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Thank you so much for taking the time to answer this! I had a feeling I was thinking about it too much :)

Hello! I am reviewing some labs and have hit a wall on a particular lab. I'm probably overly worried about it, but I would really appreciate any input! This is an elderly patient that has history of heart failure and CAD. He was admitted for dyspnea. Other abnormal or pertinent labs: Troponin: WNL CPK: HIGH CPK-MB: HIGH Albumin: LOW H/H: LOW All renal and liver tests WNL Now, what I'm wondering about is his differential and absolute counts. They are actually all considered WNL, but one of them is still bothering me, just because I want to know what caused the change: Day 1 abs lymphs: 2450 Day 2 abs lymphs: 1940 (this also showed in the differential with an increased %) Day 3 abs lymphs: 2690 No major changes in Neuts. Any ideas of what could have caused the drop in lymphs for just the one day? Like I said, I know it is still considered WNL, but it is still bothering me :) Thanks! I appreciate your time!

thanks! I'm glad I was on the right track.

Hello, I couldn't find recent discussions on nursing diagnoses so I didn't know where to ask this but I need help... My pt is dx with coronary artery disease (also has hypertension, DM2, hyperlipidemia) but was admitted for atrial flutter. Upon arrival to the hospital HR was 144 and he had an ECG stating he had the flutter. When I actually saw him, his HR was 66 but irregular and was going for a cardioversion--which returned his HR to regular. Pt states he sometimes has dyspnea on excursion and sometimes, but rarely a dull ache in the location of his heart (nerver dx with angina or anything, but does have nitroglycerine rx'd prn while at the hospital only). I know that isn't all of the assessment information, but I wanted to get to what I need help with: Basically, I need to pick a priority diagnosis for this pt. I was thinking "Decreased Cardiac Output" but then didn't know if it should be "RISK OF Decreased Cardiac output" or not, considering now he has had cardioversion, on meds for arrhythmias and an anticoagulant, and HR is stable". Also, originally I was thinking the priority dx would revolve around the atrial flutter, but then I realized that the whole reason he is getting the flutter is because of the coronary artery disease. Should the priorty dx be based on that then? Or any other suggestions on a priority dx?? Hope I was able to explain myself and gave enough information. Thanks in advance. :)

Hi! I was also conditionally accepted to Cocoa Spring 2010! I dropped off my signed email to the Orlando campus just the other day. They told me the information about the FDLE background check will be coming to us shortly (probably after the 10th). I also asked to join the facebook group. Looking forward to meeting you all!