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Similar to some of our other lessons, this lesson is going to focus on the different types of labs that are associated with a particular illness, injury, disease, or condition. This is not a comprehensive list, this is not all inclusive, but what we've done is we've compiled a list of the most common types of labs you are going to see with different types of diseases.
When we’re talking about COPD, this is a very common cause of admission. COPD can become exacerbated nd we need to figure out what's going on with our patient. This helps us to develop a plan of care by looking at their different types of labs.
These are the different types of routine lab tests that you're probably going to see for your patient with COPD.
Pulse oximetry is not a lab test, but it's a diagnostic tool that helps us determine our patient’s current oxygen level. You can expect your patients with COPD to be a lower than normal usually somewhere in the ninety percent range. What you end up doing is talking to your provider and saying what level of pulse ox do you want them, and they'll tell you and it's going to be lower than normal, so don't panic.
For the most important ones that we're going to see if our patient are ABG so arterial blood gas, CBG, capillary blood glucose or bedside glucose testing, cultures, metabolic panel and CBC.
To get started the first thing that we look at and we come in later in for a patients with COPD and COPD exacerbation is arterial blood gases. Their CO2 levels are a lot higher than other patients, so we want to continue to monitor those and monitor them over time.
The other thing that they're going to do is your COPD patients are commonly going to be using steroids, so that throws their glucose levels all out of whack. What we want to do is continue to monitor those and make sure that we don't need to give them supplemental insulin, especially a lot of them that are already diabetic.
The other thing you commonly do for your patients that have COPD is do some sort of culture because we're concerned about some sort of level of infection. That could either be blood cultures, or sputum cultures. We want to make sure that they're not developing any complications like pneumonia.
Also you do things like a comprehensive metabolic panel especially if your patients are on steroids, because that affects liver function as well.
Also we’ll do things like a complete blood count, because that helps us determine if there's some sort of a systemic inflammation or infection going on that we need to take care of pure.
So things that you need to be aware of as the nurse is that the ABG so the blood gases, are going to go in their own little syringe down to the lab. You're going to put them on typically on ice, but find out what your facility policy is.
Your CBGs are going to be done at bedside and they're quick and easy way to get your patient’s blood sugar.
If you're doing any sort of cultures, you can expect them to go in these blood culture jars, or if it's a sputum culture may have to provide your patient a sputum culture collection cup so that they can actually spit into that.
Your metabolic panels are going to go in your green top tubes, and your cbc's are going to go to in lavender top tubes, that has EDTA in it which of the anti-clotting additive that keeps your cells from clotting.
So for patients with COPD, we focus on lab values, gas exchange, and oxygenation when we're determining what they're lab value should look like
So let's recap,
For our patients with COPD, we want to focus on monitoring this ABGs and trending those CO2 levels over time.
Because our patients are chronically on steroids, we want to monitor the CBGs and check bedside blood glucose is to make sure that their glucose is under control.
If we're suspicious that infection is going on, will pay attention to both a culture and a CBC as well.
And we want to continue to monitor a patient's organ function and electrolyte levels and will do that with metabolic panels
That's it for a lesson on lab values associated with COPD. 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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