Lab Value Interpretation: Difference between revisions
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==Introduction== | ==Introduction== | ||
[[File:Lab values.jpg|frameless|right]] | [[File:Lab values.jpg|frameless|right]]Using laboratory values can be a key piece of assessment to determine what is occurring within the body of a patient. There are numerous laboratory tests that can be done. The most common tests include chemistry panels, hematology (such as the complete blood count), and blood gases. | ||
=== Risk and benefit considerations to therapeutic intervention === | === Risk and benefit considerations to therapeutic intervention === | ||
The fundamental consideration when reviewing patient laboratory findings is toward determining an appropriate plan of care and weighing the anticipated benefit of a therapy intervention against the potential of the patient | The fundamental consideration when reviewing patient laboratory findings is toward determining an appropriate plan of care and weighing the anticipated benefit of a therapy intervention against the potential of the patient. | ||
Physical therapists should: | |||
* Carefully anticipate the physiological changes that might have occurred whenever a laboratory value is out of range. | |||
* Be aware of the heightened risk level if a value should fall into the critical range. | |||
* Be aware of the importance of understanding pertinent lab values and the subsequent potential of adverse events when practicing in this kind of practice setting. | |||
When commencing or continuing care of patients in the acute care setting, always use sound clinical decision making<ref name=":0">1. James T., Traci N., Kim L. Academy of Acute Care Physical Therapy-APTA Task Force on Lab Values. Laboratory values interpretation Resource. 2017</ref>. The Lab values alone may or may not determine whether you’re going to intervene with a patient, or whether you’re going to hold<ref name=":1">Physicaltherapy.com. Available from: http://www.physicaltherapy.com/articles/essential-role-lab-values-and-3637 </ref>. | |||
== Be aware == | |||
Things to consider when looking at the patient’s condition | Things to consider when looking at the patient’s condition | ||
* Potential drug interactions | * Potential drug interactions | ||
| Line 13: | Line 22: | ||
* Electrolyte panels might change with intravenous infusions, medications, and diet | * Electrolyte panels might change with intravenous infusions, medications, and diet | ||
* Chronic medical conditions (such as anemia) might be asymptomatic during exercise, while a patient with precipitous drop in hemoglobin and hematocrit might require urgent medical attention. | * Chronic medical conditions (such as anemia) might be asymptomatic during exercise, while a patient with precipitous drop in hemoglobin and hematocrit might require urgent medical attention. | ||
== Complete Blood Count == | |||
Complete blood count is one of the most basic laboratory examinations to assess the overall health status of a patient. It can help diagnose infections, autoimmune disorders, anemia, and other blood diseases.<ref>Nurse Buff [https://www.nursebuff.com/laboratory-values-for-nurses/ Laboratory Values and Interpretation – A Nurse’s Ultimate Guide] Available :https://www.nursebuff.com/laboratory-values-for-nurses/ (accessed 29.5.2021)</ref><ref>Flashcard Machine: available from: http://www.flashcardmachine.com/contraindications-to-ptinacutecaresetting.html </ref> | |||
{| class="wikitable" | {| class="wikitable" | ||
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Resistive exercise (>5,000 mm<sup>3</sup> as tolerated) | Resistive exercise (>5,000 mm<sup>3</sup> as tolerated) | ||
|} | |} | ||
== Electrolytes == | |||
[[Electrolytes]] are minerals that are involved in some of the important functions in our body. Serum electrolytes are routinely ordered for a patient admitted to a hospital as a screening test for electrolyte and acid-base imbalances.<ref>Nurse labs Lab Values Available from:https://nurseslabs.com/normal-lab-values-nclex-nursing/#serum_electrolytes-2 (accessed 29.5.2021)</ref> | |||
{| class="wikitable" | {| class="wikitable" | ||
!Lab values | !Lab values | ||
| Line 86: | Line 99: | ||
|95-105mEq/L | |95-105mEq/L | ||
|Reduction: often occur during metabolic alkalosis | |Reduction: often occur during metabolic alkalosis | ||
Elevations: Metabolic acidosis | Elevations: Metabolic acidosis<ref name=":2">1. Physical Therapy Reviewer. Available from: http://ptreviewer.com/lab-values-3/ </ref> | ||
|} | |} | ||
== Coagulation == | |||
Clotting is what prevents excessive bleeding, the blood moving through your vessels shouldn’t clot. If such clots form, they can travel through the bloodstream to the heart, lungs, or brain. This can cause a heart attack, stroke, or even death. | |||
Coagulation tests measure the blood’s ability to clot, and how long it takes to clot. Testing can help assess the risk of excessive bleeding or developing clots (thrombosis) somewhere in your blood vessels. Coagulation tests are useful in monitoring people who take medications that affect clotting ability. Coagulation tests are also sometimes recommended before surgery. | |||
Conditions that can cause coagulation problems include: | |||
* Liver disease | |||
* Thrombophilia, which is excessive clotting | |||
* Hemophilia, which is an inability to clot normally | |||
There are many types of coagulation tests. Some of the more common are listed below.<ref>Health line [https://www.healthline.com/health/coagulation-tests#purpose Coagulation tests] Available from: https://www.healthline.com/health/coagulation-tests#purpose (accessed 29.5.2021)</ref> | |||
{| class="wikitable" | {| class="wikitable" | ||
|Lab values | |Lab values | ||
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>6.0 PT contraindication | >6.0 PT contraindication | ||
|} | |} | ||
The outline was created to assist the clinician with lab value considerations for the general population. | The above outline was created to assist the clinician with lab value considerations for the general population. | ||
* Be aware that “norm” are created for the healthy adult, and each patient’s lab value should be interpreted within the context of the patient’s current medical status<ref name=":0" />. | |||
* Pediatrics population lab values range is not included above<ref name=":2" />. | |||
The video below gives a good introduction to lab values and normal ranges | The video below gives a good introduction to lab values and normal ranges | ||
Revision as of 07:41, 29 May 2021
Introduction[edit | edit source]
Using laboratory values can be a key piece of assessment to determine what is occurring within the body of a patient. There are numerous laboratory tests that can be done. The most common tests include chemistry panels, hematology (such as the complete blood count), and blood gases.
Risk and benefit considerations to therapeutic intervention[edit | edit source]
The fundamental consideration when reviewing patient laboratory findings is toward determining an appropriate plan of care and weighing the anticipated benefit of a therapy intervention against the potential of the patient.
Physical therapists should:
- Carefully anticipate the physiological changes that might have occurred whenever a laboratory value is out of range.
- Be aware of the heightened risk level if a value should fall into the critical range.
- Be aware of the importance of understanding pertinent lab values and the subsequent potential of adverse events when practicing in this kind of practice setting.
When commencing or continuing care of patients in the acute care setting, always use sound clinical decision making[1]. The Lab values alone may or may not determine whether you’re going to intervene with a patient, or whether you’re going to hold[2].
Be aware[edit | edit source]
Things to consider when looking at the patient’s condition
- Potential drug interactions
- Significant trends in the values over time
- Electrolyte panels might change with intravenous infusions, medications, and diet
- Chronic medical conditions (such as anemia) might be asymptomatic during exercise, while a patient with precipitous drop in hemoglobin and hematocrit might require urgent medical attention.
Complete Blood Count[edit | edit source]
Complete blood count is one of the most basic laboratory examinations to assess the overall health status of a patient. It can help diagnose infections, autoimmune disorders, anemia, and other blood diseases.[3][4]
| Lab values | Normal range | Rehabilitation consideration |
|---|---|---|
| Hematocrit(%RBC) | 43-49%(male)
38-44%(female) |
No exercise (<25%)
light exercise (25-30%) Resistive exercise (>30%) |
| Platelets | 150,000-350,000/µL | No exercise (<20,000µL)
Light exercise (20,000-50,000µL) Resistive exercise (>50,000µL) |
| Hemoglobin | 14.4-16.6gm/dL (male)
12.2-14.7gm/dl (female) |
No exercise (<8gm/dl)
light exercise (8-10gm/dl) Resistive exercise (>10gm/dl) |
| White blood cell(WBC) | 4,500-11,000 mm3 | No exercise (<5,000 mm3 )
Light exercise (>5,000 mm3) Resistive exercise (>5,000 mm3 as tolerated) |
Electrolytes[edit | edit source]
Electrolytes are minerals that are involved in some of the important functions in our body. Serum electrolytes are routinely ordered for a patient admitted to a hospital as a screening test for electrolyte and acid-base imbalances.[5]
| Lab values | Normal range | Rehabilitation consideration |
|---|---|---|
| Sodium | 135-145mEq/L | Reduction: Cramps, weakness, confusion
Elevation: Fluid retention, Swelling, Hypertension |
| Potassium | 3.5-5.0mEq/L | Reductions: Flattened T waves, arrthymias
Elevations: Peaked T waves, shortened QT interval |
| Calcium | 8.5-10.5mg/dl | Reductions (Moderate to severe): parathesias, muscle spasms and seizure and
QT interval prolongation. Elevations (severe only): Bradycardia, AV block, and short QT interval, coma |
| Magnesium | 1.7 to 2.2mg/dl | Reductions: prolonged PR or QT intervals, T-Waves flattening or inversion, SVT.
Elevation: weakness, respiratory failure, coma, paralysis. |
| Chloride | 95-105mEq/L | Reduction: often occur during metabolic alkalosis
Elevations: Metabolic acidosis[6] |
Coagulation[edit | edit source]
Clotting is what prevents excessive bleeding, the blood moving through your vessels shouldn’t clot. If such clots form, they can travel through the bloodstream to the heart, lungs, or brain. This can cause a heart attack, stroke, or even death.
Coagulation tests measure the blood’s ability to clot, and how long it takes to clot. Testing can help assess the risk of excessive bleeding or developing clots (thrombosis) somewhere in your blood vessels. Coagulation tests are useful in monitoring people who take medications that affect clotting ability. Coagulation tests are also sometimes recommended before surgery.
Conditions that can cause coagulation problems include:
- Liver disease
- Thrombophilia, which is excessive clotting
- Hemophilia, which is an inability to clot normally
There are many types of coagulation tests. Some of the more common are listed below.[7]
| Lab values | Normal range | Rehabilitation consideration |
| Prothrombin time(PTT) | 11-12.5sec | Assesses extrinsic pathway (fast system)
Therapeutic range: 1-2 times normal Risk of bleeding: >2-3 times normal |
| International normalized
Ratio (INR) |
0.9-1.1 | normalized ratio PT, used to assess effect of warfarin
therapeutic range: Afib/DVT/PE (2-3) Valve replacement (2.5-3.5) Risk of bleeding: >4.0 light exercise only >5.0 hold exercise, PT eval only >6.0 PT contraindication |
The above outline was created to assist the clinician with lab value considerations for the general population.
- Be aware that “norm” are created for the healthy adult, and each patient’s lab value should be interpreted within the context of the patient’s current medical status[1].
- Pediatrics population lab values range is not included above[6].
The video below gives a good introduction to lab values and normal ranges
References[edit | edit source]
- ↑ 1.0 1.1 1. James T., Traci N., Kim L. Academy of Acute Care Physical Therapy-APTA Task Force on Lab Values. Laboratory values interpretation Resource. 2017
- ↑ Physicaltherapy.com. Available from: http://www.physicaltherapy.com/articles/essential-role-lab-values-and-3637
- ↑ Nurse Buff Laboratory Values and Interpretation – A Nurse’s Ultimate Guide Available :https://www.nursebuff.com/laboratory-values-for-nurses/ (accessed 29.5.2021)
- ↑ Flashcard Machine: available from: http://www.flashcardmachine.com/contraindications-to-ptinacutecaresetting.html
- ↑ Nurse labs Lab Values Available from:https://nurseslabs.com/normal-lab-values-nclex-nursing/#serum_electrolytes-2 (accessed 29.5.2021)
- ↑ 6.0 6.1 1. Physical Therapy Reviewer. Available from: http://ptreviewer.com/lab-values-3/
- ↑ Health line Coagulation tests Available from: https://www.healthline.com/health/coagulation-tests#purpose (accessed 29.5.2021)
- ↑ Khanacacemymedicine. Introduction to lab values and normal ranges | Health & Medicine | Khan Academy. Available from: https://www.youtube.com/watch?v=_mGszRbve9s (last accessed 26.4.2019)
