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Adult I > Nursing Process/ Lab Values > Flashcards

Nursing Process/ Lab Values Flashcards

1
Q

Why is the nursing process is important?

A
  • Problem solving approach
  • Identifies and manages patient problems
  • Provides an organizing framework for the practice of professional nursing
  • Provides the foundation for nursing knowledge, judgement and actions.
  • Requires reasoning, analysis, synthesis as well as psychomotor and affective skills.
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2
Q

List the nursing process.

A
  1. ) Assessment
  2. ) Diagnosis
  3. ) Planning
  4. ) Implementation
  5. ) Evaluation
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3
Q

During assessment, the RN collects subjective and objective patient data… which includes what?

A
  • From the admitting history and physical, obtain the history, duration and symptoms of current illness. Be sure to understand what problems started this hospitalization.
  • Note history of previous illnesses
  • Significant illnesses that can affect current problems that should be particularly noted include diabetes, CV disease, chronic pulmonary disease, chronic renal disease.
  • Any symptoms that you observe and any that patient reports should be included in the assessment.
  • Gather lab data
  • Examine the most recent values as well as the trends.
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4
Q

Complete blood count (CBC) includes ______ and _______, RBC, WBC and ______

A

hemoglobin, hematocrit, platelets

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5
Q

Normal hemoglobin level?

A

12-14

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6
Q

Normal hematocrit level?

A

40-54%

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7
Q

In what scenarios are CBCs most commonly decreased?

A
  • Protein malnutrition
  • Acute or chronic blood loss
  • Drug toxicities
  • Diseases such as anemia, leukemia, chronic renal failure.
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8
Q

In what scenarios are CBCs most commonly increased?

A
  • High altitudes
  • Dehydration
  • Late stage emphysema
  • Polycythemia vera (bleeding out of every orifice)
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9
Q

Normal Red blood cell (RBC) count?

A

4.5-5.9

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10
Q

Decreased RBCs are most often associated with ______, excessive intravascular fluid, chronic renal failure, _______ and radiation, and anemia.

A

leukemia, chemotherapy

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11
Q

Increased RBCs are most often associated with Polycythemia vera, ______, high altitude, and _________ disease.

A

dehydration, cardiovascular

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12
Q

What are RBCs indices used for?

A

Useful in differentiating various types of anemias.

*include MCV, MCH, and MCHC

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13
Q

MCV is the average ____ of red blood cells.

A

size

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14
Q

MCH is the ____ of the hemoglobin (hemoglobin amount per RBC).

A

weight

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15
Q

MCHC indicates the hemoglobin _______ per unit volume of RBC.

A

concentration

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16
Q

What is the reticulocyte count?

A

Immature red blood cells

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17
Q

Normal range of Platelets?

A

150,000-400,000

  • Critical values: 1,000,000
  • Platelets provide info about clotting factors
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18
Q

Normal range of WBC count (respond immediately to foreign invaders) and differential?

A

Total: 4,500-10,000

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19
Q

_______-identifies numbers of specific white blood cells

A

Differential

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20
Q

Elevated values of WBC (_______) - common with acute inflammation/ infection, tissue necrosis, leukemia, collagen diseases

A

leukocytosis

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21
Q

Decreased values of WBC include certain ______, viral infections, and drug influences.

A

anemias

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22
Q

What are two other diagnostic tests elevated during inflammatory process?

A
  1. ) C-reactive protein

2. ) Erythrocyte sedimentation rate (ESR)

23
Q

What is included in the white blood cell differential?

A

Neutrophils, Eosinophils, Basophils, Monocytes, Lymphocytes

24
Q

______: first line of defense against acute infections (segments are mature and bands are immature)

A

Neutrophils

25
Q

_______: increase during allergic or parasitic conditions.

A

Eosinophils

*increased steroid levels produced my meds or stress can cause decrease in eosinophils.

26
Q

______: increase during healing

A

Basophils

27
Q

______: second line of defense against bacterial infections and foreign substances-respond late during acute phase of infection or inflammation.

A

Monocytes

28
Q

______: occur in chronic and viral infections- often seen in chronic lymphocytic leukemia. May be decreased during excessive adrenocortical hormone secretion or steroid therapy.

A

Lymphocytes

29
Q

What is a basic metabolic profile (BMP) ?

A

A group of blood tests that determine metabolism- Chemistry 7

30
Q

BMP includes _____ level, BUN and _______, glomerular filtration rate, and ______ (sodium, potassium, chloride, and bicarbonate)

A

glucose, creatinine, electrolytes

31
Q

Normal glucose level?

A

70-110

32
Q

Normal BUN?

A

5-25

33
Q

Normal creatinine?

A

0.5-1.5

34
Q

BUN and creatinine give an overview of _____ function. Most often elevated with _______ or a renal damage/ disorder with creatinine being more sensitive to kidney disease.

A

renal, dehydration

35
Q

Glomerular Filtration Rate…decreased renal reserve level: ___-___. Renal insufficiency: ___-___. Renal Failure: ___-___. End stage renal disease (ESRD): ____

A

40-60, 20-40, 10-20, <10

36
Q

Normal sodium level?

A

135-145

37
Q

Normal Potassium level?

A

3.5-5.0

38
Q

Normal chloride level?

A

95-105

39
Q

For coagulation, what do you assess for?

A
  • Platelets
  • Prothrombin time (PT)
  • International normed ratio (INR)
  • Partial Thromboplastin time (PTT)
  • Look for elevations in patients on anticoagulants, liver disease.
40
Q

What four things do you assess for liver function studies?

A
  1. ) Bilirubin
  2. ) AST/SGOT
  3. ) ALT/SGPT
  4. ) Alkaline Phosphatase
41
Q

Normal Bilirubin level?

A
  1. 1-1.0
    * elevations can occur in autoimmune or hemolytic induced reactions, liver damage congestive heart failure.
    * significant elevations can cause jaundice
42
Q

Normal AST/SGOT?

A

8-38

  • Enzyme normally found in heart and liver muscles.
  • Level increase with acute MI, and liver damage.
43
Q

Normal ALT/SGPT?

A

10-35
*Enzyme found primarily in liver cells-used to diagnose liver disorders- Used to differentiate jaundice caused by liver disease and hemolytic disorders.

44
Q

Alkaline Phosphatase has ___ _____ indicator of liver and bone disease.

A

non specific

45
Q

To assess pancreatic studies, what is labs are used?

A

Amylase and Lipase

46
Q

Normal amylase levels?

A

60-160

  • Enzyme that changes starch to sugar.
  • Rises significantly with damage to pancreas such as pancreatitis- causes severe inflam. and pain. Also with abdominal surgery involving the gallbladder and stomach.
47
Q

Normal Lipase levels?

A

20-80

  • Enzyme secreted by pancreas aids in digesting fats
  • Lipase increases in the blood stream when there is damage to pancreas such as pancreatitis, cancer, hepatitis.
48
Q

When evaluating a patients nutrition status, how do you assess?

A
  • Ht/weight

* BMI: weight in lbs x 703, divided by heigh in inches squared

49
Q 
What are the BMI levels? 
Underweight: \_\_\_\_\_
Healthy:\_\_\_\_\_
Overweight:\_\_\_\_\_
Obese: \_\_\_\_\_
Morbid Obesity: \_\_\_\_\_
A

30, >40

50
Q

When evaluating labs for nutrition status, Pre-albumin, _____, and transferrin may be low during inflammatory metabolic response b/c the liver _____ production of these labs.

A

albumin, decreases

  • Differentiation between that and poor nutritional status are important.
  • Note any significant weight loss, history of nausea, vomiting, anorexia, dysphagia, which may contribute to nutritional intake.
51
Q

During analysis and synthesis, take each piece of collected abnormal data and begin to group it, patterns will emerge that will indicate your patients problems also known as the nursing ________.

A

diagnoses

52
Q

Name some nursing diagnosis

A
  • activity intolerance
  • airway clearance, ineffective
  • anxiety
  • altered nutrition less than body requirement
  • altered skin integrity
  • impaired mobility
  • breathing pattern ineffective
  • risk for infection
  • altered circulation (peripheral, cerebral)
  • altered cardiac output
  • altered comfort (acute or chronic pain)
  • altered fluid and electrolytes
  • impaired gas exchange.
53
Q

An _____ is defined as the result of achievable nursing interventions and pt responses.

A

outcome

  • specific
  • measurable
  • consider pt’s desires and resources
  • created by listing items and behaviors that can be observed or heared.
  • definitie time frame for achievement–Example: Pt will ambulate in hall 15 mins four times per day within 24 hours, WBC count will return to normal within 48 hrs.—> outcome documentation and measurement provide the direction for planning and validating nursing interventions!
54
Q

During _______, reassess, and determine if outcomes have been met, revise interventions according to the pt’s desires or resources.

A

evaluation

Adult I (3 decks)

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