By Tiffany Lai October 4, 2024
When I was trying to break into acute care, I remember having the impression that knowing lab values was the most significant difference between working in a SNF vs a hospital, which was an oversimplification of the truth.
The important things to learn as a new acute care therapist is the role of the staff at the hospital and your role, how to spot red flags in the chart and in person that a patient is not stable to be seen by therapy, and the procedures that the hospital has at it’s disposal to rectify issues. Knowing lab values helps with one aspect, which is with your chart review.
Most therapists don’t memorize the chart of lab values. Hospital charting programs will actually flag abnormal values for you. What does happen is that, with experience you will start to recognize what lab values are important to check for what diagnoses and will start to remember the lower or upper limits naturally.
(To start, it may be helpful to memorize the most commonly checked lab values: hemoglobin and hematocrit.)
As a new therapist to acute care, it may be more helpful to know how abnormal labs may impact your therapy session rather than memorizing numbers. Here is a very generalized summary:
Cardiac patients
- Troponin (trend is biggest factor) - increasing levels may indicate unresolved heart issues
- Potassium levels - abnormal levels are at increased risk of arrhythmias
Cancer patients
- Low platelets - higher risk of bleeding. In your heme onc population, it give you an idea of whether they are getting better with treatment
- Low WBC/ANC - neutropenic precautions, risk of infection
Ortho patients, surgical patients, GI bleed. Almost everyone…
- Low hgb/hematocrit - orthostatic hypotension, dizziness
AMS patients
- Low sodium - impaired cognition, orthostatic hypotension
- High sodium - impaired cognition
- Low calcium - impaired cognition
- Low phosphate - impaired cognition
Neuro patients
- Check BP parameters given by the doctor
For a more indepth look at lab values, here is a fantastic resource.