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The Role of Lab Values in Clinical Decision Making and Patient Safety for the Acutely Ill Patient

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1.  Lab Values and Vitals Signs are an essential part of your chart review and intervention because: Lab tests are one factor in determining the overall health of our patients Abnormal resting vital signs may also be an indicator for modifying or deferring intervention on a given day As critical values might evolve quickly in the acute care setting, frequent reassessment is required for safe and effective patient management All of the above

2.  When monitoring vitals signs, which of the following changes indicates that treatment should be terminated: Increase in patient's heart rate by 30 bpm A change in the patient's systolic blood pressure of 30 mmHg A change in the diastolic blood pressure of 10 mmHg Dizziness not resolved within 60 seconds of obtaining upright All of the above are indications that treatment should be terminated

3.  According to HFH guidelines, what Hemoglobin range would indicate no OT or PT to be completed that day? Less than 7.0 gm/dL 7.1-7.9 gm/dL 8.0-10.0 gm/dL Greater than 8.0 gm/dL

4.  For a patient receiving a blood transfusion, PT and OT should be deferred for the first ______ minutes of each bag of blood: 15 30 45 60

5.  What is the Merck manual normal value for potassium? 2.0 - 3.4 mEq/L 3.5 - 5.0 mEq/L 4.5 - 7.5 mEq/L 5.0 - 8.0 mEq/L

6.  Critical values for sodium in which PT and OT should monitor cognition and vitals closely are less than 130 or greater than 155 mEq/L. Which of the following answers are true? Maintains cell membrane potential; acid-base balance Promotes neuromuscular, renal and adrenal functions Values show hydration state of patient The brain is most susceptible to changes in sodium All of the above

7.  Hypoglycemia ____________________________. Is usually defines as having a glucose level of less than 70 mg/dL May cause confusion or delirium May cause seizures or blurred/impaired vision All of the above

8.  Mrs. B has leukemia and has come to the hospital with low platelet counts. Currently her platelets are 19,000. Based on APTA AACPT lab values resource, it would be indicated to do which of the following: No therapeutic exercise/hold therapy Symptom based approach to appropriateness of activity Fall risk awareness secondary to risk for spontaneous hemorrhage Both B and C

9.  All of the following are conditions commonly associated with cardiac troponin elevation in absence of Acute Myocardial Infarction EXCEPT: Myocarditis Peripheral vascular disease Renal failure Stroke or subarachnoid hemorrhage

10.  Mr. Smith has been diagnosed with an acute DVT, which of the following reasons would indicate he can be mobilized by PT and OT at this time: An IVC filter was placed this morning He has been started on a Heparin drip and his PTT is>200 He will receive his first dose of Lovenox within the next hour He has no complaints of pain