When I was in nursing school my profs always focused on us memorizing lab values. Which I always thought was silly because all lab reports list the normal range. Anyway, It would have been helpful if they spent more time on helping us interpreting the lab values.
So in my new role as Charge nurse in LTC the Supv always drops off the labs to me at the start of shift. It is then up to me to interpret them and figure out what can wait, what needs to be addressed ASAP. ANd I struggle with that.
Anyone know of a resource (book, website) that focuses on this in simple terms?
i.e. BUN is elevated so you should push fluids and check the creatiine. That sort of thing.
It's not up to you to interpret the results of the labs. It is your responsibility to report ABNORMAL lab values the the NP or MD. Unless you have specific parameters from each doc on how abnormal something needs to be, you're better off reporting any abnormal.
Does you lab call you with values that are critical? If not, they should, and you should make it a priority to call the doc on those.
You'll get to learn what lab values mean.
I agree with this. There is a limit to the amount of interpreting you should be doing. Another thing that is important is to know why the labs were ordered. What diseases does the patient have, what would be the expected values and what is going on with the patient that these particular labs were ordered.
You do need to have an actual conversation with the doc about critical and stat labs, as well as PT/INRs, which is so much fun at 3:00 in the morning. Most abnormal lab results can be called in to the messaging system during the business day if you know that they will be getting those messages and calling you back that same day.
Just keep in mind that if they don't call you back you may have to follow up with an actual conversation with the doc that day. A lab with all normal results also needs to be reported, but you can just leave a message for that.
A positive UA, or an abnormal X-ray or ultra sound needs an actual converation because that's the kind of thing that you will need tx orders for, and the sooner the better.
You will eventaully learn that the doc ordered a certain lab because they want to know a specific type of information about the patient's disease process. Usually if the abnormals are not completely out of range into critical those calls can wait until business hours. It takes practice to figure out what's important.
It's also important to compare current lab values with earlier ones so that you get a feel for the patient's baseline. I learned that not everyone is normal so it's important as someone else said to know what is a really big difference that may need called. Also lab values that have to do with medication such as Dilantin or Lamictal are important because if they are too low or too high then meds need to be adjusted, also PT/INRs for Coumadin levels.
mazy
932 Posts
I agree with this. There is a limit to the amount of interpreting you should be doing. Another thing that is important is to know why the labs were ordered. What diseases does the patient have, what would be the expected values and what is going on with the patient that these particular labs were ordered.
You do need to have an actual conversation with the doc about critical and stat labs, as well as PT/INRs, which is so much fun at 3:00 in the morning. Most abnormal lab results can be called in to the messaging system during the business day if you know that they will be getting those messages and calling you back that same day.
Just keep in mind that if they don't call you back you may have to follow up with an actual conversation with the doc that day. A lab with all normal results also needs to be reported, but you can just leave a message for that.
A positive UA, or an abnormal X-ray or ultra sound needs an actual converation because that's the kind of thing that you will need tx orders for, and the sooner the better.
You will eventaully learn that the doc ordered a certain lab because they want to know a specific type of information about the patient's disease process. Usually if the abnormals are not completely out of range into critical those calls can wait until business hours. It takes practice to figure out what's important.