Vital Signs

Heartrate: 80—100 bpm Therapeutic Drug Levels

Respiratory rate: 12—20 rpm Carbamazepine
4—10 mcg/ml
Blood pressure: 110—120/60 mmHg (Tegretol)
Temperature: 37°C (98.6°F) Digoxin (Lanoxin) 0.8—2.0 ng/ml
Gentamycin 5—10 mcg/ml (peak),
Hematology Values (Garamycin) <2.0 mcg/ml (valley)
RBCs: 4.5—5.0 million Lithium (Eskalith) 8—1.5 mEq/L
WBC’s: 5,000—10,000 Phenobarbital
15—40 mcg/ml
Platelets: 200,000—400,000 (Solfoton)
Hemoglobin 12—16gm (female) Phenytoin (Dilantin) 10—20 mcg/dL
(Hgb): 14—18gm (male) Theophylline
10—20 mcg/dL
Hematocrit (Hct): 37—47 (female) (Aminophylline)
5—10 mcg/ml (peak),
40—54 (male) Tobramycin (Tobrex) 0.5—2.0 mcg/ml
Serum Electrolytes (valley)
Sodium 135—145 mEq/L Valproic Acid
50—100 mcg/ml
(Depakene)
Potassium 3.5—5.5 mEq/L
Vancomycin 20—40 mcg/ml (peak),
Calcium 8.5—10.9 mEq/L 5to15 mcg/ml
Chloride 95—105 mEq/L (Vancocin) (trough)
Magnesium 1.5—2.5 mEq/L Anticoagulant Therapy
Phosphorus 2.5—4.5 mEq/L 10—12 seconds
Sodium warfarin
(control)
ABG (Values! (Coumadin) PT
The antidote is Vitamin K
pH 7.36—7.45 INR (Coumadin) 0.9—1.2
HCO3 24—26 mEq/L 30—45 seconds
CO2 35—45 mEq/L (control)
PaO2 80%—100% Heparin PTT
The antidote is
SaO2 >95% Protamine sulfate
APTT 3—31.9 seconds
Acid_Base Balance 203—377 mg/dL
 Remember ROME (respiratory! Opposite/ Fibrinogen level
metabolic equal) to remember that inConversions
respiratory acid base disorders the pH is
opposite to the other components. 1 teaspoon(t) 5 ml
 Use the Tic-tac-toe Method for interpreting! 1 tablespoon (T) 15 ml
ABGs.
1 oz 30 ml
Chemistry Values
Glucose 70—110 mg/dL 1 cup 8 oz
Specific Gravity 1.010—1.030 1 quart 2 pints
BUN 7—22 mg/dL
1 pint 2 cups
Serum creatinine 0.6—1.35 mg/dL
LDH 100—190 U/L 1 grain (gr) 60 mg
Protein 6.2—8.1 g/dL 1 gram (g) 1000mg
Albumin 3.4—5.0 g/dL
Bilirubin <1.0 mg/dL 1 kilogram (kg) 2.2 lbs
Total Cholesterol 130—200 mg/dL 1 lb 16 0z
Triglyceride 40—50 mg/dL
C+40 multiply by
Uric acid 3.5—7.5 mg/dL Convert C to F
9/5 and subtract 40
CPK 21—232 U/L
Convert F to C F + 40 multiply by
 5/9 and subtract 40 Pregnancy Category N — Not yet classified

Maternity Normal Values

Fetal Heart Rate 120—160 bpm
Drug Schedules
Variability 6—10 bpm Schedule I
Amniotic fluid 500—1200 ml ― No currently accepted medical use and for
Contractions 2—5 minutes apart with research use only
duration of 90 seconds ― (e.g., heroin, LSD, MDMA)
and intensity of <100 Schedule II
mmHg ― Drugs with high potential for abuse and
AVA The umbilical cord has
requires written prescription
two arteries and one
vein
― (e.g., Ritalin, hydromorphone (Dilaudid),
APGAR Scoring: meperidine (Demerol), and fentanyl
Appearance Schedule III
Pulses ― Requires new prescription after six months or
Grimace
five refills
Activity
Reflex Irritability
― (e.g., codeine, testosterone, ketamine)
Schedule IV
 Done at 1 and 5 minutes with a score of: ― Requires new prescription after six months
0- for absent ― (e.g., Darvon, Xanax, Soma, and Valium)
1- for decreased
2- for strongly positive Schedule V
7- and above are generally normal ― Dispensed as any other prescription or
4 to 6- fairly low without prescription
3- and below critically low ― (e.g., cough preparations, Lomotil, Motofen)
STOP
—Treatment for maternal hypotension after an
epidural anesthesia:
 Stop infusion of Pitocin
 Turn the client on her left side
 Administer oxygen
Medication(Classificat
 If hypovolemia is present, push IV
fluids

PregnancyCategory(of( ions
Antacids
Drugs! ― Reduces hydrochloric acid in the
Category A — No risk in controlled human stomach
studies Antianemics
Category B — No risk in other studies ― Increases blood cell production
Examples: Amoxicillin, Anticholinergics
Cefotaxime ― Decreases oral secretions
Category C — Risk not rules out Anticoagulants
Examples: Rifampicin (Rifampin), ― Prevents clot formation
Theophylline (Theolair), etc. Anticonvulsants
Category D — Positive evidence for risk ― Used for management of seizures
Examples: Phenytoin, Tetracycline and/or bipolar disorders
Category X — Contraindicated in Pregnancy Antidiarrheals
Examples: Isotretinoin (Accutane), ― Lower blood pressure and increases
Thalidomide blood flow
(Immunoprin) Antihistamines
 ― Block the release of histamine Hydroxyzine (Vistaril)
Antihypertensives ― Treatment of anxiety and itching
― Lower blood pressure and increases― WOF dry mouth
blood flow Isoniazid
― Can case peripheral neuritis, take
Anti-infectives vitamin B^ to counter
― Used for the treatment of infections Methylphenidate (Ritalin)
Bronchodilators ― Treatment of ADHD
― Dilates large air passages ― Assess for heart related side-effects
― E.g., COPD and report immediately
Diuretics ― Child may need a drug holiday because
the drugs stunts growth
― Decreases water/sodium from the
Midazolam (Versed)
Loop of Henle ― Given for conscious sedation
Laxatives ― Watch out for (WOF) respiratory
― Promotes the passage of stool depression and hypotension
Miotics Rifampicin
― Constricts the pupils ― Causes red-orange tears and urine
Mydriatrics Warfarin (Coumadin)
― Dilates the pupils ― WOF for signs of bleeding, diarrhea,
fever, or rash
Narcotics/Analgesics
― Stress importance of complying with
― Relieves moderate to severe pain prescribed dosage and follow-up
appointments
Rule of Nines for calculating Total Body
Surface Area TBSA for burns Developmental Milestones
Head and neck:…………9% 2 to 3 months
Upper Limbs:…………….18% (9% each) ― Able to turn head up, and can turn
side to side
Anterior Torso:………..18% ― Makes cooing or gurgling noises and
Posterior Torso:……….18% can turn head to sound
Legs: …………………………36% (18% each) 4 to 5 months
Genitalia:……………………1% ― Grasps, switch and roll over tummy to
back
Medications ― Can babble and can mimic sounds
6 to 7 months
Aluminum Hydroxide (Amphojel) ― Sits at 6 and waves bye-bye
― Treatment of GERD and kidney ― Can recognize familiar faces and
stones, WOF constipation knows if someone is a stranger
Amiodarone (Cordarone) ― Passes things and forth between hands
― WOF diaphoresis, dyspnea, 8 to 9 months
lethargy ― Stands straight at eight, has
― Take missed dose any time in favorite toy, plays peek-a-boo
the day or o skip it entirely 10 to 11 months
― Do not take double dose ― Belly to butt
Digoxin (Lanoxin) 12 to 13 months
― Assess pulses for a full minute, if ― Twelve and up, drinks from a cup
less than 60 bpm hold dose ― Cries when parents leave
― Check digitalis and potassium levels ― Uses furniture to cruise
Dopamine
― Treatment of hypotension, shock, and Cultural Considerations
low cardiac output African Americans
― Monitor ECG for arrhythmias and blood ― May believe that illness is
pressure caused by supernatural causes and
Ethambutol seek advice and remedies form
― Causes problems with vision, liver faith healers
problem
 ― They are family oriented\ have ― May consult with a curandero or
higher incidence of high blood voodoo priest
pressure and obesity\ ― Family members are typically
― High incidence of lactose involved in all aspects of
intolerance with difficulty decision making such as terminal
digesting milk and milk products illness
Arab Americans ― May see no reason to submit to
― May remain silent about health mammograms or vaccinations
problems such as STIs, substance Native Americans
abuse, and mental illness ― May turn to a medicine man to
― A devout Muslim may interpret determine the true cause of an
illness as the will of Allah, a illness
test of faith ― May value the ability to endure
― May rely on ritual cures or pain or grief with silent stoicism
alternative therapies before ― Diet may be deficient in vitamin D
seeking help from health care and calcium because many suffer
provider from lactose intolerance or don’t
― After death, the family may want drink milk
to prepare the body by washing ― Obesity and diabetes are major
and wrapping the body in unsewn health concerns
white cloth ― May divert eyes to the floor when
― Postmortem examinations are they are praying or paying
discouraged unless required by attention
law Western Culture
― May avoid pork and alcohol if ― May value technology almost
Muslim exclusively in the struggle to
― Islamic patients observe month conquer diseases
long fast of Ramadan (begins ― Health is understood to be the
approximately mid-October) absence, minimization, or control
― People suffering from chronic of disease process
illnesses, pregnant women, breast ― Eating utensils usually consists
feeding, or menstruating don’t of knife, fork, and spoon
fast
― Three daily meals is typical
― Females avoid eye contact with
males
― Use same sex family members as
interpreters.
Asian Americans
― May value ability to endure pain
and grief with silent stoicism
― Typically, family oriented
― Extended family should be
involved in care of dying patient
― Believes in “hot-cold” yin’yang
often involved
― Sodium intake is generally high
because of salted and dried foods
― May believe prolonged eye contact
is rude and an invasion of
privacy
― May not without necessarily
understanding
― May prefer to maintain a
comfortable physical distance
between the patient and the
health care provider
Latino Americans
― May view illness as a sign of
weakness, punishment for evil
doing