lOMoARcPSD|13445102
5:7:18 Adult Health HESI Study Guide
Critically Ill (Duquesne University)
Studocu is not sponsored or endorsed by any college or university
Downloaded by samuel kamunyu ()
, lOMoARcPSD|13445102
Adult Health HESI Study Guide
Go over:
- Cancer
- Neuro diseases
- Kidneys
- Arterial vs venous
- Intra ocular pressure should be within 10-21
Fluid and Electrolytes
Blood Administration
Preparation
o Patient history
o Complications
o Type of blood and cross match matters because of universal donor = TYPE O
universal recipients = TYPE AB+ (andy baldo can receive anything)
o Consent (one per hospital stay)
TO TAKE A TYPE BLOOD SAMPLE AND CROSS MATCH YOU NEED:
o TWO BLOOD SAMPLES TAKEN FIVE MINUTES APART
o TWO RN SIGNATURES!!!!!
Types:
o Packed Red Blood Cells 1 unit/2 hours … low hematocrit and hemoglobin or
fluid loss
o Platelets 15-30 minutes … low platelets
o Fresh-Frozen Plasma 15-30 minutes … improve clotting and volume expansion
o White Blood Cells 1 unit/1 hour … sepsis and neutropenia (when antibiotics
do not work)
Blood lasts for 4 hours = initiate transfusion within 30 minutes = only 3.5 hours left!!!!!!!
2 RNs need to identify: ABO group, Rh type, donor number, expiration date, patient, and
patient ID# BEFORE BLOOD TRANSFUSION!!!!!!!
Blood with NORMAL SALINE ONLY
NO MEDICATION DURING BLOOD
Monitoring Patient
o Baseline Vital Signs (before transfusion begins temperature most important)
o 1st set of vitals (15 minutes after administration)
1
Downloaded by samuel kamunyu ()
, lOMoARcPSD|13445102
o Continuous every hour (usual 4 hours)
o If blood begins at 800, then vitals are taken 800 (or 759), 815, 900, 1000, 1100,
1200
Complications
o Reaction = STOP BLOOD
o Call physician
o Obtain vitals
o Collect blood product, IV tubing send to blood bank
o Administer isotonic solution at a normal rate
5% dextrose
0.9% NaCl
Reaction Types
o Transfusion Reaction: adverse reaction as a result of a blood transfusion
o Hemolytic:
o Allergic:
o Febrile: fever
o Septicemia:
o Graft
o Host Disease:
o SIGNS AND SYMPTOMS: restlessness, hives, anxiety, chills, flushing, fever, chest
pain, lumbar pain, tachycardia, tachypnea, nausea, shock
Dispose of blood products in a contaminated waste RED bag
Acid-Base Imbalances
Arterial Blood Gas provides:
o pH
acidity vs. alkalinity based on H+ ions present
NORMAL: (acidosis) 7.35 - 7.45 (alkalosis)
o pCO2
Amount of carbon dioxide dissolved in arterial (oxygenated) blood
NORMAL: (alkalosis) 35 – 45 (acidosis)
RESPIRATORY
o HCO3
Amount of bicarbonate in the bloodstream
NORMAL: (acidosis) 22 – 26 (alkalosis)
METABOLIC
o Pa02 (not important)
NORMAL: 80 - 100 mm Hg
o Sa02 (not important)
2
Downloaded by samuel kamunyu ()
, lOMoARcPSD|13445102
NORMAL: 95% - 100%
Acid-Base Imbalances: based on metabolic problems, respiratory problems, or both
Acidosis: excess of hydrogen ions, increase in acids
Alkalosis: decreased amount of free hydrogen ions, increase in bases
RESPIRATORY ACIDOSIS
o DECREASE PH, INCREASE CO2
o Hypoventilation take pulse ox and respiration rate NEEDS OXYGEN
RESPIRATORY ALKALOSIS
o INCREASE PH, DECREASE CO2
o Hyperventilation take pulse ox, dehydrated, respiration rate, restlessness
NEEDS OXYGEN (non-invasive before invasive) = non-rebreather mask, talk to
them, therapeutic touch, get people out, turn temp down, turn lights of
METABOLIC ACIDOSIS
o DECREASE PH, DECREASE HCO3
o Excessive vomiting too much acid in the system
METABOLIC ALKALOSIS
o INCREASE PH, INCREASE HCO3
o Gastric suctioning difficult to give acid back so VERY dangerous
“ROME” respiratory opposite, metabolic equal
Compensation:
o Uncompensated
pH not normal + 1/2 not normal
o Partially Compensated
pH normal + 2/2 not normal
OUTSIDE OF 7.35-7.45 RANGE
Change range to 7.4
o Fully Compensated
pH normal + 2/2 not normal
INSIDE OF 7.35-7.45 RANGE
Change range to 7.4
Cancer
Uncontrolled growth of abnormal cells in the body
Warnings: “CAUTION”
o C: changes in bowel/bladder
o A: a sore throat
o U: unusual bleeding
o T: thickening or lump in the body
o I: indigestion or difficulty swallowing
3
Downloaded by samuel kamunyu ()
5:7:18 Adult Health HESI Study Guide
Critically Ill (Duquesne University)
Studocu is not sponsored or endorsed by any college or university
Downloaded by samuel kamunyu ()
, lOMoARcPSD|13445102
Adult Health HESI Study Guide
Go over:
- Cancer
- Neuro diseases
- Kidneys
- Arterial vs venous
- Intra ocular pressure should be within 10-21
Fluid and Electrolytes
Blood Administration
Preparation
o Patient history
o Complications
o Type of blood and cross match matters because of universal donor = TYPE O
universal recipients = TYPE AB+ (andy baldo can receive anything)
o Consent (one per hospital stay)
TO TAKE A TYPE BLOOD SAMPLE AND CROSS MATCH YOU NEED:
o TWO BLOOD SAMPLES TAKEN FIVE MINUTES APART
o TWO RN SIGNATURES!!!!!
Types:
o Packed Red Blood Cells 1 unit/2 hours … low hematocrit and hemoglobin or
fluid loss
o Platelets 15-30 minutes … low platelets
o Fresh-Frozen Plasma 15-30 minutes … improve clotting and volume expansion
o White Blood Cells 1 unit/1 hour … sepsis and neutropenia (when antibiotics
do not work)
Blood lasts for 4 hours = initiate transfusion within 30 minutes = only 3.5 hours left!!!!!!!
2 RNs need to identify: ABO group, Rh type, donor number, expiration date, patient, and
patient ID# BEFORE BLOOD TRANSFUSION!!!!!!!
Blood with NORMAL SALINE ONLY
NO MEDICATION DURING BLOOD
Monitoring Patient
o Baseline Vital Signs (before transfusion begins temperature most important)
o 1st set of vitals (15 minutes after administration)
1
Downloaded by samuel kamunyu ()
, lOMoARcPSD|13445102
o Continuous every hour (usual 4 hours)
o If blood begins at 800, then vitals are taken 800 (or 759), 815, 900, 1000, 1100,
1200
Complications
o Reaction = STOP BLOOD
o Call physician
o Obtain vitals
o Collect blood product, IV tubing send to blood bank
o Administer isotonic solution at a normal rate
5% dextrose
0.9% NaCl
Reaction Types
o Transfusion Reaction: adverse reaction as a result of a blood transfusion
o Hemolytic:
o Allergic:
o Febrile: fever
o Septicemia:
o Graft
o Host Disease:
o SIGNS AND SYMPTOMS: restlessness, hives, anxiety, chills, flushing, fever, chest
pain, lumbar pain, tachycardia, tachypnea, nausea, shock
Dispose of blood products in a contaminated waste RED bag
Acid-Base Imbalances
Arterial Blood Gas provides:
o pH
acidity vs. alkalinity based on H+ ions present
NORMAL: (acidosis) 7.35 - 7.45 (alkalosis)
o pCO2
Amount of carbon dioxide dissolved in arterial (oxygenated) blood
NORMAL: (alkalosis) 35 – 45 (acidosis)
RESPIRATORY
o HCO3
Amount of bicarbonate in the bloodstream
NORMAL: (acidosis) 22 – 26 (alkalosis)
METABOLIC
o Pa02 (not important)
NORMAL: 80 - 100 mm Hg
o Sa02 (not important)
2
Downloaded by samuel kamunyu ()
, lOMoARcPSD|13445102
NORMAL: 95% - 100%
Acid-Base Imbalances: based on metabolic problems, respiratory problems, or both
Acidosis: excess of hydrogen ions, increase in acids
Alkalosis: decreased amount of free hydrogen ions, increase in bases
RESPIRATORY ACIDOSIS
o DECREASE PH, INCREASE CO2
o Hypoventilation take pulse ox and respiration rate NEEDS OXYGEN
RESPIRATORY ALKALOSIS
o INCREASE PH, DECREASE CO2
o Hyperventilation take pulse ox, dehydrated, respiration rate, restlessness
NEEDS OXYGEN (non-invasive before invasive) = non-rebreather mask, talk to
them, therapeutic touch, get people out, turn temp down, turn lights of
METABOLIC ACIDOSIS
o DECREASE PH, DECREASE HCO3
o Excessive vomiting too much acid in the system
METABOLIC ALKALOSIS
o INCREASE PH, INCREASE HCO3
o Gastric suctioning difficult to give acid back so VERY dangerous
“ROME” respiratory opposite, metabolic equal
Compensation:
o Uncompensated
pH not normal + 1/2 not normal
o Partially Compensated
pH normal + 2/2 not normal
OUTSIDE OF 7.35-7.45 RANGE
Change range to 7.4
o Fully Compensated
pH normal + 2/2 not normal
INSIDE OF 7.35-7.45 RANGE
Change range to 7.4
Cancer
Uncontrolled growth of abnormal cells in the body
Warnings: “CAUTION”
o C: changes in bowel/bladder
o A: a sore throat
o U: unusual bleeding
o T: thickening or lump in the body
o I: indigestion or difficulty swallowing
3
Downloaded by samuel kamunyu ()
