Understanding Lab Values in Physical Therapy Management

Lab Tests Purpose

Screening, diagnosis, and monitoring patient conditions.

Screening

Searching for hidden disease processes.

Diagnosis

Identifying or ruling out symptom causes.

Monitoring

Assessing condition after disease diagnosis.

Sensitivity

Ability to correctly identify true positives.

Specificity

Ability to correctly identify true negatives.

Reference Range

Normal values vary by facility and population.

Normal Range

Expected lab values for healthy individuals.

Critical Low

Significantly low lab values indicating urgent concern.

Critical High

Significantly high lab values indicating urgent concern.

Acute Condition

Requires conservative management and careful monitoring.

Chronic Condition

More resources available for management and compensation.

Risk vs Benefit

Evaluate risks of intervention against potential benefits.

Sex and Gender Considerations

Different normal values for males and females.

Race and Culture Impact

Genetic or lifestyle differences affect lab values.

Trends in Lab Values

Consider changes over time, not just single values.

Clinical Context

Factors influencing lab results and patient condition.

SBAR Technique

Structured communication: Situation, Background, Assessment, Recommendation.

Follow-up Research

Provide evidence and discuss findings with team.

Patient Management

Decide therapy based on lab values and context.

Intervention Timing

Use lab trends to inform intervention schedules.

Collaboration with IDT

Work with interdisciplinary team for patient care.

Basic Metabolic Panel (BMP)

Tests for electrolytes, kidney, and blood sugar status.

Electrolyte Levels

Measure of sodium, potassium, chloride, calcium concentrations.

Sodium

Critical for fluid volume and nerve function.

Potassium

Essential for nerve, muscle, and heart function.

Chloride

Indicates hydration and acid/base balance.

Calcium

Important for neuromuscular function and bone health.

Carbon Dioxide (HCO3)

Regulates acid/base balance in blood.

Blood Glucose

Reflects blood sugar level at testing time.

Hemoglobin A1C (HgbA1C)

Average blood glucose control over past 3 months.

Blood Urea Nitrogen (BUN)

Reflects kidney function and protein metabolism.

Creatinine

Waste product indicating kidney excretory function.

HYPO-natremia

Low sodium concentration in the blood.

HYPER-natremia

High sodium concentration in the blood.

HYPO-kalemia

Low potassium concentration in the blood.

HYPER-kalemia

High potassium concentration in the blood.

HYPO-chloremia

Low chloride concentration in the blood.

HYPER-chloremia

High chloride concentration in the blood.

HYPO-calcemia

Low calcium concentration in the blood.

HYPER-calcemia

High calcium concentration in the blood.

Critical Sodium Value

Critical level below 110 mEq/L.

Critical Potassium Value

Critical levels below 3.2 or above 5.1 mEq/L.

Calcium Reference Value

Normal range 9-11 mg/dL.

BUN Reference Value

Normal range 10-20 mg/dL.

Creatinine Reference Value

Female: 0.5-1.1 mg/dL, Male: 0.6-1.2 mg/dL.

Hypoglycemia Symptoms

Includes tachycardia, confusion, seizures.

Hyperglycemia Symptoms

Includes lethargy, dehydration, Kussmaul respirations.

Basic Metabolic Panel (BMP)

Tests for electrolytes, kidney status, and blood sugar.

Carbon Dioxide (Bicarbonate)

Regulates acid/base balance in blood.

Blood Glucose

Reflects current blood sugar level.

Hemoglobin A1C

Average blood glucose control over three months.

Blood Urea Nitrogen (BUN)

Indicates liver function and kidney excretion.

Creatinine

Waste product indicating kidney function.

HYPO-natremia

Low sodium concentration in blood.

HYPER-natremia

High sodium concentration in blood.

HYPO-kalemia

Low potassium concentration in blood.

HYPER-kalemia

High potassium concentration in blood.

HYPO-chloremia

Low chloride concentration in blood.

HYPER-chloremia

High chloride concentration in blood.

HYPO-calcemia

Low calcium concentration in blood.

HYPER-calcemia

High calcium concentration in blood.

Critical Sodium Value

<110 mEq/L indicates severe risk.

Critical Potassium Value

<3.2 or >5.1 mEq/L indicates severe risk.

Critical Calcium Value

><7 mg/dL (tetany) or >12 mg/dL (coma).

Normal BUN Range

Adult 10-20 mg/dL.

Normal Creatinine Range

Female 0.5-1.1 mg/dL, Male 0.6-1.2 mg/dL.

Hypoglycemia Symptoms

Diaphoresis, tachycardia, confusion, seizures.

Hyperglycemia Symptoms

Lethargy, dehydration, confusion, Kussmaul respirations.

PT Implications

Monitor symptoms and adjust activity accordingly.

Routine Monitoring

Used for outpatient and inpatient assessments.

Notify nurse

Inform the patient's nurse about the situation.

Postpone treatment

Delay the scheduled treatment for the patient.

Wait for retest results

Hold off on actions until glucose levels are confirmed.

Hypomagnesemia

Low magnesium levels; causes include alcohol abuse.

Hypermagnesemia

High magnesium levels; causes include renal failure.

Magnesium Reference Value

Normal range: 1.5-2.5 mEq/L.

Comprehensive Metabolic Panel (CMP)

Includes BMP plus hepatic function tests.

Bilirubin

Red bile pigment; indicates liver function.

Alanine Aminotransferase (ALT)

Enzyme indicating hepatocellular damage.

Aspartate Aminotransferase (AST)

Enzyme released during liver cell damage.

Alkaline Phosphatase (ALP)

Elevated in bile duct obstruction.

Gamma Glutamyl Transferase (GGT)

Elevated with significant liver disorders.

Lactate Dehydrogenase (LDH)

Elevated in metastatic disease and muscle damage.

Blood Ammonia

Increased with severe liver injury.

Albumin

Protein that maintains blood fluid balance.

Complete Blood Count (CBC)

Measures RBCs, WBCs, and platelets.

Leukocytosis

Increased WBCs; indicates infection or inflammation.

Leukopenia

Decreased WBCs; indicates viral infections or chemotherapy.

Neutropenia

Low neutrophil count; increases infection risk.

Hemoglobin (Hb)

Measures oxygen-carrying capacity of blood.

Hematocrit (Hct)

Percentage of RBCs in blood volume.

Anemia

Condition of low red blood cell count.

Polycythemia

Excessive red blood cells; increases blood viscosity.

Peripheral Edema

Swelling due to fluid accumulation.

Hepatic Encephalopathy

Cognitive decline due to liver dysfunction.

Ascites

Fluid accumulation in abdominal cavity.

Right Upper Quadrant Pain

Pain indicating possible liver or gallbladder issues.

Diaphoresis

Excessive sweating; may indicate hypermagnesemia.

Nystagmus

Involuntary eye movement; may indicate hypomagnesemia.