then rush to the site of damage,
they form plug (clot) to fix the damage.
A normal platelet count is 150,000-450,000 platelets per
microliter of blood.
The risk for bleeding develops if a platelet count falls below
10,000-20,000.
When the platelet count is less than 50,000, bleeding is likely
to be more serious if there is any cut or bruises in the body.
 SERUM ELECTROLYTES
Electrolytes are involved in many essential processes
in the body. They play a vital role in conducting
nervous impulses, contracting muscles, keeping body
hydrated and regulating the pH levels.
Electrolyte' is the umbrella term for particles that
carry a positive or negative electric charge. Or in
nutrition, the term refers to essential minerals found
in blood, sweat and urine. When these minerals
dissolve in a fluid, they form electrolytes positive or
negative ions used in metabolic process.
 Serum Sodium
Sodium, which is an osmotically active anion, is one of
the most important electrolytes in the extracellular
fluid. It is responsible for maintaining the extracellular
fluid volume and also for regulation of the membrane
potential of cells.
Hyponatremia has neurological manifestations.
Patients may present with headache, confusion,
nausea, delirium. Symptoms of hypernatremia include
tachypnea, sleeping difficulty and feeling restless.
Normal range: 135-145 mmol/L
 Serum Potassium
 Potassium is mainly an intracellular ion. The sodium-potassium
adenosine triphosphatase pump has the primary responsibility for
regulating the homeostasis between sodium and potassium, which
pumps out sodium in exchange for potassium, which moves into the
cells.
 Normal range: 3.6-5.5 mmol/L
 Potassium disorders are related to cardiac arrhythmias. Hypokalemia
occurs when serum potassium levels are under 3.6 mmol/L-weakness,
fatigue, and muscle twitching present in hypokalemia.
 Hyperkalemia occurs when the serum potassium levels are above 5.5
mmol/L, which can result in arrhythmias. Muscle cramps, muscle
weakness, rhabdomyolysis, myoglobinuria are presenting signs and
symptoms in hyperkalemia.
 Serum Calcium
 Calcium has a significant physiological role in the body.
 It is involved in skeletal mineralization, contraction of muscles,
the transmission of nerve impulse, blood clotting, and secretion
of hormones. It is mostly present in the extracellular fluid.
 A low calcium level may cause tingling (often in the lips, tongue,
fingers, and feet), muscle aches, spasms of the muscles in the
throat (leading to difficulty breathing), stiffening and spasms of
muscles (tetany), seizures and abnormal heart rhythms.
 Normal range: 8.8-10.7 mg/dL
 Hypercalcemia may cause abnormal heart rhythms, muscle
twitches, cramps, weakness, depression, memory loss, confusion,
coma, bone pain, osteoporosis, fractures, abdominal pain, nausea
and vomiting.
 Serum Magnesium
Magnesium is an intracellular cation. Magnesium is
mainly involved in ATP metabolism, contraction and
relaxation of muscles, proper neurological
functioning, and neurotransmitter release.
Normal range: 1.46-2.68 mg/dL
Hypomagnesemia: Nausea, vomiting, weakness,
decreased appetite, numbness, tingling, muscle
cramps, seizures, muscle spasticity and abnormal
heart rhythms.
 Bicarbonate
The acid-base status of the blood drives bicarbonate
levels. The kidneys predominantly regulate
bicarbonate concentration and are responsible for
maintaining the acid-base balance. Kidneys reabsorb
the filtered bicarbonate and also generate new
bicarbonate by net acid excretion. Diarrhea usually
results in loss of bicarbonate, thus causing an
imbalance in acid-base regulation.
Normal range: 23-30 mmol/L. It increases or decreases
depending on the acid-base status.
 Phosphorus
Phosphorus is an extracellular fluid cation. Eighty-five
percent of the total body phosphorus is in the bones
and teeth in the form of hydroxyapatite. Phosphate is
regulated simultaneously with calcium by vitamin D,
PTH, and calcitonin. The kidneys are the primary
avenue of phosphorus excretion.
Phosphorous: Normal range: 3.4-4.5 mg/dL
 Chloride
Chloride is an anion found predominantly in the
extracellular fluid. The kidneys predominantly
regulate serum chloride levels. Most of the chloride is
filtered by the glomerulus.
Nomal level: 96 to 106 mEq/L
Thank you