NURSES POCKET NOTES

NORMAL VALUES

COMPLETE BLOOD COUND (CBC) ADULTS Male Hemoglobin (g/dl) 13.5-16.5 41-50 45-55 <14.5 80-100 26-34 31-37 100000450000 CREATININE KINASE (CK) ISOENZYMES CK-BB CK-MB (cardiac) CK-MM Creatinine Phosphakinase (CPK) Creatinine (mg/dl) ELECTROLYTES Calcium Calcium, ionized Chloride Magnesium Phosphate Potassium Sodium Ferritin (ng/ml) Folate (ng/ml) Glucose, fasting Glucose (2 hours postprandial) (mg/dl) Hemoglobin A10 Iron (mcg/dl) 6-8 65-150 8.5-10.2mg/dl 2.24-2.46mEq/L 95-107 mEq/L 1.6-2.4mEq/L 2.5-4.5 mg/dl 3.5-5.2 mEq/L 135-145 mEq/L 13-300 3.6-20 60-110 (mg/dl) Up to 140 0% 0-3.9% 96-100% 8-150 IU/L 0.5-1.4 Hematocrit (%) RBCs (x106/ml) RDW (RBC distribution width) MCV MCH MCHC % Platelet count Female 12.0-15.0 36-44 40-49

Lactic acid (mEq/L) LDH (lactic dehydrogenase) Cholesterol, total HDL cholesterol LDL cholesterol Triglycerides Osmolality SGOT (AST) SGPT (ALT) Free T3 Serum T3 Free T4 Serum T4 TSH Total iron binding capacity (TIBC) Transferrin Uric acid (male) Uric acid (female) WBC (cells/ml) Segmented neutrophils Band forms Basophils Eosinophils Lymphocytes monocytes

0.7-2.1 56-194 IU/L <200 mg/dl 30-70 mg/dl 65-180 mg/dl 45-155 mg/dl (<160) 289-308 mOsm/kg <35 IU/L (20-40) <35 IU/L

LIPOPROTEINS AND TRIGLYCERIDES

LUNG SOUNDS Crackles or rales wheezing stridor rhonchi Range Normal Mild hypoxia Moderate hypoxia Severe hypoxia Albumin Alkaline Phosphatase (Adults: 25-60) Adults: >61yo Ammonia Bilirubin, direct Bilirubin, tota Arterial pH pCO2 pO2 HCO3 O2 Sat % BUN 7.35-7.45 35-45 70-100 19-25 90-95 7-20 mg/dl 51-153 IU/L 20-70 mcg/dl 0-0.3 mg/dl 0.1-1.2 mg/dl BLOOD GASES Venous 7.32-7.42 38-52 28-48 19-25 40-70 <85% Give 100% oxygen with positive pressure 3.2 g/dl 33-131 IU/L High-pitched whistling expirations Harsh, high-pitched inspirations Coarse, gravelly sounds PULSE OXIMETRY Value 95-100% 91-94% 86-90% Treatment None or placebic Give oxygen Give 100% oxygen Crackling or rattling sounds

THYROID FUNCTION TESTS 2.3-4.2 pg/ml 70-200 ng/dl 0.5-2.1 ng/dl 4.0-12.0mcg/dl 0.25-4.30 microunits/ml 250-420 mcg/dl >200 mg/dl 2.0-8.0 mg/dl 2.0-7.5 mg/dl 4500-10000 54-62% 3-5% (above 8% indicates left shif) 0-1 (0-0.75%) 0-3 (1-3%) 24-44 (25-33 %) 3-6 (3-7%) WBC + DIFFERENTIAL

NURSING CONSIDERATIONS FOR BT Confirm that the transfusion is prescribed Check if Px blood has been typed and crossmatched Verify the consent from has been signed Explain the procedure to the Px and instruct px for s/sx of transfusion reaction (itching, hives, chills, sweeling, fever, shortness of breath) Take pxs vital signs to establish baseline for comparing of vital signs during transfusion Standard precaution during BT as per hospital policy Use gauge 20 or larger needles for BT Maximum hours for BT is 4 hours Double check obtained PRBC from blood bank Double check labes with other RN or MD to make sure of ABO and Rh compatibility Check blood for unusual color, bubbles or cloudiness, it may indicate bacterial growth or hemolysis Make sure PRBC is initiated within 30 minutes after removal from blood bank refrigerator For first 15 minutes, run transfusion slowly not more than 5ml/min, observe for side effects, then increase flow rate unless px is risk for circulatory overload. Observe px frequently for 15 to 30 minutes Be alert for adverse reactions, circulatory overload, sepsis, febrile reactions, allergic reactions and hemolytic reactions. Change tubing after every 2 units transfused Obtain BS and compare with initial VS Document procedure Monitor px for response to and effectiveness of the procedure atSO4 Aminophylline Aeknil Benadryl Burinex Ca gluconate Cardepine Carricor Calmegic Cefamandole Cefuroxime Cordarone Cyklokapron Demerol Dexamethasone Dextrose Diazepam Diclofenac Na (Voltaren) Dilantin Dobutrix Dopamine Dormicum Ephedrine Famotidine Furosemide Hyosine Hbr. Isoket Isoptin Drug Adrenaline Use Bronchodilator cdc stim. & vasoconstrictor Anticholinergic Bronchodilator Anti-pyretic Anti-histamine Diuretic Electrolyte modifier Ca antagonist Anti-arrhythmic Analgesic/ anti-pyretic Anti-infective Anti-infective Anti-arrhythmic Coagulant Narcotic agent Anti-inflammatory Caloric agent Sedative Non-steroidal antiinflammatory agent Anti-convulsant; atni-arrythmic Inotropic agent Vasopressor, inotropic agent Sedative Bronchodilator Anti-ulcer Diuretic Antispasmodic Anti-angina Ca channel blocker, antianginal, anti-hypertension, Toradol Zantac Zofran Zinacef Perlinganit Reglan Sensorcain HCl Solucortef Nubain NaHCO3 Nitroprusside Nipride Nimotop NTG (transderm) Nitrobid Orudis Promethazine HCl Isotonic NaCl KCl Lanoxin Cystine Acetate Losec MgSO4 Morphine Metochlorpramide Narcan Nicardipine

anti-arrhythmic Elec. Mod. Elec. Mod. Digitalis Analgesic Anti-ulcer Anti-convul Narcotic anal Anti-emetic Narc. Antag Ca channel blocker, antiangina, vasodilator, antihypertension Narc. Analg. Elec. Mod., alk. Agent Anti-hpn Cal channel blocker Atni-ang., vasodil Vasodil, anti-angi Anti-inflam Anti-histamine, anti-emetic, sed Anti-angina Anti-emetic Adrenalien Immune response & inflame Supp. Analgesic Anti-histamine receptor Anti-emetic Anti-infective

What is the normal value of serum glucose? What is the normal arterial blood pH value? What is the normal PaC02?

60-110 mg/dl

5) If AST level is elevated,

7.35 to 7.45

what does that mean? (Aspartate aminotransferase) If ALT level is elevated,

Cell necrosis of heart, liver skeletal muscle

35-45 mmHg 80-100mmHg 22-28 mEq 3.5 to 5.5 mEq/l 135-145 mEq/l 8-25 mg/dl 275-295 mOs/kg

Normal Pa02? Normal HC03? Normal value of K? Normal serum sodium level? Normal BUN? Normal blood osmolarity? If a patient's level of Creatine kinase (isoenzyme MB) is high, what does this mean? If a patient's level of Creatine kinase (isoenzyme BB) is high, what does this mean? If a patient's level of

what does that mean?

Cell necrosis of Liver,

(Alanine aminotransferase) skeletal muscle

What is significance of elevated amylase? Normal value of total bilirubin? Normal value of direct bilirubin?

Pancreas, salivary gland cell necrosis .2 - 1.5 mg/dl

0 to .3 mg/dl Serum (total) is 9.0 to 10.5, ionized is 4.5 to 5.6. 50% of

Cell necrosis in heart.

Normal calcium levels Cell necrosis in brain

calcium in blood is bound to protein, 40% is free or ionized.

Creatine kinase (isoenzyme Cel necrosis in heart or MM) is high, what does this skeletal muscle mean? If LDH-1 is high, what does it mean? (lactate dehydrogenase isoenzyme 1) If LDH-5 is high, what does it mean? (lactate dehydrogenase isoenzyme Cell necrosis of heart, erythrocytes, or skeletal muscle

Cell necrosis of Liver or skeletal muscle