Labs - REVIEW DAILY

Question 1

pH

Answer 1

7.35-7.45

Question 2

Bicarbonate (HCO3)

Answer 2

22-26

Question 3

PaCO2 levels
- When do you intubate?

Answer 3

35-45

> 60s = RESPIRATORY FAILURE
= prepare to intubate + ventilate

Question 4

Serum Creatinine

Answer 4

0.6-1.2

Elevation = impaired kidney fx
*another lab is BUN

Question 5

INR/PT

Answer 5

Therapeutic: 2-3 seconds

Question 6

aPTT

Answer 6

Heparin

Normal: 20 - 30 sec
Therapeutic: 1.5x-2.5x normal

Question 7

K

• Sxs are same as prefix, except for (2)?
• What to never do?
• best tx for HYPER kalemia?
• Max and min [K] to give?

Answer 7

3.5-5.3

• HEART; affects QT interval
• Inverse to Na
• All Sxs are the same, except HYPER = low HR + urine output

Best way to tx HYPERkalemia = D5W w/ reg. insulin + Kayexalate

Never do these:
1. Give IV push or IM injection
2. Give >40mmol/L (max) of IV fluid DILUTE

Question 8

BUN

Answer 8

Kidney function
- Measures nitrogen waste products in blood

8-25
Elevated = dehydration (e.g. GI losses)

Question 9

HgB

Answer 9

Haemoglobin
12-18

Drop <8 = assess for bleeding + prepare to give blood

Question 10

Hematocrit

Answer 10

% of RBCs in vascular volume
36% - 54% (3x Hgb)

ELEVATED = assess for dehydration

Question 11

PaO2

Answer 11

78-100

PRIORITY: in the 60s = respiratory failure

Question 12

O2 Sat

Answer 12

93% - 100%

PEDS <95% = give O2!!

Question 13

BNP

Answer 13

(Brain natriuretic peptide)
= Indicates CHF (ventricular stretch)

<100

Question 14

Na
- C/F of Hyper/Hypo??

Answer 14

135-145

Abnormal Na levels + change in LOC = CRITICAL
hypEr = dEhydratioon
hypO = Overload

Inverse to K

Question 15

WBCs
- Total?
- ANC?
- CD4?

Answer 15

5K - 11K
Absolute Neutrophil count (ANC) >500
CD4 >200
= lower CD4, HIV&raquo_space; AIDS

Question 16

Low platelet count is called _______?

Answer 16

Thrombocytopenia (clotting deficiency)

PRIORITY: if <40K

Question 16

RBC deficiency

Answer 16

Anemia

Question 17

MAP

Answer 17

An accurate BP reading from arterial line

> 60 mmHg for adequate perfusion to body

TOO LOW = hypovolemic shock

Question 18

Normal urine output

Answer 18

> 0.5 mL/kg/hr (>30 mL/hr)

Question 19

Ejection Fraction

Answer 19

55-70%

Question 20

Calcium

Answer 20

9-11

Can be a diuretic + sedative
HYPO = tetany
HYPER = lower NM excitability
- Deals w/ skeletal m. + nerves
- Inverse to phosphate; same to Vit. D + Magnesium

Question 21

Magnesium
- Relative to other electrolytes

Answer 21

Deals w/ heart
1.6 - 2.6 mg/dL

Inverse to phosphate; same to Ca
*Do not give rapid IV, or else CARDIAC ARREST

Question 22

C-reactive protein

Answer 22

Released at acute inflammation of heart
- Indicative of increased risk of CAD

Question 23

What enzymes are elevated for pt w/ MI?

Answer 23

Elevated Troponin, Myoglobin, Creatine Kinase-MB

Question 24

Digoxin therapeutic levels

Answer 24

0.5 - 2

Question 25

What are ESR and CRP indicators of?

Answer 25

Inflammation

Question 26

What are ALT and AST indicators of?

Answer 26

Liver function

Question 27

Serum Lactate

Answer 27

Indicates Anaerobic metabolism is happening = HYPOperfusion >20 mg/dL = tissue hypoxia

Question 28

Absolute Neutrophil Count (ANC) indicates _____?

Answer 28

Severity of NEUTROPENIA (WBC deficiency) <500

Question 29

What is normal BMI and Obese BMI?

Answer 29

Normal = 18-24 Obese >30

Question 30

d-dimer is indicative of ______?

Answer 30

A protein released into bloodstream when a blood clot ruptures (in cases of DVT)

Question 31

What is at risk when uric acid levels are elevated?

Answer 31

AKI

Question 32

Normal A1C levels Diabetic range?

Answer 32

Normal < 5.9% Good diabetic control, < 7%

Question 33

Relationship b/w amount of urine and urine specific gravity

Answer 33

More urine = lower USG

Question 34

Neonatal hypoglycemia

Answer 34

Heel stick 2.2 - 2.5

Question 35

Stages of labor

Answer 35

Stage 1 = latent/early (0-5cm dilation) = Active (0-6cm) Stage 2 = birth Stage 3 = maternal recovery + placental expulsion (give Oxytocin)

Question 36

Braxton Hicks

Answer 36

False labor (no progression in contractions, effacement, engagement) - contractions are relived by activities

Question 37

Oxytocin

Answer 37

Uterotonic = Helps with uterine contractions - good for regulating bleeding

Question 38

Preterm labor - Complications of premature babies? - Tx?

Answer 38

Under 37 wks Premature babies = low birth weight = Immature organ development (respiratory distress/Cardiac defects/Necrotizing enterocolitis**) Treatments - Magnesium sulfate IF UNDER 32 WEEKS (fetal neuro protection) - Tocolysis (stop contractions) - Corticosteroids (rapid lung maturity) - Abx (GAS prophylaxis)

Question 39

Umbilical prolapse - Why is it an emergency? - RFs?

Answer 39

when umbilical cord comes out before baby = can suppress fetal oxygenation if baby if cord is compressed RFs - Breeched position/Disengagement - Ruptured membranes/Polyhydramnios Dx = RAPID CHANGE IN FETAL HR (Bradycardia, severe variable decelerations) Tx = Manually push fetal head up = Knee-to-chest position (gravity helps)

Question 40

Postpartum hemorrhage

Answer 40

Due to: - TONE (uterine atony/weakness post-birth) - TRAUMA (vagina/cervix) - TISSUE (placenta BVs are compressed = bleed) - THROMBIN (clotting problems) CHECK 1. Perineal pad (>1 pad/hr + large clots) 2. Maternal Sxs = hypotensive Tx = Oxytocin + Fundal massage (to help uterus clamp down)

Question 41

How to nurse Postpartum depression?

Answer 41

1. Monitor for suicidal or infanticidal thoughts 2. Observe maternal-newborn interactions

Question 42

Postpartum Psychosis - Tx?

Answer 42

Rapid hormonal changes = psychosis (mania, depressive, hallucinations/delusions) = Mood stabilizers (Lithium/Valproic acid) = Antipsychotics = Benzos (for Insomnia)