Cool Toolbox REFERENCE

Normal lab values

Adult reference ranges with a plain-language line on what a high or a low commonly signals. Sourced, printable, and your facility's ranges win.

Reference ranges: Open RN, Health Alterations, Appendix A — CC BY 4.0. Retrieved 2026-08-14.

Complete blood count and differential CBC with diff

TestTypical adult rangeHigh commonly signalsLow commonly signals
RBC (red blood cell count) M 4.50 – 5.90 million/mm3F 4.00 – 5.20 million/mm3 dehydration, chronic low oxygen, polycythemia blood loss, anemia, bone marrow suppression
RDW (red cell distribution width) 11.5% – 14.5% red cells of mixed sizes, often an early or combined nutritional anemia rarely meaningful on its own
MCV (mean corpuscular volume) 80 – 100 fL B12 or folate deficiency, alcohol use, some marrow disorders iron deficiency, thalassemia trait, chronic disease
MCH (mean corpuscular hemoglobin) 0.4 – 0.5 fmol/cell tracks with large-cell (macrocytic) anemia tracks with iron deficiency and small-cell anemia
MCHC (mean corpuscular hemoglobin concentration) 30 – 35 g/dL hereditary spherocytosis, or a sample handling artifact iron deficiency, chronic blood loss
Hemoglobin M 13 – 17 g/dLF 12 – 15 g/dL dehydration, chronic low oxygen, smoking bleeding, anemia, fluid overload diluting the sample
Hematocrit M 40% – 52%F 36% – 47% dehydration, polycythemia bleeding, anemia, overhydration
WBC (white blood cells) 4,000 – 10,000 mm3 infection, inflammation, stress response, steroid effect marrow suppression, overwhelming infection, some viral illness
Neutrophils 46 – 78% bacterial infection, acute inflammation, tissue injury neutropenia, and with it a higher infection risk
Lymphocytes 18 – 52% viral infection, some chronic infections and leukemias acute stress, steroid effect, HIV, immunosuppression
Monocytes 3 – 10% chronic infection, the recovery phase of inflammation marrow suppression
Eosinophils 0 – 6% allergy, asthma, parasitic infection, drug reaction acute stress response, steroid effect
Basophils 0 – 3% allergic reaction, some myeloproliferative disorders rarely meaningful on its own
Platelet count 150,000 – 400,000 mm3 inflammation, iron deficiency, absent spleen; clot risk when very high bleeding and bruising risk, marrow suppression, platelet consumption

Metabolic panel BMP / CMP chemistry

TestTypical adult rangeHigh commonly signalsLow commonly signals
Sodium 135 – 145 mmol/L water deficit, dehydration, high salt load; confusion at extremes fluid overload, SIADH, diuretic effect; confusion and seizure risk when very low
Potassium 3.5 – 5 mmol/L kidney impairment, acidosis, cell breakdown; heart rhythm risk GI losses, diuretic effect, alkalosis; weakness and heart rhythm risk
Chloride 95 – 105 mmol/L dehydration, metabolic acidosis, excess saline vomiting, gastric suction, metabolic alkalosis
Calcium 8.5 – 10.2 mg/dL overactive parathyroid, malignancy, prolonged immobility kidney disease, low albumin, thyroid or parathyroid surgery; muscle spasm and tingling
Magnesium 1.5 – 2 mEq/L kidney impairment, excess supplementation; slowed reflexes alcohol use, GI losses, diuretic effect; tremor and heart rhythm risk
Phosphate 0.8 – 1.5 mmol/L kidney impairment, cell breakdown malnutrition, refeeding after starvation, heavy antacid use
Glucose 65 – 110 mg/dL diabetes, stress response, infection, steroid effect fasting, too much insulin effect, liver failure, alcohol use
BUN (blood urea nitrogen) 8 – 21 mg/dL dehydration, kidney impairment, GI bleeding, high protein load overhydration, liver disease, low protein intake
Creatinine 0.8 – 1.3 mg/dL kidney impairment, dehydration, large muscle mass low muscle mass, pregnancy

Liver function tests LFTs

TestTypical adult rangeHigh commonly signalsLow commonly signals
ALP (alkaline phosphatase) 50 – 100 U/L bile duct obstruction, bone turnover, pregnancy malnutrition, low zinc; uncommon
ALT (alanine aminotransferase) 5 – 30 U/L liver cell injury; the more liver-specific of the two transaminases rarely meaningful on its own
AST (aspartate aminotransferase) 5 – 30 U/L liver injury, and also muscle or heart injury rarely meaningful on its own
Albumin 35 – 50 g/L dehydration concentrating the sample malnutrition, liver disease, protein loss, chronic inflammation; swelling
Total protein 60 – 80 g/L dehydration, chronic inflammation, some blood cancers malnutrition, liver disease, protein-losing kidney or gut conditions
Total bilirubin 2 – 20 µmol/L red cell breakdown, liver disease, bile obstruction; jaundice rarely meaningful on its own
Amylase 30 – 125 U/L pancreatitis, salivary gland disorders, bowel obstruction advanced chronic pancreatitis, severe liver disease

Coagulation profile clotting

TestTypical adult rangeHigh commonly signalsLow commonly signals
Prothrombin time (PT) 11 – 14 sec anticoagulant effect, liver disease, vitamin K deficiency; bleeding risk rarely meaningful; often a sample handling artifact
INR (international normalized ratio) 0.9 – 1.2 anticoagulant effect, liver disease; bleeding risk in someone being anticoagulated, under-treatment and clot risk
aPTT (activated partial thromboplastin time) 20 – 40 sec anticoagulant effect, clotting factor deficiency; bleeding risk acute-phase reaction, early consumptive clotting

Acid base arterial blood gas

TestTypical adult rangeHigh commonly signalsLow commonly signals
pH 7.35 – 7.45 alkalosis, respiratory or metabolic in origin acidosis, respiratory or metabolic in origin
PaCO2 35 – 45 mmHg under-breathing and CO2 retention; respiratory acidosis over-breathing from anxiety, pain, or fever; respiratory alkalosis
HCO3 18 – 22 mmol/L metabolic alkalosis from vomiting or gastric loss, or compensation for chronic CO2 retention metabolic acidosis from ketoacidosis, diarrhea, or kidney impairment
PaO2 80 – 100 mmHg supplemental oxygen, over-breathing low blood oxygen from poor gas exchange or mismatched ventilation and perfusion

Transcribed exactly as printed in the source. Bicarbonate is one of the ranges that differs most between labs, and many report 22 to 26 mmol/L instead. Use the range on your own report.

Cardiac markers heart muscle

TestTypical adult rangeHigh commonly signalsLow commonly signals
CK (creatine kinase) 25 – 200 U/L muscle injury, hard exercise, muscle inflammation, crush injury low muscle mass; not usually followed
CK-MB 0 – 4 ng/mL heart muscle injury, and it rises and falls faster than troponin the expected result
Troponin 0 – 0.4 ng/mL heart muscle injury; also kidney failure, sepsis, and pulmonary embolism the expected result

Cholesterol panel lipids

TestTypical adult rangeHigh commonly signalsLow commonly signals
Total cholesterol 3 – 5.5 mmol/L or < 200 mg/dL raised cardiovascular risk over time malnutrition, overactive thyroid, liver disease
HDL 40 – 80 mg/dL generally a favorable cardiovascular profile raised cardiovascular risk; often tracks with inactivity and metabolic syndrome
LDL 85 – 125 mg/dL raised cardiovascular risk and arterial plaque deposition generally favorable; very low values track with malnutrition or liver disease
Triglycerides 50 – 150 mg/dL metabolic syndrome, poorly controlled diabetes, alcohol use; pancreatitis risk when very high malnutrition, overactive thyroid

Thyroid hormones thyroid panel

TestTypical adult rangeHigh commonly signalsLow commonly signals
TSH (thyroid stimulating hormone) 0.5 – 5 mIU/L an underactive thyroid, because the body is pushing the gland harder an overactive thyroid, or a pituitary problem
Total thyroxine (T4) 4.9 – 11.7 mg/dL overactive thyroid; heat intolerance, weight loss, fast heart rate underactive thyroid; cold intolerance, fatigue, weight gain
Total triiodothyronine (T3) 0.7 – 1.5 ng/dL overactive thyroid underactive thyroid, or severe illness unrelated to the thyroid

Total T4 is printed as mg/dL in the source and transcribed here unchanged. Most US labs report total T4 in µg/dL over the same numeric span.

Iron studies iron panel

TestTypical adult rangeHigh commonly signalsLow commonly signals
Total serum iron M 65 – 180 µg/dLF 30 – 170 µg/dL iron overload, red cell breakdown, heavy supplementation iron deficiency, chronic blood loss, poor absorption
Ferritin M 12 – 300 ng/mLF 12 – 150 ng/mL iron overload, but it also rises with any inflammation, so a normal value can hide a deficiency iron deficiency; the most specific single marker for it
Transferrin 200 – 350 mg/dL iron deficiency, as the body makes more carriers to hunt for iron chronic disease, malnutrition, liver disease
Total iron-binding capacity (TIBC) 45 – 85 µmol/L iron deficiency chronic disease, iron overload, malnutrition

Hemoglobin A1C glycemic control

TestTypical adult rangeHigh commonly signalsLow commonly signals
A1C 3.9 – 6.2% average blood glucose has run high for roughly the past three months repeated low glucose, or a shortened red cell lifespan that makes the result read low

Other common markers miscellaneous

TestTypical adult rangeHigh commonly signalsLow commonly signals
BNP (brain natriuretic peptide) < 100 pg/mL heart failure and fluid overload stretching the ventricle heart failure is a less likely cause of the breathlessness
CRP (C-reactive protein) < 5 mg/L inflammation or infection somewhere; it does not say where no measurable inflammation at the moment
D-dimer < 500 ng/mL clot formation and breakdown somewhere; also rises with surgery, pregnancy, age, and infection clot is much less likely; the test earns its keep by ruling out, not ruling in
LDH (lactate dehydrogenase) 50 – 150 U/L cell or tissue breakdown anywhere in the body; nonspecific rarely meaningful on its own

Urinalysis UA

Most of this panel is qualitative, so there is no high and low. The third column is what an abnormal finding commonly signals.

TestTypical adult findingAn abnormal result commonly signals
Appearanceclearcloudy urine commonly signals infection, crystals, or mucus
Coloramber yellowdark commonly signals concentration or dehydration; red or brown, blood or muscle breakdown
Odoraromaticstrong or foul commonly signals infection; sweet or fruity, ketones
pH5 – 8high commonly signals infection with urea-splitting bacteria; low, metabolic acidosis or a high protein diet
Proteinnegativepositive commonly signals kidney disease, and can be transient with fever or hard exercise
Specific gravity1.002 – 1.030high commonly signals dehydration; low, overhydration or reduced concentrating ability
Leukocyte esterasenegativepositive commonly signals white cells in the urine, usually infection
Nitritesnegativepositive commonly signals certain bacteria, and supports a urinary tract infection
Ketonesnegativepositive commonly signals fasting, a very low carbohydrate intake, or uncontrolled diabetes
Bilirubinnegativepositive commonly signals liver or bile duct disease
Crystalsnegativepresent commonly signals a stone-forming tendency, or a sample that sat too long before testing
Casts0 – 4 hyaline casts/lpfcellular or increased casts commonly signal kidney involvement rather than a bladder problem
Glucosenegativepositive commonly signals blood glucose above the level the kidney can reabsorb
WBCs0 – 5/hpfincreased commonly signals infection or inflammation in the urinary tract
RBCs0 – 5/hpfincreased commonly signals infection, stones, trauma, or kidney disease

How to use this page

This is a study sheet. It is aimed at nursing school, NCLEX prep, and the first year on the floor, when the hard part is not finding the range but remembering what a number is trying to tell you. On the floor the EMR already flags the range inline, which is why the two right-hand columns exist at all.

Learn the panel, not the row. Values move in patterns. A high BUN next to a high creatinine reads differently than a high BUN with a normal creatinine. Reading across a panel is the skill the exam is testing.

Ranges are a population, not a verdict. A reference range is set so that roughly 95% of a healthy reference group falls inside it, which means healthy people land outside it all the time, and a sick person can sit squarely inside it. The trend across several draws usually says more than any single value.

Critical values belong to your facility. What counts as critical, who gets called, and how fast are set by local policy, and escalation follows your facility's protocol. No page on the internet, including this one, can tell you those thresholds.

Print it. The print button strips the dark background and lays the panels out compactly for a clipboard or a binder. The source line prints with it.

Sources

Every reference range on this page is transcribed from Appendix A of an openly licensed nursing textbook: Open Resources for Nursing (Open RN); Ernstmeyer K, Christman E, editors. Health Alterations [Internet]. Eau Claire (WI): Chippewa Valley Technical College; 2024. Appendix A, Normal Reference Ranges. Available from https://www.ncbi.nlm.nih.gov/books/NBK613071/. Retrieved 2026-08-14.

That work is licensed under a Creative Commons Attribution 4.0 International License. The ranges are reproduced here under that license, unmodified except for formatting and the addition of the two "commonly signals" columns, which are not part of the source. The source in turn cites Medscape, Lab values, normal adult (2024), as its own reference.

Panels transcribed: acid base, cardiac, cholesterol panel, coagulation profile, complete blood count and differential, HbA1C, iron, metabolic panel, liver function tests, thyroid hormones, urinalysis, and the miscellaneous group (BNP, CRP, D-dimer, LDH). No other source was used, and no range was written from memory.

The two right-hand columns are ours. They are short, general associations of the kind found in any nursing fundamentals text, written to be memorable rather than exhaustive. They name no drugs, give no doses, and are not directed at any individual result.

Reference ranges: Open RN, Health Alterations, Appendix A — CC BY 4.0. Retrieved 2026-08-14. Ranges vary by lab and facility; the range on your own report is the one that counts.