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
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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
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