Therapeutic Levels

Lithium

0.6-1.2mEq/L

Digoxin

0.5-2ug/L

Theophylline

10-20mg/dL

Phenytoin

10-20mg/dL

Digitalis

0.8-2.0ng

CBC

Margaret Denise Del Rosario,

RN

Acid-Base Levels
pH

7.35-7.45

pO2

80-100mmHg

pCO2

35-45

HCO3

22-26

R-espiratory

RBC

4.5-5.5mil/cu mm

O-pposite

WBC

5000-10000/cumm

M-etabolic

Hgb

12-15g/dL

E-qual

Hct

38-54 vol%

Platelet

200,000-400,000/mm3

Neutrophils

55-70%

Lymphocytes

20-40%

Monocytes

2-8%

Eosinophils

1-4%

Basophils

0.5-1%

A pH
B pCO2
A HCO3

Alkalosis
Acidosis
pH

PCO2

pH
HCO3

Nutrients

Carbs

Proteins

Fat

Water

Energy,
Body
temp.

Tissue
growth
and
repair

Energy
and
repair,
carries
Vitamin A
&D
Carries
nutrients,
regulates
body
process,
lubricates
joints

Minerals
Simple:
sugars,
fruits,
nuts
Complex:
grains,
potatoes
Meat,
fish,
eggs,
milk,
poultry,
beans,
peas and
nuts
Animal
fat, meat,
nut, milk,
fish,
poultry
Liquids,
most
fruits and
veggies

Ca

Vitamins
A

Renews
bones &
teeth;
regulate
heart &
nerves

Milk, green veggie,

cheese, salmon,
legumes

Bones &
teeth,
maintain
nerve
function

Cheese, oats, meat,

milk, fish, poultry,
nuts

Fe

Renews Hgb

Iodine

Regulates
thyroid

Meat, eggs, liver,

flour, yellow or
green veggies
Table salt, sea foods

Enzyme
s

Enzymes

Grains, green
veggies

Na

Water
balance,
nerve
function

Salt, cured meat

Meat, milk veggies

Cl

Nerve
function
Gastric juices

Salt

Zn

Enzymes

Meat, sea food

B1
B2

B3
B1
2

Eyes, skin,
hair, fights
infection
Nerves,
carbs
function
Skin,
mouth
and nerve
function
Oxidation
of CON &
carbs
Muscle,
nerves,
heart,
metabolis
m
Cell
integrity
and tissue
repair
Allows use
of Ca & P
Antioxidan
t
Aids in
blood
clotting

Yellow fruits &

veggies, liver,
kidney, fish
Bread, cereals,
pork, milk, pea
Milk, cheese, dark
green veggies,
cereals
Meat, fish, poultry,
eggs, bread
Organ meats, milk

Citrus fruit,
tomato, green
veggies, potato
Milk, margarine,
fish, liver, eggs
Peanut, veg oil
Green leafy
veggies

Pulmonary Functions
Tidal
Volume

Residual
Volume
Functional
Residual
Volume

Air inhaled or
exhaled

Solutions

510ml/kg

Amount of diluent to add:

Air in lungs in
deep
breathing

1200ml

Strength of the solution to be

used:

Air in lungs in
normal
exhalation

2400ml

Reflexes
NAME

ELICITED BY

Babinski

Stroking lateral
sole of foot

Great toes fans

out

Chaddoc
k

Stroking below
lateral
malleolus

Great toes fans

out

Oppenhei
m

Stroking tibial
surface

Great toes fans

out

Gordon

Squeezing calf
muscle

Great toes fans

out

Hoffman

Flicking middle
finger down

Flexion of the
thumb

Ankle
clonus

Brisk
dorsiflexion of
foot

Up and down
movement of
the foot

Kernig

Straightening
with thigh
muscle flexed

Pain along
posterior thigh

Flexing chin on
chest

Limitations with
pain

amount of solution amount of solute

to use

NOTE: change the gram of solute

into ml

Amount of solution to be used:

Amount of solute to be used:

Vital
Capacity

Air exhaled
after max.
inhalation

4800ml

Total Lung
Capacity

Total air in
lungs in max.
inhalation

6000ml

Concentration of solution after

dilution:

Brudzinsk
i

RESPONSE

Blood Compatibility
BLOOD TYPE

ABAB-

Can Donate
TO
A-. A+
B-, B+
AB-, AB+

Can Receive
FROM
A-, OB-, OAB-, A-, B-, O-

A+

A+

A+, A-, B-, O-

B+

B+

AB+

AB+

O-

ALL BLOOD
TYPES
O+, A+, B+,
AB+

B+, B-, O+,

OALL BLOOD
TYPES
O-

O+

E IV Meds

VMT Catecholamine
Blood

0.2-0.9

Urine

0.27.0

Blood Fasting
With Fasting

No Fasting

BUN

CREA

Triglyceride

Amorphous

Total Protein

O+. O-

CBG

Uric Acid

SGOT, SGPT

Lipid profile
(HDL/LDL)

Direct & Indirect

Bilirubin
Na, K, Cl

Epinephrine

1:1000 SQ

Glucagon

1-2mg IM

D50%

Push

Others

D5W

Veno

Hgb AC

3.5-6.8%

Handwash: 10
sec

Doxorubucin &
Panorubucin

55-mg/m2

PTT, bleeding
time

VALUES
Urine
Specific
1.010-1.025
Gravity
Glycosuri
a
Clini &
Bene Test
AciTest

>200mg/dL
Glycosuria: (-) blue +1 green +2
yellow +3 orange +4 brick red
Acetone: (+) purplish pink

Quantitat
ive urine

24, HCG, Ketosteriod

Fractiona
l

<24, Amylase

Catheterization
Male
Fr: 16-18; 6-9
inches

Female
Fr: 12-14; 3-4
inches

Sputum
Hotsitz: 40-43 C

CultureSensitivity
Cytology AFB

With oral hygiene

Without oral hygiene

Oxygenation
Infants: Not >4%
Suction: 10 sec

Musculo-Skelital

COPD: low O2
HyperO2 : 15-30
sec

Extension
Pelvic

TNM Class

2-5.5 kg
4.5-9 kg

X
0

Physical Assessment

Cardiovascular

Blanc
h
Test
Chest

I-Pa-A

Digitalis

I-A-PaPe

<4 sec
I-P-P-A

Eyes,
heart,
head
Abdomen

Operating Room
Hem
o
Steril
e
field

48
15cm
above,
below

Infection
Airborne
organism
s

2-11
days
<5
microns

MI

CK
MB

0.82.0
ng

No access
None

2.5 ng:!

Myoglob
ulin

Increase 1-3; 12 peak

Troponin

Increase 3wks ; 2-4 peak

Electrolytes
135-145
3.5-5

Ca

8.5-10.5

PT

11-15 sec

PTT

60-70 sec

APTT

30-40 sec

Coudamin
Reaction
Heparin
Reaction
Coagulation
Time

2-2.25 x control
1.5-3 x control; 20 mins
5-15 mins

Thyroid

24 peak

Na
K

Clotting Time

Mg
Phos
phoru
s
Cl

LGBPS

PBI

4-8mcg

Bilirubin

T3

70-170mcg

T4

TSH

4.5-11.5
mcg
0.4-4.15

TBM
R

20-30; PP +
PR 111

BUN

Pancreat
itis

Crea

1.8-2.7
2.5-4.5
96-108

RAIU

Urine test:
24milliouries;
Uptake: 1540%
Urine: 4080%

Atrial
Natriuret
ic
peptide

Con: 0.30.8
UCon: 0.10.3
Jaun!: >2.5
Inc
amylase,
lipase
1020mg/dL
0.71.5mg/dL
Opposite of
RAS

Respiratory
ACIDOSIS
Causes: Carbonic
excess,
pneumonia,
hyperventilation,
obesity
S/Sx: Confusion,
CNS depression

Metabolic
ACIDOSIS
Causes:
Bicarbonate

deficit,
ketoacidosis,
shock, starvation,
diarrhea, renal
failure
S/Sx: Weakness,
disorientation,
coma

ALKALOSIS
Causes: Anxiety,
fear,
hyperventilation,
anemia, asthma
S/Sx:
Unconsciousness
(late sign)

ALKALOSIS
Causes:
Cushings,
hypokalemia,
hyperkalemia,
excessive
vomiting,
diuretics
S/Sx: Respiratory
depression,
tetany, mental
dullness

DIALYSIS

ELECTROLYTE IMBALANCES

ACID-BASE IMBALANCES

HypoN
a
HyperN
a
HypoK
HyperK

S/Sx

Causes

Weak,cold,cla
mmy
Thrist,dry,flus
hed
Weak,arrhyth
mias
Anxiety,arrhy
thmias

Overhydrate,
diarrhea
Dehydration,
SIADH
Diar,alkalosis
,polyuria
Burns,acidosi
s,renal
failure

HypoC
a

Cramps,spas
m,convulsion

Parath.d/o,
vitD def

HyperC
a

Bonepain,
n/v,
constipation

Bona Ca,
osteoporosis

HyoMg

Tremors,tach
y, HPN
Lethargy,
respiratory
difficulty

CA, chemo,
polyuria
Parath d/o,
renal failure

Hyper
Mg

Peritoneal

Infusion

2L of fluid to
peritoneal cavity

Dwell/Equilibrium

Osmolarity to
diffusion
Colorless to straw
colored

Drainage

!: Bleeding, Peritonitis

Hemodialysis
Diffusion

Remove ions and

renal waste

Osmosis

Remove excess
water
Regain balance

Ultrafiltration

Stages

Pre-renal
Intra-renal
Post-renal

Decrease GFR
Rhabdomyolysis
Obstruction

BLOOD GLUCOSE
Hyperglycemia
REACTIONS
>250mg/dL

Medications that cause

urine discoloration
Dark Yellow
Orange

Pink or Red
Green or Blue
Brown or Black

Timed Urine

Vitamin B2
Sulfonamide,
Pyridium,
Coudamin,
Rifampicin
Thorazine, Ex-Lax,
Phenytoin,
phenytoin
Amitriptylie,
Methyline blue,
Triamterine
Iron, Levodopa,
Test
Nitrofurantoin,
Metronidazole

Quan, Albumin

24

Amino Acid

24

Amylase

Chloride
Concentration
and Dilution
Crea
Clearance
Estriol

2,
12,
24
24
12 &
24
24

Glucose
Toler
17
Hydroxy
Urinalysi
s

12-24

Urine
Culture
Urine
Sensitivit
y
Urobilino
gen

Rando
m
Rando
m

Hypoglycemia
<60mg/dL
EARLY: Sweatiness,
shakiness, dizziness,
headache and hunger
LATE: numbness of
lips/tongue, difficulty
concentrating, mood
change, irritability,
vision changes, pallor
!: seizure, coma

TX: 10-15 g of glucose

or 2 glucose tabs or 5
pcs candy or 4 oz
orange juice (repeat q
15 min, if needed)

Regul
Insulin

Rando
m

Epinephrine

EARLY: excessive thirst,

frequent urination,
fatigue, weakness
LATE: abdominal paian,
n/v, general ache, loss
of appetite, flushed dry
skin, fruity breath,
drowsiness
!: labored breathing,
coma
TX: monitor CBG, test
urine for ketones,
provide IV hydration,
provide potassium
replacements, give
insulin per MD order

Short

ar

24

E DRUGS

Inter
media
te
2-4hr

6-8hr

15min

301hr

PEAK

30min

2-4hr

612hr

1824hr

DURA
TION

3hrs

6-8hr

24hrs

36hrs

Rando
m
Note: 90 SQ

Vasopressin
Atropine

Symptomatic
bradycardia, PVC

Sodium
Bicarbonate
Magnesium

Metabolic Acidosis
Tortades de
Pointes

CPR
Respiratory Arrest
ADULT

Long

ONSE
T

Cardiac arrest,
asystole
Alternative to
epinephrine

C
HI
LD

INFANT

1. Head-tilt, chin-lift
2. Check Carotid Pulse
3. Do mouth to mouth or
4. 10-20 RR/min
5. Full slow regulated
breaths
6. Blow 1, 1002, 1003,
1, Blow, 1, 1002,
1003, 2
Up to 1012, Blow (q
5sec).

Brachial
/ & nose to nose
2- RR/min
Gentle, Slow
Blow 1, 1001, Blow 1,
1002, Blow 1, 1003
Up to 1020, Blow (q
3sec)

Respiratory and Cardiac Arrest

ADULT

CHILD

INFANT

30:2 (compression: ventilation)

1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16
,17,18,19,20,1,2,3,4,5,6,7,8,9 & 1
Blow, Blow
1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16
,17,18,19,20,1,2,3,4,5,6,7,8,9 & 2
Blow, Blow
(up to 5 cycles)

Volume

4-8 L/min

Pulse grade

Pulse pressure

30-40 mmHg (systolediastole)

Pulse deficit

Heart rate- Pulse rate

Cardiac Output

Stroke volume Heart

rate

Digitalis

0.8-2.0
ng/ml

A. Tach:
150-250

PR

0.12-2.0

A. Flut:
250-350

QRS

0.04-1.0

A.Fib: .
350

ST

0.32-0.40

V.Tach:
101-250

HDL

40-60

Increase
ESR: MI

LDL

<130

CKMB:
0.88ng/ml
CVP: 512cm/H2
O

Triglyce
ride

<150

Cholest
erol

<200

RIGHT

HYPOCHONDRI
AC REGION
Right Portion
of kidney
Right renal
artery
Right adrenal
gland
Right lobe of
liver
Gall Bladder
Portion of
duodenum

EPIGASTRIC
REGION
Pancreas
Pyloric
Sphincter
Aorta
Duodenum
Portion of liver
Stomach

LEFT
HYPOCHONDRI
AC REGION
Tail of small
intestine
Spleen
Stomach
Tail of
pancreas
Left upper pole
of kidney
Left adrenal
gland

RIGHT LUMBAR
REGION
Right lower
half of Kidney
Portion of
jejenum and
ileum
Ascending
colon

UMBILICAL
REGION
Transverse
colon
Lower part of
duodenum
Jejenum and
ileum

LEFT LUMBAR
REGION
Descending
colon
Left lower part
of Kidney
Upper ureter
Portions of
jejenum and
ileum

RIGHT ILIACT
REGION
Right ovary
Right Fallopian
tube
Appendix
Cecum
Right
spermatic cord
Right ureter
Lower end of
ileum

HYPOGASTRIC
REGION
Uterus
(pregnancy)
Prostate
Ileum
Bladder

LEFT ILIACT
REGION
Left Lower
ureter
Left Fallopian
tube
Left Ovary
Let spermatic
cord

GCS

SNS

PNS

Eyes
4 Spontaneous

Heart

HR

HR

3 To command

Vessels

Constriction

Dilation

Lungs

RR

RR

GI

Peristalsis

Peristalsis

Anal

Closes
sphincter

Opens
sphincter

GU

Relaxes
bladder

Constricts
bladder

Eye

Dilates pupils

Constricts
pupils

Skin

Goose flesh,
pallor,
diaphoresis

Gastric and
salivary

Secretions

Liver

glycogenolysi
s

Pancreas

pancreatic
enzymes

Adrenal
Medulla

Norepinephrin
e

Penis

Ejaculation

2 To Pain
1 None

Verbal
5Oriented
4 Confused
3 Inappropriate words
2-- Grunting
1None

Motor
6obeys command
5 localizes pain
4 withdraws to pain

Cranial Nerves
I.
II.
III.
IV.
V.
VI.
VII.
VIII.
IX.
X.
XI.
XII.

Olfactory
Optic
Occulomoto
r
Tochlear
Trigeminal
Abducens
Facial
Vestibulo
cochlear
Glossophary
ngeal
Vagus
Acessory
Hypoglossal

3 Decorticate (Flex)
2 Decerebrate
(Extend)
1-- None

Secretions

pancreatic
enzymes

Erection