L&D Labs

RochesterRN-BSN, BSN, RN · Feb 27, 2009

Its been a long time since I was an L&D nurse but-- laboring patients are at risk for bleeding-- like if there is a placental abruption or small tear. A low HCT will tell you if a patient is losing blood somewhere-- one of the causes anyways-- so that would be important to know. Glucose-- just because a patient is not diabetic does not make this lab unimportant. I would assume that high levels could be harmful to the baby. --It is not that uncommon to run standard labs on the mom-- CBC with diff, Chem panel--just to be sure all is good. They need to know that there is nothing going on that could effect the baby or the mother and then the baby....If they know about things ahead of time then can plan and treat if needed before delivery or right after in need be. This patient could have also had other medical things going on that you didn't know about --there are other things that effect BG other that the most common Diabetes. If the patient is going to have a C-section or is at high risk am a good chance there may be one needed.......its good to have Hct and what not to make sure that you prepare for a need for PRBCs --if you start with a low HCT going in then have some significant blood loss on top of that you got a problem and will likely need a transusion. good to know what you are starting with.

Someone currently in and with years of experience can maybe better answer these but I figured I give you a start.

ohmeowzer RN, RN · Feb 27, 2009

those labs are extremely important to the mother and the baby. of course you need those labs, i don't want to do your homework for you, it's very important that you know the dynamics of pregnancy and what happens to a woman's body when she is pregnant and what happens after and before labor to affect these labs.

i think if you think about it , you can figure this out. you have to know this material it's a very important part of the delivery and health of the mother and infant.

1. why would you check someone's H&H after they deliver ? What would the normal after a delivery be High or low and why ?

2. why is checking a blood sugar on the mother and baby important? what happens to the baby if the blood surgar is low, why after all that labor would a new mom have a low blood sugar?

pull out your textbook and read !! it is soo interesting !! i promise!! yess i love this stuff !!

nocturnalnurse · Feb 27, 2009

we get a CBC on all patients to check H&H (are they low to start with? where is your baseline for if they bleed, how much have they dropped from when they came in, do they need supplemental iron after deilvery, etc...) and another reason is that anesthesia always wants platelet levels before epidurals. We also need an Rh type (+ or -) for purposes of rho. injection canidates. VDRL, Hepititis, etc...are usually on file already but those with no prenatal care are also drawn additional labs. Mostly just the CBC and Rh type are drawn on all patients though.

jennfinn · Feb 27, 2009

thanks for the replies so far, I did read my Maternity Nursing book for reasons why we would be concerned about glucose levels, but every section I could find about it only discussed the rational for Gestational diabetes or if your pt had diabetes previous to pregnancy, in this case my pt had neither, perhaps the answer is that I am just trying to get a baseline reading, the problem is that I have such a limited amount of knowledge on the subject that I wouldn't know that that was what I was looking for. I don't fully understand the role of insulinase during pregnancy, but I do know that it drops off after delivery, could that have something to do with this? I know that glucose crosses the placenta and that the baby does produce its own insulin after a certain point in the pregnancy, could it have something to do with that? These may seem like stupid questions to someone who has been working as a nurse for many years, but I am having a hard time wrapping my mind around them! Thanks!

smarti15 · Feb 27, 2009

Google is my best friend! I have two lab books and when I can't find something there...I just google it. Some books are better than others so you might want to get a couple of lab books with nursing implications. I like "Davis's Comprehensive Handbook of Laboratory and Diagnostic Tests with Nursing Implications". It goes more in depth than some of the others. I hope this helps and good luck!

beckinben, CNM · Feb 27, 2009

I have never worked at a hospital or even heard of routinely checking the blood sugar of a non-diabetic mother in labor. Newborns, yes, although routinely checking their blood sugars is not recommended either, but it's still done.

The only labs I routinely order in labor are a type and hold (blood type) and a CBC without diff.