Science of NP

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Author:
allisond
ID:
28533
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Science of NP
Updated:
2010-07-31 14:47:59
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final
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finals notes
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  1. Hyperkalemia EKG
    increased QRS complex, elevated/peaked T wave, shallow U wave
  2. hypokalemia EKG
    smaller QRS complex, flattened or inverted T waves, prominent U wave
  3. ALT/ AST lab values
    • ALT: 7-56
    • AST: 5-35
  4. PT and APTT lab values
    • prothrombin time: 11-15 seconds
    • Activated partial thromboplastin time: 60-70 seconds
  5. WBC counts
    3.4- 11.2
  6. platelets levels
    150-450
  7. Hb/Hct levels
    • Hemoglobin: 12-16
    • Hematocrit: 35-47
  8. Creatinine
    .5-1.5
  9. glucose
    70-105
  10. Chlorine
    94-110
  11. BUN
    blood urea nitrogen: 5-25
  12. CO2
    bicarbonate: 22-32
  13. unapproved abbreviations
    • U for unit and IU for international unit
    • q.d and q.od for daily and every other day
    • magnesium sulfate and morphine sulfate
    • anything for left/right or both eyes or ears
    • micrograms has to be written out
    • no 0 after a decimal point, always a 0 before the decimal point
    • H.S for bedtime
  14. Potassium deficit cause
    • GI losses
    • medications
    • acid-base balance alterations
    • hypoaldosterism
    • poor dietary intake
  15. Hypokalemia signs
    • fatigue, anorexia, n/v dysrhythmias, muscle weakness
    • paresthesis, glucose intolerance
    • * need to look our for digitalis toxicity in older adults- increased sensitivity of myocardium to digitalis induced dysrhythmias
  16. high potassium foods
    fish ( not shellfish), whole grains, nuts, broccoli, collards, potatoes with skin, cantaloupe and other melons, brewed coffee, tomato juice
  17. low potassium foods
    corn, sweet potatoes, lima beans, apples, blueberries, cranberries, instant coffee, soda, ginger ale
  18. kayexalate use
    • to reduce hyperkalemia- removes excess Potassium from the system
    • must give diluted with IV fluids- not dextrose
    • 10-20 mEq/l per hour can be given
    • if this doesnt work, assess for hypomagnesemia- once you administer magnesium the potassium levels will also increase
  19. fluid deficit signs
    • thirst
    • restless or irritable behavior
    • dry mucus membranes ,warm skin
    • decreased BP but increased HR ( due to decreased CO)
    • concentrated urine, dark in color
  20. fluid overload signs
    • peripheral edema
    • electrolyte imbalance
    • bounding pulse, increased BP
    • headache, confusion
    • diarrhea
  21. SIADH expected lab findings
    • syndrome of inappropriate ADH secretion
    • causes hypervolemia and affects the Na ratio in our bodies
    • increases water in the body and it looks like we dont have enough Na, so more ADH is secreted
    • causes dilutional hyponatremia
    • can be caused by CNS injury
  22. calcium levels
    8.5-10.5
  23. magnesium levels
    1.8-2.7
  24. phosphate levels
    2.5-4.5
  25. hyperphosphatemia
    • causes: renal failure, excess vitamin D, hypoparathyroidism, chemo
    • patient teaching related to diet
    • manifestations: few symptoms, soft tissue calcifications, symptoms may be related to hypocalcemia
    • usually need to treat underlying disorder first
  26. hypophosphatemia
    • causes: alcoholism, refeeding patients after starvation, heat, stroke, major burns
    • manifestations: neuro symptoms, confusion, tissue hypoxia, muscle and bone pain, increased susceptibility to infection
    • management: oral or IV phosphorus replacement, foods high in phosphorus
  27. 5 rights of delegation
    • person
    • task
    • supervision
    • communication/direction
    • circumstance
  28. infiltration
    • fluid is no longer going into the vein
    • skin is cool to touch, pale, may be swollen, will meet resistance when you try and inject something through that IV
  29. phlebitis
    • can develop from infiltraion
    • skin will be red, tender, swollen- infection is beginning

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