Lab value making NPO detrimental

[Susie Q.]

For which (female) pt. would it be more detrimental to their health if they had to be NPO for a procedure?

Someone with a hgb of 9 (norm is 12-16), someone with a RBC of 7 million (norm 4-5.4 million), someone with a hct of 30% (norm 37-47%), or someone with a WBC of 3,000 (norm 5,000-10,000)? Any help or explanations would be much appreciated.

[PICNICRN, BSN, RN]

I'd say the low crit... worry about being too dry.

[morte, LPN, LVN]

i was thinking the elevated RBC

[geekgolightly, BSN, RN]

I'd say the low crit... worry about being too dry.

When they are dry, though, aren't the cells packed more closely together, making lab values higher?

[geekgolightly, BSN, RN]

i was thinking the elevated RBC

I think that, too, but I could be missing something. I see a low white count and then fret about cancer, but this is a short term NPO order. I really think the elevated RBC would be most worrisome for a short term NPO order.

[leslie :-D]

wouldn't the elevated rbc's be polycythemia?

anyways, and yes, elevated rbc's would be my answer.

think of that thickened, sluggish blood circulation.

wouldn't want to be npo on top of that!

yikes.

leslie

[Rabid Response]

My answer would be the patient with the low WBC. When a patient is NPO there may be transmigration of bacteria from the gut, and a patient who is immunocompromised will not be able to mount a strong immune response.

[lpn16yrs]

Elevated RBC's

[MaraG.]

With hgb it could be low d/t a bleed or rehydration (a dehydrated pt put on IV fluids) or any other issue. We have pt with low hgb NPO frequently for G&E's and other procedures. Low HCT could be over hydration. Take a look at these websites, I am sure you will be able to find the answer with some work. Good Luck!

http://www.heartpumper.com/hematocrit.htm

http://www.questdiagnostics.com/kbase/topic/medtest/hw4260/results.htm

[kanzi monkey]

wouldn't the elevated rbc's be polycythemia?

anyways, and yes, elevated rbc's would be my answer.

think of that thickened, sluggish blood circulation.

wouldn't want to be npo on top of that!

yikes.

leslie

I am going to allow my brain to be lazy and not try to think this through too much. So, at the risk of missing a totally obvious explanation, would you mind explaining why? Don't see polycythemia very often (or at all, yet) so not too familiar. Only thing I can think is that digestion increases metabolic demand, and O2 carried by slow/sluggish blood may actually be inadequate--so, NPO with some IVF could be beneficial?

Going out on a limb here, cause Leslie tends to know what she's talking about, and I'm running on 2 hours of sleep...

[Freshman RN]

npo doesn't mean no iv and what is procedure?? I would be way more concerned about bowel surgery in a pt with alow whit count than a healthy young lady have an d&c

[ElliShay]

I agree with Leslie-- the elevated RBCs make for sludgy circulation AND crowd out clotting factors-- increasing the risk of bleeding.