Patient Monitoring (20) Flashcards
female 12-15 g/dL
male 14-17g/dL
Hgb Normals
Hgb (3)
“Hemoglobin”
Iron-rich protein on RBCs
Helps xt O2
Helpful to spot anemia/bleeding/etc
Special Procedures
Any situation requiring abnormally large needles and RN (eg., Bx, drain plcm’t, aspirations)
HCT
Measures…
Depends on…
Usually part of…
Low values (often) from…
“Hematocrit”
Measures % of RBCs in whole blood
Depends on size/# RBCs
Usually part of CBC
Low values often from bleeding/anemia
HCT Normals
(female<male)
35-50%
Plt
High may indicate…
Low may indicate…
“Platelets”
Clotting disorder
Potential for bleeding (disorders)
Plt Normals
150K-400K per mcL
PT (labs)
Prothrombin Time
Time for liquid portion (plasma) to clot
High PT may be contraindication for procedure d/t inc’d risk of bleeding
PT Normals
11-13.5 sec
PTT
(Partial Thromboplastin Time)
measures blood coagulation time
PTT Normals
25-35 sec
INR
Represents…
High may…
“International Standardized Ratio”
Represents coagulation tendency of blood. High may be contraindication d/t POSS of uncontrolled bleeding
INR Normals
0.8-1.2
Anxiolysis
Minimal Sedation:
Relaxes
Reduces anxiety
Common in radiology
Conscious Sedation (2)
(“Moderate Sedation”)
Pt follows specific directions
Common in radiology
Deep Sedation (2)
(“Deep Sedation”)
Limited response to stimuli
POSS support of vital functions
General Anesthesia
General anesthesia:
unresponsive
req’s sig support of vital functions
Sedation prep (4)
No solids x 6h
Clear liq x2h
IV access
Baseline vitals
Sedation Concurrent (2)
Supplemental O2
Re-assess vitals (gen ea 5 min)
Sedation: After (3)
Vitals/consiousness reassessed until ready for d/c
f/u instructions provided
no driving/isolation x24h
Oral Temp Normals
97-99.5 (36.1-37.5)
Rectal Temp Normals
Oral +1 deg F
Axillary Temp Normals
(Least accurate) 1-2 deg F < Oral
Tympanic Temp Normals
0.5-1 deg F > oral
Pulse: 3 considerations
Rate, rhythm, amplitude
Pulse Normals
Adult: 60-100
Influences to BP (4)
Force of ventricular contractions
Arterial wall elasticity
Peripheral vascular resistance
Blood volume/viscosity
BP Normals
100/60-119/79
Respirations considerations (4)
Rate, rhythm, depth, sound
Respiration Normals
12-20
Oximetry
oxygen content in circulation
Hemodynamics
Science of blood flow and its impact on tissues/organs
End-tidal CO2 monitoring (2)
Recommended for all patients under moderate sedation;
More sensitive (than O2) indicator of respiratory status
EtCO2 Normals
35-45 mmHg
< 35: anxiety
> 45: respiratory failure
EKG: Depolarization
Contraction
EKG: Repolarization
Relaxation of atria/ventricles
EKG allows for identification of…(3)
Heart rhythm disturbances (arrhythmias)
Conduction abn’s
Elecrolyte imbalances
P wave
Electrical activity through atria
QRS complex
Represents…
Occurs during…
Electrical impulses through ventricles
Ventricular systole
ST segment
Ventricle is contracting but no elec’l current flowing through it
Gen’y straight/level line b/w QRS-complex and T-wave
T wave
Represents…
Occurs during…
Ventricles resetting electrically and prep’g for next contraction
Ventricular diastole
Low HCT often d/t
Bleeding/Anemia
High INR may be contraindication d/t
POSS uncontrolled bleeding
Sedation/Analgesia:
Most common meds combo
Midazolam (Versed)/ fentanyl (Sublimaze)
Sedation/Analgesia:
Alternative to most common combo (4)
Diazepam (Valium)
Lorazepam (Ativan)
Hydromorphone (Dilaudid)
Morphine
Midazolam
Versed
Fentanyl
Sublimaze
Diazepam
Valium
Lorazepam
Ativan
Hydromorphone
Dilaudid
EtCO2 < 35 mmHg indicates
Anxiety
EtCO2 > 45 mmHg indicates
Respiratory failure
Neoplasm
“Tumor”
Abnormal growth of tissue: malignant (cancerous) or benign
Malignant
Cancerous: can spread to other areas
Benign
Cannot spread to other areas
Cancer
Uncontrolled growth & spread of abnormal cells
Carcinogenesis
Development of cancer in the body
Primary liver cancer is often denoted by _______ _______ tumor(s), while metastatic liver cancer is often denoted by _______ _______ tumor(s)
One Large
Several small
Invasion and multiplication of microorganisms in body tissues
Infection
Accumulation of fluid in the tissues of an organ or body structure
Inflammation (doesn’t necessarily include infection)
A form of inflammation in which a massive amount of abnormal fluid is collected in body structures
Ascites
Reactive inflammatory fluid resulting as a response to malignant processes
Ascites
A bruise on the surface of the brain in the subdural space
Subdural Hematoma
An accumulation of blood outside of a blood vessel
Hematoma
Tear in the body of an organ
Laceration (fracture): can result in hematoma and infarction
Loss of blood supply to an organ or region of tissue
Infarction–presents as areas that aren’t receiving adequate blood flow and therefore no contrast
Abnormal sac-like structure filled with fluid, gas and/or semi-solids
Cyst
Abnormal enlargement of a blood vessel
Aneurysm
