FINALLY Unlock the Power of Lab Interpretation: Go Beyond the Numbers to Transform Patient Care

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Handouts/Brochure

Speaker

Cyndi Zarbano, MSN-Ed, CCRN, PCCN, CMSRN, LNC, NLCP Related seminars and products

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Cyndi Zarbano, MSN-Ed, CCRN, PCCN, CMSRN, LNC, NLCP, brings 30 years of frontline nursing experience across intensive care, emergency, and flight nursing – and she continues to take patient assignments as an intensive care nurse at Mayo Clinic in Minnesota. That direct patient care isn’t just background; it’s the foundation of everything she teaches.

A sought-after speaker on national and international stages, Cyndi is known for delivering evidence-based clinical content with the kind of real-world perspective and genuine humor that makes learning stick. She practices what she preaches when it comes to professional growth, currently pursuing her third master’s degree – this one in leadership.

Her expertise extends well beyond the bedside. Since 2008, Cyndi has served as a legal nurse consultant on more than 300 cases spanning plaintiff, defense, and boards of nursing matters. She has accumulated critical perspectives on clinical documentation, standards of care, and the moments when nursing judgment makes all the difference. A 10-year US Navy veteran who left service as a Lieutenant Commander, she carries that same precision, discipline, and commitment to excellence into every room she enters.

 

Speaker Disclosures:
Financial: Cynthia Zarbano is the owner of Clinical Review Consultants and has an employment relationship with Mayo Mankato. She receives a speaking honorarium, recording, and book royalties from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Cynthia Zarbano has no relevant non-financial relationships.

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Objectives

1. Evaluate the results of coagulation studies (PT/INT/ APTT, 10a levels, Fibrinogen, D-Dimer).
2. Explore a deeper understanding of the clotting cascade and which labs correlate with which part of the cascade.
3. Analyze a Complete Blood Count (CBC) with differential and associated clinical applications (anemias, “shift to the left”, clues to infections, platelet abnormalities, breaking down the differential, etc).
4. Recognize the clinical implications of metabolic panels.
5. Comprehend liver function tests and decipher the clues from the test results.
6. Plan for reversal of anticoagulation agents, including factor 10a inhibitors.
7. Distinguish between life-threatening electrolyte imbalances, as well as potential causes and interventions.
8. Predict renal function based on BUN, Creatinine, BUN/CR ratio, and GFR.
9. Interpret cardiac panel results in a suspected acute myocardial infarction.
10. Evaluate gram stains and differentials.
11. Analyze blood gases and pertinent clinical implications.
12. Differentiate between bacterial, viral meningitis, and viral encephalitis based on lumbar puncture findings.
13. Recognize the key clinical indicators and implications for infection on a urinalysis.

Outline

• Basic Metabolic Profile (BMP) and More

• Glucose
• Acid base
• Renal function
  • Acute and chronic renal failure labs and findings
  • How labs can help you differentiate cause of AKI
  • Creatinine
  • BUN
  • BUN/Creat ratios
  • Glomerular Filtration Rate (GFR)
  • Urine Na+ and Osmolality
  • FENA
  • Discover the difference between ATN and pre-renal causes based on the labs/other patient clues
• Life-threatening electrolytes
  • Potassium
  • Magnesium
  • Sodium
  • Calcium
  • Phosphorous
• Anion gap
• Ionized calcium
• Corrected calcium equation

• Comprehensive Metabolic Panel: Adding the LFTs to the BMP

• LFTs: Exploring the liver and changes related to liver failure
• AST/ALT/ALP/Total bilirubin/proteins
• Shall we add transaminase?
• Health issues and symptom management in severe liver failure
  • Jaundice
  • Ascites
  • Hepatic encephalopathy
  • Coagulopathies

• CBC with Differential: Interpreting the Components

• What can impact WBC’s and neutrophil findings
• Anemias/polycythemia
• Understanding the differential
• The “Shift to the Left” explained
• Current Guidelines on transfusing
• Exploring those blood products

• Cardiac Labs: Ishemia vs. Myocardial Infarction

• Troponin I and Troponin Delta’s
• EKG Signals: What am I seeing?
• Distinguishing a STEMI vx. NSTEMI
• Another cardiac lab: BNP vs Pro-BNP

• Coagulation/Thrombotic Risk Panels: Clues to Clotting

• The Clotting Cascade
• Selecting the correct lab test for different medications
• aPTT
• PT
• INR
• 10a
• Fibrinogen
• D-dimer
• Anticoagulants and reversal agents
• Disseminated Intravascular Coagulopathy (DIC) and DIC panels

• Urinalysis: Does Your Patient Have a UTI?

• Current guidelines
• UA’s
• Clues to a UA typically depend on the patient population

• Blood Gases: Identifying the Underlying Abnormality

• Three types of blood gases: Choosing the right test for the right result
  • Arterial, venous, mixed Venous
• Interpreting arterial blood gases: It’s easier than you think using a simple tool!

• Blood Cultures

• Culture reminders!
• Cultures from central lines or dialysis ports …
• Gram stains
• Sensitivities

• Labs and Sepsis: Taking a Team Approach

• Systematic inflammation and the progression from SIRS to MODS
• Labs of sepsis
  • Lactate levels
  • Procalcitonin levels
  • WBCs
  • Neutrophils – Shift to the Left
  • So many other clues – Current surviving sepsis campaign guidelines

• Lumbar Punctures/Cerebral Spinal Fluid

• LP procedure
• Bacterial meningitis
• Viral meningitis
• Viral encephalitis

• Understanding Thyroid Dysfunction

• TSH
• T4 levels
• T3 levels

• Glycemic Abnormalities

• Hypoglycemia
• Hyperglycemic states – Differentiating and treatment clarification
  • Hypoglycemia
  • DKA
  • HHS (HHNK)
  • Treatment for each

Target Audience

• Nurses
• Nurse Practitioners
• Clinical Nurse Specialists
• Physician Assistants
• Physical Therapists
• Occupational Therapists