What is the normal arterial blood gas (ABG) range for the partial pressure of oxygen (PO2)? o 80-100 mmHg o What if it’s higher than 100? What if it’s lower than 80? ▪ Higher = too much oxygenation … lower = hypoxia ➢ What is the normal arterial blood gas (ABG) range for the partial pressure of carbon dioxide (PaCO2)? o 35-45 mmHg o What if it’s lower than 35? What is it’s higher than 45? ▪ Decreased = Respiratory alkalosis … increased = Respiratory Acidosis ➢ What is the normal range for the compensatory arterial blood gas (ABG) bicarbonate (HCO3)? o 21-28 mEq/L o What is it’s higher than 28? What if it’s lower than 21? ▪ Higher = respiratory acidosis (compensation for metabolic alkalosis) … Lower = respiratory alkalosis (compensating for metabolic acidosis) ➢ What is the normal range for glucose? o 60-100 mg/dL ➢ What is the range of pre-diabetes for an impaired fasting glucose (IFG) test? o 100-125 mg/dL ➢ What is the range of pre-diabetes for a 2 hour oral glucose tolerance (IGT) test? o 140-199 mg/dL ➢ What is the normal range for a glycosylated hemoglobin (HbA1C) test? ▪ 4-6% ➢ What is the reference range for the electrolyte phosphorus? o 3 – 4.5 mg/deciLiter ➢ What is the reference range for the electrolyte magnesium? o 1.3 – 2.1 milli-Equivalents/Liter 2 ➢ What is the reference range for the electrolyte chloride? o 98 – 106 milli-Equivalents/Liter ➢ What is the reference range for the electrolyte calcium? o 9 – 10.5 mg/deciLiter ➢ What is the reference range for the electrolyte potassium? 3 o 3.5 – 5 milli-Equivalents/Liter ➢ What is the reference range for the electrolyte sodium? o 136 – 145 milli-Equivalents/Liter ➢ What is the reference range for hemoglobin? o 14-18 gram/deciliter ➢ What is the reference range for hematocrit? o 42-52% ➢ What is the reference range for blood osmolarity? o 285-295 mOsm/kg ➢ What are the normal levels for serum creatinine? o 0.6-1.2 ➢ What are the normal levels for BUN? o 10-20 ➢ What are major risk factors for VTE? [Name 5] o (1) prolonged immobility (2) central venous catheter (3) surgery (4) obesity (5) older age (6) blood prone to clotting (7) prior history ➢ If a patient has a VTE, what are the priority nursing interventions? [Name all in order] o (1) oxygen therapy (2) anticoagulant or fibrinolytic therapy (3) monitoring patient’s response ➢ If a patient is suspected of a VTE, when should you sit them in highFowler’s position? o Immediately after putting them on oxygen ➢ If a patient with a VTE is receiving fibrinolytics, what antidotes should be ready in case of overdose? [Name all] o (1) clotting factors (2) fresh frozen plasma (3) aminocaproic acid (Amicar) ➢ What are 4 priority problems for a patient with a PE? [Name all in order] o (1) hypoxemia (2)hypotension (3) potential for bleeding related to anticoagulant/fibrinolytic therapy (4) anxiety ➢ What are the classic symptoms for a PE? [Name all] o (1) sudden onset of dyspnea (2) sharp, stabbing chest pain (3) restlessness (4) feeling of impending doom (5) cough (6) hemoptysis o What other symptoms may they experience? [Name 3] ▪ (1) tachypnea (2) crackles (3) pleural friction rub (4) tachycardia (5) sweating (6) low-grade fever (7) decreased 4 O2 Saturation (8) S3 or S4 heart sounds/gallop (9) petechiae all over chest ➢ What conditions could cause a patient to be at risk for ventilatory failure? [Name 5] o (1) COPD (2) Pulmonary Embolism or PE (3) ARDS (4) pulmonary edema (5) stroke (6) increased intracranial pressure (7) opioids (8) spinal cord injury (9) massive obesity (10) sleep apnea ➢ What is the hallmark of acute respiratory distress syndrome (ARDS)? o Hypoxemia that persists even with 100% oxygen ➢ If your patient is at risk for a PE, what symptoms would let you know to notify the rapid response team? [Name all] o (1) jugular vein distention (2) syncope (3) cyanosis (4) hypotension ➢ What method is most commonly used to diagnose a PE? o CT scan ➢ Despite the different causes for acute lung injury, what triggers ARDS? o Systemic inflammatory response ➢ What is the nursing priority in the prevention of ARDS? o Early recognition in high risk patients ➢ What kind of patients are considered at high risk for ARDS? o (1) patients with tube feeding and impaired swallow/gag reflex because of aspirating very acidic gastric contents (2) pancreatitis (3) transfusion reactions (4) trauma o What physical assessments indicate early symptoms of ARDS? ▪ (1)assess breathing – (a) for increased rate (b) noisy respirations (c) retractions (d) increased effort; (2) cyanosis (3) mental status (4) pallor (5) hypotension (6) tachycardia (5) dysrhythmias ▪ Why don’t you assess for abnormal lung sounds? ● Because it occurs in the interstitial spaces first and not the airways ➢ What is FiO2? o Fraction of inspired oxygen ➢ What ABG result will diagnose ARDS? o Lowered PaO2 (partial pressure of oxygen) o What does this value look like later? ▪ Increased ➢ What are common interventions for a patient with ARDS? [Name all]