Lab Skeletons/ "fishbone"

Nurses General Nursing

Updated:   Published

I think we need some clarification here and I've found that an internet search produces mixed/unreliable results.

I'm talking about how we do lab notations. I've seen what I thought were basic lab skeletons done in ways that I thought was all wrong only to find that it seems to be a regional thing. Do you think that's true? I've also heard nurses say, "it's all Greek to me" which further underscores our need to get this information out there.

I say let's pool our "fishbones" and see what's different and what we have in common.

I'm not quite sure about my skeleton for LFT's.. that I've seen the most variation with and I think it needs a spot for albumin so I'm not happy. I'd like to see a skeleton for ABG's too as I don't have a standard.

No, I am not a 5 year old.

Specializes in CVICU, CCU, Heart Transplant.

I work in the ICU and write down the standard chemistry & hematology fishscales on my flow sheet with every patient. You can quickly access lab values when you need them! I make sure every nursing student knows them by the end of the day! Here is the other common ones.

fishscales.gif.221f4c6a38300c0097ec01acda82b324.gif

There are other threads on this topic that might be helpful -- or may just muddy the water more.

https://allnurses.com/lab-values-worksheet-t89608/

https://allnurses.com/fish-scales-t162234/

I also have not seen a consistent pattern for using the fishbone grids for organizing lab values. I guess choose one and stick with it (and make sure your school or facility don't have a preset grid layout that they want you to use).

Ah, thank you. Etiquette boo-boo

Vespertinas said:
Ah, thank you. Etiquette boo-boo

No worries on my part. I just happen to be looking for discussions on the topic and came across this thread after those other two, LOL.

fishbone-from-pdf.jpg.07283aff313566b0d9f6d4da62f9690e.jpg

Here are the fishbone images from the PDF referenced in the other thread. Note: in the "short" fishbone (middle row of this set) sometimes the bottom middle is CO2 sometimes bicarbonate, which as you know, are related to each other)

For ABG, I really like usingĀ 

Screen Shot 2021-03-07 at 7.37.52 AM.png
Specializes in Community Health, Med/Surg, ICU Stepdown.
On 1/13/2012 at 11:08 AM, StayLost said:

I work in the ICU and write down the standard Chemistry & hematology fishscales on my flow sheet with every patient. You can quickly access lab values when you need them! I make sure every nursing student knows them by the end of the day! Here is the other common ones.

fishscales.gif.221f4c6a38300c0097ec01acda82b324.gif

Love it!! Do you put potassium too? Wish I had thought of this when I worked in Stepdown instead of just writing all the labs in a list form LOL

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