Pneumonia Labs

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Chance Reaves
MSN-Ed,RN
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Included In This Lesson

Study Tools For Pneumonia Labs

Causes of Dyspnea (Mnemonic)
Pneumonia Risk Factors (Mnemonic)
Pneumonia Pathochart (Cheatsheet)
Pneumonia (Image)
Upper Respiratory System (Image)
Respiratory Anatomy (Image)
Pneumonia Xray (Image)
Pneumonia Symptoms (Image)
Cyanosis (Image)
63 Must Know Lab Values (Book)

Outline

Overview

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

Nursing Points

General

  1. Pneumonia
    1. Labs to consider for disease process
      1. Comprehensive/Basic Metabolic Panel
      2. Complete Blood Count
      3. Cultures
      4. Therapeutic drug levels
    2. Lab purposes
      1. Comprehensive/Basic Metabolic Panel
        1. Organ function
        2. Electrolytes
      2. Complete Blood Count
        1. Checking for signs of infection/inflammation
      3. Cultures
        1. Sputum
          1. Identify pathogen
          2. Check for sensitivity
        2. Blood
          1. Identify pathogen
          2. Check for sensitivity
      4. Therapeutic drug levels
        1. Necessary for certain antibiotics
    3. Special Considerations
      1. CMP/BMP
        1. Green top
      2. CBC
        1. Lavender top
      3. Cultures
        1. Blood cultures
          1. Aerobic & anaerobic culture jars
        2. Sputum culture
          1. Sputum cup
      4. Therapeutic drug levels
        1. Will vary per facility
        2. Gel separators will absorb drug

Nursing Concepts

  1. Lab Values
  2. Gas Exchange
  3. Oxygenation

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Transcript

In this lesson we’re going to take a look at what kind of labs we would expect to run on a patient that has pneumonia.

Now similar to some of the other lessons that we have, the goal with this lesson is to help you guys identify the common types of labs that you’re going to see, what different types of diseases, illnesses, injuries. Now there are individual lessons on all of these different types of illnesses, so I encourage you to check those out.

With pneumonia, we realize that is a very common admission to the hospital. Remember that pneumonia is a buildup of fluid in the lungs that’s a result of inflammation that because of some sort of bacteria, fungus, or virus. What we want to do is identify the cause, and develop a plan of care so that our patients can get on the road to recovery. And part of how we do that is by using different types of lab tests to figure out what’s going on.

So to get started, the first thing we’re going to look at it either some sort of comprehensive or a basic metabolic panel, we’ll also take a look at blood counts through a CBC. We will also look at different types of cultures to identify what type of pathogen is growing. Also we’ll take a look at different types of therapeutic drug levels and I’ll go into all of that and just a minute.

To get started, we’re going to look at some sort of metabolic panel. It’s either going to be comprehensive or it’s going to be basic. If you go take a look at the lessons on lab panels, you’ll see that the basic metabolic panel focuses primarily on kidneys and electrolytes, whereas your comprehensive metabolic panel is going to have things like liver function, expanded electrolytes, and also protein levels. The point of this panel is to take a look at organ function and electrolytes for a patient that has pneumonia.

Now CBC is really important for a pneumonia patient. And the reason is is it helps identify the level of infection and it does this with the differential. The differential is going to give us different types of white blood cells, and it’s going to tell us if what kind of inflammatory process may be happening.

We’re also probably going to do some form of culture for a patient. There’s two specific goals with the culture. First is to identify what’s causing the infection. That can be a virus, it could be a bacteria, or it can even be some sort of fungus growing. So that’s what the culture first does. Secondly the culture focuses on figuring out what type of medication is going to treat it by different types of sensitivities. The sensitivity is going to tell us what medication is going to be most effective in treating the cause of the patient’s pneumonia.

Lastly we want to pay attention to therapeutic drug levels. And what I mean is that some of the drugs that we used to treat pneumonia, most commonly antibiotics, can be toxic to the patient at certain doses. So, what we want to do is make sure that we’re giving our patients the right drug at the right dose, and make sure that they’re responding appropriately. So we’ll do this by monitoring their drug levels repeatedly.

So what should you be looking for whenever you’re drawing your patients labs and sending them off?

First off any sort of metabolic panel, either basic or comprehensive, is going to go in this Green Top tube. It’s also going to cover your electrolytes.

Your CBC, is it going to go into this purple top that has EDTA in it. We want to make sure that those cells are free-flowing and that we get accurate counts.

Your cultures, whether they’re blood or sputum, are going to go in some sort of specific container. Your blood cultures are going to go in these blood culture jars. If your patient has a sputum sample that they need to submit it’ll go into a sputum collection container. They’ll take a couple of big deep breaths, and then they’ll cough and try to bring up some of that sputum that’s in their lungs in the hospital into the jar and then that goes off to the lab to be evaluated.

I know one thing I want to mention is that your therapeutic drug levels are going to vary by facility. Find out what specific test you need in terms of testing, and follow facility policy. Sometimes they’re red tops sometimes they’re not, so just find out from your lab.

For today’s nursing concepts we really focused on those lab values for a patient with pneumonia. We’re also focusing on improving their gas exchange and oxygenation by identifying with their cause of the pneumonia is.

So let’s recap.

First off in your metabolic panel they’re going to help you figure out what your patients organ function is like, it’s also going to give you some insight into your electrolytes.

The cbc’s what we’re going to use to determine how significant your patient’s infection is by looking at the different types of white blood cells better in their blood.

You’re going to use cultures by either the patient’s blood or their sputum to figure out what specific pathogen is growing, and the sensitivity is going to tell us what type of drug is going to treat it.

Anytime you’re dealing with any sort of drugs that could potentially become toxic, most of the time we’re going to have some sort of therapeutic drug level that you’re going to have to monitor. Just ask what your facility policy is in terms of how you submit that test.

That’s it for our lesson on labs for your patient with pneumonia. 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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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