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
Pulmonary Critical Values
SaO2 <88%
Respiration Rate >35 breaths/min
PEEP >10cm H2O
FiO2 >0.6
Cardiovascular Critical 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
Purpose Considerations Critical 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
BUN Excretory 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 mobility Mobilize Verify with MD
Coumadin (Warfarin) INR <2*
*Hours since last dose
INR 2-5 INR > 5
*Increased bleeding!*
Low molecular wt. Heparin
– Dalteparin
– Enoxaparin
– Fragmin
– Innohep
– Tinzaparin– Lovenox – therapeutic dose
(mg = pt.’s weight)
<3 hours >5 hours 3-5 hours
Fondaparinux (Arixtra) <2 hours >3 hours 2-3 hours
Unfractionated Heparin (IV) <24 hours >48 hours 24-48 hours ago
Novel oral anticoagulants

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

<2 hours >3 hours 2-3 Hours
Pending Ultrasound for DVT IVC Filter in place = Mobilize
Otherwise, use Well’s Criteria for DVT Calculator
Pending Ventilation/Perfusion for PE Well’s Criteria for PE Calculator
Cardiac Enzymes & Markers
Purpose Ranges
Troponin Proteins 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-MB Marker for acute MI or myocardium injury Reference: 0% – 6%
C-Reactive Protein Produced primarily in the liver in response to an inflammatory process or condition 0.1–0.3 mg/dL: average risk of future cardiovascular event
>0.3 mg/dL: high risk of future cardiovascular even
BNP Hormones secreted by the heart when volume overload is present; differential diagnosis of CHF Mild heart failure: 100–300 pg/ml
Moderate heart failure: 300–700 pg/ml
Severe heart failure: >700 pg/ml
Myoglobin Released into the bloodstream during ischemia or in cases of muscle inflammation or trauma Normal: 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
C Celsius
cc Cubic centimeter
cg Centigram
cm Centimeter
cu Cubic
dl Deciliter
g Gram
IU1 International Unit
ImU International milliunit
IμU International microunit
k Kilo
kg Kilogram
L Liter
mEq Milliequivalent
mEq/L Milliequivalent per liter
mg Milligram
mL Milliliter
mmHg Milliliter of mercury
mmH2O Millimeter of water
mol Mole
mmol Millimole
MOsm Milliosmole
Millimicron
mU Milliunit
mV Millivolt
ng Nanogram
nm Nanometer
nmol Nanomole
Pa Pascal
pg Picogram
pl Picoliter
pm Picometer
pmol Picomole
SI International System of Units
μ Micron
μ³ Cubic micron
μg Microgram
μlU Microinternational unit
μl Microliter
μm³ Cubic micrometer
μmol Micromole
μU Microunit
U Unit
Units Conversion Table
1 L 1000 mL
1 mL 1 cc
1 Tbsp 15 mL
1 Tbsp 3 tsp
1 tsp 5 mL
1 oz 30 mL
1 oz 2 Tbsp
1 Kg 2.2 lb
1 Kg 1000 g
1 G 1000 mg
1 mg 1000mcg
1 in 2.54 cm
1 ft 12 in
1 yard 3 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