Nursing actions for lab values- HELP!!!!

Blackheartednurse · Nov 17, 2009

Please open a book and do you own homework when you get some diagnoses then come back for correction... :down:

GilaRRT · Nov 17, 2009

-1 for asking this question on a totally unrelated thread.

ldalzell · Nov 17, 2009

I am totally sorry for affending anyone with my question. I had horrible nurses you did not help me during clinicals.....not an excuse. My diagnosis IS DEHYDRATION!!!!! I Can't find any nursing actions on high glucose and BUN so excuse me for asking.....

GilaRRT · Nov 17, 2009

I am totally sorry for affending anyone with my question. I had horrible nurses you did not help me during clinicals.....not an excuse. My diagnosis IS DEHYDRATION!!!!! I Can't find any nursing actions on high glucose and BUN so excuse me for asking.....

I do not think dehydration is an approved NANDA nursing diagnosis. You need to look at the labs and make connections with your patients conditions and signs/symptoms. Additionally, you do not take nursing actions on an abnormal lab without first associating that lab with the big picture. Why is the BUN elevated? What is causing the elevation? Does the patient have signs and symptoms to back this value up?

Additionally, your CBC findings indicate problems other than dehydration. Dehydration alone should not cause a decreased H&H. As stated earlier, you need to look through your book and perhaps do some google searching. You need to try to put a big picture together.

AugustRain · Nov 17, 2009

I am totally sorry for affending anyone with my question. I had horrible nurses you did not help me during clinicals.....not an excuse. My diagnosis IS DEHYDRATION!!!!! I Can't find any nursing actions on high glucose and BUN so excuse me for asking.....

Well, yes, dehydration is the medical diagnosis, but what's your nursing diagnosis? Freaking out isn't going to help you, so calm down and grab your care plan book. Find the nursing diagnosis that correlates with dehdyration and you should find a whole list of nursing interventions (it likely won't be related to the high glucose, that's another issue...but it likely will mention your other values).

If you're confused about how to use the care plan book or select a nursing diagnosis, I'm sure someone would be happy to point you in the right direction.

ldalzell · Nov 17, 2009

The medical diagnosis is Dehydration....sorry....My nursing diagnosis is

Impaired physical mobility related to weakness as evidenced by impaired ability to ambulate independently and pt. stating “I’m too weak to walk”.

I looked up the labs and found this:

Elevated glucose levels: When a pt. is dehydrated it increases the levels of glucose in the blood because of decreased circulation. This can also cause diminished circulation to the capillaries.

Elevated BUN: Related to dehydration et CHF- Renal blood flow is dimished. This is one lab test done to diagnose dehydration(increase in BUN).

As for the CBC I assume the pt. has anemia.

My teachers want: What are the nursing actions related to this abnormal laboratory value.

I was not sure if notifying the physician is sufficient enough. Or would you notify physician?

kknox40 · Nov 17, 2009

I realy want to help but trust me when I say you will only learn and retain the information if you look it up yourself. I rememer the careplans I thought they were such a waste of time and the pt care was way more important. The need for those extensive care plans will go away but the knowledge you retain will not. That may be why you are having a hard time getting answers from this source.

RedhairedNurse, BSN, RN · Nov 17, 2009

The medical diagnosis is Dehydration....sorry....My nursing diagnosis is
Impaired physical mobility related to weakness as evidenced by impaired ability to ambulate independently and pt. stating “I’m too weak to walk”.
I looked up the labs and found this:
Elevated glucose levels: When a pt. is dehydrated it increases the levels of glucose in the blood because of decreased circulation. This can also cause diminished circulation to the capillaries.
Elevated BUN: Related to dehydration et CHF- Renal blood flow is dimished. This is one lab test done to diagnose dehydration(increase in BUN).
As for the CBC I assume the pt. has anemia.
My teachers want: What are the nursing actions related to this abnormal laboratory value.
I was not sure if notifying the physician is sufficient enough. Or would you notify physician?

I would think the most important nursing diagnoses would be decreased urinary output r/t dehydration, this can also be a cause of your BUN being elevated. Remember 'Oliguria' is decreased urine output

Good job on what you've come up with, really sounds like you're on the right track, keep up the good work.

AugustRain · Nov 17, 2009

The medical diagnosis is Dehydration....sorry....My nursing diagnosis is
Impaired physical mobility related to weakness as evidenced by impaired ability to ambulate independently and pt. stating "I'm too weak to walk".
I looked up the labs and found this:
Elevated glucose levels: When a pt. is dehydrated it increases the levels of glucose in the blood because of decreased circulation. This can also cause diminished circulation to the capillaries.
Elevated BUN: Related to dehydration et CHF- Renal blood flow is dimished. This is one lab test done to diagnose dehydration(increase in BUN).
As for the CBC I assume the pt. has anemia.
My teachers want: What are the nursing actions related to this abnormal laboratory value.
I was not sure if notifying the physician is sufficient enough. Or would you notify physician?

You're on the right track, but now you need to think about how the pieces fit together. Think about why the pt feels weak. What do your lab values have to do with it? What do they mean in terms of this pt? What is going on with this pt that caused the values to be off? Once you know that, then you can figure out what actions you can take (your care plan book will help with this).

Also, do you only need one nursing diagnosis?

rn undisclosed name · Nov 17, 2009

Patients with CHF frequently have elevated BUN level as they frequently have renal insufficiency.

ETA: With a BUN level it is important to know their creatinine.

ldalzell · Nov 17, 2009

Yes we just need one but I am sure they would not care if we had more than one....the assignment only calls for 1 with 5 interventions. Thanks for your help AugustRain and RedHairedNurse