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83 Cards in this Set
- Front
- Back
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What is the normal lab value for Cholesterol?
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< 200
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What is the normal lab value for Triglycerides?
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< 150
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What is the normal lab values for LDL? HDL?
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LDL < 130
HDL > 40 |
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What is the normal lab value for WBC?
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4,500 to 10,000
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What is the normal lab value for Platelets?
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150,000 to 4000,000
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What is the normal lab value for Na?
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135 to 145
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What is the normal lab value for K (Potassium)?
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3.5 to 5.0
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What is the normal lab value for BUN?
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10 to 20
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What is the normal lab value for Creatinine?
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0.5 to 1.5
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What is the normal lab value for GFR?
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> 60
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what are the normal lab value for Hgb in a Male & Female?
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M: 13.5 to 17
F: 12 to 15 |
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What are the normal lab values for Hct in a Male and Female?
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M: 40% to 54%
F: 36% to 46% |
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What is the normal lab value for Blood Glucose?
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Between 70 and 110
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What is the normal lab value for Fasting Blood Sugar?
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< 100
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What are the normal lab values for RBCs in a Male and Female?
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M: 4.6 to 6.0
F: 4.0 to 5.0 |
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What is the normal lab value for albumin?
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3.5 to 5.0
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What are the normal values for Temperature F and C?
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96.2 - 100.4 degrees F
36.2 -38 degrees C |
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What are the normal values for Pulse, Respirations & Blood Pressure?
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Pulse: 60 - 100
Respirations: 12 - 20 BP: 120/80 |
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What are the signs & symptoms of Hyperglycemia?
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Elevated BG
Increased Urination Increased Appetite Weakness, Fatigue Blurred Vision Headache Glycosuria N & V Abd Cramps |
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What are the signs & symptoms of Hypoglycemia?
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BG < 70
Cold, Clammy Skin Numbness Rapid Heartbeat Emotional Changes Headache Nervousness, Tremors Faintness, Dizziness Unsteady Gait Slurred Speech Seizures, Coma |
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Type I Diabetes is also known as _____ ?
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Juvenile Onset, IDDM
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What are the "3 P's" of Type I Diabetes?
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"Starving in the sea of plenty"
Polyphagia (Excessive Hunger) Polyuria (Frequent Urination) Polydipsia (Constantly Thirsty) |
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Who are Type I Diabetics?
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Lean body type
Peak Onset: 11 - 13 yo ABSOLUTE LACK OF INSULIN 3 P's Need Injection, Cannot take oral. |
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What are 3 contributing factors to Type I Diabetes?
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Genetic predisposition
Environmental factor (exposure to virus) Autoimmune Response |
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Type II Diabetes is also known as _____ ?
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Adult Onset, NIDDM
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Who are Type II Diabetics?
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Usually > 40 yo
Onset of S&S may take years 80% -90% of all diabetics Often Obese (abd & Visceral) Lack of exercise Pancreas produces some insulin |
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What are some Symptoms of Type II Diabetes?
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Fatigue
Recurrent Infections Vaginal Yeast Infections Visual Changes Wounds that wont heal |
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What are 4 Metabolic problems that contribute to the development of Type II Diabetes?
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Insulin resistance in glucose & lipid metabolism
Decreased ability of the pancreas to produce insulin Impared glucose production in the liver Alteration in the production of hormones by adipose tissue |
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What test are used to diagnose Diabetes?
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Fasting Blood Glucose (FBS) >126mg/dl
Random Blood Glucose > 200mg/dl Glycosolated hemoglobin (HgA1c) |
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What can the test Glycosolated Hemoglobin (HgA1c) do?
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It can see over the last 3 months how a person has been controlling BG levels.
10/11% is VERY high Normal: 4% to 6% (goals for diabetic is HgA1c 1 to 2% above the normal) |
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Two hour oral glucose tolerance is most often used when?
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During pregnancy
> 200mg/dl If elevated, Dx for diabetes Pregnant ladies cannot take oral agent(harms baby). only insulin |
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What are some important things to remember about glucose monitoring? ( 6 )
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3x per day (as many as 6-8x)
Keep a record, bring to visit Periodically monitor HbgA1c Maintain a testing schedule Pt. or Caregiver should perform Med dosages are adjusted according to the readings |
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What medication is often needed by Type II Diabetics? Type ! ?
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Type II: Oral Hypoglycemics, Insulin may be needed as disease progresses.
Type I: Insulin |
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What is DKA?
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Diabetic Ketoacidosis
ketones build up in the blood, severe electrolyte imbalance, precipitated by many factors, significant insulin deficiency. Elevated BG levels (hyperglycemia), ketosis, acidosis & dehydration occur. |
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What are the symptoms of DKA?
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High BG
Poor skin turgor Dry mucous membranes Tachycardia Hypotension Lethargy Fruity Breath N/ V Kussmaul Respirations Abd pain Diarrhea |
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What are the lab results for DKA?
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BG > 300mg/dl
Arterial blood pH < 7.30 Serum bicarbonate level 15mEq/L Ketones in the blood & urine |
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How does one treat DKA?
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Maintain airway patency/give supplemental O2
Check BG Fluid replacement Regular Insulin ONLY IV K+ replacement as needed Hourly Labs |
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What are the lab results for HHS?
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BG > 400mg/dL
Increase in serum osmolarity Ketone bodies are absent or minimal in blood & urine |
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In which type of diabetes is HHS most common?
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Type II Diabetes
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What is the major difference between HHS & DKA?
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in HHS the pt can produce enough insulin to prevent DKA, but not enough to prevent severe hyperglycemia, osmotic diuresis, & extracellular fluid depletion.
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What are some important things to know concerning foot care and Diabetes? ( 6 )
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DO NOT soak hands & feet
DO NOT clip toenails Inspect feet regularly Assess type of footwear worn Keep feet clean & Dry Nail care from specialist (Podiatrist) |
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What are some important things to teach patients with Diabetes? (8)
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Recieve foot exam at least once a year
Inspect feet daily Never walk barefoot File instead of clipping No OTC foot preps Avoid elastic stockings, garters DO NOT cross legs Wash minor cuts immediately |
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What is some Important exercise information in pts with Diabetes? (4)
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Exercise regularly to improve circulation
Exercise INCREASES insulin sensitivity and DECREASES insulin resistance BG monitoring before, during & after exercise Results in lowered BG and decrease of CV risk factors |
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What is RAS?
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Reticular Activating System
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What does the RAS do?
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Responsible for stimulus arousal and wakefulness.
Allows individual to perceive certain stimuli that they encounter. Mediates all sensory stimuli to cerebral cortex; can receive stimuli even in deep sleep. |
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What are the 3 types of sensory deprivation & what are some examples of each?
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Reduced sensory input (From visual or hearing deficit)
Elimination of patterns or meaning from input (Exposure to strange environments) Restrictive environments (Bed rest) |
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What are some ways to prevent sensory deprivation? (5)
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Encourage the pt. to use eyeglasses and hearing aids
Provide a telephone, radio and or TV, clock, and calendar Encourage social interaction through activity groups or visits by family and friends Increase their stimulation through physical care measures such as back massages, hair care, and foot soaks Encourage the use of self-stimulation techniques such as singing , humming, whistling, or reciting |
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What is sensory overload?
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Develops when either environment or internal stimuli exceeds a higher level than the person’s sensory system can effectively process
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Who is at risk for sensory overload? ( 4 )
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Acutely ill pt
Pt. in constant pain Pt. undergoing frequent monitoring Pt. hospitalized in the ICU (look for fingering tubes and dressings) |
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What are some ways to prevent sensory overload? (5)
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Minimize unnecessary light, noise and distraction. Provide dark glasses and earplugs as needed.
Control pain as indicated Introduce yourself by name and address the pt. by name Provide orienting clues such as clocks, calenders, equipment and furniture in the room Speak in a low tone of voice and in an unhurried manner |
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What is insomnia?
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Chronic difficulty falling asleep, frequent awakenings from sleep, and/or a short sleep or nonrestorative sleep
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What is sleep apnea?
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Lack or airflow through the nose and mouth for periods of 10 seconds or longer during sleep
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What is Narcolepsy?
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Dysfunction of mechanisms that regulate the sleep-wake states; person feels sudden excessive daytime tiredness and falls asleep; uncontrollably at inappropriate times
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What is Cataplexy?
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Sudden muscle weakness during intense emotions such as danger, sadness, or laughter, occurs at any time during the day
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What are some ways of promoting sleep?
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Cluster/schedule nursing care to avoid interrupting sleep
Create comfortable and restful environment Promote rest and relaxation Support bedtime routines and rituals Offering foods that promote sleep Maintain safety of the pt. Teach about sleep hygiene; practices the client associates with sleep Administer/complete pt. teaching about sleep-inducing meds |
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What are nutrients?
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Substances in foods that are required by the body for energy, growth, maintenance, and repair
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What are the 6 categories of nutrients?
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Proteins
Carbs Fats Vitamins Minerals Water |
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What is the difference between Essential Vs Non-Essential Nutrients?
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Essential: MUST be acquired through food because our body cannot produce them on its own.
Non-Essential: Produced by the body |
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What is Malnutrition?
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deficit, excess, or imbalance of the essential components of a balanced diet
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How many kilocalories (kcal) does Carbs, Protein & Fats equal?
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Protein = 4kcal/1g
Carbs= 4kcal/1g Fats= 9kcal/1g |
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What can you look for as signs of Malnutrition?
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Check skin decreased elasticity, hair dry and brittle, conjunctiva pale, tongue red and beefy, gums pale, abdomen distension
Albumin will be decreased with malnutrition! |
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When are tube feedings necessary?
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When a pt cannot consume food orally
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What is a Dubhoff aka NG feeding tube?
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A thin white tube stretching from the nose to the stomach.
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What is a PEG aka G-Tube feeding tube?
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A tube surgically inserted into the stomach.
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What is a PEJ aka J-Tube?
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A tube surgically inserted into the upper section of the Small Intestines
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What is the chain of infection?
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1. Infectious agents (pathogens)
2. Reservoir (living or nonliving/ ppl or floors) 3. Portal of exit (sneezing/diarrhea) 4. Mode of transmission (direct/droplet/airborne) 5.Susceptible host(immuno-compromised) |
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What is a HAI (hospital acquired infection) aka nosocomal infection?
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Infection acquired in a health care facility.
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What are the 3 types of HAI's?
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Exogenous infection: pathogen acquired from HC environment
Endogenous: Normal flora multiply and cause infection as result of tx Iatrogenic: due to action of HCP pr prescribed therapy (chemo) |
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What is Pain?
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Pain is w/e the patient perceives it to be, regardless of objective data.
The 5th vital sign |
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What are the 2 types of pain?
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Nociceptive: peripheral receptors; somatic or visceral tissue; surgical incision, broken bones, arthritis; opioid, non-opioids
Neuropathic: abnormal process of stimuli by NS; damage to peripheral nerve or CNS; burning, shooting, stabbing, electrical pain |
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What are the 2 Classifications of pain?
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Acute: sudden onset; 3 months; goes away as recover; GOAL: pain control with eventual elimination; SNS manifestations
Chronic: gradual onset; > 3 months; cause may be unknown; Doesn’t go away; GOAL: control to extent possible, enhancing function and quality of life |
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What must a pt. know before surgical consent? (6)
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Nature and intention of surgery
Name an qualifications of person performing it Risks (tissue damage, disfigurement, death) Chances of success Possible alternative measures Right to refuse or later withdraw consent!!! Other plans and alternatives |
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What is surgical consent?
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An agreement by a pt. to accept a course of tx or a procedure after being provided complete info by a HCP
Req for all surgical procedures, must be voluntary, must be informed, legal responsibility of doctor, nurse witnesses the signature |
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What must the nurse do for Pre Op care of the patient?
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Mentally: Teaching, explain what happens before, during, after surgery, discuss feelings, Printed materials, TCDB, exercises
Physically: NPO (8 H), skin (surgical scrub), bowel prep, empty bladder (void or catheter prior to preop medicine) |
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What must the nurse do for Post Op care of the patient?
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Airway Management, patency, O2 sat
Vitals (Every 15 minutes for the first hour) Pain control Incentive spironmetry: Suck in, deep breathing increases lung volume (tidal) lung expansion opens alveoli TCDB-promotes coughing to clear secretions Early ambulation |
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What does Incentive Spirometry do in regards to oxygenation?
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Promotes Respiratory Function
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What is Hypertension? What are the Values?
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A sustained elevation of BP
Systolic >140 Diastolic >90 |
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What is the difference between primary vs secondary HTN?
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Primary; No identifiable cause, 90-95% of all cases, several factors, Treatment is NOT a cure
Secondary:Elevated BP with a specific cause, 5-10% in adults, 80% in children, multiple underlying causes |
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What are some modifiable risk factors for hypertension? (6)
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Alcohol use
Obesity Tobacco use Sedentary lifestyle Stress Diabetes |
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What are some symptoms of HTN?
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Often NOT present. No symptoms
but, symptoms can include fatigue dizziness palpitations angina dyspnea |
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What is CAD?
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Affects blood vessels, including vessels feeding the heart
Athersclerosis is major cause Progressive disease, Takes years to develop |
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What are some modifiable risk factors for CAD? (7)
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Inactivity
Obesity Tobacco use HTN Elev. Serum Lipids DM Stressful Lifestyle |
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What is Chronic Stable Angina?
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Chest Pain of discomfort lasting 3-5 minutes
No change in pain with position or breathing |
