Lab Values in the ICU

Question 1

What are the two types of Cardiac Enzymes?

Answer 1

1. Creating Kinase (CK)

2. Troponins

Question 2

Elevation of CK indicates: (3)

Answer 2

1. damage to muscle
2. trauma
3. alcoholism

Question 3

Elevation of CK can be an indicator of: (4)

Answer 3

1. MI
2. Rhabdomyolysis
3. Muscular dystrophy
4. Acute renal failure

Question 4

CK or CPK levels rise within ___ of a heart attack and return to normal after ___.

Answer 4

4-8 hours

3-4 days

Question 5

What are Troponins a component of?

Answer 5

striated muscle

Question 6

Troponin T and Troponin I are specific to what kind of muscle?

Answer 6

cardiac muscle, only released after cardiac damage.

Question 7

Both Troponin T and Troponin I are highly sensitive to detecting MI for up to ___ post MI.

Answer 7

20 hours

Question 8

Post MI, Troponin T and Troponin I:
Rise within ___
Peak between ___
Normal levels within ___

Answer 8

Rise within 4-6 hours
Peak between 10-24 hours
Normal levels within 10 days

Question 9

Are Troponins or CK a better indicator of MI?

Answer 9

Troponins

Question 10

What should you consider as a PT when working with a patient who has elevated Troponins?

Answer 10

Watch HR, BP, O2 sats, check for angina, pain, etc.

Question 11

What is Hemoglobin (HG or Hgb)?

Answer 11

Protein molecule in RBCs that carry oxygen from the lungs to the body’s tissues and returns carbon dioxide from the tissues to the lung.

Question 12

What are normal values of Hemoglobin?
Critical Values?
PT Considerations?

Answer 12

11.0 - 15.9 g/dL
< 7.0 g/dL
< 8.0 g/dL –> NO EXERCISE

Question 13

What are signs and symptoms of a decrease Hemoglobin? (4)

Answer 13

1. fatigue
2. weakness
3. tachycardia
4. decrease activity tolerance

Question 14

What is Hematocrit?

Answer 14

Proportion of blood volume that is occupied by RBCs.

Question 15

What are normal values of Hematocrit?
Critical Values?
PT Considerations?

Answer 15

35.5-45%
< 25%
< 25%

Question 16

If Hematocrit is < 25%, what should a PT do and why?

Answer 16

Only PROM is indicated (NO ACTIVE EXERCISE) as the patient can spontaneously bleed.

Question 17

What is the clinical presentation of low Hematocrit and what is it indicative of?

Answer 17

Low hematocrit is often indicative of anemia. S&S:

1. fatigue
2. weakness
3. tachycardia
4. decreased activity tolerance

Question 18

What are Platelets?

Answer 18

Small anuclear cells present in blood that assist with hemostasis.

Question 19

Normal values and critical values of platelets?

Answer 19

Normal values:​ 130,000-400,000/mm​3

Critical values​: < 25,000 or > 1,000,000

Question 20

What is a Pt with low platelets at risk for?

Answer 20

Pts with low platelets may present with bruising, spontaneous nose and gum bleedings.

Question 21

What is a Pt with high platelets at risk for?

Answer 21

Pts with high platelets are at risk for excessive clotting, thrombus formation.

Question 22

What levels are at PT considerations for platelets?

Answer 22

1. < 50,000: no resistive exercise
2. 20,000-50,000: only light exercise
3. 10,000-20,000: very light exercise
4. < 10,000: no PT treatment
5. < 5,000: strict bed rest
6. < 20,000 → risk of spontaneous bleed