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Lactic Acid

Lactic Acid is a topic covered in the Davis's Lab & Diagnostic Tests.

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Synonym/Acronym:
Lactate.

Rationale
To assess for lactic acid acidosis related to poor organ perfusion and liver failure. May also be used to differentiate between lactic acid acidosis and ketoacidosis by evaluating blood glucose levels.

Patient Preparation
There are no activity or medication restrictions unless by medical direction. Instruct the patient to fast and to restrict fluids overnight. Instruct the patient not to ingest alcohol for 12 hr before the test. Protocols may vary among facilities.

Normal Findings
Method: Spectrophotometry/enzymatic analysis.

Conventional UnitsSI Units (Conventional Units × 0.111)
0–90 d3–32 mg/dL0.3–3.6 mmol/L
3–24 mo3–30 mg/dL0.3–3.3 mmol/L
2 yr–adult3–23 mg/dL0.3–2.6 mmol/L

Critical Findings and Potential Interventions

Adults

  • Greater than 31 mg/dL (SI: Greater than 3.4 mmol/L).

Children

  • Greater than 37 mg/dL (SI: Greater than 4.1 mmol/L).

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.

Consideration may be given to verification of critical findings before action is taken. Policies vary among facilities and may include requesting immediate recollection and retesting by the laboratory or retesting using a rapid point-of-care testing instrument at the bedside, if available.

Observe the patient for signs and symptoms of elevated levels of lactate, such as Kussmaul breathing and increased pulse rate. In general, there is an inverse relationship between critically elevated lactate levels and survival.

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Citation

Bladh, Mickey Lynn., and Anne M. Van Leeuwen. "Lactic Acid." Davis's Lab & Diagnostic Tests, 7th ed., F.A. Davis Company, 2017. Nursing Central, nursing.unboundmedicine.com/nursingcentral/view/Davis-Lab-and-Diagnostic-Tests/425266/3/Lactic_Acid.
Bladh ML, Van Leeuwen AM. Lactic Acid. Davis's Lab & Diagnostic Tests. 7th ed. F.A. Davis Company; 2017. https://nursing.unboundmedicine.com/nursingcentral/view/Davis-Lab-and-Diagnostic-Tests/425266/3/Lactic_Acid. Accessed July 17, 2019.
Bladh, M. L., & Van Leeuwen, A. M. (2017). Lactic Acid. In Davis's Lab & Diagnostic Tests. Available from https://nursing.unboundmedicine.com/nursingcentral/view/Davis-Lab-and-Diagnostic-Tests/425266/3/Lactic_Acid
Bladh ML, Van Leeuwen AM. Lactic Acid [Internet]. In: Davis's Lab & Diagnostic Tests. F.A. Davis Company; 2017. [cited 2019 July 17]. Available from: https://nursing.unboundmedicine.com/nursingcentral/view/Davis-Lab-and-Diagnostic-Tests/425266/3/Lactic_Acid.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Lactic Acid ID - 425266 A1 - Bladh,Mickey Lynn, AU - Van Leeuwen,Anne M, BT - Davis's Laboratory & Diagnostic Tests UR - https://nursing.unboundmedicine.com/nursingcentral/view/Davis-Lab-and-Diagnostic-Tests/425266/3/Lactic_Acid PB - F.A. Davis Company ET - 7 DB - Nursing Central DP - Unbound Medicine ER -