NURSING 4530 Mark Klimek Test taking strategies.

Mark Klimek Test taking strategies.

Mark Klimek Test taking strategies


Lab Values:
DEADLY DANGEROUS:
• Elevated K+ ( >6)
- Hold K+, Assess heart, Prepare Kayexalate/D5W, Call Dr.
• Elevated pH ( >6)
- Assess Vitals, Call doctor
• CO2 in the 60’s
- Assess Resp., Do purse lip breathing, prepare to intubate and
ventilate, Call Resp. Therapy, Call Dr.
• PO2 < 60’s
- Assess Resp., Give O2, Prepare to intubate and ventilate, Call
resp. therapy, Call Dr.
• Platelets < 40,000
- Assess for bleeding, Place on Bleeding precautions, prepare for
administration on Platelets


CRITICAL:
• INR > 4
• Low K+ ( < 3.5)
• High K+ (5.4 – 5.9)
• Elevated Hgb ( < 8)
• CO2 in the 50’s
- Assess Resp., Do purse lip breathing, DO NOT GIVE O2
• Low PO2 but still in the 70’s
- Assess Resp., Give O2
• O2 < 93%
- Assess Resp., Give O2
• Abnormal Na+ with a change in LOC
• WBC < 5000
• ANC < 500 Place patient
• CD4 < 200 in
Neutropenic
• Platelets <
90,000
- Assess for bleeding, Place on bleeding precautions


BE CONCERED:
• Elevated BUN
- Check for dehydration
• Elevated Hgb
- Monitor for Bleeding

, Mark Klimek Test taking strategies.

• Elevated BNP (Best indicator for heart failure)
• Abnormal Na+
- If elevated, assess for dehydration
- If Low, assess for overload




ABNORMAL BUT NOT A CONCERN:
• Elevated Creatinine ( > 1.2, Best indicator for Kidney function)
• HCO3
• Hct
- Assess for bleeding




*** HOLD, ASSESS, PREPARE, CALL DOCTOR***




Creatinine: 0.6-1.2
HCO3: 22-26 BNP <100
INR: 2-3
Na+: 135-145 WBC: 5000-
K+: 3.5-5.0 10,000

pH: 7.35-7.45 Co2: 35-45 ANC: 500

BUN: 8-30 Hct: 36-54 CD4: >200

Hgb: 12-18 PO2: 78-100 Platelets:
150,000-400,000
Acid Base balance:
• Rule of the B’s: If the pH and the Bicarb are Both in the same direction
then it is metaBolic

• MacKussmauls: Kussmauls Respirations only occur in Metabolic ACidosis

• As the pH goes, so goes my patient except K+
- If pt has a LOW pH, s/s will be elevated except K+