20/07/2024, 21:20 The Basics - Cpnre Review
CPNRE EXAM REVIEW
The Basics
The Nursing Process (ADPIE)
Assessment – subject and objective information collection
Diagnosis
o Create plan based on most serious nursing diagnosis FIRST
o Airway, breathing, circulation
Planning – setting goals and expected outcomes with the patient (and patient’s family if needed)
Implementation – use of nursing interventions to activate the plan
Evaluation – determining if outcomes are met, and if not, RESTART
Normal Vital Signs
TEMPERATURE: 36.5 to 37.5 – average is 37.0
o Newborn: may fluctuate during the first year of life due to the infant’s heat-regulating
mechanism not being fully developed
o Illness: infective agents and inflammatory mechanism may cause an INCREASE in temperature
o Inspect for any inflammation, redness, swelling or discharge when taking tympanic temp **
PULSE: 60 to 100 bpm
o Check pedal pulses in the older client **
o CONSIDERATIONS:
Heart rate SLOWS with age – normal
Exercise, hemorrhage, pain and stimulant medications increases HR
APICAL PULSE:
Left midclavicular line, fifth intercostal space
RESPIRATIONS: 12 to 20 breaths per min
o CONSIDERATIONS:
Head injury or decreased intracranial pressure will depress the respiratory center
Shallow respirations or slowed breathing seen
Opioid analgesics depress respirations
BLOOD PRESSURE: 120mmhg (systolic) over 80mmhg (diastolic)
o Orthostatic Vitals:
BP and pulse checked with the client supine, sitting and standing (readings obtained 1 to
3 minutes after client changes position)
o CONSIDERATIONS:
BP increases in the older adult
Higher among African Americans
Antihypertensive medications and opioids analgesics decrease BP
PULSE OXIMETRY: 95-100%
o Values below 90 are only acceptable in chronic conditions
COPD, emphysema
Pain
Acute: associated with an injury, medical condition or surgical procedure (lasts hours to a few days)
Chronic: associated with long-term or chronic illnesses (months or years)
Phantom: occurs after loss of a body part
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, 20/07/2024, 21:21 The Basics - Cpnre Review
Laboratory Values **
Platelets: 150,000 – 400,000
WBC count: 5,000 – 10,000
aPTT: 30-40 seconds
HgbA1C: under 6% in an adult without diabetes
eGFR: 90-120
o If too low, renal insufficiency when combined with creatinine and BUN
LABORATORY VALUES
Potassium Sodium Creatinine Blood Urea Nitrogen
Normal Level 3.5-5.0 mEq/L 135-145 mEq/L Male: 53-106 (0.6-1.2) 3.6-7.1 mmol/L
Female: 44-97 (0.5-1.1)
Higher Renal failure Corticosteroid Severe renal Severe renal
Addison’s Disease therapy disease disease
Dehydration Dehydration In conjunction with Burns
Massive tissue Impaired renal a high BUN and Dehydration
destruction function low eGFR Shock
Metabolic Increased sodium UTI
acidosis* intake
Lower Burns Addison’s Disease Diseases with Fluid overload
Cushing’s Decreased sodium decreased muscle Malnutrition
Diarrhea (severe) intake mass Severe liver
Diuretic therapy Diabetic damage
GI fistula ketoacidosis
Insulin Diuretic therapy
Vomiting Excessive loss
Starvation from GI tract
Excessive
perspiration
LABORATORY VALUES – BLOOD CHEMISTRIES
INR PT (Prothrombin Hemoglobin Fasting Blood Glucose
Time) *transports oxygen
Normal Level 0.9-1.2 11-12.5 seconds Women: 120 to 155 FASTING: 4.0-6.0
On warfarin: 2-3 *Amount of time it Men: 135 to 175 mmol/L
High dose: 3-4.5 takes in seconds for clot
formation
Higher/Why use? Warfarin treatment Used to monitor COPD Acute stress
warfarin sodium Smoking cigarettes Cerebral lesions
INCREASED RISK OF therapy Heart or lung Diabetes
BLEEDING** If within 2 seconds diseases Hyperthyroidism
Used to monitor effects (+ or -) – still Pancreatic
of some anticoagulants considered normal insufficiency
If this is ordered,
Pt can be taking specimen should Instruct client to
warfarin and heparin at be drawn BEFORE withhold morning
same time – WHY? giving insulin or oral
Warfarin takes time to anticoagulation hypoglycemic until
start working- pt is kept theray after blood is drawn **
on both heparin and Provide pressure to EAT RIGHT AFTER
warfarin UNTIL the site for 3-5 ** have meal ready or
warfarin starts to work minutes snack
Lower Risk for blood Diets high in green Lack of iron in diet Insulin overage
about:blank 2/10
CPNRE EXAM REVIEW
The Basics
The Nursing Process (ADPIE)
Assessment – subject and objective information collection
Diagnosis
o Create plan based on most serious nursing diagnosis FIRST
o Airway, breathing, circulation
Planning – setting goals and expected outcomes with the patient (and patient’s family if needed)
Implementation – use of nursing interventions to activate the plan
Evaluation – determining if outcomes are met, and if not, RESTART
Normal Vital Signs
TEMPERATURE: 36.5 to 37.5 – average is 37.0
o Newborn: may fluctuate during the first year of life due to the infant’s heat-regulating
mechanism not being fully developed
o Illness: infective agents and inflammatory mechanism may cause an INCREASE in temperature
o Inspect for any inflammation, redness, swelling or discharge when taking tympanic temp **
PULSE: 60 to 100 bpm
o Check pedal pulses in the older client **
o CONSIDERATIONS:
Heart rate SLOWS with age – normal
Exercise, hemorrhage, pain and stimulant medications increases HR
APICAL PULSE:
Left midclavicular line, fifth intercostal space
RESPIRATIONS: 12 to 20 breaths per min
o CONSIDERATIONS:
Head injury or decreased intracranial pressure will depress the respiratory center
Shallow respirations or slowed breathing seen
Opioid analgesics depress respirations
BLOOD PRESSURE: 120mmhg (systolic) over 80mmhg (diastolic)
o Orthostatic Vitals:
BP and pulse checked with the client supine, sitting and standing (readings obtained 1 to
3 minutes after client changes position)
o CONSIDERATIONS:
BP increases in the older adult
Higher among African Americans
Antihypertensive medications and opioids analgesics decrease BP
PULSE OXIMETRY: 95-100%
o Values below 90 are only acceptable in chronic conditions
COPD, emphysema
Pain
Acute: associated with an injury, medical condition or surgical procedure (lasts hours to a few days)
Chronic: associated with long-term or chronic illnesses (months or years)
Phantom: occurs after loss of a body part
about:blank 1/10
, 20/07/2024, 21:21 The Basics - Cpnre Review
Laboratory Values **
Platelets: 150,000 – 400,000
WBC count: 5,000 – 10,000
aPTT: 30-40 seconds
HgbA1C: under 6% in an adult without diabetes
eGFR: 90-120
o If too low, renal insufficiency when combined with creatinine and BUN
LABORATORY VALUES
Potassium Sodium Creatinine Blood Urea Nitrogen
Normal Level 3.5-5.0 mEq/L 135-145 mEq/L Male: 53-106 (0.6-1.2) 3.6-7.1 mmol/L
Female: 44-97 (0.5-1.1)
Higher Renal failure Corticosteroid Severe renal Severe renal
Addison’s Disease therapy disease disease
Dehydration Dehydration In conjunction with Burns
Massive tissue Impaired renal a high BUN and Dehydration
destruction function low eGFR Shock
Metabolic Increased sodium UTI
acidosis* intake
Lower Burns Addison’s Disease Diseases with Fluid overload
Cushing’s Decreased sodium decreased muscle Malnutrition
Diarrhea (severe) intake mass Severe liver
Diuretic therapy Diabetic damage
GI fistula ketoacidosis
Insulin Diuretic therapy
Vomiting Excessive loss
Starvation from GI tract
Excessive
perspiration
LABORATORY VALUES – BLOOD CHEMISTRIES
INR PT (Prothrombin Hemoglobin Fasting Blood Glucose
Time) *transports oxygen
Normal Level 0.9-1.2 11-12.5 seconds Women: 120 to 155 FASTING: 4.0-6.0
On warfarin: 2-3 *Amount of time it Men: 135 to 175 mmol/L
High dose: 3-4.5 takes in seconds for clot
formation
Higher/Why use? Warfarin treatment Used to monitor COPD Acute stress
warfarin sodium Smoking cigarettes Cerebral lesions
INCREASED RISK OF therapy Heart or lung Diabetes
BLEEDING** If within 2 seconds diseases Hyperthyroidism
Used to monitor effects (+ or -) – still Pancreatic
of some anticoagulants considered normal insufficiency
If this is ordered,
Pt can be taking specimen should Instruct client to
warfarin and heparin at be drawn BEFORE withhold morning
same time – WHY? giving insulin or oral
Warfarin takes time to anticoagulation hypoglycemic until
start working- pt is kept theray after blood is drawn **
on both heparin and Provide pressure to EAT RIGHT AFTER
warfarin UNTIL the site for 3-5 ** have meal ready or
warfarin starts to work minutes snack
Lower Risk for blood Diets high in green Lack of iron in diet Insulin overage
about:blank 2/10
