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Fish Scales

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by Pachinko Pachinko (Member)

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That's what they call them here, at least--the little grids that you can use to do shorthand recording of lab values. One (I think) looks like a big x, and the other is longer, with hash marks.

OK, I'm doing a crappy idea of describing this, but someone more knowledgeable will know what I'm talking about. Anyone know where I can find an example of one so I know how they're used. I googled "fishscale" and "fish scale" with "labs" and came up with nothing. Thanks--

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Daytonite has 40 years experience as a BSN, RN and specializes in med/surg, telemetry, IV therapy, mgmt.

2 Followers; 4 Articles; 100,733 Visitors; 14,602 Posts

Are you talking about the little grid that the doctors make when they are documenting electrolytes in their progress notes? Are you wanting to know what goes into each of the little boxes of that grid?

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Daytonite has 40 years experience as a BSN, RN and specializes in med/surg, telemetry, IV therapy, mgmt.

2 Followers; 4 Articles; 100,733 Visitors; 14,602 Posts

i thought that might be what the op was referring to. yours is a much better example of what i found on this webpage:

http://www.phoenix.tc-ieee.org/000_background/meeting%20notes/phoenix_meeting_2006-09-10.html - position coded electrolytes. halfway down the page the physician shorthand for the chem 7 (probably the fishscale you are referring to) and the cbc are shown as best possible with the software program.

basically, the structure and contents of the grid is this (hard to create the look on this software program):

sodium |chloride|** bun**/

----------------------------glucose

potassium|bicarb|creatinine\

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7,777 Visitors; 289 Posts

Yes, the grids the doctors use--both of these are useful, thanks so much!

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1 Article; 32,411 Visitors; 5,758 Posts

One thing you can say about nursing is you learn something new everyday even if you live to be 100. All those years I have been looking at those things(40), never heard them called fish scales before. Interesting....

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elcue has 31 years experience and specializes in OR, transplants,GYN oncology.

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One thing you can say about nursing is you learn something new everyday even if you live to be 100. All those years I have been looking at those things(40), never heard them called fish scales before. Interesting....

Me too! Thanks. Have a good week, everyone. Linda

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Actually, the grid or template is called a fish bone (not a fish scale). That is because the BMP (basic metabolic panel) grid looks like a fish bone:

 

 

 

Na+|Cl-|BUN

---|---|----

K+ |CO2|Creat

 

 

Notice how the template looks like a fish bone skeleton:

 

--|--|--

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On this thread, someone said CO2 goes in the middle bottom cell, and someone else said bicarb. Which is it???

Thanks.

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Template usage is inconsistent. Below are links to variations I have found. Also attached below is a PDF file that includes fishbone templates/grids for labs. You should pick one you like and use it consistently for your own use. If there is a standard at your place of employment, you should (obviously) conform.

http://en.wikipedia.org/wiki/Complete_blood_count

http://en.wikipedia.org/wiki/File:CBC_with_Hct.jpg

http://en.wikipedia.org/wiki/Basic_metabolic_panel (Grid is half-way down the page under "Reporting")

https://allnurses.com/general-nursing-discussion/format-handwritten-lab-248493.html

Lab grids templates.pdf

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On this thread, someone said CO2 goes in the middle bottom cell, and someone else said bicarb. Which is it???

Thanks.

CO2 and bicarb are interchangable. CO2 does not travel in the blood as a gas, but gets changed into bicarb in the tissues and then back to CO2 in the lungs by a reaction with H2O and the enzyme carbonic anhydrase. So when they say CO2 they are actually measuring bicarb, but the bicarb level represents the level of CO2 in the blood. So basically its 2 ways if referring to the same thing.

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I made up my own version of the "fishbones" with blank templates as well as a "key" with the labels filled in.

Awesome! Thank you so much!

Edited by Esme12
TOS/advetisement

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