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68WM6 NCLEX Review

68WM6 NCLEX Review Lectures

QuestionAnswer
WBC 5,000 - 10,000
HCT 41-49
Hgb 12-16(Female) 14-18(Male)
PLT 200-400 thousand
Na 135-145
K 3.5 - 5.5
Cl 98-107
Glucose 70 - 110
Co2 35 - 45
Kidneys release _____renin in response to low ____ concentration. Renin , Na
Renin stimulates conversion of angiotensinogen to _____ which converts to _____ in the lungs. angiotensin I , angiotensin II
ACE inhibitors do what? blocks the conversion of angiotensin I to angiotensin II..blocks the constriction affect and prevents HTN.
What does angiotensin II do? Major vasoconstrictor, stimulates Aldosterone release, causes Na retention, increases water reabsorbtion, releases K+ and H+
Mag 1.5 - 2.5
Ca 8.5 - 10.9
Phos 2.5 - 4.5
BUN 7 - 22
Creat 0.6 - 1.35
PT 10 - 12
PTT 30 - 45
INR 2-3
Billi < 1.0
Alb 3.4 - 5.0
Alk 20-125
PreRenal Failure causes Fluid Volume Loss Hemorrhage GI Losses (vomiting, diarrhea) Renal Losses Burns Inadequate Volume Replacement
PreRenal Failure causes r/t Inadequate Cardiac Output CHF MI cardiogenic shock dysrhythmias cardiac tamponade, PE
Vasoconstriction/Occlusion of Renal Blood Vessels r/t AFR catecholamines hypertension vasopressors renal vessel embolism
RAAS System retain volume increase sodium and water reabsorption
ARF Diagnostics Decreased Urine Sodium , Urine Osmolality Increased (decreased free water excretion), Urine Specific Gravity Increased(> 1.020), oliguria/anuria, BUN:Cr ratio is increased >20
ARF Treatment Volume Replacement Extracellular Volume Sequestration, Inadequate Cardiac Output , Renal Artery Occlusion
Postrenal failure includes Obstruction kidney, ureter, bladder, urethra Increased Intra-tubular Pressure abnormal nephron function reverses rapidly once obstruction is removed
Diagnosis of Renal Failure KUB, ultrasound, IVP, retrograde pyelography, CT
Causes of Intrarenal Failure Glomerulus or Renal Tubule Damage, glomerular, vascular or hematologic problem glomerulonephritis systemic lupus erythematosus (SLE) DIC endocarditis pre-eclampsia
decrease in the blood supply to a bodily organ, tissue, or part caused by constriction or obstruction of the blood vessels ischemia
Acute Tubular Necrosis (ATN) perfusion to the kidney is severely reduced Vasoconstriction & Ischemia damage the glomerular basement membrane and tubular epithelium
Na+/K+ Pump Fails sodium remains in cell potassium remains outside cell causes additional cellular dysfunction and cellular edema
Uric Acid 3.5 - 7.5
Triglyceride 40 - 50
Total Cholesterol 130 - 200
Protein 6.2 - 8.1
HCO3 24 - 26
Protein 6.2 - 8.1
LDH 100 - 190
CPK 21 - 232
HR 80 - 100
RR 12 - 20
BP 110 - 120 (Sys) / 60 - 90 (Dia)
Digoxin 0.5 - 2.0 mg
Lithium 0.8 - 1.5 mEq
Dilantin 10 - 20 mcg
Theophylline 10 - 20 mcg
Spec Gravity 1.010 - 1.030
Therapeutic level of PT/ PTT 1.5 - 2 times base
3 segments of small intestine Duodenum - 1st segment Jejunum - 2nd segment Ileum - 3rd segment
funciton of liver Plays Major Role in Bile Secretion Iron Metabolism Plasma-Protein Production Detoxification of Drugs & Other Substances
where is the gallbladder? Depression on Posterior Surface of Liver hangs from anterior/inferior margin of the liver
Function of the gallbladder Secretes/Stores Bile Produced by Liver
where is the pancreas? Posterior to Greater Curvature of Stomach
Arterial Bleed from Acute Longitudinal Tear in the Gastroesophageal Mucosa Mallory-Weiss Tear
Associated with Chronic Cirrhosis causes the liver to become less compliant Pressure Increases in the Portal Circulation Blood in the Splanchnic System collateral circulation Esophageal Varicies
bright red blood or "coffee-ground" emesis Hematemesis
shiny, black, foul-smelling stool from UGI bleeding Melena
bright red blood from the rectum indicates a lower GI bleed may also come from hemorrhoids or fissures Hematochezia
test for occult blood in the stool Guaiac
Signs of Shock Hypotension (advanced shock) Tachycardia, Dyspnea Decreased Peripheral Pulses Cool, Clammy Skin Increased Capillary Refill Decreased LOC Decreased Urinary OutputĀ  Assess for Cardiac Ischemia (EKG)
describe the action of Crystalloid Solutions source for electrolytes and a temporary source of fluid volume. They flow out of the vascular system rather quickly...fluid expanders
example of Crystalloid solution Lactaced Ringers and Normal Saline
describe the action of Colliod Solutions colloidal solutions are needed when a solution is required to remain in the vascular system and contain a protein
examples of Colloids Whole human blood U.S.P. and Hetastarch are examples of colloid solutions.
action of antacids control the pH of the gastric mucosa side effects diarrhea, electrolyte disturbances, metabolic alkalosis
action of histamine blockers block stimulation of acid secretion from parietal cells Cimetidine Ranitidine Famotidine
side effects of histamine blockers mucosa due to decreased pH increased risk of nosocomial pneumonia can cause thrombocytopenia
action of proton pump inhibitors work within parietal cells, decrease acidity of acid pump Pantoprazole Omeprazole Side effects GI distress, headache, dizziness
action of Mucosal Enhancers reduce effects of acid secretion by improving the mucosal barrier sucralfate
injection of a necrotizing agent into bleeding vessel Sclerotherapy
use of a heater probe, laser photocoagulation and electrocoagulation Thermal Tamponade
results in thrombosis, sloughing, fibrosis of varix Endoscopic Band Ligation
removal of lower portion of stomach Antrectomy
removal of the stomach Gastrectomy
surgical connection of the stomach to the jejunum Gastroenterostomy
Vagotomy severing of the vagus nerve to the stomach
Billroth I vagotomy and antrectomy with anastomosis of the stomach to the duodenum
Billroth II vagotomy and antrectomy with anastomosis of the stomach to the jejunum
action of Vasopressin (ADH) lowers portal pressure constricts splanchnic arterial bed decreases pressure and flow in liver collateral circulation channels to decrease bleeding
Created by: jrstrader