Understanding laboratory values is a core aspect of patient care and nursing practice. It is important for nurses to be knowledgeable about laboratory tests in order to make informed clinical decisions regarding the results to safeguard patient care. To assist nurses with developing and enhancing this skillset, this module will provide a basic overview of the most common laboratory tests, including the complete blood count, comprehensive metabolic panel, lipid panel, thyroid function tests, fasting blood glucose, glycated hemoglobin, and coagulation profile. As with all aspects of patient care, in order to fully comprehend laboratory data, the results must always be correlated with the patient's clinical signs and symptoms. All laboratory data and values listed within this module are compiled from the American Board of Internal Medicine (ABIM) guide to laboratory reference ranges and refer to healthy, non-pregnant adults. However, it is important to recognize that normal reference ranges will vary between laboratories (ABIM, 2019).
Potassium helps regulate the communication channels between nerve fibers and muscles, serving an important role in heart contraction and muscle functioning. Hypokalemia results when the potassium level drops below the normal range, and can occur from diuretic medications, diarrhea, vomiting, or in severe illness such as diabetic ketoacidosis. Symptoms of hypokalemia may include constipation, muscle weakness or spasms, numbness or tingling sensations, palpitations, and fatigue. Hyperkalemia occurs when the potassium level is higher than the upper limit of normal and can be due to excess dietary potassium intake, impaired renal clearance, or drug-induced from potassium-sparing diuretics. Symptoms of hyperkalemia may include muscle fatigue, weakness, paralysis, cardiac arrhythmias, and nausea. The collection process of the serum sample is important because if the sample becomes hemolyzed (cells are ruptured), hyperkalemia can be inaccurately reported on the lab results, thereby reinforcing the need to associate all laboratory data with the patient's clinical presentation. Since more than 90% of potassium is excreted in the urine, which is then filtered and reabsorbed proximally before being excreted by the distal tubules, it is not uncommon for patients with severe renal disease to exhibit abnormal potassium levels (Bakerman et al., 2014).
Bakerman Abc Of Interpretive Laboratory Data Pdf 18
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Reference intervals are useful both in the clinical and research environment. Medical laboratory reference intervals are primarily used for clinical purposes. They can be used as an indicator of good health. Alternatively, reference intervals/limits can be used to screen for physiological or pathological conditions hence important in routine health assessment, particularly for screening of anemia, blood disorders and diseases of the immune system. Reference intervals are important for accurate interpretation of laboratory data and provide assistance to the clinician in creating a more comprehensive clinical perspective for diagnosis and management of patients [10]. Of particular importance is the use of reference values as surrogate markers for monitoring disease progression and response to antiretroviral therapy in HIV-infected individuals [11]. For example, decisions to initiate, continue, or change antiretroviral therapy regimens are determined using CD4+ T-lymphocyte cell (CD4) counts, while drug toxicity is monitored using liver function tests, renal function tests, and full blood counts (FBC) [12, 13]. The hemoglobin concentration is used as a marker of anemia. As part of the management of anemia, the clinician conducts additional tests to identify a reversible etiology for anemia (eg, iron deficiency, infection) and if present treats it appropriately. However, in the clinical environment, the statistical definition of reference intervals may not allow certain clinical uses. Because these reference intervals have been derived statistically from a healthy population, they may not be used to rule in or rule out specific medical conditions. The statistically derived 95% reference interval would mean that 5% of normal subjects would have abnormal laboratory values. This is erroneously interpreted that 95% of diseased individuals would fall outside the derived reference interval. It is recommended that the number of diseased individuals who fall outside the defined 95% reference intervals be determined through a study of the distribution of such persons with the target condition [14]. Thus, it is necessary to confirm the validity of the proposed reference intervals with clinicians using a particular test to manage patients. 2ff7e9595c
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