Term
Normal Sodium Level:
Primary intra/extracellular ion?
maintain _____ balance |
|
Definition
135-145 mEq/L
extracellular
acid-base |
|
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Term
|
Definition
restricted diet, alcoholism
skin loss...sweat, burns
Renal....diuretics, adrenals
GI losses: suctioning, diarrhea, vomit
wound drainage, fistula, laxative abuse |
|
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Term
|
Definition
| (+)intake, IV or meds, Heart/Renal failure, corticosteroids, cirrhosis, Cushing's, hyperaldosteronism, near drowning |
|
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Term
POTASSIUM
Normal levels
Primary intra/extracellular ion?
maintains intracellular _____
helps regulate ______ balance
deposition of _____ into the liver |
|
Definition
3.5 - 5.0 mEq/L
intracellular
osmolality
acid-base
glucose |
|
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Term
|
Definition
Low intake: starvation, alcoholism
Diaphoresis
Insulin Admin: Tx of DKA
metabolic alkalosis
GI losses: surgery, intestinal bypass, suctioning, vomit, diarrhea, fistula, laxatives
Renal: polyuria, Hypomagnesium, CHF, hyperaldosteronism, sodium restriction
Cushing's, Steroids, Cirrhosis, RAAS, diuretics, burns |
|
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Term
|
Definition
(+)intake, KCl salt substitute, blood transfusion, drugs containing K.
Renal Disease, Addison's
Drugs: NSAIDs, ACE inhibitors, ARBs, K-sparing diuretics, Cyclosporine
leaks from muscle:trauma, transfusion reaction, catabolism
Intra-ExtraCellular Shift: Acidosis, Insulin Deficiency, hyperthermia, Succinylcholine/digitalis |
|
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Term
CALCIUM
Normal Level
formation of ___ & ___
____ function of muscle
important in blood ____ pathway |
|
Definition
4.5 - 5.5 mEq/L
bones, teeth
contractility
coagulation |
|
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Term
|
Definition
(-)intake or absorption
dietary deficiency
Hypoparathyroidism, hypoMag, Renal Failure
Vitamin D deficiency
Malabsorption syndrome
Alcoholism, Cushing's, Steroid Therapy
Diuretics, Diarrhea, hyperPhosphatemia,
Alkalosis, Pancreatitis
Drugs: Aminoglycosides, Cimetidine, Heparin, Theophylline |
|
|
Term
|
Definition
(+)intake, supplements, Ca antacids
HyperParathyroidism, VitD excess, Prolonged immobility, Thiazide diuretics, adrenal insufficiency, renal failure
cancer, Tuberculosis |
|
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Term
MAGNESIUM:
Normal Level
Aids in _____ conduction
Enzymes for metabolism of ___ &_____
aids in _____pump across cell membrane |
|
Definition
1.6-2.1 mEq/L
neuromuscular
CHO PRO
sodium-potassium |
|
|
Term
|
Definition
malnutrition, starvation, alcoholism, prolonged IV nutrition,
DRUGS: diuretics, ETOH, steroids
Vomit, diarrhea, suctioning, hypoparathyroidism, hyperaldosteronism
DKA, HF
extra-intracellular shift: insulin for DKA, AMI, amino acid solutions |
|
|
Term
| Causes of HyperMagnesemia |
|
Definition
enemas, laxatives, MagSulfate, Mag antacids, renal failure, HyperPTH, HypoAldosteronism, Hypothyroidism
Intra-extracellular: Ketoacidosis, burns, rhabdomyolysis |
|
|
Term
Blood Urea Nitrogen (BUN)
Normal Range
End product of ____ metabolism excreted by the kidney
Related to ___ intake & _____ metabolism
A more useful measurement of GFR is _____ |
|
Definition
6-23 mg/dl
protein
Protein / Nitrogen
creatinine |
|
|
Term
|
Definition
renal failure
urinary tract obstruction
shock, burns, GI bleed, Nephrotoxic drugs |
|
|
Term
|
Definition
Hepatic Failure
Cachexia
Low protein High Carb diet |
|
|
Term
Creatinine
Normal Levels
Excreted by filtration through the _____. Creatinine Clearance is an acceptable clinical measure of ___. |
|
Definition
0.7 - 2.1 mg/dl
glomerulus
GFR |
|
|
Term
|
Definition
(+) Renal Failure, Urinary Tract Obstruction, Nephrotoxic Drugs, Hypothyroidism
(-): reduced muscle mass |
|
|
Term
Documentation of Chemistries:
___N___|___C__|__B__/ G
K | H | C \ |
|
Definition
Na Cl BUN
Glucose
K HCO3 Creatinine |
|
|
Term
CBC
\___H_____/ M
W / H \ P
B/L |
|
Definition
Hemoglobin MCV
WBC Platelets
Hematocrit Bands/Lymphs |
|
|
Term
Arterial Blood Gas
p | P | P | H | B | S |
|
Definition
| pH PaO2 PaCO2 HCO3 BE SaO2 |
|
|
Term
TROPONIN I
Normal range
Contractile regulatory protein of ____ muscle; there are _ subunits with cardiac troponin I expressed only in cardiac muscle.
Allows differentiation between ___muscle and ____muscle injury |
|
Definition
< 1.5 ng/ml
striated
3
Myocardial, Skeletal |
|
|
Term
TROPONIN I
increased in....
Sensitivity 50% in _hrs
__% in 6hrs
Cardiac Trauma or Surgery
Post _____implantation |
|
Definition
|
|
Term
TROPONIN I
Not increased in.... |
|
Definition
skeletal muscle disease
noncardiac trauma/surgery
Rhabdomyolysis
Severe muscular exertion
Chronic renal failure |
|
|
Term
Creatine Kinase MB (CKMB)
normal range
3 isoenzymes made of 2 subunits M & B
Cardiac Muscle M_
Skeletal Muscle M_
Brain Tissue __
Increased by: |
|
Definition
<16 IU/L
B
M
BB
MI, Cardiac Trauma |
|
|
Term
Prothrombin Time (PT)
range & panic level
Monitors what drug?
evaluates ___pathway of coagulation
(+)levels: LD, VKD, IC, MT |
|
Definition
11-15 sec, >30sec
Coumadin (warfarin)
liver disease, Vitamin K deficiency, Intravascular Coagulation, Massive transfusions |
|
|
Term
Partial Thromboplastin Time (PTT)
normal and panic level
monitors what drug?
causes of increases? |
|
Definition
25-35sec
>60sec without Heparin
Heparin
remember lowercase ptt, the 2 t's look like an "H" for heparin
hemophilia, DIC, deficiency of individual coagulation factors except XIII & VII |
|
|
Term
CV Triad Assessment Tool:
3 factors to assess patient's hemodynamic status: |
|
Definition
|
|
Term
Creatine Kinase MB (CKMB)
normal range
3 isoenzymes made of 2 subunits M & B
Cardiac Muscle M_
Skeletal Muscle M_
Brain Tissue __
Increased by: |
|
Definition
<16 IU/L
B
M
BB
MI, Cardiac Trauma |
|
|
Term
Prothrombin Time (PT)
range & panic level
Monitors what drug?
evaluates ___pathway of coagulation
(+)levels: LD, VKD, IC, MT |
|
Definition
11-15 sec, >30sec
Coumadin (warfarin)
liver disease, Vitamin K deficiency, Intravascular Coagulation, Massive transfusions |
|
|
Term
Partial Thromboplastin Time (PTT)
normal and panic level
monitors what drug?
causes of increases? |
|
Definition
25-35sec
>60sec without Heparin
Heparin
remember lowercase ptt, the 2 t's look like an "H" for heparin
hemophilia, DIC, deficiency of individual coagulation factors except XIII & VII |
|
|
Term
CV Triad Assessment Tool:
3 factors to assess patient's hemodynamic status:
3 Vital signs assessed: |
|
Definition
Rate
Pump
Volume
Pulse, BP, Lung sounds |
|
|
Term
Triad Assessment:
If pt has hypoperfusion, assess this first _____.
Hypotension with Brady indicates need for HR increase by: |
|
Definition
Rate
Atropine, transcutaneous pacing |
|
|
Term
TRIAD Assessment:
Hypotension with Tachy needs reduction in rhythm by: |
|
Definition
| antiarrhythmic drugs or cardioversion |
|
|
Term
TRIAD:
HR corrected, reassess these....
Pt still hypo, assess for these.... |
|
Definition
BP, lung sounds
pump or volume problem |
|
|
Term
TRIAD:
Hypo & congested lung sounds mean...
May be ___ or ___ in origin
due to these 3 things |
|
Definition
pump problem
contractility, valvular
ischemia, MI, shock |
|
|
Term
TRIAD: Tx
Pump problems:
IA
V
I
SROTV
P/R |
|
Definition
Inotropic Agents
Vasodilators
IABP
Surgical repair of valve
PCI/revascularization |
|
|
Term
TRIAD: PUMP
Reassess vitals
Keep IV rate at slowest possible to prevent overload |
|
Definition
|
|
Term
TRIAD: Volume
Hypo with clear lungs indicates:
Due to: |
|
Definition
Volume problem
volume loss or decreased SVR |
|
|
Term
TRIAD: Volume
Tx
Monitor lung sounds and heart for: |
|
Definition
Fluid bolus in 500ml increments
Volume expanders (colloids, blood)
Vasoconstrictors
Reassess vitals
Volume Overload |
|
|
Term
TRIAD: Rate Problem..
BP down, wet lungs =
BP down, dry lungs = |
|
Definition
pump problem
volume/vessel problem |
|
|
Term
|
Definition
|
|
Term
BUN 7-20 mg/dl
creatinine 0.7-1.2 mg/dl |
|
Definition
| greater than 20:1 Prerenal (before the kidney). BUN reabsorption is increased. BUN is disproportionately elevated relative to creatinine in serum. Dehydration is suspected. |
|
|
Term
| 10-20:1 Normal range. (Normal or postrenal).Can also be postrenal disease. BUN reabsorption is within normal limits. |
|
Definition
| less than 10:1. Intrarenal (within kidney). Renal damage causes reduced reabsorption of BUN, therefore lowering the BUN:Cr ratio. |
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