RBC - ✔✔ females 4.2-5.4 million
males 4.7-6.1 million
decrease RBC - ✔✔ anemia
WBC - ✔✔ 5,000-10,000
elevated WBC - ✔✔
... [Show More] infection
decreased WBC - ✔✔ immunosuppression
Iron - ✔✔ females 60-160 mcg
males 80-180
elevated iron - ✔✔ hemochromatosis, iron excess
liver disorder, magaloblastic anemia
decreased iron - ✔✔ anemia or hemorrhage
platelets - ✔✔ 150,000-4000,000
increased platelets - ✔✔ malignancy or polycythemia vera
decreased platelets - ✔✔ autoimmune disease
bone marrow suppression or enlarged spleen
Hbg - ✔✔ females 12-16
males 14-18
decrease Hgb and Hct - ✔✔ anemia
Hct - ✔✔ females 37%-47%
males 42-52%
anemia in children
S & SX: - ✔✔ pallor, brittle spoon shaped nails
irritability, muscle weakness
systolic heart murmur, enlarged heart, HF
iron supplements - ✔✔ give 1 hr before or 2 hr after antacid to prevent malabsorpt
N/D and constipation common at start of therapy
use straw for liquid iron to prevent staining of teeth
aPTT - ✔✔ 1.5-2X control range of 30-40 seconds
test clotting factors and monitor heparin therapy
increased aPTT - ✔✔ hemophilia
disseminated intravascular coagulation DIC
liver disease
PT - ✔✔ 11-12.5 seconds, 85-100%
increased PT time - ✔✔ evidence of deficiency or clotting
decreaed PT time - ✔✔ evidence of vit K excess= bleed out
acute hemolytic blood transfusion reactions - ✔✔ **low back pain, TACHYcardia, HYPOtension
febrile reactions - ✔✔ 30 min-6 hr after transfusion
-chills, fever, flushing, headache
use WBC filter, administer antipyretics
mild allergic reactions - ✔✔ during or up to 24hr after transfusion
- itching, urticarial, flushing
administer benadryl
anaphylactic shock - ✔✔ wheezing, dyspnea, cyanosis, hypotension
maintain airway, admin O2, IV fluids, antihistamines, corticosteroids and vasopressor
fluid overload - ✔✔ HYPERtension,
jugular vein distention, peripheral edema
orthopnea, crackles at base of lungs
sudden anxiety
sepsis and septic shock - ✔✔ -fever, N/V, abdominal pain, chills HYPOtension
administer antibiotics, blood cultures, vasopressor (dopamine)
if disseminated intravascular coagulation (DIC) - ✔✔ admin heparin in early stage
-blood products and clotting factors in late stage
PICA - ✔✔ eating things like soil, chalk, for at least 1 month
parenteral iron - ✔✔ given Z track
erythropoietin - epoetin alfa (epogen, Procrit) - ✔✔ used to increased production of RBC
monitor increase in BP, Hgb, Hct
folic acid - ✔✔ turn urine dark yellow
necessary for new RBC
hypovolemia causes - ✔✔ peritonitis, ascites, burns , NPO
causes of dehydration - ✔✔ hyperventilation
DKA
tube feeding without sufficient water intake
subjective and objective HYPOvolemia - ✔✔ Hyperthermia, Tachycardia, HYPOtension
decreased central venous pressure
hypoxia
thirst, dizziness, N/V,
-poor skin turgor, tentin
lab test hypovolemia - ✔✔ increased: HCT, specific gravity, NA, protein, BUN, glucose
Hypervolemia causes - ✔✔ HF, cirrhosis, increased gluccorticosteroids
hypertonic fluids
S & SX HYPERvolemia - ✔✔ bounding pulse, increased CVP, HYPERtension, confusion, muscle weakness, ascites, diminished breath sounds, distended neck veins
lab test HYPERvolemia - ✔✔ Decreased: HCT, BUN, electro
respiratory alkalosis PaCO2 less than 35, increased PH
notify doctor if - ✔✔ weight gain 1-2 lb/24 or 3 lb in a wk
foods high in potassium - ✔✔ avocados, broccoili, dairy products, dried fruit, cantaloupe, bananas
HYPOcalcemia - ✔✔ positive chvosteks ( facial twitching)
positive trousseau (hand/finger spasm with blood pressure cuff inflation
excess caffeine causes excretion - ✔✔ calcium in urine
secondary osteoporosis results from - ✔✔ hyperparathyroidism, long term corticosteroid
long term anticonvulsant (Dilantin)
manifestations: kyphosis
stages of grief - ✔✔ 1. denial 4. depression
2. anger 5. acceptance
3. bargaining
theophylline - ✔✔ relaxation of bronchioles causing bronchodilator
oral used to control asthma or COPD
therapeutic range 5-15
avoid in HTN, liver and kidney dysfunction
theophylline interactions - ✔✔ caffeine
glucocorticoids:
beclomethasone- inhalation
prednisone- PO - ✔✔ prevent inflammation, suppress airway mucus production
leukotriene (monelukast) - ✔✔ suppressing inflammation, bronchoconstriction's, airway edema, mucus production
digoxin - ✔✔ makes the heart beat stronger and regular rhythm
therapeutic 0.5-2.0
S & SX of dig tox - ✔✔ fatigue, weakness, vision changes, GI effects
infuse over 5 min
hemophilia - ✔✔ difficulty controlling bleeding
X linked recessive disorder
joint pain and stiffness, impaired mobility, easy bruising
slurred speech
lab test indication of hemophilia - ✔✔ prolonged aPTT
avoid unnecessary needle sticks, apply pressure for 5 mins after needle sticks
monitor for occult blood
DDAVP - ✔✔ synthetic form of vasopressin increases plasma factor VIII
not for hemophilia B
acute hemolytic blood transfusion reactions - ✔✔ **low back pain, TACHYcardia, HYPOtension, hemoglobinuria,
ICP - ✔✔ 10-15 mm Hg
mannitol - ✔✔ osmotic diuretic treat cerebral edema
phenytoin (Dilantin) - ✔✔ prophylactically to prevent or treat seizures
crainiotomy - ✔✔ removal of nonviable brain tissue that allows for expansion or removal of epidural or subdural hematomas
KUB (kidneys, urter, bladder - ✔✔ determines size shape and position of structures
cystoscopy - ✔✔ use a scope to visualize the bladder and urthera
reflex incontinence - ✔✔ Reflex - The involuntary loss of a moderate amount of urine usually without warning due to
hyperreflexia of the detrusor muscle, usually from altered spinal cord activity.
treatment for urinary infections - ✔✔ gentamycin and Keflex take with food
may change urine odor and report loose stools
TCA (nortriptyline (pamelor) - ✔✔ helps relieve urinary incontinence
-cause dizziness
monitor BP, don't take with MAOI [Show Less]