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Monday, December 27, 2010

Normal Values (Laboratory Tests, etc.)

NORMAL  VALUES

HgAIC = <7%
HDL  > 40mg/dl
Serum ammonia 15 to 45mcg/dl
Blood loss during menses – 40ml
Theophylline level – 10 to 20mcg/ml
Serum amylase 25 to 151
Serum lipase 10 to 140
Serum ammonia 35 to 65 mcg/dl
PCWP 8 to 13mmHg normal with RDS
Nasogastric tube suction pressure 25mmHg
Digoxin - .5 to 2.0 ng/ml
Normal aPTT – 40 SECS. (x 1.5 and 2.0 times normal, making the aPTT 60to 80 secs)
·        If decreased – prone to clotting
·        If increased – lower it down coz u will bleed
Digoxin 0.5 to 2.0 ng/m
Normal INR – 2.0 to 3.0 ; for clients with mechanical heart valves – 3.0 to 4.5
Normal PT – 12 to 14 secs. pt time 1.5 to 2.5 times the normal
Serum albumin – 3.4 to 5g/dl
Normal serum osmolality 285 to 295mosm/kg
Normal ICP 0 to 10mmhg
Magnesium – 1-6 to 2-6 mg/dl
Magnesium : 4 to 8mg/dl
PTT 1.5 to 2.5 x control

Fasting blood sugar – 70 to 110mg/dl
Serum lipase – 20 to 180 iu/l
Urine gravity 1.018 to 1.024
Total cholesterol level – less than 200mg/dl
Triglycerides <250mg/dl
Goal BP in diabetic pt – 130/80
FBS 80-120mg/dl
Phosphate 2.5 – 4.5
1L D5W = 170 calories
RBC 4-6 mm3
Normal lifespan of RBC 80-120 days
WBC: 5,000-10,000/mm3
Folic Acid- 1.8-9ng/ml
Vitamin B12: 200-900pg/ml
Completely soaked sanitary napkin = 50ml
Neutrophil (ans) 1,500 & up normal
                    <1,000 moderate risk for infection
                    <500 high risk for infection
                    <100 and less life threatening
= inc infection <ANC
neutrophil 2,00/mm3
normal PR interval: .12-.20 secs.
normal QRS :  .08 -.10 secs.
normal P wave : .11secs.
adult CPR :        depressed sternum : 1.5 to 2 inches
                compression 15:2
ESR .5 – 1.5%
Calories of TPN: 3,000-4,000 cal/day
1L = insensible loss (add usually output)

pressure of suction – 80-120mmhg (adult)
alcohol metabolism = 20mg/dl/hr
protime 12 to 20 secs
Magnesium level therapeutic 4.8 – 9.6 mg/dl
Admin of potassium: 5-10 mEq/hr not to exceed 20 meq/hr
CVP – 3 to 8 cm water pressure
Vancomycin therapeutic level: 10-25meg/ml
1 gm = 1 ml
Cerebral perfusion pressure : 70-100
Dilantin level: 10-20m3g/ml
Normal ICP : 10-20
Parkland formula: 4ml x Wt in Kg x % of body surface burned(amount of fluid to be given in 24 hrs)
Normal pulmonary arterial wedge pressure: 4-12mmhg
        If inc: hypervolemia
        If dec: hypovolemia
INR>6 < spontaneous bleeding
Normal INR : 2.0 to 3.0
ICP – 0-15mmhg if >20mmhg considered to be increased
NORMAL CVP 8 cm of h2O
Suction pressure 80-120mmhg
Calcium: 9.3-10.9 mg/dl
Chloride:9.5 to 10.5meq/l
Mg: 1.5 – 2.5 mEq/l
Phosphorus: 2.5 – 4.5 meq/L
Creatinine: .6-1.35 mg/dl
                <2 in older calients
Phenylalanine - <2mg/dl
LDH:100-190 u/l
CPK: 21-232 ul
Alkaline phosphatase: 4.5 to 13 units/dl
Total bilirubin: 8.4 to 10.2 mg/dl
Normal fasting blood glucose: 70 to 115mg/dl            
Hemoglobin: females 12 to 16g/dl
                      Males 14 to18g/dl
Coagulation time: 1 to 9 mins.
Sedimentation rate 0 to 30mm/hr
Total bilirubin <1.5mg/dl
Tegretol: 3 to 14mcg/ml
CHEST COMPRESSION IN AN INFANT – 100 per minute


Sunday, December 26, 2010

TURP

Transurethral resection of the prostate (TURP)
   The most common type of surgical procedure for BPH.
   A resectoscope is inserted through the urethra into the prostate to remove the blocking portions of the prostate.

Saturday, December 25, 2010

GENERAL TEST TAKING RULES FOR NCLEX

General Test Taking Rules for NCLEX
Identify the topic of the question
   Read from the first word to the last word
   Look for hints in the wording of the question

Select an answer by eliminating choices:
   Stem, Distractors, Correct Answer/s
   Information based questions vs. Analysis/Application questions
   Not sure? – leave the option for consideration
   Do not use background information unless absolutely necessary.
   NCSBN constructs test questions so the incorrect answers reflect background info.
   Will include too much info, often distractors.  Be careful!
   Do not read into the question
   Think about what the answer choices REALLY mean.
   What the patient is saying & how it reflects to the situation
   Patience & thoughtful consideration

Key words:
   The best, first/last, sometimes, priority, most appropriate, probably, usually, understands, indicate, chief purpose, early/late stage, immediately after, almost immediately, after several days, on the day of admission, before discharge, most likely/least likely, post op, initial nursing action, highest priority, give immediate attention

While taking the exam…
   Keep moving forward!
   Don’t listen to negative words or behavior.
   Don’t be anxious if other test takers seem to be working harder on answering questions more quickly.
   Keep breathing!
   Do some quick isometric exercise during the exam. This is helpful especially if your concentration is wandering or energy is waning.



“If you’re going through storms right now, know that better days are ahead.  Because God is faithful.  You will overcome.  Because God is faithful.  You will be victorious.  Because God is faithful.  The Bible says, He will not abandon you… (Deuteronomy 4:31)”




Friday, December 24, 2010

RULES OF MANAGEMENT

   The Rules of Management
1.    Do not delegate assessment, teaching, or evaluation
2.    Delegate care for stable patients with expected outcomes
3.    Delegate tasks that involve standard, unchanging procedures
4.    Stable vs. unstable

   Right Task – can the task be delegated?
   Right person – who is the competent person for the selected task?
   Right communication – how do I get the person selected for the task to understand what I want?
   Right feedback – “How do I give feedback during my periodic inspection?”


Nurse’s aide, unlicensed assistive personnel (NA, UAP’s) does the following:
   Bed making, bathing, feeding, ambulating, general ADLs
   Unchanging, uncomplicated tasks
   Stable clients

Licensed Practical Nurse (LPN), Licensed Vocational Nurse (LVN’s)
Procedures requiring knowledge of sterile technique, medication administration (PO, SQ, IM but not IV)
   Examples: suctioning, catheterization, wound care
   Supplementary health teaching

Registered Nurses (RN’s)
   Decision making for all facets of client care
   Communicates with members of the health care team to relay changes in client’s condition
   Examples; administering chemotherapy, starting BT, caring for ventilator clients
   Most critically ill or sickest client

A 7-year old boy with a compound fracture of the left femur is being admitted to a pediatric unit.  Which of the following actions is best for the nurse to take?
1.  Ask the nursing assistant to obtain the child’s vital signs while the nurse obtains a history from the parents.
2.  Ask the LPN/LVN to assess the peripheral pulses of the child’s left leg while the nurse completes the admission forms.
3.  Ask the LPN/LVN to stay with the child and his parents while the nurse obtains phone orders from the physician.
4.  Ask the nursing assistant to obtain equipment for the child’s care while the nurse talks with the child and his parents.

Answer: 4