Term
| How does a nurse use critical thinking? |
|
Definition
How a nurse uses information to reason , make inference and form a mental picture of what is happening to a client
Active, organized, cognitive, process
May be equated to trouble shooting using your head, thinking something through |
|
|
Term
| What are the different levels of critical thinking? |
|
Definition
#1 Novice: New nurse
#2 Advanced beginner: first year
#3 Competent: takes 2 years
#4 Proficient: takes 3-5 years
#5 Expert: after 5 years |
|
|
Term
| How does critical thinking effect time management and judgement? |
|
Definition
Proportionally affect your time management
As a student you will be able to use judgment on how to manage one client vs. a group of clients
EXPERIENCE will be needed to develop your critical thinking |
|
|
Term
| What is the nursing process? |
|
Definition
An approach to problem solving that enables a nurse to organize and deliver care
A professional nurse’s approach to identify, diagnosis, and treat human responses to health and illness. |
|
|
Term
| What are the 5 steps of the nursing process? |
|
Definition
Assessment
nursing diagnosis
planning
implementation
evaluation |
|
|
Term
| What are the 2 phases to assessment? |
|
Definition
Collection of data
analysis of the data
the most important step of nursing process
all additional steps are reflective of the thoroughness of this step |
|
|
Term
| What are reactions to hospitalization? |
|
Definition
Infant task trust vs. mistrust, need for a consistent caregiver who is available to meet his needs
Primary caregiver #1 support
9 months stranger anxiety/operant conditioning
Infant feeding patterns
Additional reactions:
Relief with family – respite care
Conclusive diagnosis or treatment – answer questions |
|
|
Term
| What is a toddlers reaction to a hospital? |
|
Definition
Toddlers, task autonomy vs. shame and doubt the toddler develops his autonomy by making choices. Desires self-control. Limiting choices or harsh punishment leads to feelings of shame and doubt
bParents #1 support
Need for large muscle activities for exploring. Doesn’t like being confined |
|
|
Term
| What is a preschoolers reaction to hospital? |
|
Definition
Preschool, initiative vs. guilt these children like to pretend and try new roles. A conflict occurs when a kid has a desire to explore and limits are placed which lead to frustration and guilt
Primary caregiver maybe parents grandparent or older sibling
Asks a lot of questions! Explain a procedure as you are performing. Encourage helping with procedures. Examples: let them track I&O (you will also keep track) let them squirt neb med in cup before treatment. |
|
|
Term
| What is a schooler age reaction to hospital? |
|
Definition
School age: industry vs. inferiority eager to apply themselves to learning socially productive skills and tools thrive on accomplishments and praise
Primary caregiver parent or grandparent
May or may not ask questions and may have parent ask the question. |
|
|
Term
| What is a adolescent reaction to hospital? |
|
Definition
Adolescent: identity vs. role confusion development begins with the goal of achieving some perspective or direction to the answer of the question “who am I”
Primary support: peers then parents
Developmentally concerned about the here and now |
|
|
Term
| What is a young adults reaction to hospital? |
|
Definition
young adult: intimacy vs. isolation having developed a sense of identity are in search for meaningful friendships and an intimate relationship
Support from their partner or significant other
Concerns originate regarding school or work |
|
|
Term
| What is a middle age adults reaction to hospital? |
|
Definition
Middle aged: generativity vs. stagnation focus on supporting future and community involvement
Primary support, spouse or partner, and children
Concerns center around lifestyle family history and community involvement |
|
|
Term
| What is a late adults reaction to hospital? |
|
Definition
late adult: integrity vs. despair attainment of purpose in life need to feel has something to offer
Primary support is spouse or children or grandchildren
Concerned about partner, pet, house when hospitalized Anxiety noted with confusion. Needs reassurance. |
|
|
Term
| What are specialty needs for the visually impaired? |
|
Definition
Orient to surroundings
Speak when you enter the room
Explain what you are doing
Physically show client where items are
Do not move physically surroundings
Other senses are more acute
Anxiety will be observed when unfamiliar |
|
|
Term
| What is data collection and what are the types of data? |
|
Definition
First step in nursing process assessment
Types of data
Subjective: what client tells us
Objective: what you can see |
|
|
Term
| What are the sources of data collection? |
|
Definition
Client
Family or significant other
Health care team
Medical records
Other records
Literature review
Experience |
|
|
Term
| What are the methods of data collection? |
|
Definition
Interview
Nursing health history
Physical exam
Lab and Diagnostic exams |
|
|
Term
| How should you prepare for a client? |
|
Definition
1st impressions happening only one time
Be prepared for the client
Organize tools that will be needed for an admission
Familiarize yourself with the diagnosis in preparing for special needs |
|
|
Term
| During an interview, what does AMPLE stand for? |
|
Definition
A – allergies
M – medications
P – previous history
L – last meal
E – exam, physical assessment |
|
|
Term
| What are the 3 phases of a working relationship? |
|
Definition
| Orientations: introduction Working: helping pt and getting things done for the pt Termination: end of shift |
|
|
Term
| What is involved in a professional relationship? |
|
Definition
prepare physically and intellectually
Attitude
Professional manner
appearance
Setting the tone |
|
|
Term
| what is involved with the nursing health history? |
|
Definition
Data collected about the clients level of wellness
Health hx
family hx
Changes in health patterns
Socio-cultural hx
Spiritual health
Emotional reaction to illness |
|
|
Term
| What is involved during a physical exam? |
|
Definition
Most important to be systematic
head to toe
repetitive in all assessments |
|
|
Term
| What is involved with in a physical exam? |
|
Definition
Consent form
VS
Privacy and draping
Psychological prep
Physical prep
Assist the HCP
Care of equipment |
|
|
Term
| What are the 4 methods to assessment? |
|
Definition
inspection
auscultation
palpation
percuss: listening to abd by tapping |
|
|
Term
| What are two major parts of inspections et what are examples? |
|
Definition
Vision et smell
resp rate, cyanosis, cap refill
wounds, breath smells, body odor |
|
|
Term
| What are the 2 types of palpation et what are they used for? |
|
Definition
Light superficial delicate gentle
generally depth of 1 cm under the skin using the finger pads
et deep utilized to reveal information about the position of organs and masses
use the hands to explore the body’s internal structures of a depth of 4-5 cm or more
most often used with abd and reproductive organs
skin temp, moisture, turger, distension, hematomas, organ placement, bowel movement |
|
|
Term
| What are percussions et what are they used for? |
|
Definition
technique of striking an object against another to cause vibrations that produce sounds
identify air, fluids, or solids
direct vs. indirect percussion |
|
|
Term
| What is auscultation et what is it used for? |
|
Definition
Act of listening to body organs
direct vs. indirect auscultation
direct place steth on skin
indirect listening with out steth
Heart, lungs, BP, Bowels |
|
|
Term
| When is a general survey done et what is assessed? |
|
Definition
general survey completed while you perform the vs
physical presence
psychological presence |
|
|
Term
| What do you observe for in a physical presence? |
|
Definition
stated age vs apparent age
general appearance
body fat
stature
motor activity
body and breath odors |
|
|
Term
| What is observed during for psychological presence? |
|
Definition
dress, grooming and personal hygiene
mood and manner
speech
facial expression |
|
|
Term
| What do you observe for during inspection of the skin? |
|
Definition
color
bleeding
ecchymosis
vascularity
lesions
moisture
temperature
texture
turgor
edema |
|
|
Term
| What do you inspect the hair for? |
|
Definition
color
distribution
lesions
texture |
|
|
Term
| What do you inspect the nails for? |
|
Definition
|
|
Term
| What do you assess when examining the head et neck? |
|
Definition
|
|
Term
| What do you assess with the face? |
|
Definition
Symmetry
Shape and features
Palpation |
|
|
Term
| What do you assess with the eyes? |
|
Definition
Visual acuity: Snellen Chart
PERRLA: Pupils Equal round reactive to light and accommodation (Brisk slow or absent) |
|
|
Term
| What do you assess with the ear? |
|
Definition
|
|
Term
| What do you assess with the nose et mouth? |
|
Definition
Patency
Dental state
Gag reflex
throat |
|
|
Term
| What do you assess with the neck? |
|
Definition
|
|
Term
| What do you assess with the chest? |
|
Definition
Inspect shape of the thorax
symmetry
resp pattern, depth, symmetry
Cough, sputum (cough productive vs. non productive)
Auscultation lung sounds
Auscultation heart sounds |
|
|
Term
| What do you assess with the abdomen et genitals? |
|
Definition
Inspect abdominal contour, symmetry
Auscultate bowel sounds
percussion followed with palpation
inspect the genitals |
|
|
Term
| What do you assess with the back et extremities? |
|
Definition
Look for curvatures (kyphosis, scoliosis, loridosis)
Inspect the Back, when standing observing for
Normal spinal curvature
Extremities Inspect;
Symmetry, muscle mass, ROM
Distal pulses
Dependent edema |
|
|
Term
|
Definition
| removal of a small piece of living tissue for microscopic exam. |
|
|
Term
|
Definition
| a device or agent that scars or burns the tissue |
|
|
Term
|
Definition
| exam o f vagina and cervix with colposcope |
|
|
Term
|
Definition
| removal of cone-shaped sample of tissue |
|
|
Term
|
Definition
| Lab test to cultivate microorganism in special growth medium. |
|
|
Term
|
Definition
| scraping of material from the wall of a cavity or other surface |
|
|
Term
|
Definition
|
|
Term
|
Definition
| normal physiologic increase in the diameter of a body opening, vessel or tube. |
|
|
Term
|
Definition
| abnormal development of tissue |
|
|
Term
|
Definition
| the science o identification of cells and tissue |
|
|
Term
|
Definition
| time between exposure to onset of s/s |
|
|
Term
|
Definition
| to introduce a substance into the body to produce or increase immunity. |
|
|
Term
|
Definition
| simple smear to examine obtained exfoliative cells, commonly cells of the cervix |
|
|
Term
|
Definition
| a form or a process to order a diagnostic exam or request from a different department. |
|
|
Term
|
Definition
| lab smear for micro exam, prepared by spreading a thin film of tissue on a glass slide. |
|
|
Term
| What do you need to remember about collection of specimens? |
|
Definition
Obtain specimen before starting antibiotics
Maintain sterile curette
proper labeling
send specimen to the lab immediately |
|
|
Term
| What are different types of specimens? |
|
Definition
wound
throat
nasopharyngeal
urine
blood
stool |
|
|
Term
| what needs to be done in preparation for diagnostic exams? |
|
Definition
Check procedure book
Rule of thumb chemistries are fasting and x-rays with contrast NPO
Nurses are responsible from the time the lab is ordered to completion. and then receiving and reporting of the results
Requisition form
instructions: educate to the procedure, preps and follow up
diet and fluids: fasting with chemistries, NPO with contrasts, diet alterations with bowel exams
allergies: re check and ask especially with contrast exams
Preps: bowel prep with ordered mag-citrate, x-prep, go lightly, suppository or enema
Safety: access to bathroom, check fatigue level with bowel prep
Follow up: bowel contrast check for evacuation, check venapuncture sites for ecchymosis or bleeding |
|
|
Term
| What the objectives of diagnostic tests? |
|
Definition
Recognize abnormal blood chemistry, urine, hematology and coagulation values
Identify possible cause of abnormal values
identify medications that will interfere with results
understand the nurses responsibilities in recognizing abnormal values
develop a body of knowledge for educating the client
Incorporate abnormal values into the plan of care for the client
Nurses throughout their practice have seen a dramatic increase in the number and complexity of diagnostic tests
Roles have changed from assisting to information specialists
Nurses are responsible for understanding and interpreting laboratory test results and have a legal responsibility to recognize abnormal and their values |
|
|
Term
|
Definition
it is not our responsibility to remember all normal values but know the basic ones
normal values vary from lab to lab
the first test on a client is considered a baseline |
|
|
Term
| Patient's rights for diagnostic tests: |
|
Definition
right to refuse and right to know why being done
tell them who will perform the exam
refer to test by its whole name
be honest tell them it might hurt
explain to them who will contact them with results
legal right to know the benefits and dangers before consenting to a test |
|
|
Term
| How much blood does an average person have? |
|
Definition
| The average person has 5 liters of blood that may be separated into 3 liters of plasma and 2 liters of cells |
|
|
Term
| What is plasma et what does it contain? |
|
Definition
| plasma is the liquid part of the blood and contains blood proteins |
|
|
Term
|
Definition
| Serum is the liquid after whole blood clots. Serum is clear |
|
|
Term
| What part of blood are cells et where is it formed? |
|
Definition
| Cells are the solids that are formed mainly by the bone marrow |
|
|
Term
| Overview of blood formation: |
|
Definition
Blood can be thought of as tissue that serves many functions
Without plasma cells cannot circulate and without cells the vascular fluid cannot maintain life
Production of red cells platelets and white cells is referred to as hematoporiesis occurring mainly in the bone marrow
red cells dominate for every 500 red cells there are approximately 30 platelet cells and only 1 white cell |
|
|
Term
| What are diagnostic tests for blood? |
|
Definition
Hematology
Urinalysis
Coagulation Studies |
|
|
Term
| What makes up hematology? |
|
Definition
CBC: complete blood count
RBC: red blood cell count
hgb: hemoglobin
hct: hematocrit
WBC: white blood count
differential |
|
|
Term
| Complete Blood Count (CBC) is composed of: |
|
Definition
|
|
Term
RBC
Description
Function
Lifetime |
|
Definition
Biconcave, pale pink to deep red in color
function is to maintain a high concentration of hemoglobin
they only live up to 120 days |
|
|
Term
| What does a red blood cell combine with? |
|
Definition
| Combination of hemoglobin and oxygen gives arterial blood the bright red appearance |
|
|
Term
| Do males or females have a lower RBC count? |
|
Definition
| Men generally have more RBC’s than men |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
4mil to 6 mil cu/mm
written 4.0-6.0
infants: 4.8-7.2
children: 3.8-5.5 |
|
|
Term
| An increase in RBC may be due to__________? |
|
Definition
|
|
Term
| A decrease in rbc may be due to ______________? |
|
Definition
anemia
fluid overload
hemorrhage
ABO and Rh incompatibility
bone marrow failure |
|
|
Term
|
Definition
immature RBC
gives us an indication of bone marrow activity
when bone marrow is active there is an increase retic count
when bone marrow is less active the retic count will decrease |
|
|
Term
| normal values for reticulocytes: |
|
Definition
adults 0.1 -1.5 retic/100 rbc or 0.15-1.5%
infants 0.5-3.5%
children: 0.5-2% |
|
|
Term
| What nursing cares for a client with decreased RBC? |
|
Definition
assess for cause: blood loss, anemia, renal insufficiency, leukemia, over hydration
assess for fatigue, pallor, dyspnea with exertion, tachycardia, headache
cares: space cares so not to exert, COP slowly, safety needs to avoid injury = slow healing
education: compliance with iron supplements and diet rich in iron
Take medication with meals to decrease gastric upset
educate to change in stool color and potential constipation |
|
|
Term
| What nursing cares for a client with increased RBC? |
|
Definition
assess for s/s of hemoconcentration
dehydration, severe diarrhea, shock
cares: fluid resuscitation, treat diarrhea (BRAT diet, electrolyte fluids)
Compare weights |
|
|
Term
| What % et what component of blood make up Hematocrit? |
|
Definition
RBC make up about 45% of the volume of whole blood
this percentage is called the HCT
men have a higher HCT than women
lows HCT indicated anemia |
|
|
Term
|
Definition
|
|
Term
| What increases or decreases HCT? |
|
Definition
increases hemoconcentration due to dehydration, shock, polycythemia
decreases: after hemorrhage, most anemia, leukemia |
|
|
Term
Where is hemoglobin found?
Who has more, men or women?
What does HGB contain? |
|
Definition
hgb makes up one third of the mass of each blood cell is HGB
carries oxygen from the lung to the tissues of the body
men have more RBC so usually a higher HGB
HGB contains iron |
|
|
Term
|
Definition
adults 12-18 grams (per 100mL of blood)
Females 12-16 Men 14-18
infants 10-17 gms
children 11-16 gms |
|
|
Term
| What are the nursing cares for an increase or decrease in HCT et HGB? |
|
Definition
same as with increase and decrease of RBC.
with low hgb you will see poor healing , growin fatigue SOA with exertion |
|
|
Term
| With pregnancy, what changes in RBC, HCT, et Hgb values will occur? |
|
Definition
during pregnancy a woman will increase blood volume 33%
this will cause slight decrease in RBC, HCT, Hgb values |
|
|
Term
| What is the normal range for WBC et what is their fucntion in the body? |
|
Definition
normal range is between 4,000-10,000 per cubic mL
their main defense is against infections and purging when there is injury or inflammation |
|
|
Term
| What is an increase in WBC called et when does this happen? |
|
Definition
leukocytosis
elevation of WBC are seen in conditions suck as infections, injuries, and after surgery
slight increase with emotional upsets, strenuous exercise or paroxysmal tachycardia, these elevations will return to normal in 1-3 hrs |
|
|
Term
| What is a decrease in WBC called et when does this happen? |
|
Definition
Leukopenia
decrease in WBC may be seen in blood, dyscrasias, overwhelming infections, drug and chemical toxicity
mild decrease is often seen in viral infections |
|
|
Term
| What are the 5 types of WBC in order from most important to least? |
|
Definition
Neutrophils
Lymphs
Monocytes
Eosinophil
Basophil |
|
|
Term
| What does the differential in WBC assess et help diagnosis? |
|
Definition
assessing the amount of each type of WBC
Diagnosis of many diseases are characterized by an increase or decrease of one WBC cell type
shift to left or shift to right: more cells on the right side of the counter. shift to the left means more neutrphils. shift to the right means more basophils or esoinphils
Neutrophils and lymphocytes make up 80-89% of the total WBC’s |
|
|
Term
Neutrophils:
Range
Types
Increase
Decrease |
|
Definition
normal 50-70%
Two types
bands and segs
Increase with bacterial infections, acute inflammation, leukemia
decrease in viral infections overwhelming infections, bone marrow damage, toxic drugs and chemicals |
|
|
Term
Lymphocytes:
Range
Location
Function
Increase
Decrease |
|
Definition
Normal values 20-40-%
Present in lymph tissue
Main constituents of the immune system which is the defense for virus’s, bacteria, fungi
Increase in lymphocytes with viral infections and chronic bacterial infections
decrease in lymphocytes with small doses of radiation and corticosteroids |
|
|
Term
Monocytes:
Normal values
Function in body |
|
Definition
Normal value 3-8%
Second line of defense against bacterial infections
Stronger than neutrophils and can ingest larger particles
Increase in Monocytes during the recovery of severe infections such as TB, malaria, Rocky Mountain Spotted Fever, monocytic leukemia
Continue to function during the chronic phase of phagocytosis |
|
|
Term
Esoinophils:
Normal value
Increase
Decrease |
|
Definition
Normal value 2-4%
Increase in allergic response or parasitic infections
decrease with steroid use |
|
|
Term
Basophils:
Normal value
Increase
decrease |
|
Definition
Normal value 0.5-1%
Secrete substances which mediates hypersensitivity reactions
Increase during the healing process
decrease with steroids |
|
|
Term
| What are sedimentation rates (SED rate) et what are the normal values? |
|
Definition
the rate at which RBC settle in unclotted blood in millimeters per hour
Non-specific test for inflammatory process
Values
<50 years male 0-15mm/hr
<50 yrs female 0-20mm/hr
>50 male 0-20mm/hr
>50 female 0-30mm/hr |
|
|
Term
| What caused decreased SED rate values? |
|
Definition
Polycythemia vera
CHF
Sickel cell anemia
Infectious mono
OA
Angina pectoris |
|
|
Term
| What causes an increase SED rate values? |
|
Definition
RA
Rheumatic fever
Cancer of the stomach, colon, breast, liver, kidney
Hodgkins disease
Multiple myeloma
Bacterial endocarditis
Acute MI
TB
Golmerulornephritis
SLE systemic lupus
Pregnancy 2nd and 3rd trimester |
|
|
Term
|
Definition
Complex fluid, composed of 95% water and 5% solids
It is the end product of metabolism resulting in an average of 1-1.5 liters per day, depending upon intake
Tremendous blood flow through the kidneys
Almost all substances found in the urine are also found in blood
For routine screening obtains 10mL, sent within 1 hr or refrigerate
Pale yellow to amber
Dark urine related to hydration status medications, chemicals, foods, blood, purulent matter |
|
|
Term
|
Definition
slightly aromatic
standing urine and bacteria have a strong odor due to the breakdown of urea to ammonia
Increase odor due to certain medications, foods, diabetes, malnutrition, dehydration, infections |
|
|
Term
| What are normal appearances of urine? |
|
Definition
| should be clear with no particles causes of turbid urine, renal and bladder infections |
|
|
Term
What is specific gravity
Normal values
Low values
High values |
|
Definition
Normal values 1.005-1.040
Measures the urines concentration that indicates fluid status and the kidneys ability to concentrate urine
Lower values diluted urine
high values concentrated urine due to dehydrations, acute glomerulonephritis, nephritic syndrom |
|
|
Term
PH:
Normal values
Alkaline urine
Acidic urine |
|
Definition
Normal values 4.5-8.0
Urine that is allowed to stand will have a higher pH
Alkaline urine seen with UTI, alkalosis, pyloric obstruction chronic renal failure
acidic urine seen with fever acidosis uncontrolled diabetic |
|
|
Term
Protein:
Normal value
Causes |
|
Definition
Normal value NONE
persistene presence warrants further investigation
some causes: severe stress, renal failure, renal disease, toxemia of pregnancy, kidney stones, trauma |
|
|
Term
Glucose:
Range
At what value will glucose spill into the urine?
Causes |
|
Definition
normal value NONE
Glucose spills into the urine when blood glucose exceeds 150mg/dl
some causes: diabetes, renal disease, Cushings syndrome
About 70% of normal pregnant women show spilling of glucose without clinical significance |
|
|
Term
Ketones:
Normal values
When are ketones found in the urine? |
|
Definition
normal value NONE
The end product of fatty metab
negative urine glucose with positive ketones indicates increased fat metabolism
presence of glucose and ketones may indicate diabetic ketoacidosis
clients with diabetic may spill ketones during stress or inadequate glucose control
other causes include starvation prolonged vomiting and diarrhea and high protein diet |
|
|
Term
Nitrates:
Normal values
Why are nitrates formed in urine?
Causes |
|
Definition
Normal values NONE
presence of nitrates which are formed by bacteria supports the need for a urine culture
causes include bacterial infection, pyelonephritis, cystitis |
|
|
Term
RBC in Urine:
Normal values
Causes |
|
Definition
normal value 0-3
Increased number may mean contamination of the sample from menstrual flow
Other causes: inflammation, obstruction, infection, renal stones, trauma, tumors |
|
|
Term
Urine WBC:
Normal values
Causes
TNTC |
|
Definition
Normal values 0-4
A few are normal
some causes include: bacterial infection of the urinary tract
TNTC: too numerous to count |
|
|
Term
What are Urine Casts?
Normal value
Causes |
|
Definition
Normal values NONE
Casts are collections of proteins, cells and debirs formed in the renal tubules
Some cause include trauma to the glomerular capillary membrane or inflammation/infection of the renal tissue |
|
|
Term
Urine bacteria:
Normal values
Small #
Large #
Causes |
|
Definition
Normal values NONE
Small numbers may indicate a contaminated specimen
Large numbers suggest the need to perform a C&S
Causes include genitourinary tract infection |
|
|
Term
| What is a 24 hr urinalysis used for, what factors do you need to remember about this test et what substances are you looking for? |
|
Definition
collection of all urine in a 24 hr period
use of a special container
collect all the urine for that 24 hours
observing for particular substances such as, protein, aldosterone, sodium, potassium, creatinine
May also draw blood levels during the 24 hr period |
|
|
Term
What are you looking for in Coagulation Studies? What is their function?
Normal values |
|
Definition
Platelets
Smaller then RBCs
One drip of blood containts 5m RBCs and 140,000-450,000 platelets
Their function is to stop bleeding from injured small blood vessels |
|
|
Term
What are the Platelets function?
Normal values
What happens with low counts?
What happens with high counts? |
|
Definition
Stick together to form a plug
Normal values 140,000-450,000
Low count cause bleeding more easily and excessively
increase seen in diseases of the bone marrow, fractures, pregnancy |
|
|
Term
| What drugs is used as a platelet aggregate? |
|
Definition
ASA
Plavix (Clopidogrel)
Patiki sign of thrombocytopemia |
|
|
Term
PT:
lab values
What it is used for?
Measure clotting ability, factors I, II, V, VII, X
Factors synthesized in the liver. Liver injuries will alter PT |
|
Definition
Measure clotting ability, factors I, II, V, VII, X
Factors synthesized in the liver. Liver injuries will alter PT
Utilized to monitor anticoagulant therapy (warfarin)
Normal values 10-13 seconds for anticoagulant therapy 1.5-2 times the control seconds |
|
|
Term
INR or International Normalized Ratio:
What is it used for?
Normal values
Target range |
|
Definition
developed as a standardized test for PT with anticoagulant therapy
Normal value is 2.0-3.0
Designed for long-term warfarin therapy once the client has stabilized. At least one week to stabilize
target range2.5-3.5 with valve replacement |
|
|
Term
PTT:
What is it used for?
Normal values
Anticoagulant therapy values |
|
Definition
used to measure all clotting factors except VII and XIII and to detect platelet variations
useful for monitoring heparin therapy adjustment to the dosage with this test
Normal values vary
PTT 60-70 sec
Anticoagulant therapy is 1.5-2 times the control seconds |
|
|
Term
| What lab test will be for Coumadin? |
|
Definition
|
|
Term
| What lab test is for Heparin? |
|
Definition
|
|
Term
|
Definition
Activated partial thromboplastin time
The aPTT is utilized to detect congenital and acquired abnormalities of the intrinsic coagulation pathway and to monitor patients receiving heparin
More sensitive minor clotting defects can be detected |
|
|
Term
| Blood Chemistries; general information |
|
Definition
Generally blood chemistries will be a collection of a group of lab tests
Chem 6 chem 8 or chem. 12
Also called a metabolic panel
Serum=plasma after removal of clotting factors
Chemistries are done on serum
dextrosticks are done on plasma |
|
|
Term
Alkaline Phosphatase:
Where is it produced?
What are the values?
What diseases does this help identify? |
|
Definition
Enzyme produced mainly in the liver and bone, with some in the intestine, kidney and placenta
useful in determining liver and bone disease
Normal value (adult) 42-136 units/liter
Normal value (13-18 yrs) 50-230 units/L (because of bone growth) |
|
|
Term
| What causes a decrease in Alkaline Phosphate? |
|
Definition
Hypothyroidism
Malnutrition
Scurvy (vit c deficiency)
Pernicious anemia
Hypophosphatasia (low levels of phosphorous in blood) |
|
|
Term
| What causes an increase in Alkaline Phosphate? |
|
Definition
Obstructive biliary disease
CA of liver
Hepatitis
Cirrhosis
CA of bone
healing fracture
Multiple Myeloma (CA in blood that triggers osteoclasts for the back & ribcage)
Exacerbated RA
2nd and 3rd trimester of pregnancy |
|
|
Term
What does a blood sugar diagnose?
Normal ranges |
|
Definition
Blood sugars/glucose
Utilized to confirm diagnosis of diabetes
Monitor levels of diabetic client
Normal FBS is 70-110 |
|
|
Term
What glucose level indicates diabetes?
What level does glucose spill into the urine? |
|
Definition
Level greater than 125 indicates diabetes
Level 150 or greater glucose can be found in urine |
|
|
Term
|
Definition
|
|
Term
|
Definition
| elevated blood sugars > 110 |
|
|
Term
|
Definition
| taking bs 2 hrs after a meal |
|
|
Term
| What causes a decrease in blood glucose levels? |
|
Definition
Hypoglycemic reaction
Cancer stomach liver lung
adrenal gland hypofunction
Malnutrition
Alcoholism, cirrhosis
Strenuous exercise
Hyperinsulinism
Large growth spurts |
|
|
Term
| What causes an increase in blood glucose levels? |
|
Definition
diabetes
diabetes acidosis
adrenal gland hyperfunction
hypothermia
Acute MI or acute trauma
acute pancreatitis
Cancer of the pancrease
Post gastrectomy (dumping syndrome)
Drugs: cortisone, thiazide, and loop diretics raise BS |
|
|
Term
What in Hemoglobin A1C (Glycosylated Hemoglobin)?
How does it control diabetes? |
|
Definition
Bond between glucose and hemoglobin occurring slowly over 120 days
Monitors and elevates diabetes control |
|
|
Term
| What are normal values for Hemoglobin A1C? |
|
Definition
Non diab 2-5%
Controlled diab 2.5-6%
High average 6.1-7.5%
Uncontrolled greater than 8% |
|
|
Term
| What causes decreases in Hemoglobin A1C? |
|
Definition
Decreased values
anemia
long term blood loss
Chronic renal failure |
|
|
Term
| What causes increases in Hemoglobin A1C? |
|
Definition
uncontrolled diab
hyperglycemia
alcohol ingestion
pregnancy
hemodialysis |
|
|
Term
What does Blood Urea Nitrogen (BUN) detect?
What are normal serum creatine levels? |
|
Definition
detect renal disorder or dehydration
with dehydration, serum creatinine will be normal
Normal 5-25 mg/dl |
|
|
Term
What causes decreases in BUN?
What causes increases in BUN? |
|
Definition
decrease
severe liver damage
low protein diet
overhydration
malnutrition
IV fluids
Increase
dehydration
high protein diet
GI bleeding
pre renal failure with CHF etiology
diabetes
renal failure due to shock
kidney disease (glomerularnephritis, pyelonephritis)
nephrotoxic drugs (garomyacin, vancomyacin; drugs that end in myacin; ototoxic) |
|
|
Term
Where is creatinine produced?
What is it filtered by?
How is it excreted?
What are the normal values? |
|
Definition
by product of muscle catabolism proportional to muscle mass
filtered by the glomeruli and is excreted in the urine
when a person has 50% or more of nephrons destroyed, serum creatinine levels increase, evaluates glomerular/renal function
normal values 0.5-1.5 mg/dl |
|
|
Term
What causes decreases in Creatinine levels?
What causes increases in Creatinine levels? |
|
Definition
decrease
pregnancy
eclampsia
seen with elderly due to decreased muscle mass and decreased creatinine production
increase
acute and chronic renal failure
prolonged shock
SLE systemic lupus Erythematosis
cancer of intestines, bladder, testes, uterus, prostate
leukemia’s
Hodgkin’s
essential HTN
diabetic neuropathy
Chronic CHF
diets rich in creatinine (beef and poultry)
Nephrotoxic drugs |
|
|
Term
What do you monitor Ca+ levels for?
What are the normal vlaues? |
|
Definition
Monitor Ca+ levels for muscle function, innervation
Normal values 4.5-5.5 mEg/L 8.9-10.1 mg/dl |
|
|
Term
|
Definition
| tetany (stiffening of muscles) |
|
|
Term
|
Definition
|
|
Term
| What causes decreases et increases in Ca+? |
|
Definition
Decrease
diarrhea
malabsorption of Ca from GI tract
extensive infections
burns
lack of Ca+ and vit D
hypoparathyroidism
Chronic renal failure
alcoholism
pancreatitis
Increase
Hypervitaminosis D
Hyperparathyroidism
Malignant neoplasm of the bone, lung, breast, bladder, kidney
Multiple myeloma
Prolonged immobilization
Multiple fractures
Renal calculi
Alcoholic binge
Increase in Alkaline Phosphatase |
|
|
Term
Why is Chloride (Cl-) important?
How does it work in the body?
What are normal values? |
|
Definition
Anion of the extracellular fluid important in maintaining body water balance
combines with hydrogen to produce HCL in the stomach
competes with bicarbonate for sodium essential for acid base balance
Normal values 95-105 |
|
|
Term
| What causes decreases et increases in Cl-? |
|
Definition
decrease
vomiting gastric suctioning
Diarrhea, gastroenteritis, colitis
Hypokalemia (calcium)
Hyponatremia (salt)
low sodium diet
diabetic acidosis
acute infections
burns
excessive diaphoresis
increase
dehydration
hypernatremia
cancer of the stomach
multiple myeloma
adrenal gland hyperactivity
head injry
eclampsia
renal dysfunction
hyperparathyroidism
excessive IV saline |
|
|
Term
Potassium:
What are normal ranges?
What are fatal ranges?
What is it important for?
Other facts: |
|
Definition
narrow therapeutic range need to be closely monitored
Normal value: 3.5-5.3
fatal to have levels below 2.5 or greater than 7.0
major intracellular ion
important electrolyte for nerve conduction
Body does not conserve potassium. 90% of bodys k+ excreted in the urine
Spirolactone (Aldaetazide) K+ sparing diuretics
destruction of cells causes K+ to enter the extracellular fluid |
|
|
Term
| What causes decreases et increases in Potassium? |
|
Definition
decreased
vomiting and diarrhea
dehydration
malnourished
crash dieting
anorexia
stress
gastric suction
intestinal fistula
Burns
renal tubular disorders
increased
Oliguria/Anuria
acute renal failure
IV potassium in fluids
Crushing injury
potassium sparing diuretics
Burns |
|
|
Term
| What foods are high in potassium? |
|
Definition
| Tropicana pure OJ, winter squash (cooked), spinach (cooked), catalope, bananas, skim milk, raisins (1 cup), potatoes |
|
|
Term
How does sodium work in the body?
What are the normal ranges? |
|
Definition
major caution in the extracellular fluid
water retaining effect maintains body fluids
involved in enzyme activity
regulates acid-base with Cl or HCO3
Measures sodium imbalances
Normal values 135-145 mEq/L |
|
|
Term
| What causes decreases et increases in sodium? |
|
Definition
decrease
vomiting and diarrhea
gastric suction
excessive perspiration
low sodium diet
burns
inflammatory reaction
salt wasting renal disease
increase
dehydration
severe N&V water loss greater than NA loss
CHF (?diet)
Cushing’s disease
hepatic failure
High NA diet |
|
|
Term
What body part is cholesterol synthesized by et where is it found in the body?
What are the normal levels? |
|
Definition
A blood lipid synthesized by the liver found in RBCs cell membranes and muscles
used by the body to form bile salts for fat digestion and for the formation of hormones
desirable level less than 200 mg/dl
moderate CV risk 200-240mg/dl
High risk CV greater than 240 mg/dl |
|
|
Term
| What causes decreases et increases in Cholesterol? |
|
Definition
decrease
hyperthyroidism
cushings
starvation malabsorption
anemias
acute infection
increased
atherosclerosis
hypothyroidism
biliary (tubes off of liver et gallbladder) obstruction
family hx of hypercholesterolemia
uncontrolled diab
nephritic syndrome
high cholesterol diet |
|
|
Term
Lipoproteins (serum lipids):
What do lipoproteins bind to?
What are the 3 types of lipids?
What are the blood values that measure lipids?
Lipids bound to protein
three types of lipids
triglycerides
energy source
phospholipids
builds plasma membranes
Steriods
cholesterol
Blood values that measure lipids
HDL Good cholesterol
LDL bad cholesterol
VLDL: carry triglcerides in the blood |
|
Definition
Lipoproteins (serum lipids)
Lipids bound to protein
three types of lipids
triglycerides
energy source
phospholipids
builds plasma membranes
Steriods
cholesterol
Blood values that measure lipids
HDL Good cholesterol
LDL bad cholesterol
VLDL: carry triglcerides in the blood |
|
|
Term
How does bilirubin work in the body?
What are the values? |
|
Definition
Bilirubin
Break down of hemoglobin carried by plasma to the liver
conjugated bilirubin (direct bili) is bili that has been taken up by the liver cells and conjugated to for the water soluble bili diglucuronide
unconjugated is the lipid soluble form of bili that circulates in loose association with the plasma proteins
values
total 0.1-1.2 mg/dl
direct 0.1-0.3
indirect 0.1-1.0 |
|
|
Term
| What causes decreases et increases in bilirubin? |
|
Definition
decrease
iron deficiency anemia
increase
obstructive jaundice due to stones, neoplasms, damaged liver cells (cirrhosis)
mono
hyperbilirubinemia of infancy
indirect values increase
Erythromblastosis fetalis
sickle cell anemia
transfusion reaction
hemolytic anemia
hepatitis |
|
|
Term
What is uric acid a product of?
What is it used for?
Normal ranges: |
|
Definition
by product of purine metabolism
elevations related to renal function purine metabolism and intake of purine foods
used to monitor levels with gout
Normal men 3.5-8.0 women 2.8-6.8 |
|
|
Term
| What causes decreases et increases in uric acid? |
|
Definition
decrease
Wilsons disease
folic acid deficiency
anemia
burns
pregnancy
increase
gout
alcoholism
leukemias
metastatic cancer
multiple myeloma
severe eclampsia
hyperlipoproteinemia
diabetes severe
glomerulonephritis
high protein weight reducing diet
strenuous exercise
DRUGS: Uroloric, allopurinal, Cholchicine |
|
|
