Many times students are overwhelmed looking at a cumulative lab report, wondering what does it all mean and what is important. Often lab tests are integrated with various disease processes throughout the curriculum and therefore you look at one or two values at a time not looking at the big picture and how values are related. From the very beginning of your clinical experience you should evaluate lab values as part of your assessment of the patient. To do a general overview look at the groups of labs for abnormalities, if there are none that's good and move on, but if there are abnormalities in that group you will have an idea of what to be concerned about. Discuss with your instructor, primary nurse, and the physician. Medicine is very specialized these days; sometimes the Cardiologist overlooks the UA results.

Look at important groups of chemistries:

Electrolytes—Think electrical activity! Electrical activity in the human body includes important items such as nerve impulse transmission and depolarization / repolarization of muscles (including the heart). Disturbances can effect mental status, induce seizures, induce cardiac dysrhythmias, change the effect of antidyrsrhythmic drugs, cause muscle excitation or weakness. (Look at Potassium, Sodium, Chloride, Calcium, Magnesium)

Indicators of Renal Function—Kidney function is vital and somewhat tenuous in the elderly population. The kidneys remove waste products from the body and in some cases excrete drugs. Delayed drug excretion could lead to toxicity. Monitor renal function (Look at Creatinine and BUN) carefully, especially if your patient is undergoing any procedures using contrast dye. Any x-ray exam ending in "ography" tend to use contrast medium that is hard on the kidneys, such as angiography. Protein in the urine also indicates kidney problems.

Indicators of Diabetes—Diabetes is a risk factor for cardiovascular, kidney (look at indicators of renal function), and other disease processes. Identifying the presence of diabetes (Look at Glucose), or the effectiveness of treatment (Look at Hgb A1C) is vital. Hemaglobin A1C gives an indication of average blood sugars for the past 3 months. If a diabetic patient is under good control blood sugars should be in the normal range. Spikes in blood sugars are seen with infections (Check WBC), changes in patient behaviors (might indicate neurological changes such as a patient admitted with high blood sugar because they are eating inappropriately due to advancing dementia)