SBAR final II

value for RBC

4-6

value for Hb

12-16

value for Hct

40-50%

value for WBC

5,000-10,000

value for K+

3.5-4.5

value for Na+

135-145

value for Cl

90-100

values for creatine

0.7-1.3

value for BUN

8-25

value for troponin

<0.1

value for BNP

<100

RBC	5 mill/mm3
Hb	14 gm/100mL blood
Hct	50%
WBC	15,000 per mm3
K+	2.5 mEq/L
Na+	140 mEq/L
Cl	90 mEq/L
Creatinine	1.0 mg/dL
BUN	19 mg/dL
Troponin	0.0 ng/mL
BNP	100 pg/mL

identify the values and what causes these values? Also identify to which pt this labs belongs to.

Asthma: WBC elevated due to infection

RBC	5 mill/mm3
Hb	20.5 gm/100mL blood
Hct	55 %
WBC	12,000 per mm3
K+	4 mEq/L
Na+	135 mEq/L
Cl	90 mEq/L
Creatinine	0.7 mg/dL
BUN	10 mg/dL
Troponin	0.0 ng/mL
BNP	100 pg/mL

identify the values and what causes these values? Also identify to which pt this labs belongs to.

Emphysema: WBC elevated due to infection, HB/Hct elevated due to polycythemia and chronic hypoxemia.

RBC	5 mill/mm3
Hb	13 gm/100mL blood
Hct	45 %
WBC	6,000 per mm3
K+	3.0 mEq/L
Na+	120 mEq/L
Cl	60 mEq/L
Creatinine	0.8 mg/dL
BUN	15 mg/dL
Troponin	1.2 ng/mL
BNP	130 pg/mL

identify the values and what causes these values? Also identify to which pt this labs belongs to.

pulmonary edema: almost everything is decreased due to fluid overload, high BNP and troponin due to cardiac issues

RBC	4-6mill/mm3
Hb	12-16gm/100mL blood
Hct	40-50%
WBC	5,000-10,000per mm3
K+	3.5-4.5 mEq/L
Na+	135-145 mEq/L
Cl	90 mEq/L
Creatinine	0.7-1.3mg/dL
BUN	8-25mg/dL
Troponin	<0.1ng/mL
BNP	<100pg/mL

identify the values and what causes these values? Also identify to which pt this labs belongs to.

normal healthy pt

treatment for asthma

peak flow x3 and nebulizer (albuterol 2.5mg)

treatment for emphysema

nebulizer on medical air avoid over oxygenating

treatment for pulmonary edema

pep therapy for 2 mins (20 start setting on 5 L/min)

cardiac for asthma

S1/S2: no murmurs
PMI: reduced
RHYTHM: depends on scenario (tachy, brady, normal)

pulmonary for asthma (8)

CXR: hyperinflation
I:E RATIO: 1:4
A/P DIAMETER: increased
PERCUSSION: hyperresonant
ACCESSORY MUSCLE USAGE: yes
BREATHING PATTERNS: depends on scenario (tachy, brady, eupnea, apnea)
cough: productive
sputum: yellow 

Renal

URINE IN/OUT: use formula:  body weight/2.2kg (24)

Extremities for Asthma:

CAPILLARY REFILL: <3 sec
SKIN: pink
CLUBBING: no
TEMP: normal (unless has fever)
EDEMA: no
TOBACCO STAINING: no

Tests:

ABG: If pt does not improve.
CXR: If pt does not improve.

Plan of care for Asthma:

- IV STEROIDS
- ALBUTEROL 2.5 MG Q4
- PEAK FLOW
- SPUTUM CULTURE

Goals:

AMBULATE
DISCHARGE

Neuro

PERLA: normal
A&O: x3
GLASCOW: 15

Cardiac for Emphysema:

S1/S2: no murmurs
PMI: reduced
RHYTHM: depends on scenario (tachy, brady, normal)

Pulmonary for Emphysema/pneumonia:

CXR: flatten diaphragm, hyperinflation, consolidation on effected side
I:E RATIO: 1:4
A/P DIAMETER: barrel chest
PERCUSSION: hyper resonant
ACCESSORY MUSCLE USAGE: yes
BREATHING PATTERNS: eupnea
COUGH: productive
SPUTUM: green/black

Extremities for Emphysema:

CAPILLARY REFILL: <3 sec
SKIN COLOR: pink
PULSE: normal
CLUBBING: yes
TEMP: normal
EDEMA: no
TOBACCO STAINING: yes

Plan of care for Emphysema:

- IV STEROIDS
- DESIRED FiO2
- ALBUTEROL 2.5 MG Q4
- sputum culture

Cardiac for Edema:

S1/S2: no murmurs
PMI: shift to Lt
RHYTHM: depends on scenario (tachy, brady, normal)

Pulmonary for Edema:

CXR: butterfly, batwing, fluffy, Kerley b lines
I:E RATIO: 1:2
A/P DIAMETER: normal
PERCUSSION: dull on bases
ACCESSORY MUSCLE USAGE: yes
BREATHING PATTERNS: depends on scenario (tachy, Brady, eupnea)
cough: productive
sputum: pink frothy

Extremities for Edema:

CAPILLARY REFILL: >3 sec
SKIN COLOR: pink
CLUBBING: no
TEMP: normal
EDEMA: yes
TOBACCO STAINING: no

Plan of care for Edema:

-LASIX
-DESIRED FiO2
-PEP THERAPY Q4 (2 MINS)