ATI Comp Pred Review
manifestations of vaso-occlusive crisis
(sickle cell crisis) sever pain in bones, joint, abdomen swollen anorexia vomit/fever hematuria obstructive jaundice
baby can roll back to side at: infant can sit unsupported at: infant has gross motor to change position from prone to sitting at:
4 months 8months around 10 months
Allopurinol (Zyloprim) risk for
Allopurinol (lower uric acid- gout) rhabdomyolysis: muscle injury results in kidney failure/damage
Findings following thoracentesis to report
Assess for mediastinal shift: decreased breath or absence Assess for pneumothorax: -distended neck veins -asymmetry of chest -respiratory distress -cyanosis Assess for bleeding: hypotension decrease hemo coughing
Adverse Effects of Clozapine
Clozapine (Antipsychotic-schitzophrenia) -Metabolic syndrome -increase BS -anticholinergic effects -mild EPS tremors
What to report taking Clozapine?
Clozapine (antipsychotic- schitzo) -glactorrhea (milk from breasts) -gynecomastia (breast tissue/men) -Ortho hypotension -agitation, sedation, dizzy, sleep disturbance
Phenelzine is for? Avoid what?
MAOI (antidepressant) avoid tyramine products
Adverse Effect of Methylprednisolone Sodium Succinate
Methylprednisolone(glucocorticoid) -increased BS -infection (sore throat, malaise, weak) -weight gain (edema) -HYPOKALEMIA (muscle weakness)
First degree heart block EKG sign?
PR extended to greater than 20 seconds
Positioning for C-section
Position supine with wedge under hip place catheter before also
Education on trach care: q hour many hours clean with?
Q8Hrs sterile technique hydrogen proxide for cleaning surgical aseptic to remove/clean inner
three or more PVS's ending in rate over hundred indicates?
V tach
rationalization adaptive use vs maladaptive use
adaptive: must already have a boyfriend when rejected maladaptive: drive home drunk because he needs to feed his dog
Phenytoin is for what? Side effects?
antihypertension slurred speach dizzy drowsiness
Teaching following a cataract extraction.. do not:
avoid coughing, sneezing, bending at waist, straining during bm, rubbing or touching eye, rapid head movement
What to do if patient has deep vein thrombosis?
bed rest elevate above heart continuous warm/moist compress dont massage thigh high compressions/stockigns
migraine medications
divalproex or topiramte (anticonvulsants) verapamil amitriptyline propranolol sumatriptan ergotamine
providing cost effective care: three main points
dont compromise quality of care return non contaminated items or unused delegate tasks that dont utilize nursing skills
Dietary teaching after gastric resection
dumping syndrome pain, nausea, vomit, sweating, dizzy drink liquids at least half hour or hour after meal, avoid simple sugars, avoid really hot or cold foods
Hypovolemic shock extreme thirst dry skin/flushed postural hypotension restless/agitiation confusion manifestations of..
fluid volume deficit
complications of furosemide and: -digoxin -antihypertensives -NSAIDS
furosemide/digoxin: digoxin toxicity.. v dysrhythmias, hypokalemia furosemide/antihypertensive: hypotension furosemide/NSAIDs: decreased urine output as it decreases blood flow to kidney decreases effect of furosemide
15 monthes uses hand gesture instead of talking do what?
hearing evaluation
Child is non vocal at 7 months do what?
hearing evaluation
long term therapy of connective tissue disorders
hydroxychloroquine or calcium channel blockers to treat symptoms
True labor indications
increase contractions when walking felt in lower back progressive change in dilation and effacement
Findings to report when taking Contraceptives: -vaginal ring -hormonal -implantable
increased BP weight gain ectopic pregnancy signs (vaginal bleeding, abdominal/pelvic pain, fainting, nausea, vomiting)
What immunizations can pregnant women have? influenza mumps varicella pertussis tetanus hep B
influenza rubella pertussis (Tdap- tetanus and diptheria too) Hep B
pregnancy urinary consistency issues
kegal exercises dont drink right before bed DO NOT limit fluid intake
Caring for client with preclampsia
lateral position monitor vitals (right sized cuff, dont talk during) clean catch urine sample to check for proteinuria
If you have a banana allergy... be careful of what in hospitals?
latex allergy
Clinical findings of abruptio placentae
localized intense pain with red vaginal bleeding uterine tenderness (localized or boardlike) contractions w hyptonicity fetal distress hypovolemic shock symptoms
Priority adverse effect of losartan
losartan (Cozar) (antihypertensive): -ANGIOEDEMA (skin wheals or swelling of tongue) -Fetal death.. don't take 2nd tri.
sumatriptan treats
migraines take at first sign or aura
teaching about misoprostol
misoprostol: for ulcers -notify if dysmenorrhea or spotting -diarrhea or abdominal pain -take with meals and at bedtime
Third degree heart block EKG sign?
no P wave in front of every QRS
Amnioinfusion for oligohydroamnios education
normal saline or rings inserted in amniotic cavity by catheter only if membranes have already ruptured if no rupture.. amniotomy
How to screen for idiopathic scoliosis: -observe for -positioning -high incidence
observe from behind look for asymmetry of ribs and flanks position by bending at waist and have arms hang down 8-15 years important time for screening
Cyclosporine for organ transplant teaching
on this medication for life
Methadone is used for?
opiod withdrawal
unexpected weight loss, abdominal pain/swelling, urinary frequency/incontinence, dyspepsia, and gas are possible manifestations of...
ovarian cancer
Confirming placement of nasogastric tube in jejunum
ph balance and aspirate check x ray dont insert air in stomach
Pareacentesis client prep
place catheter or void before upright sitting on edge of bed or high fowlers weight and measure abdominal girth
Blood clots larger than quarter change in lochial pattern uterine atony all signs of
postpartum hemorrhage
priority finding after colostomy
purple/blue/pale stoma should be pink red and shiny edema around stoma normal for 6-8 weeks stomal retraction, prolapse
vasovagul attack what does it do? causes?
rapidly lowers bp and hr stimulation of vagus nerve through strained BM
Hypoglycemia manifestation
shaky mental confusion palpations sweating palpations lack of coordination seizures and coma tachycardia, low BP
nicotine patch... shave hair or gloves more important
shave hair
Cystic fibrosis priority findings
smelly/greasy stool cold or pneumonia sob coughing up blood
Methylphenidate teaching -when to take -avoid what?
take at 4pm... reduce insomnia/restless take before or after meal to reduce weight loss avoid phenytoin, warfarin, and phenobarbital.. increase serum levels
Varicella: -transmission -contagious -incubation period
transmitted by airborne, direct, droplet, objects contagious 1 day before lesions appear incubation period is 14-16 days
amitriptyline education
trycylic antidepressant -postural hypotension -avoid dehydration -exercise -wear sunglasses outside anticholinergic effect
MAOI's avoid...
tyramine! avocados smoked foods pepperoni cheeses etc..
Cranial nerve II tests..
visual acuity (optic)
Give what vitamin after birth? Why? How much? Adverse?
vit K to prevent/treat hemorrhage 05-1mg given IM within hour of birth delayed for breastfeeding Adverse -erythema -hemolysis -hyperbilirubinemia (especially with preterm or large dose)
administering fresh frozen plasma.. watch for? What to do if there is a reaction?
watch for temp... 1 degree or greater within 2 hrs stop infusion give antipyretic hemolytic reaction: antihistamine like diphenhydramine
Manifestations of early dumping syndrome? Given what to help?
-cramps, diarrhea, tachycardia, dizzy, fatigue -give six small meals after resuming eating to prevent dumping syndrome
renal calculi dietary modifications
-avoid Calcium phosphate: limit animal protein, limit sodium, -avoid calcium oxxalate: spinach, rhubarb, pecans, peanuts -avoid uric acid: organ meats, poulty, fish, wine, sardines
therapeutic lithium levels
0.4-0.8 greater than 1.5.... toxicity
Pressure wound: revising the care plan: -check what lab -provide what nutrition -materials to not use when cleaning
-check for low serum albumin (dont want less than 3.5) this means there needs to be an increase in protein, increase risk for skin impairment -provide hydration, protein and calorie needs -dont use cotton balls, or materials that shed fibers when cleaning wound
Communicable diseases to report to local health department:
-cholera -gonorrhea -chlamydia -pertussis -rubella -shigellos -syphilis -smallpox no to herpes
Enoxaparin (lovenox) -prevents/treats
Enoxaparin (lovenox) (anticoagulant) Prevents: -DVT's -pulmonary embolism -some MI's
