SBAR final

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	20 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: eosinophils are high which causes WBC to elevate, Hb is high due to chronic hypoxemia

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 stress, HB/Hct elevated due to polycythemia and chronic hypoxemia.

RBC	5 mill/mm3
Hb	10.6 gm/100mL blood
Hct	30 %
WBC	5,000 per mm3
K+	3.0 mEq/L
Na+	120 mEq/L
Cl	60 mEq/L
Creatinine	0.4 mg/dL
BUN	6 mg/dL
Troponin	0.0 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

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 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)

keywords for edema

CHF, swollen extremities

keywords for emphysema

COPD, smoker, packs per year, chronic cough

keywords for asthma

exacerbation, wheezing, severe SOB

cardiac for asthma

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

pulmonary for asthma

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

Renal

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

Extremities for Asthma:

CAPILLARY REFILL: <3 sec
SKIN COLOR: pink
PULSE: normal
CLUBBING: no
TEMP: normal
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
- DESIRED FiO2
- ALBUTEROL 2.5 MG Q4

Goals:

AMBULATE
DISCHARGE

Neuro

PERLA: normal
A&O: x3
GLASCOW: 15

Cardiac for Emphysema:

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

Pulmonary for Emphysema:

CXR: flatten diaphragm, hyperinflation
I:E RATIO: 1:4
A/P DIAMETER: barrel chest
SYMMETRY: symmetrical
PERCUSSION: hyper resonant
ACCESSORY MUSCLE USAGE: yes
BREATHING PATTERNS: eupnea

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

Cardiac for Edema:

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

Pulmonary for Edema:

CXR: butterfly, batwing, fluffy
I:E RATIO: 1:2
A/P DIAMETER: normal
SYMMETRY: symmetrical
PERCUSSION: dull on bases
ACCESSORY MUSCLE USAGE: yes
BREATHING PATTERNS: depends on scenario (tachy, Brady, eupnea)

Extremities for Edema:

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

Plan of care for Edema:

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