EP 201: Lab Values to Know as a Nurse
Lab Values to Know as a Nurse
What are the lab values to know as a nurse? Lab values and what they show could mean so many things. They are used to determine the patient’s overall well-being and health and on nurses to base their care plan. Different factors affect the patient’s lab values result, but the most common factors affecting it are the patient’s age, race, gender, medical history, and presence of any underlying conditions. Knowing and understanding lab values is essential in your nursing career.
There are different lab values to know as a nurse. In this episode, we will talk about all the different labs we look at in the hospital. We will go over their normal values, what they signify, and what can happen if they are out of their normal range.
This will be a good refresher episode for everyone who deals with labs and a great one for any nursing students because these are the labs you’ll need to know to pass some of your classes and the NCLEX.
- Potassium is one of the most important minerals in the body. It helps regulate fluid balance, muscle contractions, and nerve signals.
- Normal level: 3.5-5 mEq/L
- Hyperkalemia signs: heart arrhythmias, numbness, and tingling, breathing problems
- Hypokalemia signs: muscle weakness, fatigue, heart arrhythmias
- Clinical problem
- Increased level: Acute renal failure, Crushed/burn injury, acidosis
- Decreased level: vomiting/diarrhea, dehydration, malnutrition, gastric suction, Diuretics
- Sodium plays a key role in your body. It helps maintain normal blood pressure, supports the work of your nerves and muscles, and regulates your body’s fluid balance.
- Normal level: 135-145 mEq/L
- Hypernatremia signs: lethargy, myoclonic jerks, confusion, nystagmus, tachycardia
- Hyponatremia signs: nausea and vomiting, lethargy, seizure, neurological deficits
- Clinical problem
- Increased level: Dehydration, severe vomiting, diarrhea, Heart failure, hepatic failure, Cushing’s disease
- Decreased level: vomiting, diarrhea, gastric solution, D5W, SIADH,
- It is a mineral that is necessary for life. In addition to building bones and keeping them healthy, calcium enables our blood to clot, our muscles to contract, and our heart to beat. About 99% of the calcium in our bodies is in our bones and teeth.
- Normal level: 8.5 to 10.2 mg/dL
- Hypercalcemia signs: bone pain, muscle weakness, excessive thirst, lethargy, nausea
- Hypocalcemia signs: numbness and tingling in digits, muscle cramps, wheezing, fatigue
- Clinical problem
- Increased level: Hyperparathyroidism, malignant neoplasm of bone, lung, breast, kidney, multiple myeloma, and prolonged immobilization.
- Decreased level: Diarrhea, malabsorption of calcium, Hypoparathyroidism
- Chloride is one of the essential electrolytes in the blood. It helps keep the amount of fluid inside and outside of your cells in balance. It also helps maintain proper blood volume, blood pressure, and pH of your body fluids.
- Normal level: 95-105 mEq/L
- Hyperchloremia signs: diarrhea, vomiting, fatigue, dry mucous membrane
- Hypochloremia signs: diarrhea, vomiting, weakness, dehydration
- Clinical problem
- Increased level: Dehydration, hypernatremia, head injury, metabolic acidosis.
- Decreased level: Vomiting, gastric suction, diarrhea, hypokalemia.
- It helps to maintain normal nerve and muscle function, supports a healthy immune system, keeps the heartbeat steady, and helps bones remain strong. It also helps adjust blood glucose levels. It aids in the production of energy and protein.
- Normal level: 1.5-2 mEq/L
- Hypermagnesemia: diminished deep tendon reflexes, flushing, headache, nausea, drowsiness.
- Hypomagnesemia: muscle weakness, twitches, or tremors; irritability, insomnia, drowsiness
- Clinical problem
- Increased level: Severe dehydration, renal failure, leukemia
- Decreased level: Protein malnutrition, malabsorption, cirrhosis of the liver, alcoholism, hypokalemia
- It is a mineral that makes up 1% of a person’s total body weight. It is the second most abundant mineral in the body. It is present in every cell of the body. Most of the phosphorus in the body is found in the bones and teeth.
- Normal level: 2.5-4.5 mg/dl
- Hyperphosphatemia signs: osteoporosis, cardiovascular disease
- Hypophosphatemia signs: changes in mental state, bone pain/fragility, fatigue, weight loss, weakness
- Clinical problem
- Increased level: Renal failure, hypocalcemia, hypoparathyroidism
- Decreased level: starvation, hypercalcemia, hypomagnesemia, chronic alcoholism
- Ammonia is a waste product made by your body during protein digestion.
- Normal level: 15-50 μmol/L
- Hyperammonemia signs: Lethargy (ETOH Pt), rapid or heavy breathing, Altered mental status
- Clinical problems
- Increased level: Hepatic failure, High protein diet with liver failure, acidosis.
- It is a chemical created when the body breaks down substances called purines.
- Purines are usually produced in the body and are also found in some foods and drinks.
- Normal level 0.18-0.48 mmol/L
- High signs: Joint pain, joint stiffness, redness, and swelling.
- Clinical problems
- Increased level: Gout, alcoholism, severe eclampsia, renal failure
- Creatinine is a waste product produced by muscles from the breakdown of a compound called creatine. It is removed from the body by the kidneys.
- Normal level 0.8-1.3 mg/dL
- High signs: Nausea, muscle cramps, vomiting, fatigue, HTN
- Clinical problem
- Increased level: Hypothyroidism, CKD, intense exercise, dehydration
- Decreased level: Renal impairment, hyperthyroidism, ALS
- BUN is the end product of protein metabolism and is excreted by the kidneys
- Normal level 8-21 mg/dL
- High signs: Frequent urination, itching, muscle cramps, fatigue.
- Clinical problem
- Increased level: Dehydration, GI bleeding, prerenal failure, Acute MI, sepsis, shock
- Decreased level: Severe liver damage, overhydration, malnutrition
- A urine-specific gravity test compares the density of urine to the density of water. This quick test can help determine how well your kidneys dilute your urine.
- Normal level 1.010-1.030
- High signs: Dehydration, Diabetes, Proteinuria, SIADH
- Low signs: Polydipsia, Diabetes Insipidus, Diuretics, early stages of CKD
- Lactic dehydrogenase (LDH) is an intracellular enzyme in nearly all metabolizing cells, with the highest concentration in the heart, skeletal muscle, liver, kidney, brain, and RBCs.
- Normal level 50-150 U/L
- Increased level: Acute MI, P.E, Sepsis, shock, CVA, sickle cell.
- The reticulocyte count is an indicator of bone marrow activity
- Normal level 4.5-5.0 million
- Increased level: sickle cell, hemolytic anemia, leukemias
- Decreased level: Anemia, radiation therapy, post hemorrhage, cirrhosis of the liver (alcohol suppresses reticulocytes)
- White blood count, part of a complete blood count, is composed of 5 types of WBCs
- Normal level 5,000-10,000
- Increased level: Acute infection, Inflammatory diseases (RA, gout), Tissue damage (acute MI, burns)
- Decreased level: leukemias, immunosuppressive agents
- Platelets (thrombocytes) are essential elements in the blood that promote coagulation.
- Normal level 200,000-400,000
- Increased level: Polycythemia vera, trauma, acute blood loss, Metastatic carcinoma
- Decreased level: Multiple myeloma, Anemias, Leukemias, liver disease, lupus, DIC, Cirrhosis
- Hemoglobin responsible for the transportation of oxygen
- Normal level
- male 13-17 g/dL
- female 12-15 g/dL
- Increased level: Dehydration, polycythemia, COPD, HF, severe burns
- Decreased level: Anemias, Hemorrhage, cirrhosis of the liver, Leukemias, Hodgkin’s disease, kidney disease
- The hematocrit is a ratio of the volume of red blood cells to the volume of all these components, called whole blood. The value is expressed as a percentage or fraction.
- Normal level Male 40%-52% Female 36%-47%
- Increased level: Dehydration/hypovolemia, severe diarrhea, diabetic acidosis, burns.
- Decreased level: Acute blood loss, anemias, RA, lupus, CKD, cirrhosis
- Partial thromboplastin time (PTT) is a blood test that looks at how long it takes for blood to clot. It can help tell if you have a bleeding problem or if your blood doesn’t clot properly.
- Normal level 25-35 sec. If on Heparin 1.5-2.5x normal
- Increased level: Hemophilia, cirrhosis, vitamin k deficiency, Von Willebrand disease, DIC.
- Prothrombin Time. It is synthesized by the liver and is an inactive precursor in the clotting process.
- Normal level 11- 14 sec
- Increased level: Liver disease, Clotting factor issues (Factor 2 deficiency), Heart failure, leukemias
- Decreased level: Thrombophlebitis, MI, P.E
- The international normalized ratio (INR) is a laboratory measurement of how long it takes blood to form a clot. It is made to monitor patients receiving warfarin.
- Normal level 0.9-1.2 If on Coumadin 1.5 – 3
- Reticulocytes are immature red blood cells (RBCs).
- Normal range 0.5-1.5%
- Are the most numerous circulating WBCs, respond mainly to inflammation & tissue injury.
- Normal range 2-8 x 10^9/L
- Basophils increase during the healing process
- Basophils are white blood cells that defend your body from allergens. Basophils release histamine
- Normal Range < 1 x 10^9/L
- Increased during chronic and viral infections
- Normal range 1-4 x 10^9/L
- The second line of defense. More extensive and more substantial than neutrophils can ingest large particles and debris.
- Normal range 0.2-0.8 x 10^9/L
- Increase during allergic and parasitic conditions
- Normal level < 0.5 x 10^9/L
- The hemoglobin A1c test tells you your average blood sugar level over the past 2 to 3 months. It’s also called HbA1c, glycated hemoglobin test, and glycohemoglobin.
- Normal level <6.5%
- Simple sugar is used as an energy source and is stored as glycogen in the liver and skeletal muscles.
- Normal level 70-110 mg/dL
- Increased level: DM, Diabetic acidosis, adrenal gland hyperfunction (Cushing’s)
- Decreased level: Hypoglycemia, malnutrition
- Bilirubin is formed from the breakdown of hemoglobin by the reticuloendothelial system and is carried in the plasma to the liver. Bilirubin (unconjugated or indirect) is bound to serum albumin and transferred to the liver, which is conjugated to glucuronate by glucoronyl transferase. Conjugated (direct) bilirubin is excreted into the bile.
- Normal level
- Direct Bilirubin 0-6 µmol/L
- Total Bilirubin 2-20 µmol/L
- Increased level: Obstructive jaundice caused by stones, hepatitis, cirrhosis, liver cancer
- Decreased level: Iron-deficiency anemia.
- Albumin is a protein made by your liver. Albumin helps keep fluid in your bloodstream so it doesn’t leak into other tissues. It also carries various substances throughout your body, including hormones, vitamins, and enzymes.
- Normal level 35-50 g/L
- Increased level: Dehydration, severe vomiting, severe diarrhea
- Decreased level: Cirrhosis of the liver, acute liver failure, severe burns, severe malnutrition, preeclampsia, renal disorders, prolonged immobilization.
- ALT/AST is an enzyme found primarily in the liver cells and is effective in diagnosing hepatocellular destruction.
- Normal level 5-30 U/L
- Increased level: Acute (viral) hepatitis and liver necrosis (Drug or chemical toxicity).
- Amylase is an enzyme derived from the pancreas, the salivary glands, and the liver. Its function is to change starch to sugar.
- Normal level: 30-125 U/L
- Increased level: Acute pancreatitis, obstruction of the pancreatic duct, acute cholecystitis, diabetic acidosis, diabetes mellitus, renal failure.
- Lipase, an enzyme secreted by the pancreas, aids in digesting fats. Appears in the bloodstream following damage to the pancreas.
- Normal level: 10-150 U/L
- Increased level: Acute and chronic pancreatitis, cancer of the pancreas, and obstructions.
- IHydroxyprogesterone is a hormone made by the adrenal glands, two glands on top of the kidneys. A 17-OHP test is used for Hydroxyprogesterone levels to help diagnose a rare genetic disorder called congenital adrenal hyperplasia.
- Normal level: 0.2-1 mg/L
- Adrenocorticotropic hormone (ACTH) is made in the pituitary gland. It is needed for your adrenal glands to work properly and help your body react to stress. ACTH stimulates the release of another hormone called cortisol from the adrenal gland’s cortex (outer part).
- Normal level: 4.5-20 pmol/
- Increased level: Addison’s disease, Stress, pituitary neoplasm, pregnancy.
- Congenital adrenal hyperplasia (CAH) refers to a group of genetic disorders that affect the adrenal glands, a pair of walnut-sized organs above the kidneys. The adrenal glands produce essential hormones, including Cortisol, which regulates the body’s response to illness or stress.
- Thyroid-stimulating hormone is a pituitary hormone that stimulates the thyroid gland to produce thyroxine (T3), and triiodothyronine (T4) which stimulates the metabolism of almost every tissue in the body.
- Normal level: 0.5-5 mIU/L
- Increased level: Hypothyroidism, acute thyroiditis, viral hepatitis, myasthenia gravis, preeclampsia
- Decreased level: Hyperthyroidism
- Serum T4 levels are commonly used to measure thyroid hormone concentration and the function of the thyroid gland.
- So, if your T3 and T4 levels are too low, the pituitary gland will release more TSH. If they’re too high, the gland will release less TSH — but this give-and-take system only works if everything functions properly.
- Normal level:
- Free T3 0.2-0.5 ng/dL
- Free T4 10-20 pmol/L
- Total T4 4.9-11.7 mg/dL
- Total T3 0.7-1.5 ng/dL
- Increased level: Hyperthyroidism, acute thyroiditis, myasthenia gravis, preeclampsia
- Decreased level: Hypothyroidism, Protein malnutrition.
- FSH, a gonadotropic hormone produced and controlled by the pituitary gland, stimulates the growth and maturation of the ovarian follicle to produce estrogen in females and promote spermatogenesis in males.
- Normal level:
- (FSH) 1-10 IU/L (M/F)
- 5-25 IU/L (ovulation)
- 30-110 IU/L (postmenopause)
- Increased level: Gonadal failure such as menopause, Pituitary tumor, Turner’s syndrome, Klinefelter’s syndrome
- Decreased level: Neoplasms of the ovaries, testes, adrenal: polycystic ovarian disease, hypopituitarism; anorexia nervosa.
- Human growth hormone (hGH), a hormone from the anterior pituitary gland, regulates the growth of bone and tissue.
- Normal level: (fasting) 0-5 ng/m
- Increased level: Gigantism (children), Acromegaly (adults), major surgery.
- Decreased level: dwarfism in children, hypopituitarism
- It is secreted by the corpus luteum, a temporary endocrine gland that the female body produces after ovulation during the second half of the menstrual cycle.
- Normal level 70-280 ng/dL
- Increased level: Ovulation, pregnancy, ovarian cysts, tumors of the ovary or adrenal gland.
- Decreased level: Gonadal dysfunction, luteum deficiency, threatened abortion, placental failure.
- It is a hormone produced by your pituitary gland, which sits at the bottom of the brain. Prolactin causes breasts to grow and develop and causes milk to be made after a baby is born.
- Normal level: < 14 ng/mL
- Increased level: Pregnancy, breastfeeding, pituitary tumor, amenorrhea, hypothalamic disorder, endometriosis, chronic renal failure, Addison’s disease.
- Decreased level: Postpartum pituitary infarction
- Testosterone is the primary male sex hormone and an anabolic steroid. In male humans, testosterone plays a crucial role in developing male reproductive tissues such as the testes and prostate and promoting secondary sexual characteristics such as increased muscle and bone mass and body hair growth.
- Normal level: 10-25 nmol/L
- Increased level: Adrenal hyperplasia or tumor, polycystic ovaries in females
- Decreased level: Testicular hypofunction, Klinefelter’s syndrome (primary hypogonadism), Alcoholism, hypopituitarism
- LDL stands for low-density lipoproteins. It is sometimes called the “bad” cholesterol because a high LDL level leads to a buildup of cholesterol in your arteries.
- Normal level: 85-125 mg/dL
- Saturated fat and cholesterol in your food make your blood cholesterol level rise.
- HDL stands for high-density lipoproteins. It is sometimes called the “good” cholesterol because it carries cholesterol from other parts of your body to your liver. Your liver then removes the cholesterol from your body.
- Normal level: 40-80 mg/dL
- Triglycerides are a type of fat (lipid) found in your blood. When you eat, your body converts any calories it doesn’t need to use right away into triglycerides. The triglycerides are stored in your fat cells.
- Normal level: 50-150 mg/dL
- Increased level: Hyperlipoproteinemia, acute MI, Hypertension, cerebral thrombosis, hypothyroidism
- Decreased level; Hyperthyroidism, hyperparathyroidism, and protein malnutrition.
- A measure of the total amount of cholesterol in your blood. It includes low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol.
- Normal level: 3-5.5 mmol/L
- Creatine kinase is an enzyme found in the heart, brain, skeletal muscle, and other tissues. Increased amounts of CK are released into the blood when there is muscle damage.
- Normal level: 25-200 U/L
- Increased level: exercise and inflammation of muscles, called myositis, and myopathies such as muscular dystrophy. Rhabdomyolysis.
- Troponins are a group of proteins found in skeletal and heart (cardiac) muscle fibers that regulate muscular contraction—used for cardiac disease diagnosis of acute MI.
- Normal level: 0-0.4 ng/mL
- Increased level: MI, myocardial damage
- It is produced in the liver in response to tissue injury and inflammation.
- Normal level < 5 mg/L
- Increased level: Chronic infections, cardiovascular and peripheral disease, acute MI, Stroke, inflammatory bowel disease, RA, Lupus, bacterial meningitis.
- D-dimer is a fibrin degradation product, a small protein fragment in the blood after a blood clot is degraded by fibrinolysis.
- Normal level: < 500 ng/mL
- Increased level: DIC, P.E, Thrombosis, COVID
- Brain Natriuretic peptide is a neurohormone secretion primarily in the cardiac ventricles and will increase in response to volume expansion and pressure overload.
- Normal level: < 100 pg/ml
- Increased level: Heart failure, Left ventricular hypertrophy, myocarditis, AMI, Renal failure, prolonged systemic hypertension.
- Serum alpha-fetoprotein (AFP), a screening test, is usually done between 16 and 20 weeks gestation to determine the probability of twins or to detect low birth weight or severe birth defects, such as neural-tube defects.
- Normal level: 0-44 ng/mL
- Increased level: Cirrhosis of the liver, hepatitis, Spina bifida, Fetal death, fetal distress, Turner’s syndrome
- Decreased level: Down’s syndrome, absence of pregnancy
- Human chorionic gonadotropin is a hormone produced by cells that surround a growing embryo, which eventually forms the placenta after implantation. The presence of hCG is detected in some pregnancy tests. Appears in the blood and urine 14-26 days after conception.
- Normal level: <5 IU/I
- Increased level: Pregnancy, Chorionepithelioma of pregnancy is a malignant tumor originating in connection with pregnancy.
- Decreased level: Nonpregnant, dead fetus, postpartum (3-4 days)
- Cancer Tumor Markers (CA 19-9) is a cancer antigen in diagnosing pancreatic, hepatobiliary, gastric, and colorectal cancer.
- Normal level: <40 U/mL
- Decreased levels = Effective response to treatment, benign disease
- There are also different tumor markers. You won’t need to know all of these, but we thought we should include them.
- CA 15-3: Metastatic breast cancer, ovarian, lung, pancreas, cirrhosis, colon cancer.
- CA-27.29: Recurrence of breast cancer
- CA 50: Gastrointestinal tumor, biliary tract tumors
- CA 125: Ovarian breast cancer, uterine tumors, pancreas, breast, colon, lung, cirrhosis, pancreatitis.
- Carcinoembryonic antigen (CEA) has been found in the gi epithelium of embryos and has been extracted from tumors in the adult gastrointestinal tract.
- Normal level: <4 ug/L
- Increased level: GI tract (esophagus, stomach, small and large intestine, rectum cancer), leukemia, Ulcerative colitis.
- Prostatic acid phosphatase (PAP) originates in the prostate and usually is present in small amounts in the blood.
- Normal level: 0-3 U/dL
- Increased level: prostate cancer, testicular cancer, leukemia, and non-Hodgkin’s lymphoma.
- Prostate-specific antigen (PSA) is always present in low concentrations in the blood of adult males.
- Normal level: <4 ug/L
- Increased level: Prostate cancer
- Folate is one of the B vitamins needed to make red and white blood cells in the bone marrow, convert carbohydrates into energy, and produce DNA and RNA.
- Normal level: 7-36 nmol/L
- Increased level: Pernicious anemia (is a deficiency in red blood cells caused by lack of vitamin B12)
- Decreased level: Folic acid anemia, vitamin b6 deficiency anemia, malnutrition, malabsorption syndrome (small intestine), pregnancy, liver disease.
- It is a Fat-soluble vitamin absorbed from the intestine in the presence of lipase and bile. Vitamin A moves to the liver and is then stored in the body as retinol.
- Vitamin A is vital for normal vision, the immune system, reproduction, and growth and development.
- Normal level: 30-65 µg/dL
- Increased level: Hypervitaminosis, Chronic kidney disease
- Decreased level: Night blindness, liver, intestinal, or pancreatic disease, chronic infections, cystic fibrosis, protein malnutrition, malabsorption, celiac disease
- Vitamin B6, also known as pyridoxine, is a water-soluble vitamin your body needs for several functions. It’s significant to protein, fat, and carbohydrate metabolism and the creation of red blood cells and neurotransmitters.
- Normal level: 5-30 ng/mL
- Decreased level: Malnutrition, chronic alcoholism, gestational diabetes, pregnancy, lactation, small bowel inflammatory disease, renal failure.
- Vitamin B12 is a nutrient that helps keep the body’s nerve and blood cells healthy and helps make DNA, the genetic material in all cells. Vitamin B12 also helps prevent a type of anemia.
- Normal level: 130-700 ng/L
- Decreased level: Pernicious anemia, malabsorption syndrome, liver diseases, hypothyroidism (myxedema), pancreatic insufficiency, Crohn’s disease.
- Increased level: Acute hepatitis, leukemia.
- Ascorbic acid is a water-soluble vitamin important for forming collagen and certain amino acids for wound healing and withstanding stress, injury, and infection.
- Normal level: 0.4-1.5 mg/dL
- Decreased levels: Scurvy, malabsorption, pregnancy, cancer, and severe burns.
- Vitamin D is a fat-soluble vitamin occurring from exposure to the ultraviolet rays of sunlight and is absorbed in the presence of bile and stored in the liver. Vitamin D helps regulate the amount of calcium and phosphate in the body. These nutrients are needed to keep bones, teeth, and muscles healthy.
- Normal level: 5-75 ng/mL
- Decreased level: Malabsorption, cirrhosis of the liver, rickets, osteomalacia, hypoparathyroidism, celiac disease, inflammatory bowel disease
- RF factor is a screening test used to detect antibodies (Igm, IgG, or Ig)
- Normal level: <25 IU/ml
- Increased level: Rheumatoid arthritis, lupus, tuberculosis, leukemia
- An erythrocyte sedimentation rate (ESR) is a type of blood test that measures how quickly erythrocytes (red blood cells) settle in unclotted blood in millimeters per hour.
- It can show if you have inflammation in your body.
- Normal level: >2 mm/h
- Increased level: RA, rheumatic fever, AMI, Hodgkin’s disease, multiple myeloma, bacterial endocarditis, gout, hepatitis
- Decreased level: Polycythemia vera, heart failure, sickle-cell anemias, factor V deficiency
- The ACE test measures the level of angiotensin-converting enzyme (ACE) in the blood.
- Normal level: 20-50 µmol/L
- Increased level: Sarcoidosis, Diabetes Mellitus, hypothyroidism, Respiratory distress syndrome
- Decreased level: Therapy for sarcoidosis, diabetes mellitus, hypothyroidism
- Found in lead-based paint, unglazed pottery, batteries, leaded gasoline
- Normal level: < 25 IU/ml
- Higher levels can damage the kidneys and nervous system.
Refresh your memory and relearn the lab values by watching the full episode here 👇👇👇
01:21 About the episode
02:35 Electrolytes Potassium K+
Ammonia Uric acid
Lactic Dehydrogenase (LDH)
Partial thromboplastin time (PTT)
Prothrombin Time (PT)
International Normalised Ratio (INR)
Thyroid-Stimulating Hormone (TSH)
Thyroxine Follicle-Stimulating Hormone (FSH)
Human Growth Hormone (hGH)
36:57 Lipids Low-Density Lipoproteins (LDL)
High-Density Lipoproteins (HDL)
Triglycerides Total Cholesterol
39:11 Cardiac Markers
Brain Natriuretic Peptide (BNP)
41:56 Tumor Markers
CA 19-9 Carcinoembryonic Antigen (CEA)
Prostatic Acid Phosphatase (PAP)
Prostate-Specific Antigen (PSA)
Rheumatoid Factor (RF)
Erythrocyte Sedimentation Rate (ESR)
Angiotensin-Converting Enzyme (ACE)