Hesi

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HESI REVIEW CH # 1

Lab Ranges

* Hgb| * Male 14-18 * Female 12-16| * High-altitude living increases values. Slight Hgb decreases normally occur during pregnancy | * | * Hct| * Male 42-52 * Female 37-47| * Prolonged stasis from vasoconstriction secondary to tourniquet can alter values| * | * RBC| * Male 4.7-6.1 * Female 4.2-5.4| * Never draw specimen from an arm with an infusing IV. | * | * WBC| * 5,000-10,000 | * Anesthetics, stress, exercise, and convulsions can cause increased values| * | * Platelets| * 150,000-400,000| * Values may increase with high altitude, oral contraceptives,. * Values may decrease due to hemorrhage, DIC, reduced production of platelets, infections, prosthetic heart values, and drugs (acetaminophen, aspirin, chemo, H2 Blockers, INH, Levaquin, streptomycin, sulonamiedes, thiazide diuretics. | * | * K * * * * Flat T waves on ECG with K 5.0| * 3.5-5.0| * Hemolysis of specimen can result in falsely elevated values. Exercise of the forearm with tourniquet in place may cause an increased potassium level| * Treatment Hypokalemia: *Admin potassium supplements orally or IV. * *Oral forms of Potassium are unpleasant tasting and irritating to GI tract ( do not give on empty stomach; dilute) * *Assess urinary output, prior to admin * *Encourage foods high in potassium (bananas, oranges, cantaloupes, avocados, spinach, potatoes) * * * Treatment Hyperkalemia: Eliminate parenteral potassium from IV infusions and medications * *Admin 50% glucose with regular insulin (insulin will push K into cells). * *Kayexalate * *Administer calcium gluconate to protect the heart * *Renal dialysis may be required| * Na| * 135-145| * Do not collect from arm with an infusing IV. Hyponatremia d/t D5W or hypotonic IV fluids| * Treatment: Restrict fluids (safer) * | * Ca * * * * * | * 9-10.5| * Use of thiazide diuretics can cause increased calcium values| * | * Hypocalcemia 10.5 * (hyperparathyroidism, malignant bone disease, prolonged immobilization, excess calcium supplementation | * S/S: muscle weakness, constipation, anorexia, N/V, polyuria, polydipsia, neurosis, dysrhythmias, Ca>10.5| * | * *Calcitonin * *Avoid calcium-based antacids, renal dialysis may be required| * Hypomagnesium * (alcoholism, malabsorption, diabetic ketoacidosis, prolonged gastric suction, diuretics) | * Anorexia, distention, neuromuscular irritability, depression, disorention, Mg 2.5 | * | * *Avoid magnesium-based antacids and laxatives| * Cl| * 98-106| * Do not collect from arm with an IV infusing| * | * PO| * 2-4.5 | * | * *Administer oral replacement of phosphates with Vitamin D * *For hyperphosphate administer aluminum hydroxide with meals to bind phosphrous | * Relationship of Ca and PO| * | * | * |

* ABGs| * | * | * |
* PT| * 11-12.5 sec| * Used in regulating Coumadin therapy. Therapeutic range is 1.5 to 2 times normal or control| * | * INR| * | * | * |
* PTT| * 60-70 sec| * Used in regulating Heparin therapy. Therapeutic range is 1.5 to 2.5 times normal or control| * | * BUN| * 10-20| * None | * |
* Creatinine | * Male 0.6-1.2 * Female 0.5-1.1| * Ratio of 20:1 BUN to creatinine indicates adequate kidney functioning | * | * | * | * | * |
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* Acid-Base Conditions| * pH| * Pco2| * HCO3| * Normal| * 7.35-7.45| * 35-45| * 22-26|
* Resp Acidosis| * | * | * Normal|
* Resp Alkalosis| * | * | * Normal|
* Meta Acidosis| * | * Normal| * |
* Meta Alkalosis| * | * Normal| * ...
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