potassium
3.5-5
sodium
135-145
with sodium think dehydration VS fluid overload--fluids
the one with the E is dehydration, the one with the O is overload (hypOnatremia)
...
Serum Electrolytes
...
kalemias do the same as the prefix except for heart rate and urine output
...
hyperKALEMIA
agitation
irritabilty
tachypnea
BRADYCARDIA
OLIGURIA
diarrhea
borborygmi
spastic muscles
hyperreflexia
ecg in HYPERkalemia
tall Pwaves and elevated ST waves
HyhypoKALEMIA
lethargy
TACHYCARDIA
bradypnea
dynamic illeum
constipation
flaccid muscles
hyporeflexia
POLYURIA
NEVER IV PUSH POTASSIUM
...
Never give more than ____ of K/liter of IV fluid
40 mEq, question the order IF more is ordered
FASTEST WAY TO LOWER POTASSIUM
D5W WITH INSULIN; IT WILL PUSH THEINTO THE CELL THIS IS TEMPORARY BUT WORKS FAST
Kayexalate (sodium polystyrene sulfonate) (K+)
a medication used to reduce high serum potassium; exchanges sodium for potassium in the intestine
give with fluids to correct the hypernatremia that it will cause..takes hours but is permanent
calcium
9.0-10.5
Calcemias do the ______________ of the prefix. (muscles and nerves)
opposite
HYPERcalcemia
bradycardia
bradypnea
flaccid muscles
hypoactive reflexes
lethargy
constipation
HYPOcalcemia
tachycardia
agitation
irritability
tachypnea
diarrhea
borborygmi
spastic muscles
hyperreflexia
seizure
what two signs are seen in HYPOcalcemia
chvostek sign (think CHeek/face spasm)
trousseau sign (BP hand spasms)
Magnesium
1.3-2.1
magnesium do the _______ of prefixes
opposite
hypermagnesmia
bradycardia, bradypnea, flaccid muscles, hypoactive reflexes, lethargy, constipation
magnesium antidote
Calcium gluconate
Hypomagnesemia
tachycardia, agitation, irritability, tachypnea, diarrhea, borborygmi, spastic muscles, hyperreflexia, seizure
Phosphorus
3.0-4.5
chloride
98-106
arterial blood gases
...
ph
7.35-7.45
c02
35-45
if c02 is elevated what do you do (2)
rr
purse liped breathing
if c02 is 60 or higher, wht do you do (4)
rr
prepare for intubation/ventilation
respiratory therapy
doctor
PaCO2
35-45
pa02
80-100
low 70s (pa02), what do you do (2)
assess resp. give 02
60 and lower (pa02) is hypoxia, what do you do
give 02, assess resp. prepare for intubation/ventilation, call resp. then doctor
hc03
21-28
cbc
...
rbcs
4-6 million
ANC (absolute neutrophil count)
<500= neutropenic= high risk for infection
want it greater than 500
A healthy person has an ANC between 2,500 and 6,000. The ANC is found by multiplying the WBC count by the percent of neutrophils in the blood. For instance, if the WBC count is 8,000 and
CD4
200+
low cd4=aids place on neutropenic precautions
...
Hemoglobin
12-18
if hemoglobin is between 8-11 what do you assess for [3]
anemia
bleeding
malnutrition
if below 8 what do you do (3)
bleeding
prepare to give blood
call doctor
Hematocrit (3x the hemoglobin)
36-54 (12
3) (18
3) 36,54
wbcs
5000-10000
ESR
less than 20
total cholesterol
less than 200
ldl
less than 130
hdl
Males >45
Females >55
pt
11-12.5 seconds
NORMAL aPTT value and drug use
25-35 seconds HEPARIN
aPTT (partial thromboplastin time) theraputic value
60-70 seconds
INR is 0.8-1.1, the desired value is increased when a client requires anticoagulation to what
2-3
anything greater than 4 in an INR is critical
...
platelets
150000-400000
platelets below __ is critical, while platelets below __ is deadly
90,000
40,000
HOLD HEPARIN WHEN PLATELETS ARE LOW
...
albumin
3.5-5
ammonia
10-80
bun
10-20
creatinine
0.6-1.2
1.3 with creatinine is deadly (one point THREE -- DEADLY)
...
gfr is the best indicator of overall renal function
...
fasting glucose
70-105
HgbA1C
4-6%
over 8 is poor glucose control
lithium level
0.6-1.2
Lithium toxicity usually occurs with the following:
Dehydration
Decreased renal function (eg, elderly clients)
Diet low in sodium
Drug-drug interactions (nonsteroidal anti-inflammatory drugs [NSAIDs] and thiazide diuretics)
.
Lithium is cleared renally. E
...
digoxocin level (lanoxcin)
0.8-2
phenobarbital
10-40
Phenytoin (Dilantin)
10-20
Gingival hyperplasia or hypertrophy is a known side effect of phenytoin (Dilantin) and is not a reason to stop the drug.
Vigorous dental hygiene beginning within 10 days of initiation of phenytoin therapy can help control it.
...
theophylline
10-20
Aminophylline
10-20
bilirubin in NB
less than 9.9
elevated bilirubin of 10-20 you hospitalize halfway (14)
...
position NB goes in when having Kernicterus (bilirubin encephalopathy)
opisthotonus
what position you place nb in that has kernicterus
on their side
if oxygen is less than 93, what do you do (3)
assess rr, raise HOB, give 02; unless BEST OPTION GIVE 02
BNP greater than 100
CHF
earliest sign of any electrolyte imbalance
numbness/tingleness (parasthesia)
NCLEX WILL USE CIRCUMORAL PARASTESHIA
ALL ELECTROLYTES IMBALANCES CAUSE MUSCLE WEAKNESS AKA PARESIS
...
if it is a critical lab value, hold any meds and do a FOCUSED assessment, prepare and call doctor
...