Lab Values

Prothrombin Time

NL: 11-12.5 s

if 1.5-2X the normal time= high risk for excessive bleeding

International Normalized Ratio

NL: 0.8-1.1

Therapeutic INR (pt on warafrin): 2-3 or 2.5-3.5 depending on condition treated

RED FLAG: >5.5 pt should not exercise until cleared

Activated Partial Thromboplastin Time

NL: 30-40 sec

Therapeutic aPTT NL: 40-70 sec

RED FLAG: if aPTT > 70 secs then pt should seek clearance before activity

D-dimer

NL: <250 mg/mL

RED FLAGL >450 mg/mL (high risk for a VTE/DVT)

Troponin

NL

T: <0.1

I: <0.03

Monitor troponin level trends, no PT/exercise until troponin levels have shown a peak and decline

High Sensitivity Troponin

F: <14

M: <22

Brain Natriuretic Peptide

NL: <100 pg/mL

RED FLAG: >400 pg/mL (higher risk for heart failure)

100-300= mild level

300-900= moderate level

>900= severe level

Ethanol

NL: 0

Intoxication: >80 mg/dL

critical: >300 mg/dL

serum ethanol= 250

elevated ethanol levels will cause patient to have symptoms such as loss of balance, risk of fall, low cognition so a safe mobility assessment might not be appropiate until their intoxication has resolved

Lactic Acid

venous: >5-20

arterial: >3-7

over these ranges indicates possible tissue hypoxic states

Prealbumin

NL: 15-36

RED FLAG: <10.7

could be caused by protein malnutrition, inflammation, and/or illness

Arthrocentesis fluid study

• removing synovial fluid from joint using a needle to analyze lab values

• normal WBC within fluid should be <200

  • if WBC is >200 could indicate an infection within the fluid/joint cavity

• normal RBC within fluid should be <2,000

  • if RBC is >2,000 could indicate hemarthrosis (bleeding within the joint cavity)

Lumbar Puncture fluid studies

• removes CSF from subarachnoid space to analyze

• Normal findings include

  • pressure <20 cm H2O

  • clear fluid

  • no bacteria or WBC in fluid

Parencentesis fluid study

• removal of fluid from peritoneal cavity surround abdominal wall

• if fluid is transudate (thin/clear), could indicate CHF or cirrhosis

• if fluid is exudate (thick/cloudy) could indicate an infection or neoplasm

When analyzing a culture what is the amount of microrganisms that need to be present to indicate an infection?

>100,000 organisms/mL

What is normal CO levels?

4-8 L/min

What is normal SV levels?

55-130 mL

What is considered a normal cardiac index? What cardiac index is diagnostic of a cardiogenic shock?

NL: 0.3 L/min/m2

cardiogenic shock: <2.2 L/min/m2

What is normal intracranial pressure and cerebral perfusion pressure?

ICP= 7-15 mmHg

CPP= 50-70 mmHg (CPP= MAP - ICP)

WBC

NL: 5,000-10,000

RED FLAG: <2500, no exercise

ANC: <1,000, use neutropenic precautions

Hgb

NL

F= 12-16

M= 14-18

RED FLAG: <7-8, precaution of symptoms with activity and collab with other health professions

CL: <5 or >20

7-10= light exercise

>10= exercise as tolerated

Hct

NL

F= 37-47%

M= 45-52%

RED FLAG= <25%, symptom based activity with collab

CL: <15% or >60%

if 25-30%= light exercise

if >30%= resistance exercise as tolerated

Platelets

NL: 150,000-400,000

RED FLAG: <20,000, mobility and AROM but need approval

20,000-50,000= moderate exercise wiht light weights

>50,000= progressive resistance exercise

Na

NL= 136-145

RED FLAG= <120 (risk for orthostasis) or >160 (seizure precautions)

K

NL: 3.5-5

RED FLAG: <2.5 or >6.5

• risk for arhythmias

Cl

NL: 98-106

Ca

NL: 9-10.5

RED FLAG: <6 or >13

• risk for arhytmias

BUN

NL: 6-25

Creatinin

NL

F= 0.5-1.1

M= 0.6-1.2

Mg

NL: 1.3-2.1

RED FLAG= <0.05 (risk for VT/Torsades de Pointes) or >3 risk for arythmia

Glucose

NL: 74-106

RED FLAG: <50 or >400 at risk for Diabetic Ketoacidosis (DKA)

• no PT until levels have been re-evaluated and resolved

CO2

NL: 22-29