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68WM6 NCLEX Review
68WM6 NCLEX Review Lectures
| Question | Answer |
|---|---|
| WBC | 5,000 - 10,000 |
| HCT | 41-49 |
| Hgb | 12-16(Female) 14-18(Male) |
| PLT | 200-400 thousand |
| Na | 135-145 |
| K | 3.5 - 5.5 |
| Cl | 98-107 |
| Glucose | 70 - 110 |
| Co2 | 35 - 45 |
| Kidneys release _____renin in response to low ____ concentration. | Renin , Na |
| Renin stimulates conversion of angiotensinogen to _____ which converts to _____ in the lungs. | angiotensin I , angiotensin II |
| ACE inhibitors do what? | blocks the conversion of angiotensin I to angiotensin II..blocks the constriction affect and prevents HTN. |
| What does angiotensin II do? | Major vasoconstrictor, stimulates Aldosterone release, causes Na retention, increases water reabsorbtion, releases K+ and H+ |
| Mag | 1.5 - 2.5 |
| Ca | 8.5 - 10.9 |
| Phos | 2.5 - 4.5 |
| BUN | 7 - 22 |
| Creat | 0.6 - 1.35 |
| PT | 10 - 12 |
| PTT | 30 - 45 |
| INR | 2-3 |
| Billi | < 1.0 |
| Alb | 3.4 - 5.0 |
| Alk | 20-125 |
| PreRenal Failure causes | Fluid Volume Loss Hemorrhage GI Losses (vomiting, diarrhea) Renal Losses Burns Inadequate Volume Replacement |
| PreRenal Failure causes r/t Inadequate Cardiac Output | CHF MI cardiogenic shock dysrhythmias cardiac tamponade, PE |
| Vasoconstriction/Occlusion of Renal Blood Vessels r/t AFR | catecholamines hypertension vasopressors renal vessel embolism |
| RAAS System | retain volume increase sodium and water reabsorption |
| ARF Diagnostics | Decreased Urine Sodium , Urine Osmolality Increased (decreased free water excretion), Urine Specific Gravity Increased(> 1.020), oliguria/anuria, BUN:Cr ratio is increased >20 |
| ARF Treatment | Volume Replacement Extracellular Volume Sequestration, Inadequate Cardiac Output , Renal Artery Occlusion |
| Postrenal failure includes | Obstruction kidney, ureter, bladder, urethra Increased Intra-tubular Pressure abnormal nephron function reverses rapidly once obstruction is removed |
| Diagnosis of Renal Failure | KUB, ultrasound, IVP, retrograde pyelography, CT |
| Causes of Intrarenal Failure | Glomerulus or Renal Tubule Damage, glomerular, vascular or hematologic problem glomerulonephritis systemic lupus erythematosus (SLE) DIC endocarditis pre-eclampsia |
| decrease in the blood supply to a bodily organ, tissue, or part caused by constriction or obstruction of the blood vessels | ischemia |
| Acute Tubular Necrosis (ATN) | perfusion to the kidney is severely reduced Vasoconstriction & Ischemia damage the glomerular basement membrane and tubular epithelium |
| Na+/K+ Pump Fails | sodium remains in cell potassium remains outside cell causes additional cellular dysfunction and cellular edema |
| Uric Acid | 3.5 - 7.5 |
| Triglyceride | 40 - 50 |
| Total Cholesterol | 130 - 200 |
| Protein | 6.2 - 8.1 |
| HCO3 | 24 - 26 |
| Protein | 6.2 - 8.1 |
| LDH | 100 - 190 |
| CPK | 21 - 232 |
| HR | 80 - 100 |
| RR | 12 - 20 |
| BP | 110 - 120 (Sys) / 60 - 90 (Dia) |
| Digoxin | 0.5 - 2.0 mg |
| Lithium | 0.8 - 1.5 mEq |
| Dilantin | 10 - 20 mcg |
| Theophylline | 10 - 20 mcg |
| Spec Gravity | 1.010 - 1.030 |
| Therapeutic level of PT/ PTT | 1.5 - 2 times base |
| 3 segments of small intestine | Duodenum - 1st segment Jejunum - 2nd segment Ileum - 3rd segment |
| funciton of liver | Plays Major Role in Bile Secretion Iron Metabolism Plasma-Protein Production Detoxification of Drugs & Other Substances |
| where is the gallbladder? | Depression on Posterior Surface of Liver hangs from anterior/inferior margin of the liver |
| Function of the gallbladder | Secretes/Stores Bile Produced by Liver |
| where is the pancreas? | Posterior to Greater Curvature of Stomach |
| Arterial Bleed from Acute Longitudinal Tear in the Gastroesophageal Mucosa | Mallory-Weiss Tear |
| Associated with Chronic Cirrhosis causes the liver to become less compliant Pressure Increases in the Portal Circulation Blood in the Splanchnic System collateral circulation | Esophageal Varicies |
| bright red blood or "coffee-ground" emesis | Hematemesis |
| shiny, black, foul-smelling stool from UGI bleeding | Melena |
| bright red blood from the rectum indicates a lower GI bleed may also come from hemorrhoids or fissures | Hematochezia |
| test for occult blood in the stool | Guaiac |
| Signs of Shock | Hypotension (advanced shock) Tachycardia, Dyspnea Decreased Peripheral Pulses Cool, Clammy Skin Increased Capillary Refill Decreased LOC Decreased Urinary Output Assess for Cardiac Ischemia (EKG) |
| describe the action of Crystalloid Solutions | source for electrolytes and a temporary source of fluid volume. They flow out of the vascular system rather quickly...fluid expanders |
| example of Crystalloid solution | Lactaced Ringers and Normal Saline |
| describe the action of Colliod Solutions | colloidal solutions are needed when a solution is required to remain in the vascular system and contain a protein |
| examples of Colloids | Whole human blood U.S.P. and Hetastarch are examples of colloid solutions. |
| action of antacids | control the pH of the gastric mucosa side effects diarrhea, electrolyte disturbances, metabolic alkalosis |
| action of histamine blockers | block stimulation of acid secretion from parietal cells Cimetidine Ranitidine Famotidine |
| side effects of histamine blockers | mucosa due to decreased pH increased risk of nosocomial pneumonia can cause thrombocytopenia |
| action of proton pump inhibitors | work within parietal cells, decrease acidity of acid pump Pantoprazole Omeprazole Side effects GI distress, headache, dizziness |
| action of Mucosal Enhancers | reduce effects of acid secretion by improving the mucosal barrier sucralfate |
| injection of a necrotizing agent into bleeding vessel | Sclerotherapy |
| use of a heater probe, laser photocoagulation and electrocoagulation | Thermal Tamponade |
| results in thrombosis, sloughing, fibrosis of varix | Endoscopic Band Ligation |
| removal of lower portion of stomach | Antrectomy |
| removal of the stomach | Gastrectomy |
| surgical connection of the stomach to the jejunum | Gastroenterostomy |
| Vagotomy | severing of the vagus nerve to the stomach |
| Billroth I | vagotomy and antrectomy with anastomosis of the stomach to the duodenum |
| Billroth II | vagotomy and antrectomy with anastomosis of the stomach to the jejunum |
| action of Vasopressin (ADH) | lowers portal pressure constricts splanchnic arterial bed decreases pressure and flow in liver collateral circulation channels to decrease bleeding |
Created by:
jrstrader
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