CHAPTER 11 Fluids and Electrolytes^447
- Hematocrit (Hct): decreased in anemia, chronic disease, hemolytic reaction,
adrenal insufficiency, leukemia, lymphoma. Normal range 34.3–44.4% - Hemoglobin (Hgb): decreased in anemia, cancer, hemolytic reaction, liver
disease, kidney disease, hyperthyroidism, SLE; increased in chronic obstruc-
tive pulmonary disease, hemoconcentration, polycythemia, burns. Normal
range 11.5–15.2 g/dL - Erythrocyte sedimentation rate (ESR): Low means anti-inflammatories (ster-
oids, aspirin), blood sample not processed in timely manner (allowed to
sit); high means inflammation, hormonal effect (pregnancy, menses, oral
contraceptives). Normal range 0–30 - Sodium (Na): Low means diarrhea, vomiting, edema, excess water intake,
diuretic use, nasogastric suction, Addison’s disease, hypothyroidism; high
means dehydration, bronchitis, Cushing’s disease, diabetes insipidus, insuffi-
cient water intake. Normal range 136–146 mmol/L - Calcium (Ca): Low means decreased albumin levels, hyperphosphatemia, hypo-
parathyroidism, vitamin D deficiency, acute pancreatitis; high means cancer,
hyperparathyroidism, hyperthyroidism, prolonged immobilization, Paget’s
disease. Normal range 8.5–10.5 mg/dL - Phosphorus: Low means hyperparathyroidism, elevated insulin level, diabetic
coma, vomiting, renal tubular acidosis; high means renal insufficiency, hypo-
thyroidism, hypocalcemia, excess intake of alkali, Addison’s disease, healing
fractures. - Magnesium: Low means hemodialysis, blood transfusion, hypoparathyroidism,
malabsorption, chronic disease, chronic pancreatitis; high means renal fail-
ure, diabetic acidosis, Addison’s disease, hypothyroidism, antacid use. - Chloride (Cl): Low means vomiting, nasogastric suctioning, chronic respir-
atory acidosis, metabolic alkalosis, Addison’s disease, SIADH, excess water
intake; high means dehydration, diarrhea, metabolic acidosis, hyperpara-
thyroidism, Cushing’s syndrome, renal tubular acidosis. Normal range 99–108
mmol/L - Potassium (K): Low means GI loss, renal loss, diuretic use, eating disorders,
wound drainage, respiratory alkalosis, licorice intake; high means dehydra-
tion, renal failure, metabolic acidosis, diabetic ketoacidosis, sickle cell ane-
mia, interstitial nephritis. Normal range 3.4–5.2 mmol/L - Blood urea nitrogen (BUN): Low means fluid overload, low muscle mass,
with low protein, low carbohydrate diet; high means renal disease, dehy-
dration, acute MI, ketoacidosis, excess protein intake. Normal range 8–25
mg/dL