med surg lecture uno Flashcards
White blood cells critically low
<2,000
White blood cells critically high
> 40,000
Red blood cells
4.2-6.1
hemoglobin critically low
<7
hemoglobin critically high
> 21
hematocrit (HCT)
<21%
hematocrit critically high
> 65%
platelet critically low
<20,000
platelet count critically high
> 1,000,000
PTT critically high
> 100 seconds
PT critically high
> 20 seconds
INR normal range
0.8-1.1
INR critically high
> 5
Magnesium level normal
1.3 - 2.1
magnesium critically low
<0.5
magnesium critically high
> 3
HGA1C
4-6%
D-Dimer
<500
ESR (erythrocyte sedimentation rate)
<20
CRP (c-reactive protein)
<10
sodium critically low
<120
sodium critically high
> 160
potassium critically low
<3
potassium critically high
> 6.1
chloride normal level
98-106
chloride critically low
<80
chloride critically high
> 115
glucose critically low
<40
glucose critically high
> 450
EGFR
> 60
total calcium critically low
<6
total calcium critically high
> 13
AST
0-35
coagulation labs
pt
ptt
inr
lipid panel
HDL
LDL
triglycerides
total cholesterol
cardiac labs
troponin
creatine kinase
bnp
digoxin
inflammatory marker labs
ESR
CRP
kidney function labs
creatine clearance
EGFR
pancreatic function labs
amylase
lipase
blood glucose labs
HGA1C
glucose
thyroid labs
TSH
total T3
total T4
free T4
complete blood count labs
WBC
RBC
Hgb
Hct
platelet count
cbc with diff labs
everything in cbc plus:
neutrophils
lymphocytes
monocytes
eosinophils
basophils
renal function labs
BUN
serum creatinine
creatinine clearance -best
EGFR
diagnostic testing includes:
drawing blood
collecting urine
imaging
What is required before, during and after any diagnostic test?
Patient Education
Lab values are obtained for what reasons?
To diagnose a patient
To rule out a clinical problem
To monitor therapy of various drugs
methods of obtaining blood samples
venous blood draw
arterial blood draw
capillary puncture
electrolytes includes:
sodium
potassium
calcium
magnesium
chloride
phosphate
What causes imbalances of our electrolytes?
Malnutrition
dehydration
over hydration
vomiting/diarrhea
sweating
medications
What complications can occur with electrolyte imbalances?
Cardiac and/or neurological
How does electrolyte imbalances affect the heart?
Causes irregular rate and rhythm and arrhythmias can lead to cardiac arrest
When you think of sodium which part of the body should you think of?
Brain
hyponatremia
low sodium anything less <136
hypernatremia
high sodium anything >145
signs and symptoms of hyponatremia
mental status change
lethargy
dizziness
headaches
seizures
coma
death
causes of hyponatremia
excessive sweating without proper replacement of sodium
fluid volume disturbances (primarily hypervolemia)- too much fluid in the vascular system - dilutes sodium
Interventions for hyponatremia
keep patient safe due to mental status change
-seizure precautions
-assess and monitor neurological status
-daily weights
- monitor intake and output
-replace sodium
-restrict “free” water
-educate
signs and symptoms of hypernatremia
-thirst
-mental status changes - irritability, agitation, confusion
-twitching and tremors
-seizures
causes of hypernatremia
-fluid volume disturbances (hypovolemia - not enough volume)
-increased sodium intake or unable to excrete sodium (due to kidney failure)
interventions for hypernatremia
-keep patient safe
-seizure precautions
-assess and monitor neurological status
-daily weights
-monitor intake and output
-restrict sodium
-educate
what part of the body pertains to potassium?
-cardiac/heart
- muscles
-respiratory
-mental status
-GI system
causes of hypokalemia
-inadequate intake
-excessive loss
-medications
interventions for hypokalemia
-cardiac monitor
-perform appropriate focused assessments
-give potassium rich foods
-potassium supplements
-educate
Hyperkalemia signs and symptoms
cardiovascular system
-cardia arrhythmias, can lead to cardiac arrest
-weak pulses
-low blood pressure
muscle twitching and cramps followed by muscle weakness
increased GI motility
-diarrhea
Causes of hyperkalemia
-excessive potassium intake
-kidney failure
-medications
interventions of hyperkalemia
-cardiac monitor
-perform appropriate focused assessments
-give medications to decrease potassium levels
-restrict potassium rich foods
-educate
what medication could decrease potassium levels?
lasix
role of calcium
-essential for proper functional excitable muscle cells
-promotes muscle contraction
-helps maintain normal heart rhythm
-blood vessels constriction
-aids in keeping bones and teeth strong
-calcium is stored in these locations
how does vitamin d get to its active form
by the kidneys
hypocalcemia signs and symptoms
cardiac arrhythmias, possible cardiac arrest
hypotension
hyperactive deep tendon reflexes
positive trousseau and chvostek signs
numbness and tingling in fingers and around mouth
hypocalcemia causes
medications
vit d deficiency
renal disease
hypocalcemia interventions
cardiac monitor
monitor BP - BP DROPS
perform appropriate focused assessments
administer calcium supplements
encourage calcium rich foods
keep patient safe
education
hypercalcemia signs and symptoms
cardiac arrhythmias, possible cardiac arrest
hypertension
skeletal muscle weakness
possible kidney stones
hypercalcemia causes
excessive intake of calcium or vit d
medications
interventions for hypercalcemia
cardiac monitor
monitor BP
perform appropriate focused assessments
give medications to decrease calcium levels
avoid foods high in calcium
educate
roles of magnesium
critical in nearly all metabolic processes
works with calcium for proper function of excitable cells
cardiac muscle, smooth muscle and nerve cells
magnesium imbalances are usually accompanied by a ________ imbalances?
calcium
signs and symptoms of hypomagnesemia
cardiac dysrhythmias, possible cardiac arrest
hyperactive deep tendon reflexes
tetany
causes of hypomagnesemia
decreased intake (malnutrition)
excessive loss (severe diarrhea)
chronic alcoholism
interventions for hypomagnesemia
cardiac monitor
perform appropriate focused assessments
give supplements to replace magnesium
encourage magnesium rich foods
hypermagnesemia signs and symptoms
-cardiac arrhythmias
-lethargy
-skeletal muscle weakness - respiratory failure
-hypotension
hypermagnesemia causes
increased intake
renal failure
hypermagnesemia interventions
-cardiac monitor
-perform appropriate focused assessments
-give medications to decrease magnesium level
-avoid foods and medications rich in magnesium
If the patient was abusing the antacid maalox, what might you see?
low magnesium
role of chloride
helps maintain the body’s acid-base balance (ph levels)
helps move fluid in and out of the cells
role of phosphate
necessary for formation of bones and teeth
used by the cell for energy
plays an important structural role in building cell membranes
stored in the bones
normal blood pH
7.35 to 7.45
red blood cells are also know as what
erythrocytes
What is the “vehicle” for oxygen and carbon dioxide transport
Hemoglobin
Erythrocytosis is
elevated RBCs, Hgb, Hct
