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Discussion

lab values

Okay guys I am for some reason stumped on this. My patient was admitted with dehydration and I am suppose to pick applicable labs and so far I have picked sodium, chloride, bun, creatine , rbc, hemoglobin, and hematocrit. I defined why the beginning ones were high or low but the last 2 hemoglobin and hematocrit are low and the only thing I can think of is nutritional deficit? But she is in for dehydration, in my lab book it says it would be increased if she was dehydrated? I'm confused why they are low

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    • Featured Replies

    • Author

    Nothing in my lab book pertains to her except nutritional deficit

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    • Guides

    Are these the admitting labs or has the pt been given IVF? Are the dehydrated or hypovolemic?

    Sent from my iPhone.

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    Your lab book is right. Dehydration causes hemoconcentration and that causes increased HCT/HGB/RBC. The plasma is concentrated with RBCs and it appears higher than normal.

    What is your patients complete assessment and medical diagnoses?

    Does this patient have a hx of anemia? Is she bleeding somewhere? Any renal issues?

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    • Author

    These were admitting labs, and on admission she was diagnosed with dehydration/delusions. She is fine now, and no history of anemia and not bleeding, no renal issues, this is why I was so confused? The reason for the delusions was an adverse affect to Oxycontin, she was given narcan upon admission. Under my care she ate one bite of food, so it kind of makes sense, but I just wanted to make sure I wasn't missing the whole Dehydration aspect because I know she is but it says for those labs to be low it wouldn't be dehydration. So that's why I chose nutrition deficit.

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    • Experts

    How low is the H/H? Remember if dehydration concentrates the results when the patient is hydrated the values will drop even further. Why is the patient on Oxycodone? Has the patient had a recent surgery? Was the patient evaluated for GI issues? What is the patient assessment/history?

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    How "low" were the H&H? Labs flag a Hematocrit of 35 as low when, in reality, it's a perfectly fine hematocrit for a woman, especially a premenopausal woman. Please give us numbers and more information on the patient.

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