[Entepe]

Hi;
Does anyone know of a good website/resource to find specific laboratory values which are correlated to specific types of pathophysiology? In other words, if a patient has a diagnosis of CHF, diabetes mellitus type II, and renal insufficiency, which lab values would be crucial to look at and assess. Or, if someone has pulmonary patho. going on, which specific values would be important, and why. There's lots of info on lab values, ranges, what is happening if the values are out of range, yet I need to know what specifically to look for, why, and how these values relate to the disease process going on in a patient.???
Any assistance with resources would be greatly appreciated!!!
Thanks!
Entepe

[Daytonite]

The only site I can think of that does something like this is Lab Tests Online (http://www.labtestsonline.org/). When ever I go to one of the pages for a lab test they often list the diseases that the test is used to diagnose. I never used it the other way around though. They do have a search box on each page, so you can input a disease and do a search and links to pages on their site come up.

There is also this page on the Family Practice Notebook http://www.fpnotebook.com/LAB.htm which has lists of tests by medical specialty. If you look down at the "Related Topics from other Books" area on the page you will see a series of arrows for various medical specialties. These are drop down menus. The items in these menus are links to the diagnostic tests commonly ordered by those specialties in diagnosing and treating diseases within that division of medicine. These lists are hardly exhaustive though. If you click on one of them, you are usually taken to a page that gives you information about the test. You can always try putting a labtest into the search box on their site to see if you get a hit for it.

A couple of books that I use for reference here at my computer might be helpful to you. One I just acquired. Nurse's 5-Minute Clinical Consult: Diseases just published by Lippincott Williams & Wilkins. It has over 400 diseases listed in it. Each disease is given two pages in the book where a lot of information is listed including diagnostic tests that are commonly ordered. This book also includes nursing diagnoses, outcomes, nursing interventions and patient teaching. Another book with more extensive pathophysiology but only medical diseases is Pathophysiology: A 2-in-1 Reference for Nurses also from Lippincott Williams & Wilkins. The clinical consult book has psych and OB/GYN conditions listed in it. The 2-in-1 Reference does not.

I have other online resources for lab if you want the links, but they are not cross-referenced in the way you are wanting. If you know a patient's disease you are always going to find information about how the doctor treats it on Family Practice Notebook and in the articles on eMedicine (http://www.emedicine.com/). eMedicine articles are continuing education articles for doctors, but they often start out by presenting the incidence, pathophysiology and diagnostic tests required to diagnose the disease. You may have to register to see the articles, but it is free.

[SMK1]

Originally Posted by Entepe

Hi;
Does anyone know of a good website/resource to find specific laboratory values which are correlated to specific types of pathophysiology? In other words, if a patient has a diagnosis of CHF, diabetes mellitus type II, and renal insufficiency, which lab values would be crucial to look at and assess. Or, if someone has pulmonary patho. going on, which specific values would be important, and why. There's lots of info on lab values, ranges, what is happening if the values are out of range, yet I need to know what specifically to look for, why, and how these values relate to the disease process going on in a patient.???
Any assistance with resources would be greatly appreciated!!!
Thanks!
Entepe

Think about the patho of these disease processes and it will lead you in the right direction. CHF= stretching of the left ventricle (if it is left sided or left and right failure) so check brain natriuretic peptide (BNP) test for elevation. Renal function tests (glomerular filtration rate, Blood urea nitrogren (BUN), creatinin) and electrolytes because of decreased cardiac output with CHF that can decrease renal perfusion. CHF can cause impaired gas exchange due to fluid backing up into the lungs. Look at arterial blood gases (pH, Pa02, PC02, bicarb) if the fluid has been sitting in the lungs for days or longer they have an increased risk for infection so WBC's are important. Are neutrophils or lymphocytes high? if renal dysfunction is present RBC/hgb/hct could be low due to decreased production of RBC because the kidneys aren't releasing erythropoietin. If you have right sided heart failure there could be pressure over the liver from fluid back up. Could cause portal HTN so liver enzymes might elevate due some damage. ETC.... Know the patho and it will lead you to some basic labs.

[Entepe]

Hello and thank-you so much! I love this website! I've told quite a few of my colleagues about it, and they have been very appreciative!
SMK1, your knowledge base is amazing. I aspire to have all of that patho info ingrained in my head, so I can rattle off what you wrote without having to look in my texts! There's so much to know, that's what I love about nursing, yet that's also what I find overwhelming at times.
Daytonite-thanks so much! you're always so quick to respond and also have so much knowledge! This is so much appreciated, and admirable!
Cheers fellow nurses and have a wonderful day!
Entepe

[SMK1]

Enterpe, I am a student also (senior), so you will get there, the nurses know so much more it amazes me. Step by step we will all get there. Daytonite always has good resources.