Critical Labs ... Do something VERY SOON!!!

Question 1

Potassium

Note:
K+ is inversely r/t HR

Answer 1

5.4 - 5.9 **

• *Hold K+ (if running)
• *Assess HR
• *Prepare to infuse D5W with Regular Insulin
• *Call Doctor

Low ##

## Assess Heart
## Prepare to infuse K+ (po or IV)
## Call Doctor

Question 2

CO2

Note:
This lab value is useless if pt has COPD

Answer 2

In the 50’s

Assess Resp. Status
Have pt HYPERventilate with PURSED LIPS

Question 3

PO2

Answer 3

Low 70 - 77

Assess Resp. Status
Give O2

Question 4

Platelets

Answer 4

40k - 90,000

Bleeding precautions:
(Thrombocytopenic protocol)

AVOID Vena Puncture 
(*may have PICC line or central line)
Handle pt gently - use draw sheet, etc.
Use ELECTRIC RAZOR
NO hard foods or tooth brushing (use soft tooth brush)
NO contact sports
NOTHING rectally
NO aspirin or other anti-coagulants
NO bare feet or tight clothes
Use stool softener and NO straining
Call MD if blood in the stool or urine

Question 5

INR

Note:
Monitors Coumadin
AKA Warfarin therapy

Answer 5

over 4

Hold medication
Assess for bleeding
Prepare to administer Vit K (antidote)
Call Doctor

Question 6

INR

higher chance to BLEED too much

Answer 6

> therapeutic level

Note: therapeutic level is 2-3

Question 7

O2 Sat

Answer 7

under 93

Assess Resp Status
Give O2 (contact doctor if indicated)

Question 8

Sodium

Answer 8

If pt has Change in LOC

Question 9

Hgb

Answer 9

under 8

may end-up administering Blood Transfusion

Question 10

INR

more likely to CLOT

Answer 10

“less than the therapeutic level”

Note: therapeutic level is 2-3

Question 11

critical WBC

what type of precautions

Answer 11

Neutropenic AKA: reverse precautions, protective precautions, leukopenic or bone marrow precautions

Question 12

Neutropenic precautions

what type of meds taking

Answer 12

Meds taking: (antifungal, antiviral, & antibacterial)

Question 13

Neutropenic precautions

what do you do?

Answer 13

Strict handwashing
Shower BID with Antimicrobial soap
AVOID crowds (pt wear mask)
Assign to PRIVATE room
LIMIT visitors (must be healthy visitors) = NO KIDS!!!
NO fresh flowers or potted plants
LOW bacteria diet ( NO yogurt)
NO fresh fruits & vegetables
Vitals Q4 (esp TEMP)
Use anything disposable (plates, silverwear, cups)
Give pt DEDICATED items (BP cuff, etc)
Check WBC counts DAILY

Question 14

WBC
(total critical value)

Note: monitor for immunity

Answer 14

{Total count less than 5,000}

Question 15

WBC

ANC critical value

Answer 15

{Less than 500}

Question 16

WBC

CD4 critical value

Answer 16

{Less than 200}