Erythrocyte Sedimentation Rate (ESR) Lab Values

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Abby Rose
BSN,RN
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Study Tools For Erythrocyte Sedimentation Rate (ESR) Lab Values

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Outline

Objective:

Determine the significance and clinical use of Erythrocyte Sedimentation Rate in clinical practice

 

Lab Test Name:

Erythrocyte Sedimentation Rate- ESR

 

Description:

The Erythrocyte Sedimentation Rate (ESR) test measures sedimentation of Red Blood Cells (RBCs). 

In normal conditions, RBCs settle or sediment very little. 

Inflammation affects proteins in the blood causing RBCs to stick and settle together out of the liquid portion of the blood.

 

Indications:

Identifies inflammation which assists in diagnosing:

  • Cancer
  • Infection
  • Autoimmune diseases

 

Normal Therapeutic Values:

Normal – 0-20 mm/hr

 

What would cause increased levels?

Increased

Conditions:

  • Anemia
  • Chronic Renal Failure
  • Systemic Lupus Erythematosus (SLE)
  • Infection
  • Tuberculosis
  • Pregnancy
  • Polymyalgia Rheumatica
  • Multiple myeloma

Medications:

  • Oral contraceptives
  • Theophylline
  • Vitamin A

 

What would cause decreased levels?

Decreased

Conditions:

  • Sickle cell anemia
  • Polycythemia Vera
  • Leukocytosis
  • Congestive Heart Failure (CHF)

Medications:

  • Aspirin
  • Cortisone
  • Quinine

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Transcript

Hey everyone, Abby from Nursing.com here. In this lesson, we will discuss ESR or erythrocyte sedimentation rate. We’ll talk about its normal value and times when we would see that value increase or decrease in clinical practice, let’s take a look. 

 

Erythrocyte sedimentation rate measures, the sedimentation or the settling of red blood cells in a blood specimen tube. Now, in normal conditions, red blood cells don’t settle very much, but in times of inflammation, the blood, the red blood cells get really sticky and they do settle. They sediment down at the bottom as you can see here in some of these tubes. So, a clinical indication would be when inflammation is present. This lab is drawn to assist in diagnosing inflammatory disease and disorders like cancer, times of infection, and autoimmune diseases. Normal therapeutic values are between zero and 20 millimeters per hour. Isn’t that cool? It actually measures the distance that the red blood cells travel and sediment in the blood tube. Now, collection takes place in westergren tubes. So, these are specialized tubes that actually measure that distance. 

 

When lab values are increased, it’s in conditions such as anemia or chronic renal failure. We talked about our autoimmune diseases and infection. It can also be increased in tuberculosis, pregnancy, polymyalgia rheumatica, and multiple myeloma. Certain medications can also cause an increase in the ESR like oral contraceptives, Theophylline, and vitamin A. The ESR will be decreased in conditions that affect the blood’s viscosity and also when we take into account the shape of red blood cells, so things like that would be sickle cell anemia, polycythemia, Vera leukocytosis, and even congestive heart failure. Certain medications will cause a decrease as well like aspirin, cortisone, and Quinine. 

 

Our linchpins for this lesson are that the ESR or the erythrocyte sedimentation rate measures the distance that the RBCs travel as they sediment. A normal value is between zero to 20 millimeters per hour. Inflammatory marker is the ESR and it is measured in times of elevated inflammation and that’s when the result will also be elevated. The value will decrease depending on the blood’s viscosity and red blood cell shape. Remember, we talked about sickle cell anemia. 

 

Now, you all did great on this lesson and go out, be your best self today. Remember, we’re always here for you. Happy nursing.

References:

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Lab Values

The Lab Values Course will help you understand how to interpret some of the most common and most important laboratory values you might see in your patients. We’ll break them down by body system and help you understand how the numbers you see in the chart relate to what’s actually happening to your patient. We’ll even walk you through how to draw blood in the right order and how to easily document lab values on your patient.

Course Lessons

Lab Values Course Introduction
Lab Values Course Introduction
Lab Basics
Lab Panels
Order of Lab Draws
Shorthand Lab Values
Cardiovascular Labs
Troponin I (cTNL) Lab Values
Brain Natriuretic Peptide (BNP) Lab Values
Cardiac (Heart) Enzymes
Hematology Labs
Red Blood Cell (RBC) Lab Values
Hemoglobin (Hbg) Lab Values
Hematocrit (Hct) Lab Values
White Blood Cell (WBC) Lab Values
Platelets (PLT) Lab Values
Coagulation Studies (PT, PTT, INR)
Cultures
Cyclic Citrullinated Peptide (CCP) Lab Values
Absolute Neutrophil Count (ANC) Lab Values
Mean Platelet Volume (MPV) Lab Values
Total Iron Binding Capacity (TIBC) Lab Values
Red Cell Distribution Width (RDW) Lab Values
Absolute Reticulocyte Count (ARC) Lab Values
Carboxyhemoglobin Lab Values
Methemoglobin (MHGB) Lab Values
Mean Corpuscular Volume (MCV) Lab Values
D-Dimer (DDI) Lab Values
Iron (Fe) Lab Values
Fibrin Degradation Products (FDP) Lab Values
Fibrinogen Lab Values
GI and Hepatic Labs
Albumin Lab Values
Cholesterol (Chol) Lab Values
Ammonia (NH3) Lab Values
Total Bilirubin (T. Billi) Lab Values
Liver Function Tests
Gamma Glutamyl Transferase (GGT) Lab Values
Alanine Aminotransferase (ALT) Lab Values
Alkaline Phosphatase (ALK PHOS) Lab Values
Lipase Lab Values
Prealbumin (PAB) Lab Values
Protein (PROT) Lab Values
Renal Labs
Blood Urea Nitrogen (BUN) Lab Values
Creatinine (Cr) Lab Values
Glomerular Filtration Rate (GFR)
Urinalysis (UA)
Protein in Urine Lab Values
Creatinine Clearance Lab Values
Endocrine Labs
Glucose Lab Values
Hemoglobin A1c (HbA1C)
Anion Gap
Free T4 (Thyroxine) Lab Values
Thyroid Stimulating Hormone (TSH) Lab Values
Cortisol Lab Vales
Glucagon Lab Values
Glucose Tolerance Test (GTT) Lab Values
Growth Hormone (GH) Lab Values
Triiodothyronine (T3) Lab Values
Thyroxine (T4) Lab Values
Metabolic Labs
Carbon Dioxide (Co2) Lab Values
Vitamin B12 Lab Values
Vitamin D Lab Values
Phosphorus (PO4) Blood Test Lab Values
Bicarbonate (HCO3) Lab Values
Lactate Dehydrogenase (LDH) Lab Values
Direct Bilirubin (Conjugated) Lab Values
Homocysteine (HCY) Lab Values
Beta Hydroxy (BHB) Lab Values
Ionized Calcium Lab Values
Myoglobin (MB) Lab Values
Immunology and Inflammatory Labs
Cyclic Citrullinated Peptide (CCP) Lab Values
Hepatitis B Virus (HBV) Lab Values
Creatine Phosphokinase (CPK) Lab Values
Erythrocyte Sedimentation Rate (ESR) Lab Values
C-Reactive Protein (CRP) Lab Values
Prostate Specific Antigen (PSA) Lab Values
Procalcitonin (PCT) Lab Values
Urine Culture and Sensitivity Lab Values
Antinuclear Antibody Lab Values
Perinatal Labs
Alpha-fetoprotein (AFP) Lab Values
Pharmacology Labs
Lithium Lab Values
Lab Values By Diagnosis
Pregnancy Labs
Pneumonia Labs
Dysrhythmias Labs
Sepsis Labs
Congestive Heart Failure (CHF) Labs
COPD (Chronic Obstructive Pulmonary Disease) Labs
Renal (Kidney) Failure Labs
Pediatric Bronchiolitis Labs
Ischemic (CVA) Stroke Labs