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    Profile photo of Amanda May
    Amanda May

    I need some help. I would like to learn more in-depth info about lab values and their relation to the most common meanings related to what’s going on with a pt. Does anyone know a good app or book I can get? I have some material that explains lab values but doesn’t explain some issues that go with some values. I work in a skilled care/ rehab facility so if I could atleast get some common ones down it would be helpful to me when some drs are not.

    Profile photo of Sara Maedke

    In a SNF environment the most common and the most important values:

    PT/INR. Normal range is 2-3 on Coumadin. When you call for new Coumadin orders know how long the patient has been taking (new since surgery or long term for a-fib). When was last PT/INR, what was the range, what was that result.

    CBC- includes H&H. Know when your patient may be receiving transfusion. Know if they will need another Aranesp injection (hold if above 11).

    Understand the BMP- understand the correlation between FR and the sodium level. Understand the correlation between CHF/Lasix/K+. Understand the BUN and Cr and GFR.

    BNP is interesting, not seen a whole lot. Vitamin D also interesting, but not seen a whole lot.

    Also understand the TSH as this correlates to the Levothyroxine dose.

    The other labs like CMP or all of the ID labs like ESR and CRP for infection, those are interesting, but not crucial.

    Really get the PT/INR down. Many patients come in on Heparin transition to Coumadin and finally progress to ASA as they become more mobile. Be aware of patients who may stop Coumadin, stop wearing TEDS and aren’t as mobile as they are telling their surgeons— they are at primed for a DVT/PE. Keep close tabs on these patients.

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