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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

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

thyroxine normal range

4.6-12 mcg/dL

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

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

Florence Nightingale

Sanitary. Health/illness model. OT and rehab. Continuing education. Documentation/research

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

chloride

hypo/hyper chloremia 95-105 mEq/L 95-105 YO have chLOride LOW energy

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

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.

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

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

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

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

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%

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

Urine pH range

4.5-8 6 is avg

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)

metabolic acidosis treatment

a hypoglycemic medication, specifically, insulin, as a result of diabetic ketoacidosis.

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

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

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

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"

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

Dorothea Dix

Rights activist on behalf of mentally ill patients - created first wave of US mental asylums

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

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.

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.

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


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