Which of these labs should be done for all new admissions?

  1. 0 Cbc
    sma7
    pt
    hemogram
    cmp
    urinalysis
    fasting specimens
    ptt
    urine c& s
    ekg
    rhythm strip
  2. Visit  NursingBro profile page

    About NursingBro

    NursingBro has '4' year(s) of experience. From 'McAllen, Texas USA'; Joined Aug '12; Posts: 250; Likes: 107.

    18 Comments so far...

  3. Visit  SuzieVN profile page
    6
    Whichever ones are ordered?
  4. Visit  tyvin profile page
    4
    Which ever ones the doc orders...
  5. Visit  Jory profile page
    7
    I hope that isn't a real question.

    Labs should only be drawn and focused on what the patient complaint is. To do anything else is just running unnecessary labs and wasting resources.
  6. Visit  NursingBro profile page
    0
    Quote from tyvin
    Which ever ones the doc orders...
    At the place I work the LVN fills out this form for each new patient. I have to choose which labs are done for each new admission.

    EDIT: Before this job I also thought only doctors should choose what labs are done but I do not want to get in trouble and just learning as much as possible on each of these labs. We have to fill the form out for each new admission. :/
  7. Visit  SuzieVN profile page
    4
    Quote from NursingBro
    At the place I work the LVN fills out this form for each new patient. I have to choose which labs are done for each new admission.

    EDIT: Before this job I also thought only doctors should choose what labs are done but I do not want to get in trouble and just learning as much as possible on each of these labs. We have to fill the form out for each new admission. :/

    They call it 'practicing medicine without a license', which is a felony. Yes- everywhere nurses are allowed to use (unspoken/unwritten) discretion- but to determine what labs to draw on a form, without an order, is a tad risque?
  8. Visit  smartypantsnurse profile page
    1
    Weird? Well I guess it would depend on their medical diagnoses, meds, condition, etc
    loriangel14 likes this.
  9. Visit  TheCommuter profile page
    0
    Ideally, the patient's attending physician is the one who should be deciding which labs to order upon admission, which is why the nurse is expected to call the doctor and verify admission orders whenever a newly admitted patient arrives to the floor. "By the way, Doctor, which labs do you want drawn? Thanks!"

    The attending physician at the specialty hospital where I work always wants a CBC, CMP, and UA with C&S for all newly admitted patients, so we check off these labs until he actually rounds. After he rounds and lays eyes on the patient, he'll order additional labs on a physician's order sheet.
  10. Visit  NursingBro profile page
    0
    Quote from TheCommuter
    Ideally, the patient's attending physician is the one who should be deciding which labs to order upon admission, which is why the nurse is expected to call the doctor and verify admission orders whenever a newly admitted patient arrives to the floor. "By the way, Doctor, which labs do you want drawn? Thanks!"

    The attending physician at the specialty hospital where I work always wants a CBC, CMP, and UA with C&S for all newly admitted patients, so we check off these labs until he actually rounds. After he rounds and lays eyes on the patient, he'll order additional labs on a physician's order sheet.
    CBC, CMP, and UA with C&S are the same ones they want me to check for each new admission. I will leave it like this and the doctor can add more labs if he wants.
  11. Visit  jadelpn profile page
    2
    I would let the MD fill it out, period. You may or may not have the results of most of these from the ED.
    You could suggest that you have a standing order for admission testing that includes which ever labs an MD wants.
    Something to speak to your NM about.
    Be careful about pre-filling out orders. It could bite you in the butt.
    GrnTea and SoldierNurse22 like this.
  12. Visit  Esme12 profile page
    2
    Depending on your facility......these can be considered "standing orders". Nurses do this all the time in the ER in Triage. I am not sure what your state allows for LPN's and admissions/initial assessment and what the requirement is......so would check with your facility policy and nurse practice act. What kind of facility is this? I would ask your manager/charge nurse what is the standard protocol for these admission for this MD.

    LABS should be individualized on assessment/history of the patient, on a patient to patient basis. I would be sure your state allows LPN's to do thisand I would request the policy that dictates how this policy is to be followed and by whom.

    CBC: Common admit lab if differential needed
    sma7: common admit lab
    PT: order if patient is on anti-coagulants
    hemogram: short version of CBC, less expensive, H&H without the Differential
    CMP: Comprehensive Metabolic profile.....extended version of SMA
    urinalysis: routine admission order
    fasting specimens: What fasting specimens are performed?
    PTT: again order if patient is on any anti-coagulants.
    urine c& s: many facilities do these these days to document whether or not a patient is admitted with UTI
    EKG: Clinically done on patients with cardiac history....MI, CABG, Pacemakers, Angina etc.
    rhythm strip: a peek at a patients rhythm if cardiac issues present.
    SoldierNurse22 and BSNbeDONE like this.
  13. Visit  mmc51264 profile page
    1
    We had standing orders for labs AFTER MD saw them. Usually BMP, CBC w/diff, PT/INR if on coumadin and u/a w/ c&s.
    BSNbeDONE likes this.
  14. Visit  KelRN215 profile page
    2
    Quote from Jory
    I hope that isn't a real question.

    Labs should only be drawn and focused on what the patient complaint is. To do anything else is just running unnecessary labs and wasting resources.
    I agree. When I worked in the hospital our clinical nurse specialist and nurse practitioner would go nuts about rotating residents who came over from the adult hospital and wanted to order "routine labs" on everyone who was admitted.

    In answer to the OP, I would say "none of the above." You do labs based on MD orders and the patient's condition, not just because they present to a facility.


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