Memorize Me
Creatinine normal range
0.7-1.4 mg/dL
Typically, a client's urine specific gravity is greater than_______in the presence of fluid-volume deficit.
1.030
angle of peripheral IV catheter
10-30 degrees
prothrombin time (Pro time, PT)
11-12.5 seconds INR 1.1 (2-3 Coumadin)
Total Cholesterol
130-200
Sodium normal range Na+
135-145 mEq/L. pH 7.35-7.45 CO2 35-45 "35-45 minutes Collecting salty Phones"
vit E dose
15 mg
Rapid acting insulin (lisper, glulisine, aspart)
15 minutes feels like 1 hr during 3 rapid responses onset. peak. duration
A pregnancy weight gain of _____ pounds is recommended for obese women
15-25 lbs
Platelets normal range (thrombocytes)
150,000-400,000 platelets admin <10,000, or in bleeding thousands of thrombocytes
INR
2.0 to 3.0 In healthy people an INR of 1.1 or below is considered normal. An INR range of 2.0 to 3.0 is generally an effective therapeutic range for people taking warfarin for disorders such as atrial fibrillation or a blood clot in the leg or lung.
vit D dose
20 mcg
serum albumin level
3.5-5.0, less will decrease wound healing
Open irrigation technique of indwelling urinary catheter requires instilling_____________ mL of irrigation fluid. using a ______________ mL syringe
30 to 40 mL
SCUDS mmHg
35-55 mmHg
Hct normal range
37-52% Male: 42-52% Female: 37-47%
WBC normal range
4,500-10,000 lymphocytes (killer B, helper T), granulocytes, monocytes(macrophage) granulocytes: neutrophils, basophils, eosinophil
RBC normal range
4.2-6.1 million/uL
Urine pH range
4.5-8 6 is avg
thyroxine normal range
4.6-12 mcg/dL
HDL normal
40-59 or above is better
Neutrophils normal range
50-60% neutropenia is immune compromising ANC <1,500 temp, cough sputum, dysuria, sore throat 50-60% is also the percent water weight of body (water is neutral)
Calcium normal range Ca2+
8.5-10.5 mg/dL ages 8.5-10.5 love milk
position for insertion of NG tube
90 degrees/high fowler's
Chloride normal range Cl-
95-105 mEq/L 95-105 YO have chLOride LOW energy
Triglycerides
<150 mg/dL
cheese grams fat
<3 grams fat
Major anions
> Cl-, HCO3- (bicarbonate), and PO43-
Desired ————- x quantity (amount per unit) Have
Dose
calcium
Hypo/hyper calcemia 8.5-10.5 mEq/L muscle cramps, confusion, and tingling in the lips and fingers. ages 8.5-10.5 love milk
Weber test in conductive hearing loss (tuning fork)
In conductive hearing loss, tone is louder on affected side, because compensatory neural mechanisms or mechanical factors increase the perceived volume on the side of conduction problem
LDL Normal Range
Less than 100; The lower, the better
insulins mnemonic Lick Gargoyles And Run Now Don't Lollygag
Lick LISPRO }rapid Gargoyles GLULISINE }rapid And ASPART. }rapid Run REGULAR } short Now NPH } intermediate Don't DETEMIR. }long Lollygag LANTUS GLARGINE}long
CKD diet
Low protein Low sodium Low Potassium Low phosphate low calcium
TNM staging
Metastasis is more important than lymph node involvement T Tx, T0, Tis, T1-4 N Nx N0, N1-3 M Mx M0 M1 stage I-IV
intermediate acting insulin NPH
Nurses Play Hero to(2) 8 16 yo's onset. peak. duration
Desired units x Quantity/hr ————- = Quantity/hr Have units
Quantity or amount per hour
Dorothea Dix
Rights activist on behalf of mentally ill patients - created first wave of US mental asylums
Florence Nightingale
Sanitary. Health/illness model. OT and rehab. Continuing education. Documentation/research
Denial
The most primitive--in which the ego simply refuses to acknowledge anxiety producing realities.
American Nurses Association (ANA)
The national professional membership association of nurses that works for the improvement of health standards and the availability of healthcare services, fosters high professional standards for the nursing profession, and advances the economic and general welfare of nurses
for suction of a tracheostomy 120-150
The nurse should select a suction catheter that is half the size of the lumen to prevent hypoxemia and trauma to the mucosa. --suction pressure to approximately 120 mm Hg and no higher than 150 mm Hg --100% oxygen before suctioning to prevent hypoxemia. --intermittent, while removing catheter
metabolic acidosis treatment
a hypoglycemic medication, specifically, insulin, as a result of diabetic ketoacidosis.
hydrolyzed formula (elemental)
composed of partially digested protein peptides and are referred to as free amino acids partially functioning GI tract impaired ability to digest and absorb foods 1.0-1.2 cal/mL High calorie formulas provide 1.5-2.0 ca
Hypoglycemia S/S
confusion, nausea, nervousness, & irritability, sweatinesss w/ pale skin.diaphoresis, pale cool skin, irritability, normal/shallow respirations, tachycardia and palpitations, strange or unusual respirations. slurred speeech, headache and blurred vision, decreasing loc, seizures leading to coma, change in emotional behavior,difficulty thinking.
milk based formula
contain lactose and are poorly tolerated by clients who have inflammatory bowel disease.
enteral for dehydration
continuous-->even levels of BG low protein
lipid emulsions contain what allergen
eggs
respiratory acidosis causes
electrolyte imbalances, inadequate chest expansion, respiratory depression, and airway obstruction.
Calcium
facilitates nerve transmission and cell membrane permeability
Nurse ethics
fidelity veracity autonomy beneficence justice accountability nonmaleficence
enteral tube administration of medication
flush 15mL before and 30-60mL after with sterile water dissolve each medication in 30mL sterile water (warm)
diarrhea
frequent passage of loose, watery stools THREE or more per day
chloride
hypo/hyper chloremia 95-105 mEq/L 95-105 YO have chLOride LOW energy
magnesium 1.5-2.5
hypo/hyper magnesemia 1.5-2.5 mEq/L 15-25 yo are magnetic
phosphate 1.7-2.7
hypo/hyper phosphatemia 1.7-2.7 mEq/L. 17-27 yo love phones
Sodium
hyponatremia/hypernatremia 135-145 mEq/L n/v, cramping, headache, tachycardia, weakness, hypovolemia
direct percussion over the area of the kidneys to evaluate them for____________.
inflammation
cantaloupe and captopril
interact due to high levels of potassium in cantaloupe
Enteral for bloating and cramping
low fat formula
normal pre meal/fasting blood glucose
normal preprandial 70 - 99 mg/dl. 100 - 125 mg/dl indicates prediabetes. American Diabetes Association recommends a preprandial glucose target of 80-130 mg/dl.
DASH (Dietary Approaches to Stop Hypertension)
normal sodium 1.35-1.45 normal cholesterol 130-200 normal glucose fasting 70-99
Rationalization
offers self-justifying explanations in place of the real, more threatening, unconscious reasons for one's actions.
Phosporous levels too high (parallels hypOcalcemia)
phosphorus toxicity reflect those of hypocalcemia, =numbness and tingling around the mouth and extremities, and tetany. Deficiencies of phosphorus rarely occur 1.7-2.7 phone calls (hypo CAL)
With metabolic alkalosis,
the pH is high, the PaCO2 is high or within the expected reference range, and the bicarbonate is high.
With metabolic acidosis,
the pH is low, the PaCO2 is low or within the expected reference range, and the bicarbonate is low.
With respiratory acidosis
, the pH is low, the PaCO2 is high, and the bicarbonate is high or within the expected reference range.
Flow rate of nasal cannula
1-6 L/min
how much fluid per day
2,500-3,000 mL/day
max amount of bran fiber
3 tablespoons
Total body fluid ____ percent of weight
50-60%
meat oz per day
<5 oz/day
colonoscopy
After 50, one every 10 years
vitamin K interacts with
Coumadin/warfarin
GGT (gamma glutamyl transferase)
Elevated = biliary obstruction
ALT, AST
Enzymes released liver inflammation
Potassium
Hypo/hyper kalemia 3.5-5 mEq/L numbness extremities. 35-50 yo smoke pot
Major cations
Na+, K+, Ca2+, H+, Mg+
Joyce Travelbee: Human to human relationship
compassionate and empathetic --> trust not covered by the other theories Travelbee trust
metabolic alkalosis causes
total parenteral nutrition, blood transfusions, nasogastric suctioning, thiazide diuretics, and hypercortisolism.
Normal HbA1c
6.5- 7%
margarine grams fat
<2 grams fat
Clara Barton
American Red Cross 1881. Civil War activism, geneva convention battlefield nursing
Mary Breckenridge (1920s)
Established the FNS/Frontier Nursing Services in 1925, health care services for rural Kentucky, The FNS is still in operation-- vital service to rural Kentucky. Breckenridge collected data that proved real decrease in mortality with FNS care
Mary Elizabeth Mahoney
First African American nurse 1879
braden scale criteria
Sensory Motor Activity Mobility Nutrition Friction/shear
SBAR stands for
Situation Background Assessment Recommendation
sodium too high or too low
Sodium too high= confusion, headache, nausea, dizziness, and abdominal cramps. sodium toxicity include confusion, thirst, and weakness. 135-145
test cranial nerve V
The nurse should touch the client's corneas with a wisp of cotton and measure light touch and pain across the client's face to test cranial nerve V, the trigeminal nerve.
syringe size for wound irrigation
The nurse should use a 35-mL syringe to irrigate the wound. Syringes that hold 30 to 60 mL of fluid create a safe but effective amount of pressure for wound irrigation.
Iron absorption is enhanced by:
Vitamin C
Lutein
a carotenoid found in vitamin A, slows the progression of AMD and is found in kale, spinach, collards, and mustard greens.
projection (defense mechanism)
accuse/attribute to others of own unacceptable feelings (my doll misses daddy) strict upbringing leading to strong anti porn campaigning
metabolic acidosis causes
alcohol or ethanol intoxication, diabetic ketoacidosis, hypoxia, kidney failure, diarrhea, and pancreatitis.
Jean Watson: Human Science and Human Care
altruism/loving kindness human dignity thru emotional physical spiritual (miracles) whats a miracle
3 drinks per day
always a wrong answer
metabolic acidosis treatment
antidiarrheal medication as a result of prolonged diarrhea. aciDosis Diarrhea
metabolic alkalosis treatment
antiemetic medication as a result of prolonged vomiting. Vomiting ViKtim
Modular product supplement formulas
are intended to increase the intake of a specific nutrient without increasing volume; they are not intended for clients who have impaired digestion.
Madeleine Leininger culture care theory
art and science culture-specific care/ culturally congruent/ adjust & repattern Leines of Culture
Continuous enteral feedings reduce
aspiration risk diarrhea
Phosphorus
assists in the formation of bones and teeth, and the regulation of hormone activity, but it is not a micronutrient that improves night vision.
Vitamin B6
assists in the formation of heme in hemoglobin and the synthesis of neurotransmitters
active immunity
body makes own antibodies after exposure to pathogen (naturally or in vaccination/artificial)
timing of tube feeding NG
bolus intermittent feedings over 15 to 30 min and intermittent enteral feedings over 30 to 60 min.
reaction formation
by which the ego unconsciously switches unacceptable impulses into their opposites. Thus, people may express feelings that are the opposite of their anxiety-arousing unconscious feelings.
cane use left side weakness
cane opposite affected leg (COAL)-move cane and the bad leg forward first 6-12 inches/15-30cm at a time trochanter height
Aldosterone function
causes kidneys to retain sodium to increase blood pressure, water retention
sublimation
channeling socially unacceptable impulses into constructive, even admirable, behavior
Chloride levels too high or low
chloride deficiency are lack of emotion, anorexia, and muscle cramps. chloride toxicity is vomiting. 95-105
chemo metallic taste
citrus pickles mouthwash
Malnutrition S&S
decrease in lean body mass, decrease in fat stores, dehydration, weight loss, weakness, decreased functioning dry eyes. dry skin low reflexes edema due to protein deficiency corneal vascularization
hematocrit and fluid levels
dehydration increases Hct fluid excess decreases Hct 37-52%
low residue diet
diet that gives the least possible fecal residue, such as gelatin, sucrose, dextrose, broth, and rice eliminates or limits foods that are high in bulk and fiber and fatty meats decreases the amount of stool traveling through the intestinal tract. Eggs, cheese, and bananas are low residue foods.
Urine Specific Gravity
dilute=1.005-->1.030=concentrated
displacement
discharging impulses from a threatening object to a safer object
Hyperglycemia S/S
frequent urination, deep rapid labored respirations, thirst, hunger, dry mucous membranes, weakness, malaise, rapid, weak pulse, hypotension, soft eyeballs, ketone breath, vomiting, abd pain
Nasogastric
gastric pH 4 (fasting) or <5.5 intestinal pH
passive immunity
given antibodies not produced by own body natural=breastmilk, passive IVIG, rabies antidote
Insulins not to mix
glargine and detemir
purine high amounts
gout
Enteral feeding for pulmonary disease
high calorie high fat high protein low carb (carbs increase rate of CO2 prod)
regression
in which an individual faced with anxiety retreats to a more infantile psychosexual stage, where some psychic energy remains fixated
Angiotensin II
increases blood pressure by stimulating kidneys to reabsorb more water and by releasing aldosterone
Droplet precautions
infections that spread via droplet nuclei that are larger than 5 microns in diameter, including rubella, meningococcal pneumonia, and streptococcal pharyngitis.
Airborne precautions
infections that spread via droplet nuclei that are smaller than 5 microns in diameter, including tuberculosis, measles, herpes zoster, varicella, Flu
fluid retention measures
low sodium diet 1.5 L/day fluids
respiratory alkalosis causes
mechanical ventilation, aspirin toxicity, shock, anxiety, and hyperventilation.
polymeric formula
milk-based, blenderized; the patient's gastrointestinal tract needs to be able to absorb whole nutrients contains complex nutrient molecules and is not indicated for clients who have impaired digestion.
Crutches
move with bad leg 15 cm/6in 2 finger widths elbows slight bend
Airborne precautions protective equip
private room, neg pressure with 6-12 air exchanges/hr mask & respirator N95 for TB
levodopa-carbidopa binds with what nutrient? (decreases effectiveness)
protein
RACE (fire safety)
rescue, alarm, contain, extinguish
pain
severity/intensity quality manifestations aggravations onset/duration pattern
short acting insulin (regular)
short staffed nurses went from 30 to(2) 8 patients onset. peak. duration
anorexia bulimia
stay with patient for an hour assign mealtimes privileges based on compliance daily weight
Positive Chvostek's sign
tapping on the facial nerve triggering facial twitching hypocalcemia <8.5. (8.5-10.5 normal) hypomagnesemia <1.5 (1.5-2.5 normal)
long acting insulin. glargine and detemir
the two long nursing shifts never peaked but lasted 24 hours onset. no peak. duration
A nurse is preparing a heparin infusion for a client who was hospitalized with deep-vein thrombosis. The order reads: 25,000 units of heparin in 250 mL of 0.9% sodium chloride to infuse at 800 units/hr. At what rate should the nurse set the infusion pump? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero
"8 mL/hr" (800/25,000)x250 mL STEP 1: What is the unit of measurement the nurse should calculate? mL/hr STEP 2: What is the dose the nurse should administer? Dose to administer = Desired 800 units/hr STEP 3: What is the dose available? Dose available = Have 25,000 units STEP 4: Should the nurse convert the units of measurement? No STEP 5: What is the quantity of the dose available? 250 mL STEP 6: Set up an equation and solve for X. Desired x Quantity/Have = X mL 800 units x 250 mL/25,000 units = X mL X = 8 mL / hr
With respiratory alkalosis
, the pH is high, the PaCO2 is low, and the bicarbonate is low or within the expected reference range.
Repression
- Involuntary blocking of unpleasant feelings and experiences from ones awareness. EX: An accident/abuse victim can remember nothing about the accident/abuse
Nightingale's Environmental Theory
- relationship between individual's environment and health - health as a continuum - preventative care
Treatment for respiratory acidosis
-If hypoxic make sure they have a patent airway then give them O2 -Pneumonia Postural drainage, percussion, suctioning, deep breathing exercises, fluids, elevate HOB, teaching and use of IS -Pneumothorax Chest tube -Post-op Cough & deep breathing exercises (bubbles for kids)
grapefruit interactions
-STATINS (LOVASTATIN, SIMVASTATIN, ATORVASTATIN) - BNZ: BUSPIRONE, DIAZEPAM, TRIAZOLAM -DHPCCB: NICARDIPINE, FELODIPINE, NISOLDIPINE, NIFEDIPINE -OTHER -TELITHROMYCIN (MACROLIDE) -VORICONAZOLE (AZOLE) -VERAPAMIL (DHP CCB)
metabolic alkalosis compensation
-compensatory hypoventilation to retain CO2 and decrease pH -may cause hypoxemia
grams per kg protein
.8-1.2 grams/kg
Two fluid compartments
1. ICF- waters and electrolytes within cells ECF- water and electrolytes in plasma, lymph, and interstitial spaces, also specialized fluid that separates epithelial layers. a. Cerebrospinal fluid b. Aqueous/Vitreous fluid c. Synovial fluid d. Serous fluid e. Glandular secretions Transcellular fluid-37% ECF 30% ICF 70%
Magnesium normal range Mg2+
1.5-2.5 mEq/L. 15-25 yo are magnetic
Phosphate (PO4 3-) normal range
1.7-2.6 mEq/L 17-26 yo phone home
Temporary substitute for TPN
10% Dextrose at same rate prevent hypoglycemia
BUN normal range
10-20 mg/dL
Prothrombin time PT Pro T
11.0 to 12.5 seconds. Altered coagulation can cause reduced blood supply to the wound and impair wound healing.
Hgb normal range
12-18 g/dL <8 PRBCs admin acute erythropoietin admin (Procrit) "12-18 year olds hate goobers"
How much urine is produced daily?
1500-2000 mL or one to two liters
Braden risk number
16 or less (23 max)
prealbumin normal levels
16--40 mg/dL Prealbumin, also referred to as transthyretin, is a transport protein for thyroid hormone. It is synthesized by the liver and partly catabolized by the kidneys. Normal serum prealbumin concentrations range from 16 to 40 mg/dL; values of <16 mg/dL are associated with malnutrition
eggs per week
3 eggs/week
Albumin range and fluid levels
3.5-5 g/dL dehydriation increases albumin fluid excess decreases albumin. 3.5-5 eggs is fine
potassium normal range K+
3.5-5.0 mEq/L "smoked pot from age 35 to 50"
how much urine per hour
30 mLs
post gastric bypass diet
30-60 m per meal protein first stop at fullness 3 meals 2 snacks