Nursing 265 Exam 4 Study Guide Updates

Nursing 265 Exam 4 Study Guide Updates
Labs
• Hbg 12-18
• Hct 37-52%
• WBC 5-10
• RBC 4.2-6.1
• PLT 150-400
• PT 11-12.5 sec (1.5-2.5x normal on Coumadin = 16.5-31.25 sec)
• INR 0.9-1.2 sec (Therapeutic level 2-3x normal = 1.8-3.6 sec)
• PTT 60-70 sec (1.5-2.5x normal on Heparin = 90-175)
• Na 135-145
• K+ 3.5-5
• Creatinine 0.5-1.2
• BUN 10-20
• Albumin 3.5-5
• Mg 1.5-2.5
• Ca 9-10.5
• Cl 98-106
• Phosphorus 2-4.5
• Specific Gravity 1.005-1.030
Discoid lupus
• Affects only the skin and is not lethal - Caused by UV rays
• Macular Rash & Discoid Rash
• Skin biopsy to dx
Systemic Lupus Erythematosus (313-317) ***TEMPERATURE***
• Chronic, progressive, inflammatory connective tissue disorder that affects multiple body systems &organs
o REMISSIONS/EXACCERBATIONS (can end up in the ICU) - Autoimmune
o Attracted to KIDNEY’s—Lupus Nephritis is leading cause of death; this is direct damage to the kidneys
• Poor survival associated with high creatinine, low hematocrit, proteinuria
o Young Women of child bearing age 20-40 Y (primary AA women)
o SLE & DLE both share a disfiguring and embarrassing rash!!
• Clinical manifestations
o Malar rash – red flat or raised rash over cheeks sparing nasolabial folds “butterfly rash”
o Discoid rash – Red raised patches with scaling follicle plugging
o Photosensitivity– discoid skin rash from sun exposure - pt should wear sunscreen or protective clothing
o Oral ulcers–usually painless
o Polyarthritis-multiple joints affected
• Small joints and knees inflamed
• Osteonecrosis from chronic steroid use (5y+)
o Pleuritis with pleural effusion or pericarditis
o Fever is the major sign of exacerbation
o Generalized weakness, fatigue, anorexia, weight loss
o Renal disorders–proteinuria, cellular casts
o Neurologic disorders – seizures, psychosis and also peripheral neuropathies
o Raynaud’s phenomena
• Exposure to cold or extreme stress – red, white, blue & pain of digits
o Alopecia or hair loss common

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