Insulin: Reg 30-60 min onset, 2-4 hr peak and 5-7 duration NPH 1-3 hr onset, 6-12 hr peak and 18-24 duration
Lispro-fast acting and to eat right away, DON’T MIX
Rules of Nines: 9% is head and both arms, 18% is front torso, back torso and both legs and 1% is groin
5 P's with fractues: pain,...
Na 135-145
K 3.5-5.5
Ca 8-10
Mg 1.5-2.0
Platelets 150,000-450,000
ptt 30-60 seconds
WBC 5,000-11,000
RBC 4.5-6.0 million
Hct 35-45%
Hgb 12-16
BUN 7-20
Creatinine 0.5-1.5
pH 7.35-7.45 below=acidic above=alkalosis
PaCO2 35-45 respiratory and ventilation
PaO2 80-100% oxygenation
HCO3 22-26 metabolic and renal function
Quickening 16 weeks
Fetal heart tones 20 weeks
Fetal heart rate 120-160
Fetal Heart strips:
VEAL CHOP
Variable Cord
Early Head
Accelerations Ok
Late Placental insufficiency
200-300 ml blood loss with vaginal birth, 500 ml with C-section, over is
hemorrhage
Heparin look at ptt and antidote is Protamine Sulfate
Coumadin look at INR and antidote is vitamin K
Mag Sulfate antidote is Calcium Gluconate
Narcotic antidote is Narcan
Tyenol antidote is Mucomist
,NCLEX RN UPDATED VERSION
Insulin: Reg 30-60 min onset, 2-4 hr peak and 5-7 duration
NPH 1-3 hr onset, 6-12 hr peak and 18-24 duration
Lispro-fast acting and to eat right away, DON’T MIX
Rules of Nines: 9% is head and both arms, 18% is front torso, back torso and
both legs and 1% is groin
5 P's with fractues: pain, pallor, pulselessness, paresthesia and paralysis
Addison's (ad-aldosteron deficiency to remember) disease- ↓na and ↑ k,
hypoglycemia.
remember – if there is low/absent na+ in the body, than nothing holds h2o in.
thus, ↑urine output, hypotension +, hypovolumia, dehydration and ↓ co.
major function of aldosteron – is to keep na+ in & k+ out of the body .
Cushing’s (too much glucocorticoids) syndrome is opposite to addison’s.
adrenal hypersecretion of glucocorticoids. ↑ na ↓k and ca, hyperglycemia.
When assessing think of the cushion (moon face, buffalo hump, truncal obesity).
pheochromocytoma - htn is a hallmark.
Sodium: 135-145
Hyponatremia: Nausea, muscle cramps, increased ICP, confusion,
convulsions. Treat with LR or 0.9%NaCl and water restrictions
Hypernatremia: weakness, disorientation, hallucinations, hypotension and
tachycardia. Treat with hypotonic solutions (D5W, 0.3% or 0.45%NaCl)
Hyperkalemia: EKG changes, dysrhythmia, cardiac arrest, muscle weakness,
paralysis. Treat with Kayexalate (can cause diarrhea), emergency situations
calcium gluconate, regular insulin, and dialysis
Calcium: 9-11
Hypocalcemia: Tetany, Trousseau’s sign- inflate BP cuff on upper arm=
carpal spasms. Chvostek’s sign- tap facial nerve= twitching of facial muscle.
Treat with calcium gluconate, seizure precaution, caution with digitalis
patients, phosphate binding antiacids, calcitriol, Vit D.
Hypercalcemia: sedation effect, muscle weakness, abdominal pain and
distention, depressed deep tendon reflexes.
Treat with Calcitonin, Lasix, prevent development of renal calculi, may be
caused by hyperparathyroidism.
Magnesium: 1.5-2.5 **Magnesium acts as a depressant
Hypomagnesium: increased neuromuscular irritability, tremors, tetany,
seizures, dysrhythmia, dysphagia. Treat with increase Mg (green veggies,
nuts, bananas, oranges, peanut butter, chocolate.) Magnesium sulfate, keep
self inflating breathing bag and monitor respirations, test ability to swallow
before PO fluids.
Hypermagnesium: Depresses CNS, depresses cardiac impulses, hypotension,
facial flushing, muscle weakness, absent deep tendon reflexes, shallow
respirations. EMERGENCY, treat with iv calcium gluconate, support
ventilation, (Mag Sulfate antidote is Calcium Gluconate)
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