“Alterations in potassium, chloride, BUN, and creatinine provide important information about patients’ renal function, volume status, and acid-base balance… [and] demonstrate the importance of the nurse’s ability to integrate laboratory results with patient history, hospital course, physical examination findings, and underlying physiological mechanisms.”

Years ago, I monitored my patients’ labs by checking to see which results had been flagged by the lab as abnormal and making sure the physician was aware of these. I was on top of glucose and PTT’s, and knew well the steps we had to take in order to correct abnormal glucose or coagulation levels.

But I was fuzzy on the significance of many other changes in blood chemistry or hematology, and rarely connected any lab values with the larger picture of the patient’s overall health trajectory—nor, for that matter, was I expected to, back in the 1980s.

Today, nurses are more intimately involved in monitoring and managing lab abnormalities.

To help all of us update our ability to interpret a patient’s lab values, AJN has launched the Back to Basics series. In this second installment, in the June issue, “Abnormal Basic Metabolic Panel Findings: Implications for Nursing,” author Lydia Bertschi offers a comprehensive look at potassium, chloride, BUN, and creatinine.

Normal physiology, the clinical significance of abnormalities, and problem management are reviewed, and boxes and charts throughout the article provide succinct summaries of key points.

Don’t miss this excellent update.