Lab values

Question 1

When to stop treatment based on EKG?

Answer 1

unstable arrhythmia
runs of PVC
ST segment depression/elevation
chest pain
severe SOB

Question 2

indications of cardiac instability, absolute contraindications

Answer 2

decompensated CHF
runs of PVC
V fib
third degree heart block
new onset a fib
chest pain w EKG changes
pulmonary edema
unstable angina

Question 3

indications of cardiac instability, relative contraindications

Answer 3

RHR>100
HTN at rest >160/90
hypotensive at rest
MI in last 2 days without knowing troponins
a fib w HR >100
ventricular ectopic beats at rest

Question 4

ischemic causes of cardiac instability

Answer 4

ST segment changes
increasing PVCs
onset of CHF
systolic BP dropping >10
HR dropping >10
increased RPE without changes in vitals
disphoresis, cyanosis, compensation etc

Question 5

pump failure causes of cardiac instability

Answer 5

ischemic symptoms
wide pulse difference
pulmonary artery pressure changes >10
central venous pressure change of 6mmhg

Question 6

CBC: HgB

Answer 6

total red blood cell count
hold: <7, >20
caution: 8-10

Question 7

CBC: HCT

Answer 7

RBCs per 100ml blood
hold: <15-20, >60

Question 8

CBC: platelet

Answer 8

hold: <20
light exercise: 20-50
PT: 50+
monitor below 150
risk for DVT above 450

Question 9

electrolytes: Na+

Answer 9

136-143

Question 10

electrolytes: K+

Answer 10

3.8-5
<3.5 arrhythmia
>5 myocardial contraction affected

Question 11

hyperkalemia leads to

Answer 11

decreased HR
decreased contractile forces
arrhythmia
EKG changes

Question 12

hypokalemia leads to

Answer 12

EKG changes

Question 13

hypercalcemia leads to:

Answer 13

increased HR/contractility
kidneys, confusion, coma

Question 14

hypocalcemia leads to:

Answer 14

arrhythmia

Question 15

hypermagnesmia leads to

Answer 15

ca blocker, arrhythmia/cardiac arrest

Question 16

hypomagnesmia leads to

Answer 16

ventricular arrhythmias, coronary aa. vasospasm

Question 17

elevated CPK indicates

Answer 17

muscle damage

Question 18

troponins

Answer 18

indicate myocardial damage
increase 3-12 hours w symptoms, peak 24 hours, decrease over 2 weeks
should be trending down on two measures before PT started

Question 19

CRP/C reactive protein

Answer 19

marker of vascular inflammation, predict cardiovascular events
low: <1
avg: 1-3
high: 3-10

Question 20

BNP

Answer 20

b natriuretic peptide
indicator of heart failure

Question 21

ABGs

Answer 21

pH, O2, CO2 in blood
lung and cardiac function
normal: pO2>80 and O2 sat 97%, ok is 60 and 90, no exercise if SpO2 <85%

Question 22

BUN

Answer 22

protein breakdown in liver
amount of nitrogen in blood

Question 23

creatinine kinase

Answer 23

kidney function
if excess or low, kidney dysfunction

Question 24

GFR

Answer 24

glomerular filtration rate
calculation of creatinine considering age, gender, race, weight

Question 25

A therapist is treating a patient with a platelet count of 150 K/uL. The BEST course of action is to: a. Limit resistive exercises b. Continue with plan of care c. Cancel therapy

Answer 25

B

Question 26

75 yo female with a history of atrial fibrillation presents to the hospital after a fall. Lab work reveals a Hgb of 9.2 g/dL down from yesterday’s baseline of 12.3 g/dL. Her current INR is 5.1. The patient is referred for a PT evaluation. Which of the following actions is most appropriate? a. Proceed with the PT evaluation as planned b. Hold PT c. Proceed only after the patient receives packed red blood

Answer 26

C lower INR

Question 27

An ultramarathon runner presents to the ED with dehydration after an extremely long training session in the heat. Which of the following lab values would most likely be elevated? a. Hemoglobin (Hgb) b. White Blood Cells (WBC) c. Red Blood Cells (RBC) d. Platelets e. All of the above

Answer 27

E