I'm having a hard time figuring out what my patients lab may indicate. This semester we are expected to explain if abnormal labs are a sign of worsening, improving, or stable conditions. This is the first time i have been on a cardiac unit and so I'm finding it very difficult to explain what my patients labs mean. I have looked in the lab book that I have and searched online trying to understand the significance of some of the lab results i recorded, but I'm just not sure if I'm right about some of my conclusions. SO my patient had a somewhat low H&H and RBC, and high PTT and troponin, also low potassium and high cholesterol. I know what the results mean I just don't know what's causing them to be increased/decreased. My patient was there due to a NSTEMI, was taking lipitor, lopressor, aspirin, tylenol, nitroglycerin patch, had a heparin drip at 25ml/hr with NS running as well. He was scheduled for a coronary angiography. This is pretty much the only information I could find about my patient other than the fact that he had a headache, but was no longer having any chest pain. He had been there for two days when I took care of him. His VS were all normal. I really want to understand this and would appreciate if someone could help me a little.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Thank you all! The aspirin can cause anemia in some patients so that could be contributing to the low h&h as well. But I'm not sure what you're getting at with the potassium.
Hypokalemia can result from two general causes: either from an overall depletion in the body's potassium or from excessive uptake of potassium by muscle from surrounding fluids...
AND....Stress/surgery on the body will decrease Mg+ and K+ reserves in the body. Is this patient a drinker? You are right about the aspirin
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Ok at first I had #1 decreased cardiac output, #2 impaired skin integrity (because of the angiography) an #3 acute Pain (because the angina). But now I'm thinking #2 should be altered tissue perfusion rt atherosclerotic processes (because of the high cholesterol) and #3 risk for bleeding (because he is on heparin). Does that sound like a better care plan to follow? I mean those are the most important issues to make interventions for especially since this patient wasn't in pain anymore on the day I cared for him. And I feel like the interventions for impaired skin integrity could go under risk for bleeding, because they're mainly about making sure the site doesn't bleed and caring for it.
#2 is pretty good you know there ahs been a disturbace to perfusion he had a heart attack.
I KNOW I have explained this to you before......your care plan is based on what the patient NEEDS! What are his complaints? What is your ASSESSMENT.....of the PATIENT! Not a list of his medical diagnosis......What actual evidence that the patient has a decreased cardiac output? Is this patient complaining of chest pain? Had the patient already have the procedure...what was your assessment of HIM .....the patient?
This patient had no complaints except for a headache and had no abnormal assessment data except for the labs. I think the interventions for he ones I mentioned are more important than impaired skin integrity and pain. Most of the things I did for him were related to those. The only thing about it is my instructors don't want me to put the top 3 in the same column. I disagree with that, but ill just make them happy I guess. Thank you for the help once again.
13.3 is a pretty good hemoglobin, IMO. MY hemoglobin isn't even that high. I work in oncology where anything > 7 is considered good. Same with the potassium. 3.7 is WNL (normal range is broadly considered to be 3.5-5 mEq/L) though cardiac floors sometimes like it to be closer to 4. I doubt that this patient would be symptomatic of anything with a K+ level of 3.7. My K+ was 3.1 before my doctor even put me on supplements.
Sounds like this pt may have not changed his lifestyle after last CABG?
That is a bit presumptive...I have seen pt's who change their lifestyle after an event (events?) and still have more cardiac issues. Perhaps there is a genetic issue causing the elevated cholesterol issues.
Also, since you (the OP) brought it up again, what do you think is causing the pt's headache?
That is a bit presumptive...I have seen pt's who change their lifestyle after an event (events?) and still have more cardiac issues. Perhaps there is a genetic issue causing the elevated cholesterol issues.
Also, since you (the OP) brought it up again, what do you think is causing the pt's headache?
Actually, it was.a question, not a statement. Dont you see the question mark. I think its you who is presumptive.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Actually, it was.a question, not a statement. Don't you see the question mark. I think its you who is presumptive.
Nitro=headache
I think psu_213 knows why the patient has a headache....the question is did the OP use her critical thinking skills after looking up this patients meds to discover the side effects of Nitro and apply it to this patient ans this patients plan of care.?
Esme12, ASN, BSN, RN
20,908 Posts
AND....Stress/surgery on the body will decrease Mg+ and K+ reserves in the body. Is this patient a drinker? You are right about the aspirin