Sepsis Labs

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Chance Reaves
MSN-Ed,RN
Master
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Included In This Lesson

Study Tools For Sepsis Labs

Toxicity Sepsis- Signs and Symptoms (Mnemonic)
Shock – Signs and symptoms (Mnemonic)
Shock (Cheatsheet)
63 Must Know Lab Values (Book)
WBC Differential Lab Value (Picmonic)
Blood Acid-Base Control (Picmonic)
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Outline

Overview

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

Nursing Points

General

  1. Sepsis
    1. Labs to consider for disease process
      1. Comprehensive/Basic Metabolic Panel plus electrolytes
      2. Complete Blood Count
      3. Type and screen
      4. ABG
      5. Coagulation Studies
      6. Lactate
      7. Cardiac markers
      8. Cultures
    2. Lab purposes
      1. Comprehensive/Basic Metabolic Panel plus electrolytes
        1. Organ function
        2. Electrolyte imbalances
        3. Monitoring Anion Gap
      2. Complete Blood Count
        1. Infection
          1. Degree of infection
          2. Stimulation of bone marrow
        2. Inflammation
      3. Type and screen
        1. Needed for transfusions
      4. ABG
        1. Check blood pH (will trend)
        2. Send on ice
        3. Will be done in ABG syringe
      5. Coagulation Studies
        1. Early onset or onset of clotting abnormalities
      6. Lactate
        1. Trending of lactic acid
        2. Send on ice
      7. Cardiac markers
        1. Troponins
        2. Monitoring for demand ischemia or myocardial cell injury
      8. Cultures
        1. Identify pathogens
        2. Check for sensitivity
    3. Special Considerations
      1. Comprehensive/Basic Metabolic Panel plus electrolytes
        1. Green top
      2. Complete Blood Count
        1. Lavender top
      3. Type and screen
        1. Pink top
      4. ABG
        1. ABG Syringe
        2. Send on ice
      5. Coagulation Studies
        1. Blue top
      6. Lactate
        1. Gray top
        2. Send on ice
      7. Cardiac markers
        1. Green top
      8. Cultures
        1. Blood cultures
          1. Aerobic/Anaerobic jars
        2. Swabs
          1. Area of concern
          2. Check with policy

Nursing Concepts

  1. Infection Control
  2. Lab Values

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Transcript

In this lesson we’re going to take a look at what labs we would expect to find for a patient if we’re suspicious that they have sepsis.

Just like all of our other lessons similar to this, what we’ve done is we’ve compiled the list of the most common types of labs when you’re probably going to see for your patients with different conditions, diseases, or illnesses. This is not a comprehensive list that includes absolutely every type of test that you’re ever going to run on your patient with every type of condition, but they’re the most common types that we’re seeing here so let’s get started. Now sepsis is a common admission for a patient in the hospital, and we need to figure out what’s going on with them in terms of what’s causing their source of the infection. Once we identify the cause of the infection, then what we can do is identify the needs and support their care and the way we do this is through monitoring their labs.

Typically the most type of routine tests that you’re going to see if a patient that has sepsis are a comprehensive metabolic panel, and you’re going to check your electrolytes.

You are also going to see things like a complete blood count and a type and screen

You’re going to see some things like your arterial blood gas and your lactates, in addition to coagulation studies.

It some cases you can see different types of cardiac markers and most importantly we’re going to pay attention do cultures.

To get started we’re going to focus on our patient comprehensive or basic metabolic panel. We want to pay attention to the liver values, other organ functions, we went to pay attention to proteins and we also want to pay attention to the electrolytes. The electrolytes are going to give us a lot of information, especially for things like the anion gap. There is a good lesson on a anion gap so I encourage you to go check that out.

We’re also going to pay attention to the CBC because the CBC is going to tell us how well their body is protecting or responding to the infection. That’s going to tell us what degree of inflammation is occurring.

The other thing the CBC tells us is going to tell any type of anemia that may be happening.

You’re also probably going to get a type and screen on your patient, because some patients will receive blood transfusions throughout their stay. So you need to make sure that your patient is typed and cross-matched prior to giving them any blood.

Also one of the big things that we pay attention to his arterial blood gas. It’s going to tell if pH and it’s going to allow us to turn those over time. One thing that you really need to be mindful of is that your abg’s are always going to go on ice and they are usually in their own little syringe.

The other thing you’re going to trend is lactate which gives us an idea as to what type of lactic acid build-up is occurring. That’s going to contribute to the change in the ph, and you’re also going to send that on ice as well.

For these patients were also going to pay attention to different types of coagulation studies because sometimes they can have a systemic response where their ability to clot gets all haywire, so we need to pay attention to those.

The other thing we’re going to pay attention to is to cardiac markers. We want to check those troponins. And make sure that our patient heart muscles not being affected by the sepsis.

Also we are going to try to figure out some sort of source of infection by doing the culture. We’re going to either do a culture that we think is at the source, so sometimes those are wound cultures, but we also do something called a panculture, which basically means we’re going to culture everything. This means sputum, blood, urine, and you sort of suspicious area that we think is causing the type of systemic response to the infection.
So what do we need to think about when we’re sending these Labs off.

Well your metabolic panel your electrolytes and your cardiac markers are all going to go in a green top tube.

Your CBC is going to go in your purple top tube, and that’s the one that has EDTA in it to keep it from clotting.

Now remember that your ABG and your lactate also need to be on ice so don’t forget about that. But with your ABG is going to have its own particular syringe, and with your lactate is going to go in this grey top tube.

For cultures, we need to figure out where it’s coming from, so expect the pan culture your patient which means you’re going to be using these blood culture jars or you’re going to be swabbing some area that you may be suspicious that is the cause of infection

For a patient with sepsis, we focus on the nursing concepts of lab values and infection control

Okay so let’s recap.

For a metabolic panel in electrolytes, we’re looking at overall organ function and we’re going to continue to monitor for organ failure because that can be a common result of sepsis.

We’re going to use the CBC to monitor a patient’s level of infection, inflammation, and if they have any sort of anemia.

With your lactating your AVG you want to make sure that we’re turning those and we’re sending those on Ice.

Four cultures we won’t identify the cause of the infection, so that Source could either be blood, some sort of wound, the urinary tract, Etc. Just know that you may end up culturing everything in the process.

Lastly want to pay attention was quite relation studies, cuz we want to make sure that our patient isn’t developing some sort of clotting problem as a result of the sepsis.

And that’s our lesson on what lab values your comely going to see what your patient with sepsis.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
  • Cardiac Disorders
  • Disorders of the Thyroid & Parathyroid Glands
  • Integumentary Important Points
  • Pregnancy Risks
  • Urinary Disorders
  • Vascular Disorders
  • Central Nervous System Disorders – Brain
  • Nervous System
  • Lower GI Disorders
  • Intraoperative Nursing
  • Eating Disorders
  • Circulatory System
  • Postoperative Nursing
  • Liver & Gallbladder Disorders
  • Emergency Care of the Cardiac Patient
  • Female Reproductive Disorders
  • Shock
  • Respiratory System
  • 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