SOME OF THE CONTENT IN BRIEF:
Normal Lab Values
Hgb (hemoglobin): males=14-18 females=12-16; w/ 4 points in 2 weeks= ↑ risk for seizures
RBC’s: males=4.7-6.1 million females=4.2-5.4 million
Arterial Blood Gases
...
SOME OF THE CONTENT IN BRIEF:
Normal Lab Values
Hgb (hemoglobin): males=14-18 females=12-16; w/ <6.8= NC of 2L
o <12= iron deficiency anemia…… >15= dehydration, HF, or COPD
Hct (hematocrit): males=42-52 females=37-47; ↑ of >4 points in 2 weeks= ↑ risk for seizures
RBC’s: males=4.7-6.1 million females=4.2-5.4 million
Arterial Blood Gases
o pH: 7.35-7.45
o CO2 (respiratory driver): 35-45- Acidodic
o HCO3 (metabolic driver): 21-28- Alkalosis
Fluid & Electrolytes
Fluid Volume Deficit Fluid Volume Excess
↑hematocrit ↓ hematocrit
↓ BP ↑BP
↑ Urine specificity >1.030 ↓ urine specificity
↑ CVP (normal 4-11)
↑ BUN Antidotes
Digoxin→ Digiband
Coumadin→ Vitamin K
Benzodiazepines→ Flumazenil (Tomazicon)
Mg Sulfate→ Calcium Gluconate Pediatrics
The preferred injection site for vitamin K in the newborn is the lateral aspect of the
middle third of the vastus lateralis muscle in the newborn's thigh.
Newborn S&S of hiatal hernia: vomiting, coughing, wheezing, short periods of apnea,
and failure to thrive. Myelomeningocele= cover w/ moist sterile water dressing, prone positioning- prevents
meningitis
NO MMR on kids w/ an egg/ neomycin Physiologic jaundice is normal @ 2-3 days caused by a rupture of large amounts of
blood cells within a short period. Leopold’s Maneuvers Gerontology
o Most reliable sign of infection >65= tachypnea
o Renal threshold Medical-Surgical
Respiratory
o Assess cough reflex & ability to swallow before giving fluids= ↑ ICP & risk for aspiration.
o Rifampin for TB= turns urine rusty/red/orange * NO eye contacts.
o Isoniazid (INH) for TB= ↑ Dilantin levels Cardiac
♥ Hold digoxin <60
♥ Stay in bed after 1st ACE inhibitor dose.
♥ Pts w/ hypertension should avoid weight lifting & hot baths/sauna- can lead to hypotension. Endocrine
Hypophysectomy- removal of pituitary gland
Check output- they might not be producing ADH which will lead to copious amounts of
urine. Cushing’s syndrome is a metabolic disorder characterized by abnormally increased secretion
(endogenous) of cortisol, caused by increased amounts of adrenocorticotropic hormone
(ACTH) Gastrointestinal
Lipitor (statin) given in PM only! No grapefruit juice.
Peptic ulcer disease should avoid: ASA, Alcohol, & caffeine.
Duodenal ulcer (feed) pain is relieved by food. Genitourinary
PET scan= teaching: empty bladder before test
Clomidene- increases ovulation… S/E= multiple births Musculoskeletal
Following a myelogram encourage fluids to get rid the oil based dye.
Never pull yourself up using a walker= safety Psychiatry
Pts admitted against their will still retain their right to refuse tx.
Phobias involve projection & displacement Psychiatry
Pts admitted against their will still retain their right to refuse tx.
Phobias involve projection & displacement Positioning
NG tube placement: high fowler’s
G-tube= liquid med (sorbitol) is of great concern since it can cause diarrhea
THR- (only abducted) NO! adduction past midline or hip flexion past 90 Pre/post-operative care:
Breathing is taught before sx
Incentive spirometry= inhale slowly & completely hold for 5 seconds. Done 10 x’s a day.
↑ corticosteroids & insulin’s too if needed Diseases/Illnesses
Reynaud’s disease:
o Warm up car before starting to drive/ avoid cold weather: wear wool gloves & stay home.
o Go to yoga class after clinic (↓ stress) Herbs
Chamomile interferes w/ anticoagulants
St. John’s wort: Contraindicated in pregnancy & lactation. Do not take if experiencing major
depression, or while on: MAOI’s, SSRI’s, or levodopa. AVOID: tyramine foods & excessive sunlight Nutrition
K+= bananas, dried fruits, citrus, potatoes, legumes, tea, peanut butter, raisins, cantaloupe, &
strawberries. Diets
Full liquid: plain ice, cream, sherbet, custards, milk, pudding, soups, breakfast drinks.
Clear liquids: water, bouillon, broth, coffee, gelatin, lemonade, tea, hard candy,
carbonated beverages Feedings
When preparing to D/C PN the nurse should first slow down the infusion rate.
Nurse must get infusion pump before hanging infusion Pharmacology
Anticonvulsants **CNS depressants**
o Phenytoin (Dilantin)→10-20 therapeutic level Ginko, gensin, garlic= antiplatelet properties
o Trough draw: 30 min. before administration.
o Peak draw: 30 min. after administration.
o Watch for hyperK+ w/ aldactone (spironolactone) & ACE inhibitors.
o Fibronolytics= streptokinase
o Persantine combined with warfarin sodium (Coumadin) is prescribed to protect the client's artificial
heart valves.
o w/ Rimfampin check levels of SGPT (liver)
o Neupogen ↑ levels of uric acid. (When using the IV line should be flushed before & after w/ 5%
dextrose)
o Pentazopine hydrochloride (Talwin) - for stenosis of the spine. Assess of respirations & lethargy.
o Amoxifen citrate (Nolvadex) causes soft tissue disease & subsides rapidly.
o Carbidopa (Sinemet) - makes levodopa more readily available for transport.
o Risperdal-S/E includes hyperglycemia, weight loss, & blurred vision.
Monitor glucose
o Cyclophosphamide (Cytoxan)- S/E are leukopenia; check WBC
o Phentolamin mesylate- should be infiltrated when extravasation of dopamine occurs.
o Sodium thiomate- S/E are a ↓ in platelets- check for bruising & bleeding.
o Clozapine (clorazil)-schizophrenia=adverse effect- agranulocytosis-leukemia; monitor WBC’s.
o Gentamicin sulfate- avoid sunlight exposure (photosensitivity).
o Zoloft- watch out for nausea, vomiting, abdominal cramps, & diarrhea= hyponatremia.
o Plasma cholesterol screening: only sips of water for 12 hours before the test.
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