January 29, 2018 - Lab abnormality level B – abnormal and you...

Mark Klimek Lecture #8 January 29, 2018 Lab Values Lab abnormality level A – abnormal but really no big deal Lab abnormality level B – abnormal and you need to be concerned but just watching them closely Lab abnormality level C – High priority, critical you must do something about it Lab abnormality level D – Highest priority, stay at the bedside Serum Creatinine – best indicator of renal function

0.6 – 1.2A

INR – monitors warfarin therapy

• – 3C (if >4)

Potassium3.5 – 5.3Low K + – C High K +

• D

PH7.35 – 7.45 Low PH (<7) – D BUN -nitrogen waste products

• – 25 High BUN (assess for

dehydration) - A Hemoglobin12 – 18 (8 -11) – B (<8) – C Bicarb (HCO3)22 – 26 A Carbon Dioxide35 – 45 High CO2 (>50, >60) – C, D Hematocrit (3x the hgB) 36 – 54 Elevated Hematocrit - B PO278 – 100 Low PO2 - C SPO293 – 100 <93 - C BNP – best indicator of congestive heart failure <100Elevated - B Sodium135 – 145 B Change in LOC - C

WBC5,000 – 11,000C

ANC>500C CD4>200C RBC4 – 6 millionB This study source was downloaded by 100000807533334 from CourseHero.com on 06-18-2021 17:06:11 GMT -05:00

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Psych Drugs All psych drugs cause low blood pressure and makes your weight change Phenothiazines (First generation – typical antipsychotics) All end in -zine Actions – reduce symptoms of psych disease In large doses they are antipsychotics In small doses they are antiemetic’s Considered major tranquilizers oSide effects – Anticholinergic (Dry mouth), blurred vision, constipation, drowsiness, EPS (extrapyramidal syndrome – like Parkinson’s), fotosensitivity, aGranulocytosis Nursing Care is treating the side effects Deaconate – long acting, IM form given to non-compliant clients, could be court ordered Tricyclic Antidepressants (NSSRI’s) Mood elevators used to treat depression Side effects – anticholinergic (dry mouth), blurred vision, constipation, drowsiness, euphoria Take for 2-4 weeks before beneficial effects Benzodiazepines Minor tranquilizers Always have -zep in the name Works right away Side effects – anticholinergic (dry mouth), blurred vision, constipation, drowsiness MAOIS Antidepressants Patient teaching – to prevent hypertensive crisis, patient must avoid ALL foods containing tyramine.oFoods not allowed to have – fruits and veggies don’t typically have tyramine except three – bananas, avocados, raisins, not allowed to have organ meats, preserved meats, or certain processed lunch meats, dairy (cheeses except for cottage and mozeralla), yogurt, no alcohol, or chocolate.Lithium Used for treating bipolar disorder – decreases mania Side effects – pee, poop, paresthesia Toxic effects – hold and call if tremors, metallic taste, and severe diarrhea Make sure they are on increased fluids because they are constantly peeing and pooping.Lithium is closely linked to sodium - if sodium is low, lithium is toxic, if sodium is high, lithium wont work Prozac (SSRI) This study source was downloaded by 100000807533334 from CourseHero.com on 06-18-2021 17:06:11 GMT -05:00

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Side effects – anticholinergic (dry mouth), blurred vision, constipation, drowsiness, euphoria Prozac causes INSOMNIA so give it before noon, DO NOT GIVE at bedtime Watch for increased suicidal risk in adolescents and young adults Haldol Deaconate form – long acting IM oSide effects – Anticholinergic (Dry mouth), blurred vision, constipation, drowsiness, EPS (extrapyramidal syndrome – like Parkinson’s), fotosensitivity, aGranulocytosis NMS – elderly and white schizophrenics may develop NMS, high temp - >102, tremors, anxiety, medical emergency oALWAYS take a temperature Safety concerns related to side effects Clozaril (clozepene) Original first second generation atypical antipsychotic Used to treat severe schizophrenia Does not have the side effects ABCDEF, does have agranulocytosis WHITE count is a big deal, always measure Zoloft (sertraline) Causes insomnia but can be given at bedtime Increases toxicities with other drugs This study source was downloaded by 100000807533334 from CourseHero.com on 06-18-2021 17:06:11 GMT -05:00

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