Mark Klimek T est taking strategies Lab Values: DEADLY DANGEROUS :
Elevated K+ ( >6) -Hold K+, Assess heart, Prepare Kayexalate/D5W, Call Dr. Elevated pH ( >6) -Assess Vitals, Call doctor CO2 in the 60’s -Assess Resp., Do purse lip breathing, prepare to intubate and ventilate, Call Resp. Therapy, Call Dr. PO2 < 60’s -Assess Resp., Give O2, Prepare to intubate and ventilate, Call resp. therapy, Call Dr.
Platelets < 40,000
-Assess for bleeding, Place on Bleeding precautions, prepare for administration on Platelets CRITICAL:
INR > 4 Low K+ ( < 3.5) High K+ (5.4 – 5.9) Elevated Hgb ( < 8)
CO2 in the 50’s -Assess Resp., Do purse lip breathing, DO NOT GIVE O2
Low PO2 but still in the 70’s -Assess Resp., Give O2
O2 < 93%
-Assess Resp., Give O2
Abnormal Na+ with a change in LOC WBC < 5000
ANC < 500
CD4 < 200
Platelets < 90,000
-Assess for bleeding, Place on bleeding precautions
BE CONCERED : Elevated BUN -Check for dehydration Elevated Hgb -Monitor for Bleeding Place patient in
Neutropenic
Precautions
MARK KLIMEK TEST TAKING STRATEGIES: LATEST UPDATE Elevated BNP (Best indicator for heart failure) Abnormal Na+ -If elevated, assess for dehydration
-If Low, assess for overload ABNORMAL BUT NOT A CONCERN :
Elevated Creatinine ( > 1.2, Best indicator for Kidney function) HCO3
Hct -Assess for bleeding *** HOLD, ASSESS, PREPARE, CALL DOCTOR***
Creatinine: 0.6-1.2
INR: 2-3
K+: 3.5-5.0
pH: 7.35-7.45
BUN: 8-30
Hgb: 12-18
Acid Base balance:
Rule of the B’s: If the pH and the Bicarb are Both in the same direction then it is metaBolic MacKussmauls: Kussmauls Respirations only occur in Metabolic ACidosis As the pH goes, so goes my patient except K+ -If pt has a LOW pH, s/s will be elevated except K+HCO3: 22-26 BNP <100
Na+: 135-145 WBC: 5000-
10,000
Co2: 35-45 ANC: 500
Hct: 36-54 CD4: >200
PO2: 78-100 Platelets: 150,000-400,000
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