Laboratory Values

Review for ATI Proctored Exam FBS BUN Creatinine

Triglycerides Platelets Iron etc
 Fasting Blood Sugar (FBS)

Diagnostic criteria for diabetes mellitus: an 8-hr FBS of 126 mg/dL or more

Client education:

● No food or drink other than water for 8 hr prior to blood draw

● No antibiotic medications until after level is drawn
 Iron
Iron deficiency anemia: most common anemia in U.S.

● Risk factors:
○ Adolescents at risk d/t poor diet, rapid growth, menses, strenuous activities, and obesity
○ Premature birth, excessive intake of cows’ milk in toddlers, malabsorption disorders,
poor dietary intake of iron (most common), increased iron requirements (blood loss)
● Expected findings: tachycardia; pallor; brittle, spoon-shaped fingernails; fatigue, irritability,
muscle weakness; systolic heart murmur
● Lab tests:
○ Decreased hemoglobin (production requires iron)
○ Elevated total iron binding capacity
● Complication: developmental delay
 Iron, continued
Supplement iron (differs depending on age):

● Infants:
○ Iron supplements (1 hr before or 2 hr after milk or antacid to promote absorption; give
with vitamin C)
○ Iron-fortified formula and cereal when solids are introduced
● Older children:
○ Dietary sources (dried beans and lentils, peanut butter, green/leafy veggies, iron-fortified
breads and flour, poultry, red meat)
○ Iron supplements (same as infants; use straw and brush teeth afterwards to prevent
staining; stools will turn tarry green)
 BUN

Normal: 10-20 mg/dL

Elevated BUN can indicate impaired renal function (if Cr is elevated too), dehydration, heart failure,
and obstructive uropathy

● Examples of renal impairment: acute glomerulonephritis, hemolytic uremic syndrome, acute

renal failure, chronic renal failure
● Tx depends on diagnosis
● Nursing: prevent dehydration!
 Creatinine (Cr)
Normal range: male- 0.6-1.2mg/dL, female- 0.5-1.1mg/dL

Renal Disorders

● Elevated Cr
○ Acute glomerulonephritis, Hemolytic uremic syndrome, acute renal failure, chronic renal
failure
● Nursing Care
○ Monitor strict intake and output, obtain daily weight, monitor vital signs and treat
hypertension, monitor neurological status and observe for behavioral changes
 Triglycerides
Triglycerides come from two sources which include naturally made from carbohydrates in the body
and the end product of fat indigestion

High triglycerides (> 250 mg/dL)

● Risk factors
○ Obesity, uncontrolled diabetes, hypothyroidism, kidney disease
○ Can lead to insulin resistance and type 2 diabetes mellitus
○ Isotretionoin treatment for acne can elevate triglycerides

● Nursing care

○ Monitor patients diet, educate on physical activity and diet at home

 Complete Blood Count (CBC)
Included in CBC: red blood cells (RBC), white blood cells (WBC), platelet count, hemoglobin (Hgb),
hematocrit (Hct)

RBC: normal range is 4.0-5.2x10^6/ul

WBC: normal range is 5,000-10,000 mm3

● Increased: leukemia, bacterial infection, severe sepsis

● Decreased: chemotherapy, viral infections, congenital disorders, autoimmune disorders,
antibiotics
 CBC, continued

Hgb: normal range is 11.5-15.5g/dL

Decreased: Anemia, hemorrhage

Hct: normal range is 35-45%

Increased: Dehydration, chronic hypoxemia

 Platelets
Thrombocytopenia can be a complication of myelosuppression

Normal range: 150,000-400,000

● Nursing actions for bleeding

○ Monitor for petechiae, ecchymoses, hematuria, bleeding gums, hematemesis, tarry
stools
○ Avoid unnecessary skin punctures, use surgical aseptic techniques when performed
○ Apply pressure for 5 minutes to stop bleeding with skin punctures
○ Administer platelets concentrates or platelet rich plasma as prescribed
● Client education
○ Use a soft toothbrush, and avoid astringent mouthwash
○ Avoid activities that can lead to injury or bleeding
 Jeopardy

https://jeopardylabs.com/play/pediatric-basic-lab-review-3
 Urinalysis, Specific Gravity,
CBC, Hemoglobin A1c, Thyroid

ATI Proctored Exam Review of Labs

Urinalysis
●Characteristics
○Color
○Odor
○Clarity
●Specific gravity
○1.010-1.030
■Less than 1.010- diluted urine
■Greater than 1.030- concentrated urine (dehydration)
●pH
○4.5-8
HbA1c
The expected reference range for glycosylated hemoglobin or (hba1c) is 4% to
5%, but an acceptable range for children who have diabetes can be 6.5% to 8%,
with a total target goal of less than 7%
Diabetes mellitus
● Type 1 is characterized by destruction of pancreatic beta cells.
● Type 2 is characterized when the body fails to use insulin properly
combined with insulin deficiency.
Blood Sugar

❏ Pediatric normal blood sugar is between 70-105 mg/dl

❏ Hypoglycemia: <70mg/dl
❏ Hyperglycemia: >105mg/dl
Thyroid Levels
★ T3: The range for a normal T3 value is 100-200 ng/dl ( nanograms per
deciliter), a high reading for this may indicate hyperthyroidism, and a low
t3 reading may indicate hypothyroidism
★ T4: A normal lab value is 4.5 to 11.2 mcg/dl. A low reading for a t4 level
may indicate hypothyroidism.
Why is this important?
Hypothyroidism in a pediatric patient may be associated with impaired
physical or cognitive development. This is where we see failure to thrive in a
lot of patients, always a good thing to check when assessing pediatrics
References

· Assessment Technologies Institute, (2016). RN nursing care of children. (10 Ed.) Chicago, IL.: Author

· Ball, J.W., Binder, R.C., Cowen, K.J., Shaw, M. H. (2019) Child health nursing partnering with children &
families (Updated 3rd Ed). Upper Saddle River, New Jersey, Pearson.