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CDM 1 Exam 1 > Patient Assessment Values > Flashcards

Patient Assessment Values Flashcards

1
Q

Vital Signs 4 + 2

A

Temp
Blood Pressure
Heart Rate
Respiratory Rate

+
Oxygen Saturation
Pain

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2
Q

hypothermia temp

A

< 96.9F or 36C

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3
Q

Hyperthermia temp

A

> 100.4F or 38C

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4
Q

Temp conversion

A

(C* 1.8)+ 32

(F-32)/ 1.8

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5
Q

Systolic BP

A

Peak pressure in arteries

N: 120, R 100 - 140

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6
Q

Diastolic BP

A

Lowest Arterial Pressure

N: 80, R 70-90

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7
Q

Hypotensive BP

A

S <100 or D <70

or both

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8
Q

Normotensive BP

A

S 100-139 and D 70-89

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9
Q

Hypertensive BP

A

S > 140 or D > 90

or both

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10
Q

Reference Range HR

A

60 to 100 bpm

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11
Q

Bradycardia HR

A

< 60 bpm

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12
Q

Tachycardia HR

A

> 100 bpm

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13
Q

Reference Range Respiratory Rate (RR)

A

14 to 18 breath/min

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14
Q

Referemce Range O2 Sat

A

92 - 100% on Room air

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15
Q

Actual Body Weight

A

Wt Lbs / 2.2 = KG

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16
Q

Ideal Body Weight

A

Men: 50 + 2.3 (# of in over 5f)
Women: 45.5 + 2.3(# of in over 5f)

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17
Q

Metabolic Profile Chart Thingy

A

Na, Cl, Bun
—————– Glucose
K, HCO3, Cr

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18
Q

Sodium

A

R: 135 - 146 MEQ/L

Found predominantly in Extracellular fluid
Abnormalities usually result of change in water homeostasis

Fluid imbalances can be caused by volume overload (HF/LF) or volume depletion (V/ Blood loss)

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19
Q

Hypernatremia

A

> 146 MEQ/L

Sodium gain most common cause’Occurs secondary to intake of high-Na containing products (0.9 NaCL, antibiotics like oxacillin)

Typically asymptomatic, but muscle spasm may occur

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20
Q

Hyponatremia

A

< 135 MEQ/L

typically caused by loss of sodium, gain of water or both

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21
Q

Hyponatremia Symptoms

A

Fatigue
confusion
muscle weakness/spasm
and coma in serious case

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22
Q

Hyponatremia Sodium causes

A

Excess sweating, nausea/vomiting, medication (diuretics), or shifting from extra to intracellular spaces.

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23
Q

Hyponatremia Water Gain

A

Increased intake

SIAD which incur water retention

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24
Q

Potassium

A

R 3.4-5.2 MEQ/L

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25
Q

Hypokalemia

A

<3.4 MEQ/L

Typically caused by fluid loss

Bleeding, diarrhea, diuresis, vomiting

Poop can have 40-60 mEq/L of K

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26
Q

Hyperkalemia range

Typical cause and induced by

A

> 5.2 MEQ/L

Typically caused by renal dysfunction (Decrease clrance)

May be drug induced (ACEi,ARB,Ksparing Diuretics)

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27
Q

Hypo-, Hyperkalemia Symptoms and Signs

A

Muscle Weakness

Dysrhythmias can be induced

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28
Q

Chloride

A

R 98-110 MEQ/L

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29
Q

Hypochloremia

Cause and symptoms

A

< 98 MEQ/L
Cause: Diuretic use, vomiting

May cause muscle excitability and tremors

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30
Q

Hyperchloremia

Range, cause, symptoms

A

> 110 MEQ/L
Cause: Diuretic use, vomiting

May cause weakness and Lethargy

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31
Q

Bicarbonate

A

R 24-32 MEQ/L

Marker of Acid/base balance

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32
Q

Hypobicarbonatemia

A

<24 MEQ/L

may indicate acidotic process (Metabolic, diabetic ketoacidosis) or OD of ethylene, methanol, salicylates

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33
Q

hyperbicarbonatemia

A

> 32 MEQ/L

levels may indicate long term COPD or alkaloid process

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34
Q

Blood Urea Nitrogen (BUN)

A

R 7-23 MG/DL

waste product from production of ammonia by liver
healthy kidney can filter and remove this via urine

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35
Q

Low BUN levels may indicate

A

Liver Disease/Damage

Malnutrition

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36
Q

High BUN levels may indicate

A

Renal Disease/damage
dehydration
high protein intake

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37
Q

Serum Creatinine (SCR)

A

0.5 - 1.1 MG/DL

waste product produced mostly by muscle metabolism

38
Q

Low Scr can indicate

A

Lack of nutrition

muscle disease

39
Q

high Scr can indicate

A

Renal Disease/damage

excess muscle mass

40
Q

Glucose (Glu)

A

R 70-100 Mg/DL

regulated by insulin and glucagon

41
Q

Glucose level <60 mg/dl can…

A

induce somnolence and coma

42
Q

Glucose level >125 mg/dl can…

A

indicate impairment and may lead to diagnosis of diabetes

43
Q

Serum Calcium (CA)

A

R 8.4 - 10.4 Mg/DL

Regulated by Vitamin D and parathyroid hormone
99% stored Skeleton and teeth
40% bound to serum albumin

44
Q

Hypocalcemia Causes

A

< 8.4 mg/DL
Poor calcium intake and/or Vitamin D deficiency

Hypoparathyroidism

45
Q

Hypocalcemia Symptoms/side effects

A

Paraesthesia
Tetany
QTc Prolongation/ Arrhythmias

46
Q

Hypercalcemia Causes

A

> 10.4 mg/DL

Malignancy due to bone metastases
Hyperparathyroidism
Renal insufficiency

47
Q

Hypercalcemia Symptoms/ side effects

A

“Bones, stones, groans and psychic moans”

Lytic lesions
Urinary calculi
Malaise
N/V
Mental Status Changes (Confusion, depression)
48
Q

Components of Serum Calcium

A

Albumin Bound Calcium (40%)
ionized (free) Calcium ( 45%)
Salt-bound calcium (15%)

49
Q

Serum vs Ionized Calcium

A

Changes in serum calcium can be due to any one of the 3 features (Albumin, Ionized, salt bound)

Not as sensitive as changes in serum calcium can be seen with no alteration to ionized calcium

?????????

50
Q

Ionized calcium

A

only fluctuates with changes in parathyroid hormone and vitamin D levels

C Range: 4.4-6 mg/dL
A Range: 4.4 - 5.3 mg/dL

51
Q

Corrected serum Ca calc

A

Observed serum Ca + 0.8(4-serum albumin)

52
Q

Phoshate

A

R 2.4 - 4.4 MG/DL

53
Q

Hypophosphatemia

A

< 2.4 mg/DL

Moderate: 1-2.5 mg/DL
Severe < 1mg/DL

54
Q

Hypophosphatemia Causes

A

Inadequate dietary intake
Hyperparathyroidism (Inc excretion0
DKA = Diabetic ketoacidosis

55
Q

Hypophosphatemia Symptoms/Side effects

A

Muscle Weakness/dysfunction

Mental Status changes

56
Q

Hyperphosphatemia

A

> 4.4 mg/DL

57
Q

Hyperphosphatemia Causes

A

Common renal failure

58
Q

Calcium Phosphate Product

A

Ca X PO4

If product is >55 in CKD, precipitation occurs and lytic lessons form

59
Q

Magnesium

A

R 1.6 - 2.6 mg/dl

60
Q

Hypomagnesemia

A

< 1.6 mg/dL

61
Q

Hypomagnesemia causes

A

V, diarrhea, diuretics

often coincides with hypokalemia, replace Mg along with K

62
Q

Hypomagnesemia Symptoms/Side effects

A

N,V, and EKG changes

63
Q

Hypermagnesemia

A

> 2.6 mg/DL

64
Q

Hypermagnesemia Causes

A

Excessive magnesium intake or renal failure

65
Q

Hypermagnesemia Symptoms/Side effects

A

Sedation, N/V, decreased reflexes and EKG changes

66
Q

AST/ALT

A

R 0-35 IU/L

Increase may indicate injury (hepatitis or cirrhosis)

67
Q

Meds that can cause increase AST/ALT are..

A

Statins
TZDs
EtOH

68
Q

Alkaline Phosphatase

A

R 30-120 U/L

increases may indicate an obstruction (Liver/biliary) or bone disease/breakdown (Paget’s disease)

69
Q

Lactate Dehydrogenase

A

R 50-150 U/L

increases may indicate some type of liver dysfunction
almost always increases post MI within 10/12hr

70
Q

If total bilirubin increase > 2mg/dl then…

A

jaundice can develop

71
Q

Bilirubin

A

total: 0.1-1 mg/dl
Direct: 0-0.2mg/dl

72
Q

Hyperbilirubinemia

A

Prehepatic (hemolysis)

Hepatic (defective removal of bilirubin from blood or conjugation)

Posthepatic or cholestatic (obstruction)

73
Q

Albumin

A

R 3.5-5 G/DL

marker of true hepatic function

74
Q

3 Major functions of Albumin

A

controlling oncotic pressure in plasma

Transporting amino acids synthesized in liver to other tissues

Transporting poorly soluble ligands

75
Q

Amylase & Lipase

A

0-130 IU/L
0-160 IU/L
enzymes secreted b pancreas for breakdown

increase after onset of acute pancreatitis in most patients

76
Q

INR

A

R 0.8-1.2

Measure clotting tendency of blood

prolonged in those receiving warfarin, or liver damage

77
Q

Complete blood count includes

A

Hgb
Hct
WBCs
RBCs

78
Q

HgB range

A

Males: 14-18 g/DL
Females: 12-16 g/dL

79
Q

Platelets range

A

140-400 x 10^3 m/l

80
Q

Hct

A

39-49% males

33-43% females

81
Q

WBC

A

3.2-9.8 10^3 cells

82
Q

Anemia occurs when….

A

Hgb,HcT, and/or RBC decrease

83
Q

Neutrophils

A

60% of WBC

increase: infection, tissue destruction, inflam disease, stress, steroids
decrease: cancer, post chemo, side effects of drugs

84
Q

Absolute neutrophil count

A

WBC * % Neutrophils

85
Q

Bands

A

5% of WBC

increase in response to acute infection

left shift = bands >5%

86
Q

Lymphs

A

30% of WBC

87
Q

moncytes

A

7% of WBC

increase in subacute bacterial endocarditis, malaria, TB, recovery phase form infection, initial recovery from chemo

88
Q

Eosinophils

A

make up 3% of WBC

89
Q

Basophils

A

Make up <1% of WBC

maybe increased in chronic inflam and leukemia

90
Q

Cockcroft and Gault Equation

A

use IBW unless patients ABW is less, then use ABW

((140-age)X(IBW))/(72XSCr)

X 0.85 if women

91
Q

Hematology Chart thing

A

\ HgB /
WBC———– Platelets
/ Hct \

CDM 1 Exam 1 (14 decks)

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