Lead

General

Synonym/Acronym:
Pb.

Rationale
To assess for lead toxicity and monitor exposure to assist in diagnosing lead poisoning.

Patient Preparation
There are no food, fluid, activity, or medication restrictions unless by medical direction.

Normal Findings
Method: Atomic absorption spectrophotometry or inductively coupled plasma/mass spectrometry.

Conventional UnitsSI Units (Conventional Units × 0.0483)
Children and adults (CDC)Less than 3.5 mcg/dLLess than 0.17
CDC = Centers for Disease Control and Prevention.

Critical Findings and Potential Interventions

  • Levels equal to or greater than 5 mcg/dL (SI: Greater than 0.24 micromol/L) indicate exposure above the reference level.
  • Levels equal to or greater than 45 mcg/dL (SI: Greater than 2.2 micromol/L) may require chelation therapy.
  • Levels greater than 70 mcg/dL (SI: Greater than 3.3 micromol/L) may cause severe brain damage and result in death.


Timely notification to the requesting health-care provider (HCP) of any critical findings and related symptoms is a role expectation of the professional nurse. A listing of these findings varies among facilities.

Observe the patient for signs and symptoms of elevated lead levels to include headache, impaired hearing, weight loss, disturbances of the nervous system, severe stomach cramps, and anemia. The pediatric patient may also demonstrate delayed learning and delayed growth.

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