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07.02 Pneumonia Labs

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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

Reference Links

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Video 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!!

  • Question 1 of 2

A client with a lung infection must undergo an ABG. The client asks the nurse why this lab test is necessary. Which of the following should the nurse include that would explain the reasons for this test? Select all that apply.

  • Question 2 of 2

The nurse is reviewing a clients lab results. Which of the following results for vancomycin would the nurse recognize as within the therapeutic range?

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