CBC
Your patient's leukocyte count = 12. What could this indicate?
Infection
What is the "gold standard" to check kidney function?
Creatinine
What does the ROME pneumonic stand for?
Respiratory Opposite, Metabolic Equal
Your patient's Hgb = 90. Name two potential causes.
iron-deficiency anemia, hypovolemia, heavy menstruation, low folate or B12, bone marrow suppression
Your patient has a creatinine of 0.8 and a BUN of 25, what is the likely cause?
Dehydration.
Your patient has a ph of 7.33. Does this patient show acidemia or alkalemia?
Acidic.
What is another test that, in conjunction with low Hgb, can point to anemia?
Hematocrit
What does hypomagnesia put a patient at risk for (esp if pt is also hypokalemic)?
Torsades de pointes.
Your patient has a ph of 7.31, PaC02 of 52, and HC03 of 24. The patient's Pa02 = 85%. What does this reflect?
Respiratory Acidosis.
Your patient's PTT/INR is 3.6. They are scheduled to receive Warfarin po. What are your next nursing actions?
Hold warfarin, notify MRP and await possible orders for PCC or Vit K
Your patient has an Na+ of 120. What are they at risk for, and what is your first nursing intervention?
Seizures.
Nursing Intervention = restrict fluids
Your patient comes in with gastric symptoms of nausea and vomiting. Their ph = 7.48, paC02 = 40, and HC03 = 28. What does this reflect?
Metabolic alkalosis.
Your patient's aPTT = 70 sec. They are currently on a Heparin IV continuous drip. What are your next nursing actions?
Stop Heparin IV drip, contact MRP. Anticipate possible order for protamine sulfate. Observe closely for s/s of bleeding/hemorrhage.
Your patient has a K+ of 6.2. What is that patient at risk for? What is a primary nursing intervention?
Cardiac complications (arrhythmias, MI, asystole).
Nursing Interventions: cardiac monitoring, kayexelate protocol and/or insulin/dextrose IV
Your patient comes in with hypotension, is tachycardic, and is febrile with a temp of 38.7C. Their ph = 7.18, PaC02 = 32, and HC03 = 12. Their Pa02 = 84%. What does their ABG panel reflect, and what do you think may be going on with this patient?
Metabolic acidosis (with partial respiratory compensation).
Suspect sepsis, and initiate SIRS protocol.