Sepsis Labs

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Chance Reaves
MSN-Ed,RN
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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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4th Semester

Concepts Covered:

  • Renal Disorders
  • Endocrine and Metabolic Disorders
  • Urinary System
  • Shock
  • Musculoskeletal Trauma
  • Postoperative Nursing
  • Preoperative Nursing
  • Cardiac Disorders
  • Renal and Urinary Disorders
  • Cardiovascular Disorders
  • Circulatory System
  • Respiratory System
  • Digestive System
  • Integumentary Disorders
  • Nervous System
  • Pregnancy Risks
  • Neurological Trauma
  • Neurologic and Cognitive Disorders
  • Emergency Care of the Neurological Patient
  • Neurological Emergencies
  • Respiratory Disorders
  • Substance Abuse Disorders
  • Central Nervous System Disorders – Brain
  • Basics of Sociology
  • Statistics
  • Urinary Disorders
  • Fundamentals of Emergency Nursing
  • Prioritization
  • Test Taking Strategies
  • Delegation
  • Documentation and Communication
  • Legal and Ethical Issues
  • Community Health Overview
  • Communication
  • Eating Disorders
  • Noninfectious Respiratory Disorder
  • Integumentary Disorders
  • Disorders of Pancreas
  • Upper GI Disorders
  • Acute & Chronic Renal Disorders
  • Liver & Gallbladder Disorders
  • Respiratory Emergencies
  • Emergency Care of the Cardiac Patient
  • Disorders of the Posterior Pituitary Gland

Study Plan Lessons

Fluid Volume Overload
Fluid Volume Deficit
Nursing Care and Pathophysiology for Sepsis
Nursing Care and Pathophysiology for SIRS & MODS
Nursing Care and Pathophysiology for Compartment Syndrome
Nursing Care and Pathophysiology for Rhabdomyolysis
Discharge (DC) Teaching After Surgery
Informed Consent
Performing Cardiac (Heart) Monitoring
Nephrotic Syndrome
Congenital Heart Defects (CHD)
EKG (ECG) Waveforms
The EKG (ECG) Graph
Electrical A&P of the Heart
Electrolytes Involved in Cardiac (Heart) Conduction
Breathing Movements
Breathing Control
Respiratory Functions of Blood
Liver & Gallbladder
Respiratory Structure & Function
Burn Injuries
Spinal Cord
Electrical Activity in the Heart
Cardiac (Heart) Physiology
Nutrition (Diet) in Disease
Blood Cultures
Drawing Blood
Spinal Precautions & Log Rolling
Neuro Assessment
Ischemic (CVA) Stroke Labs
Renal (Kidney) Failure Labs
Sepsis Labs
Dysrhythmias Labs
Anion Gap
Glucose Lab Values
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
Albumin Lab Values
Cultures
White Blood Cell (WBC) Lab Values
Hematocrit (Hct) Lab Values
Hemoglobin (Hbg) Lab Values
Red Blood Cell (RBC) Lab Values
Lab Panels
Urinary Elimination
Shock
Triage
Prioritization
Delegation
Documentation Pro Tips
Admissions, Discharges, and Transfers
Legal Considerations
Levels of Prevention
Nursing Care Delivery Models
Advance Directives
What Guides Nurses Practice
Fluid Compartments
Fluid Shifts (Ascites) (Pleural Effusion)
Phosphorus-Phos
ABGs Nursing Normal Lab Values
ABG (Arterial Blood Gas) Interpretation-The Basics
ROME – ABG (Arterial Blood Gas) Interpretation
Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Alkalosis
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic Alkalosis
Lactic Acid
Base Excess & Deficit
Burn Injuries
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Nursing Care and Pathophysiology for Pancreatitis
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Chronic Renal (Kidney) Module Intro
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
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)
Restrictive Lung Diseases (Pulmonary Fibrosis, Neuromuscular Disorders)
Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
Blunt Chest Trauma
Nursing Care and Pathophysiology for Pneumothorax & Hemothorax
Brain Death v. Comatose
Nursing Care and Pathophysiology for Parkinsons
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)
Seizures Module Intro
Spinal Cord Injury
Preload and Afterload
Nursing Care and Pathophysiology of Angina
Heart (Cardiac) Failure Module Intro
Nursing Care and Pathophysiology for Heart Failure (CHF)
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)
Legal Aspects of Documentation
Dehydration
Cerebral Palsy (CP)
Spina Bifida – Neural Tube Defect (NTD)
Vasopressin
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)