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Nursing Procedures and Skills

COMMON LABORATORY VALUES NURSES SHOULD KNOW

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Common Laboratory Values
VALUENORMAL RANGEUNIT
COMPLETE BLOOD COUNT
Red Blood Cell (RBC)M: 4.5—5.5
F: 4.0—4.9
x105/ml
White Blood Cell (WBC)4,500—10,000cells/mcL
Platelets100,000—450,000cells/mcL
Hemoglobin (Hgb)M: 13.5—16.5
F: 12.0—15.0
Pregnant: 10—15
g/dL
Hematocrit (Hct)M: 41—50%
F: 36—44%
 
Mean Corpuscular Volume (MCV)80—100fL
DIFFERENTIAL COUNT
Neutrophils54—62% 
Eosinophils1—3% 
Basophils0—0.75% 
Lymphocytes25—33% 
Monocytes3—7% 
SERUM ELECTROLYTES
Sodium (Na+)135—145mEq/L
Potassium (K+)3.5—5.5mEq/L
Chloride (Cl-)95—105mEq/L
Calcium8.5—10.9mEq/L
Calcium, ionized2.24—2.46mEq/L
Magnesium (Mg)1.5—2.5mEq/L
Phosphorus (P)2.5—4.5mEq/L
URINALYSIS
Volume1,000—2,000mL/day
30mL/hour
Specific Gravity1.010—1.020 
pH4.5—8 
Casts1—2per high power field
Glucosenone 
Proteinnone 
Uric AcidF: 3.5—7.2
M: 2.6—6.0
mg/dL
CHEMISTRY VALUES
GlucoseAdults: 70—110mg/dL
Blood Urea Nitrogen (BUN)Adults: 7—18
Child: 5—20
Infant: 5—15
mg/dL
Serum Creatinine0.6—1.35mg/dL
Creatinine Clearance (CrCl)F: 85—132
M: 90—138
mL/min
Albumin3.4—5.0g/dL
Bilirubin<1.0mg/dL
Uric Acid3.5—7.5mg/dL
Creatine phosphokinase (CPK)21—198units/L
COAGULATION STUDIES
Prothrombin Time (PT)11—14seconds
Partial Thromboplastin Time (PTT)25—35seconds
International Normalized Ratio (INR)0.8—1.2 
Activated Partial Thromboplastin Time (aPTT)1.5—2.5 
Fibrinogen203—377mg/dL
Bleeding time1—6mins
LIPOPROTEINS AND TRIGLYCERIDES
Total CholesterolIdeal: below 200
Borderline: 200—240
High: above 240
mg/dL
Low Density Lipoprotein (LDL)<70mg/dL
High Density Lipoprotein (HDL)<60mg/dL
TriglyceridesNormal: below 150
Borderline high: 150—199
High: 200—499
Very high: above 500
mg/dL
SGOT (AST)<35IU/L
SGPT (ALT)<35IU/L
CARDIAC MARKERS
Troponin (CTN-1 or CTN-T)Normal I: 0.03
Critical level I: above 1.5
Critical level T: 0.2
ng/L
C-reactive proteinBelow 0.8mg/dL
CD40 Ligand1.51—5.35mg/L
Creatinine Kinase (CK-MB)0—3mcg/L
ARTERIAL BLOOD GAS
pH7.35—7.45 
Partial Pressure of CO2 (pCO2)35—45mmHg
Partial Pressure of O2 (pO2)80—100mmHg
Bicarbonate (HCO3)22—26mEq/L
Base Excess (BE)-2—+2mEq/L
Oxygen Saturation (SaO2)95—100% 
THYROID FUNCTION STUDIES
Thyroid-Stimulating Hormone (TSH)Adults: 0.2—5.4
Neonate: 3—20
mU/L
Thyroxine (Total T4)Adult: 5.4—11.5
Child: 6.4—13.3
mcg/dL
Free Thyroxine (Total T4 F4)Adult: 0.7—2.0ng/dL
Thyroid-Binding Globulin (TBG)Male: 15—30
Female: 11.5—32.2
Pregnancy
1st Trimester: 19.8—64.7
2nd Trimester: 41.4—63.9
3rd Trimester: 31.0—73.6
mcg/dL
Triiodothyronine (Total T3)75—200ng/dL
Free Triiodothyronine (FT3)260—480pg/dL
Thyroglobulin (Tg) Antibody5—25ng/mL
TUMOR MARKERS
CA 19-9 Tumor Markers<37U/mL
CA 27.29Above 38Uml
CA 15.3Above 22Uml
CA 1250—35Uml
Carcinoembryonic Antigen (CEA)Above 5ng/mL
THERAPEUTIC SERUM DRUG LEVELS
Carbamazepine (Tegretol)4—10mcg/mL
Digoxin (Lanoxin)0.8—2.0ng/mL
Lithium (Eskalith)0.8—1.5mEq/L
Phenobarbital (Solfoton)15—40mcg/mL
Theophylline (Aminophylline)10—20mcg/mL
Valproic Acid (Depakene)50—100mcg/mL

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Nursing Procedures and Skills

Essential Strategies for Dealing with Difficult Patients and Families in Healthcare Settings

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As nurses, we sometimes encounter patients and their families who are difficult to work with. These individuals may be demanding, uncooperative, or even hostile. While these situations can be challenging, we must develop strategies to handle them effectively. Here are a few of the approaches to handling difficult patients and relatives:

Understand the Patient’s Background

It is important to understand that difficult behavior may be a result of the patient’s underlying condition, personality, or previous experiences. For example, patients who are in pain, anxious, or feeling vulnerable may be more likely to act out. It is therefore important for the nurse to try to understand the patient’s background and perspective and tailor your approach accordingly.

Be Calm and Stay Objective.

It is essential for the nurse to remain composed and calm when dealing with difficult patients. This will help you maintain control of the situation and prevent it from escalating. It is also important for nurses to remain objective and not take patients’ and relatives’ behavior personally when dealing with their difficult behavior. Try to focus on the patient’s needs and the care that you are providing, rather than getting caught up in their emotional reactions.

Show Empathy

Empathy is one of the essential qualities of a nurse. It is an important skill when dealing with difficult patients and their families. Showing empathy means acknowledging the patient’s feelings and concerns and trying to see the situation from their perspective. The nurse can use phrases like “I understand how you feel” or “I’m sorry you’re going through this” to demonstrate empathy.

Use Effective Communication Techniques

Effective communication is key when dealing with difficult patients and their relatives. Make an effort to listen actively to the patient or family member’s concerns. Use active listening skills, such as repeating back what the patient has said to ensure you have understood their concerns correctly. Using open-ended questions encourages the patient to talk and express their concerns. This will show that you care about their needs and are willing to work with them.

Know When to Seek Help

It’s important to know when to seek help from colleagues or a supervisor. If you are feeling overwhelmed or unable to manage a difficult patient or family member, don’t hesitate to ask for assistance from colleagues or a supervisor.

Involve the Patient in their Care

The patient is at the center of care. Empowering the patient and involving them in their care can help reduce difficult behavior. Encourage the patient to participate in their care plan, and explain the reasoning behind any treatments or interventions. This can help allay the client’s anxiety.


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Lifestyle

HOW TO COMMUNICATE EFFECTIVELY WITH PATIENTS

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Effective communication with patients is a crucial aspect of healthcare. It allows healthcare providers to establish trust and rapport with their patients, gather accurate information about their health concerns, and provide effective treatment and follow-up care. In this article, we will discuss some key strategies for effective communication with patients.

First, it is important to establish a warm and welcoming environment for patients. This can be achieved through nonverbal cues such as maintaining eye contact, smiling, and using a friendly tone. It is also important to give patients your undivided attention and to listen actively to what they have to say. This includes using techniques such as rephrasing and clarifying to ensure that you have accurately understood the patient’s concerns.

It is also important to communicate clearly, concisely, and respectfully. This means using simple, easy-to-understand language and avoiding jargon or technical terms that may be confusing to patients. It is also important to be patient and allow the patient to ask questions or express any concerns they may have.

In addition to verbal communication, it is important to consider nonverbal cues as well. This includes maintaining appropriate physical boundaries and using appropriate touch. Nonverbal cues can also be used to show empathy and support, such as by nodding or maintaining a comforting facial expression.

Another important aspect of effective communication with patients is cultural competency. It is important to be sensitive to the cultural and linguistic backgrounds of patients and to take steps to ensure that they feel respected and understood. This may include using interpreters or translation services or simply taking the time to learn about and respect the cultural beliefs and practices of the patient.

Effective communication with patients is not only important for the provision of quality healthcare, but it is also essential for building trust and rapport with patients. By following the strategies outlined above, healthcare providers can improve their communication skills and provide the best possible care for their patients.


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Nursing Procedures and Skills

IMPROVING NURSE-PATIENT RELATIONSHIP

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Improving the nurse-patient relationship is essential for providing high-quality healthcare and ensuring positive patient outcomes. A strong nurse-patient relationship can lead to increased trust, improved adherence to treatment plans, and a more positive work environment for nurses. The following are ways for improving the nurse-patient relationship:

Communicate effectively: Effective communication is key to building a strong relationship with patients. This means listening actively to what patients have to say, using clear and straightforward language, and providing information in a way that is easy for patients to understand.

Show empathy: Empathy is the ability to understand and share the feelings of others. By showing empathy, nurses can help patients feel heard and supported, which can improve the relationship and lead to better patient outcomes.

Be respectful: Treating patients respectfully is an important part of building a strong relationship with them. This means showing respect for their autonomy, privacy, and dignity, and treating them as partners in their own care.

Be responsive: Patients may have questions or concerns at any time, and it is important for nurses to be responsive to their needs. This means being available to answer questions and address concerns and making sure patients have the information they need to make informed decisions about their care.

Collaborate with other healthcare providers: Nurses often work with other healthcare providers, such as doctors, therapists, and social workers, to provide comprehensive care for patients. By collaborating with these providers, nurses can ensure that patients receive the best possible care and support.

Involve patients in their care: Involving patients in their own care can help improve the nurse-patient relationship. This means giving patients the opportunity to participate in decision-making and allowing them to express their preferences and concerns.

By implementing these tips, nurses can improve the nurse-patient relationship and provide better care for their patients. A strong nurse-patient relationship can lead to better outcomes and a more positive healthcare experience for everyone involved.


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