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Discussion

Chemistries during dialysis

Hi everyone, I'm a new nurse working in sicu/micu. I been working in my unit for close to a year and have learned so much and I am still continuing to build my knowledge and skills. My question is is it forbidden or not advised to draw morning labs while the patient is undergoing dialysis? My patient had a time cardiac study that had to be done at that specific time and also had a schedule cbc and cmp so blood was collected by the phlebotomist at the same time. I got a call later that the potassium was critically low and informed the doctor who then in turn told me in a very rude way that I shouldn't be drawing labs while the patient is undergoing dialysis. I honestly never knew this. Does it really affect the lab results for everything like CFCs? Or just for cmp?

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    I'm a dialysis nurse and as I understand it it affects all labs. Some docs want labs during (say if the pt has a critically high K to see if the tx is working) but otherwise they need to be drawn pre or post.

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    In our unit the dialysis nurse would draw any labs that are scheduled during that time. That's part of the reason why we LOVE dialysis days! Whether dialysis is at the bedside in ICU or in the dialysis unit, all I do is say to the dialysis RN, "here are the lab labels" and she takes care of it.

    Our docs are very understanding and I don't think I would ever have a comment like that.

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    I don't see it as forbidden - your numbers would just be clinically worthless.

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    Dialysis only affects those things that can pass through the dialysis filter. WBC's, red blood cells, and platelets do not pass through the filter. There might be a small variation in the HCT if a large volume of water is removed during the treatment. Coags are unaffected. Accurate chemistry values would be obtained if drawn two hours after the end of a treatment.

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