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Ohara ACLS handout
handout packet
43
Health Care
Not Applicable
11/06/2012

Additional Health Care Flashcards

 


 

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Term
Normal Sodium Level:
Primary intra/extracellular ion?
maintain _____ balance
Definition
135-145 mEq/L
extracellular
acid-base
Term
Causes of HypoNatremia
Definition
restricted diet, alcoholism
skin loss...sweat, burns
Renal....diuretics, adrenals
GI losses: suctioning, diarrhea, vomit
wound drainage, fistula, laxative abuse
Term
Causes of HyperNatremia
Definition
(+)intake, IV or meds, Heart/Renal failure, corticosteroids, cirrhosis, Cushing's, hyperaldosteronism, near drowning
Term
POTASSIUM
Normal levels
Primary intra/extracellular ion?
maintains intracellular _____
helps regulate ______ balance
deposition of _____ into the liver
Definition
3.5 - 5.0 mEq/L
intracellular
osmolality
acid-base
glucose
Term
Causes of HYPOkalemia
Definition
Low intake: starvation, alcoholism
Diaphoresis
Insulin Admin: Tx of DKA
metabolic alkalosis
GI losses: surgery, intestinal bypass, suctioning, vomit, diarrhea, fistula, laxatives
Renal: polyuria, Hypomagnesium, CHF, hyperaldosteronism, sodium restriction
Cushing's, Steroids, Cirrhosis, RAAS, diuretics, burns
Term
Causes of HYPERkalemia
Definition
(+)intake, KCl salt substitute, blood transfusion, drugs containing K.
Renal Disease, Addison's
Drugs: NSAIDs, ACE inhibitors, ARBs, K-sparing diuretics, Cyclosporine
leaks from muscle:trauma, transfusion reaction, catabolism
Intra-ExtraCellular Shift: Acidosis, Insulin Deficiency, hyperthermia, Succinylcholine/digitalis
Term
CALCIUM
Normal Level
formation of ___ & ___
____ function of muscle
important in blood ____ pathway
Definition
4.5 - 5.5 mEq/L
bones, teeth
contractility
coagulation
Term
Causes of HYPOcalcemia
Definition
(-)intake or absorption
dietary deficiency
Hypoparathyroidism, hypoMag, Renal Failure
Vitamin D deficiency
Malabsorption syndrome
Alcoholism, Cushing's, Steroid Therapy
Diuretics, Diarrhea, hyperPhosphatemia,
Alkalosis, Pancreatitis
Drugs: Aminoglycosides, Cimetidine, Heparin, Theophylline
Term
Causes of HYPERcalcemia
Definition
(+)intake, supplements, Ca antacids
HyperParathyroidism, VitD excess, Prolonged immobility, Thiazide diuretics, adrenal insufficiency, renal failure
cancer, Tuberculosis
Term
MAGNESIUM:
Normal Level
Aids in _____ conduction
Enzymes for metabolism of ___ &_____
aids in _____pump across cell membrane
Definition
1.6-2.1 mEq/L
neuromuscular
CHO PRO
sodium-potassium
Term
Causes of HypoMagnesemia
Definition
malnutrition, starvation, alcoholism, prolonged IV nutrition,
DRUGS: diuretics, ETOH, steroids
Vomit, diarrhea, suctioning, hypoparathyroidism, hyperaldosteronism
DKA, HF
extra-intracellular shift: insulin for DKA, AMI, amino acid solutions
Term
Causes of HyperMagnesemia
Definition
enemas, laxatives, MagSulfate, Mag antacids, renal failure, HyperPTH, HypoAldosteronism, Hypothyroidism
Intra-extracellular: Ketoacidosis, burns, rhabdomyolysis
Term
Blood Urea Nitrogen (BUN)
Normal Range
End product of ____ metabolism excreted by the kidney
Related to ___ intake & _____ metabolism
A more useful measurement of GFR is _____
Definition
6-23 mg/dl
protein
Protein / Nitrogen
creatinine
Term
BUN increases
Definition
renal failure
urinary tract obstruction
shock, burns, GI bleed, Nephrotoxic drugs
Term
BUN decrease
Definition
Hepatic Failure
Cachexia
Low protein High Carb diet
Term
Creatinine
Normal Levels
Excreted by filtration through the _____. Creatinine Clearance is an acceptable clinical measure of ___.
Definition
0.7 - 2.1 mg/dl
glomerulus
GFR
Term
CREATININE + & -?
Definition
(+) Renal Failure, Urinary Tract Obstruction, Nephrotoxic Drugs, Hypothyroidism
(-): reduced muscle mass
Term
Documentation of Chemistries:

___N___|___C__|__B__/ G
K | H | C \
Definition
Na Cl BUN
Glucose
K HCO3 Creatinine
Term
CBC
\___H_____/ M
W / H \ P
B/L
Definition
Hemoglobin MCV
WBC Platelets
Hematocrit Bands/Lymphs
Term
Arterial Blood Gas
p | P | P | H | B | S
Definition
pH PaO2 PaCO2 HCO3 BE SaO2
Term
TROPONIN I
Normal range
Contractile regulatory protein of ____ muscle; there are _ subunits with cardiac troponin I expressed only in cardiac muscle.
Allows differentiation between ___muscle and ____muscle injury
Definition
< 1.5 ng/ml
striated
3
Myocardial, Skeletal
Term
TROPONIN I
increased in....
Sensitivity 50% in _hrs
__% in 6hrs
Cardiac Trauma or Surgery
Post _____implantation
Definition
MI
4
97%
PCI or ICD
Term
TROPONIN I
Not increased in....
Definition
skeletal muscle disease
noncardiac trauma/surgery
Rhabdomyolysis
Severe muscular exertion
Chronic renal failure
Term
Creatine Kinase MB (CKMB)
normal range
3 isoenzymes made of 2 subunits M & B
Cardiac Muscle M_
Skeletal Muscle M_
Brain Tissue __
Increased by:
Definition
<16 IU/L
B
M
BB
MI, Cardiac Trauma
Term
Prothrombin Time (PT)
range & panic level
Monitors what drug?
evaluates ___pathway of coagulation
(+)levels: LD, VKD, IC, MT
Definition
11-15 sec, >30sec
Coumadin (warfarin)
liver disease, Vitamin K deficiency, Intravascular Coagulation, Massive transfusions
Term
Partial Thromboplastin Time (PTT)
normal and panic level
monitors what drug?
causes of increases?
Definition
25-35sec
>60sec without Heparin
Heparin
remember lowercase ptt, the 2 t's look like an "H" for heparin
hemophilia, DIC, deficiency of individual coagulation factors except XIII & VII
Term
CV Triad Assessment Tool:
3 factors to assess patient's hemodynamic status:
Definition
Rate
Pump
Volume
Term
Creatine Kinase MB (CKMB)
normal range
3 isoenzymes made of 2 subunits M & B
Cardiac Muscle M_
Skeletal Muscle M_
Brain Tissue __
Increased by:
Definition
<16 IU/L
B
M
BB
MI, Cardiac Trauma
Term
Prothrombin Time (PT)
range & panic level
Monitors what drug?
evaluates ___pathway of coagulation
(+)levels: LD, VKD, IC, MT
Definition
11-15 sec, >30sec
Coumadin (warfarin)
liver disease, Vitamin K deficiency, Intravascular Coagulation, Massive transfusions
Term
Partial Thromboplastin Time (PTT)
normal and panic level
monitors what drug?
causes of increases?
Definition
25-35sec
>60sec without Heparin
Heparin
remember lowercase ptt, the 2 t's look like an "H" for heparin
hemophilia, DIC, deficiency of individual coagulation factors except XIII & VII
Term
CV Triad Assessment Tool:
3 factors to assess patient's hemodynamic status:
3 Vital signs assessed:
Definition
Rate
Pump
Volume
Pulse, BP, Lung sounds
Term
Triad Assessment:
If pt has hypoperfusion, assess this first _____.
Hypotension with Brady indicates need for HR increase by:
Definition
Rate
Atropine, transcutaneous pacing
Term
TRIAD Assessment:
Hypotension with Tachy needs reduction in rhythm by:
Definition
antiarrhythmic drugs or cardioversion
Term
TRIAD:
HR corrected, reassess these....
Pt still hypo, assess for these....
Definition
BP, lung sounds
pump or volume problem
Term
TRIAD:
Hypo & congested lung sounds mean...
May be ___ or ___ in origin
due to these 3 things
Definition
pump problem
contractility, valvular
ischemia, MI, shock
Term
TRIAD: Tx
Pump problems:
IA
V
I
SROTV
P/R
Definition
Inotropic Agents
Vasodilators
IABP
Surgical repair of valve
PCI/revascularization
Term
TRIAD: PUMP
Reassess vitals
Keep IV rate at slowest possible to prevent overload
Definition
Term
TRIAD: Volume
Hypo with clear lungs indicates:
Due to:
Definition
Volume problem
volume loss or decreased SVR
Term
TRIAD: Volume
Tx
Monitor lung sounds and heart for:
Definition
Fluid bolus in 500ml increments
Volume expanders (colloids, blood)
Vasoconstrictors
Reassess vitals
Volume Overload
Term
TRIAD: Rate Problem..
BP down, wet lungs =
BP down, dry lungs =
Definition
pump problem
volume/vessel problem
Term
chloride levels
Definition
97-107
Term
BUN 7-20 mg/dl
creatinine 0.7-1.2 mg/dl
Definition
greater than 20:1 Prerenal (before the kidney). BUN reabsorption is increased. BUN is disproportionately elevated relative to creatinine in serum. Dehydration is suspected.
Term
10-20:1 Normal range. (Normal or postrenal).Can also be postrenal disease. BUN reabsorption is within normal limits.
Definition
less than 10:1. Intrarenal (within kidney). Renal damage causes reduced reabsorption of BUN, therefore lowering the BUN:Cr ratio.
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