Ischemic (CVA) Stroke Labs

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Chance Reaves
MSN-Ed,RN
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Included In This Lesson

Study Tools For Ischemic (CVA) Stroke Labs

Stroke Assessments (Mnemonic)
Stroke Pathochart (Cheatsheet)
Stroke Locations (Cheatsheet)
Cerebral Circulation (Image)
Overview Of Nervous System (Image)
Brain MRI (Image)
Unequal Pupils (Image)
Cerebral Blood Flow Scan (Image)
Intraparenchymal Hemorrhage (Image)
NIHSS Image (Image)
Picture Board For Aphasia (Image)
Communiation Board For Aphasia (Image)
63 Must Know Lab Values (Book)
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Outline

Overview

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

Nursing Points

General

  1. Ischemic stroke
    1. Labs to consider for disease process
      1. Comprehensive/Basic metabolic panel
      2. Capillary Blood Glucose (CBG)
      3. Lipids
      4. Complete blood count
      5. Coagulation studies
    2. Lab purposes
      1. Comprehensive/Basic metabolic panel
        1. Organ function
        2. Electrolytes
          1. Sodium
            1. Low sodium causes cerebral edema
      2. Capillary Blood Glucose
        1. Bedside testing
          1. Quick testing
          2. Hypoglycemia mimics stroke
          3. Rule out at bedside
      3. Lipids
        1. Determines risk for arteriosclerosis
        2. Increased risk of ischemic stroke
      4. Complete Blood Count
        1. Anemia
        2. Infection
        3. Platelets
          1. Anticoagulation therapy based on platelet counts
            1. tPA
      5. Coagulation studies
        1. Monitoring therapy of other anticoagulants
    3. Special considerations
      1. CMP/BMP
        1. Green top
      2. CBG
        1. Bedside blood sugar  testing
      3. Lipid panel
        1. Green top
      4. CBC
        1. Lavender top
      5. Coagulation studies
        1. Blue top

Nursing Concepts

  1. Intracranial Regulation
  2. Perfusion
  3. Lab Values

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Transcript

All right in this lesson we’re going to take a look at the labs associated with ischemic stroke

Similar to that some of the other lessons, what we’ve done is we’ve gotten together a framework of the potential labs that you may end up seeing for your patients with particular illnesses, diseases, or injuries. This is not an all-inclusive list, but I want you to understand that our goal here is to give you some sort of idea of the labs that you may potentially run into so that you know why we do them.

What we’re dealing with patients with ischemic strokes, it’s a really common admission. The goal here is to number one, access them quickly which is why we do some of the labs that we do. We need to differentiate between an ischemic stroke and a hemorrhagic stroke because the treatments are vastly different. Once we figure out what’s going on with our patient then we can develop an a plan of care focused on what’s going on with them.

The first test you’ll probably see is some form of imaging. This is most commonly a CT scan and sometimes MRIs. But we’ll go into that a little bit. Other tests that you’re going to see our comprehensive or a basic metabolic panel and also cbgs, or capillary blood glucoses. It’s not uncommon to get lipid panels on these guys and also to do complete blood counts and coagulation studies

The reasons why we do these are very very important. Aside from all the imaging associated with it these are the labs that you’re most likely going to run into.

With the comprehensive or basic metabolic panel, we’re looking at organ function. We want to get an idea of what’s going on inside of our patient. The other thing that we pay attention to particular really early electrolytes mostly sodium. Low sodium causes cerebral edema, so we want to make sure that our sodium levels are good.

Your the thing you’re going to do is probably a capillary blood glucose or bedside glucose testing. The reason you do it for a couple of reasons. First it’s quick, and it gives you pretty immediate results. Secondly, hypoglycemia mimics stroke. The treatment for low blood sugar is so much easier than treating a patient is having an ischemic stroke. So identifying that it’s not actually low blood sugar and then it actually is a stroke helps us to take the correct steps.

The other thing that we’re going to take a look at is CBC. The reason we take a look at CBC is because we want to keep an eye on those platelets. Platelets play a role in how we use TPA to break up those clots. There’s a great lesson on ischemic strokes I encourage you to check it out and it goes more into depth about treatment options, but this is why you need to pay attention to it. The other reason we want to check the CBC out as to check for any sources of infection or potential anemia.

When we do a lipid panel is what we’re looking for a risk for plaques. High levels of lipid deposits in a blood like cholesterol and LDL can contribute to risk for ischemic stroke.

And lastly we want to pay attention to those coagulation studies. If we’re going to put our patient on any sort of anticoagulants in the future, we need to know where we start from the beginning.

So what do you need to know about whenever you’re submitting your Labs? First off know that your metabolic panel and your electrolytes are going to go in a green top tube. Your CBC is going to go in the lavender top tube, and your coags are going to go into your blue top tube. Also your lipids go into your green top tube as well.

Well you do have a glucose that comes back with your metabolic panel, you’re also going to be using your bedside glucometer to check your cbgs on your patient.
For patients that have an ischemic stroke, are nursing Concepts focus on lab values, intracranial regulation and perfusion.
So let’s recap.

Imaging is one of the first steps that you’re going to see for a patient that suspicious of an ischemic stroke. You need to see if there’s an active lead or if there’s ischemia. We need to figure out what’s going on so that we make the correct steps to treat it.

You’re going to check out my metabolic panel is to look at organ function and electrolytes particularly sodium.

You’re going to be doing CGBs of the bedside, mainly because they quickly realized hypoglycemia which mimics and ischemic stroke.

Your patients will also probably getting lipid panels to identify risks of plaques and arteriosclerosis.

Finally your patient will probably be getting some coagulation studies just to check for monitoring problems and you need to do you.

And that’s all I sent for patients that had ischemic stroke and the labs that you may see for them. 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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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