Diagnostics Empty Client Charts DOB mm/dd/year

Byrphillips

ABG

Legend: H= Critical High Value L=Critical Low Value
TestReference Values (Adult)Date/Time:Date/Time:Date/Time:Date/Time:Date/Time:Date/Time:
ABGpH7.35 – 7.45
pCO₂ (mEq/L)35 – 45
pO₂ (mm Hg)75 – 100
HCO₃ (mEq/L)22 – 26
O₂ Sat. (%)≥95

Hematology

Legend: H= Critical High Value L=Critical Low Value
TestReference Values (Adult)Date/Time:Date/Time:Date/Time:Date/Time:Date/Time:Date/Time:
HEMATOLOGYHgbA1C (%)4.0-6.9
RBC male: 4.7-6.1 x 1012/L
female: 4.2-5.4 x 1012/L
Hgb (g/dL)Male: 140-180 g/L
Female: 120-160 g/L
Hct (%)Male: 0.4-0.5
Female: 0.37-0.47
MCV (fl)80.0 – 97.0
Platelets 150 – 350 x 109/L
WBC 3.5-10 x 109/L
Neutrophils 2.0–7.5 × 109/L
Neut Seg. (%)54 – 62
Neut Bands(%)3 – 5
Eosinophils 0–0.5 × 109/L
Basophils 0–0.1 × 109/L
Monocytes 0.1–1.0 × 109/L
Lymphocytes male: 0.8–3.5 × 109/L
female: 0.8–3.3 × 109/L
ESR (mm/hr)Male: 0-20
Female: 0-30

Chemistry

Legend: H= Critical High Value L=Critical Low Value
TestReference Values (Adult)Date/Time:Date/Time:Date/Time:Date/Time:Date/Time:Date/Time:
CHEMISTRYNa (sodium)135 – 145 mmol / L
K  (potassium)3.5 – 5.0 mmol / L
Cl (chloride)97 – 107 mmol / L
Mg (magnesium)0.7401.03 mmol/L
Phosphorus (PO4)0.81–1.58 mmol/L
Ca (calcium – total)2.12–2.52 mmol/L
Mg (mg/dL)0.74–1.03 mmol/L
Glucose (Random)3.5-7.8 mmol/L
CO2 (Total)23-29
BUN (blood urea nitrogen)2.5- 8 mmol/L
CreatinineMale 70-120
Female 50-90 mmol/L
eGFR (Estimated Glomerular Filtration Rate )> 18 mL/min/1.73mE2
Protein (Total) Age > 30
65–78 g/L
Albumin 34–50 g/L
Pre-Albumin 180-450 mg/L
Transferrin (mg/dL)Male: 215-365
Female: 250-380
Iron (mcg/dL)Male: 65-175
Female: 50-170
TIBC (mcg/dL)250-350
Bilirubin (Total)<20.4 µmol/L
Bilirubin (Direct) 0.1-0.3 µmol/L
AST (aspartate aminotransferase)8 – 20 U/L
ALT (alanine aminotransferase)7 – 30 U/L
GGT (Gamma- Glutamyl Transferase)0 – 49 U/L
ALP (alkaline phosphatase)38-150 U/L
Amylase 50 – 180U/L
Lipase 8- 78 U/L
Anion Gap 5-15
Uric Acid (mg/dL)Male: 4.4-7.6
Female: 1.3-6.6
CK (Creatinine Kinase )Male: 64-104 U/L
Female: 49-90 U/L
CK-MB
0-5 ng/L
Troponin 0-0.4 ng/L
Hs-Tnl (Troponin -high sensitivity)<15 ng/L
BNP (brain natriuretic peptide)<300ng/L
Cholosterol Total 0 – 5.2 mmol/L
HDL  (cholesterol)Male ≥1.00 mmol/L
Female ≥1.30 mmol/L
LDL (cholesterol calculated and direct)0-3.5 mmol/L
Triglycerides 0- 1.7 mmol/L

Coagulation

Legend: H= Critical High Value L=Critical Low Value
TestReference Values (Adult)Date/Time:Date/Time:Date/Time:Date/Time:Date/Time:Date/Time:
COAGULATIONPTT (partial thromboplastin time)25 – 35 seconds
INR (International normalizing ratio)0.8 – 1.2
D-Dimer (mcg/L)<500 ng/mL – negative
Fibrinogen (mcg/mL)2 – 10

Urine

Legend: H= Critical High Value L=Critical Low Value
TestReference Values (Adult)Date/Time:Date/Time:Date/Time:Date/Time:Date/Time:Date/Time:
URINEColorAmber-Yellow
AppearanceClear
Odornone
Specific Gravity1.005-1.030
pH4.6-8.0
Leukocyte EsteraseNegative
BilirubinNegative
BloodNegative
Epithelial
GlucoseNegative
ProteinNone or up to 8 mg/dL
NitriteNegative
KetonesNegative
WBCs0-4
Micro: Bacteria

Other Diagnostics

Legend: H= Critical High Value L=Critical Low Value
TestReference Values (Adult)Date/Time:Date/Time:Date/Time:Date/Time:Date/Time:Date/Time:
MISCELLANEOUSANANegative
C-Reactive Protein (CRP)0-7.99 mg/L
Rheumatoid factor (IU/mL)0-20
Digoxin (ng/mL)0.8-2
Toxic level > 2.4
Print Friendly, PDF & Email

Similar Posts