From the Guidelines
Normal admission labs for a nursing home patient should include a comprehensive metabolic panel (CMP), complete blood count (CBC), urinalysis, and electrolyte panel, which assesses kidney and liver function, electrolyte balance, and blood glucose levels, as well as screens for anemia, infection, or bleeding disorders, as recommended by the American Heart Association and the Heart Failure Society of America 1.
Key Laboratory Tests
- Comprehensive metabolic panel (CMP) to assess kidney and liver function, electrolyte balance, and blood glucose levels
- Complete blood count (CBC) to evaluate red and white blood cell counts, hemoglobin, and platelets
- Urinalysis to detect urinary tract infections, kidney problems, or diabetes
- Electrolyte panel, including potassium, sodium, and hematocrit, as specified in the guidelines for heart failure management in skilled nursing facilities 1
Rationale for Test Selection
The selection of these laboratory tests is based on the need to establish a baseline health status for the patient, identify any immediate concerns requiring intervention, and provide reference points for future comparison. The tests are also relevant to the management of common conditions in nursing home patients, such as heart failure, as outlined in the guidelines from the American Heart Association and the Heart Failure Society of America 1.
Additional Considerations
Additional tests may be ordered based on the patient's medical history, current medications, and presenting symptoms. However, the core laboratory tests listed above provide a foundation for assessing the patient's overall health status and guiding further evaluation and management. The guidelines emphasize the importance of communicating essential clinical data, including laboratory values, between healthcare providers to ensure continuity of care 1.
From the Research
Normal Admission Labs for Nursing Home Patients
Normal admission labs for patients in nursing homes typically include:
- Complete Blood Count (CBC) with differential, which provides information about the production of all blood cells and identifies the patient's oxygen-carrying capacity through the evaluation of red blood cell (RBC) indices, hemoglobin, and hematocrit 2
- Basic Metabolic Panel (BMP), which includes electrolytes such as potassium and chloride, as well as blood urea nitrogen and creatinine, to reflect and impact renal function as well as acid-base homeostasis 3
Components of Complete Blood Count
The Complete Blood Count (CBC) components include:
- Red Blood Cell (RBC) indices
- Hemoglobin
- Hematocrit
- White Blood Cell (WBC) count with differential These components are helpful in diagnosing anemia, certain cancers, infection, acute hemorrhagic states, allergies, and immunodeficiencies, as well as monitoring for side effects of certain drugs that cause blood dyscrasias 2, 4
Importance of Laboratory Tests
Laboratory tests, such as the CBC and BMP, are essential for providing quality care to patients in nursing homes, as they help nurses to: