Now THAT'S a lab result

AZQuik · Aug 26, 2015

40 po??
I run a K at 2.9 so my doc makes me take 40 po daily so I can go to work and live my life. But I get admitted at 2.4 for IV K+ and I know it.
At 1.7 even I would take the central line. I've been down to 1.9 and it's AWFUL.

Yeah. Took 4 hours to get her to take the 40, she refused more after that.

BSN GCU 2014.

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MICUSarah · Aug 26, 2015

pH of 7.68 with Cl of 67. Put on a HCl gtt. Lived a week or two but never woke up purposefully again. (This was after 9 days of AGGRESSIVE lasix therapy and had diuresed 25KG (not lbs) in this this time. I wanted so badly to tell this family to sue the hospital)

BG 2300. Alive. Not sure if he walked out or not. He was also very septic and GI bleeding.

Plt

emtb2rn, BSN, RN, EMT-B · Aug 27, 2015

Dilaudid level 0, alive.

Christy1019, ASN, RN · Aug 28, 2015

pH of 7.68 with Cl of 67. Put on a HCl gtt. Lived a week or two but never woke up purposefully again. (This was after 9 days of AGGRESSIVE lasix therapy and had diuresed 25KG (not lbs) in this this time. I wanted so badly to tell this family to sue the hospital)
BG 2300. Alive. Not sure if he walked out or not. He was also very septic and GI bleeding.
Plt
I was just asking some docs that I work with about the treatment for metabolic alkalosis because I had never seen it in 8yrs. They all told me "treat the underlying cause and supportive therapy", this is the first I've ever heard of a HCL gtt, very interesting! Is there anything else you guys use?

calivianya, BSN, RN · Aug 28, 2015

I was just asking some docs that I work with about the treatment for metabolic alkalosis because I had never seen it in 8yrs. They all told me "treat the underlying cause and supportive therapy", this is the first I've ever heard of a HCL gtt, very interesting! Is there anything else you guys use?

The quickest fix we use is slowing the respiratory rate on the vent way down so the patient will retain a little CO2 and get some acid back in their system. Obviously not going to work if the patient is not vented, but if they weren't already, wouldn't hurt to throw them on the vent just for this reason. It doesn't fix things, but it'll normalize the pH in an emergency so the patient won't die before that fixing the underlying cause part can actually fix things.

I have also given diamox - helps the patient pee out all of the excess bicarb.

coast2coast · Aug 29, 2015

I don't understand this one- I thought that elevated TSH always indicated hypothyroid. Can someone explain this to me? :)
The highest TSH I've ever seen before was 157. Pt very fatigued, low heart rate, low B/P, overweight, and so on.

he was severely hypothyroid due to med noncompliance due to mania ...

13rnkdb · Sep 1, 2015

BUN 207...dead

cree0165, LPN, LVN · Sep 4, 2015

Hemoglobin 6.2-Alive; said "I feel just fine thank you"

Anna S, RN · Sep 4, 2015

he was severely hypothyroid due to med noncompliance due to mania ...

Thank you.

calivianya, BSN, RN · Sep 4, 2015

Hbg drop from 8.0 to 4.7 in 12 hours in a non-bleeding patient.

Patient was putting out less than 10cc urine/hour and receiving around 400ml/hr fluids, sometimes hitting around 600-700ml/hr when the ABX were running. Lab calls and demands a recollect. Recollect was Hgb 4.7.

Is it anybody else's pet peeve when lab calls for a recollect when you know you did everything right? That earns the biggest, most frustrated eye roll ever on my part.

Ruby Vee, BSN · Sep 5, 2015

Hbg drop from 8.0 to 4.7 in 12 hours in a non-bleeding patient.
Patient was putting out less than 10cc urine/hour and receiving around 400ml/hr fluids, sometimes hitting around 600-700ml/hr when the ABX were running. Lab calls and demands a recollect. Recollect was Hgb 4.7.
Is it anybody else's pet peeve when lab calls for a recollect when you know you did everything right? That earns the biggest, most frustrated eye roll ever on my part.

My pet peeve is when the lab calls you for a hemoglobin of 9.1 and asks "Has he had surgery or something? This is a big change." Yes, he's had surgery. He's in the SICU. And it's a very big change from the 6.5 hemoglobin 4 hours ago! I also hate it when they call back "panic values" that are just a hair below normal but "forget" to call with the K+ of 1.9! (Alive, but not for much longer.)

Lev, MSN, RN, NP · Sep 13, 2015

I once had the lab NOT call because results were so altered they thought it was a bad specimen and didn't feel it was necessary to check with the RN who has the patient in front of her. Guess who got written up!?