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Nurses

Nurses

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Published by Dhingskie

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Published by: Dhingskie on Jun 29, 2009
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08/16/2014

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NURSES’ POCKET NOTESNORMAL VALUESLUNG SOUNDSCrackles orralesCrackling or rattling soundswheezingHigh-pitched whistlingexpirationsstridorHarsh, high-pitchedinspirationsrhonchiCoarse, gravelly soundsPULSE OXIMETRYRangeValueTreatmentNormal95-100%None or placebicMildhypoxia91-94%Give oxygenModeratehypoxia86-90%Give 100% oxygenSeverehypoxia<85%Give 100% oxygenwith positivepressureAlbumin3.2 g/dlAlkaline Phosphatase(Adults: 25-60)33-131 IU/LAdults: >61yo51-153 IU/LAmmonia20-70 mcg/dlBilirubin, direct0-0.3 mg/dlBilirubin, tota0.1-1.2 mg/dlBLOOD GASESArterialVenouspH7.35-7.457.32-7.42pCO
2
35-4538-52pO
2
70-10028-48HCO
3
19-2519-25O
2
Sat %90-9540-70BUN7-20 mg/dlCOMPLETE BLOOD COUND (CBC) ADULTSMaleFemaleHemoglobin (g/dl)13.5-16.512.0-15.0Hematocrit (%)41-5036-44RBC’s (x10
6
/ml)45-5540-49RDW (RBCdistribution width)<14.5MCV80-100MCH26-34MCHC %31-37Platelet count100000-450000CREATININE KINASE (CK) ISOENZYMESCK-BB0%CK-MB (cardiac)0-3.9%CK-MM96-100%Creatinine Phosphakinase(CPK)8-150 IU/LCreatinine (mg/dl)0.5-1.4ELECTROLYTESCalcium8.5-10.2mg/dlCalcium, ionized2.24-2.46mEq/LChloride95-107 mEq/LMagnesium1.6-2.4mEq/LPhosphate2.5-4.5 mg/dlPotassium3.5-5.2 mEq/LSodium135-145mEq/LFerritin (ng/ml)13-300Folate (ng/ml)3.6-20Glucose, fasting60-110(mg/dl)Glucose (2 hours postprandial)(mg/dl)Up to 140Hemoglobin A
10
6-8Iron (mcg/dl)65-150Lactic acid (mEq/L)0.7-2.1LDH (lactic dehydrogenase)56-194 IU/LLIPOPROTEINS AND TRIGLYCERIDESCholesterol, total<200 mg/dlHDL cholesterol30-70 mg/dlLDL cholesterol65-180 mg/dl Triglycerides45-155 mg/dl (<160)Osmolality289-308 mOsm/kgSGOT (AST)<35 IU/L (20-40)SGPT (ALT)<35 IU/L THYROID FUNCTION TESTSFree T32.3-4.2 pg/mlSerum T370-200 ng/dlFree T40.5-2.1 ng/dlSerum T44.0-12.0mcg/dl TSH0.25-4.30 microunits/ml Total iron binding capacity(TIBC)250-420 mcg/dl Transferrin>200 mg/dlUric acid (male)2.0-8.0 mg/dlUric acid (female)2.0-7.5 mg/dlWBC + DIFFERENTIALWBC (cells/ml)4500-10000Segmentedneutrophils54-62%Band forms3-5% (above 8% indicatesleft shif)Basophils0-1 (0-0.75%)Eosinophils0-3 (1-3%)Lymphocytes24-44 (25-33 %)monocytes3-6 (3-7%)NURSING CONSIDERATIONS FOR BT
Confirm that the transfusion is prescribed
Check if Px blood has been typed and cross-matched
Verify the consent from has been signed
Explain the procedure to the Px and instruct pxfor s/sx of transfusion reaction (itching, hives,chills, sweeling, fever, shortness of breath)
 Take px’s vital signs to establish baseline forcomparing of vital signs during transfusion
Standard precaution during BT as per hospitalpolicy
Use gauge 20 or larger needles for BT
Maximum hours for BT is 4 hours
Double check obtained PRBC from blood bank
Double check labes with other RN or MD to makesure of ABO and Rh compatibility
Check blood for unusual color, bubbles orcloudiness, it may indicate bacterial growth orhemolysis
Make sure PRBC is initiated within 30 minutesafter removal from blood bank refrigerator

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