Patient Centered Care Flashcards
The study of abnormalities in bodily functions as a cause or result of disease
pathophysiology
The study of normal functions of the living organism and its parts
Physiology
Describes a condition when the cause is unknown
Idiopathic
The pharmacological treatment of a disorder
pharmacotherapy
The cause of a disease
Etiology
The number of cases of a disease that are newly diagnosed w/in a population during a specific period of time
Incidence (epidemiology)
The number of cases of a disease that are currently present w/in a population during a specific period of time
prevalence (epidemiology)
What are the three IV routes
peripheral IV (hand, arm, foot)
central IV (neck, groin, chest)
PICC (catheter in arm to large vessel)
IV that has a short half-life or narrow therapeutic range seen in ICUs
Continuous IV
This IV has a long half-life but can not be given IV push due to drug properties and has a smaller bag containing medication connected to the patient’s main IV line
IV piggyback
IV that has a long half life or can act quickly
IV push
What is the angle for an IM injection
90 degrees
What is the angle for a SQ injection
45 degrees
What is the angle for intradermal injection
10 degrees
What tube is flexible plastic inserted through the nose down into the stomach
NG
What is the tube that is inserted through the abdomen into the stomach
PEG
What is the tube inserted through the abdomen into the jejumum
J
What are urinary, texas, and PureWich catherters used for
Urinary: placed through urethra
texas: “condom” catheter for guys
PureWick: uses suction for women
What are the 5 components of the PPCP
collect
assess
plan
implement
follow-up
What are the three parts of describing a plan in PPCP
patient-centered, evidenced-based, cost-effective
Who should be included in implementing a plan in PPCP
the patient
IBW equation for male and female
male: 50+2.3(height-60)
female: 45.5+2.3(height-60)
Adjusted BW equation
IBW + 0.4(ABW-IBW)
What is the definition of a fever
> 100.4 over 1 hour
101 for any period of time
Conditions where fluid balance matters
heart failure, kidney failure, septic shock
Do rectal and tympanic temperatures raise or lower body temp? What about axillary and temporal?
rectal and tympanic: raise
axillary and temporal: lower
F to C conversion
C = (5 (F-32) ) / 9
C to F conversion
F = ( 9(C)/5 ) + 32
BP increases or decreases when patients stand up
decrease
Normal respiratory rate
12-16 breaths/minute
Pulse range
60-100 bpm
Fluids inside the cells
intracellular
fluids between cells and outside the blood
interstitial
includes intravascular and interstitial fluids
extracellular
includes intracellular and interstitial fluids
extravascular
What is this fluid measurement for: 100ml/kg
0-10 kg
What is this fluid measurement for: 1000ml + 50ml/kg
11-20 kg
What is this fluid measurement for: 1500 ml + 20ml/kg
> 20 kg
What are these tests included in: Na, Cl, K, CO2, SCr, BUN, blood glucose, Ca
Basic metabolic panel (BMP)
What are these tests included in: BMP + ASL, alk phos, bilirubin, albumin, total protein
Complete metabolic panel (CMP)
Chemistries not available on panel
Mg, phosphorous
Sodium:
location
used for
Natremia
extracellular
maintains normal extracellular fluid balance, muscle contraction, nerve function
What is the equation for correcting sodium
Na+ measured + (0.016(serum glucose-100))
Potassium:
location
used for
kalemia
intracellular
maintains normal fluid balance, muscle contraction, nerve function
Chloride:
location
used for
chloremia
extracellular
works with Na+ to regulate fluid balance, nerve function, pH balance
Calcium:
location
used for
calcemia
extracellular
muscle contraction, nerve contraction, blood clotting, bone formation
What does serum calcium represent
calcium bound to albumin + free (ionized) calcium
What is the corrected calcium equation
ca2+ measured + (0.8(4-albumin measured))
Glucose:
normal range
<110
glycemia
Carbon Dioxide:
used for
it marks bicarbonate concentrations in the blood
Blood Urea Nitrogen (BUD):
used for
measures urea, indicator of kidney function, elevated if patients have upper GI bleed
Azotemia vs Uremia
Azotemia: retention of nitrogenous waste products resulting of acute kidney injury
Uremia: retention of nitrogenous waste products leading to multiorgan system dysfunction (from chronic kidney ijury)
How to find BUN ratio
do BUN to SCr
10:1 primary renal failure
20:1 decreased blood flow to kidney
Creatinine (SCr):
used for
byproduct of muscle/protein metabolism
What are the two methods of calculating CrCl
24-hour urine collection calculation:
((urine creatinine)*(urine volume)/time)/serum creatinine
Cockcroft-gault method:
((140-age)(IBW) / (72)(SCr))
*0.85 if female
Anion gap:
used for
equation
identify acid/base imbalance
represents number of unmeasured anions in the blood
(Na+)-(Cl- + HCO3+)
Osmolality:
equation
used for
number of particles in 1 kg of solution
2(Na+)+(BUN/2.8)+(BG/18)
What is an osmole gap and what is the equation to calculate it
indicates there are unmeasured, osmotically active particles present in the blood
osmole gap = actual - estimated osmolality
Albumin:
used for
most abundant protein in the blood
bind to drugs
Phosphorus:
used for
phosphatemia
bone/tooth formation, DNA/RNA formation, ATP & cell functioning
Calcium-phosphorus product
high calcium-phosphate product may lead to precipitation in the body
calcium-phosphate product = (Ca2+)(PO4 3-)
Concerned for calcification when product is >55
Magnesium:
location
used for
magnesemia
maintain muscle and nerve function, support energy production
What are these apart of:
Aspartate aminotransferase
Alanine aminotransferase
Alkaline phosphatase
Lactate dehydrogenase
Gamma glutamyltransferase
LFTs
What is the indicator of liver disease
+ alk phos
+ GGT
What is the indicator of bone disease
+ alk phos
normal GGT
Child-pugh score
scale that describes the level of liver dysfunction
indicates need for drug dosage modification
components: bilirubin, albumin, prothrombin time, ascites, ammonia
Glycosylated hemoglobin:
range
function
< 5.7%
the percentage of hemoglobin that has glucose bound to it
HgbAlC represents ~3 months
AGB ranges:
pH
PaCO3
PaO2
HCO3
pH: 7.35-7.45
PaCO2: 35-45 mmHg
PaO2: 90-100 mmHg
HCO3: 22-26 mEq/L
Metabolic acidosis/alkalosis indicator
Respiratory acidosis/alkalosis indicator
Metabolic: HCO3
Respiratory: PaCO2
What are these tests included in: RBC, WBC, PLT, Hgb, Hct, RBC indices
Complete blood count: CBC
What are these tests included in: neutrophils, lymphocytes, monocytes, eosinophils, basophils
Differential (diff)
Blood formation/destruction
spongy substance found in center of bones
forms RBC, PLT, WBC
Lymphatic system
part of immune system
defends against infection
lymph
Reticuloendothelial system
aka macrophage system
cells w/in major organs have phagocytosis
Whole blood is composed of ____, _____, _____, ______
RBC, WBC, platelets, plasma
What type of blood is used for CMP/BMP/Chem
plasma and serum
What type of blood is used for CBC
whole blood
What type of blood is used for clotting factors
plasma
WBC (white blood cells)
high: leukocytosis
low: leukopenia
defend the body against infections and foreign materials
HgB (hemoglobin)
binds and carries the oxygen that RBC are responsible for transporting throughout the body
Hct (hematocrit)
the percentage of RBC in the blood
MCV (mean corpuscular volume)
low: microcytic
high: macrocytic
MCV calculated if not provided in the CBC
MCV (mean corpuscular volume) equation
MCV=(Hct%*10)/RBC
RDW (red cell distribution width)
RDW>15%-Anisocytosis
measurement of range differences in volume and size of RBC, high RDW indicates a high amount of variation btw cells
RBC: (red blood cells)
high/low
function
lifespan
high: erythrocytosis/polycythemia
low: erthrocytopenia/anemia
carry oxygen to different parts of the body
lifespan is 120 days
Reticulocyte count:
nomenclature
function
High is reticulocytosis
immature red blood cells
MCH (mean corpuscular hemoglobin)
function
equation
the amount of hemoglobin per red blood cell
MCH=(Hgb*10)/RBC
MCHC (mean corpuscular hemoglobin concentration)
nomenclature
function
equation
low: hypochromic
high: hyperchromic
volume of RBC that is occupied by hemoglobin (mass/volume), describes the color of RBC
MCHC=(MCH*100)/MCV
Platelets:
nomenclature
function
lifespan
low: thrombocytopenia
high: thrombocytosis
function: initiate hemostasis to prevent or stop bleeding
lifespan 10 days
neutrophils:
range
interpretations
40-60%
segs or PMN
ANC
(seg% + band %) *WBC
bands:
range
interpretations
0-5%
infection (bacterial)
Lymphocytes:
range
interpretations
20-40%
infection (viral)
Monocytes:
range
interpretations
4-8%
various infections and chronic inflammatory diseases
Eosinophils:
range
interpretations
1-3%
allergic reaction or parasitic infection
Basophils:
range
interpretations
0-1%
allergic reactions and myeloproliferative diseases (including some leukemias)
Iron:
function
used to form hemoglobin (protein in RBC that transports oxygen)
Ferritin:
function
intracellular protein that binds and stores iron
surrogate measure of the amount of iron that is stored in the body
TSAT (transferrin saturation)
extracellular protein that binds and trasnports iron in the body
TSAT equation
TSAT = (Fe/TIBC)*100
TIBC (total iron binding capacity)
an estimate of the amount of transferrin available to bind to iron
Folic Acid (Vit B9)
DNA/RNA synthesis, protein metabolism for effective erythropoiesis, important in early pregnancy for preventing of neural tube defects
Vit B-12
aka: cyanocobalamin
DNA/RNA synthesis, protein metabolism for effective erythropoiesis
PT (prothrombin time)
function
monitor of what drug
time it takes to form a clot in a blood sample, coagulation pathways
helps monitor warfarin
aPTT (activated partial thromboplastin time)
function
monitor of what drug
form a blood clot, coagulation pathways, helps monitor heparin
anti-factor Xa level
clotting factor inhibited by specific anticoagulants
indirect measurement of the activity of heparin and low molecular weight heparin
