VIEWS: 173 PAGES: 3 POSTED ON: 3/24/2010
DIAGNOSTIC LAB STUDY INTERVENTIONS - NSG 220 Lab Study Interventions T & CM Assess: -decreased H & H Interventions: -identify type, Rh. Orders: -identify number of units available Thyroid Assess: Decreased T3, T4 -fatigue, lethargy, cold intolerance, dry skin, weight gain, Elevated TSH constipation, decreased pulse and B/P, slow mental ability Interventions: -provide rest periods Orders: -administer levothyroxine (Synthyroid) Thyroid Assess: Elevated T3, T4 -tachyarrhythmias, hunger, weight loss, heat intolerance, Decreased TSH insomnia, exophthalmos, nervousness Interventions: -provide extra calories, between meal snacks, increase fluids, no caffeine -provide rest periods and quiet environment Orders: -administer Beta Blockers, PTU, Tapazole FBS and/or Hgb A1C Assess: Elevated -polyphagia, polydipsia, polyuria, fatigue, weight loss, DKA, HHNS -cause: diabetes, steroid use, stress, TPN Interventions: -teach importance of tight glucose control with diet, meds, and exercise Orders: -maintain diabetic diet -administer insulin and/or oral antidiabetic medications Prealbumin, Albumin, and Assess: Total protein -malnutrition (decreased protein and calcium), edema, Decreased infection, poor wound healing, and skin breakdown -liver abnormalities - jaundice, itching, N/V, increased bilirubin Interventions: -skin care, protect from infection -fluid and Na restrictions, increase protein in diet Orders: -administer TPN -administer diuretics, albumin NSG 220 Diag/lab interventions Amylase and Lipase Assess: Increased -hypovolemia, LUQ, epigastric pain, N/V -complications: hypocalcemia, hypokalemia, hyperglycemia, jaundice Orders: -administer pain medications -NPO, administer IV fluids -administer antiemetic and possible NG insertion -administer antibiotics Total bilirubin Assess: Elevated -jaundice, itching, icteric sclera, clay colored stool, amber urine, N/V -intolerance to fatty foods, anorexia -abdominal pain in RUQ or LUQ -bruising, and bleeding Interventions: -tepid bath, oatmeal soap-Aveeno, cool environment Orders: -administer cholestyramine (Questran). -administer fat soluble vitamins A, D, E, K Direct (conjugated) bilirubin -as above with total bilirubin Elevated Assess : -S & S of obstructive jaundice (especially from gallstones). RUQ pain, N/V, intense stabbing epigastric pain Indirect (unconjugated) bilirubin -as above with total bilirubin Elevated Assess: -liver dysfunction cirrhosis, cancer, and hepatitis AST and ALT Assess: Elevated -bone or liver abnormalities - bone pain, jaundice, itching, elevated bilirubin, and N/V Interventions: -safety measures to prevent fractures AST and ALT Assess: Decreased -malnutrition Interventions: -increase protein, vitamins, and calcium in diet Alkaline Phosphatase Assess: Elevated -bone and liver abnormalities - bone pain, jaundice, itching, elevated bilirubin, and N/V Interventions: -safety measures to prevent fractures NSG 220 Diag/lab interventions Ammonia Assess: Elevated -cirrhosis and liver cancer -disorientation, tremors, asterixis, decreased coordination, decreased LOC, elevated liver function studies Interventions: -reorient frequently -safety precautions Orders: -administer low protein diet and/or enteral amino acid formula -administer Neomycin -administer Lactulose, Cephulac -if GI bleeding prepare for gastric lavage to remove blood -If hypokalemic, administer K+ to keep levels normal Hepatitis Screen Assess: Positive -slight fever, GI upset, anorexia Interventions: -provide rest, decrease stress, balanced diet -teach hand washing, safe sex practices, food handling, and how to avoid spreading disease -teach no alcohol or acetaminophen Orders: -administer Interferon for Hep. B/C and Y-globulin for A -teach hand washing, safe sex practices, food handling, and how to avoid spreading disease -teach no alcohol or acetaminophen C. difficile toxin Assess: Positive -frequency, color, and odor of stools Interventions: -contact isolation, obtain bedside commode, -provide perirectal skin care Orders: -administer antibiotic Occult blood in stool Assess: Positive -anemia, fatigue, decreased H & H Interventions: -teach follow up screening and possible colonoscopy CEA level Assess: Elevated -change in stool pattern, caliber, and frequency -colon/breast cancer, heavy smoking, cirrhosis, ulcerative colitis, diverticulitis, peptic ulcer, or pancreatitis Interventions: -provide emotional support Urinalysis Assess: +glucose -hyperglycemia, DKA, HHNS +ketones -elevated blood glucose monitoring results. +microalbumiuria Interventions: +protein -teach importance of tight glucose control via meds, diet, and exercise Orders: -administer insulin and oral anitdiabetic medication NSG 220 Diag/lab interventions
"Nursing 220 Lab Interventions"