LABS

SODIUM 135 - 145

POTASSIUM 3.5 - 5
CALCIUM 8.5- 10
MAGNESIUM 1.5 - 2.5
PHOSPHOROUS 2.7 - 4.5
ALBUMIN 3.5 - 5 FLUID DEFICIT OR OVERLOAD.
EXP (BURNS) A
BUN 10 - 20 CR NORMAL BUN INCR =
DEHYDRATION
CREATNINE 0.6 - 1.2 KIDNEY
HEMOGLOBIN 12-18
HEMATACRIT 3X HGB = 36 -54
WBC 5000 - 10, 000
Packed RBC Anemia, hemorrhage, surgery
PLATELETS 150 - 450 Bleeding/thrombocytopenia
FFP 11 - 12.5 SEC BLEEDING DEFICIENCY
COTTING FACTORS
COMADIN = 11 - 16
HEPARIN = PTT BASE 30 - 40 GOAL: 45 - 80 SECONDS
X 1 1/2

INR 2-3
PACKED RBC 12-18 ANEMIA, HEMMORHAGE,
SURGERY. CHECK H& H/

PAWP 4 - 12 INCREASED = HYPERVOLEMIA

DECREASE = HYPOVOLEMIA
LITHIUM LEVELS 0.4 - 1.4
TOTAL CHOLESTEROL <200

HDL >60
LDL <100
TRIGLYCERIDES <150

BNP <300
FASTING 70 - 100
GLUCOSE/FINGERSTICK
A1C <6 IDEAL 4-6 OVER 3 MONTH PERIOD/FOR
MANAGEMENT
PA02 80-100
PH ACID 7.35 -7.45 BASE
HCO2 BASE 35 - 45 ACID
HC03 ACID 22 - 26 BASE
MEASUREMENTS FAT = 9 GRAMS TROUGH LEVEL IS DONE 15 TO
30 ML = 1 OZ PROTEIN = 4 GRAMS 30 MINS PRIOR TO
8 0z = 1 cup CARBS - 4 GRAMS ADMINISTRATION OF MEDS
2 cups -1 pint 1350 CALORIES IN 1 LB
5 RIGHTS OF LPN CAN: VANCOMYCIN/REDMAN
hang, change fluid and tuning, SYNDROME
DELEGATION TO MINIMIZE ADMINISTER
Task monitor site
discontinue IV OVER 6O MINS.
Person
hang premix meds. LIVE CULTURED YOGURT
Right circumstance
Communication
supervision
6 RIGHTS OF MEDS RN: Always look for objective data
Right medication initiate IV therapy vitals, HR, BP before subjective
Right person IV Push data)
Right route central line
Right time mixing of IV meds
Right dose
Right document
Right assessment
Right education
Right refusal
When answering, questions Maslow: physiologic Lango - heart defect/ see child
follows: squatting
(food/water)
ABC Tetralogy - septal
Safety & security
Maslow defect(deoxygenated)
Love & belonging
nursing process
Self -esteem
prioritization
Self- actualization
Self- transcendence

Insulin Ulcers Definitions:

Reg insulin given on sliding
scale.
Do not shake reg insulin/roll
gently.
Do not mix insulin
Stage 1 -- keep dry, keep Epistaxis - nosebleed
pressure off Mydriasis -- dilated pupils
Stage II apply moist dressing to
wound. Occlusive dressing
Stage III - cleanse saline, moist
saline, avoid heat and antiseptic
Stage IV -- debridement, pain
med
Blood infusions

Blood transfusion with Normal Saline only with filter and Y tubing
RN only person to administer blood/ once stable can be assigned to LPN
Vitals Q 15 mins
Maximum hang time for Blood transfusion/ 4 hours
Short of breath after transfusion/ suspect fluid overload (check for bilateral crackles in lungs)
See spike in potassium when giving blood /BNP
Hypotension: fluid volume overload
Febrile response: slow down rate and give Tylenol
Uticaria -- slow down rate, give Benadryl (premeditate with Benadryl
Low back pain/flank pain -- kidney (life threatening) stop.
Anaphylaxis -- angioedema, loss of airway (life threatening) stop transfusion,

Patient with low back pain -- patient should lay on back or side laying with knees to chest

Myocardial Infarction -- oxygenation/ extinction -- heart failure/listen to base of lungs

Nocturnal dyspnea -- wake up and can't breathe

Fluid -- fine crackles -- auscultate lungs, pt in high fowlers, give 02, fluid

Default strategies: chest tube drainage system

Chest tube -- water seal chamber has bubbles -- means there is air leak
Tube come out of chest wall --- place a bulky dressing with tape on 3 sides
Use an occlusive dressing when tube is in
When do you clamp the chest tube: when you are changing drainage system

Walking cane care

Cane should be used on the opposite affected leg

cane used on strong side
walker safety/ move walker out then walk into it

EBOLA

Notify health department

Diagnose blood/quarantine patient
There is no vaccine for EBOLA

GENTAMYCIN

nephrotoxicity (otoxicity)
Give with Aspirin, furosemide cause tinnitus

Cyclins
Acne/photosensitivity

Foods to avoid if Gluten intolerant

Barley, rye, oats, and wheat

Dumping Syndrome
Sugars
Drink fluid and eat food separately
Teach to lay down after eat

ARTERIAL PERFUSION: LEGS DOWN

VENOUS PERFUSION: LEGS UP

Antidote for Magnesium -- calcium gluconate

Hemophiliac
Ice, pressure, elevate legs above heart level, administer clotting factors

Sickle cell
Infection lead to sickle cell crisis
Pan activities that encourage energy conservation
Give 02, hydrate, pain management, rest

AB+ blood type can receive any blood

Universal blood type=

Universal donor =O negative

Troponin MI

C reactive protein Inflammation

LDL Cholesterol

BNP Heart Failure

Stable Angina is relieved by rest or nitroglycerine

Patient with liver disease has a high risk for bleeding

Cardiac Rhythms

PAWP normal range 4-12 measures fluid volume

High/ hypervolemia > 12.
Low/ hypovolemia < 4

Burns:

4 Ml x BODY WEIGHT x % OF BURN SURFACE

GIVE 1/2 OF FLUIDS IN FIRST 8 HOURS
OTHER 1/2 FLUIDS REMAINING 16 HOURS OF THE FIRST 24 HOURS
Minimum output = 30 ML hour
Example: 187/2.2 = 85
4ml x 85kg x 38 = 12,920
12,920/2 = 6,460 from time of burn

GI Tract

Lose acid above waist = alkalosis (vomiting)

Lose acid below the waist = acidosis (diarrhea)

Right side of heart is deoxygenated blood which comes from the vena cava and go to the pulmonary
artery (lungs) get oxygenated flood from lungs and then go to the left side (aorta) the to the body.

Pressure is the oxygenated blood to the lungs. PAWP measures the amount of blood the heart is
pumping to the Aorta (body)

Netalengenic Nevi goes away by age 1 or 2

FAT Embolism = confusion, fever, petechia, hypotension, hypoxia,