A - Low Priority LAB VALUES 1.

HOLD
B - Watch Closely 2. ASSESS
C – Critical 3. PREPARE
D - Deadly Dangerous 4. CALL

Lab Value Normal Range Abnormality Class Do:

Continue to monitor. **dye procedure
Creatinine 0.6-1.2 ↑ A
contraindication. Means kidneys are failing
1. Hold all warfarin/coumadin
↑ INR =
INR (international 2. Assess bleeding
2-3. Bleed Risk. ≥4 C
normalized ratio) 3. Prepare to give vitamin K
is Critical
4. Call Doctor
1. Assess heart
↓ C 2. Prepare to give potassium
3. Call Doctor
1. Hold potassium
Potassium 3.5-5.3 2. Assess heart
↑ - 5.4-5.9 C
3. Prepare kayexalate/D5W & insulin
4. Call Doctor
↑↑ DO ALL AT ONCE ↑↑
↑ - ≥6 D
Do NOT leave bedside
** CALL DR STAT**
1. Assess vital signs
pH 7.35-7.45 ↓ in the 6’s D
2. Call Doctor
Do NOT leave beside
BUN (blood urea
8-30 ↑ A Assess for dehydration
nitrogen)
↓ 8-11 B Assess for bleeding/malnutrition
1. Assess for bleeding
Hemoglobin 12-18
↓ <8 C 2. Prepare for transfusion
3. Call Doctor
HCO3 (bicarbonate) 22-26 Abnormal A Not worrisome
Respiratory insufficiency
1. Assess respirations
↑ in the 50s C
2. Initiate pursed lip breathing – usually solves
the problem
Respiratory failure
CO2 (carbon
35-45 1. Assess respirations
dioxide)
2. Initiate pursed lip breathing (for comfort)
↑ in the 60s D 3. Prepare to intubate and ventilate
4. Call RT
5. Call Doctor
Do NOT leave bedside
Hct (hematocrit) 36-54 ↑ B Assess for dehydration
Respiratory insufficiency
↓ 70-77 C 1. Assess respirations
2. Give Oxygen – usually solves the problem
Respiratory failure
1. Assess respirations
PO2 (oxygen) 78-100
2. Give oxygen (comfort measure)
↓ ≤60 D 3. Prepare to intubate and ventilate
4. Call RT
5. Call Doctor
Do NOT leave bedside
1. Assess respirations
2. Give oxygen
O2 Saturation 93-100 ↓ <93 C
**anemia and dye procedures can cause falsely
elevated results
BNP (B-type
<100 ↑ B Watch for CHF
natriuretic peptide)
Abnormal B Watch for change in LOC
Abnormal
Sodium 135-145
and change in C Safety issue. Call Doctor.
LOC

Page 1 of 2 Samantha Ng
 A - Low Priority LAB VALUES 1. HOLD
B - Watch Closely 2. ASSESS
C – Critical 3. PREPARE
D - Deadly Dangerous 4. CALL

TOTAL: 5000-
↑ = Leukocytosis
11’000
WBC (white blood Want 200 and above.
NEUTROPHILS: Abnormal C
cells) 1. Assess for infection
>500
2. Put on neutropenic precautions
CD4: >200 ↓ = AIDS
1. Assess for bleeding
<90’000 C
2. Put on bleeding precautions
1. Assess for bleeding – can spontaneously
150’000-
Platelets bleed to death
400’000
<40’000 D 2. Put on bleeding precautions
3. Call Doctor
Do NOT leave bedside.
RBC (red blood cells) 4-6 Abnormal B Monitor closely.

THE 5 D’s: (Remember the 6’s)

1. K+ ≥6
2. pH in the 6s
3. CO2 in the 60s
4. PO2 ≥60
5. Platelets <40’000

THE 10 C’s:
1. INR ≥4
2. ↓ Potassium
3. Potassium 5.4-5.9
4. Hemoglobin <8
5. CO2 in the 50s
6. PO2 70-77
7. O2 Sat <93
8. Sodium ↓or↑ with altered LOC
9. ↓ WBCs
10. Platelets <90’000

If you remember the Cs and Ds – you will know who to prioritize.

Page 2 of 2 Samantha Ng