NURSES POCKET NOTES NORMAL VALUES LUNG SOUNDS Crackles or rales wheezing stridor rhonchi

RBCs (x10 /ml) RDW (RBC distribution width) MCV

45-55 <14.5 80-100 26-34 31-37 100000450000

40-49

Crackling or rattling sounds High-pitched whistling expirations Harsh, high-pitched inspirations Coarse, gravelly sounds Treatment None or placebic Give oxygen Give 100% oxygen Give 100% oxygen with positive pressure 3.2 g/dl 33-131 IU/L 51-153 IU/L 20-70 mcg/dl 0-0.3 mg/dl 0.1-1.2 mg/dl Arterial 7.35-7.45 35-45 70-100 19-25 90-95 7-20 mg/dl Female 12.015.0 36-44 Venous 7.32-7.42 38-52 28-48 19-25 40-70

MCH MCHC % Platelet count

THYROID FUNCTION TESTS Free T3 Serum T3 Free T4 Serum T4 TSH Total iron binding capacity (TIBC) Transferrin Uric acid (male) Uric acid (female) WBC + DIFFERENTIAL WBC (cells/ml) Segmented neutrophils Band forms Basophils Eosinophils Lymphocytes monocytes

2.3-4.2 pg/ml 70-200 ng/dl 0.5-2.1 ng/dl 4.0-12.0mcg/dl 0.25-4.30 microunits/ml 250-420 mcg/dl >200 mg/dl 2.0-8.0 mg/dl 2.0-7.5 mg/dl

PULSE OXIMETRY Range Value Normal Mild hypoxia Moderate hypoxia Severe hypoxia Albumin Alkaline Phosphatase (Adults: 25-60) Adults: >61yo Ammonia Bilirubin, direct Bilirubin, tota BLOOD GASES pH pCO2 pO2 HCO3 O2 Sat % BUN 95-100% 91-94% 86-90% <85%

CREATININE KINASE (CK) ISOENZYMES CK-BB CK-MB (cardiac) CK-MM Creatinine Phosphakinase (CPK) Creatinine (mg/dl) ELECTROLYTES Calcium Calcium, ionized Chloride Magnesium Phosphate Potassium Sodium Ferritin (ng/ml) Folate (ng/ml) Glucose, fasting Glucose (2 hours postprandial) (mg/dl) Hemoglobin A10 Iron (mcg/dl) Lactic acid (mEq/L) LDH (lactic dehydrogenase) LIPOPROTEINS AND TRIGLYCERIDES Cholesterol, total <200 mg/dl HDL cholesterol LDL cholesterol Triglycerides Osmolality SGOT (AST) SGPT (ALT)

0% 0-3.9% 96-100% 8-150 IU/L 0.5-1.4

8.5-10.2mg/dl 2.24-2.46mEq/L 95-107 mEq/L 1.6-2.4mEq/L 2.5-4.5 mg/dl 3.5-5.2 mEq/L 135-145 mEq/L 13-300 3.6-20 60-110 (mg/dl) Up to 140 6-8 65-150 0.7-2.1 56-194 IU/L

4500-10000 54-62% 3-5% (above 8% indicates left shif) 0-1 (0-0.75%) 0-3 (1-3%) 24-44 (25-33 %) 3-6 (3-7%)

COMPLETE BLOOD COUND (CBC) ADULTS Male Hemoglobin (g/dl) 13.5-16.5 Hematocrit (%) 41-50

30-70 mg/dl 65-180 mg/dl 45-155 mg/dl (<160) 289-308 mOsm/kg <35 IU/L (20-40) <35 IU/L

NURSING CONSIDERATIONS FOR BT Confirm that the transfusion is prescribed Check if Px blood has been typed and cross-matched Verify the consent from has been signed Explain the procedure to the Px and instruct px for s/sx of transfusion reaction (itching, hives, chills, sweeling, fever, shortness of breath) Take pxs vital signs to establish baseline for comparing of vital signs during transfusion Standard precaution during BT as per hospital policy Use gauge 20 or larger needles for BT Maximum hours for BT is 4 hours Double check obtained PRBC from blood bank Double check labes with other RN or MD to make sure of ABO and Rh compatibility Check blood for unusual color, bubbles or cloudiness, it may indicate bacterial growth or hemolysis Make sure PRBC is initiated within 30 minutes after removal from blood bank refrigerator For first 15 minutes, run transfusion slowly not more than 5ml/min, observe for side effects, then increase flow rate unless px is risk for circulatory overload. Observe px frequently for 15 to 30 minutes

Be alert for adverse reactions, circulatory overload, sepsis, febrile reactions, allergic reactions and hemolytic reactions. Change tubing after every 2 units transfused Obtain BS and compare with initial VS Document procedure Monitor px for response to and effectiveness of the procedure Use Bronchodilator cdc stim. & vasoconstrictor Anticholinergic Bronchodilator Anti-pyretic Anti-histamine Diuretic Electrolyte modifier Ca antagonist Anti-arrhythmic Analgesic/ anti-pyretic Anti-infective Anti-infective Anti-arrhythmic Coagulant Narcotic agent Anti-inflammatory Caloric agent Sedative Non-steroidal anti-inflammatory agent Anti-convulsant; atni-arrythmic Inotropic agent Vasopressor, inotropic agent Sedative Bronchodilator Anti-ulcer Diuretic Antispasmodic Anti-angina Ca channel blocker, anti-anginal, anti-hypertension, anti-arrhythmic Elec. Mod. Elec. Mod. Digitalis Analgesic Anti-ulcer

MgSO4 Morphine Metochlorpramide Narcan Nicardipine Nubain NaHCO3 Nitroprusside Nipride Nimotop NTG (transderm) Nitrobid Orudis Promethazine HCl Perlinganit Reglan Sensorcain HCl Solucortef Toradol Zantac Zofran Zinacef

Drug Adrenaline atSO4 Aminophylline Aeknil Benadryl Burinex Ca gluconate Cardepine Carricor Calmegic Cefamandole Cefuroxime Cordarone Cyklokapron Demerol Dexamethasone Dextrose Diazepam Diclofenac Na (Voltaren) Dilantin Dobutrix Dopamine Dormicum Ephedrine Famotidine Furosemide Hyosine Hbr. Isoket Isoptin Isotonic NaCl KCl Lanoxin Cystine Acetate Losec

Anti-convul Narcotic anal Anti-emetic Narc. Antag Ca channel blocker, anti-angina, vasodilator, anti-hypertension Narc. Analg. Elec. Mod., alk. Agent Anti-hpn Cal channel blocker Atni-ang., vasodil Vasodil, anti-angi Anti-inflam Anti-histamine, anti-emetic, sed Anti-angina Anti-emetic Adrenalien Immune response & inflame Supp. Analgesic Anti-histamine receptor Anti-emetic Anti-infective

If LDH-1 is high, what does it Cell necrosis of heart, mean? (lactate erythrocytes, or skeletal dehydrogenase isoenzyme muscle 1) If LDH-5 is high, what does it mean? (lactate Cell necrosis of Liver or dehydrogenase isoenzyme skeletal muscle 5) If AST level is elevated, what Cell necrosis of heart, liver does that mean? (Aspartate skeletal muscle aminotransferase) If ALT level is elevated, what Cell necrosis of Liver, does that mean? (Alanine skeletal muscle aminotransferase) What is significance of elevated amylase? Normal value of total bilirubin? Normal value of direct bilirubin? Pancreas, salivary gland cell necrosis .2 - 1.5 mg/dl 0 to .3 mg/dl Serum (total) is 9.0 to 10.5, ionized is 4.5 to 5.6. 50% of calcium in blood is bound to protein, 40% is free or ionized.

Normal calcium levels What is the normal value of 60-110 mg/dl serum glucose? What is the normal arterial 7.35 to 7.45 blood pH value? What is the normal PaC02? 35-45 mmHg Normal Pa02? Normal HC03? Normal value of K? Normal serum sodium level? Normal BUN? 80-100mmHg 22-28 mEq 3.5 to 5.5 mEq/l 135-145 mEq/l 8-25 mg/dl

Normal blood osmolarity? 275-295 mOs/kg If a patient's level of Creatine kinase (isoenzyme MB) is Cell necrosis in heart. high, what does this mean? If a patient's level of Creatine kinase (isoenzyme BB) is Cell necrosis in brain high, what does this mean? If a patient's level of Creatine Cel necrosis in heart or kinase (isoenzyme MM) is skeletal muscle high, what does this mean?