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Assessing the Results of Diagnostic Tests

Directions

Use this assessment to record the dates and results of commonly administered diagnostic medical tests. The blank spaces at the bottom on the following page can be used to list additional tests. Refer to information in this chapter to review the purposes of these tests.

Test Typical Reference Range Results Date
1. Alanine aminotransferase (ALT) 1-75 U/l ____________________ ____________________
2. Albumin 4-5 g/dl ____________________ ____________________
3. Alkaline phosphate 35-128 mg/dl ____________________ ____________________
4. Aspartate aminotransferate (AST) 1-50 U/l ____________________ ____________________
5. Bilirubin 0.3-1.5 mg/dl ____________________ ____________________
6. Blood pressure 120/80 mmHg ____________________ ____________________
7. Blood urea nitrogen (BUN) 8-22 mg/dl ____________________ ____________________
8. Calcium 8.9-10.2 mg/dl ____________________ ____________________
9. Carbon dioxide 20-34 mEq/l ____________________ ____________________
10. Chest x-ray Pos/Neg ____________________ ____________________
11. Chloride 96-106 mEq/l ____________________ ____________________
12. Cholesterol (total) 125-210 mg/dl ____________________ ____________________
13. Creatinine 0.8-1.4 mg/dl ____________________ ____________________
14. Dental check-up Pos/Neg ____________________ ____________________
15. Electrocardiogram (ECG) Pos/Neg ____________________ ____________________
16. Eye examination and tonometry Pos/Neg ____________________ ____________________
17. Free T4 hormone 1.0-4.3 ng/dl ____________________ ____________________
18. Globulin 1.5-3.8 g/dl ____________________ ____________________
19. Glucose 65-115 mg/dl ____________________ ____________________
20. Hematocrit 42% - 52% ____________________ ____________________
21. Hemoccult Pos/Neg ____________________ ____________________
22. High-density lipoprotein (HDL) 32-96 mg/dl ____________________ ____________________
23. HIV test Pos/Neg ____________________ ____________________
24. Iron (total) 50-180 mg/dl ____________________ ____________________
25. Lactic dehydrogenase 90-250 U/l ____________________ ____________________
26. Low-density lipoprotein (LDL) < 130 mg/dl ____________________ ____________________
27. Lymphocyte 20% - 40% ____________________ ____________________
28. Mammography* Pos/Neg ____________________ ____________________
29. Pap smear* and pelvic examination Pos/Neg ____________________ ____________________
30. Phosphorous 2.3-4.6 mg/dl ____________________ ____________________
31. Potassium 3.8-5.3 mEq/l ____________________ ____________________
32. Prostate † Pos/Neg ____________________ ____________________
33. Protein 6.6-8.1 g/dl ____________________ ____________________
34. Pulse rate 60-80 bpm ____________________ ____________________
35. Red blood cell (RBC 4.2-6.1 mill/ml ____________________ ____________________
36. Sedimentation rate < 50 15-20 mm/hr ____________________ ____________________
37. Sodium 135-143 mEq/l ____________________ ____________________
38. Stress ECG Pos/Neg ____________________ ____________________
39. Thyroid stimulating hormone (TSH) 0.1-5.0 mU/l ____________________ ____________________
40. Total iron binding capacity (TIBC) 250-390 mg/dl ____________________ ____________________
41. Triglycerides 30-200 mg/dl ____________________ ____________________
42. Uric acid 3.6-8.1 mg/dl ____________________ ____________________
43. White blood cell (WBC) 4.8-10.8 thou/cumm ____________________ ____________________
44. ____________________ ____________________ ____________________ ____________________
45. ____________________ ____________________ ____________________ ____________________
46. ____________________ ____________________ ____________________ ____________________
47. ____________________ ____________________ ____________________ ____________________
48. ____________________ ____________________ ____________________ ____________________
49. ____________________ ____________________ ____________________ ____________________
50. ____________________ ____________________ ____________________ ____________________

*Women

†Men


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