Laboratory Values Interpretation Resource Flashcards
Lab Values:
International Normalized Ratio (INR)
International Normalized Ratio (INR ) is an international standard for the prothrombin time test. INR results are independent of reagents or laboratories. INR is individualized for each patient.
- Allows monitoring Coumadin (warfarin) at different times and comparable between laboratories.
- For individuals who are not in the therapeutic range they are at risk for bleeding (supratherapeutic) and thrombotic (subtherapeutic) events.
Lab Values:
White Blood Cells (Leukocytes)
Complete Blood Count
White Blood Cells (Leukocytes ): Play a crucial role in the immune system by providing protection against infectious diseases and foreign invaders. WBC testing is utilized to identify the presence of infection and conditions that cause inflammation, allergic reactions, and cancers of the blood and lymphatic system.
- Fluctuations of WBCs occur at all ages but are greatest in infants. Pre-term and full-term infants have physiologically higher baseline WBC count, compared to adults.
Lab Values:
Hematocrit
Complete Blood Count
Hematocrit is the percentage of RBCs in the total blood volume. Abnormal values may indicate blood loss or fluid imbalance.
Lab Values:
Platelets (Thrombocytes)
Complete Blood Count
Platelets (Thrombocytes) help stop bleeding by forming a clot. There is limited evidence to support an absolute or relative threshold to discontinue physical therapy intervention for patients that are thrombocytopenic.
- Musculoskeletal bleeding is a key characteristic of many bleeding disorders and can result in permanent damage to the joints and muscles.
Lab Values:
Red Blood Cells (Erythrocytes)
Complete Blood Count
Red Blood Cells (Erythrocytes):
- Transport oxygen to the tissues throughout the body and use it to produce energy. These cells also carry carbon dioxide to the lungs. RBCs contain hemoglobin, an iron-rich protein, which gives blood its red color.
- Patients presenting with erythrocytosis have an increased risk for vaso-occlusive events, including myocardial infarction and stroke. This is secondary to increased viscosity of the blood and clot development risk.43
Lab Values:
Hemoglobin
Hemoglobin is the main component of RBCs and transports oxygen and carbon dioxide.
- Elevated values (> 20 g/dL) can lead to clogging of capillaries because of hemoconcentration.35 Iron deficiency anemia is the most common hematologic disorder and the most common cause of anemia among infants and children.
Lab Values: CBC
What can be found in a CBC?
Complete Blood Count (CBC):
- White Blood Cells (per mm3)
- Red Blood Cells (106/µL)
- Platelets (per mm3)
- Hemoglobin (g/dL)
- Hematocrit
Lab Values: CBC
White Blood Cells:
- Normal Adult = ?
- Critical Values = ?
White Blood Cells (Leukocytes - per mm^3):
- Adult / Child > 2 years: 5,000-10,000
- Critical Values: < 2,500 or > 30,000
- Newborn: 9,000-30,000
- Child ≤ 2 years: 6,200-17,000
Trending Up:
- Fever
- Fatigue
- Bleeding
- Bruising
- Frequent infections
Trending Down:
- Frequent and/or persistent infections
- Inflammation or ulcers in and around the mouth
- Headache
- Stiff neck
- Sore throat
- Night sweats
Lab Values: CBC
Red Blood Cells:
- Normal Adult = ?
Red Blood Cells (Erythrocytes - 106/µL)
Adult:
- Male: 4.7-6.1
- Female: 4.2-5.4
Newborn: 4.8-7.1
- 2-8 weeks: 4.0-6.0
- 2-6 months: 3.5-5.5
- 6 months-1 year: 3.5-5.2
- 1-18 years: 4.0-5.5
Trending Up:
- Weakness
- Fatigue
- Headache
- Lightheadedness
- Dyspnea
Trending Down:
- Orthostatic hypotension
- Weakness
- Fatigue
- Dyspnea on exertion
- Pallor
- Dizziness
- Chest pain
- Leg cramps with exercise
Lab Values: CBC
Platelets:
- Normal Adult = ?
- Critical Values = ?
Platelets (Thrombocytes - per mm^3):
- Adult/Child: 150,000-400,000
- Possible Critical Values: < 50,000 or > 1 million
- Premature infant: 100,000-300,000
- Newborn: 150,000-300,000
- Infant: 200,000-475,000
- Child/adult: 150,000-400,000
- Possible Critical Values: < 50,000 or > 1 million
Trending Up:
- Weakness
- Fatigue
- Headache
- Lightheadedness
- Dyspnea
Trending Up:
- Orthostatic hypotension
- Weakness
- Fatigue
- Dyspnea on exertion
- Pallor
- Dizziness
- Chest pain
- Leg cramps with exercise
Lab Values: CBC
Hemoglobin:
- Normal Adult = ?
- Critical Values = ?
Hemoglobin (g/dL):
Adult:
- Male: 14-18
- Female: 12 -16
- Pregnant: > 11
- Older adult: values are slightly decreased
- Possible Critical Values: < 5 or > 20
Newborn: 14-24
0-2 weeks: 12-20
2-6 months: 10-17
1-6 years: 9.5-14
6-18 years: 10-15.5
Trending Up:
- Fatigue
- Headache
- Dizziness
- Visual changes
- Transient ischemic attack (TIA)
- Dysrhythmias
- Bruising
- Bleeding
Trending Up:
- Pallor
- Tachycardia
- Orthostatic hypotension
- Dysrhythmias
- Impaired endurance and activity tolerance
Lab Values:
Hematocrit
- Normal Adult = ?
- Critical Values = ?
Hematocrit:
Adult:
- Male: 42-52%
- Female: 37-47%
- Pregnant: > 33%
- Older adult: values may be slightly decreased
- Possible Critical Values: < 15% or > 60%
Newborn: 44-64%
2-8 weeks: 39-59%
2-6 months: 35-50%
6 months-1 year: 29-43%
1-6 years: 30-40%
6-18 years: 32-44%
Trending Up:
- Fatigue
- Headache
- Dizziness
- Visual changes
- TIA
- Dysrhythmia
- Bruising
- Bleeding
Trending Down:
- Orthostatic hypotension
- Dizziness
- Headache
- Pallor
- Cold hands/feet
- Angina
- Dysrhythmia
- Dyspnea
Lab Values: Coagulation Tests and Analysis
INR
- Normal Adult = ?
- Critical Values = ?
International Normalized Ratio (INR)
Adult:
- 0.8-1.1
- Possible Critical Value INR: > 5.5
Child:
- 1-5 years: 0.92-1.14
- 6-10 years: 0.87-1.2
- 11-16 years: 0.97-1.3
Infant:
- Day 1: 1.15-1.35
- Day 3: 1.05-1.35
- 1-12 months: 0.86-1.22
Elevated Levels:
* Increased bleeding tendency
* Bruising
* Oozing from wounds
* Mucosal bleeding
Lab Values:
Plasma D-Dimer
- Normal Values = ?
Plasma D-Dimer: Is a protein fragment as a result of a clot breakdown.
Normal Value:
- < 250 ng/mL or < 0.4 mcg/mL
Lab Values: Cardiovascular Specific Labs
References Ranges:
- Cardiac Troponin T = ?
- Cardiac Troponin I = ?
Cardiac troponins are important biomarkers for cardiac disease, particularly in the evaluation of suspected acute
coronary ischemic syndromes.
- Given their high specificity for myocardial cell injury and prolonged time course of
elevation, troponins are the preferred blood test for in the evaluation of patients with chest pain.
Reference Ranges (ng/mL)^3:
- Cardiac Troponin T: < 0.1
- Cardiac Troponin I: < 0.03
Upward Trend:
- Myocardial injury
- Myocardial infarction
Clinical Implications:
- Initiate physical therapy intervention when troponins are stable and/or down trending.
- Monitor closely for indicators of unstable cardiac status (including medical team diagnosis, pending diagnostic testing, dysrhythmias, unstable vital signs, and supportive medications).
- Monitor vital signs continuously.
