MARK KLEMIK: NCLEX SG Lab Values A: abnormal (do nothing, not as important) B: be concerned (assess/monitor) C: Critical (priority/Do something) D: Dangerous (Highest priority/Do something NOW) S... erum Creatinine: do nothing Best indicator for what_____? therapeutic range____? Kidney Function (^Serum Cr.=kidney disease) 0.6-1.2 (same as Lithium range) INR (International Normalized Ratio) Monitors what____? Therapeutic range___? Coumadin (Warfarin Therapy) 2 – 3 >4 (Critical priority) o Hold/Stop all warfarin o Assess for bleeding (focused assess.) o Prepare to administer Vit. K (antidote) o Notify/Call HCP Potassium: Therapeutic range___? What to do for K+ <3.5? What to do for K+ >5.3? 3.5 – 5.3 <3.5 (DO SOMETHING) o Assess heart o Prepare to administer K+ o Call HCP 5.4-5.9 (DO SOMETHING) o Hold K+ o Assess heart o Prepare to administer Kayexelate & d5W regular insulin o Call/Notify HCP >6 (DEADLY DANGEROUS/NOW) o Do steps simultaneously (STAT) o Stay with your patient (Deadly patient) pH: Ref. Range___? What What to do for pH <6? 7.35 – 7.45 (drop in pH = patient drops as well) pH in the 6’s (Deadly = severe acidosis) o Assess VS (to make sure they are alive) o Call/notify HCP if VS is bad (call Rapid Response team) o TX the underlying cause (HCP responsibility) BUN (Blood Urea Nitrogen) Ref. Range 8-25 (Bun‟s come in 8/pack) Elevated BUN o Assess for dehydration Blood value goes up b/c concentration. HgB (Hemoglobin) Ref. range 12-18 (people) 8-11 (do nothing) o Assess for anemia/malnutrition (low hgb) <8 (do something) o Assess for bleedingo Prepare to administer blood o Call HCP HCO3 (Bicarb) Ref. range___? 22 – 26 Abnormal not an issue CO2 (Carbon Dioxide) receive it from where__? ref. range___? Arterial Blood Gas 35 – 45 CO2 in 50’s: (Critical / Do something people without COPD) o Assess Respiratory status o Pursed lip breathing (candle blow out) prolonging exhalation = gets out CO2 Effective treatment = breathe easier CO2 in 60‟s: (Respiratory Failure) o Medical emergency/ HIGH PRIORITY o Stay with patient o Assess Respiratory status o If symptomatic call RAPID RESPONSE o Prepare to INTUBATE/ VENTILATE o Call HCP/Respiratory therapist Hct (Hematocrit) ref. range____? 36 – 54% (3x the hgb. ie, 12x3 = 36 & 18x3=54) Elevated Hct o Assess for dehydration PO2: Oxygen level in blood; obtained from ABG. ref. range____? Respiratory Failure range__? 78 – 100 Low PO2 in the 70’s (Critical/Priority) o Assess Respiratory o Provide Oxygen [Show More]
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