Question on lab. Test

Nurses General Nursing

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A Person has been complaining of feeling tired, having no energy and seems to be putting on weight steadily. Doctor orders lab work for TSH, WBC, Hemoglobin, and lytes. He also orders an in and out catheter for a urine sample.

I understand that Dr. Order TSH lab test as patient is putting on wt. and it could be because of increased secretion of TSH, hemoglobin test for tiredness but why he ordered WBC, lytes and urine test

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Specializes in Cardiac Telemetry, ED.

If you are a nurse, you should know this.

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Maybe he's checking for bacterial infection or something. Maybe he's checking cortisol too. I like to go to this site called labtestsonline. It's extremely helpful.

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Use your critical thinking, what disease processes can cause tiredness, no energy, and/or weight gain. Could something like lupus cause that and be shown from a WBC differential? BUT! you know who would have the best answer, the doc. "Hey Dr. So-So, I'm curious about what you're thinking for this pt. Could you explain to me what you're looking for? I can only think of this-that-or the other."

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A Person has been complaining of feeling tired, having no energy and seems to be putting on weight steadily. Doctor orders lab work for TSH, WBC, Hemoglobin, and lytes. He also orders an in and out catheter for a urine sample.

I understand that Dr. Order TSH lab test as patient is putting on wt. and it could be because of increased secretion of TSH, hemoglobin test for tiredness but why he ordered WBC, lytes and urine test

Lytes...explains weight gain. High Na=High fluid retention hence wieght gain.

WBC=To check immune status. Immunosuppression may lead to fatigue. Viral/Bacterial disease may lead to fatigue.

Urine test to check kidney function r/o acute renal failure and to r/o infection.

My 2 cents.

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Use your critical thinking, what disease processes can cause tiredness, no energy, and/or weight gain. Could something like lupus cause that and be shown from a WBC differential? BUT! you know who would have the best answer, the doc. "Hey Dr. So-So, I'm curious about what you're thinking for this pt. Could you explain to me what you're looking for? I can only think of this-that-or the other."

Not necessarily. Being tired, no energy and weight gain could easily signal the person is consuming too much junk food, have high blood pressure, elevated cardio crp and a host of other things related to diet and exercise. The person is probably too sedentary and needs to change their diet. That usually helps. If the doc suspected Lupus he may have ordere other tests, don't you think?

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If you are a nurse, you should know this.

That was not my question

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If you are a nurse, you should know this.

FYI questions are posted on forums when people have some doubt. Everyone knows the answer but sugestions from other members help to broaden your thoughts. It is sad to see experienced people like you post these comments and make other people feel bad rather than helping them.

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Thanks all for your help:)

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Specializes in Hemodialysis.

yeah... you're right! that's why allnurses.com was greated to help nurses. We do our job hand in hand by sharing our thoughts so that means what is confusing to the other may compensate by the other by sharing his/her knowledge. We don't do this by keeping what we already know. Life is a continuous learning, so even though you're already working as an RN for 25 years you don't stop learning new things. I hope this make sense to all the professional nurses out there. Believe in what Elen Degeneres said: "Personality opens the opportunity, but only character can keep it open" Have a nice day people... :)

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Specializes in Hemodialysis.
Lytes...explains weight gain. High Na=High fluid retention hence wieght gain.

WBC=To check immune status. Immunosuppression may lead to fatigue. Viral/Bacterial disease may lead to fatigue.

Urine test to check kidney function r/o acute renal failure and to r/o infection.

My 2 cents.

nice one...

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It sounds like a good general workup which is needed for those things that don't have an obvious answer as a starting point and an inexpensive workup to check what the doctor might already suspect.

I know it might seem redundant for a nurse to ask questions that you would think they would know. From what I've seen many here are pre-nursing, LPN, RN, PA/NP, etc. We are all at different skill levels. Also, I'm not sure if this happens to anyone else but when it comes to my family or myself I am the stupidest RN in the world. It's like I forget everything I know or have learned. :uhoh3:

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