Lab value placement

[Redandgraystars]

Can someone help me decide where the correct placement of these lab values belong on data collection sheets. Options are: Health promotion, Musculoskeletal, Cardiovascular, Respiratory, Urinary/reproductive, Endocrine, There are other slots but are obviously not acceptable.

Abnormal Red blood cell count 3.7g/dl --- Cardiovascular (where they reside), Urinary/reproductive (chemoreceptors determine amount made), or Musculoskeletal (where they are made).

Abnormal H/H 11.4/34.2--- Cardiovascular, Respiratory (Offloading carbon dioxide and oxygen uploading (COPD patient)), Musculoskeletal, Endocrine (Nitric oxide effect).

Abnormal BUN/Creatine 36/2.2--- Cardiovascular, Urinary/reproductive (Kidney malfunction) , Endocrine (latent diabetic effect (current glucose--97)), Gastrointestinal (Gi bleeding or high protein diet).

A1C indicated diabetic, Occult testing indicated blood in stool, (medical dx): COPD, CHF, Chronic Renal Failure, Hypothyroidism, Chronic Anemia.

The question: Is there standard placement for these values and where are they suppose to go?

[KelRN215, BSN, RN]

They belong under "lab values".

[Redandgraystars]

Haha, that would be to easy.

[KelRN215, BSN, RN]

That's honestly where I've put them on any sort of documentation I've ever done in every nursing job I've ever had. In the hospital, we did written report and labs went in the box titled "labs". If I were to put lab results in a narrative note, they'd be in the section titled "labs". If you read an MD's progress note or discharge summary, they're under "labs".

[Esme12, ASN, BSN, RN]

What do you mean??? exactly.

[Redandgraystars]

At our school we use a set of documents where we organize the patients data collected during the interview and examination into a boxed off grid.

Horizontal sections (rows) consists of Health promotion, Psycho-Social, Spiritual/Religious, Integument, Musculoskeletal, Cardiovascular, Respiratory, Urinary/Reproductive, Gastrointestinal, Neurological, and Endocrine.

Each category has two vertical sections (columns) Subjective and Objective.

The lab values or diagnostic tests must be placed in the appropriate rows and columns. IE: blood pressure, pulses, heart sounds would be placed in the objective column of the cardiovascular row, or should the patient say my back is itchy this data would be placed in the subjective column of the integument row, or if a D-dimer test comes back positive and patient is short of breath, short of breath would go into respiratory row in the subjective column and the test results would go in the respiratory row objective column (thinking Pulmonary Embolism)(if DVT then in musculoskeletal). All blood lab tests are objective but do not neatly fit into any category and can go into multiple categories.

I propose for the red blood cell count:

From the medical dx. of Chronic renal failure: the abnormal red blood cell count is a product of the kidneys inability to either sense the need for or unable to produce enough erythropoietin the test results then should be placed in Urinary/reproductive row.

From the medical dx. of Chronic Anemia: the abnormal Red blood cell count is a function of lack of iron intake or lack of iron absorption placing this in the Gastrointestinal or health promotion rows.

Occult testing revealed blood so the abnormal red blood cell count is a product of blood loss in the upper Gastrointestinal area and the Gastrointestinal row is where the lab results should be stated.

There in lies the problem, I could continue to think of other places to put this lab since everything is so interconnected. On my last set of documents, I asked the ELITIST CLINICAL NURSING GOD where to put such data, and was told to think critically and identify which role is more important.

[MendedHeart]

Cardiovascular would probably be above Urinary, one is the cause or factor and the other is effected.

[KelRN215, BSN, RN]

At our school we use a set of documents where we organize the patients data collected during the interview and examination into a boxed off grid.

Horizontal sections (rows) consists of Health promotion, Psycho-Social, Spiritual/Religious, Integument, Musculoskeletal, Cardiovascular, Respiratory, Urinary/Reproductive, Gastrointestinal, Neurological, and Endocrine.

Each category has two vertical sections (columns) Subjective and Objective.

The lab values or diagnostic tests must be placed in the appropriate rows and columns. IE: blood pressure, pulses, heart sounds would be placed in the objective column of the cardiovascular row, or should the patient say my back is itchy this data would be placed in the subjective column of the integument row, or if a D-dimer test comes back positive and patient is short of breath, short of breath would go into respiratory row in the subjective column and the test results would go in the respiratory row objective column (thinking Pulmonary Embolism)(if DVT then in musculoskeletal). All blood lab tests are objective but do not neatly fit into any category and can go into multiple categories.

I propose for the red blood cell count:

From the medical dx. of Chronic renal failure: the abnormal red blood cell count is a product of the kidneys inability to either sense the need for or unable to produce enough erythropoietin the test results then should be placed in Urinary/reproductive row.

From the medical dx. of Chronic Anemia: the abnormal Red blood cell count is a function of lack of iron intake or lack of iron absorption placing this in the Gastrointestinal or health promotion rows.

Occult testing revealed blood so the abnormal red blood cell count is a product of blood loss in the upper Gastrointestinal area and the Gastrointestinal row is where the lab results should be stated.

There in lies the problem, I could continue to think of other places to put this lab since everything is so interconnected. On my last set of documents, I asked the ELITIST CLINICAL NURSING GOD where to put such data, and was told to think critically and identify which role is more important.

Technically, erythropoietin is a hormone and since this patient's chronic anemia is likely related to his renal failure and the lack of production of erythropoietin, I'd argue these lab values belong under "endocrine". Why do you think iron deficiency has anything to do with this? Patients with chronic renal failure will have anemia regardless of the amount of iron they consume because they're deficient in erythropoietin. Is this patient on subq epogen injections? His H&H is barely abnormal anyway, it's better than mine.

[Redandgraystars]

Thanks KelRN215 I am going to run with your suggestion. Off to class we go.

[Esme12, ASN, BSN, RN]

Thanks guys....

OP thank you for explaining....I didn't get a chance to get back...I knew you would find help! We have great people who hang out here!

[Redandgraystars]

Thanks for the input this is just an FYI, According to the instructor: RBCC is always Endocrine, H/H is almost always cardiovascular, and BUN/creatine are always Urinary/reproductive.

This instruction would have been far more productive then me spending three hours thinking/researching and asking others for their input of the different places the data could go. UGH -15 points.

[nurseprnRN, BSN, RN]

Thanks for the input this is just an FYI, According to the instructor: RBCC is always Endocrine, H/H is almost always cardiovascular, and BUN/creatine are always Urinary/reproductive.

This instruction would have been far more productive then me spending three hours thinking/researching and asking others for their input of the different places the data could go. UGH -15 points.

Oh, it's not lost time. You'll never forget this, whereas I can guarantee you that a substantial number of your classmates (and maybe even yourself) would have forgotten it if it were just handed to you. You did some excellent critical thinking and practiced justifying your conclusions. You done fine.