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Random Saunders Pgs
| Cystic Fibrosis | Chronic multisystem disorder characterized by exocrine gland dysfunction. Progressive and incurable; respiratory failure is a common cause of death. Organ transplant can increase survival rate |
| CF Mucus | Abnormally thick and copious, causing obstruction of small passageways of resp, GI, and reproductive systems |
| CF Symptoms | Associated with pancreatic enzyme deficiency and fibrosis caused by duct blockage, progressive chronic lung disease, and sweat gland dysfunction (^ Na and Cl sweat concentrations) |
| CF: Respiratory system | Stagnation of mucus leads to bacterial colonization and destruction of tissue; emphysema and atelectasis occur; chronic hypoxemia; pulm HTN, cor pulmonale; pneumothorax, hemoptysis. Wheezing, cough, cyanosis, clubbing, barrel chest, bronchitis, pneumonia |
| CF: GI System | Meconium ileus, intestinal obstruction (pain, abd distention, N/V), frothy foul-smelling stools, deficiency of vit A,D,E,K, malnutrition, hypoalbuminemia, rectal prolapse, pancreatic fibrosis |
| CF: Dx Tests | Quantitative sweat chloride test (40-60 mEq/L); newborn screening; CXR; pulmonary function tests; stool, fat, enzyme analysis |
| CF: Interventions for Resp | Antibiotics, chest physiotherapy, suction, flutter mucus clearance device, hand-held percussors, vest, PEEP mask, huffing, brochodilator meds, exercise, O2 during acute episodes, vit k replacement, bedrest, vaccinations |
| CF: Interventions for GI | High-calorie, high-protein, well-balanced diet; multivitamin w/ vit A, D, E, K; monitor weight, stool patterns; replace pancreatic enzymes within 30 mins of eating; monitor for constipation; monitor for GERD; blood glucose level; adequate salt intake |
| Hirschsprung's disease | Congenital; absence of ganglion cells in the rectum and other areas of intestine; mechanical obstruction results because of inadequate motility; most serious complication is enterocolitis |
| Hirschsprung's disease assessment | Newborn: failure to pass meconium, refusal to suck, abd distention, bile-stained vomit. Children: failure to gain weight, abd distention, vomiting, constipation/diarrhea, ribbon-like foul-smelling stool |
| Hirschsprung's disease interventions | Low-fiber, high-calorie, high-protein diet, stool softeners, daily rectal irrigations, measure abd girth, avoid rectal temps, colostomy and excision of portions of bowel |
| Omphalocele | Herniation of abdominal contents through umbilical ring with an intact peritoneal sac; cover sac with sterile wet gauze immediately with plastic wrap; frequent vitals, NPO, IV fluids, surgical repair |
| Gastroschisis | Herniation of the intestine is lateral to the umbilical ring, without membrane. Cover loosely with saline-soaked pads and plastic drape; surgery within several hours |
| Glomerulonephritis | Group of kidney disorders characterized by inflammatory injury in the glomerulus, most of which are caused by an immunological reaction (usually antigen-antibody reaction); results in in proliferative and inflammatory changes in the glomerular structure |
| Causes of glomerulonephritis | Immunological diseases, autoimmune diseases, steptococcal infection, history of pharyngitis or tonsillitis 2-3 wks before symptoms |
| Complications of glomerulonephritis | Renal failure, hypertensive encephalopathy, pulmonary edema, heart failure |
| Glomerulonephritis assessment | Periorbital and facial edema (more prominent in AM), anorexia, decreased urine output, cloudy, foamy, brown urine (hematuria), pallor, irritability, lethargy, HA, abd/flank pain, dysuria, HTN, proteinuria, azotemia, ^ BUN, ^ Cr, ^ antistreptolysin O titer |
| Gloermerulonephritis interventions | Monitor vitals, weight, I&O, characteristics of urine, limit activity; Na, K, protein and fluid restrictions,; diuretics, antihypertensives, antibiotics, anticonvulsants; seizure precautions |
| Nephrotic syndrome | Kidney disorder characterized by massive proteinuria, hypoalbuminemia, and edema. Goals: reduce excretion of urine protein, reduce edema, prevent infection, maintain protein-free urine |
| Nephrotic syndrome interventions | Monitor vitals, I&O, daily weights, urine sp grav and protein, edema; regular diet without added salt (Na and fluid restrictions during edema), corticosteroids, immunosuppressants, diuretics, plasma expanders |
| Hemolytic-uremic syndrome | Acute renal failure in children; sx: Triad of anemia, thrombocytopenia, and renal failure, proteinuria, hematuria, urinary casts, ^BUN&Cr, low Hgb and Hct, vomiting, irritability, lethargy, pallor, bruising/bleeding, oliguria/anuria, seizures, coma |
| Hemolytic-uremic syndrome interventions | Hemodialysis or peritoneal dialysis, fluid restrictions, blood products |
| Impetigo | Contagious bacterial skin infection; associated with poor hygiene; common sites of infection are on the face, around mouth, hands, neck; lesions begin as vesicles w/ edema and redness, become exudative and honey-colored crusts |
| Impetigo assessment | lesions, erythema, pruritis, burning, secondary lymph node involvement |
| Impetigo interventions | Contact isolation, allow lesions to dry by air exposure, antibacterial soap, warm saline compresses, Burrow's solution, antibiotic ointments, antibiotics, emollients, handwashing, use separate towels, linens, etc |
| S/S of Respiratory Alkalosis | Lethargy, lightheadedness, confusion, tachycardia, dysrhythmias r/t hypokalemia, N?V, epigastric pain, and numbness/tingling of the extremeties |
| Rapid-Acting Insulin | End in "log"; Onset: 15-20 mins, Peak: 30 mins-3, Duration: 3-5 hrs |
| Short-Acting Insulin | "Regular" "R" in brand name; Onset: 30 mins, Peak: 2-5 hrs, Duration: 5-7 hrs |
| Intermediate-Acting Insulin | "N" and Levemir (1, 6-8, 5-24); Onset: 1.5 hrs, Peak: 4-12 hrs, Duration: 16-24+ hrs |
| Long-Acting Insulin | Lantus; Onset: 2-4 hrs, no peak, Duration: 24 hrs |
| Platelets | 150,000-400,000 |
| WBCs | 4,500-11,000 |
| RBCs | Male: 4.5-6.2 million, Female: 4.5-5 million |
| Sodium | 135-145 mEq/L |
| Potassium | 3.5-5.1 mEq/L |
| Chloride | 98-107 mEq/L |
| Bicarbonate (venous) | 22-29 mEq/L |
| aPTT | 20-36 seconds (should be 1.5-2.5xnormal with heparin; >90 seconds=bleeding precautions) |
| PT | 9.6-11.8 seconds (2-3xnormal with coumadin; PT > 30 seconds=bleeding precautions; vitamin K shortens PT) |
| Erythrocyte sedimentation rate | 0-30 mm/hr; For acute and chronic illness, inflammation, advanced neoplasm, and tissue necrosis or infarction |
| Hemoglobin | Male: 14-16.5, Female: 12-15 |
| Hematocrit | Male: 42-52%, Female: 35-47% |
| Serum iron | Male: 65-175, Female: 50-170 |
| Creatine kinase (CK) | 26-174 units/L; cell trauma, rises within 6 hrs, peaks at 18, returns to normal in 2-3 days |
| CK-MB | Cardiac muscle; 0-5% of total |
| CK-MM | 95-100% of total; skeletal muscle |
| CK-BB | 0% of total; brain tissue |
| Lactate dehydrogenase (LDH) | 140-280; MI; begins to rise after 24 hrs, peaks in 48-72 hrs, returns to normal in 7-14 days. When LDH1 is higher than LDH2, it indicates MI. |
| Troponins | I: <0.6 ng/mL, >1.5 ng/mL indicates MI; T: >0.1-0.2 ng/mL indicates MI; eleaves in 3 hrs, remain elevated 7-10 days |
| Myoglobin | Normal <90 mcg/L; elevation indicates MI, rises in 2 hrs, drops after 7 hrs |
| BNP | Primary marker for CHF; normal <100 pg/mL |
| Albumin | 3.4-5 g/dL |
| Ammonia | Byproduct of protein catabolism; 10-80 mcg/dL |
| Amylase | Enzyme produced by pancreas; in acute pancreatitis level is greatly increased, starts rising in 3-6 hrs after onset of pain, peaks in 24 hrs, returns to normal in 2-3 days; normal: 25-151 units/L |
| Lipase | Elevation 24-36 hrs, remains elevated up to 14 days; normal: 10-140 units/L |
| Bilirubin | Direct (conjugated): 0-0.3 mg/dL, Indirect (unconjugated): 0.1-1 mg/dL, Total: <1.5 mg/dL |
| Total cholesterol | 140-199 |
| LDL | <130 |
| HDL | 30-70 |
| Triglycerides | <200 |
| Uric acid | Male: 4.5-8, Female: 2.5-6.2 |
| Creatinine | 0.6-1.3; elevation indicates decreased GFR |
| BUN | 8-25; elevation indicates decreased GFR |
| Calcium | 8.6-10 |
| Magnesium | 1.6-2.6 |
| Phosphorus | 2.7-4.5 |
| CD4+ | 500-1600 |
| Normal Urine pH | 4.5-7.8 |
| Urine Sp. Gravity | 1.016-1.022 |
| Urine glucose | <0.5 g/day |
| Urine ketones | none |
| Urine protein | none |
| Urine bilirubin | none |
| Urinary casts | none-few |
| Urine crystals | none |
| Urine bacteria | none or <1000/mL |
| Urine RBC | <3 cells/HPF |
| Urine WBC | <4 cells/HPF |
| Urine chloride | 110-250 mEq/24 hrs |
| Urine magnesium | 7.3-12.2 |
| Urine potassium | 25-125 |
| Urine sodium | 40-220 |
| Uric acid | 250-750 |
| Folic acid sources | Green leafy vegetables, liver, beef, fish, legumes, grapefruit, oranges |
| Niacin sources | Meats, poultry, fish, beans, peanuts, grains |
| Vitamin A sources | Liver, egg yolks, whole milk, green or orange vegetables, fruits |
| Vitamin K sources | Green leafy vegetables, cauliflower, cabbage |
| Calcium sources | Broccoli, carros, cheese, collard greens, green beans, milk, spinach, tofu, yogurt |
| Magnesium sources | Avocado, tuna, cauliflower, cooked rolled oats, green leafy vegetables, milk, peanut butter, peas, pork, beef, chicken, potatoes, raisins, yogurt |
| Potassium sources | Avocado, bananas, canteloupe, carrots, fish, oranges, pork, beef, veal, potatoes, raisins, spinach, strawberries, tomatoes |
| Iron sources | Breads, cereals, dark green vegetables, egg yolk, liver, meats |
| Zinc sources | Eggs, leafy vegetables, meats, protein-rich foods |
| Gas-forming foods | Apples, artichokes, barley, beans, bran, broccoli, brussels sprouts, cabbage, celery, cherries, coconut, eggplant, figs, honey, melons, milk, molasses, nuts, onions, radishes, soybeans, wheat, yeast |
| Fat-restricted diet | For malabsorption disorders, pancreatitis, gallbladder disease, GERD |
| High-calorie, high-protein diet | For severe stress, burns, cancer, wound healing, HIV, AIDS, COPD, respiratory failure |
| Sodium-restricted diet | For HTN, heart failure, renal disease, cardiac disease, liver disease |
| Protein-restricted diet | For renal disease and liver disease |
| Low-purine diet | Used for gout, kidney stones, and elevated uric acid levels; restrict anchovies, herring, mackerel, sardines, scallops, glandular meats, gravies, meat extracts, wild game, goose, and sweetbreads |
Created by:
kahadzima1
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