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Tonometry: normal (10-21 mm Hg)NC

PR Interval: normal (0.12-0.20 seconds)

Serum Amylase: normal (25-151 units/dL)

Serum Ammonia: normal (35 to 65 mcg/dL)

Calcium: adult (8.6-10 mg/dL)
child (8 to 10.5 mg/dL)
term<1week hg =" inadequate">11 mm Hg = too much fluid

Potassium: 3.5-5.0 mEq/L
Sodium: 135-145 mEq/L
Calcium: 4.5-5.2 mEq/L or 8.6-10 mg/dL
Magnesium: 1.5-2.5 mEq/L
Chloride: 96-107 mEq/L
Phosphorus: 2.7 to 4.5 mg/dL

PR measurements: normal (0.12 to 0.20 second)

QRS measurements: normal (0.04 to 0.10 second)

Ammonia: 35 to 65 ug/dL
Amylase:25 to 151 IV/L

Lipase: 10 to 140 U/L

Cholesterol: 140 to 199 mg/dL
LDL: <130>0.1 to 0.2 ng/mL = MI

Erythrocyte studies: 0-30 mm/hour

Serum iron: Male 65-175 ug/dL
Female 50-170 ug/dL

RBC: Male 4.5 to 6.2 M/uL
Female 4.0 to 5.5 M/uL



Theophylline levels normal (10 to 20 mcg/dl)




MOTOR DEVELOPMENT


Chin up
1 month

Chest up
2 month

Knee push and “swim”
6 month

Sits alone/stands with help
7 month

Crawls on stomach
8 month

Stands holding on furniture
10 month

Walks when led
11 month

Stands alone
14 month

Walks alone
15 month


AT THE PLAY GROUND

* Stranger anxiety: 0 -1 year
* Separation anxiety: 1 - 3 years
* Solitary play: 0 – 1 year
* Parallel play: 2 – 3 years
* Group play: 3 – 4 years


PSYCHOLOGICAL DEVELOPMENT

AGE
ERIKSON
FREUD
PIAGET
Infant
0 – 1.5
Trust vs. mistrust Oral (trust & dependence
sensorimotor
Toddler
1.5 -3
Autonomy vs. shame Anal (holding vs. letting out)
preoperational
Pre-school
3 - 6
Initiative vs. guilt Phallic (Oedipus complex)
preoperational
School age
6 - 11 Industry vs. inferiority
latency
Concrete operational

11 - 20 Identity vs. role confusion
genital
Formal operational

20 – 25
Intimacy vs. isolation

25 – 50 Generativity vs. stagnation

50 - ?
Integrity vs.despair


LABORATORY VALUES

ELECTROLYTES

Sodium (Na+): 135 – 145 meq/L
(increase-dehydration; decrease overhydration)
Potassium (K+): 3.5 - 5.0 meq/L
Magnesium (Mg++): 1.5 – 2.5 meq/L
Calcium (Ca++): 4.5 – 5.8 meq/L
Neonate : 7.0 to 12 mg/dL
Child: 8.0 to 10.5 mg/dL
Phosphorus (PO4): 1.7 – 2.6 meq/L
Chloride (Cl-): 96 – 106 meq/L

COAGULATION STUDIES

Activated partial thromboplastin time(APTT): 20 – 36 seconds depending on the type of activator used
Prothrombin time(PT): male: 9.6 – 11.8 seconds
Female: 9.5 – 11.3 seconds
International Normalized Ratio(INR): 2.0 - 3.0 for standard Coumadin therapy
3.0 – 4.5 for high-dose Coumadin therapy
Clotting time: 8 – 15 minutes
Platelet count: 150,000 to 400,000 cells/Ul
Bleeding time: 2.5 to 8 minutes

SERUM GASTROINTESTINAL STUDIES

Albumin: 3.4 to 5 g/dL
Alkaline phosphatase: 4.5 to 13 King-Armstrong units/dL
Ammonia: 15 to 45 ug/dL
Amylase: 50 – 180 Somogyi U/dL in adult
20 – 160 Somogyi U/dL in the older adult
Bilirubin: direct: 0 - 0.3 mg/dL
Indirect: 0.1 – 1.0 mg/dL
Total: less than 1.5 mg/dL
Cholesterol: 120 – 200mg/dL
Lipase: 31 -186 U/L
Lipids: 400 – 800 mg/dL
Triclycerides: Normal range: 10 – 190 mg/dL
Borderline high: 200 – 400 mg/dL
High: 400 – 1000mg/dL
Very high: greater than 1000mg.dL
Protien: 6.0 – 8.0 g/L
Uric acid: male: 4.5 – 8 ng/dL
Female: 2.5 – 6.2 ng/dL


GLUCOSE STUDIES

Fasting blood sugar: 70 – 105 mg/dL
Glucose monitoring (capillary Blood): 60 – 110 mg/dL





RENAL FUNCTION TEST

Creatinine: 0.6 – 1.3 mg/dL
Blood urea nitrogen (BUN): 5 – 20 mg/dL

ERYTROCYTES STUDIES

Erytrocyte sedimentation rate(ESR): 0 – 30 mm/hr depending on age
Hemoglobin: male: 14 – 16.5 g/dL
Female: 12 – 15 g/dL
Hematocrit: male: 42% - 52% (increased in hemoconcentration, fluid loss and dehydration)
Female: 35% - 47% ( decreased in fluid retention)
Red blood cell (RBC): male: 4.5 to 6.2 million/uL
Female: 4 to 5.5 million/uL

White blood cell (WBC): 4500 to 11,000/uL
Erytrocyte Protoporthyrin (EP) : <9ug/dl>25 mg/dL

CRANIAL NERVES

MAJOR FUNCTIONS

I. Olfactory (S)
smell

II. Optic (S)
vision

III. Oculomotor (M)
IV. Trochlear (M)
Eye movement

V. Trigeminal (S-M) Facial sensation
Jaw movement

VI. Abducent (M)
Eye movement

VII. Facial (S-M) Taste
Facial expression

VIII. Acoustic (S)
Hearing and balance

IX. Glossopharyngeal (S-M) Taste
Throat sensation
Gag and swallow

X. Vagus (S-M) Gag and swallow
Parasympathetic activity

XI. Spinal Accessory (M) Neck and back muscles

XII. Hypoglossal (M)
Tongue movement

On Old Olympus’ Towering Tops, A Finn And German Viewed Some Hops
Some Says Marry Money, But My Brother Says Bad Business Marry Money

ARTERIAL BLOOD GAS (ABG)

pH: 7.35 – 7.45
PCO2: 35 - 45 mmHg
PO2: 80 - 100 mmHg
HCO3: 22 - 27 mEq/L
O2 saturation: 96% - 100%
Acid-base “RAMS”(Respiratory Alternate, Metabolic Same)

GLASGOW COMA SCALE

Eye opening response
Motor response
Verbal response

AUTONOMIC NERVOUS SYSTEM

SYMPATHETIC/
ADRENERGIC PARASYMPATHETIC/
CHOLINERGIC

Heart Increased heart rate
Increased conduction
Increased force
Decreased heart rate

Bronchi
dilation
constriction

GI tract
Reduced motility
Increased motility

Rectum
Allows filling Empties rectum
Relaxes internal sphincter

Bladder
Allows filling Empties bladder
Relaxes internal sphincter

Erection
Maintains erection

Ejaculation
Triggers ejaculation

Pupils of eye
Big (mydriasis)
Small (miosis)

Salivary glands
Secretion

Blood vessels Depends on receptors
-a contrict
-b dilates






FLOW OF BLOOD THROUGH THE HEART

Inferior vena cava and superior vena cava – right atrium – tricuspid valve – right ventricle – pulmonic valve – pulmonary artery – lungs – pulmonary veins – left atrium – bicuspid valve (mitral) – left ventricle – aortic valve aorta – systemic circulation

CARDIAC IMPULSES

Sinoatrial (SA) node – right and left atria (atria contract) – atrioventricular (AV) node – bundle his – bundle brabches – purjinje’s fibers – ventricles contract.

Blood volume: 5000mL
Central venous pressure: 4 to 10 cmH2O (increased in cardiac overload; decreased in dehydration)
Pressure within the right atrium: 2 to 7 mmHg
Capillary refill time: <3 gr =" 60" gr =" 300" gr =" 1000mg" gr ="0.4" oz =" 30" dr =" 4" t =" 15" min =" 1" min =" 1mL" min =" 1" dr =" 1" qt =" 1000mL" qt =" 2" pt =" 16" oz =" 1" 2lb =" 1" 8 =" C" 32 =" F" q =" X" factor =" gtt" infuse =" Infusion">25 mg/dL
Urine specific gravity: 1.016 - 1.022 increase in SIADH; decrease in diabetes insipidus
Normal CSF protein: 15 – 45 mg/dL increase in Guillain-Barre syndrome
Normal CSF pressure: 5 – 15 mmHg
Normal serum osmolality: 285 – 295 mOsmlkgH2O increase in dehydration;
Decrease in over hydration
Normal scalp pH: 7.26 and above
Borderline acidosis: 7.20 to 7.25
Acidosis: