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nclex review > vital signs + labs > Flashcards

vital signs + labs Flashcards

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1
Q

factors affecting pulse

A
  • heart slows with age
  • emotions stimulate SNS + increase HR
  • pain increases HR
  • high body temp can increase HR
  • stimulant meds can increase HR
  • depressants can decrease HR
  • low BP/blood volume + hemorrhage increases HR
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2
Q

pulse points

A
  • temporal artery (in front of ear)
  • carotid (by trachea
  • apical (left midclavicular intercostal space)
  • brachial (antecubital fossa, between bicep and tricep)
  • radial (by thumb)
  • ulnar (by pinky)
  • femoral (between symphysis pubis and anterosuperior iliac spine)
  • popliteal (behing knee)
  • posterior tibial (inner side of ankle, behind and below ankle bone)
  • dorsalis pedis (on top of foot)
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3
Q

systolic vs diastolic measurements

blood pressure

A
  • force on walls of artery exerted by blood under pressure from heart
  • systolic = max pressure into aorta
  • diastolic = pressure in aorta when ventricles relax
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4
Q

factors affecting BP

A
  • increases with age
  • increases with stress
  • high BP more common in black and east asian populations
  • opioids decrease BP
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5
Q

hypertension catergories

A

Stage 1: systolic 130 - 139mmHg or diastolic 80 - 89mmHg
Stage 2: systolic over 140 or diastolic over 90
Hypertensive crisis: systolic over 180 or diastolic over 120

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6
Q

what it measures

pulse oximetry

A
  • registers oxygen saturation of hemoglobin
  • capillary O2 saturation (SaO2) is a percentage
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7
Q

meds + nursing considerations

non-opioid analgesics

A
  1. nonsteroidal antiinflammatory drugs (NSAIDs) + acetylsalicylic acid (aspirin)
    * can cause gastric irritation, bleeding, can amplify anticoagulant effects, can cause hypoglycemia with oral antidiabetic meds, risk of toxicity with calcium channel blockers
  2. acetaminophen
    * contraindicated with hepatic/renal disease + alcoholism
    * major concern is hepatotoxicity!!
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8
Q

nursing considerations

opioid analgesics

A
  • act on respiratory/cough center, suppresses respiration/coughing as well as pain impulses
  • produce euphoria/sedation that can cause physical dependence
  • give 30-60 min bedore painful activities
  • monitor for bradycardia + hypotension
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9
Q

purpose

adjuvant analgesics

A
  • complement effect of opioids
  • helpful for neuropathic pain
  • gabapentin, venlafaxine, amitriptyline
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10
Q

function

serum sodium

A
  • osmotic pressure (main cation of ECF)
  • acid-base balance
  • nerve impulse transmission

~ absorbed from small intestine, excreted in urine

normal value: 135-145 mmol/L

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11
Q

function

serum potassium

A
  • regulates water balance (major intracellular cation)
  • electrical conduction in muscles
  • acid-base balance

~ obtained through ingestion, preserved/excreted by kidneys

used to evaluate cardiac, renal, GI function

normal value: 3.5 - 5.0 mmol/L

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12
Q

activated partial thromboplastin time (aPTT)

A
  • measures amount of time it takes for plasma to clot after partial thromboplastin is added
  • evaluates how well coagulation sequence (intrinsic clotting system) is working
  • used to monitor heparin therapy + screen for coagulation disorders

elevated with: clotting factor deficiency, hemophilia, heparin therapy, liver disease

normal: 30 - 40 seconds

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13
Q

prothrombin time (PT)

A

prothrombin = vitamin K-dependent glycoprotein (made by liver) needed for fibrin clot formation
* PT measures amount of time it takes for clot formation
* used to monitor warfarin therapy, dysfunction of extrinsic clotting system from liver disease, vit K deficiency, disseminated intravascular coagulation

normal value: within 2 seconds (plus/minus) control value set by lab

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14
Q

international normalized ratio (INR)

A
  • calculated in lab based on PT results
  • measures effect of some anticoagulants
  • high INR = slower blood clotting
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15
Q

function, what causes high + low levels

platelets

A
  • function in hemostatic plug formation, clot retraction, coagulation factor activation
  • produced by bone marrow to function in hemostasis
  • elevated by: acute infections, granulocytic leukemia, chronic pancreatitis, cirrhosis, collagen disorders, polycythemia, postsplenectomy, high altitudes, cold weather
  • lowered by: leukemia, chemotherapy, disseminated intravascular coagulation, hemorrhage, infection, systemic lupus erythematosus, thrombocytopenic purpura

normal: 150 000 - 400 000 mm3

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16
Q

hemoglobin + hematocrit

A
  • hemoglobin = main component of erythrocytes, vechile for transporting oxygen + CO2
  • hematocrit = RBC mass, indicates anemia or polycythemia

elevated values caused by:
* hemoglobin: COPD, high altitudes, polycythemia
* hematocrit: dehydration, high altitudes, polycythemia

lowered values caused by:
* hemoglobin: anemia, hemorrhage
* hematocrit: anemmia, bone marrow, failure, hemorrhage, leukemia, overhydration

males: hemoglobin 140 - 180 g/L, hematocrit 0.42 - 0.52
females: hemoglobin 120 - 160 g/L, hematocrit 0.37 - 0.47

17
Q

lipids

A
  • cholesterol: cell membrane component (with phospholipids), starting molecule for body steroid synthesis + bile salts - is made by liver
  • low-density lipoproteins: carry cholesterol from liver to tissues + organs to make membranes or steroids (considered “bad” cholesterol bc contributes to plaque deposits/coronary artery disease)
  • high-density lipoproteins: transport cholesterol from body tissues back to liver where cholesterol joins bile to be excreted in feces (considered “good” cholesterol bc transports it for destruction/removal)
  • triglycerides: major form of stored energy (fat) in body, made in liver from fatty acids, protein, + glucose, major makes up 90% of body lipids

blood lipids = mostly cholesterol, triglycerides, + phospholipids

18
Q

causes

high LDL/cholesterol/triglycerides

A

LDL/cholesterol: biliary obstruction, cirrhosis hyperlipidemia, hypothyroidism, idiopathic hypercholesterolemia, renal disease, uncontrolled diabetes, oral contraceptive use

triglycerides: diabetes mellitus, hyperlipidemia, hypothyroidism, liver diseases

cholesterol: < 5.0 mmol/L
HDLs: > 1.55 mmol/L
LDLs: < 2.59 mmol/L
triglycerides: 0.45 - 1.81 mmol/L (male), 0.40 - 1.52 mmol/L (female)

19
Q

what it is + what is indicates

fasting blood glucose

A

glucose = monosaccharide from fruit/carbohydrate digestion/glycogen conversion by liver - main source of cellular energy (essential for brain + RBC function)

diagnoses diabetes mellitus + hypoglycemia

20
Q

what it is + what it indicates

glycosylated hemoglobin (HbA1c)

A

hemoglobin A1c = blood glucose bound to hemoglobin

reflection of how well blood glucose levels have been controlled over the past 3 months

5% = 5.57 mmol/L
7% = 8.6 mmol/L
10% = 13.4 mmol/L

normal value < 5.7%
prediabetes = 5.7 - 6.4%
diabetes = > 6.5%

21
Q

what it is + what it indicates

serum creatinine

A
  • product of muscle metabolism, released into blood at relatively constant rate
  • indicator of renal function
  • increased levels = slower GFR
  • elevated in severe renal disease
22
Q

what it is + high/low causes

blood nitrogen urea (BUN)

A

urea nitrogen = waste product from protein breakdown, formed in liver

  • high levels caused by: burns, dehydration, GI bleed, protein catabolism (fever/stress), renal disease, UTI
  • low levels caused by: fluid overload, malnutrition, severe liver damage, SIADH
23
Q

WBCs

A
  • left shift = increase of immature neutrophils
  • low total WBC count with left shift = recovery of bone marrow depression or high intensity infection (neutrophil demand is greater than bone marrow’s ability to release them)
  • high total WBC count with left shift = response to overwhelming infection/inflammation
  • right shift = cells have more than normal number of nuclear segments

clients receiving chemotherapy at risk for neutropenia = increased risk for infection

nclex review (12 decks)

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