Lab work connected to which medicaiton!!

[Singlemom40]

Does anyone have a form that tells what lab work should be drawn for certain medications? I am auditing some charts and don't want to miss any.

Thank You,

Singlemom

[suzanne4, RN]

Any lab work needs a specific order by a provider unless you have standing orders in the facility for them.

Best suggestion for you is just to contact the pharmacy that your facility uses, they can give you a list of the common meds and what levels need to be checked routinely for them, or should be.

[debi49]

This is by no means an exhaustive list:

Tegretol

digoxin

lithium

dilantin

depakote

Phenobarbital.

coumadin

The purpose for checking levels is to make sure the patient has a therapeutic level in blood, and not too little or too much.

[CoffeeRTC, BSN, RN]

Don't forget the thyroid meds/ labs

What about Lytes if they are on any K+

[debi49]

or lytes and bun/Creatine for diuretics.

[sonja77]

vancomycin

gentamycin

and lately our pharmacy won't fill an order for lovenox if the pt doesn't have a current platelet count.

[debi49]

Clozaril....requires a wbc done monthly. pharmacy wont refill without this.

[MikeyJ, RN]

I am unaware of any standing orders on my floor for labs with the exception of drawing a lab after a rider has completed.

[CoffeeRTC, BSN, RN]

I take is this is LTC? I'm amazed at how many labs are missed all the time. When I was doing change over, I would try to reorder them or make sure they were on the calander.

Is this what you are trying to organize?

[Singlemom40]

Yes, I am trying to make a list of the medications and the labs related to the medication. I understand that the MD orders the lab, but in LTC is lab tends to get overlooked at times. Ex. Coumadin --> PT/PTT, Lasix --> Lytes, etc,.

Any more help would be appreciated.

Thank You,

:nurse::nurse:

[achot chavi]

This is by no means an exhaustive list:

Tegretol

digoxin

lithium

dilantin

depakote

Phenobarbital.

coumadin

The purpose for checking levels is to make sure the patient has a therapeutic level in blood, and not too little or too much.

for coumadin we just check the PT/PTT (INR)levels

we used to check Quinidine levels too but havent seen that on a pts chart in years.

BTW you can ask that your doctors be responsible for this ( ask the med director) and make a list for your head nurses to keep their heads up about it.

Twice in the last month I recommended that the doc ck the Dilantin levels on 2 pts who fell (for no reason- no sustained injury) and the doc said she just cked it but will do it again- both times the levels were very low and the doc thanked me.

Another time I noticed drastic changes in an ALF resident- confusion, inappropriate behavior, loss of continence, poor hygiene, cursing,etc. Asked for Phenobarb levels and they were sky high- turns out the pt was buying them himself and self medicating- we gave one 100mg a day and he was taking 2 more (maybe he was getting a high from it) Since then, we check his room for his stash. We found out the private doc who gave him the prescription and asked him to ck blood levels b4 giving him a private prescription again. Within a week the guy was back to normal and has been since. We still ck his room when we do housekeeping (I do it myself with 2 witnesses so no one can be accused of stealing and chart results)

[CapeCodMermaid, RN]

Your pharmacy consultant should be watching this and alert you if labs haven't been done. You can get tagged for 'unnecessary medication' if you haven't done a lab test. Why put someone on a statin if you're not checking their cholesterol??? (and LFTs too!)