Review for Module 4Exam IIChapter Topic Number of questions41 Diuretics 644 RAAS 545 CCB 446 Vasodilators 347 HTN 548 HF 1049/PP Dysrhythmia 250 CAD 751 Angina 8Many of the questions about medications are discussed in more than one chapter. However, this is the general blueprint of the test. There are a couple of questions that may require a calculator. You should be familiar with the lab values we used in the case studies (Na, Cl, K, Cr)BloodsampleNormal Clinical SignificanceArterial Blood Gases (ABG)PaO2 = 80-100 mm HgPaCO2 = 35-45 mm HgpH = 7.35-7.45HCO3 = 22-26 mEq/lSaO2 = 95-99%Panic Values for ABGsPaO2: < 40PaCO2: < 20 or > 70pH: < 7.2 or > 7.6HCO3: < 10 or > 40SaO2: < 60%Degrees of Hypoxia:mild: PaO2 of 60-80 mmmod: PaO2 of 40-60 mmsevere: PaO2 < 40 mmHematocrit (Hct)Female: 36-46%Male: 42-52%Low values = Anemia: monitor for fatigue, dyspnea, tachycardia, tachypneaRBC / Whole Blood = ___ %Hemoglobin (Hgb)Female: 12-15 g/dlMale: 14-17 g/dlLow values = Anemia: monitor for fatigue, dyspnea, tachycardia, tachypneaChemotherapy: < 10 -- hold aerobic exerciseRBC Count Female: 4 -5.5 million/mm3Male: 4.5 - 6.2 million/mm3Low values = Anemia: monitor for fatigue, dyspnea, tachycardia, tachypneaHigh values: In COPD, may indicate Polycythemia, a compensation for pulmonary dysfunction that makes blood thicker, and increases risk of CVA, etc.Total WBC Count5,000 - 10,000 /mm3> 10,000 indicates systemic infection (more than justlocal colonization)Chemotherapy : < 5,000: use reverse isolation, see patient in room, careful hygiene, hold aerobic exercisePlatelets,Thrombocytes200,000 - 500,000 /mm3Chemotherapy:- 30,000 – 50,000: avoid resisted exercise, risk of internal hemorrhage, ambulation OK- < 30,000: bedside, gentle AROM- < 20,000: consult with physician or nurse before activity"Sed Rate",Erythrocyte Sedimentation Rate (ESR)Female: 1-25 mm/hrMale: 0-17 mm/hrBad if elevated.Used to diagnose, or follow the course of inflammatory diseases, e.g. rheumatic conditionsAlternative calculation of normal value:Female: (age + 10) / 2Male: age / 2 Creatinine Female: 0.6 - 1.2 mg/dlRenal function measure: high values are bad.May indicate nephropathy, end stage renal d.Male: 0.5 - 1.1 mg/dlElderly values are lower because of reduced muscle massCan occur in brittle diabetics also.Potassium (K)3.5 - 5.0 mEq/l Low (hypokalemia) secondary to: vomiting, diarrhea, sweating, or use of loop diuretics e.g. Lasix, furosemide. Also increases the risk of digitalis toxicity. Result of low K: ventricular arrhythmiasHigh (hyperkalemia) secondary to: overuse of K supplements, renal or endocrine problem.Result of high K: ventricular arrhythmias, asystoleCalcium (Ca) 8.2 -10.2 mg/dlLow (hypocalcemia): secondary to: abuse of laxatives, renal failure, low dietary calcium or Vit. D intake, excessive magnesium intake.Result of low Ca: osteoporosis, muscle spasms / tetany, calcium deposits in tissue; cardiac arrhythmia, asystoleHigh (hypercalcemia): secondary to: immobilization, metastatic bone CA; overuse of antacids containing calciumResult of high Ca:thirst; polyuria; renal stones; decreased muscle tone and DTRs; tachycardia; cardiac arrhythmia, asystoleSodium (Na) 136 -145 mEq/lLow (hyponatremia) secondary to: fluid loss from diarrhea, vomiting, diaphoresis, diuretic use.Result of low Na: postural hypotension, abdominal cramps, headache, fatigue, weaknessHigh (hypernatremia) secondary to: dehydration, high salt intake, poor renal functionResult of high Na: edema,
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