|
Lab test numbers and indications
References: Advanced Rehabilitative strategies for the evaluation and treatment of the medically complex geriatric patient. Carole Lewis, Seminar, Summer 1998. *Goodman CC, Snyder TEK. Laboratory Tests and Values in: Goodman CC, Boissonnault, WG, Fuller KS, eds.. Pathology: Implications for the Physical Therapist, 2nd ed. 2003:1174-1197.
Retrieved Jan. 16, 2007 from American Physical Therapy Association, Section on Geriatrics, Listserv. http://health.groups.yahoo.com/group/geriatricspt/files/
|
Blood
sample |
Normal |
Clinical
Significance |
| Arterial
Blood Gases (ABG) |
PaO2 = 80-100 mm Hg
PaCO2 = 35-45 mm Hg
pH = 7.35-7.45
HCO3 = 22-26 mEq/l
SaO2 = 95-99% |
Panic Values
for ABGs
PaO2: < 40
PaCO2: < 20 or > 70
pH: < 7.2 or > 7.6
HCO3: < 10 or > 40
SaO2: < 60%
* See more information
regarding CO2 Retention. |
Degrees of Hypoxia:
mild: PaO2 of 60-80 mm
mod: PaO2 of 40-60 mm
severe: PaO2 < 40 mm |
Hematocrit
(Hct) |
Female:
36-46%
Male: 42-52%
|
Low values = Anemia: monitor for fatigue, dyspnea, tachycardia, tachypnea
RBC / Whole Blood = ___
% |
Hemoglobin
(Hgb) |
Female:
12-15 g/dl
Male: 14-17 g/dl |
Low values = Anemia: monitor for fatigue, dyspnea, tachycardia, tachypnea
Chemotherapy:
< 10 -- hold aerobic exercise |
| RBC
Count |
Female:
4 -5.5 million/mm3
Male: 4.5 - 6.2 million/mm3 |
Low values = Anemia: monitor for fatigue, dyspnea, tachycardia, tachypnea
High values: In
COPD, may indicate Polycythemia, a compensation for
pulmonary dysfunction that makes blood thicker, and increases
risk of CVA, etc. |
| Total
WBC Count |
5,000
- 10,000 /mm3 |
> 10,000 indicates systemic infection (more than just local
colonization)
Chemotherapy :
< 5,000: use reverse isolation, see patient in room, careful hygiene,
hold aerobic exercise |
Platelets,
Thrombocytes |
200,000
- 500,000 /mm3 |
Chemotherapy:
- 30,000 – 50,000: avoid resisted exercise, risk of internal hemorrhage, ambulation OK
- < 30,000: bedside, gentle AROM
- < 20,000: consult with physician or nurse before activity
|
"Sed
Rate",
Erythrocyte Sedimentation Rate (ESR) |
Female:
1-25 mm/hr
Male: 0-17 mm/hr |
Bad if elevated.
Used to diagnose, or follow the course of inflammatory diseases,
e.g. rheumatic conditions
Alternative
calculation of normal value:
Female: (age + 10) / 2
Male: age / 2 |
| |
|
|
| Creatinine |
Female:
0.6 - 1.2 mg/dl
Male: 0.5 - 1.1 mg/dl
Elderly values are lower because of reduced muscle mass |
Renal
function measure: high values are bad.
May indicate nephropathy, end stage renal d.
Can occur in brittle diabetics also. |
| Potassium
(K) |
3.5 - 5.0 mEq/l |
Low (hypokalemia)
secondary to: vomiting, diarrhea, sweating, or use of loop
diuretics e.g. Lasix, furosemide. Also increases the risk
of digitalis toxicity.
Result of low K: ventricular arrhythmias
High (hyperkalemia)
secondary to: overuse of K supplements, renal or endocrine
problem.
Result of high K: ventricular arrhythmias, asystole |
| Calcium
(Ca) |
8.2
-10.2 mg/dl |
Low (hypocalcemia):
secondary to: abuse of laxatives, renal failure, low dietary
calcium or Vit. D intake, excessive magnesium intake.
Result of low Ca: osteoporosis, muscle spasms / tetany,
calcium deposits in tissue; cardiac arrhythmia, asystole
High (hypercalcemia):
secondary to: immobilization, metastatic bone CA; overuse
of antacids containing calcium
Result of high Ca:
thirst; polyuria; renal stones; decreased muscle tone and
DTRs; tachycardia; cardiac arrhythmia, asystole |
| Sodium
(Na) |
136
-145 mEq/l |
Low (hyponatremia)
secondary to: fluid loss from diarrhea, vomiting, diaphoresis,
diuretic use.
Result of low Na: postural hypotension, abdominal cramps,
headache, fatigue, weakness
High (hypernatremia)
secondary to: dehydration, high salt intake, poor renal
function
Result of high Na: edema, tachycardia |
Diabetes
| Fasting Blood Glucose (FBG) |
Glucose Level |
Indication |
| 70 to 99 mg/dL |
Normal fasting glucose |
| 100 to 125 mg/dL |
Impaired fasting glucose (pre-diabetes)
Contributes to the diagnosis of Metabolic Syndrome |
| >126 mg/dL |
Diabetes |
Oral Glucose Tolerance Test (OGTT)
(Sample drawn 2 hours after a 75-gram glucose drink) |
Glucose Level |
Indication |
| < 140 mg/dL |
Normal glucose tolerance |
| 140 to 200 mg/dL |
Impaired glucose tolerance (pre-diabetes)
Contributes to the diagnosis of Metabolic Syndrome |
| > 200 mg/dL |
Diabetes |
Conversion tool for Blood Glucose to HBA1c
Chart with comparative values for HBA1c & Blood Glucose
| Glycosylated
Hemoglobin HBA1c, or A1c |
4 -
6%
is normal |
Lab work done at
the doctor's office, that gives an average of the last 3 month's
blood glucose.
The goal for diabetic patients it to keep the value <
7% |
Pulmonary
Function Test (PFT) results: COPD & RLD
| |
FVC |
FEV1 |
FEV1
/ FVC |
| COPD |
Decreased.
Mild: 65-80% of predicted
Mod: 50-65% of predicted
Severe: < 50% of predicted |
Decreased.
Mild: 65-80% of predicted
Mod: 50-65% of predicted
Severe: < 50% of predicted |
Decreased.
Mild: 65-80% of predicted
Mod: 50-65% of predicted
Severe: < 50% of predicted |
| RLD |
Decreased.
Mild: 65-80% of predicted
Mod: 50-65% of predicted
Severe: < 50% of predicted |
Decreased.
Mild: 65-80% of predicted
Mod: 50-65% of predicted
Severe: < 50% of predicted |
Normal
or increased.
80-100% of predicted |
BP - lifespan values
Vital signs - pediatric
values
| Adult Values |
SBP |
DBP |
| Normal |
<
120 |
<
80 |
| PreHypertension |
120-139 |
80-89 |
| HTN
- Stage 1 |
140-159 |
90-99 |
| HTN
- Stage 2 |
>
160 |
>
100 |
- According to the Seventh Report of the Joint National
Committee on Detection, Education, and Treatment of High Blood Pressure
(JNCVI). 2003
Ejection Fraction
(EF), defines degrees of heart failure:
- > 55% normal
- 40-55% mild LV dysfunction
- 30-40% moderate LV dysfunction
- < 30% severe LV dysfunction
Ottawa Cardiovascular Centre. (2004). Congestive Heart Failure Survival Kit. Continuing Medical Implementation Inc. Retrieved 7-2-2011. http://www.cvtoolbox.com/downloads/CHF_SurvivalKit.pdf
CHF is quantified by an echocardiogram (US) reading
of elevated EDV (End Diastolic Volume and decreased
SV (Stroke Volume)
Rheumatic diseases
and tests with which they may be strongly associated:
Bartlett, S. (2006). Clinical Care in the Rheumatic
Diseases. (3rd ed.). Association of Rheumatology Health Professionals.
American College of Rheumatology. Atlanta : ARHP
| Rheumatoid
factor (RF) |
RA
-70%, Sjogrens -90% (p.44-5) |
| Antinuclear
Antibodies: ANA (Fluorescent ANA = FANA) |
SLE
- 99% (p.45) |
| HLA
B27: Human Leukocyte Antigens |
AS
- 90%, Reiters - 80% (p.178) |
| ESR
Erythrocyte Sedimentation Rate & CRP (C-reactive protein) |
RA and
Polymyalgia Rheumatica
Most useful
as serial measurements to track the course of the disease,
especially when in active inflammation (p.48) |
| Uric
Acid Crystals (synovial aspiration) |
Gout
or pseudogout (p.44) |
| WBC
levels |
- Most
indicative of Gout (synovial aspiration)
- Normal
in RA, but can be elevated during inflammatory phase (p.47-48).
- Leukopenia
and other hematologic disorders can occur in SLE (p.188)
|
BMI
calculator
BMI
table
| Underweight |
<
18.5 |
| Normal
weight |
18.5
- 24.9 |
| Overweight |
25
- 29.9 |
| Obesity |
>
30 |
| Morbid
Obesity |
>
40 |
VO2 Max / 3.5 = METs
Ankle Brachial Index
(ABI):
Clinical application: decisions about use of compression, and use
of sharp debridement. Prognostic for wound healing.
Ankle SBP / Brachial SBP
Must have a doppler US to hear SBP at the dorsalis pedis artery.
Cuff goes around calf).
For normal persons, leg SBP is higher than brachial SBP.
| 0.9
- 1.2 |
Normal |
| 0.7
- 0.9 |
Mild
arterial disease (intermittent claudication pain) |
| 0.5
- 0.7 |
Moderate
arterial disease (claudication pain at rest) |
| <
0.5 |
Severe
arterial disease (risk of gangrene) |
Falsely high values that
are > 1.2 may indicate arteriosclerosis (diabetes), because
the vessels are calcified and non-compressible by the BP cuff. Referral
for other testing would be appropriate.
Diagnostic Imaging for the Physical Therapist
by Darryl Hosford & Ken Hurd
|
University
of Missouri
School of Health Professions
Department of Physical Therapy
Last updated
December 10, 2011
Contact
webmaster |
|
