I'm embarrassed to admit this.... - page 2

but i really suck at interpreting LAB WORK. I really believe I must've been out sick when this class was discussed at school. I know my K levels, WBC's and H&H's... but with the others-- I'm... Read More

  1. by   cbs3143
    HeartRNJenn,

    You are absolutely correct about the BNP being indicative of CHF and not PE. I skipped right over it. Just one more reason to always double check your source.

    Chuck
  2. by   liberalrn
    I've found that lab values w/o a context are meaningless to me...
    I try to ask about the disease process w/ the docs to fully understand the labs...Funny story. Came on one AM, night nurse (very picayune, always telling other nurses how they could have done it better), says to me: I've admitted your pt and he's a +MI, no medical hx, never seen a doc in 10 yrs...yadayada...and I sent the stat PSA the doc ordered. I was more concerned w/ other matters and did not question her. MD comes in about 45 minutes later and asks, "Where is x's phosphate level?". Look in computer--no result, no test ordered! We figure it out......he said phosphate, she heard prostate!

    Well, it was funny at the time.
  3. by   Sleepyeyes
    http://www.baptisteast.com/news/default.asp?titles=2&item_id=1419

    The B-type natriuretic peptide (BNP) test, recently approved by the federal FDA, measures the level of BNP, a cardiac hormone produced when ventricles of the heart expand and overload. BNP levels increase as the level of heart failure increases. The BNP test can not only help diagnose the level of heart failure, but can also be used to determine if a patient has CHF.


    It can be confusing when a patient who may have congestive heart failure comes to the hospital with symptoms which are similar to other diseases. The BNP test is a tool to evaluate what's going on with the patient, explained Debbie Perdue, Cardiovascular and Respiratory director.


    The BNP test kit comes in a sealed pouch. A blood sample is taken from a patient and then inserted into a fluorescent immunoassay that measures the BNP level. The BNP level of a heart failure patient may be as much as 25 times higher than in people without heart failure.


    A recent study indicated a BNP level of less than 50 pg/ml is 99.7 percent accurate in ruling out CHF. BNP levels may also help differentiate end-stage renal patients with CHF from those without CHF.


    The BNP test also helps determine if congestive heart failure patients are responding to drug therapy.


    Thanks Jen and Chuck.... I'm learning.... :imbar:
  4. by   ageless
    Another tip is to look at lab values as a progression...
    To determine the weight to place on the number, be sure to look at the norms for the specific patient or disease process. For example, one would not call the physician for a high BUN/Creat level in a chronic dialysis patient. Abnormal in this patient are the norm..(don't laugh, I have heard many a physician screaming over this am call)
    Another example is if the iron level is low be sure to look at the TIBC.
    Also, a decreased albumin level can significantly change the laboratory values for bilirubin and calcium. If the albumin is low, then these lab-values will be falsely low, and then be mathematically adjusted (upward) to get the real value.

    Most lab values must be viewed as a group..individually they are worthless information
  5. by   EmeraldNYL
    I have RN Labs for my PDA (from Skyscape), it comes in very handy.
  6. by   beckymcrn
    I agree with the others who say learn what you need to know for your area. I am a cancer nurse so I know a few cancer makers for the ones I deal with and I know a CBCD. I know a few components on the chem panel but could not completely decifer it.

    As long as you know what you need to know for your area you will be fine. (Looking at the little lab notes help when they tell you if it is not normal)

  7. by   Sleepyeyes
    Ageless, I think that's my problem. If I can't relate information, I have a heckuva time remembering it.

    and Nikki *sigh* can't afford a PDA; just bought a truck.

    see thread: http://allnurses.com/forums/showthre...threadid=30976
  8. by   Agnus
    I'm with Heather, and also with those who say if it is one not done in your area don't worry about it you have enough you have to know just to do your job.
  9. by   ageless
    Originally posted by Agnus
    I'm with Heather, and also with those who say if it is one not done in your area don't worry about it you have enough you have to know just to do your job.
    I agree with the others who say learn what you need to know for your area. I am a cancer nurse so I know a few cancer makers for the ones I deal with and I know a CBCD. I know a few components on the chem panel but could not completely decifer it.



    I am confused by this. What exactly do you mean..if it's not in your area?.... a chemistry panel is everyone's area...
  10. by   Tweety
    Don't feel bad. You know what I suck at royally? That's ABG interpretation. Now that I'm off neuro and back in medical, I'm seeing more respiratory patients and realize how horrible I am at ABG's. I last took a 2-hour CEU in it about six years ago.

    Don't feel bad.
  11. by   Sleepyeyes
    Originally posted by 3rdShiftGuy
    Don't feel bad. You know what I suck at royally? That's ABG interpretation. Now that I'm off neuro and back in medical, I'm seeing more respiratory patients and realize how horrible I am at ABG's. I last took a 2-hour CEU in it about six years ago.

    Don't feel bad.
    I think that's a case of "use it or lose it" because i really had those together in school, and just a couple weeks ago, had to bug the RT to give me a 30 second refresher course.

    Thankfully, they were only too happy to share.

    --and BTW, 3rdshift, I kinda worry about assessing neuro status on 11-7 shift (we're a stroke unit too) because, well, how do you really see a subtle change in neuro status when someone's groggy from sleep?
  12. by   MelRN13
    I had an instructor who had an excellent handout on ABG's. If you would like it, PM me, and I will try to find it and scan it for anyone who would like to use it for a refresher.
  13. by   Tweety
    Originally posted by Sleepyeyes

    --and BTW, 3rdshift, I kinda worry about assessing neuro status on 11-7 shift (we're a stroke unit too) because, well, how do you really see a subtle change in neuro status when someone's groggy from sleep?
    Yep, neuro can be worrisome. A couple of times, the MD has come in the morning to assess a patient and found changes, making the nurse look real bad on 11-7. We usually did assessments at midnight and 4AM on the floor, and q2h in intermediate. But those subtle changes are tough.

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