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Nursing points
Important nursing Points
| Question | Answer |
|---|---|
| Normal Red Blood Cell Level? | 4.2-6.1 million/mm3 |
| Normal White Blood Cell Level? | 5,000-10,000 mm3 |
| Normal Hemoglobin Level? | 12-18 g/100mL |
| Normal Hematocrit Level? | 37-52% |
| Normal Sodium (Na) Level? | 135-145 mEq/L |
| Normal Potassium (K) Level? | 3.5-5 mEq/L |
| Normal Chlorine Level? | 98-106 mEq/L |
| Normal Bicarb (HCO3) Level? | 22-26 mEq/L |
| Normal Calcium (Ca) Level? | 4.5-5.5 mEq/L |
| Normal Magnesium (Mg) Level? | 1.5-2.5 mEq/L |
| Normal pH Level? | 7.35-7.45 |
| Normal PaCO2 Level? | 35-45 mmhg |
| Normal PaO2 Level? | 80-100 mm |
| Normal O2 Saturation Level? | 96-100% |
| Normal PT Level? | 11-12.5 seconds |
| Normal INR Level? | 0.76-1.27 |
| Normal APTT Level? | 30-40 seconds |
| Normal Serum Creatinine Level? | 0.5-1.2 mg/100mL |
| Normal BUN Level? | 10-20mg/100mL |
| How much Oxygen and Liters can Nasal Cannula offer? | up to 44% @ 6L/min |
| How much Oxygen and Liters can a Simple Mask offer? | up to 60% @ 7-8L/min |
| How much Oxygen and Liters can a Venturi Mask offer? | up to 55% @ 14L/min |
| Convert Farenheit to Celsius? | *F = 1.8 x *C + 32 |
| Convert Celsius to Farenheit? | *C = *F -32/1.8 |
| What happens in Respiratory Acidosis? | Incr. PCO2 Decr. pH *Hypoventilation *Hyperkalemia, hyperrelexia, muscle weakness *drowsiness, dizziness, disorientation *decreased BP with vasodilation *Causes: decreased respiratory stimuli, COPD, Pneumonia, Atelectasis |
| What happens in Respiratory Alkalosis? | Decr. PCO2 Incr. pH *Seizures, deep rapid breathing *tachycardia, hypokalemia, hyperventilation * lethargy, confusion, N/V, light headed * decreased or normal BP * numbness & tingling of extremities Causes: hyperventilation, mechanical ventilation |
| What happens in Metabolic Acidosis? | Decr. pH Dec HCO3 * HA, hyperkalemia, muscle twitching, N/V/D * decr. BP, vasodilation * Change in LOC, kussmal repirations * decr. ability of kidney to excrete acid or conserve base Causes: DKA, severe diarrhea, renal failure, shock |
| What happens in Metabolic Alkalosis? | Incr. pH Incr. HCO3 *restlessness followed by lethargy *dysrhytmias, tachycardia, confusion, N/V/D *tremors, muscle cramps, tingling of fingers & toes *hypokalemia Causes: severe vomitting, excessive GI suctioning, diuretics, excessive NaHCO3 |
| Name some hypotonic solutions. What does it do? | 0.45% NS, D5W *Fluid shifts out of vessels into the cells. |
| Name some isotonic solutions. What do they do? | 0.9% NS, LR *No major shifts *Vascular expansion *Electrolyte replacement |
| Name some hypertonic solutions. What do they do? | D5 1/2 NS, D5 NS, hypertonic saline 3% *Shifts fluid back into the circulation. *Vascular expansion *Replaces electrolytes. |
| COPD clinical findings? | (Inspection) Barrel chest, cyanosis, tripod position, use of accessory muscles. (Palpation) decr. movement *(percussion)hyperresonant or dull if consolidation *(Aucultation)crackles, rhonci, wheezes, distant breath sounds |
| Asthma clinical findings? | (Inspection)prolonged expiration, tripod position, pursed lips (Palpation) decr. movement (Percussion) hyperresonance (Auscultation)wheezes, decr. breath sounds ominous sign if no improvement |
| Pneumonia clinical findings? | (Inspection)tachypnea, use of accessory muscles, duskiness or cyanosis (Palpation)incr. fremitus over affected area (Percussion)dull over affected area (Auscultation)early: bronchial sounds, later: crackles, rhonci, egophany, whispered pectoriloquy |
| Atelectasis clinical findings? | (Inspection)no change unless involves entire segment, lobe. (Palpation)If small, no change. If large, decr. movement, incr. fremitus (Percussion)dull over affected area (Auscultation)crackles,(may disappear with deep breaths), absent sound if large |
| Pulmonary edema clinical findings? | (Inspection)tachypnea, labored respirations,cyanosis (Paplation)decr. movement or normal mvt (Percussion)dull or normal depending on amt of fluid (Inspection)fine or coarse crackles at bases moving upward as condition worsens |
| Pleural effusion clinical findings? | (Inspection)tachypnea, use of accessory muscles (Palpation)incr. movement, incr. fremitus above effusion, none over effusion (Percussion)dull (Inspection)diminished or absent over effusion, egophany over effusion |
| Pulmonary fibrosis clinical findings? | (Inspection)tachypnea (Palpation)incr. movement (Percussion)normal (Inspection)crackles or "velcro" rales |
| Indications of hypercalcemia? | N/V, change in mental status, constipation, weakness and vague muscle/joint aches, HA, polyuria, ab or flank pain (due to renal calculi) |
| Indications of hypocalcemia? | Tetany, Chvostek's, Trousseau's signs, muscle twitching, CNS changes, ECG changes |
| Indications of hypermagnesemia? | Loss of deep tendon reflexes, depression of CNS, depression of neuromuscular function |
| Indications of hypomagnesemia? | Hyperactive deep tendon reflexes, CNS changes |
| Indications of hypernatremia? | thirst, CNS deterioration, increased interstitial fluid, dehydration, elevated temp, flushed skin, dry mucous membranes |
| Indications of hyponatremia? | CNS deterioration, anorexia, N/V, confusion, agitation, HA, seizures, decreased urinary output, muscle weakness, abdominal cramps, |
| Indications of hyperkalemia? | Ventricular fibrillation, ECG changes, CNS changes, tall peaked T waves, abdominal cramps, muscle weakness |
| Indications of hypokalmeia? | Bradycardia, ECG changes, CNS changes, flat T & ST wave, hyotension, dizziness, lethargy/confusion |
| What are some possible side effects of tricyclic antidepressants? | sore throat, fever, increased fatigue, vomiting, diarrhea |
| What are the five P's of neurovascular status? | Pain, pallor, paralysis, parasthesia, pulselessness |
| What is a neonate most at risk for with a diabetic mother? | hypoglycemia |
| What type of diet would you prescribe for a cystic-fibrosis patient? | high calorie, high protein, low fat |
| What does the cerebellum maintain? | motor function, balance, |
| What needs to be done prior to a IV pyelogram? | cleansing enemas the evening before to provide adequate visulatization. |
| What is an IV pyelogram used for? | visualization of the ureters, kidney and bladder with iodine contrast |
| Under what conditions is the RhoGAM or Rh immune globulin administered? | Rh negative mother, Rh positive baby and negative Coombs test |
| How do you instruct a patient to go up and down stairs with a cane? | Up with the good, down with the bad. Up - Advance the cane and the good leg together the bad leg. Reverse for down. |
| What test do you use for tardive dyskinesia? | (AIMS) Abnormal Involuntary Movement Scale |
| What are some compensatory mechanisms for a fever? | increased respiratory rate and tachycardia |
| What precautions should you note in a care plan for a patient taking tetracycline? | Sun protection due to increased photosensitivity, don't take with milk or antacids |
| What are some symptoms of Cushing syndrome? | Buffalo hump, hyperglycemia, hypernatremia |
| Describe the defense mechanism conversion | Patient's congnitive tensions manifest as physical symptoms. Suddenly can't walk, move arms... |
| How do you draw up a Regular and NPH insulin injection? | Clear before cloudy, regular before NPH |
| What is a pt with obsessive compulsive order ritual trying to achieve? | To avoid or alleviate severe anxiety |
| What may happen when a calcium channel blocker is combined with other antihypertensives? | Hypotension and heart failure, monitor for peripheral edeam |
| What is the normal KVO rate? | 20cc/hr |
| What is a adverse side effects of beta blockers? | bronchospasm, increased airway resistance (except for cardio-selective BB) |
| What is a myelogram? | lumbar puncture with the injection of a contrast medium (or air) into spinal subarachnoid space, allowing x-ray visualization of the spinal canal |
| What is the positioning for a patient with hip replacement? | side lying with the affected hip in a position in abduction |
| What is the purpose of cuff in a cuffed tracheostomy? | to seal the trachea and prevent aspiration |
| Till how old is the Babinski reflex supposed to be present? | 12 months |
| What can precipitate digoxin toxicity? | hypokalemia |
| What are normal lithium levels? | 0.6-0.12 |
| What is the risk involved with hypoparathroidism? | laryngospasm |
| How do you calculate the estimated date of confinement? | add 7 days to the first day of last menstrual period and subtract 3 months |
| What is the appropriate care for around the clock feedings? | Rinse the bag and change the formula every 4 hours |
| How does pregnancy affect a type I diabetic? | Insulin demands increase during pregnancy and decrease afterwards |
| What are some signs of hypoglycemia? | irritability, tachycardia, diaphoresis |
| What are the isotonic, hypertonic and hypotonic fluids? | Iso: D5 1/4 NS, NS, LR Hypertonic: D5 1/2 NS, D5 in LR Hypotonic: water |
| What are some airborne precaution diseases? | TB, measles (rubeola virus), chickenpox, mycobacterium, possibly SARS |
| What are some droplet precaution diseases? | pertussis, influenza, adenovirus, rhinovirus, group A strep, meningitis, pneumonia, sepsis, scarlet fever, streptococcal pharyngitis, parvovirus B19, mumps, rubella, diptheria |
| What are some contact precaution diseases? | MRSA, VRE, c. difficle, norovirus, RSV, impetigo, scabies, ebola, viral conjunctivitis |
| What is the therapeutic range for Digoxin? | 0.5-2 ng/mL |
| How is a patient positioned for a liver biopsy? | supine with right arm over head |
| What types of foods should you avoid with hyperparathyroidism? | high calcium foods |
| What are some medications for the treatment of Tuberculosis? | Isoniazid and Rifampin |
| What are some symptoms of hypoglycemia. | hunger, shakiness, nervousness, sweating, dizziness, light headedness, confusion, difficulty speaking, anxiety |
| What are some DKA symptoms. | glucose 300, bicarb <15, acidosis ,7.3, ketonuria, confusion, abdominal tenderness, tachypnea, hypotension, acetone odor breath, tachycardia |
| What is the best way to access edema on a daily basis? | daily weights |
| What can a bile obstrution cause? | bleeding tendencies since Vit K can't be absorbed properly |
| What physical assessment finding many indicate Down Syndrome in a newborn? | Simian line on hand |
| Leg cramping in a person taking steroids may indicate? | hypokalemia |
| What may be a unique manifestation of juvenile rheumtaoid arthritis? | inflammation of the eyes |
| What is stomatitis? | inflammation of the mucosa of the mouth, tongue, cheek... |
| What is a major side effect of radiation therapy? | fatigue |
| What is rationalization? | Rationalization is offering a socially acceptable or logical explanation to justify an unacceptable feeling or behavior. |
| What are some signs of a hemolytic transfusion response? | fever, chills, flank pain, hematuria |
| What is an early sign of digitalis toxicity? | nausea |
| Where is the best location for an IM injection in a newborn? | vastus lateralis |
| What are some signs of hypokalemia? | muscle weakness and dysrhythmias |
| What is Cheynes-Stokes breathing? | periods of apnea followed by periods of rapid breathing |
| What are some signs of diabetic ketoacidosis? | fruity acetone breath, kussmal respirations, decreased alertness, circulatory volume, dry hot flushed skin, metabolic acidosis, |
| What is an early sign of cystic fibrosis the may be seen in newborns? | meconium ileus |
| Describe kussmaul respirations. | deep, rapid breathing in diabetic ketoacidosis |
| What is displacement? | unconscious redirecting of emotion from a threatening source to a non-threatening source |
| What other physical finding would you expect to find in glomerulonephritis? | periorbital edema |
| 1 gram of carbs = how many calories? | 4 calories |
| What is a sign of necrotizing enterocolitis in a preterm infant? | increasing NG tube residuals from prior feedings |
| What happens to cardiac output in the postpartum period? | it increases due to the rapid shift in fluids |
| When does acute glomerulonephritis occur and what is priority in treatment? | a noninfectious, immune-complex renal disease that occurs 10 to 21 days after a strep infection. Rest and symptomatic care |
| What happens to insulin requirements in a pregnant type 1 diabetic? | Usually first trimester: decreased insulin needs, second and third: there is a resistance to insulin so increased insulin needs |
| What serious condition may occur in a patient with an ileostomy? | dehyrdration, because it bypasses the large intestine where water is reabsorped |
| A mediolateral episiotomy is associated with? | more infections |
| Which hormones are secreted during dehydration? | ADH and Aldosterone |
| What does ADH do? | causes the renal tubules of the kidney to reabsorp water |
| What does Aldosterone do? | causes the reabsorption of sodium and excretion of potassium |
| What electrolyte parallels chlorine? | sodium |
Created by:
Azucenya
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