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Nursing points

Important nursing Points

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