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Tip of the week: Know when to notify physicians about abnormal labs

Contemporary Long-Term Care Weekly, April 2, 2009

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Faxing a pile of normal and abnormal lab reports to the physician office may not constitute proper notification. In some situations, the facility continues to have the responsibility for identifying potential problems in the laboratory reports and notifying the physician by phone. This is especially true in coagulation test and laboratory values suggesting dehydration, which are both commonly overlooked by nursing personnel. A nurse must review the lab reports soon after they are returned to the facility and determine whether the values warrant phone notification or further nursing action. The track system should make it evident if lab reports have not been returned by the lab within a reasonable period of time. Nurses should be able to tell at a glance if they are missing, then contact the lab to resolve the problem.

Additionally, nurses are responsible for recognizing conditions and risk factors for which we have nursing diagnoses. For example, these are common nursing diagnoses:

• Risk for fluid volume imbalance
• Excess fluid volume
• Deficit fluid volume
• Risk for deficient fluid volume

This tip is from HCPro’s book The Long-Term Care Legal Desk Reference, by Barbara Acello, RN, MSN.

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