Adult Care 1 HESI
Fluid and Electrolyte Balance - Sodium: 135-145
Chloride: 98-107
**Potassium: 3.5-5.0
Calcium: 8.6-10.2
Phosphate: 2.7-4.5
Magnesium: 1.5-2.5
Albumin: 3.5-5.0
common food sources of potassium - avocado, bananas, cantaloupe, carrots, fish, mushrooms, oranges,
potatoes, pork, beef, veal, raisins, spinach, strawberries, and tomatoes.
Signs of hypocalcemia - paresthesias followed by numbness, hyperactive deep tendon reflexes, and a
positive Trousseau's or Chvostek's sign, increased neuromuscular excitability, muscle cramps, twitching,
tetany, seizures, irritability, and anxiety, increased gastric motility, hyperactive bowel sounds, abdominal
cramping, and diarrhea, prolonged QT interval and prolonged ST segment
hypercalcemia - shortened ST segment and a widened T wave
hyponatremia - Hyperactive bowel sounds, flat neck veins, diminished deep tendon reflexes, muscle
weakness, increased urinary output, and decreased specific gravity
hypernatremia - Muscle twitches, Decreased urinary output, increased specific gravity of the urine
hypermagnesemia - drowsiness, sedation, lethargy, respiratory depression, muscle weakness, and
areflexia.
low levels of albumin cause - edema! And drug toxicity if drug requires albumin to bind!
,5 Rights of delegation - -Right Task: can be delegated, normally repetitive and requires little supervision
and is predictable
-Right Circumstance: right setting and environment
-Right Person: 3 implications: right person delegating right task to right person to be performed to right
person
-Right Direction: communication, clear concise description of task
-Right Supervision: monitor task, give evaluation
essential steps of effective supervision - direction, evaluation, and follow-up
SBAR - Situation
Background
Assessment
Recommendation
6 Rights of Medication - Right Patient
Right Medication
Right Dose
Right Route
Right Time
Right Documentation
...also right evaluation & always assess after giving meds
hemoglobin - male 14-18 g/dL
female 12-16 g/dL
pregnant >11 g/dL
hematocrit - male 42-52%
female 37-47%
, pregnant >33%
RBCs - male 4.7-6.1 mil/mm3
female 4.2-5.4 mil/mm3
WBCs - 5-10 thousand/mm3
platelets - 150-400 thousand/mm3
BUN - 5-18 mg/dL
Creatinine - male 0.6-1.2
female 0.5-1.1
ABGs - pH 7.35-7.45
PCO2 35-45 mmHg
PO2 80-100 mmHg
HCO3 22-28 mmHg
O2 sat 95-100%
SED rate/ESR - male- up to 15 mm/hr
female- up to 20 mm/hr
pregnant- incr in all trimesters
Prothrombin Time (PT) - 11-12.5 sec
slight decr in preg
international normalized ratio (INR) - 0.8-1.1
Fluid and Electrolyte Balance - Sodium: 135-145
Chloride: 98-107
**Potassium: 3.5-5.0
Calcium: 8.6-10.2
Phosphate: 2.7-4.5
Magnesium: 1.5-2.5
Albumin: 3.5-5.0
common food sources of potassium - avocado, bananas, cantaloupe, carrots, fish, mushrooms, oranges,
potatoes, pork, beef, veal, raisins, spinach, strawberries, and tomatoes.
Signs of hypocalcemia - paresthesias followed by numbness, hyperactive deep tendon reflexes, and a
positive Trousseau's or Chvostek's sign, increased neuromuscular excitability, muscle cramps, twitching,
tetany, seizures, irritability, and anxiety, increased gastric motility, hyperactive bowel sounds, abdominal
cramping, and diarrhea, prolonged QT interval and prolonged ST segment
hypercalcemia - shortened ST segment and a widened T wave
hyponatremia - Hyperactive bowel sounds, flat neck veins, diminished deep tendon reflexes, muscle
weakness, increased urinary output, and decreased specific gravity
hypernatremia - Muscle twitches, Decreased urinary output, increased specific gravity of the urine
hypermagnesemia - drowsiness, sedation, lethargy, respiratory depression, muscle weakness, and
areflexia.
low levels of albumin cause - edema! And drug toxicity if drug requires albumin to bind!
,5 Rights of delegation - -Right Task: can be delegated, normally repetitive and requires little supervision
and is predictable
-Right Circumstance: right setting and environment
-Right Person: 3 implications: right person delegating right task to right person to be performed to right
person
-Right Direction: communication, clear concise description of task
-Right Supervision: monitor task, give evaluation
essential steps of effective supervision - direction, evaluation, and follow-up
SBAR - Situation
Background
Assessment
Recommendation
6 Rights of Medication - Right Patient
Right Medication
Right Dose
Right Route
Right Time
Right Documentation
...also right evaluation & always assess after giving meds
hemoglobin - male 14-18 g/dL
female 12-16 g/dL
pregnant >11 g/dL
hematocrit - male 42-52%
female 37-47%
, pregnant >33%
RBCs - male 4.7-6.1 mil/mm3
female 4.2-5.4 mil/mm3
WBCs - 5-10 thousand/mm3
platelets - 150-400 thousand/mm3
BUN - 5-18 mg/dL
Creatinine - male 0.6-1.2
female 0.5-1.1
ABGs - pH 7.35-7.45
PCO2 35-45 mmHg
PO2 80-100 mmHg
HCO3 22-28 mmHg
O2 sat 95-100%
SED rate/ESR - male- up to 15 mm/hr
female- up to 20 mm/hr
pregnant- incr in all trimesters
Prothrombin Time (PT) - 11-12.5 sec
slight decr in preg
international normalized ratio (INR) - 0.8-1.1
