Products
Pre-Nursing
Nursing Student
NCLEX Prep
New Grad

07.03 Dysrhythmias Labs

This lesson is part of the NURSING.com Nursing Student Academy. Start a trial to view the entire video.
Print

Overview

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

Nursing Points

General

  1. Dysrhythmias
    1. Labs to consider
      1. 12 lead EKG
        1. Not necessarily a lab, but a diagnostic tool
          1. Indicates particular dysrhythmia
      2. Comprehensive/Basic metabolic panel
      3. Electrolytes
      4. Complete Blood Count
      5. Cardiac Markers
      6. BNP
      7. D-Dimer
      8. Thyroid Studies
      9. Digoxin level
      10. Toxicology screen
    2. Lab purposes
      1. Comprehensive/Basic metabolic panel
        1. Organ function/impairment
      2. Electrolytes
        1. Looking for imbalances that would cause arrhythmia
          1. Specifically potassium
      3. Complete Blood Count
        1. Anemia
        2. Infection
      4. Cardiac Markers
        1. Troponin
          1. Sign of injured heart muscle
      5. BNP
        1. Exacerbation of heart failure
      6. D-Dimer
        1. Identifies a concern for potential pulmonary embolism
      7. Thyroid Studies
        1. TSH, T3, T4
          1. Hyperthyroidism contributes to atrial fibrillation
          2. Hypothyroidism contributes to ventricular dysrhythmias
      8. Digoxin level
        1. Checks for appropriate levels if patient is currently receiving digoxin
      9. Toxicology screen
        1. Rules out causes for dysrhythmias
          1. Cocaine contributes to heart attack
    3. Special Considerations
      1. Comprehensive/Basic metabolic panel
        1. Green top
      2. Electrolytes
        1. Green top
      3. Complete Blood Count
        1. Lavender top
      4. Cardiac Markers
        1. Green top
      5. BNP
        1. Green top
      6. D-Dimer
        1. Blue top
      7. Thyroid Studies
        1. Red or green top
      8. Digoxin level
        1. Red or green top
      9. Toxicology screen
        1. Urine
          1. Urine cup
          2. Most common
        2. Blood
          1. Red or grey
          2. Rare

Nursing Concepts

  1. Perfusion
  2. Lab Values

Reference Links

Create Your Account

Get unlimited access to lessons and study tools

Video Transcript

All right in this lesson we’re going to take a look at what types of labs were going to see for a patient’s that have some sort of dysrhythmia.

Like our other lessons similar to this what we’ve done is we’ve compiled the list of the most common types of labs you’re going to see with different types of diseases, conditions, or illnesses. Again this isn’t a comprehensive list and there’s more information about each one of these diseases and other lessons. But what we want to do is focus on the different types of labs as a whole that you’ll see for whatever is going on with your patient.

In this lesson we’re focusing on dysrhythmias. What we are looking at are the abnormal rhythms that occur in the heart and we’re focusing on them because they’re a very common type of admission into the hospital. The first goal is to identify the cause of the dysrhythmia and then develop some sort of plan of care. The way we do that is with different types of labs.

This is a really comprehensive list, but it’s not every type of lab test that you are going to run on a patient that has a dysrhythmia. You’re probably going to start with a 12-lead EKG and that’s going to give you a basis as to what’s going on specifically with your patient. I know it’s not necessarily a lab test, but it’s something that you will do in terms of diagnostics in order to figure out what’s going on with your patient.

You’re also going to do things like a comprehensive metabolic panel, electrolytes, a complete blood count. You’re also going to do things like cardiac markers and a BNP. You’ll also probably do something like a D-dimer, and thyroid studies.

If your patient is on some sort of medication like digoxin, you’re probably going to get some sort of digoxin level, and also if you were suspicious that your patient is on any sort of recreational drugs, you may also do a toxicology screen
Right off the bat, the first thing you need to pay attention to your comprehensive metabolic panel. The first thing is going to tell us is what kind of organ function or dysfunction is happening. It’s also going to help us get some insight into liver and kidney function and in terms of proteins.

The other thing about the comprehensive metabolic panel that’s going to tell us about electrolytes, particularly potassium, because that’s when they can really throw everything off.

You also probably get a CBC on your patient, and that’s going to look at any sort of infection or anemia.

Anytime you have a heart issue, you’ll expect to run some cardiac markers and your patient at particularly troponin. If that dysrhythmia is so out of whack, it can actually keep your patient from getting enough oxygen to the heart and that can cause some cardiac cell damage. So that’s why we pay attention to troponin.

If we suspected our patients have some sort of congestive heart failure and they’re having an exacerbation of the congestive heart failure, will also do another test called a BNP which will help identify a how bad that exacerbation is.

If providers are suspicious of some sort of pulmonary embolism, you also see your providers order a D-dimer.

Another type of lab that you may see in patients that have dysrhythmias are thyroid studies. So we’re going to check T3, T4, and TSH. Hyperthyroidism can actually cause atrial fibrillation, and hypothyroidism is associated with ventricular dysrhythmias.

Like we talked about in the other slide, if your patients already on digoxin, we want to make sure that they’re not getting too much of it because that’ll throw the rhythm out of whack.

Also if you’re suspicious that your patient has had any sort of major stimulants like cocaine and methamphetamines, those types of drugs will give them some sort of arrhythmia that we need to pay attention to. That will really help guide what we do for our patients.

So what should we expect when we’re sending our labs out?

Well for our metabolic panels and electrolytes, those are going to go in a green top tube.

Your CBC is going to go in your lavender top tube and your cardiac markers in your BNP are going to go in a green top tube.

The D-dimer is going to be sent in the blue top, and your thyroid studies will commonly be sent in a red top or sometimes at green top depending on the facility.

Your toxicology screen most of the time is going to be done with a urine sample, so you’ll use a urine collection Cup. In a rare occasion to actually do a blood sample. Just pay attention to your order and figure out what you need for that particular test.

For this lesson for nursing Concepts we focus on lab values and perfusion when we’re talking about a patient with dysrhythmias
So let’s recap.

To get started, your metabolic panel and electrolytes are really going to focus on your organ function overall, and as well as pay attention to those particular electrolytes like potassium that can really throw your patient’s heart rhythm out of whack.

Your CBC is going to check for infection inflammation and anemia.

You’re also going to check your your patient’s cardiac markers like troponin could because we’re checking for cardiac cell injury.

Also if you’re suspicious that your patient has some sort of congestive heart failure we should really check a BNP on that patient to see if there’s an exacerbation.

Lastly you’re going to check your thyroid panels and probably some sort of drug screen if you’re suspicious there on some sort of recreational drug that’s causing this arrhythmia.

And that’s our lesson of for patients that have dysrhythmias and the labs that you need to check for them. 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 had an electrolyte panel drawn and the potassium level was 5.4 mEq/L. The nurse is getting ready to notify the provider about the results. Which implications would the nurse need to consider when contacting the provider about this result? Select all that apply.

  • Question 2 of 2

A nurse in the emergency department is caring for a client who presented with an irregular pulse, muscle twitching and hyperactive bowel sounds. Based on these symptoms, which of the following laboratory values would the nurse most likely see?