Mark Klimek Blue Book - all letters Questions &Exam (elaborations) answers 100% satisfaction guarantee Latest update 2024/2025 with complete solution
Hypokalemia <3.5 - ANSWER: causes of hypokalemia include gastrointestinal losses
(eg, vomiting, diarrhea, nasogastric suctioning) and medications (eg, insulin
Hyperkalemia >6.0-7.0 - ANSWER: Give D50w with regular insulin first because it will
drop the potassium quicker
Administration of IV 50% dextrose and regular insulin rapidly corrects an elevated
serum potassium level by shifting potassium intracellularly.
Hyperkalemia >6.0 with tall peak T waves, with ECG changes - ANSWER: give calcium
gluconate first
-If the client has ECG changes from hyperkalemia, calcium gluconate should be given
first to stabilize cardiac muscle.
Potassium chloride (KCl) recommended peripheral infusion rate is - ANSWER: 5-10
mEq/hr. It is irritating to the vein but can be administered slowly
Potassium chloride (KCl) concentration of 10 mEq KCL/100 mL - ANSWER: can be
administered through a peripheral vein at the recommended infusion rate
Potassium chloride (KCl) concentrations 20-40 mEq/100 mL - ANSWER: at a
maximum rate of 40 mEq/hr should be administered through a central venous access
device (CVAD) to prevent post infusion phlebitis or infiltration.
PTT normal reference range - ANSWER: 25-35 seconds
PTT control value - ANSWER: 1.5-2.0 times the normal reference range of 25-35
seconds.
Magnesium range - ANSWER: (normal 1.5-2.5 mEq/L [0.75-1.25 mmol/L])
magnesium <1.5 Hypomagnesium - ANSWER: Ventricular arrhythmias (torsades de
pointes)!
magnesium <1.5 CNS sym? - ANSWER: Neuromuscular excitability: Manifestations of
low magnesium, similar to those found in hypocalcemia and demonstrated by
,neuromuscular excitability, include tremors, hyperactive reflexes, positive Trousseau
and Chvostek signs, and seizures.
Normal serum sodium levels - ANSWER: 135-145 mEq/L [135-145 mmol/L])
sodium <100 hyponatremia - ANSWER: seizures!
(eg, headache, mental status changes, weakness).
hemoglobin level for an adult male is - ANSWER: 13.2-17.3 g/dL (132-173 g/L)
(13-17)
hemoglobin level for an adult female is - ANSWER: 11.7-15.5 g/dL (117-155 g/L)
(12-16)
male hematocrit range - ANSWER: normal: 39%-50%
Hemoglobin >22 g/dL (220 g/L) or hematocrit >65% - ANSWER: polycythemia
(increased RBCs resulting in increased circulatory viscosity) due to prolonged tissue
hypoxia. Hemoglobin >22 g/dL (220 g/L) or hematocrit >65% are a priority because
increased circulatory viscosity increases the risk for thrombus formation and stroke
Pulmonary artery wedge pressure
PAWP - ANSWER: Measure of left ventricular preload
Indicates left-sided heart function
(normal, 6-12 mm Hg)
>12 mm Hg) - ANSWER: Furosemide is an appropriate drug to decrease left
ventricular preload in a client in cardiogenic shock.
Central venous pressure (CVP) - ANSWER: 2-8 mm Hg,
Measure of right ventricular preload (pressure in the ventricle after filling)
Indicates fluid volume status
Systemic vascular resistance
(SVR) - ANSWER: 800-1200 dynes/sec/cm−5
Measure of vascular resistance
(eg, vessel dilation or constriction)
A GCS score of 8 - ANSWER: A GCS score of 8 or less is classified as a coma. These
clients are intubated for airway protection.
Blood glucose range - ANSWER: 70-110 mg/dL
,monitor the baseline blood glucose (BG) level and fingerstick BG every 6 hours while
the client is receiving? - ANSWER: TPN; it should be maintained in the range of 140-
180 mg/dL (7.8-10.0 mmol/L)
TPN - ANSWER: if delivery has stopped abruptly client at risk for severe
hypoglycemia due to increased pancreatic insulin production
blood glucose <70 mg/dL Hypoglycemia (aerobic exercise acts as insulin) - ANSWER:
sweating, tremor, and hunger
blood glucose >110 mg/dL Hyperglycemia - ANSWER: side effect of prednisone, DKA,
HHS
DKA - ANSWER: -DKA is a life-threatening complication of type I diabetes
characterized by hyperglycemia (>250 mg/dL) that results in ketosis, a metabolic
acidosis.
-Hyperglycemia causes osmotic diuresis, and clients are severely dehydrated.
Dehydration - ANSWER: signs of dehydration are poor skin turgor, dry mucosal
membranes, tachycardia, orthostatic hypotension, weakness, and lethargy.
DKA & HHS: Treatment - ANSWER: In this order,
first, always is fluid resuscitation with IV infusion for bolus rehydration therapy with
normal saline (isotonic crystalloids, usually 0.9% sodium chloride solution) *restore
organ perfusion and avoid shock and cardiovascular collapse.
second, decrease the blood glucose
third, Potassium should never be given until the serum potassium level is (known to
be normal or low) and urinary voiding is observed :)
DKA & HHS: but your client has already started regular insulin and the potassium is
LOW or normal and they are not urinating, Treatment - ANSWER: In this order, DO
NOT GIVE ANY MORE INSULIN until potassium is high again and u observed them
urinating.
first, correct the potassium carefully, at risk for (eg, ventricular tachycardia,
ventricular fibrillation)
second, start regular insulin
AGAIN Remember about DKA &HHS - ANSWER: Clients with diabetic ketoacidosis
and hyperosmolar hyperglycemic state require IV normal saline as a priority due to
severe dehydration. Once fluids are given as a bolus, insulin is initiated. The serum
potassium levels can be elevated in the initial stages despite a low total body
potassium. Potassium repletion is started once the serum potassium levels are
normalized or trending low (from elevated levels).
Normal urine output - ANSWER: 30 mL/hr.
Normal urine output in kg - ANSWER: 0.5/kg/hr
, Urinary output - ANSWER: 2 mL/kg/hr and a flat fontanel are normal findings in an
infant.
Postoperative blood loss - ANSWER: >100 mL/hr should be reported to the HCP
immediately
or excessive (eg, >1500 mL/24 hr)
Tracheotomy suction set at medium presure of? - ANSWER: 100-120
A normal blood glucose range for an infant - ANSWER: 40-60 mg/dL (2.2-3.3 mmol/L)
within the first 24 hours after delivery.
A normal respiratory rate for an infant - ANSWER: 30-60/min
A normal temperature range for an infant is - ANSWER: 97.7-99.7 F (36.5-37.6 C)
Healthy infants gain about - ANSWER: 1 ounce (30 g) per day or 0.5 lb (0.2 kg) per
week for the first 3 months.
INR - ANSWER: 0.75-1.25
Warfarin (Coumadin) - ANSWER: -INR as a routine monitoring test for this
medication
-Warfarin is usually administered for 3-6 months following PE to prevent further
thrombus formation
-Wear MedicAlert tag (eg, necklace, bracelet) when taking anticoagulants (eg,
warfarin, heparin).
Warfarin (Coumadin) range - ANSWER: PT 10-12
INR 0.9-1.2
atrial fibrillation (AF) International Normalized Ratio (INR) control - ANSWER: 2.0-3.0
mechanical heart valve International Normalized Ratio (INR) control - ANSWER:
warfarin 2.5-3.5
Warfarin (Coumadin) antidote - ANSWER: Vitamin K (phytonadione) is a fat-soluble
vitamin that is administered as an antidote for warfarin-related bleeding.
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