Congestive Heart Failure (CHF) Labs

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Chance Reaves
MSN-Ed,RN
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Included In This Lesson

Study Tools For Congestive Heart Failure (CHF) Labs

Heart Failure – Right Sided (Mnemonic)
Heart Failure-Origin (Mnemonic)
Heart Failure-Left-Sided (Mnemonic)
Cor Pulmonale – Signs & Symptoms (Mnemonic)
Heart Failure Pathochart (Cheatsheet)
R v L Heart Failure (Cheatsheet)
Pulmonary Edema with Cardiomegaly in CHF (Image)
CHF Ventricular Assist Device (Image)
Clubbed Fingers (Image)
63 Must Know Lab Values (Book)
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Outline

Overview

  1. CHF
    1. Labs to consider for disease process
    2. Lab purposes
    3. Special Considerations

Nursing Points

General

  1. Congestive Heart Failure
    1. Labs to consider for disease process
      1. Comprehensive metabolic panel
      2. Complete blood count
      3. BNP
      4. Cardiac markers
      5. Thyroid panels
      6. C-Reactive Protein
    2. Lab purposes
      1. Comprehensive metabolic panel
        1. Kidney function
        2. Electrolyte balance
      2. Complete blood count
        1. Infection/Inflammation
        2. Anemia
      3. BNP
        1. Exacerbation of CHF
      4. Cardiac markers
        1. Cardiac dysfunction
        2. Demand ischemia
      5. Thyroid panels
        1. TSH/T3/T4
        2. Hypothyroidism contributes to CHF
      6. C-Reactive Protein
        1. Indicative of inflammation
        2. Particularly in arteries or heart
    3. Special Considerations
      1. Comprehensive metabolic panel
        1. Green top
      2. Complete blood count
        1. Lavender top
      3. BNP
        1. Green top
      4. Cardiac markers
        1. Green top
      5. Thyroid panels
        1. Red/green top
      6. C-Reactive Protein
        1. Red/Green top

Nursing Concepts

  1. Perfusion
  2. Lab Values

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Transcript

For this lesson we’re going to take a look at the different types of labs we’re probably going to see for a patient with congestive heart failure

Similar to some of the other lessons, what we’ve done is we’ve taken a look at the most common types of labs are going to see for different types of diseases, illnesses, or conditions, and we put this list together for you so that you can anticipate what labs you would run on these patients. This is not a comprehensive all inclusive list, but it’s important to know what types of different tests that you’ll see for these different types of conditions.

So in this lesson we’re going to focus on congestive heart failure.

Congestive heart failure is a condition in the hospital, and what our goal is, is to determine the level of exacerbation that the patient is having. That will also help us develop a plan of care for that patient.

If is a new onset type of congestive heart failure, it helps us to identify the cause for the new onset.

You can see several different types of tests for you can just have heart failure patient, but the most common ones that you’re going to see her comprehensive metabolic panel, a complete blood count, a BNP and other cardiac markers. You may also see thyroid panel, and something called a C-reactive protein which we’ll get into in a minute.

As with all of our other metabolic panels, we do this test to figure out what type of organ function or dysfunction is going on. The comprehensive metabolic panel is going to give his kidney values, liver values, total proteins, and it’s also going to give us a pretty significant amount of electrolytes to figure out if there’s any sort of electrolyte imbalance.

The CBC is important because it tells us any indication of infection or inflammation. It also helps us to determine if there’s any sort of anemia that is contributing to the disease.

We will also run a BNP and cardiac markers on our patient. Because it’s a heart-related issue, we want to see what that BNP is because that’s really going to tell us how exacerbated the patient’s congestive heart failure is. There’s a great lesson on BNP so I encourage you to go check that out. Those cardiac markers are going to help us determine if there’s any sort of cardiac cell damage by evaluating the troponin.

The other thing we want to pay attention to our a thyroid studies. Conditions like hypothyroidism contribute to congestive heart failure.

Another test that you may see for your patients that have congestive heart failure is something called a C-reactive protein. It’s an indication of inflammation. While it’s not specific to the heart muscle, it tells us that there’s some sort of inflammation going on, and it’s very commonly elevated in patients with exacerbation of congestive heart failure.

So what do we need to know about the actual labs when we send them off?

Well your patients metabolic panel and electrolytes as well as a BMP and cardiac markers are all going to go in the green top tube.

The CBC is going to go in the purple top, or lavender top tube, that has an EDTA in it to keep those cells from clotting.

The thyroid studies are going to go in a red top tube and the patient C-reactive protein is going to go into a red or green top tube

For this lesson we really focus on our nursing concepts when it comes to congestive heart failure on evaluating a patient’s lab values so that they can adequately perfuse their body
Okay so let’s recap.

Your metabolic panel and electrolytes are going to tell us what’s going on with your patients organ function & potassium monitoring and other electrolytes.

The CBC is going to help us determine if there’s any sort of infection or inflammation or any sort of concerning an email when it comes to your patients congestive heart failure.

BNP specifically is going to tell us how significant are our patients heart failure is exacerbated.

Also we paid attention to our patients troponin, because that helps identify the degree of myocardial or cardiac cell injury.

And lastly we pay attention to our patients C-reactive protein, because that indicates inflammation that could be occurring and contributing to our patients congestive heart.

That’s it for our lesson on Labs that we do for a patient with congestive heart failure. Make sure you check out all the resources attached to this lesson. Now, go out and be your best selves today. And, as always, happy nursing!!

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Final Exam

Concepts Covered:

  • Terminology
  • Urinary System
  • Respiratory Disorders
  • Acute & Chronic Renal Disorders
  • Disorders of the Adrenal Gland
  • Oncology Disorders
  • Integumentary Disorders
  • Preoperative Nursing
  • Musculoskeletal Trauma
  • Integumentary Disorders
  • Respiratory Emergencies
  • Disorders of the Posterior Pituitary Gland
  • Hematologic Disorders
  • Renal Disorders
  • Labor Complications
  • Immunological Disorders
  • Upper GI Disorders
  • Neurological Emergencies
  • Disorders of Pancreas
  • Musculoskeletal Disorders
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  • Disorders of the Thyroid & Parathyroid Glands
  • Integumentary Important Points
  • Pregnancy Risks
  • Urinary Disorders
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  • Central Nervous System Disorders – Brain
  • Nervous System
  • Lower GI Disorders
  • Intraoperative Nursing
  • Eating Disorders
  • Circulatory System
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  • Liver & Gallbladder Disorders
  • Emergency Care of the Cardiac Patient
  • Female Reproductive Disorders
  • Shock
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  • Substance Abuse Disorders
  • Fetal Development
  • Proteins
  • Noninfectious Respiratory Disorder
  • Newborn Care
  • Statistics
  • Emergency Care of the Neurological Patient
  • Basics of Sociology
  • Bipolar Disorders
  • Infectious Respiratory Disorder

Study Plan Lessons

Diagnostic Testing Course Introduction
Fluid & Electrolytes Course Introduction
X-Ray (Xray)
X-Ray (Xray)
X-Ray (Xray)
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Addisons Disease
Computed Tomography (CT)
Computed Tomography (CT)
Computed Tomography (CT)
Fluid Pressures
Informed Consent
Nursing Care and Pathophysiology for Cushings Syndrome
Fluid Shifts (Ascites) (Pleural Effusion)
Magnetic Resonance Imaging (MRI)
Magnetic Resonance Imaging (MRI)
Magnetic Resonance Imaging (MRI)
Preoperative (Preop)Assessment
Pressure Ulcers/Pressure injuries (Braden scale)
CT & MR Angiography
CT & MR Angiography
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Nursing Care and Pathophysiology of Glomerulonephritis
Isotonic Solutions (IV solutions)
Nursing Care and Pathophysiology of Osteoarthritis (OA)
Nursing Care and Pathophysiology for Pancreatitis
Preoperative (Preop) Education
Cerebral Angiography
Cerebral Angiography
Cerebral Angiography
Hypotonic Solutions (IV solutions)
Nursing Care and Pathophysiology of Osteoporosis
Nursing Care and Pathophysiology for Peptic Ulcer Disease (PUD)
Preoperative (Preop) Nursing Priorities
Thrombocytopenia
Blood Transfusions (Administration)
Cardiovascular Angiography
Cardiovascular Angiography
Cardiovascular Angiography
Fractures
Nursing Care and Pathophysiology for Hyperthyroidism
Hypertonic Solutions (IV solutions)
Integumentary (Skin) Important Points
Preload and Afterload
Nursing Care and Pathophysiology of Urinary Tract Infection (UTI)
Echocardiogram (Cardiac Echo)
Echocardiogram (Cardiac Echo)
Echocardiogram (Cardiac Echo)
Nursing Care and Pathophysiology for Hypothyroidism
Performing Cardiac (Heart) Monitoring
Ultrasound
Ultrasound
Interventional Radiology
Interventional Radiology
Nuclear Medicine
Cardiac Stress Test
Cardiac Stress Test
Pulmonary Function Test
Pulmonary Function Test
Endoscopy & EGD
Endoscopy & EGD
Colonoscopy
Colonoscopy
Mammogram
Biopsy
Biopsy
Electroencephalography (EEG)
Electroencephalography (EEG)
Electromyography (EMG)
Electromyography (EMG)
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology for Appendicitis
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
General Anesthesia
Leukemia
Sodium-Na (Hypernatremia, Hyponatremia)
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Diabetes Management
Dialysis & Other Renal Points
Local Anesthesia
Lymphoma
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Chloride-Cl (Hyperchloremia, Hypochloremia)
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Moderate Sedation
Oncology Important Points
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
Nursing Care and Pathophysiology for Inflammatory Bowel Disease (IBD)
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Malignant Hyperthermia
Phosphorus-Phos
Nursing Care and Pathophysiology for Ulcerative Colitis(UC)
Nursing Care and Pathophysiology for Crohn’s Disease
Normal Sinus Rhythm
Post-Anesthesia Recovery
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care and Pathophysiology for Cholecystitis
Nursing Care and Pathophysiology for Heart Failure (CHF)
Postoperative (Postop) Complications
Sinus Bradycardia
Nursing Care and Pathophysiology for Anaphylaxis
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Sinus Tachycardia
Nursing Care and Pathophysiology for Cirrhosis (Liver Disease, Hepatic encephalopathy, Portal Hypertension, Esophageal Varices)
Discharge (DC) Teaching After Surgery
Pacemakers
Atrial Fibrillation (A Fib)
Premature Ventricular Contraction (PVC)
Ventricular Tachycardia (V-tach)
Ventricular Fibrillation (V Fib)
Nursing Care and Pathophysiology for Pelvic Inflammatory Disease (PID)
Nursing Care and Pathophysiology of Hypertension (HTN)
Nursing Care and Pathophysiology for Endometriosis
Nursing Care and Pathophysiology for Menopause
Nursing Care and Pathophysiology for Cardiomyopathy
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Cardiogenic Shock
Nursing Care and Pathophysiology for Distributive Shock
ABG (Arterial Blood Gas) Interpretation-The Basics
ABG (Arterial Blood Gas) Oxygenation
ABG Course (Arterial Blood Gas) Introduction
ABGs Nursing Normal Lab Values
ABGs Tic-Tac-Toe interpretation Method
Absolute Neutrophil Count (ANC) Lab Values
Absolute Reticulocyte Count (ARC) Lab Values
Alanine Aminotransferase (ALT) Lab Values
Albumin Lab Values
Alkaline Phosphatase (ALK PHOS) Lab Values
Alpha-fetoprotein (AFP) Lab Values
Ammonia (NH3) Lab Values
Anion Gap
Antinuclear Antibody Lab Values
Base Excess & Deficit
Beta Hydroxy (BHB) Lab Values
Bicarbonate (HCO3) Lab Values
Blood Urea Nitrogen (BUN) Lab Values
Brain Natriuretic Peptide (BNP) Lab Values
C-Reactive Protein (CRP) Lab Values
Carbon Dioxide (Co2) Lab Values
Carboxyhemoglobin Lab Values
Cardiac (Heart) Enzymes
Cholesterol (Chol) Lab Values
Coagulation Studies (PT, PTT, INR)
Congestive Heart Failure (CHF) Labs
COPD (Chronic Obstructive Pulmonary Disease) Labs
Cortisol Lab Vales
Creatine Phosphokinase (CPK) Lab Values
Creatinine (Cr) Lab Values
Creatinine Clearance Lab Values
Cultures
Cyclic Citrullinated Peptide (CCP) Lab Values
D-Dimer (DDI) Lab Values
Direct Bilirubin (Conjugated) Lab Values
Dysrhythmias Labs
Erythrocyte Sedimentation Rate (ESR) Lab Values
Fibrin Degradation Products (FDP) Lab Values
Fibrinogen Lab Values
Fluid Compartments
Free T4 (Thyroxine) Lab Values
Gamma Glutamyl Transferase (GGT) Lab Values
Glomerular Filtration Rate (GFR)
Glucagon Lab Values
Glucose Lab Values
Glucose Tolerance Test (GTT) Lab Values
Growth Hormone (GH) Lab Values
Hematocrit (Hct) Lab Values
Hemodynamics
Hemoglobin (Hbg) Lab Values
Hemoglobin A1c (HbA1C)
Hepatitis B Virus (HBV) Lab Values
Homocysteine (HCY) Lab Values
Ionized Calcium Lab Values
Iron (Fe) Lab Values
Ischemic (CVA) Stroke Labs
Lab Panels
Lab Values Course Introduction
Lactate Dehydrogenase (LDH) Lab Values
Lactic Acid
Lipase Lab Values
Lithium Lab Values
Liver Function Tests
Mean Corpuscular Volume (MCV) Lab Values
Mean Platelet Volume (MPV) Lab Values
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic Alkalosis
Methemoglobin (MHGB) Lab Values
Myoglobin (MB) Lab Values
Order of Lab Draws
Pediatric Bronchiolitis Labs
Phosphorus (PO4) Blood Test Lab Values
Platelets (PLT) Lab Values
Pneumonia Labs
Potassium-K (Hyperkalemia, Hypokalemia)
Prealbumin (PAB) Lab Values
Pregnancy Labs
Procalcitonin (PCT) Lab Values
Prostate Specific Antigen (PSA) Lab Values
Protein (PROT) Lab Values
Protein in Urine Lab Values
Red Blood Cell (RBC) Lab Values
Red Cell Distribution Width (RDW) Lab Values
Renal (Kidney) Failure Labs
Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Alkalosis
ROME – ABG (Arterial Blood Gas) Interpretation
Sepsis Labs
Shorthand Lab Values
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)
Thyroid Stimulating Hormone (TSH) Lab Values
Thyroxine (T4) Lab Values
Total Bilirubin (T. Billi) Lab Values
Total Iron Binding Capacity (TIBC) Lab Values
Triiodothyronine (T3) Lab Values
Troponin I (cTNL) Lab Values
Urinalysis (UA)
Urine Culture and Sensitivity Lab Values
Vitamin B12 Lab Values
Vitamin D Lab Values
White Blood Cell (WBC) Lab Values