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07.05 Congestive Heart Failure (CHF) Labs

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Overview

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

Nursing Points

General

  1. Congestive Heart Failure
    1. Labs to consider for disease process
      1. Comprehensive metabolic panel
      2. Complete blood count
      3. BNP
      4. Cardiac markers
      5. Thyroid panels
      6. C-Reactive Protein
    2. Lab purposes
      1. Comprehensive metabolic panel
        1. Kidney function
        2. Electrolyte balance
      2. Complete blood count
        1. Infection/Inflammation
        2. Anemia
      3. BNP
        1. Exacerbation of CHF
      4. Cardiac markers
        1. Cardiac dysfunction
        2. Demand ischemia
      5. Thyroid panels
        1. TSH/T3/T4
        2. Hypothyroidism contributes to CHF
      6. C-Reactive Protein
        1. Indicative of inflammation
        2. Particularly in arteries or heart
    3. Special Considerations
      1. Comprehensive metabolic panel
        1. Green top
      2. Complete blood count
        1. Lavender top
      3. BNP
        1. Green top
      4. Cardiac markers
        1. Green top
      5. Thyroid panels
        1. Red/green top
      6. C-Reactive Protein
        1. Red/Green top

Nursing Concepts

  1. Perfusion
  2. Lab Values

Reference Links

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Video Transcript

For this lesson we’re going to take a look at the different types of labs we’re probably going to see for a patient with congestive heart failure

Similar to some of the other lessons, what we’ve done is we’ve taken a look at the most common types of labs are going to see for different types of diseases, illnesses, or conditions, and we put this list together for you so that you can anticipate what labs you would run on these patients. This is not a comprehensive all inclusive list, but it’s important to know what types of different tests that you’ll see for these different types of conditions.

So in this lesson we’re going to focus on congestive heart failure.

Congestive heart failure is a condition in the hospital, and what our goal is, is to determine the level of exacerbation that the patient is having. That will also help us develop a plan of care for that patient.

If is a new onset type of congestive heart failure, it helps us to identify the cause for the new onset.

You can see several different types of tests for you can just have heart failure patient, but the most common ones that you’re going to see her comprehensive metabolic panel, a complete blood count, a BNP and other cardiac markers. You may also see thyroid panel, and something called a C-reactive protein which we’ll get into in a minute.

As with all of our other metabolic panels, we do this test to figure out what type of organ function or dysfunction is going on. The comprehensive metabolic panel is going to give his kidney values, liver values, total proteins, and it’s also going to give us a pretty significant amount of electrolytes to figure out if there’s any sort of electrolyte imbalance.

The CBC is important because it tells us any indication of infection or inflammation. It also helps us to determine if there’s any sort of anemia that is contributing to the disease.

We will also run a BNP and cardiac markers on our patient. Because it’s a heart-related issue, we want to see what that BNP is because that’s really going to tell us how exacerbated the patient’s congestive heart failure is. There’s a great lesson on BNP so I encourage you to go check that out. Those cardiac markers are going to help us determine if there’s any sort of cardiac cell damage by evaluating the troponin.

The other thing we want to pay attention to our a thyroid studies. Conditions like hypothyroidism contribute to congestive heart failure.

Another test that you may see for your patients that have congestive heart failure is something called a C-reactive protein. It’s an indication of inflammation. While it’s not specific to the heart muscle, it tells us that there’s some sort of inflammation going on, and it’s very commonly elevated in patients with exacerbation of congestive heart failure.

So what do we need to know about the actual labs when we send them off?

Well your patients metabolic panel and electrolytes as well as a BMP and cardiac markers are all going to go in the green top tube.

The CBC is going to go in the purple top, or lavender top tube, that has an EDTA in it to keep those cells from clotting.

The thyroid studies are going to go in a red top tube and the patient C-reactive protein is going to go into a red or green top tube

For this lesson we really focus on our nursing concepts when it comes to congestive heart failure on evaluating a patient’s lab values so that they can adequately perfuse their body
Okay so let’s recap.

Your metabolic panel and electrolytes are going to tell us what’s going on with your patients organ function & potassium monitoring and other electrolytes.

The CBC is going to help us determine if there’s any sort of infection or inflammation or any sort of concerning an email when it comes to your patients congestive heart failure.

BNP specifically is going to tell us how significant are our patients heart failure is exacerbated.

Also we paid attention to our patients troponin, because that helps identify the degree of myocardial or cardiac cell injury.

And lastly we pay attention to our patients C-reactive protein, because that indicates inflammation that could be occurring and contributing to our patients congestive heart.

That’s it for our lesson on Labs that we do for a patient with congestive heart failure. 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 has a brain natriuretic peptide value of 782 pg/mL. The nurse recognizes this as an indication of issues in which of the following organs?

  • Question 2 of 2

A nurse is caring for a client with increased brain natriuretic peptide (BNP). Which organ does the nurse need to be concerned about?

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