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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lab and medterm

Concepts Covered:

  • Prefixes
  • Suffixes
  • Fetal Development
  • Terminology
  • Proteins
  • Statistics
  • Med Term Basic
  • Med Term Whole
  • Respiratory Disorders
  • Hematologic Disorders
  • Emergency Care of the Neurological Patient
  • Acute & Chronic Renal Disorders
  • Communication
  • Legal and Ethical Issues
  • Immunological Disorders
  • Oncology Disorders
  • Substance Abuse Disorders
  • Renal Disorders
  • Disorders of Pancreas
  • Pregnancy Risks
  • Labor Complications
  • Lower GI Disorders
  • Cardiac Disorders
  • Intraoperative Nursing
  • Noninfectious Respiratory Disorder
  • Disorders of the Adrenal Gland
  • Emergency Care of the Trauma Patient
  • Central Nervous System Disorders – Brain
  • Disorders of the Posterior Pituitary Gland
  • Newborn Care
  • Shock
  • Circulatory System
  • Urinary System
  • Upper GI Disorders
  • Newborn Complications
  • Disorders of the Thyroid & Parathyroid Glands
  • Liver & Gallbladder Disorders
  • Documentation and Communication
  • Neurological Emergencies
  • Hematology
  • Microbiology
  • Basics of Sociology
  • Bipolar Disorders
  • Medication Administration
  • Eating Disorders
  • Respiratory Emergencies
  • Integumentary Disorders
  • Endocrine and Metabolic Disorders
  • Infectious Respiratory Disorder
  • Postpartum Complications
  • Musculoskeletal Disorders
  • Musculoskeletal Trauma
  • Vascular Disorders
  • Gastrointestinal Disorders
  • Postpartum Care
  • Basics of NCLEX
  • Test Taking Strategies
  • Preoperative Nursing
  • Urinary Disorders

Study Plan Lessons

54 Common Medication Prefixes and Suffixes
Alpha-fetoprotein (AFP) Lab Values
Carboxyhemoglobin Lab Values
Cardiac Terminology
Diagnostic Testing Course Introduction
Diagnostics Terminology
Digestive Terminology
Gamma Glutamyl Transferase (GGT) Lab Values
Growth Hormone (GH) Lab Values
Hematology Oncology & Immunology Terminology
Integumentary (Skin) Terminology
Mean Corpuscular Volume (MCV) Lab Values
Mean Platelet Volume (MPV) Lab Values
Medical Terminology Course Introduction
MedTerm Basic Word Structure
MedTerm Body as a Whole
MedTerm Prefixes
MedTerm Suffixes
Metabolic & Endocrine Terminology
Methemoglobin (MHGB) Lab Values
Musculoskeletal Terminology
Myoglobin (MB) Lab Values
Neuro Terminology
Pharmacology Terminology
Prealbumin (PAB) Lab Values
Procedural Terminology
Psychiatry Terminology
Reproductive Terminology
Respiratory Terminology
Sensory Terminology
Urinary Terminology
ABGs Nursing Normal Lab Values
Absolute Neutrophil Count (ANC) Lab Values
Absolute Reticulocyte Count (ARC) Lab Values
Acute Confusion
Acute Kidney Injury Case Study (60 min)
Advocacy & Moral Judgement for Progressive Care Certified Nurse (PCCN)
AIDS Case Study (45 min)
Alanine Aminotransferase (ALT) Lab Values
Albumin Lab Values
Alkaline Phosphatase (ALK PHOS) Lab Values
Alkylating Agents
Alpha-fetoprotein (AFP) Lab Values
Ammonia (NH3) Lab Values
Anion Gap
Anti Tumor Antibiotics
Antimetabolites
Antinuclear Antibody Lab Values
Asthma Concept Map
Basic Statistics
Beta Hydroxy (BHB) Lab Values
Bicarbonate (HCO3) Lab Values
Blood Transfusions (Administration)
Blood Urea Nitrogen (BUN) Lab Values
Bone Cancer (Osteosarcoma, Chondrosarcoma, and Ewing Sarcoma)
Bowel Obstruction Concept Map
Brain Natriuretic Peptide (BNP) Lab Values
C-Reactive Protein (CRP) Lab Values
Carbon Dioxide (Co2) Lab Values
Carboxyhemoglobin Lab Values
Cardiac (Heart) Enzymes
Cardiac Tamponade for Progressive Care Certified Nurse (PCCN)
Cholesterol (Chol) Lab Values
Coagulation Studies (PT, PTT, INR)
Comfort Provisions (Behavioral Response to Procedure) for Certified Perioperative Nurse (CNOR)
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
Crush Injuries
Cultures
Cushing’s Syndrome Case Study (60 min)
Cyclic Citrullinated Peptide (CCP) Lab Values
D-Dimer (DDI) Lab Values
Diabetes Insipidus Case Study (60 min)
Diagnostics Terminology
Dialysis & Other Renal Points
Direct Bilirubin (Conjugated) Lab Values
Dopamine (Inotropin) Nursing Considerations
Dysrhythmias Labs
Electrolytes Involved in Cardiac (Heart) Conduction
Endocarditis Case Study (45 min)
Enteral & Parenteral Nutrition (Diet, TPN)
Erythroblastosis Fetalis
Erythrocyte Sedimentation Rate (ESR) Lab Values
Fibrin Degradation Products (FDP) Lab Values
Fibrinogen Lab Values
Fluid Volume Overload
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
Hemoglobin (Hbg) Lab Values
Hemoglobin A1c (HbA1C)
Hepatitis B Virus (HBV) Lab Values
Homocysteine (HCY) Lab Values
How to Write A Nursing Progress Note
Hydatidiform Mole (Molar pregnancy)
Hypertensive Crisis Case Study (45 min)
Hypoglycemia
Infection or Inflammation? The Quick & Dirty on CBCs – Live Tutoring Archive
Ionized Calcium Lab Values
Iron (Fe) Lab Values
Ischemic (CVA) Stroke Labs
Lab Panels
Lab Values Course Introduction
Lactate Dehydrogenase (LDH) Lab Values
Lipase Lab Values
Lithium Lab Values
Liver Function Tests
Magnesium Sulfate
Magnesium Sulfate in Pregnancy
Mean Corpuscular Volume (MCV) Lab Values
Mean Platelet Volume (MPV) Lab Values
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic Alkalosis
Methemoglobin (MHGB) Lab Values
Multiple Myeloma
Myoglobin (MB) Lab Values
Newborn of HIV+ Mother
Nursing Care and Pathophysiology for Hashimoto’s Thyroiditis
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Nursing Care and Pathophysiology for Hyperparathyroidism
Nursing Care and Pathophysiology for Rhabdomyolysis
Nursing Care Plan (NCP) for Abruptio Placentae / Placental abruption
Nursing Care Plan (NCP) for Acute Kidney Injury
Nursing Care Plan (NCP) for Acute Pain
Nursing Care Plan (NCP) for Acute Respiratory Distress Syndrome
Nursing Care Plan (NCP) for Anemia
Nursing Care Plan (NCP) for Angina
Nursing Care Plan (NCP) for Asthma / Childhood Asthma
Nursing Care Plan (NCP) for Cardiogenic Shock
Nursing Care Plan (NCP) for Cellulitis
Nursing Care Plan (NCP) for Chronic Kidney Disease
Nursing Care Plan (NCP) for Diabetes Mellitus (DM)
Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA)
Nursing Care Plan (NCP) for Disseminated Intravascular Coagulation (DIC)
Nursing Care Plan (NCP) for Eating Disorders (Anorexia Nervosa, Bulimia Nervosa, Binge-Eating Disorder)
Nursing Care Plan (NCP) for Encephalopathy
Nursing Care Plan (NCP) for Endocarditis
Nursing Care Plan (NCP) for Fluid Volume Deficit
Nursing Care Plan (NCP) for Gestational Hypertension, Preeclampsia, Eclampsia
Nursing Care Plan (NCP) for GI (Gastrointestinal) Bleed
Nursing Care Plan (NCP) for Glomerulonephritis
Nursing Care Plan (NCP) for Hepatitis
Nursing Care Plan (NCP) for Hyperemesis Gravidarum
Nursing Care Plan (NCP) for Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)
Nursing Care Plan (NCP) for Hypovolemic Shock
Nursing Care Plan (NCP) for Impaired Gas Exchange
Nursing Care Plan (NCP) for Infection
Nursing Care Plan (NCP) for Meconium Aspiration
Nursing Care Plan (NCP) for Myocardial Infarction (MI)
Nursing Care Plan (NCP) for Nephrotic Syndrome
Nursing Care Plan (NCP) for Nutrition Imbalance
Nursing Care Plan (NCP) for Pancreatitis
Nursing Care Plan (NCP) for Pneumonia
Nursing Care Plan (NCP) for Postpartum Hemorrhage (PPH)
Nursing Care Plan (NCP) for Pulmonary Embolism
Nursing Care Plan (NCP) for Respiratory Failure
Nursing Care Plan (NCP) for Rhabdomyolysis
Nursing Care Plan (NCP) for Risk for Fall
Nursing Care Plan (NCP) for Skull Fractures
Nursing Care Plan (NCP) for Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
Nursing Care Plan (NCP) for Thrombophlebitis / Deep Vein Thrombosis (DVT)
Nursing Care Plan (NCP) for Vomiting / Diarrhea
Nursing Care Plan for Distributive Shock
Nursing Case Study for Hepatitis
Nursing Case Study for Maternal Newborn
Nursing Case Study for Pneumonia
Nursing Process – Assess
Order of Lab Draws
Pediatric Bronchiolitis Labs
Performing Cardiac (Heart) Monitoring
Peritoneal Dialysis (PD)
Phosphorus (PO4) Blood Test Lab Values
Plant Alkaloids Topoisomerase and Mitotic Inhibitors
Platelets (PLT) Lab Values
Pneumonia Labs
Prealbumin (PAB) Lab Values
Pregnancy Labs
Preoperative (Preop)Assessment
Procalcitonin (PCT) Lab Values
Procedural Terminology
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
Sepsis for Certified Emergency Nursing (CEN)
Sepsis Labs
Septic Shock (Sepsis) Case Study (45 min)
Shorthand Lab Values
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