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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My Study Plan

Concepts Covered:

  • Cardiac Disorders
  • Central Nervous System Disorders – Brain
  • Circulatory System
  • Urinary System
  • Female Reproductive Disorders
  • Upper GI Disorders
  • Musculoskeletal Disorders
  • EENT Disorders
  • Respiratory Emergencies
  • Gastrointestinal Disorders
  • Medication Administration
  • Liver & Gallbladder Disorders
  • Emergency Care of the Neurological Patient
  • Neurological Emergencies
  • Pregnancy Risks
  • Infectious Respiratory Disorder
  • Substance Abuse Disorders
  • Respiratory Disorders
  • Integumentary Disorders
  • Labor Complications
  • Disorders of Pancreas
  • Eating Disorders
  • Noninfectious Respiratory Disorder
  • Renal Disorders
  • Shock
  • Immunological Disorders
  • Musculoskeletal Disorders
  • Musculoskeletal Trauma
  • Integumentary Disorders
  • Integumentary Important Points
  • Hematologic Disorders
  • Oncology Disorders
  • Disorders of the Adrenal Gland
  • Disorders of the Posterior Pituitary Gland
  • Disorders of the Thyroid & Parathyroid Glands
  • Lower GI Disorders
  • Acute & Chronic Renal Disorders
  • Urinary Disorders
  • Neurologic and Cognitive Disorders
  • Central Nervous System Disorders – Spinal Cord
  • Peripheral Nervous System Disorders
  • Neurological Trauma
  • Vascular Disorders
  • Emergency Care of the Cardiac Patient
  • Cognitive Disorders

Study Plan Lessons

Troponin I (cTNL) Lab Values
Nursing Care and Pathophysiology for Cardiomyopathy
AVPU Mnemonic (The AVPU Scale)
EKG (ECG) Waveforms
The EKG (ECG) Graph
Electrical A&P of the Heart
Electrolytes Involved in Cardiac (Heart) Conduction
Nursing Care and Pathophysiology for Menopause
Enteral & Parenteral Nutrition (Diet, TPN)
Casting & Splinting
Meniere’s Disease
Hearing Loss
Nasal Disorders
Macular Degeneration
Cataracts
Glaucoma
Chest Tube Management
Stoma Care (Colostomy bag)
NG Tube Med Administration (Nasogastric)
NG (Nasogastric)Tube Management
Inserting an NG (Nasogastric) Tube
Drawing Blood
Ischemic (CVA) Stroke Labs
Congestive Heart Failure (CHF) Labs
Dysrhythmias Labs
Pneumonia Labs
Urinalysis (UA)
Glomerular Filtration Rate (GFR)
Creatinine (Cr) Lab Values
Blood Urea Nitrogen (BUN) Lab Values
Liver Function Tests
Total Bilirubin (T. Billi) Lab Values
Ammonia (NH3) Lab Values
Cholesterol (Chol) Lab Values
Albumin Lab Values
Cardiac (Heart) Enzymes
Immunizations (Vaccinations)
Pain and Nonpharmacological Comfort Measures
Fluid Pressures
Fluid Shifts (Ascites) (Pleural Effusion)
Isotonic Solutions (IV solutions)
Hypotonic Solutions (IV solutions)
Hypertonic Solutions (IV solutions)
Potassium-K (Hyperkalemia, Hypokalemia)
Sodium-Na (Hypernatremia, Hyponatremia)
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Chloride-Cl (Hyperchloremia, Hypochloremia)
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Phosphorus-Phos
ABGs Nursing Normal Lab Values
ABG (Arterial Blood Gas) Interpretation-The Basics
ROME – ABG (Arterial Blood Gas) Interpretation
ABGs Tic-Tac-Toe interpretation Method
Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Alkalosis
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic Alkalosis
ABG (Arterial Blood Gas) Oxygenation
Lactic Acid
Base Excess & Deficit
Nursing Care and Pathophysiology for Rheumatoid Arthritis (RA)
Nursing Care and Pathophysiology for Gout
Nursing Care and Pathophysiology of Osteoarthritis (OA)
Nursing Care and Pathophysiology of Osteoporosis
Fractures
Burn Injuries
Pressure Ulcers/Pressure injuries (Braden scale)
Skin Cancer
Integumentary (Skin) Important Points
Nursing Care and Pathophysiology for Anemia
Nursing Care and Pathophysiology for Sickle Cell Anemia
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Thrombocytopenia
Leukemia
Lymphoma
Oncology Important Points
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care and Pathophysiology for Anaphylaxis
Nursing Care and Pathophysiology for Lyme Disease
Systemic Lupus Erythematosus (SLE)
Addisons Disease
Nursing Care and Pathophysiology for Cushings Syndrome
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)
Nursing Care and Pathophysiology for Hyperthyroidism
Nursing Care and Pathophysiology for Hypothyroidism
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Diabetes Management
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
GERD (Gastroesophageal Reflux Disease)
Hiatal Hernia
Nursing Care and Pathophysiology for Pancreatitis
Nursing Care and Pathophysiology for Peptic Ulcer Disease (PUD)
Nursing Care and Pathophysiology for Diverticulosis – Diverticulitis
Nursing Care and Pathophysiology for Inflammatory Bowel Disease (IBD)
Nursing Care and Pathophysiology for Ulcerative Colitis(UC)
Nursing Care and Pathophysiology for Crohn’s Disease
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Nursing Care and Pathophysiology of Glomerulonephritis
Nursing Care and Pathophysiology of Renal Calculi (Kidney Stones)
Nursing Care and Pathophysiology of Urinary Tract Infection (UTI)
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of BPH (Benign Prostatic Hyperplasia)
Dialysis & Other Renal Points
Nursing Care and Pathophysiology for Cholecystitis
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Nursing Care and Pathophysiology for Cirrhosis (Liver Disease, Hepatic encephalopathy, Portal Hypertension, Esophageal Varices)
Lung Sounds
Alveoli & Atelectasis
Gas Exchange
Nursing Care and Pathophysiology for Asthma
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Restrictive Lung Diseases (Pulmonary Fibrosis, Neuromuscular Disorders)
Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
Nursing Care and Pathophysiology for Influenza (Flu)
Nursing Care and Pathophysiology for Tuberculosis (TB)
Nursing Care and Pathophysiology of Pneumonia
Hierarchy of O2 Delivery
Artificial Airways
Airway Suctioning
Vent Alarms
Nursing Care and Pathophysiology for Pneumothorax & Hemothorax
Chest Tube Management
Bronchoscopy
Thoracentesis
Levels of Consciousness (LOC)
Routine Neuro Assessments
Adjunct Neuro Assessments
Brain Death v. Comatose
Intracranial Pressure ICP
Cerebral Perfusion Pressure CPP
Nursing Care and Pathophysiology for Multiple Sclerosis (MS)
Nursing Care and Pathophysiology for Myasthenia Gravis
Nursing Care and Pathophysiology for Parkinsons
Brain Tumors
Nursing Care and Pathophysiology for Hemorrhagic Stroke (CVA)
Nursing Care and Pathophysiology for Ischemic Stroke (CVA)
Stroke Assessment (CVA)
Stroke Therapeutic Management (CVA)
Stroke Nursing Care (CVA)
Seizure Causes (Epilepsy, Generalized)
Seizure Assessment
Seizure Therapeutic Management
Nursing Care and Pathophysiology for Seizure
Neurological Fractures
Spinal Cord Injury
Nursing Care and Pathophysiology for Meningitis
Cardiac Anatomy
Coronary Circulation
Heart (Cardiac) Sound Locations and Auscultation
Hemodynamics
Preload and Afterload
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
MI Surgical Intervention
Nursing Care and Pathophysiology for Heart Failure (CHF)
Heart (Cardiac) Failure Therapeutic Management
Nursing Care and Pathophysiology of Hypertension (HTN)
Nursing Care and Pathophysiology for Valve Disorders
Nursing Care and Pathophysiology of Endocarditis and Pericarditis
Nursing Care and Pathophysiology for Arterial Disorders
Nursing Care and Pathophysiology for Aortic Aneurysm
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
Normal Sinus Rhythm
Sinus Bradycardia
Sinus Tachycardia
Atrial Flutter
Atrial Fibrillation (A Fib)
Premature Atrial Contraction (PAC)
Supraventricular Tachycardia (SVT)
Premature Ventricular Contraction (PVC)
Ventricular Tachycardia (V-tach)
Ventricular Fibrillation (V Fib)
1st Degree AV Heart Block
2nd Degree AV Heart Block Type 1 (Mobitz I, Wenckebach)
2nd Degree AV Heart Block Type 2 (Mobitz II)
3rd Degree AV Heart Block (Complete Heart Block)
Cognitive Impairment Disorders
COPD (Chronic Obstructive Pulmonary Disease) Labs