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hey everyone it's sarah thruster nurse orion comm and today we're going to go over the most common labs you need to know for the NCLEX exam and as a nurse so whenever you get done watching this youtube video don't forget to access the free quiz that will test you on these lab values so let's get started when you take the NCLEX exam there is a high probability that you're going to encounter some type of lab value question and the reason for this is whenever you're working as a nurse especially in a hospital almost every patient that walks through that door is going to have blood work performed because the blood work tells us what's going on with our patient and how we can care for them so in clicks is going to really hit on those common labs that you're going to be experiencing on a daily basis on the job so what are they well a CBC a complete blood count this tells us about the cells in our blood like our red blood cells white blood cells platelets all those important cells that help us maintain life in addition arterial blood gases ABG's this tells us the acid-base imbalance in our patients especially for patients having a respiratory or metabolic problem it can tell us how bad it is and if our treatment is working to help correct the problem another thing is metabolic panels this can be a basic like a BMP or comprehensive like a cmp and this tells us really important things like our patient's fluid and electrolyte status how's our potassium our sodium or calcium glucose along with our patient's renal function their bu in and creatinine and if it's comprehensive it can tell us how that liver is performing as well another thing you want to know especially if your patients on anticoagulants are their Co AG levels their coagulation levels like that pt/inr aPTT and this is going to tell us how our patient's clotting what's their claudine time and if their therapeutic on their medication and lipid panels this is assessing the patient's cardiovascular risk for disease and we're looking at the LD the HDL the total cholesterol and triglycerides and the last thing are those drug levels because patients many of our patients are on drugs that have this narrow therapeutic level like digoxin dilantin lithium and we want to know is it safe to give this drug what's their drug level now when you take the ink Lexx exam and you're looking at those lab values and you're trying to determine is this normal or abnormal you need to know that NCLEX is going to give you something that is noticeably abnormal it's not going to be right on the line or close to the normal range and the reason for that is because lab ranges for the normal really vary depending on the lab and the text like for instance some things will say that a normal mag is one point five to two point three while another one may say it's one point five to two point five so inc Lex is going to give you something that's really abnormal and you're gonna know it's abnormal so first let's start out talking about the complete blood count the CBC this tells us about the cells in our blood so what a normal RBC range a red blood cell range it should be four point five to five point five million for white blood cells WBC's it should be five thousand to ten thousand for platelets it should be a hundred and fifty thousand to four hundred thousand now some terms you want to be familiar with would be like thrombocytopenia what is that that is a low platelet count so they say that to you you know that's gonna be less than a hundred and fifty thousand or how about a patient with leukopenia that is a low white blood cell count so i count less than five thousand now let's look at our hemoglobin and hematocrit levels this tells us about our red blood cells and we really use this when we're transfusing packed red blood cells we want to know that hemoglobin level really and it varies between the female and the male and I would remember the differences for a female a normal hemoglobin range is twelve to sixteen grams per deciliter a normal whom a decree is 37 to 47 percent and for a male a normal hemoglobin is 14 to 18 grams per deciliter and a normal hematocrit is 42 to 52 percent now let's look at coagulation levels if your patients on an anticoagulant you definitely want to know their coagulation levels for instance if they're on warfarin you want to know their PT on R and if they're on heparin you want to know that a PTT so let's look at this PT on our PT sands for prothrombin time and a normal PT level and someone who's not on any anticoagulant should be 10 to 12 seconds an INR is calculated from the PT and I know R stands for international normalized ratio and normally it should be less than 1 and this is for someone who's not taking any anticoagulants specifically warfarin but how long they are taking warfarin what are we 1 2 on our level 2 B so their therapeutic so this drug is working to prevent blood clots we would wonder inr to be between 2 to 3 so if it's less than 2 this coumadin this warfarin is not really achieving what we need so their dose would need to be increased if it was way greater than 3 they are at risk for bleeding so their dose would need to be decrease now let's look at this a PTT this stands for activated partial thromboplastin time and this is used to for patients who are taking heparin a normal a PTT in a patient who's not taking heparin is 30 to 40 seconds now they're taking heparin we need them to be within this certain range so their therapeutic and this drug is working so we would want it to be one and a half to two and a half times this normal range with which ends up being about 60 to 80 seconds now if they were less than 60 that would mean that we're not achieving what we need they're not therapeutic so their dose would need to be increase of heparin if they're greater than 80 seconds it's taking them way too long to clot so they really have too much heparin in their system so their dose would need to be decreased now let's switch and let's look at the metabolic panel again this is going to tell us about our fluid and electrolytes which will include glucose our renal function and if it's comprehensive it's gonna tell us how our liver is functioning as well so let's look at these ranges ok glucose a normal glucose is 70 to 100 milligrams per deciliter calcium level is eight point five to ten point five milligrams per liter chloride is 95 to 105 million equivalent per liter magnesium is one point five to two point five milligrams per deciliter phosphorus is two point five to four point five milligrams per deciliter potassium is 3 point 5 to 5 milli equivalents per liter and a sodium is 135 to 140 5 milli equivalents per liter now how I remember those is that they're like multiples of 5 like everything is represented with 5 so if you can read over that it'll help keep you straight now let's look at our renal function our bu in and creatinine will tell us that normal bu in is 5 to 20 a normal creatinine is point six to one point two milligrams per deciliter now we're getting into liver function so let's look at total protein that is six point two to eight point two grams per deciliter and then albumin this is another protein remember I'll be even quite a huge role in regulating our oncotic pressure and it's three point four to five point four grams per deciliter then we have these three enzymes that are found in the liver it's the ALP the alt and the ast and if these are abnormal it could indicate liver disease or some type of other disease in the body so a normal ALP which stands for alkaline phosphatase is 40 to 120 units per liter then we have alt which stands for Abilene transaminase and a normal range of seven 256 units per liter and then the ast which is aspartate transaminase a normal is ten to forty units per liter then the last part of our metabolic panel is the Billy Ruben and this substance is created when you have the breakdown of red blood cells and when the red blood cells break down they release this reddish orangish color and a normal bilirubin level should be less than one milligrams per deciliter but if your patient has an elevated one you will notice that they will have this orangish yellowish hue to their skin or this mucous membrane where all this bilirubin has collected in the blood and has just leaked into the skin giving them that like pumpkin hue appearance now let's look at the lipid panel this test is going to tell us about our patient's risk for cardiovascular disease and it's going to look at the LDL to HDL the total cholesterol and the triglycerides so LDL this stands for low-density lipoprotein and we want this value to be low so we want it to be less than a hundred milligrams per deciliter now the HDL which stands for high density lipoprotein we want this number to be high and we want it greater than 60 milligrams per deciliter so some people get these confused by how I remember it is that l4 LDL stands for low so we want that number low and the HDL it stands for high so we want this number high now total cholesterol we want that less than 200 milligrams per deciliter and then triglycerides less than a hundred and fifty milligrams per deciliter now let's move on to arterial blood gases ABG's I have a whole video on how to interpret ABG so now if its respiratory metabolic problem if it's acidosis alkalosis compensation partial compensation and check out that video because it'll show you how to do the tic-tac-toe method and really simplify how to get those answers but you want to know the normal ranges for those so a blood pH is seven point three five seven points four or five anything less than seven point three five is acidic anything greater than seven point four five is alkaline then we have a PCO to the normal range but four that is 35 to 45 and I have switched them here because anything greater than 45 is acidic and anything less than 35 is alkaline then we have bicarb hco3 the normal range is 22 to 26 and anything less than 22 is acidic and anything greater than 26 is alkaline then we have po2 which normal is 80 to a hundred percent and then we have oxygen saturation and a normal is about 96 95 to a hundred percent now let's switch to the hemoglobin a1c test this test is really helpful in helping us determine the average glucose in a person over the last three months so it's great for patients who have diabetes so we can see their average glucose so what do we want this number to be well in a person who does not have diabetes we would want them to have a hemoglobin a1c of four to six percent but if they have diabetes we would like for their target hemoglobin a1c to be less than seven percent now let's wrap up this lecture and let's talk about the most common drug levels you may encounter on NCLEX so first up is digoxin a normal digital is 0.5 to two nanograms per milliliter then we have carbamazepine which is tegretol normal level is four to ten micrograms per milliliter dilantin a normal level is 10 to 20 micrograms per milliliter then theophylline normal level same as dilantin is 10 to 20 micrograms per milliliter then we have phenobarbital a normal level is 15 to 40 micrograms per milliliter lithium at 0.5 to 1.2 millimoles per liter and then lastly valproic acid also known as depakote it is 52 micrograms per milliliter okay so that wraps up this review over the most common lab values you need to know for the ink Lex exam thank you so much for watching don't forget to take the free quiz and to subscribe to our channel for more videos