Mark k lecture 8 Flashcards
Creatinine (Cr) (what it tells you, whats normal, what letter if abnormal)
Creatinine (Cr) Best indicator of kidney or renal function
0.6 to 1.2 Level A
Level B if dye procedure
(such as a catheterization) is
involved
INR (what it tells you, whats normal, what letter if abnormal) what do do if its bad
Monitors coumadin … Also
reflects PT (or Prothrombin
time)
2 to 3
Level C when 4 and above
- Action to take in following order … Hold Coumadin ! Focus Assessment for bleeding !
Prepare to give vit K ! Call HCP
Potassium (K+)
Blood chemistry 3.5 to 5.3 Level C if Low
Level C if High
Level D if over 6
- LOW potassium … Action to take in the following order … Nothing to hold ! Assess heart
(EKG) ! Prepare to give K+ ! Call HCP - HIGH potassium (bet 5.4 and 5.9) … Action to take in the following order … Hold K+ !
Assess heart (EKG) ! Prepare to give Insulin/Kayexelate ! Call HCP - HIGH potassium (6 or more) … Action to take in the following order … Hold K+ ! Assess
heart (EKG) ! Prepare to give Insulin/Kayexelate STAT ! Call HCP, stay with pt
pH
pH Blood chemistry 7.35 to 7.45
Level D if pH in the 6s
* Action to take … Nothing to hold ! Assess V/S ! Nothing to prepare ! Call HCP
BUN
(Blood urea
nitrogen)
Waste product in blood 8 to 25 Level A
- Action to take … Nothing to hold ! Assess for dehydration ! Prepare IV fluid ! Call
HCP
Hemoglobin (Hb) Blood
12 to 18
Level B if 8 to 11
Level C if <8
* Action to take for a Level C … Nothing to hold ! Assess for bleeding/anemia/malnutrition
! Prepare blood ! Call HCP
Bicarbonate
22 to 26 Level A
CO2
Level C if in the 50s
Level D if in the 60s or
higher
- Action to take for a Level C … Nothing to hold ! Assess for breathing ! Ask pt to perform
purse-lipped breathing ! Call HCP
o This is not a COPD pt - Action to take for a Level D … Nothing to hold ! Prepare to intubate/ventilate ! Call
(Respiratory therapy ! HCP), do not leave pt
o This is respiratory failure
Hematocrit (Hct)
Assess for dehydration 36 to 54 Level B (the percentage by volume of red cells in your blood)
O2 or PaO2
Blood chemistry
78 to 100
Level C if 70 to 77
Level D if in the 60s or
lower, respiratory failure
- Action to take for a Level C … Nothing to hold ! Assess for respiration difficulty and
dyspnea, prepare to give oxygen ! Call HCP
o In a pt with hypoxia, the heart rate increases first, then the respiratory rate increases
afterwards due to compensation
o In a coronary care unit, the 2 most common episodic causes of tachycardia in heart pt are
hypoxia and dehydration
Treatment: Give the O2 to pt and increase the rate of fluid administration usually solve the
problem - Action to take for a Level D … Prepare to intubate/ventilate pt ! (Call Respiratory
therapist ! HCP), stay with pt
O2 Saturation
93 to 100
Level C if <93
- Action to take for a Level C … Nothing to hold ! Give pt O2
- What invalidates your reading?
o Anemia
o Or a Dye procedure—It colors the blood
o Both falsely elevated
BNP
(Brain natriuretic
peptide)
B >100 indicates CHF. Monitor
pt for sign of CHF
Level B if >100
Sodium (Na) Electrolyte
135 to 145
Level B if abnormal
Level C if abnormal and
there is change in pt’s LOC
- Action to take for a Level B … Nothing to hold ! Assess for fluid overload (hypOnatremia)
or dehydration (hypERnatremia) ! Prepare for furosemide (hypOnatremia) or IV fluid
(hypERnatremia) ! Call HCP - If there is a change in LOC, pt becomes level C and a safety issue
WBC
Total 4,000
to 11,000
Level C <4,000
ANC (Absolute
neutrophil count)
> 500
Level C <500
