lab results

[coletanner]

I'm new here guys. I recently been working as a rehab nurse for about 5 months. I'm really worried now. Today just when shift about to end I saw a new lab result pop up on my patient access list. It was a critical lab value of 6.1 for potassium. This was the first time that I have this patient. I was freaked out! I told my charge nurse and nurse manager as well. They were totally surprise and didn't even know the lab came. They told me lab always call for critical lab values or fax over the results. They didn't received those labs through the fax machine or saw them posted to the patients charts yesterday so they didn't know about it to call the doctor. The thing was that this lab value stated that it was posted on 6/28/15 at 0000. However, the results just came up around 0530 on 6/29/2015.

I already gave the potassium 20 mEq as well as another nurse during the morning shift. I pretty sure to triple check the lab values before giving the medications and at that time around 2050 on 06/28/2015 there were no lab values for electrolytes such as sodium, and potassium. Now I find out after shift that they are ordering a stab lab to probably check out the patient potassium level. I just don't want any harm to my patient. I don't know why that lab result just pop up on the following day, but listed it for the previous day. They probably think I was careless of either not checking electrolytes labs before giving the medication or know the results but gave it anyway. I'm really freaking out.

[TheCommuter, BSN, RN]

Okay.....what action was taken?

Typically, with a serum potassium level of 6.1, we'd call the attending physician or internal medicine doctor and simply obtain orders for Kayexelate and a recheck of the K+ level once the patient has had a bowel movement.

Ensure the blood specimen wasn't coagulated, because coagulated blood may leak more potassium than usual, resulting in an artificial rise in the K+ lab result Several years ago a coworker reported a K+ level of 6.8 to the doctor, but she failed to mention the words 'COAGULATED' at the top of the lab report. The physician was scratching his head for several days wondering why the patient's K+ spiked from 3.9 to 6.8 overnight.

In addition, some patients can tolerate higher potassium levels without ill effects, namely those with longstanding renal impairment. Their bodies are more acclimated to a higher serum potassium than yours or mine, so they aren't always going to drop dead of a cardiac event because of it.

Good luck to you!