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ATI PN Comprehensive Predictor Exam 11
BUN levels - 10 - 20 WBC levels - 5,000-10, Serum creatinine levels - males 0.6-1.2; females 0.5-1. Therapeutic digoxin levels - 0.8-2. HbA1c levels - 4%-6% Fasting glucose levels - 70 - 105 HDL levels - males 35-65; females 35- 85 Total serum cholesterol levels - less than 200 LDL levels - less than 130 ABG values [pH, PCO2, HCO3] - pH 7.35-7. PCO2 35- 45 HCO3 21- 28 Phosphorus levels - 3 - 4. Platelet levels - 150,000-400, aPTT levels; therapeutic level? - 30 - 40 seconds; therapeutic is 1.5 to 2 times the normal INR levels - 0.7-1. Therapeutic level for INR with anticoagulant therapy - 2 - 3 PT levels; therapeutic level? - 11 - 12.5 seconds; therapeutic is 1.5 to 2 times the normal Chloride levels - 98 - 106 Calcium levels - 9 - 10. Diseases that require airborne precautions - measles, TB, herpes zoster and varicella Heparin antidote - protamine sulfate Coumadin antidote - vitamin k Digoxin antidote - digibind
Alcohol withdrawal antidote - librium (chlordiazepoxide) Potassium levels - 3.5- 5 Sodium levels - 136 - 145 Magnesium sulfate antidote - calcium gluconate Magnesium levels - 1.3-2. Diseases for droplet precautions [SPIDERMAN] - S - scarlet fever; sepsis P - pneumonia; pertussis I - influenza D - diphtheria E - epiglottitis R - rubella M - mumps; meningitis AN - adenovirus Risk factors of metabolic alkalosis - ingestion of antacids; GI suction; hypokalemia; blood transfusion; prolonged vomiting; total parenteral nutrition A cause of metabolic acidosis - diarrhea [acidosis - from the ass]; fever; hypoxia; starvation; seizure; kidney failure; diabetic ketoacidosis; dehydration Hemoglobin levels - males 14-18; females 12- 16 Hematocrit levels - males 42%-52%; females 37%-47% ESR levels - less than 20 Glucose levels [urinalysis] - less than 0.5g/day Specific gravity [urinalysis] - 1.005-1. Therapeutic lithium levels - 0.4-1. 1mg = _mcg - 1, 1g = _mg - 1, 1kg = _g - 1, 1kg = _lb - 2. 30mL = _oz - 1 1L = _mL - 1,
A - aspirin (NO!) N - needles (small gauge) D - decrease needle sticks I - injury (protect from) Stomach pain in upper right quadret - gallstones, stomach ulcers, pancreatitis Stomach pain in upper left quadret - stomach ulcer, duodenal ulcer, biliary colic, pancreatitis Stomach pain in lower right quadret - appendicitis, constipation, pelvic pain, groin pain (inguinal hernia) Stomach pain in lower left quadret - diverticular disease, pelvic pain, groin pain Stomach pain in upper middle quadret - stomach ulcer, heartburn/indigestion, pancreatitis gallstones, epigastric hernia Lab values for renal failure - low magnesium and high creatine
- tomy - the surgeon cut something
- ectomy - the surgeon cut something out
- ostomy - the surgeon made an opening
- plasty - the surgeon changes the shape of something
- pexy - the surgeon moved the organ to the right place
- rraphy - the surgen sewed something up
- desis - the surgeon made two things stick together Vaccinations contraindicated in pregnant women - smallpox, measles, mumps, rubella, varicella Don't give what food with MAOIs - tyramine (chocolate, alcohol, and fermented foods like cheese) NEVER give _ in IV push - potassium Do not give _ at bedtime - tetracycline; don't let them lie down b/c it might cause gastric reflux S/S of LSHF - cyanosis, tachycardia, orthopnea, pulmonary congestion (cough, crackles, wheezes, blood-tinged sputum, tachypnea) restlessness, paroxysmal nocturnal dyspnea S/S of RSHF - edema, weight gain, ascites, distended jugular veins, fatigue, anorexia
Risk factors of respiratory acidosis - respiratory depression; pneumothorax; airway obstruction; inadequate ventilation Risk factors of repiratory alkalosis - hyperventilation; hypoxemia; altitude sickeness; asphyxiation; asthma; pneumonia Response for fire [RACE] - R - rescue A - alarm C - contain E - extinguish How often to remove restraints and check on client - every 2 hours Characteristics that increase risk for falls - older age, cognitive/sensory impairment, impaired mobility, bowel and bladder dysfunction, side effects of medications, and history of falls Equipment at client's bedside for seizure precautions - oxygen, oral airway, and suction equipment Description of semi-fowlers - head of bed elevated at 30 degrees Description of fowlers - head of bed elevated to 45 degrees Description of high-fowlers - head of bed elevated to 90 degrees Description of supine - lying on back, head, and shoulders Description of prone - lying on abdomen, legs extended, and head turned to side Description of lithotomy - lying on the back with hips and knees flexed at righ angles and feet in stirrups Description of sims - lying on left side with most of the body weight borne by the anterior aspect of the ilium, humerus, and clavicle (client is unconscious or receiving enema) If patient isn't voiding, don't give ... - potassium Manifestations of hypokalemia (low potassium) - muscle weakness, cramping, nausea, vomiting, decreased bowel motility, dysrhythmias, irritability Manifestations of hyperkalemia (high potassium) - peaked T waves, ventricular dysrhythmias, increased bowel motility Addison's disease need to add ... - cortisol Newborn vital signs - HR 100- 160 R 40- 60 BP 60-80 systolic; 40-50 diastolic APGAR categories - HR, respiratory effort, muscle tone, reflex irritability, color
S/S of meningitis - fever, headache, irritability, altered LOC, nuchal rigidity, increased ICP Latex allergy manifestation - rhinorrhea (thin, watery discharge from the nose) Foods to avoid when taking aldactone - salt substitutes and foods with high levels of potassium Foods rich in vitamin A - liver, egg yolk, whole milk, butter, green and yellow veggies Foods rich in vitamin D - fish oils, fortified milk and margarine, sunlight Foods rich in vitamin K - egg yolk, liver, cheese, green leafy veggies Foods rich in vitamin C - citrus fruits, tomatoes, broccoli, cabbage Foods rich in vitamin B12 - lean meats, kidneys, liver Foods rich in thiamine - lean meats, whole grain cereals, leguems Foods rich in riboflavin - milk, organ meats, enriched grains, green leafy veggies Foods rich in niacin - meat, beans, peas, peanuts, enriches grains Foods rich in folic acid - leafy green veggies, eggs, liver Diabetics and foot care - Diet management for Diverticulosis - high-fiber diet Diet management for Diverticulitis - begin with clear liquids, then advance to low-fiber diet; low residue Positioning for hip arthroplasy - keep abductor pillow in place while in bed; don't flex hip more than 90 degrees Positioning for knee arthroplasty - maintain continue passive motion machine to promote joint mobility Nursing intervention for Addison's Disease - monitor and treat hypoglycemia Nursing intervention for Cushing's Disease - monitor and treat hyperglycemia Contributing factors to type 2 diabetes - family history, obesity, race/ethnicity, hypertension, history of gestational diabetes, and sedentary lifestyle Position for spinal cord injuries - high-fowlers Nursing interventions for radiation treatment - monitor condition of skin; clients should wear soft, loose clothing, and avoid exposure to sun
Foods rich in iron - fish, organ meats, green leafy veggies, enriched breads/cereal/macaroni, whole grain products, dried fruit like raisins and apricots, and egg yolk Calculating delivery date - subtract 3 months and add 7 days to the first day of the last menstraul period Five rights of delegation - right person, task, circumstances, direction and communication, and supervision and evaluation Scope of practice for LPN - meets the health needs of clients, care for client whose condition is considered to be stable and/or chronic with an expected outcome, performs reinforcement teaching, contributes to care plan (doesn't make them), administers IVPB medications, and monitors IV fluids autonomy - the right to make one's own decision beneficence - the obligation to do good for others fidelity - the obligation to be faithful to an agreement and responsibility; to keep promises nonmaleficence - the obligation not to harm others veracity - the obligation to tell the truth Buddhism dietary restrictions - vegetarian diet practiced by many; avoids alcohol Catholicism dietary restrictions - some may abstain from eating meat on Ash Wednesday and on Fridays during Lent Christian science dietary restictions - must abstain from alcohol Hinduism dietary restrictions - vegetarian diet is encouraged; most abstain from beef and pork; right hand is used for eating and left hand for toileting and hygiene; several days a year are set aside for fasting Islam dietary restrictions - food must be lawfaul; pork, alcohol, and some shellfish are prohibited; ramadan is a period of fasting during the ninth lunar month Judaism dietary restrictions - food is required to be kosher; meat and dairy can't be on same plate; pork and shellfish prohibited; fasting required on yom kippur; lactose intolerance is common among Jews of European origin Maximum IM injection dose for small infants - doesn't exceed 0.5mL Maximum IM injection dose for small children - doesn't exceed 1mL Average time for IV peak levels - 30 minutes Average time for IM peak levels - 1 hour
Manifestations of PE - dyspnea; tachypnea; chest pain; tachycardia; anxiety; diaphoresis; decreased SaO2; pleural effusion; crackles and cough Medical Asepsis (Clean Technique) - perform hand hygiene frequently; use PPE as indicated; don't place items on the floor of client's room; don't shake linen; clean least soiled area first; place moist items in plastic bags; reinforce education with client and caregivers Surgical Asepsis (Sterile Technique) - avoid coughing, sneezing, and talking directly over field; only dry sterile items touch the field (1 inch border is nonsterile); keep all objects above the waist; wash hands and don sterile gloves to perform procedure Nursing Interventions for Delirium - establish client's baseline LOC by interviewing family; monitor VS and perform neuro chekcs; monitor for acute onset and fluctuating LOC; maintain comfort measures; monitor ability to function in the immediate environment; determine physiologic reason delirum is occuring Acceptable ways to ID patient - patient's name, DOB, assigned ID number, telephone number, or other person-specific identifier Hot water heater setting for infant safety - 120.2F (49C) or lower Bath water temp for infants - 97.9F (36.6C) to 99F (37.2C) Where to test bath water - inner wrist Time to feed newborns - every 2-3 hours Stool during breastfeeding - loose, pale, and/or yellow Number of wet and poopy diapers per day - 6 - 8 wet and 3-4 poopy Cord care - keep cord dry; keep the top of the diaper folded underneath it; cord falls off around 10-14 days after birth; give sponge baths and avoid submerging newborn until cord falls off Circumcision education - change diaper at least every 4 hours and clean with warm water; following clamp procedures, apply petroleum jelly each diaper changes fro at least 24 hours after to keep diaper from adhering to penis; apply diaper loosely; don't give tub bath; warm water should be trickled; avoid premoistened towelettes; Never put these in a newborn's crib - pillows, large floppy toys, or loose plastic sheets; they can suffocate Preventing food poisoning - hand hygiene; ensure meat and fish are cooked to the correct temp; check expiration dates; refrigerate perishable items Precautions for Vancomycin-Resistant Enteroccoccus (VRE) - standard/contact precautions; hand hygiene and gloves; gown if in contact with contaminated materials
Precautions for Staphylococcal Infection - standard/contact precautions; gloves, PPE including gown/mask if in contact with site of infections Breastfeeding teaching - alternate breasts; feed every 2-3 hours (8-12 times in 24 hrs); place baby on back after feeding; breast milk can be stored at room temp for 4-6 hrs, refrigereated in sterile bottles for use withing 8 days, or frozen in steril containters for 3-6 months; thaw milk in refrigerated, under running lukewarm water, or placed in container of lukewarm water (microwaving can destroy immune factors and can lead to hot spots that can burn newborn); discard used portions of breast milk; avoid alcohol and limit caffeine Folate and pregnancy - Non-stress test interventions (pregnancy) - seat client in a reclining chair or place in semi- fowler's or left lateral position; monitor response of fetal HR to fetal movement Sodium recommendations - 1,500mg/day or less Albumin levels - 3.5- 5 Total bilirubin - 0.1- 1 Total protein - 6 - 8 Creatine clearance - males 90-139; females 80- 125 Toxic level of Digoxin - greater than 2. Mixing insulin - clear (regular) before cloudy (HPN) S/S of physical abuse - bruises, welts in various stages of healing; burns; fractures; lacerations; lack of emotional response; withdrawal; aggression S/S of emotional neglect and abuse - failure to thrive; eating disorder; withdrawal; extreme behaviors; delayed development; attemtps suicide; sleep disterbances S/S of sexual abuse - bruises; lacerations; bleeding of genitalia, anus, or mouth; STI; difficulty walking or standing; UTI; withdrawn; personality changes; regressive behaviro Medications for detoxification - chlordiazepoxie (Librium); diazepam (Valium); lorazepam (Ativan); oxazepam Medications for smoking cessation - bupropion (Zyban); nicotine gum (Nicorette); nicotine patch (Nicotrol); nicotine nasal spray (Nicotrol NS); vareniciline (Chantix) Psoriasis and vaccines - shouldn't receive any live vaccines while taking medication Interventions for ICP - avoid extreme flexion, extension, or rotation of heat; elevate HOB at least 30 degrees; monitor fluid and electrolyte values (may restrict fluid to prevent increased cerebral edema); maintain seizure precautions; avoid coughing, sneezing, straining, and suctioning;
