Now THAT'S a lab result

katierobin23 · Jul 16, 2016

BUN 300. Alive and hopefully will stay that way, this is a patient in my PICU right now. Was down to 89 when I left this morning... 25 kg kid [emoji15]

Christy1019, ASN, RN · Jul 16, 2016

Are there different units for lactic acid? It's not unusual for us to see 30's and 40's. High normal is 12 for our lab I think. The highest I've seen is 180 (died).

There must be, because our normal levels are 0.5-1mmol/L, lab calls us with a critical on anything over 2, and anything over 4 gets admitted to ICU. I've NEVER seen one in the 30s, my highest was 17 I believe, and they died

Jersiey · Jul 17, 2016

Got a transfer from another hospital, report was pt had a k of 11. For us it was 8.4, she was awake and alert, extremely peaked T waves, HR in the high 30s to low 40s, asking for pain meds.

hecallsmeDuchess · Jul 17, 2016

Blood sugar 1600s, in DKA on admission. Sugar was in 130's when he left. Apparently insulin pump had malfunctioned and pt didn't know. Alive...

EllaBella1, BSN · Jul 19, 2016

First ABG at 2256: Alive (but barely)

pH- undetectable

PCO2- 94.2

PO2- 48.2

Base Excess- -33.6

Bicarb- 6.9

O2 Saturation- 64.2

Repeat ABG at 0110, also still alive:

pH- 6.798

PCO2- 54.9

PO2- 54.4

Base Excess- -24.8

Bicarb- 8.5

O2 Saturation- 65.3

blondy2061h, MSN, RN · Jul 19, 2016

Blood sugar 1600s, in DKA on admission. Sugar was in 130's when he left. Apparently insulin pump had malfunctioned and pt didn't know. Alive...

Did he not test his blood sugar or look at his pump in a week? I've had my tubing break and not gotten insulin and caught it around 300 when I started to feel the dry mouth.

calivianya, BSN, RN · Jul 19, 2016

Lactic 18.4 (critical labs are called starting at a lactic of 1.2 at my facility). Also pH 6.84 (not the worst I've seen) and bicarb 3.1. Very, very septic from a UTI.

Was still alive and on CRRT last time I came in, four days after admission. I was sure he was going to die when I admitted him... I pulled the crash cart in the room when I had the epinephrine at 200mcgs, the levophed at 100 mcgs, vaso at 0.04 units, neo at 300 mcgs, and dobutamine at 10mcgs with a BP of 50s/20s on an art line perfectly leveled with a beautiful waveform and a HR of only 71 (Mine would be 600 on 200mcgs/min of epi plus dobutamine). Couldn't believe he was still alive when I got back after being off work a few days.

hecallsmeDuchess · Jul 20, 2016

Did he not test his blood sugar or look at his pump in a week? I've had my tubing break and not gotten insulin and caught it around 300 when I started to feel the dry mouth.

I have no idea, I don't think he was being honest as to how he was managing his diabetes at home. His A1C was also high, like 11.

TiffyRN, BSN, PhD · Jul 20, 2016

H&H 1.something and 5.something.

Feeling a little faint.

Saw the lab myself when I took care of her a couple weeks later, when she was up to 5 & 15.

Alive last I knew.

Bumex, DNP, NP · Jul 20, 2016

TSH in the 140's. Patient refused to believe she had a thyroid disorder and wouldn't take her meds.

Interesting, I saw a patient today in clinic who has had her thyroid panel run 12 times this year because she is convinced she has hyperthyroidism. Total work ups are always negative. She hopes around from provider to provider, and she will continue to until someone diagnoses her with it.

Bumex, DNP, NP · Jul 20, 2016

Not a lab but a BP from a patient in our ICU a few weeks ago: 43/12. Alive. I didn't take care of the patient, I was just relieving the tele monitor tech for lunch and saw it on the ICU monitor.

blondy2061h, MSN, RN · Jul 20, 2016

Not a lab but a BP from a patient in our ICU a few weeks ago: 43/12. Alive. I didn't take care of the patient, I was just relieving the tele monitor tech for lunch and saw it on the ICU monitor.

Possibly a comfort care patient