I'm embarrassed to admit this....

duckie · Feb 11, 2003

There are many great reference books available for this, I know cause I am not the best either. Don't fret, just find a good book to help you out. Also, most labs provide their own book so you can look up that info if you work for a place that brings a lab in to do their work. Good luck. Duckie

Sleepyeyes · Feb 11, 2003

Thanks Duckie... i have a couple of lab books but, I dunno, I seem to remember little bits of info easiest, especially if it has a mnemonic to help me along, like:

High BNP? could be a PE

or

+ troponin = + MI

Low Hgb = GI bleed / PRBC's

OBNURSEHEATHER · Feb 11, 2003

You want to know my lazy trick?

When a lab report comes up, it will show a little up or down arrow, indicating whether it's high or low. :chuckle

Seriously, I know my common labs, but I am stumped with the stuff we hardly ever see.

And every hospital, nursing school, and lab consideres different reference ranges to be normal. I let the lab do the hard work.

Heather

Liann · Feb 11, 2003

Lots of folks have little sheets of the common lab values laminated on a card or typed up and stuck to the back of a little notebook or clipboard. If you use it a lot, soon the obvious values will become easy to recognize. Our lab calls with any panic values, which are results that are higher or lower than the usual ranges. I think that each person needs to keep a handy reference of whatever they need to refer to in a hurry. Saves time.

New CCU RN · Feb 11, 2003

I would try and focus on the labs that are most important to your patient population

ie) we are real anal bout K and Mg H/H in the cardiac population, etc...

I don't know where you work, but focusing in on the biggies.....ought to help ya!

Good luck.

Liann · Feb 11, 2003

Also, relying on short mnemonics can be misleading. A low hgb is not always indicative of a GI bleed. We were taught in our school of Medical Technology to look at the entire picture of lab values to get an idea of whats going on with a patient.

RN2B2005 · Feb 11, 2003

I bought a clipboard from Nurses' Station that has all kinds of useful info on it, including reference range values for labs. Heather is right, though--the lab sheet will always have the reference range used by the lab--it's the figuring out what to do with the knowledge that is important.

Barnes & Noble sells laminated pocket lab value reference cards and pocket reference books. I don't have one for nursing school yet but I do have one that I used when I worked as a veterinary technician, and I used it very frequently. It has symptoms and dx cross-references with sample lab values.

hoolahan, ASN, RN · Feb 11, 2003

Are you talking about ranges or implications of said high or low lab?? I also just look at the lab ranges, esp b/c there may be very slight variations of what is normal from lab to lab or hosp to hosp.

To remember implications, that is just something you attach to a certain pt memory. Shoot, I still can't get it straight what an ESR is done for, and I look it up every time! I don't think I have ever seen one elevated, so it had no meaning for me. Is there a ref book on your unit? Or do you work w residents? Can you ask them? Otherwise I just write stuff down on my little report sheet and look it up when I go home, then try to look back on that pt and see if I can make a lasting link in my mind. Not talking about critical stuff which I would report asap, but things I want to remember to look up. I used to bring my little ref books w me, once I weighed my backpack...8kg worth of those little ref books!!

Sleepyeyes · Feb 11, 2003

Thanks, all, I appreciate the info and the tips!

nursecheryl · Feb 11, 2003

Sleepy eyes use the internet to get this information. Do a search for interpretation of lab test profiles and you'll have your choice of which one to use as your resource. If you have a problem with going on line for your research than get a good reference book. Please let me know what you came up with on your search. If I need any reference material I'll either go on line or open any one of my multiple reference materials I already have in my office library.

cbs3143 · Feb 11, 2003

I agree with Heather that each lab has their own specific values. They will be in the ballpark with other lab facilities, but won't be the same as some other labs. Be mindful of the fact that normal values in infants and children are frequently different from adult normals. As Heather mentioned, look at the report to see what is normal, especially if the report indicates a critical variation from normal. Then promptly notify the physician if something is wrong.

You will never be able to learn the normals and clinical implications of every lab value, but you should get to know the labs specific to your specialty. You should understand the basic lab tests such as CBC, chemical profile (whatever your facility calls it), and urinalysis. Purchase or make your own cheat sheet. Remember too, as Liann mentioned, you can't use a mnemonic to diagnose a condition. A low HGB may be caused by a GI bleed, but not always. The ESR is a nonspecific test. It can be elevated in a number of disease processes. The way that the ESR was explained to me was that it shows how hot the fire is. In other words, how intense is that disease process at the time the ESR was run..

It's not our job to diagnose, but we still need to understand what's going on. Good luck with your study of lab results and their clinical implications, but remember, you won't learn it all so don't get discouraged, and keep a reference handy.

Chuck