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Med-Surg Final Exam Study Guide (2021)

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Final Exam Study Guide LAB VALUES ABGs • pH : 7.35 – 7.45 • PaO2 : 80 – 100 mmHg • PaCO2 : 35 – 45 mmHg • HCO3 : 22 – 28 mmHg Electrolytes • Na : 135 – 145 • K : 3.5 � ... �� 5 • Ca : 8.5 – 10.2 • PO4 : 2.5 – 4.5 • Mg : 1.5 – 2.5 • Cl : 96 – 106 LFTs • ALT : 7-15 • AST : 8-48 • Albumin : 3.5 –5 • Total bilirubin : 1 – 1.2 NORMAL VALUES CVP • 2-6 CO • 4-8 L/min (HR x SV) Cl • 2.2-4.8 (CO + BSA) SvO2 • 65-85% PAP • Systolic : 15-30 • Diastolic : 4-12 PAOP • 5 - 15 ICP • 0-15 HEPATIC Labs • LFTs – elevated o Bilirubin : 1 – 1.2 o ALT : 7 – 15 (more liver specific) AST : 8 – 48 • Ammonia – elevated o 15 – 110 • Albumin – decreased o 3.5 –5 • PTT o 25 – 35 sec Care of patient with hepatitis • Overall goals o Relief of discomfort o Resumption of normal activities o Return to normal liver function w/o complications • Vaccines o Hep A & B • Drug therapy o Hep A  only symptom control o Hep B  acute (antivirals) chronic (interferon) o Hep C  interferon, ribavirin, Harvoni • Interventions o Acute  Rest, small frequent meals Ambulatory/homecare  Dietary teaching, assess for complications, regular follow ups for at least 1 yr after diagnosis, avoid alc, med education • Expected outcomes o Adequate nutritional intake o Increased tolerance for activity o Verbalization of understanding of follow-up care o Able to explain methods of transmission and methods of preventing transmission to others • Complications o Fulminant hepatic failure o Chronic hepatitis o Cirrhosis o Hepatocellular carcinoma Types of cirrhosis (4 types) • Alcoholic (Laennec’s) cirrhosis – also fatty liver • Postnecrotic cirrhosis • Biliary Cirrhosis • Cardiac Cirrhosis End stage liver disease assessment • Health history o Hepatotoxic meds  tylenol, aspirin, anesthetics, antidepressants/antipsychotics, anticonvulsants, antimicrobial agents Chronic alcoholism o Weight loss [Show More]

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