deck_2433648 (1) Flashcards by Kerry Allen

Respiratory Rate Rhythm and Pattern

Interpretation

Newborn: 33-45
1 year: 25-35
10 years: 15-20
Adult: 12-20 Rhythm
normal: Inspiration:Expiration = 1:2
COPD: I:E = 1:3 , 1:4

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ABGs: SpO2

Normal: 98-100%High: n/aLow: below 88-90% requires supplemental O2

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ABGs: PaO2

Normal: 90-100 mmHgHigh: in hyperoxygenationLow: in cardiac decompensation, COPD, some NMSPT: n/a

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ABGs: PaCO2

Normal: 35-45 mmHgHigh: in COPD, hypoventilationLow: hyperventilation, pregnancy, PE and anxiety

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ABGs: pH, whole blood

Normal: 7.35-7.45 (< acid, > alkaline)High:
* respiratory alkalosis: hyperventilation, sepsis, liver disease, fever
* metabolic alkalosis: vomiting, potassium depletion, diuretics, volume depletion
Low:
* respiratory acidosis: hypoventilation, COPD, respiratory depressants, myasthenia
* metabolic acidosis: bicarbonate deficit, increased acids (diabetes, alcohol, starvation); renal failure , increased acid intake and loss of alkaline fluids

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Hemostasis: Prothrombin Time (PT)

Normal: 11-15 secHigh: factor X deficiency, hemorrhagic dx, cirrhosis, hepatitis drugs (warfarin)

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Hemostasis: Partial Thromboplastin Time (PTT)

Normal: 25-40 secHigh: Factor VII, IX, X deficiency

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Hemostasis: INR

Normal: .9-1.1
* Target INR 2-3 = DVT, PE, Mechanical valves, A-fib
* Target INR 3.5 = pts with clotting disorders
PT: look for active signs of bleeding when treating patients and use compensatory training to reduce fall risk

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Bleeding Time and C-reactive protein (CRP) <10mg/L

Bleeding Time 2-10 minC-reactive protein (CRP) <10mg/LHigh: platelet disorders, thrombocytopenia, high levels associated with increased risk atherosclerosis>100 mg/L associated with inflammation and infection

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CBC: White Blood Cells WBCs

Normal: 4300-10800 cells/mm3 - indicative of immune systemHigh: infection (all kinds), inflammation, hematologic malignancy, leukemia, lymphoma, drugs (corticosteroids)Low: aplastic anemia, B12 or folate deficiencyPT: consider metabolic demands in presence of fever and use of mask when WBCs <1000-2000 or ANC <500-1000

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Exercise Guidelines: WBC Count

4800-10,800 cells/mm3= Normal exercise> 5,000 = light or regular exercise< 5,000 +Fever = no exercise

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CBC: Red Blood Cells RBCs

Normal: male: 4.6-6.2 women: 4.2-5.9 x106/uL
High: polycythemiaLow: anemia

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CBC: Erythrocyte Sedimentation Rate ESR

Normal: male <15 women< 20 mm/hr
High: infection and inflammation: rheumatic or pelvic inflammatory dx, osteomyelitis - used to monitor treatment; e.g. RA, SLE, Hodgkins Dx

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CBC: Hematocrit %

Normal: male: 45-52% female: 37-48%
High: erythrocytosis, dehydration, shockLow: severe anemia, acute hemmorhagePT: can cause decreased exercise tolerance and increased fatigue, tachycardia

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Exercise Guidelines: HCT %RBC whole blood

Men = 45-52%, women = 37-48% = Normal Exercise>25% light or regular exercise

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CBC: Hemoglobin Hgb

Normal: male: 13-18 g/dL women: 12-16 g/dL
High: polycythemia, dehydration, shockLow: anemia, prolonged hemmorhage, RBC destruction (cancer, sickle cell)PT: can cause decreased exercise tolerance and increased fatigue, tachnycardia

Exercise Guidelines: HgB

men = 13-18, women = 12-16 g/dL = normal unrestricted>10 regular exercise8-10 = light exercise< 8 = no exercise

CBC: Platelet Count

Normal: 150,000-450,000 cells/mm3High: chronic leukemia, hemoconcentrationLow: thrombocytopenia, acute leukemia, aplastic anemia, cancer chemo,PT: increased risk of bleeding with low levels so monitor for hematuria, petechiae and other signs <20k = AROM, ADLs only 20-30k = light exercise only
* 30-50k = moderate exercise

Exercise Guidelines: Platelet Count

150,000-450,000 = normal, unrestricted50,000-150,000 = some limitations30,000-50,000 = moderate exercise20,000-30,000 = light exercise< 20,000 = ROM, ADLs, walking w/ physician approval

Pre-Albumin

20-40 mg/dL2-day half life (short term gauge of nutrition)<15 mg.dL = malnutrition

Albumin

3.5-5.5 g/dL18-20 day half life (long term gauge nutrition)<3.5 = malnurished

Creatinine

Normal: 115-125 mL/minmeasures GFR as a measure of renal function, regulated by arterial blood pressure and renal blood flow

BUN

Normal:is urea produced in the liver as a by-product of protein metabolism that is eliminated by the kidneys

elevated with increased protein intake, GI bleeding and dehydration*
BUN-creatinine ratio is abnormal in liver disease

Glucose Levels

70-115 mg/dL (Fasting)Short term management of diabetes

Glycosylated Hemoglobin Levels (HbA1C)

4-6%long term management of diabetes

Hypokalemia

* low potassium causes: * deficient potassium * excessive loss from diarrhea, vommiting * metabolic acidosis * renal tubular disease * alkalosis observe: * ms weakness * fatigue * cardiac arrhythmias * abdominal distention * nausea/vommiting

Hyperkalemia

* high potassium causes * inadequate secretion w/ acute RF * kidney disease * metabolic acidosis * diabetic ketoacidosis * sickle cell anemia * SLE observe: * symptomless until very high levels * ms weakness * arrhythmias * ECG changes (tall T wave, prolonged PR & QRS)

Hyponatremia

* low sodium causes * water intoxication (extracellular water) * excess ADH observe: * confusion * decreased mental alertness to convulsions * signs of high ICP * poor motor coordination * sleepiness * anorexia

Hypernatremia

* high sodium causes * water deficits (not salt excess) dehydration * insufficient water intake observe * circulatory congestion * pulmonary edema w/ dyspnea * HTN * tachycardia * agitation * restlessness * convulsions

hypocalcemia

low calcium * reduced albumin levels * hyperphosphatemia * hypoparathyroidism * malabsorption of Ca or Vit D * alkalosis * acute pancreatitis * vit D deficiency observe: * muscle cramps * tetany * spasms * parasthesias * anxiety * irritability * twitching * convulsions * arrhythmias * hypotension

hypercalcemia

high calcium * hyperparathyroidism * tumors * hyperthyroidism * vit A intoxication observe * fatigue * depression * mental confusion * nausea/vommiting * increased urination * occasional cardiac arrhythmias

hypomagnesemia

low magnesium * hemodialysis * blood transfusions * chronic renal disease * hepatic cirrhosis (alcoholism) * chronic pancreatitis * hypoparathyroidism * malabsorption syndromes * severe burns * excessive loss of body fluids Observe * hyperirritability * confusion * leg and foot cramps

hypermagnesemia

high magnesium * renal failure * diabetic acidosis * hypothyroidism * Addison's Dx * dehydration * use of antacids Observe: * hyporeflexia * muscle weakness * drowsiness * lethargy * confusion * bradycardia * hypotension

Normal Urine SampleColorClaritySpecific GravitypHProteinSugar

* Color - yellow-amber * Clarity - clear * Specific Gravity - 1.010-1.025 * pH - 4.6-8.0 (6 avg) * Protein - 0.8 mg/dL * Sugar - none

Cardiac Biomarkers

Enzymes in blood stream after MI. creatine phosphokinase (CK-MB) * appears ~4 hrs after infarction * peaks 12-24 hrs * declines over 48-72 hrs troponin protein (T-1) * remains elevated for 5-7 days