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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.
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.
Method: Spectrophotometry/enzymatic analysis.
|Conventional Units||SI Units (Conventional Units × 0.111)|
|0–90 d||3–32 mg/dL||0.3–3.6 mmol/L|
|3–24 mo||3–30 mg/dL||0.3–3.3 mmol/L|
|2 yr–adult||3–23 mg/dL||0.3–2.6 mmol/L|
Critical Findings and Potential Interventions
- Greater than 31 mg/dL (SI: Greater than 3.4 mmol/L).
- 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.