Lab Values & Clinical Implications

Question 2

Blood pressure range –Adult

Answer 2

<120/80mm/hg

Abnormal Range:
-Hypertension >140/90mm/hg
-Hypotension <90/60mm/hg

Critical Value:
-Hypertensive Crisis: 180/120mm/hg

Question 3

Blood Pressure: Hypotension symptoms

Answer 3

• Weakness
• Sleepiness
• Blurred vision
• Confusion
• Syncope
• Light-headedness

Question 3

Blood Pressure: Hypertension symptoms

Answer 3

• Fatigue
• Confusion
• Chest pain
• Visual changes

Question 4

BP: Hypotension clinical implications

Answer 4

• Check pt’s BP in supine before therapy
• Proceed carefully with functional mobility, rechecking pt’s BP & reported symptoms after changes in position
• If pt’s BP drops more than 20mmHg systolic & more than 10mmHg diastolic: elevate legs. If symptoms continue = supine. Notify nurse, obvi. If symptoms subside, continue with therapy carefully, rechecking BP frequently.

Question 4

BP: Hypertension clinical implications

Answer 4

Hypertensive Crisis = Activity is contraindicated. Back out…Back out!

Question 5

HR: Normal resting range for an adult

Answer 5

60-100BPM (active people may have lower resting HRs)

Question 6

HR: Abnormal resting range

Answer 6

Bradycardia = <60BPM
Tachycardia = >100BPM

Max HR = 220 – age.
E.g., pt is 40 y/o. Max HR = 180 (220 - 40)

Question 7

Abnormal HR symptoms

Answer 7

Fatigue, dizziness, fainting, SOB, chest pain, & cardiac arrest.

Question 8

Abnormal HR clinical implications

Answer 8

Tachy = rest break; monitor; continue/discontinue.

Brady/Tachy = notify RN. May be advised to discontinue.

Question 9

Oxygen saturation (O2 levels)

Answer 9

Normal range: 97-99%
Abnormal range: <90%

Question 10

O2 level clinical implications

Answer 10

Deep breathing & upright positioning assist with oxygenation

Question 11

Glucose purpose & normal/abnormal range

Answer 11

Purpose: Measure of blood sugar levels.

Normal range: 70-110mg/dl (fasted)
Abnormal range:
- Hypoglycemia <60mg/dl
- Hyperglycemia >250mg/dl
- Prediabetes >110-200mg/dl
- Diabetes >126 mg/dl

Question 12

Hypoglycemia causes & clinical implications (including symptoms)

Answer 12

<60mg/dl
Causes: insulin overdose, skipped meals, or overexertion in exercise.

Clinical Implications:
- Symptoms) headache, weakness, shakiness, clamminess, impaired muscle control, blurred vision, or difficulty responding to commands.
- Defer therapy
- Avoid exercise before mealtime & after insulin because both can result in reduced blood sugar levels.

Question 13

Hyperglycemia causes & clinical implications (including symptoms)

Answer 13

> 250mg/dl
Causes: Diabetes mellitus or stress

Clinical implications: Acetone breath, rapid pulse, nausea, vomiting, weakness, dehydration, coma.

Defer therapy if >300mg/dl

Question 14

Leukocytes: purpose & normal/abnormal ranges

Answer 14

Purpose: Indicates immune system status, infection, or inflammation.

Normal range: 5,000-11,000/mm
Abnormal:
- Leukocytosis: >11,000/mm
- Leukopenia: <5,000/mm

Critical Values:
- >30,000/mm
- <2,000/mm

Question 15

Leukocytes clinical implications

Answer 15

<1,000/mm = Defer therapy
<4,000/mm = Neutropenic precautions observed–hand washing, PPE, disinfecting equipment prior to entering room.

Question 16

Hemoglobin: Purpose & normal/abnormal range

Answer 16

Purpose: measures the blood’s capacity to carry O2.

Normal range:
- Males: 13-18g/dl
- Females: 12-16g/dl

Abnormal range:
- <8g/dl may indicate need for transfusion.

Critical values: <5g/dl heart failure or death.

Question 17

Hemoglobin symptoms & clinical implications

Answer 17

Symptoms: weakness, fatigue, tachycardia, dyspnea on exertion, heart palpitations, & decreased exercise tolerance.

<8g/dl = Defer therapy.

8-10g/dl = Light exercise is ok, but closely monitor vitals; pt may have poor activity tolerance.

10g/dl = Resistive exercise can be incorporated into the plan of care.

Question 18

Platelets purpose & normal/abnormal ranges

Answer 18

Purpose: Platelets are responsible for blood clots.

Normal range: 150,000–400,000

Abnormal range:
- Thrombocytosis: >1mil
-Thrombocytopenia: <150,000

Critical values: <20,000

Question 19

Platelets clinical implications

Answer 19

Thrombocytopenia = risk for bleeding easily (gums, nose, internal) & for bruising.

<20,000 – Deffer

20,000-50,000 – Light AROM; light ADLs; ambulation ok

<50,000 – PROM only (no resistive exercise); ambulation & ADLs ok

50,000 – Resistive exercise ok