Standard Tests and Treatments - NCLEX-PN

The normal range for hemoglobin levels in an adult male is . Hemoglobin levels above that range may be indicative of chronic low blood oxygen, while lower levels of hemoglobin are seen in anemia.

When percussing the seventh intercostal space along the right midclavicular line, you should expect to hear a dull note, as this is directly over the solid mass of the liver.

The border of the liver can be found by percussing in a descending line along the intercostal spaces of the right midclavicular line, starting at the clavicle. The superior border of the liver can be measured at the point where percussion transforms from resonant or hyperresonant (indicating the air-filled lung) to dull (indicating the solid mass of the liver).

A healthy and normal abdominal aorta will measure between 2.5-3cm in diameter. An abdominal aorta over 3cm and under 5cm in diameter is considered to be enlarged, and surgery to prevent abdominal aortic aneurism is generally performed on abdominal aortas that surpass 5cm in diameter in females or 5.5cm in diameter in males.

The pulmonic valve can be auscultated to the left of the sternum at the second intercostal space. Auscultation at this space can aid in the identification of pulmonary murmurs such as pulmonary stenosis or regurgitation. The second right intercostal space is the location at which the nurse would be able to evaluate the aortic valve. The first intercostal space is not generally auscultated in a normal heart exam.

The fifth intercostal space on the left mid-clavicular line is the best location from which to evaluate the mitral valve. The other heart structures are paired with locations as follows:

• Aortic valve: the second intercostal space right of the sternum
• Pulmonic valve: the second intercostal space left of the sternum
• Tricuspid valve: the fourth intercostal space left of the sternum

A positive Murphy's sign is an indication of cholecystitis, or gallbladder inflammation. Testing for Murphy's sign is performed during an abdominal exam by asking the patient to breathe out slowly while the fingers of the examiner are slid under the right costal margin and held in place with firm pressure. The patient is then asked to inhale, which forces the abdominal contents upward. Murphy's sign is considered positive if the patient winces or flinches when breathing in, due to pain when the inflamed gallbladder comes in contact with the examiner's fingertips.

Rovsing's sign, psoas sign, and McBurney's point are all tests for appendicitis.

In this case, the patient is able to move their biceps brachii against gravity, but they are unable to move against gentle resistance by the examiner. This means the muscle strength should be graded at .

The muscle strength grade is as follows:

: no contraction

: muscle contraction, but no movement

: movement with gravity, but not against gravity

: movement against gravity, but not against resistance

: movement against mild resistance by the examiner

: normal muscle strength

Normal levels for sodium are between . Anything below (hyponatremia) or above (hypernatremia) this is considered abnormal and should be evaluated further.

The range for normal potassium levels in blood is . Anything above that (hyperkalemia) or below that range (hypokalemia) is considered abnormal.

The normal adult reference range for blood calcium levels is .

An adult male hematocrit is considered normal when between . Anything below this may indicate anemia, elevated white blood cell count, or blood loss, while numbers above this may indicate dehydration, chronic oxygen deficiency, or a condition of excess red blood cell production (such as polycythemia vera).

The normal reference range for an adult female hematocrit is . Anything below this may indicate anemia, elevated white blood cell count, or blood loss, while numbers above this may indicate dehydration, chronic oxygen deficiency, or a condition of excess red blood cell production (such as polycythemia vera).

A normal erythrocyte sedimentation rate should be below . Anything above this indicates some sort of inflammatory process.

All of his vitals and blood work are within normal range except his cholesterol. Normally, cholesterol is considered within normal range if it is under , but in the case of patients with past history of cardiac event or stroke, cholesterol should be maintained at under .

The normal range for a platelet count on a CBC is . Numbers below may result in poor clotting ability, while numbers above may increase risk of stroke or thrombosis.

While adults may have a specific gravity that ranges anywhere from 1.000 to 1.030, the normal reference range is generally considered to be 1.005 to 1.025. A specific gravity below 1.005 could indicate very dilute urine (the specific gravity of water is 1.000) and anything higher than 1.030 may be present in the case of dehydration, kidney disease, infection, or glucose in the urine.

The normal range for pH of blood is 7.35 to 7.45. Anything below that range is considered to be acidosis, while values above that range would be considered alkalosis. Recall that the main blood buffer system involves carbonic acid, bicarbonate, and carbon dioxide. The equilibrium equation is as follows:

A urinalysis can be an important tool in diagnosis conditions such as the presence of kidney stones, urinary tract infection and even dehydration. A typical urinalysis will contain information on all of the parameters indicated. The presence of glucose, ketones, crystals, casts, and leukocyte esterase may also be included.

A BMP is a commonly ordered lab value set on patients. It checks commonly reported electrolytes in the body. It is also known as a Chem-7. It looks at: Sodium, potassium, carbon dioxide, bicarbonate, blood urea nitrogen (BUN), creatinine, and glucose. Phosphorous is not included in this laboratory order, and must be checked separately.