Lab Values

Question 1

What is on CBC values?

Answer 1

WBC, hemoglobin/hematocrit, platelets

Question 2

What is ref range for WBC?

Answer 2

5-11 k

high (leukocytosis)- infection, tissue necrosis

low- (leukopenia)- bone marrow supresion

Question 3

What are RR for HgB?

Answer 3

Female- 12-16

Male- 14-17

Question 4

What are suggested PT implications for Hgb?

Answer 4

greater than 10- activity as tolerated

8-10 light exercise

less than 7- no exercise or only ROM

Question 5

What is ratio of Hgb to Hct?

Answer 5

1/3 of Hct

Question 6

What are Hct RR?

Answer 6

36-48- females

42-52 males

Question 7

What are pt implications for Hct?

Answer 7

30%- activity as tolerated
25-30 light exercise
less than 25 no exercise
less than 20- pt may have shortness of breath, tachy

Question 8

How much percent should Hct go up after a blood transfusion?

Answer 8

3 percent

Question 9

RR for platelets?

Answer 9

150-450 k

Question 10

Suggest PT implications for platelets?

Answer 10

50 or above- progressive resistance exercise

less than 50- no deep tissue massage, no MMT, resistance training

30-50 mod exercise

20-30 light exercise, no bike/treadmill

less than 20 : AROM and necessary ADL

Question 11

RR range for prothrombin time?

Answer 11

11-16 seconds

affected by warfarin

greater than 25, guard pt, as high risk of bleeding

Question 12

RR for PTT?

Answer 12

30-45

affected by heparin

1.5- 2.5 normal time is goal for DVT prophylaxis

Question 13

RR for INR?

Answer 13

0.9-1.1 affected by warfarin

2. 0-3.0- normal for DVT, PE, MI, THA
3. 5-3.5- recurrent DVT, mechanical valves

Question 14

What are pt implications for INR?

Answer 14

if DVT present mobilize pt if under 2

greater than 4, no resisted exercise, use RPE less than 11

greater than 5 check with physician, no exercise

Question 15

What is on a metabolic panel (Chem 7)?

Answer 15

Na/ K- Cl/HCO- BUN/creatinine- glucose

Question 16

What are RR for Na?

Answer 16

135-145

Question 17

What is hypernatremia?

Answer 17

usually associated with dehydration, increased sweating, salt diarrhea

Question 18

What are typical symtpoms of hypernatremia?

Answer 18

over 155- tachy, HTN, decrease urine, thirsty, lethargy

over 160- heart failure, seizures, coma

Question 19

What is hyponatremia?

Answer 19

associated with SIADH, fluid overload, HF, diuretics,

sx- lethargy, confusion, cramping, weakness

critical values under 125, under 110 possible irreversible damage

Question 20

What are K norms?

Answer 20

3.5-5, regulated by kidneys

Question 21

What is hyperkalemia?

Answer 21

caused by renal failure, SBO, over repletion by medical staff

sx: tremors, twitching, weakness, decreased cardiac conduction, brady

Question 22

What is hypokalemia?

Answer 22

caused by diuretics, diarrhea, NG suction, vomiting

sx: weakness, fatigue, confusion, N/V, increased cardiac irritability (PVC, VT)

Question 23

What are PT implications for K?

Answer 23

less than3.2 consider holding therapy

Question 24

What are RR for Cl?

Answer 24

100-112, accompanies Na to maintain osmotic pressure

Question 25

What is hyperchloremia?

Answer 25

caused by dehydration

sx: lethargy, weakness, hyperventalation

Question 26

What is hypochloermia?

Answer 26

caused by vomiting, over hydration, HF, diuretics

sx: neuro and muscular hyperexcitability, hypoventilation, hypotension

Question 27

What is RR for HCO?

Answer 27

22-26, part of pH buffering system

Question 28

What is RR for BUN?

Answer 28

6-21, increased in acute and chronic renal failure, high protein diets

decreased in high carb diets, malabsorption

Question 29

What are norms for creatinine?

Answer 29

0.8-1.4

increased in renal or metabolic impairment

Question 30

What is BUN/ Cre ratio?

Answer 30

used to determine chronic vs acute disease

Question 31

What is normal fasting glucose?

Answer 31

70-110

Question 32

What are PT implications for glucose?

Answer 32

avoid heat and exercise to area of insulin injections for one hour after injection

if under 100 and taking insulin may need to eat more carbs before exercise

Question 33

What is hyperglycemia?

Answer 33

polyuria, polydyspia, dry mouth

Question 34

What is ketoacidosis?

Answer 34

fruity/ acetone breath, confusion, weak rapid pulse

Question 35

What level should you defer PT?

Answer 35

greater than 240 defer till after insulin

critical level- greater than 450

Question 36

What is hypoglycemia?

Answer 36

rapid onset, sweating, shakiness, dizziness, headache, anxiety

sx can occur at 60-70

critical level is 50

Question 37

What are RR for magnesium?

Answer 37

1.7-2.2

concern is tachyarrhytmia with hypomagenisum

Question 38

What are RR for albumin?

Answer 38

3.5-5.2

protein found in serum important for intravascular oncotic pressure

hypo can contribute to edema

Question 39

When is bradycardia contraindicated?

Answer 39

if symptomatic or if caused by 2nd degree type 2 or 3rd degree heart block

Question 40

What should you do with resting HR 120-150?

Answer 40

precaution to exercise but not contraindicated

over 150 is contra

Question 41

What is diastolic number that is of concern?

Answer 41

under 60 calculate MAP

over 115 contra contact MD

if rise is greater than 10 with exercise, consider ischemia

Question 42

What is systolic number that is of concern?

Answer 42

under 100 calculate MAP

over 160 consult with medical team

over 200 contraindication refer to MD

Question 43

What is MAP formula?

Answer 43

systolic (2 x diastolic)/ 3

Question 44

What are numbers for MAP?

Answer 44

over 60 needed for end organ perfusion

under 60 is red flag unless a known baseline

Question 45

What are SP o2 numbers?

Answer 45

86-89 stop exercise use supp O2

under 85 no activty refer to md