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Medical-Surgical Nursing, 9th Ed., Ignatavicius & Workman, 2018 | Registered Nurse (RN) School Study Aid

Creatinine Lab Values

Measures Renal Function

0.6 - 1.3 mg/dL

1 min

BUN (Blood Urea Nitrogen) Lab Values

10-20 mg/dL

40 secs

Sodium (Na+) Lab Value

135-145 mEq/L

24 secs

Hyponatremia

< 135 mEq Na+

Nausea and Vomiting

Decreased LOC

Confusion / Lethargy

Seizures

Assess Airway

Reduce Diuretic Dosage

Mannitol (Osmitrol)

Fluid Restriction

Hypertonic Solution (3% or 5% NaCl)

2 mins

Potassium (K+) Lab Value

3.5 to 5.0 mEq/L

20 secs

Hyperkalemia

> 5.0 mEq/L K+

Abdominal Cramps

Muscle Weakness

Diarrhea

Arrhythmia

Tall, Peaked T Waves

IV Calcium

Infusion of Glucose and Insulin

Loop or Thiazide Diuretics

Kayexalate

Dialysis

Prevention Education

2 mins

Calcium (Ca2+) Lab Value

8.5 to 10.5 mg/dL

26 secs

Hypocalcemia

Muscle Spasms

< 8.5 mg/dL Ca2+

Decreased Bone Density

Tetany

Chvostek's Sign

Trousseau's Sign

Increased DTR

ECG Changes

QT Prolongation

Oral and IV Replacement of Ca2+

Seizure Precautions

2 mins

Hypocalcemia Causes

Hypoalbuminemia

Hypomagnesemia (Less Common Hypermagnesemia)

Hypovitaminosis D

Hypoparathyroidism

Medications

Hyperphosphatemia

Malnutrition

Acute Pancreatitis

Alkalosis

Sepsis

Chronic Kidney Disease

2 mins

Hypocalcemia Treatments

Treat Underlying Disorder

IV Calcium Gluconate

Cardioprotective

Calcium Carbonate

Calcium Citrate

Vitamin D Supplements

Treat Hypomagnesemia

2 mins

Magnesium (Mg2+) Lab Value

1.5 to 2.5 mEq/L

28 secs

Phosphate (PO43-) Lab Value

2.5 to 4.5 mg/dL

29 secs

Dialysis

Hemodialysis

Rapid Shifts of Fluid and Electrolytes

Disequilibrium Syndrome

Hypotension

NO BP IN ARM with Shunt or Fistula

Assess for Thrill and Bruit

Peritoneal Dialysis

Slow Process

Peritonitis

Loss of Protein

Hyperglycemia

3 mins

Parathyroid Gland

Blood Calcium Sensor

Parathyroid Hormone

Bone Resorption

Blood Calcium Increases

Vitamin D Activation

Calcium Absorption From The Small Intestine

1 min

Acute Pericarditis Causes

Idiopathic

Infection

Trauma

Cardiac

Myocardial Infarction

Autoimmune Diseases

Uremia

Tumor

Radiation

2 mins

Peptic Ulcer Disease Assessment

Helicobacter Pylori

NSAIDs

Increased Stomach Acid

Abdominal Pain

Heartburn (Pyrosis)

Melena

Weight Changes

GI Distress

Most Commonly in Duodenum

Duodenal: Pain Relieved by Eating

Gastric: Pain Caused by Eating

2 mins

Chronic Kidney Disease Early Symptoms Assessment

GFR < 60mL/min

Accumulation of Waste Products

General Malaise

Hypertension

Proteinuria

Hyperkalemia

Mineral and Bone Disorders

Neuropathy

2 mins

Chronic Kidney Disease Late Symptoms Assessment

Metabolic Acidosis

Severe Uremia

Arrhythmias

Edema

CNS Depression

Anemia

Oliguria

Pruritus

End Stage Renal Disease (ESRD)

GFR < 15mL/min

2 mins

Chronic Kidney Disease Interventions

Daily Weights

Strict I/O

Renal Diet

Strict Medication Regimen

Erythropoietin

Manage Hyperkalemia

Manage CKD-MBD

Dialysis

Kidney Transplant

2 mins

Total Protein Lab Values

6.4 - 8.3 g/dL

1 min

Hypercalcemia

> 10.5 mg/dL Ca²⁺

Pathologic Fractures

Lethargy

Hypercoagulation

Constipation

ECG Changes

QT Shortening

No Calcium Intake

Chelating Drugs

Calcitonin

Bisphosphonates

Loop Diuretics instead of Thiazide Diuretics

Increased Risk for Renal Calculi

Increase Fluids

3 mins

Hypercalcemia Causes

Two CHIMPANZEES Acronym

Thyroid Disorders

Calcium Supplements

Hyperparathyroidism

Iatrogenic (Drugs, immobility)

Milk-Alkali Syndrome

Paget's Disease of Bone

Acromegaly or Addison's Disease

Neoplasms

Zollinger-Ellison Syndrome

Excessive Vitamin A

Excessive Vitamin D

Sarcoidosis

2 mins

Hypercalcemia Treatments

Treat Underlying Disorder

Hydration

Dialysis

Calcium Restriction

Bisphosphonates

Calcitonin

Cinacalcet

Glucocorticosteroids

Denosumab

2 mins

Anxiety Assessment

Increased Alertness

Heightened Perception

Perception Narrowed

Short Attention Span

Shaking

Ineffective Problem Solving

Automatic Behavior

Hyperventilation

Hallucinations

Inability to Function or Communicate

2 mins

Depression Assessment

Anergia

Self Neglect

Decreased Libido

Vegetative Signs

Sad Affect

Worthlessness

Guilt

Anger and Irritability

Ineffective Problem Solving

Slowed Thinking

1 min

Heparin (Unfractionated)

Suppresses Coagulation

Deep Vein Thrombosis (DVT)

Pulmonary Embolism

Hemorrhage

Heparin-Induced Thrombocytopenia (HIT)

Monitor aPTT

Preferred (Safe) During Pregnancy

Protamine Sulfate

2 mins

Kidney Transplant

End Stage Renal Disease (ESRD)

Selective Candidacy

Close Compatibility

Immunosuppressants

Monitor for Rejection

Monitor for Infection

Monitor Urine Output

2 mins

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