Interpreting Nursing Lab Values: Critical Concepts

• Take time to understand the clinical context.
• Not all abnormal nursing lab values require intervention.
• Remember to treat the patient, not the number.

Understanding nursing lab values and formulating plans can be a daunting task, especially if you are a new nurse or a nurse moving into a different specialty. Understanding the “bigger picture” is key when interpreting lab values, even seasoned clinicians can struggle with this concept at times.

Using our three steps, you’ll be able to decode the next set of nursing lab values with confidence.

Step 1: Understand the Context

Take time to understand the clinical context. Here are a few questions to ask about your patient:

• What are the patient’s demographics?
• What is their current condition?
• What is normal or average (historically) for the patient?
• What chronic conditions do they have?
• What medications are they on?
• What was the source of your specimen and how was it collected?

Apply the answers of these questions to the context of the situation. As we will illustrate in the example below, the same number can mean very different things for different patients.

Putting it into Practice:

Patient A: Mr. Jones just finished walking with physical therapy and is at his baseline, oriented. He stops by your office for some routine labs afterwards, which reveal a blood glucose of 65.

Patient B: Mr. Smith almost collapsed during his walk with physical therapy because he was feeling weak. You walk into his room; he is diaphoretic and confused. His labs after his walk show a glucose level of 65.

How would you treat or monitor each patient?

Step 2: Know When to Intervene and When to Monitor

Not all abnormal nursing lab values require intervention. The degree of risk for the intervention should be weighed against potential harm of the condition. An intervention does not have to be a treatment, it can simply be to follow up on the result. Remember to always trend lab values and consider the context. Let’s explore further in the example below.

Putting it into Practice:

Patient A: Mr. Jones is a patient with COPD who was admitted to the hospital for a routine surgery. His pre-operative lab values reveal a fully compensated hypercapnia. He complains of no respiratory symptoms beyond his baseline COPD.

Patient B: Mr. Smith is admitted to the hospital for shortness of air. His exam reveals wheezing in all lobes and laboratory values show a non-compensated hypercapnia.

How would you treat or monitor each patient?

Step 3: Always Look at the Bigger Picture with Nursing Lab Values

Remember to treat the patient, not the number. The best plan of care is formulated when you combine the history, physical exam, labs/imaging, and patient preferences.

Nursing lab values alone should rarely be used to guide treatment. Even “normal” nursing lab values can be abnormal in some patients. Likewise, a “high normal” or “low normal” may justify further investigation.

Putting it into Practice:

Patient A: You are given report on Mr. Jones, a medical-surgical patient. You are told his diagnosis is hyponatremia and isotonic saline is being used for treatment.

Patient B: You are given report on Mr. Smith, a medical-surgical patient. You are told he was diagnosed with hyponatremia after excessive water ingestion due to psychosis. In addition to his isotonic saline treatment, you discuss the need to restrict PO intake and psychiatry consult.

How would you treat or monitor each patient?

A Summary of Nursing Lab Values

At Nursing CE Central, we know thinking like a nurse is something that not only comes with training and studying, but with experience as well. It involves critically thinking through a situation, acting on what you know and using that information to develop an appropriate plan of care. Understanding these critical concepts of interpreting nursing lab values will help you be more confident in treating your patient and, as a result, will make you a stronger nurse.

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