Lab Values in Acute Care

Vital Signs

Resting Values

Heart Rate (HR)

50 120 bpm

Systolic Blood Pressure

(SBP)

80 180 mmHg

Diastolic Blood Pressure

(DBP)

40 110 mmHg

Oxygen Saturation
(SaO2)

90%

Respiratory Rate (RR)

12 20 bpm

LAB VALUES

NORMAL
RANGES

*Hemoglobin (Hgb)

Hematocrit (Hct)

Females: 12 16
Gm/dL
Males: 14 17 Gm/dL

Females: 35 45%
Males: 39 49%

*Potassium (K)

3.5 5.0 mEq/L

Sodium (Na)

135 145 mEq/L

*If vital signs fall outside of the resting values, terminate tx if the following
symptoms are observed:
- Numbness/tingling
- Unresolved dizziness
- Nausea
- Blurred vision
- Dilated pupils
- HR of 30 bpm over baseline
- Change in SBP of 30mmHg or DBP of 10 mmHg
- Angina
- SOB

ACTIVITY LEVELS/GUIDELINES
Hgb
Hgb
Hgb
Hgb
Hgb

< 8 gm/dL: BADLs

< 8-10 gm/dL: BADLs, light aerobics, light weights (1-2 lbs)
> 8 gm/dL: Routine OT/PT, activity as tolerated, resistance exercises
< 7 gm/dL: HOLD OT/PT
7.1 7.9 gm/dL: Clarify MD orders; Monitored HR pre-, mid- and posttx;
O2 90% prior to tx
Blood transfusion: NO mobilization during the first 30 min. for each bag of
blood
Hct < 25%: BADLs
Hct < 25 35%: BADLs, light aerobics, light weights (1-2lbs)
Hct > 35%: Activity as tolerated
K < 3.0 mEq/L or > 6.0 mEq/L : HOLD PT/OT
K = 3.0-3.4 mEq/L & 5.1-6.0 mEq/L: Review chart & note cardiac workup;
Monitor vital signs; O2 90% prior to tx
Na < 125 mEq/L or > 155 mEq/L: HOLD OT/PT

Glucose

White Blood Cells

(WBCs)

LAB VALUES

Platelets

80 120 mg/dL
Some sources report
60-110 mg/dL

3,800-10,600
cells/mm3

< 70 mg/dL (hypoglycemia) or > 300 mg/dL (severe hyperglycemia):

HOLD OT/PT
No critical values

Adult female: 4,500

11,000 cells/mm3

NORMAL
RANGE
150,000 450,000
mcL

ACTIVITY LEVELS/GUIDLINES
> 50,000 mcL: Ambulation as tolerated, moderate resistance training
20,000 50,000 mcL: Ambulation and light resistance training
5,000 20,000 mcL: AROM, ambulation in room, light ADLs
< 5,000 mcL for less than 1 week: Transfers
< 5,000 mcL greater than 1 week: AROM, ambulation in room , light ADLs
-

Cardiac Markers:
Creatine
Phosphokinase (CPK)

Troponin

30 170 U/L

< 0.04

CPK-MB can be elevated after surgery or after cardiopulmonary

resuscitation especially with defibrillation

0.05 0.2: Indeterminate for myocardial damage

> 0.2 = Positive for myocardial damage
- Troponin levels peak around 12-16 hours; Typically returns to
normal within 1 wk; If a new onset increases: HOLD OT/PT

Associated with DVT:

Partial
Thromboplastin Time
(PTT)
Prothrombin Time
(PT)
International
Normalized Ratio
(INR)

22 36 sec.

Therapeutic range if on HEPARIN: 2 3x the normal range (60 109 sec.)

PTT > 200 PT/OT Discuss with MD to determine appropriate activity level
prior to tx due to increased risk of bleeding

9.5 13 sec.

Therapeutic range = 2 3x the normal range (18 30 sec.)

0.8 1.20

Therapeutic Range on standard dose oral anticoagulant = 2 3

Therapeutic range on HIGH dose oral anticoagulant = 2.5 3.5
INR > 6: PT/OT Discuss with MD to determine appropriate activity level
prior to tx due to increased risk of bleeding

Myszenski, A. (n.d.). The role of lab values in clinical decision making and patient safety for the acutely ill patient. [PowerPoint slides].
Retrieved from http://www.physicaltherapy.com/files/event/01700/01764/labvaluesslideshomyszenski4-8-13.pdf