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Fundamentals Laboratory Values While lab values vary slightly according to the source, knowing an average range for the following common lab tests will be very helpful on to you when answering ques... tions. Sodium 136-145 mEq/L Potassium 3.5-5.0 mEq/L Total Calcium 9.0-10.5 mg/dL Magnesium 1.3-2.1 mg/dL Phosphorus 3.0 –4.5 mg/dL BUN 10-20 mg/dL Creatinine 0.6 – 1.2mg/dL males, 0.5 – 1.1 mg/dL females Glucose 70 -105 mg/dL HgbA1c <6.5% WBC5,000-10,000/mm3 RBC Men 4.7-6.1 million/mm3 , Women 4.2-5.4 million/mm3 Hemoglobin Men 14-18g/100 mL, Women 12-16 g/100 mL Hematocrit Men 42-52%,Women 37-47% Platelet150,000-400,000/mm3 pH 7.35-7.45 pC02 35 to45 mm Hg p02 80-100 mmHg HCO3 21-26mmol/L Normal PT = 11-12.5 sec, Normal INR = 0.7-1.8 (Therapeutic INR 2-3) Normal PTT = 30-40 sec (Therapeutic PTT 1.5 – 2 x normal or control values) Digoxin 0.5 to 2.0ng/mL Lithium 0.8 to 1.4 mEq/L Dilantin 10-20 mcg/mL Theophylline 10 to 20mcg/mL Latex Allergies: Note that clients allergic to bananas, apricots, cherries, grapes, kiwis, passion fruit, avocados, chestnuts, tomatoes, and/or peaches may experience latex allergies as well. ATI RN Capstone Weekly tips Order of assessment: I-inspection P-palpation P-percussion A-auscultation Except with abdomen it is IAPP-inspect, auscultate, percuss and palpate. Cane walking: C-cane O-opposite A-affected L-leg Crutch walking: Remember the phase “step up” when picturing a person going up stairs with crutches. The good leg goes up first followed by the crutches and the bad leg. The opposite happens going down the stairs....OR “up to heaven...down to hell” Delegation: RNs DO NOT delegate what they can EAT--evaluate, assess, teach Helpful tool to remember Isolation Precautions: AIRBORNE: "My Chicken Hez TB" -Measles -Chicken pox -Herpes zoster -TB Management: neg. pressure room, private room, mask, n-95 for TB. DROPLET: "SPIDERMAn" -Sepsis -Scarlet Fever ATI RN Capstone Weekly tips -Strep -Pertussis -Pneumonia -Parvovirus -Influenza -Diphtheria -Epiglottitis -Rubella -Mumps -Adenovirus Management: Private room/mask CONTACT: "MRS WEE" -MRSA -VRSA -RSV -Skin infections (herpes zoster, cutaneous diphtheria, impetigo, pediculosis, scabies, and staphylococcus) -Wound infections -Enteric infections (Clostridium difficile) -Eye infections (conjunctivitis) Management: gown, gloves, goggles, private room Test taking tip: Slow Down! Reading questions too quickly can lead to errors. When you are testing, try to slow down a bit so that you do not miss any key words - Before each and every question try this: Take a deep breath in then out. Read the stem of the question, read the choices. REREAD the stem of the question to make sure to understand what is really being asked -then make your selection. Start the process all over with a deep breath in and out. Don’t forget to take advantage of your focused review following each assessment! Reviewing the topics you miss is KEY to building up your knowledge base. ATI RN Capstone Weekly tips Pharmacology Antiemetics An antiemetic is a medication used in the treatment and/or prevention of nausea and vomiting. Remember generic names are our friend because meds in the same classification often have similar generic names but brand names can come and go. Here are some common classes of antiemetics and their generic names – notice the similarities in the generic names: 5-HT3 receptor antagonists (serotonin antagonists) Dolasetron (Anzemet) Granisetron (Kytril , Sancuso) Ondansetron (Zofran) Tropisetron (Navoban) It’s ‘Tron’ to the rescue! Dopamine antagonists Prometha zine (Phenergan) Prochlorperazine (Compazine) Metoclopramide (Reglan): Now this one is different in generic name because it can have some different side effects – watch for extra-pyramidal side effects with metoclopramide. Sometimes the generic names are not as helpful and you have to remember what meds fall under certain classes. Antihistamines and cannabinoids are used as antiemetics as well: Antihistamines (H1 histamine receptor antagonists) Diphenhydramine (Benadryl) Dimenhydrinate (Gravol, Dramamine) Meclozine (Bonine, Antivert) Cannabinoids Cannabis - Medical marijuana, in the U.S., it is a Schedule I drug. Dronabinol (Marinol) - a Schedule III drug in the U.S. *Remember most antiemetics can cause sedation so watch out for additive effect if given with narcotic analgesics and protect your client from injury. Proton Pump Inhibitors (PPIs) ATI RN Capstone Weekly tips PPIs decrease stomach acid by inhibiting those gastric proton pumps that make the acid – they stop the acid at the pump! Remember generic names are our friends because meds in the same class often have similar generic names but brand names come and go: Here are some common PPIs- Omeprazole (brand names: Prilosec, Zegerid, Omepral, Omez) Lansoprazole (brand names: Prevacid, Zoton, Inhibitol) Dexlansoprazole (brand name: Kapidex, Dexilant) Esomeprazole (brand names: Nexium, Esotrex) Pantoprazole (brand names: Protonix, Somac, Pantozol, Zentro) Think of a pump in your stomach just churning out the acid – ‘Zole’ is the nice guy who shuts off the pump. ‘Zole’ is very friendly (well-tolerated by most clients) but can cause vitamin B-12 deficiency if he stays around too long (with long-term use). Erectile Dysfunction Agents Erectile dysfunction (ED) meds act by increasing nitric oxide which opens and relaxes the blood vessels of the penis causing increased blood flow (helping lead to getting and keeping an erection). Here is where the generic name is our friend again – meds in the same class often have similar generic names but brand names will come and go: Here are some common ED meds- Sildenafil (Viagra) Vardenafil (Levitra) Tadalafil (Cialis) Notice these end in ‘fil’. ‘Fil’ helps the nitric oxide to ‘fil’ the penis. While ‘Fil’ is a great guy (well-tolerated by most clients) he does have a few side effects – headache, flushing, back pain and muscle aches (with Levitra), temporary vision changes, including "blue vision" (with Viagra) and not all men can spend time with ‘Fil’. Men who have heart problems, uncontrolled blood pressure problems, history of stroke, or a health problem at can cause priapism can’t hang out with ‘Fil.’ Antianemics There are many causes of anemia and the antianemic prescribed will be based upon the cause. With iron deficiency anemia, iron supplements are commonly prescribed. Beware though - Iron is ‘heavy’ stuff and shouldn’t be taken ‘lightly’! · Iron can cause teeth staining (liquid form). Teach clients to dilute liquid iron with water or juice, drink with a straw, and rinse mouth after swallowing. · Iron can cause staining of skin and other tissues with IM injections. If IM route must be used, give IM doses deep IM using Z track technique. [Show More]

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