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Discussion

Labs

I am a new RN working in LTC. I am working with elderly population as you can see. What lab results I I should consider to be critical in order to notify MD?

Thank you!:)

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    • Featured Replies

    Labs that I have been told are important are glucose, creatnine, things like that. the actual value will vary depending on your facilities lab, they will give you the normal scale for their lab

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    WBC, RBC, Platlets, BUN, creatinine, Potassium, Magnesium, Calcium and glucose. Those are the main ones I look at for everyone. Also, when lab work is done, they will have a range next to them to help you identify when things are out of wack. There should also be some kind of notation next to the value if it is critical.

    Always, always look at the previous lab values BEFORE you call the MD though. You need to know if there was a drastic change and in what period of time. Believe me the MD will ask!

    When you know what systems are weak in which pt, you should research which lab values are effected with each process. Good luck!

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    What routine labs are taken in LTC?

    Are you routinely looking at Electrolytes? BMP/CMP?

    Diabetics need glucose...

    Chronic Renal need BUN/Creatinine...

    Liver folks need ALT/SGOT...

    Lung-ers get blood gasses...

    Those on coumadin need PT/INR...

    So any variation in critical values for the type patients you're caring for I would consider calling the MD.

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    • Experts

    Lab results come with "normal ranges" and "critical ranges" preset and noted by the labs as critical high or critical low. Both critical highs and critical lows need to be reported to the MD. Some facilities have set time limits to notify the MD and receive orders. Chemistry's........ie:Electrolytes(especially, potassium, sodium) CBC (especially Hemoglobin/hematocrit), Glucose as well as others. SOme lab values can be life threatening and need to be called immediately like High or low potassium, glucose, PT and PTT, and H&H.

    http://mghlabtest.partners.org/CriticalValues.htm MGH's critical lab book with a printable read out of critical labs

    An app store for nursing stuff

    http://www.gostudentnurse.com/nursing-apps/

    I hope this helps

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    Also, hemoglobin, hematocrit, and platelets.

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    Check your policies policies policies!!!! are facilities are different!

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    • Author

    Thank you everyone!

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    You're gonna see abnormal labs on a routine basis. Always look at previous labs for comparison as well as DXs. Knowing why a lab was obtained is also helpful, but not always clear in LTC. Progress notes can help with this.

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