Lab and IV Therapy Module
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The topic for this week is Lab Values, Diagnostics, and IV Therapy. We know that this information will be valuable to your studying and increase your chance of passing the NCLEX.
For more detailed explanation of this subject and accompanying video lecture from Cindy Liette, RN, the founder and lead instructor for Brainy Nurses, visit our website!
To begin this newsletter, we will start by discussing labs that are used to evaluate dehydration and renal function. There are five primary lab values which are evaluated to determine if a patient is dehydrated that are essential for the nursing student to understand prior to taking the NCLEX. The five lab values are:
1. BUN: Normal is 10-20. Not a great indicator of renal function. Will be high in renal dysfunction in conjunction with the creatinine.
2. Creatinine < 1.2 mg/dL. Increases in renal failure.
3. Hematocrit (Hct): 36-54%
4. Specific gravity of urine: Normal is 1.005-1.030. High values indicate dehydration. >1.020 indicates hypovolemia and need for early intervention.
5. Sodium: Normal is 135-145 mEq/L. Increases with dehydration.
The second subject that will be discussed is lab values that must be considered for patients that are diabetic. This is a very important subject for the NCLEX. The values that you need to remember for your exam are:
1. FBS 70-105 mg/dL
2. Prediabetes is 100-125 mg/dL fasting.
3. Random finger stick goal is 70-150 mg/dL
4. Critical values <50 or >400 mg/dL
5. A1C of < 7 is good
6. Ketonuria is generally not seen in diabetes type II.
I would like briefly talk about some of the complications that our patients are susceptible to when undergoing IV Therapy. Two of the most common complications are infiltration and extravasation, which will cause tissue damage. However, the priority complication that you need to remember for the NCLEX is fluid overload. In order to assess fluid overload, the following symptoms will be observed:
1. Vital Signs: They will all increase
2. Lung Sounds: Hear crackled with fluid overload
3. Respiratory Effort: Use all accessory muscles to breath
Finally, we will talk about hypocalcemia and how to properly conduct your assessment of the patient. There are multiple causes of hypocalcemia, including renal failure, hypoparathyroidism, alkalosis, malabsorption, and pancreatitis. The symptoms that must be accounted for to properly assess hypocalcemia are:
- ↑ Muscle twitching, tetany, seizures.
- ↑ Respiratory difficulty and laryngospasm.
- ↑ Irritability and memory impairment.
- ↑ Calcium moving out of the bone → bone pain.
- + Chvostek’s and Trousseau’s signs (level < 6 mg/dL).
To manage hypocalcemia, the NCLEX wants you to remember to treat the patient with calcium rich foods, oral supplements, and intravenous supplements. While giving a calcium IV is a potential management technique, you need to remember to no mix with bicarbonate containing solutions as this will cause precipitation to form.
We hope that you have enjoyed this brief explanation of some key considerations for you as you prepare for your NCLEX examination.
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