Lowest labs?

[mcknis]

The other day i walked onto my unit to find a pt with a plat count of 11,000 without any real reason. Oh I had the lowest level in the hospital I found out after talking to the lab. And this is a med surg unit. Also walked into a K of 2.7 with only 40mEq ordered PO. What? Was it questioned or was an EKG or Mag level ordered, no. The order was recieved at 0600 by the night shift nursing staff. I had to sort it out during days...argh.

So what are the lowest labs you have seen on your pts?

[ChristineN, BSN, RN]

I recall a very impressive fingerstick blood sugar of 28. I thought it was a mistake, as the pt was fully alert and orientated sitting up talking to me. I rechecked, yep, it was real.

I also recall taking care of a young girl that had a disfunctional uterine bleed (basically a period that last continually) that had gone untreated for months. When her parents finally brought her to the ED she ended up needing admitted to the PICU for emergency transfusions as her H&H was 3/12. Ironically, mom didn't think the girl was really sick...

[ChristyRN2009]

The most off levels I've personally seen....

HCT of 5-some kind of leukemia but the lady was very weak physically and perked up after several transfusions. Her husband would not let them do any diagnostics on her. She did finally stand up for herself.

Troponin of 94. The pt had a big fat MI then a messy cath apparently, the MD wrote not to call results of troponin. UM, I called anyway. Even another doc in his group was concerned but the original MD stood by his order not to call.

BNP of 14,000+-I don't remember this patient actually, just remember the level. They must not have seemed particularly sick.

Blood glucose of 13-pt was not mine but was unresponsive, decerebate posturing. Got an amp of D50 or two and came back around. I've seen a few 30s and such where patient was still sitting up and eating, not feeling it at all. You just know they are super poorly controlled at home.

WBC of 54,000. Another leukemia. But I also had a patient with a WBC of 40+ who just had lots of infection.

[blondy2061h, MSN, RN]

Blood glucose of 13-pt was not mine but was unresponsive, decerebate posturing. Got an amp of D50 or two and came back around. I've seen a few 30s and such where patient was still sitting up and eating, not feeling it at all. You just know they are super poorly controlled at home.

Not necessarily. I've had a few ultra low glucoses personally, and it's typically from more exercise than usual or other illness. I'm not overall poorly controlled, but I did have a glucose of 18 once.

WBC of 54,000. Another leukemia. But I also had a patient with a WBC of 40+ who just had lots of infection.

Highest I've seen there was around 500,000 in a chronic leukemic.