Lab Values for Nurses: Must Know Labs with Easy Memorization Tricks and Nursing Implications

Book Preface

INTRODUCTION
To offer holistic care to patients, nurses and health care workers need to identify abnormal laboratory values and diagnostic data. Although the onus of diagnosis and ordering lab tests lies with the physician, it is important for nurses to be aware of the purpose of tests, their meaning, and the normal ranges for each one being ordered.

The ability to identify normal and abnormal values of a lab test is an important asset to make an informed clinical decision as a nurse. Laboratory tests are tools that give invaluable information and insight about a patient and help in care and honing nursing acumen. Lab tests aid in confirming the diagnosis, provide the prognosis of an illness, and suggest the patient’s response to treatment.

The laboratory is an important part of the NCLEX, yet some values give no indication of the normal range of lab levels. It is the responsibility of nursing personnel to identify whether lab values are within the normal range or not as it is of vital import. Note that laboratory values will vary from institution to institution.
Easy memorization tricks to help on exams are in a separate chapter of this book.

You can glance through this single chapter just before the exams rather than sifting through all chapters if there is a time constraint

BASIC PROCEDURES

HOW TO OBTAIN A BLOOD SAMPLE

A phlebotomist or certified nurse with training in blood specimen collection is allowed to perform venipuncture for the purpose of blood sample collection. The procedure includes the following steps:

Identify the patient: ask his or her name and date of birth and explain the rationale and test procedure.
Proper position: blood specimens are best drawn in a sitting position, and the patient should remain in the same position without movement for a minimum of 5 minutes before the sample is drawn.

Confirm the lab test requested: look at the laboratory form for the ordered test, the patient information, and other requisites like allergies, fasting, dietary restrictions, and medications.

Offer comfort: make sure the patient is not wearing tight clothing that could constrict the upper arm. The arm is to be placed in a gravitating position.

Ensure proper hand hygiene: hands should be washed properly before wearing gloves.
Identify the vein: inspect the patient’s arm for an easily accessible vein for venipuncture, and then the tourniquet is to be applied 3 to 4 inches above the chosen site. Ensure that the tourniquet is not too tight and do not leave it on for more than 2 minutes.

Prepare the site: cleanse the area of the chosen vein using alcohol in circular movements, beginning at the center of the site and working outward.

Draw the sample: ask the patient to make a fist. Hold the patient’s arm using your thumb firmly to make the skin taut and position the vein to prevent it from slipping at an angle of 15 to 30º. Gently insert the needle through the skin into the lumen of the vein.

Fill the tube: collect the amount of blood sample required and then remove the tourniquet.
Remove the needle: in a single and swift motion, remove the needle from the patient’s vein and apply pressure with a folded gauze over the venipuncture site for 1 to 2 minutes.

Label the tube: the tube should be labeled correctly with the patient’s name, birth date, hospital identification number, time, and date of the sample collected.
Transport specimen: the specimen should be delivered to the laboratory immediately for processing and analysis.