Practitioners should consider the total clinical picture when deciding whether to terminate therapy, grade down, or place a hold.

Understanding the lab test and potential adverse effects is critical to patient care.

Communicate with appropriate staff such as other therapists, nurses, doctors, and techs as appropriate.

Despite “good” lab values, patients may still experience dizziness and lightheadedness during activities. Therapists must take necessary precautions to minimize the risk of falls (pacing, monitoring vitals, grading activities, bringing a wheelchair, etc.)

Observe any precautions or contraindications throughout your session, e.g. Seizures.
Check out our comprehensive list of Precautions.

Vital Signs
PulmonaryCritical Values
SaO2<88%
Respiration Rate>35 breaths/min
PEEP>10cm H2O
FiO2>0.6
CardiovascularCritical Values
MAP<65 or >120 mmHg
Systolic BP<90 or >200 mmHg
Resting HR<50 bpm or >140bpm
CBC - Complete Blood Count
Critical Values
WBC<5000 (5×109/L) with fever
<1500 (1.5×109/L) with neutropenic precautions
Hematrocrit<20% or > 60% (clot)
Hemoglobin<7 gm/dL or > 20g/dL
Platelet<20 ku/L or <10,000/μl
if cleared by MD, then light BADLs, AROM
BMP - Basic Metabolic Panel
PurposeConsiderationsCritical Values
Na
(Sodium)
Fluid volume in the body, facilitates nerve conduction, neuromuscular function, and glandular secretion– Impaired cognition
– Orthostatic hypotension
– History of Seizures
≤120 mEq/L or >160 mEq/L
K
(Potassium)
Neuromuscular function, action potentials, cardiac muscle contraction, and conductivity– Cardiac issues
– Bradycardia
– Muscle weakness
< 2.5 mEq/L or
> 5 mEq/L
Cl
(Chloride)
Facilitate exchange of O2 and CO2 in RBCs– Consciousness
– Motor function
<80
or >115 mEq/L
HCO3
(Bicarbonate)
Acid–base balance; works as a pH buffer
Byproduct of your metabolism. Blood brings bicarbonate to lungs, and exhaled as carbon dioxide. Excreted/reabsorbed by kidneys.
None<10 or
>40 mEq/L
CO2
(Carbon Dioxide)
pH level and electrolyte status
Waste product of metabolism. Present in blood as bicarbonate.
Shortness of breath<10 mEq/L
or >40 mEq/L
BUNExcretory function of kidneys and metabolic function of the liver. Indicates renal disorder for dialysis.Decreased tolerance>100 mg/dl
Cr
(Creatine)
Waste product of muscle metabolism. Filtered out of the body through urination.

Elevated creatinine may indicate a renal disorder; difficulty excreting waste products and require dialysis.

Decreased tolerance>4 mg/dl
Mg
(Magnesium)
Facilitates transport of proteins, sodium, potassium, and calcium. Important for neuromuscular function and ATP use, and stimulates parathyroid hormone secretion.– Elevated = Diaphoresis, lethargy, weakness
– Depressed = Increased reflexes, tremors, spasticity, seizures
<1 or
>9 mEq/L
Ca
(Calcium)
Cell permeability, blood coagulation, muscle contractions, bone and teeth formation. Important for cardiac conductivity. 99% of calcium is stored in bones and teeth.Impaired cognition<6 mg/dl (tetany)
>13 mg/dl (coma)
PO4
(Phosphate)
Assists with neuromuscular regulation and cellular metabolism. Bone formation.– Cognition
– Muscle Weakness
<1 mg/dl
Glucose<70 or
>200 mg/dL
Coagulation (DVT & PE)
NO mobilityMobilizeVerify with MD
Coumadin (Warfarin)INR <2*
*Hours since last dose
INR 2-5INR > 5
*Increased bleeding!*
Low molecular wt. Heparin
– Dalteparin
– Enoxaparin
– Fragmin
– Innohep
– Tinzaparin– Lovenox – therapeutic dose
(mg = pt.’s weight)
<3 hours>5 hours3-5 hours
Fondaparinux (Arixtra)<2 hours>3 hours2-3 hours
Unfractionated Heparin (IV)<24 hours>48 hours24-48 hours ago
Novel oral anticoagulants

– Apixaban
– Dabigatran
– Eliquis
– Pradaxa
– Rivaroxaban
– Xarelto

<2 hours>3 hours2-3 Hours
Pending Ultrasound for DVTIVC Filter in place = Mobilize
Otherwise, use Well’s Criteria for DVT Calculator
Pending Ventilation/Perfusion for PEWell’s Criteria for PE Calculator
Cardiac Enzymes & Markers
PurposeRanges
TroponinProteins specific to cardiac muscle tissue; released with muscle injury or MI(Prognostic)
Troponin I: >1.5 ng/ml
Troponin T: >0.1 ng/ml and rising
CK-MBMarker for acute MI or myocardium injuryReference: 0% – 6%
C-Reactive ProteinProduced primarily in the liver in response to an inflammatory process or condition0.1–0.3 mg/dL: average risk of future cardiovascular event
>0.3 mg/dL: high risk of future cardiovascular even
BNPHormones secreted by the heart when volume overload is present; differential diagnosis of CHFMild heart failure: 100–300 pg/ml
Moderate heart failure: 300–700 pg/ml
Severe heart failure: >700 pg/ml
MyoglobinReleased into the bloodstream during ischemia or in cases of muscle inflammation or traumaNormal: 0–0.09 mg/ml

Contraindications:

  • Acute MI <2 days
  • Acute Infection
  • Acute myocarditis / pericarditis
  • Pulmonary embolism
  • Severe CHF
  • Uncontrolled arrhythmias
  • Uncontrolled diabetes
Specific Conditions
Blood transfusion: Defer for at least 30 mins for NSG to monitor for reactions.

Adverse Reactions: headache, fever, chills, tachycardia, hypotension, chest/abdominal pain, flushed face, warmth at vein site.

Hemochromatosis: avoid strenuous activity 24 hours after a phlebotomy.
Units of Measurement
CCelsius
ccCubic centimeter
cgCentigram
cmCentimeter
cuCubic
dlDeciliter
gGram
IU1International Unit
ImUInternational milliunit
IμUInternational microunit
kKilo
kgKilogram
LLiter
mEqMilliequivalent
mEq/LMilliequivalent per liter
mgMilligram
mLMilliliter
mmHgMilliliter of mercury
mmH2OMillimeter of water
molMole
mmolMillimole
MOsmMilliosmole
Millimicron
mUMilliunit
mVMillivolt
ngNanogram
nmNanometer
nmolNanomole
PaPascal
pgPicogram
plPicoliter
pmPicometer
pmolPicomole
SIInternational System of Units
μMicron
μ³Cubic micron
μgMicrogram
μlUMicrointernational unit
μlMicroliter
μm³Cubic micrometer
μmolMicromole
μUMicrounit
UUnit
Units Conversion Table
1 L1000 mL
1 mL1 cc
1 Tbsp15 mL
1 Tbsp3 tsp
1 tsp5 mL
1 oz30 mL
1 oz2 Tbsp
1 Kg2.2 lb
1 Kg1000 g
1 G1000 mg
1 mg1000mcg
1 in2.54 cm
1 ft12 in
1 yard3 ft

mL – milliliter, cc – cubic centimeter, Tbsp – tablespoon, tsp – teaspoon, L – liter, oz – ounce, G – gram, Kg – kilogram, mg – milligram, lb – pound, in – inch, cm – centimeter, ft – foot