NCLEX Part 1

What are examples of erectile dysfunction drugs?

- AFIL. TadalAFIL. SildernAFIL. VardenAFIL

What are examples of ARBs?

- sartans. Losartan. Valsartan. Candesartan

When is an Apgar assessment done on a newborn?

1 minute and 5 mins are birth.

If a patient is partial weight bearing, what is the transfer method?

1 person assist with gait belt. 2 person assist with full body sling if uncooperative.

When is a PEG tube fully matured?

1-2 weeks and fully established 4-6 weeks

What are common side effects of ECT?

1. Confusion 2. Memory Loss

Magnesium

1.3-2.1

GFR

125mL/min

What is the glascow coma scale of a mild head injury?

13-15

Sodium

135-145. 138-145 in children

Ammonia

15-110

Platelets

150,000-400,000

When can Haemophilus Influenzae be given?

2 month, 4 month, 6 month, and 12 month

When can Pneumococcal vaccine be given?

2 month, 4 month, 6 month, and 12 month

When can IPV be given?

2 month, 4 month, and 6 month

When can RV be given?

2 month, 4 month, and 6 month

How many fontanelles are there?

2 most noticeable are anterior and posterior fontanelles.

What is the PPE removal process for an ebola patient?

2 pairs of gloves are worn. Outer gloves are disinfected then removed. Inner gloves are wiped between removal of each piece of PPE and removed last.

What is the PPE sequence for removing gloves when handling a ebola patient?

2 pairs of gloves. Outer glove is disinfected first then removed. The inner gloves are wiped between each piece of PPE and removed last.

If a patient is non weight bearing, what is the transfer method?

2 person assist with full body sling

When can postpartum psychosis occur?

2 weeks postpartum.

INR on warfarin

2-3 2.5-3.5 with a mechanical heart valve

What is normal uterine contraction frequency during the first stage of labor?

2-5 contractions every 10 minutes. If occur less than 2 mins apart, fetal distress can occur as a result of uteroplacental insufficiency.

CVP

2-8

What is a normal uterine resting tone in a first stage of labor?

20 mm Hg or less

How much caffeine should be consumed during pregnancy?

200-300 mg/day. 1 cup can contain 100-200 mg/day

HCO3

22-26

How long do you elevate leg amputation?

24 hours

When do you change the inner cannula and trach ties for a newly placed tracheotomy?

24 hours after insertion

When does a toddler achieve bowel and bladder sphincter control?

24 months

What are the steps to giving a TB skin test?

27 gauge 1/4 inch needle with a 1mL TB syringe. Administer injection with a 10 degree angle with bevel up. Advance tip from epidermis to dermis, outline of bevel should be visible under the skin. Make a wheal (bleb). Avoid rubbing injection site

If BMI is < 18.5 prepregnancy what is expected total weight gain?

28-40 pounds. 1.1-4.4 lb/ 1st tri. 1#/wk/2nd & 3rd tri.

How long is a Pavlik harness worn?

3-5 months until the hip bone is stable.

Female Hct

37-47%

What is the most appropriate crunch gait for patients with leg weakness, who can bear weight partial or full weight?

4 point crutch gait

What crutch gait most closely resembles normal walking?

4 point crutch gait because of 3 points of support on ground at all times

When is the introduction of solid foods?

4-6 months

How much oxygen can a simple mask put out?

40-60%

How much folic acid should be consumed for a pregnant patient?

400-800 mcg

ALP

42-128

Male HCT

42-52%

How much oxygen can a nasal cannula put out?

44%. Most inexpensive and comfortable.

How long until you must further assess if symptoms for Acute Otitis Media symptoms don't improve after antibiotics?

48-72 hours

Where is the phlebostatic axis?

4th intercostal space, midaxillary line. Applies to an arterial line. Below the nipple

Where would you check for a murmur associated with a mitral valve stenosis?

5 Iintercostal space. Midclavicular line

HgbA1c

5% or less indicates absence of DM 5.7% - 6.4% indicates pre-DM >6.5% indicates DM

WBC

5,000-10,000

AST

5-40

How often should new foods be introduced to an infant?

5-7 days between foods

Following a thoracotomy, how much chest tube drainage is expected?

50-500mL for the first 24 hours. Bright red for several hours then change to serosanguineous (pink) followed by serous (yellow) over a period of a few days

Amylase

56-90

What are the characteristics of compartment syndrome?

6 P's. Pain. Pressure. Paresthesia. Pallor. Pulselessness. Paralysis

How long should breastfeeding be exclusive?

6 months

Normal PAWP

6-12

How much curvature of the thoracic spine can cause cardiopulmonary problems such as impaired chest expansion?

65 degrees or more. 100 degrees becomes life threatening. Life threatening complications are not caused by curvatures of the sacral, lumbar, and cervical.

How lng must back up contraception be used when starting oral contraceptives?

7 days after starting contraceptives, unless starting on the first day of menses

When are fetal heart tones detected?

7 weeks gestation

What is a stable Apgar score for a newborn?

7-10

pH

7.35-7.45

MAP

70-105

T3

70-205

How often should Peripheral IV lines be changed?

72-96 hours

PaO2

80-100

How many hours of sleep does 12 year old require?

9 hours of sleep

Calcium

9-10.5

What is the glascow coma scale of a moderate head injury?

9-12. Will need further evaluation

How much oxygen can a non rebreather put out?

90-95%

Chloride

98-106

What is a normal value for a urinalysis (UA)?

< 10,000 organisms/mL

What is the glascow coma scale of a severe head injury?

< 8. Will need further evaluation

How long do you have until tooth avulsion (tooth death)?

<1 hour. Longer if placed in cold milk

LDL

<130

Triglycerides

<150

Total Cholesterol

<200

What is the time frame for tPA?

<3-4.5 hrs of initial stroke

What is a blood glucose of a newborn to be considered hypoglycemia?

<40

what is considered an abnormal value for a urinalysis (UA)?

> 10,000 organisms/mL indicate a urinary tract infection (UTI)

According to the peak flow meter, how much percentage would need emergency intervention?

> 50% means severely reduced peak expiratory flow rate

How much blood loss indicated postpartum hemorrhage?

>500mL after vaginal birth or 1000mL after cesarean birth

What are conditions that can cause chronic theophylline toxicity?

>60. Drug interactions (Alcohol, Macrolide, and Quinolone antibiotics). Liver disease

Where should MAP be maintained for a septic/anaphylactic shock patient?

>65 mm Hg

SaO2

>95%

What are symptoms of Peritonsillar?

A "hot potato" or muffled voice. Trismus (inability to open the mouth. Pooling of saliva. Deviation of the uvula to one side

How many teeth can you expect to show within the first 24 months

A formula to use is Age of child in months minus 6. By 30 months, 20 teeth should have shown.

What should the nurse anticipate when a patient has meconium stained amniotic fluid?

A neonatal resuscitation team for immediate evaluation and stabilization

What is septic arthritis (septic joint)?

A surgical emergency as impaired blood supply may lead to permananet joint destruction, sepsis, and/or death.

What is a bruit?

A swishing or buzzing sound that indicates turbulent blood flow

What is norepinephrine used for?

A vassopressor used to increase stroke volume, cardiac output, and MAP. Causes vasoconstriction and improved heart contractibility/output.

When would an High PEEP (10-20) be used?

ARDS to prevent small airway/alveolar collapse.

What are the main symptoms of autism?

Abnormailites in social interactions and communication and behavior that can be restricted and repetitive

What should be ready if Oligohydramnios should occur?

Additional personnel should be ready if resuscitation will be needed.

What is anticipatory guidance?

Addresses expected changes related to growth and development or disease progression.

What is the treatment for fifth disease "Slapped face"?

Alleviate symptoms such as ibuprofen for joint pain. Recovery usually occurs within 7-10 days

What is an example of Tricyclic antidepressants?

Amitriptyline

What is a common symptom of pinworm?

Anal itching that worst at night that will disturb sleep

What is the treatment for lactational mastitis?

Antibiotic therapy (Cephalexin/Dicloxacillin). Breast support (Soft cup bras). Adequate hydration. Analgesics (ibuprofen). Frequent continued breast feeding (every 2-3 hours)

What happens if there are s/s of meningitis present on a patient?

Antibiotic therapy immediately because condition is an life threatening medical emergency

What can thrush come from?

Antibiotic therapy. Poor caregiver hygiene therapy

What is Dicyclomine?

Anticholi/Antispasmodic used to manage symptoms of intestinal hypermotility.

What is Oxybutyin?

Anticholinergic. Antispasmodic

What must not be given when an epidural cathter is in place?

Anticoagulants (Fondaparinux), must not be administered until more than 6 hours after surgery

What are medications that can increase the risk for excessive bleeding? How long should these meds be discontinued prior to surgery?

Anticoagulants. Antiplatelets. NSAIDS. Herbal drugs. At least 5-7 days

When does lanugo disappear?

Around 36 weeks of gestation.

What do you need to assess for prior to giving Kayexalate?

Assess for normal bowel function, otherwise there is a risk for intestinal necrosis.

What is the nursing intervention for a patient with a Romberg test?

Assist with ambulation.

What is an antidote for Acetycholi inhibitors?

Atropine + Pralidoxime

What is goodpasture syndrome?

Autoimmune disorder that attacks the lungs and kidneys and can lead to hemorrhage.

What is systemic scleroderma?

Autoimmune disorder that causes inflammation and hardening of the skin, muscles, joints, lungs.

A patient with a spinal cord injury or above T6 is at risk for what?

Autonomic dysreflexia

What is a condition that can come out of IICP?

Bacterial meningitis

What foods are related to a latex allergy?

Banana. Avocado. Tomatoes. Chestnuts. Kiwis. Potatoes. Peaches. Grapes. Apricots.

What are therapeutic techniques for a patient with nocturnal emesis?

Bed alarms. Restrict fluids at bedtime. Avoid scolding/ridiculing. Awakening child at specific time to void. having child assist with wet linen changes.

How is creatinine clearance tested?

Blood specimen. 24 hour urine collection in which the first urine specimen is discarded

What are the 7 signs of cancer?

CAUTION. Change in bowel or bladder habits. A sore that doesn't heal. Unusual bleeding or discharge. Thickening or lump in breast or elsewhere. Indigestion or difficulty swallowing. Obvious change in wart or mole. Nagging cough or hoarseness

How to do Cane walking?

COAL. Cane Opposite Affected Leg. Place cane several inches in front and to the side of the unaffected foot. To walk, move the can first, then affected leg, then unaffected leg.

Where is respiratory acidosis seen?

COPD. Drug overdose. Obesity hypoventilation syndrome. Chest trauma. Sleep apnea

What does ECT do?

Cause a brief convulsion

If a patient has a new onset of restlessness, what should be the first intervention?

Check oxygenation

If Ventricular Bigeminy is suspected, what do assess?

Check potassium, magnesium, and apical radial pulse, and give the scheduled amiodarone, and notify MD

What is first step toward resolution of PTSD?

Checking client's readiness to discuss the details of the traumatic event without experiencing high levels of anxiety

What is a priority nursing action with a patient with a new trach?

Checking tightness of ties and allowing 1 finger to fit underneath. Prevent decannulation

What is a quad screen?

Checks neural tube defects at weeks 15-18. Checks AFP. hCG

What are signs of Empyema?

Chest pain. Nonproductive cough

Who is recommended for the annual influenza vaccinations?

Chronic conditions. Immunocompromised. Health care workers. Healthy children 6-23 months and >65. Pregnant women

What is Polycythemia Vera?

Chronic myeloproliferative disorder in which the bone marrow produces an abnormally high number of RBCs.

What are ND for patients with RA?

Chronic pain. Disturbed body image. Impaired physical mobility. Ineffective role performance

What is patient teaching for a postmenopausal woman?

Client should remain upright after taking a biphosphate and consume calcium and vitamin D for bone health. Check for swelling or tenderness or the legs because clotting disorders is a risk for hormone replacement therapy (HRT). Intermittent vaginal spotting after menopause can be a sign for endometrial cancer.

What is seen on chronic hypoxia?

Clubbing of the fingertips

How is Pediculosis capitis (Head lice) spread?

Combs, hair ornaments, hats, and towels

What is bronchiolitis?

Common viral illness of childhood that is usually caused by Respiratory Syncytial Virus (RSV)

What are nursing interventions that help prevent violence?

Communication. Participation in care. Promoting a a low stimulation environment. Providing comfort through medications. Provide undivided attention

What is the postical phase of a seizure?

Confusion following a seizure

What interventions must be done for older patients receiving IV therapy?

Consideration of renal and cardiac function to prevent hypervolemia. Infusion pump. Close monitoring of site for infiltration and infection. Measures to prevent skin tears.

What does moderate variability in FHR indicate?

Considered good and normal

Is acrocyanosis normal?

Considered normal during the first day of life or if the newborn comes cold.

What are medications for acute pericarditis?

Corticosteroids. NSAIDs. Antibiotics.

What is management for septic arthritis (septic joint)

Cultures. Antibiotics. Surgical debridement

What is a classic sign of intussussception?

Currant jelly like stool. Sausage shaped right sided mass felt on palpation. Inconsolable crying. Drawing the legs toward the abdomen. Vomiting followed by periods of normal behavior

What is said during Assessment in SBAR?

Current v/s. Opinion on problem

What is the most important indicator of fluid status?

Daily weight

What can PTSD patients with increased anxiety lead to?

Danger to self or others

What is the tx for Malignant Hyperthermia?

Dantrolene. Cooling the patient. Treating high potassium levels

What can an overdose of a Tricyclic antidepressants such as Amitriptyline lead to?

Death

When is an autopsy required?

Death by suicide, homicide, accident, or within 24 hours of admission. Consent is not required under these conditions. DO NOT remove any IV tubes or lines.

What is the findings of Emphysema?

Decreased breath sounds. Decreased tactile fremitus. Hyperresonant upon percussion

What is said during background in SBAR?

Diagnosis. Procedure hx. How long COC

What is the treatment for Dialysis Disequilibrium Syndrome (DDS)?

Dialysis should be stopped or slowed

What is contraindicated in patients with placental previa?

Digital vaginal examinations

What labs do you need to be aware of when giving digoxin?

Digoxin levels. Potassium levels.

What medications should you monitor for a reduction in ventricular rate in a client with Afib?

Diltiazem. Metoprolol. Digoxin

What kind of solution is used to clean contaminated C-Diff surfaces?

Diluted beach solution

What does a cystoscope do?

Directly visualize the bladder wall and urethra.

What are nonpharmacalogic measures to alleviate pain?

Distraction (watching TV, listening to music, reading). Relaxation. Guided imagery. Warm soaks. Positioning. Gentle massage

What is paranoid personality disorder?

Distrust and suspicion of others. Intense need to control other people and their environment

What is a nursing dx for anorexia diagnosis?

Disturbed body image.

What is treatment for pulmonary edema?

Diuretics (Furosemide)

What is the treatment for Dilutional hyponatremia?

Diuretics. Fluid/Salt restriction.

What is beneficence?

Doing good

What is used to treat symptomatic hypotension?

Dopamine

What is correct technique for instilling ear drops to child < 3 yo?

Down and back. In a prone or supine position

What observation should be reported from a closed wound drainage system?

Drainage changes from serosanguineous to sanguineous and amount increases after the first 24 hours following surgery

what do you need to monitor for when giving IV vanco?

Draw trough level before administration. Infusion med over at least 60 mins. Monitor BP. Observe IV site every 30 mins

What color drainage from a surgical procedure needs to be reported?

Dressing saturated with sanguineous (bright red) indicates excessive blood loss with possible hemorrhage.

What is Xerostomia?

Dry mouth

Is perinatal transmission of IV infection possible from mother to baby?

During antepartum, intrapartum, or postpartum. ART during pregnancy is important to decrease risk of transmission.

What is Naegele's rule?

EDB = (LMP minus 3 months) + 7 days

What tests are used to diagnose HIV?

ELISA test then another to verify results. Western blot to confirm dx

What is ways to prevent development of delirium in the postoperative setting?

Early ambulation. Adequate pain control

What is a finding that testes are normal?

Egg shaped

What is a Lacto-ovo-vegetarian?

Eggs, milk, and milk products

What is a side effect of Terazosin that men should be aware of?

Ejaculatory dysfunction

Who is at risk for oral candidiasis?

Elder clients with dentures. Immunosuppressed clients. Long term antibiotic use

What factors put a patient at risk for respiratory depression related to opioid use fir analgesia?

Elderly. Pulmonary disease. History of snoring. Obseity. Smoking. Post surgery (First 24 hrs)

What should be done if a patient has a new cast placed?

Elevate limb above the heart for the first 48 hours to increase venous return and decrease edema in the affected extremity.

What lab is increased in an allergy?

Eosinphils

What is the treatment for anaphylaxis?

Epi injection

What are the s/s of acute pancreatitis?

Epigastric or LUQ pain radiating to the back. n/v. Anorexia. Abd rigidity and guarding. Tachycardia. Hypotension. Jaundice. Decreased /Absent bowel sounds. Increased WBCs

When following NRP (Neonate Resuscitation Program), what is the intervention if the HR is <60 after chest compression?

Epinephrine

How often should a skin assessment be done?

Every 2-3 hours. Each time the patient is repositioned.

How often should central line dressings be changed?

Every 48 hours with a gauze dressing or 7 days with a transparent semipermeable dressing (biopatch)

How often are allergy shots given?

Every week. Maintenance doses are given every 3-5 years

What is treatment for child with Scabies?

Everyone in contact with the infected needs to be treated with one time application of permethrin. Client's bedding, clothing, stuffed toys should be placed in plastic bags for a minimum of 3 days or washed in hot water and dried on the hottest setting. Fumigation isn't neccessary.

What is Acromegaly?

Excess production of growth hormone

What are nonpharmacological strategies for improving sleep hygiene?

Exercising during the day. Avoiding naps during the day. Avoid caffeine after noon. 20 mins of sunlight each day.

What are the manifestations of pneumonia?

Fever. Chills. Productive cough. Dyspnea. Pleuritic chest pain

What are manifestations of Otitis Media in a child?

Fever. Ear pulling/rubbing. Refusal to eat.

What are common s/s of meningitis in children?

Fever. H/A. Photophobia. N/V. Lethargy. Irritability.

What are the minor symptoms of TB?

Fever. Night sweats. Weight loss. Anorexia. Fatigue

What are symptoms of a patient having a thyroid storm?

Fever. Tachycardia. Cardiac dysrhythmias. Nausea. Vomiting. Diarrhea. Altered mental status

What is the life expectancy of Trisomy 18?

Few weeks after birth.

What are examples of H1 receptor antagonists?

Fexofenadine. Cetirizine. Levocetirizine. Loratadine

What test CONFIRMS breast cancer?

Fine needle aspiration and Excisional biopsy

What is th treatment for Syndrome of inappropriate antidiuretic hormone secretion?

Fluid restriction. Hypertonic IV solution (3% saline) to correct hyponatremia

What is the antidote for benzos like Ativan?

Flumenazil

What are examples of Selective Serotonin Reuptake inhibitors (SSRIs)?

Fluoxetine. Paroxetine. Setraline. Citaloprim. Escitaloprim

What is a sign that risk for suicide is decreasing?

Forming long term personal goals

What is the PPE for Middle east respiratory syndrome (MERS)?

Gloves. Gown. N95. Eyewear

What are ways to reduce ICP?

HOB 30. Stool softners. Quiet environment. Hyperventilate and preoxygenate before suctioning

What is the criteria for a rapid response?

HR <40 or >130. SBP <90. RR <8 or >28. O2 <90 despite O2. Urine output <50mL/4 hr. ALOC

What symptoms will be present with Chronic Renal Failure?

HTN. Fluid and electrolyte abnormalities.

What is the correct PPE sequence?

Hand washing. Gown. Mask. Goggles/Face shield. Gloves

What is the cause of acute pancreatitis?

Heavy alcohol use. Gallstones

What is a primary concern with Acetaminophen?

Hepatic necrosis

What is the treatment for constipation?

High fiber diet. High fluid intake 10-12 cups daily. Regular exercise. Bulk forming fiber supplements.

What is the correct administration for nasal medication?

High fowler with head slightly forward. Insert into nostril while occluding the other. Point the tip away from the middle of the nose and towards the side. Spray and inhale. Remove nozzle and breathe through the mouth. Avoid blowing the nose for several minutes after instillation

What do African Americans have a high incidence of?

Hypertension. Stroke. Cervical Cancer. Ischemic stroke

What does a intrauterine pressure of more than 80 indicate?

Hypertonicity of the uterus

What is a symptom for salicylate poisoning?

Hyperventilation

What does the body do to compensate for metabolic acidosis?

Hyperventilation to eliminate CO2

What can cause respiratory alkalosis?

Hyperventilation. Hypoxia. Anxiety. Pain

Oxytocin-induced uterine tachysystole and non-reassuring fetal heart rate tracing are treated by what?

Immediate DC of oxytocin. Turning to side lying. Giving 10L O2 by face mask. and IVF bolus. Terbutaline may be given.

What is treatment for carbon monoxide poisoning?

Immediate administration with 100% oxygen to correct hypoxemia and eliminate toxic CO from the blood

What should a nurse do if sexual assault is suspected?

Immediate medical attention

What is a Azathioprine?

Immunosuppressant that can cause bone marrow suppression

What does Dopamine do?

Increase HR, BP, cardiac output, and urine output

What is associated with preterm birth?

Infection like UTI or Periodontal disease. Ages <17 and >35. Hx of preterm birth. Previous cervical surgery. Tobacco and drug use.

What is a major complication of peritoneal dialysis?

Infection such as peritonitis. Respiratory distress

What are the causes of acute pericarditis?

Infection. Heart Trauma. Cardiac event like MI. Autoimmune. Connective tissue disorders. Tumor Uremia. Radiation.

What does a tender lymph node indicate?

Inflammation. Infection

What does insulin and D50 do to hyperkalemia?

Insulin shifts from extracellular space to intracellular space. D50 prevents hypoglcemia.

What are clinical signs of normal labor?

Intermittent pain with contractions, small amount of blood-tinged mucus ("Bloody show")

What is assertive communication?

Involves speaking directly to the person with whom there is conflict

What are examples of inhaled anticholinergic medication?

Ipratropium. Tiotropium. Umeclidinium

What is the most common cause of anemia in pregnant patients?

Iron deficiency

What can happen alongside Pica?

Iron deficiency anemia, H/H must be checked for anemia.

What can be given as an introduction of solid foods?

Iron fortified infant cereal such as rice or oatmeal

What is a most important strategy to prevent accidental drug overdose in children?

Keep medicine out of sight in a locked drawer.

What are examples of isotonic fluids?

LR. NS. D5 3% NS

What are sources of folic acid?

Leafy green vegetables. Beans. Rice. Peanut butter. Fortified cereals. Liver. Pasta. Bread. Orange. Tomato juice

What position do better ausculate S1 and S2?

Lean forward in a sitting position

What is patient teaching for Dabigatran?

Leave medication in original container. Use bleeding precautions. Swallow pills whole with a full glass of water.

What is the process if you fail to get urine from inserting a catheter in a female patient?

Leave the original catheter in place and reinsert a new catheter above the original

What are the manifestations of Diabetic ketoacidosis (DKA)?

Lethargy. Abdominal pain. Hyperglycemia. Urine ketones.

What is a serious side effect of Azathioprine?

Leukopenia, need to check before administering

What is Concrete thinknig?

Literal interpretation of an idea. Example: "Grass is greener on the other side" is interpreted as grass is greener on another part of the grass.

Which vaccines are contraindicated in pregnancy?

Live viruses such as influenza nasal spray. Measles, Mumps, Rubella (MMR). Varicella vaccine.

What is the treatment goal for amyotrophic lateral sclerosis (ALS)?

Maintaining respiratory function. Adequate nutrition. and Quality of life.

What are methods to avoid heartburn for a pregnant client?

Maintaining upright position after meals. Eating small meals. Taking approved antacids, except for sodium bicarbonate(Alka-Seltzer) or Magnesium trisilicate

What is the goal of the health care proxy?

Make decisions for the client who is unable to do so.

What do you need to monitor with COPD exacerbation and report to MD?

Mental status. Restlessness, Decreased LOC. Difficult arousal. Confusion. Somnolence

What is the ABG for diabetic ketoacidosis?

Metabolic acidosis. Respiratory compensation may raise pH to near normal values, but CO2 will be dramatically lower than normal

What are devices that create a safety risk for infants?

Mobile Walker. High Chairs

When can transdermal fentanyl patch be used?

Moderate to severe chronic pain

What is a sign of approaching labor in the expecting term?

Mucoid, Blood tinged (pink/brownish) discharge.

What can radiation to the neck and head lead to?

Mucositis. Xerostomia

If a patient has a ileal conduit, what is expected in the urine?

Mucus. Patient should be taught to increase fluid intake as mucus is not a sign of infection

What is the patient teaching for an Coronary arteriogram (Angiogram)?

NPO 6-12 hrs. Warm flushed feeling when contrast injected. Femoral artery used. Lie flat for several hours. Same day procedure

What is myopia?

Nearsightedness

What is the antidote for anticholinergics?

Neostigmine (Prostigmine)

What is done after a percutaneous nephrolithotripsy?

Nephrostomy tube is placed to prevent obstruction by stone fragments and to promote healing of injured tissue. If obstructed, gentle irrigation with sterile normal saline can be used

What can lead poisoing lead to?

Neurological system problems such as permanent cognitive impairment, seizures, blindness, or even death.

When should Ritalin be given?

No later than 6pm

What is the culturally acceptable care for Arab men?

No other woman is allowed to alone with the patient except the wife. Also may not allow physical care by someone of the opposite sex

What is Kosher rules?

No pork, shellfish, or fish without scales. Meat or poultry must be consumed at least 3-6 hours before a dairy product can be consumed.

What is the cure of genital herpes?

None

What do you need to do if Bilateral rales are found on lung ausculation on a neonate after delivery?

Nothing. It will clear as the neonate transitions to extrauterine life.

What is universal donor?

O neg

Name the cranial nerves

Oh(Olfactory) oh(Optic) oh(Oculomotor), to(Trochlear) touch(Trigeminal) and(Abducens) feel(Facial) virgin(vestibucochlear) girl's(Glossopharyngeal) vagina(Vagus), simply(Spinal) heaven(Hypoglossal)

What causes the stoppage in growth for adolescents?

Once the epiphyseal plates (epiphyses) close

What is growth hormone replacement used for?

Option for children who are not growing according to accepted standards.

What is the treatment to correct hypoxemia, improve ventilation, and promote bronchodilation as recommended by the Global Initiative for Asthma?

Oxygen to maintain >90%. Albuterol and Ipratropium nebulizer treatments every 20 mins. Systemic corticosteroids (Solu-Medrol)

What can PEEP help reduce?

Oxygen toxicity

What does a complete heart block look like on a EKG?

P wave is in various positions with the QRS complex

What is used to monitor CVP?

PA catheter. The proximal port must be connected to a pressure monitoring system to measure CVP because its lumen exits into the right atrium

How can Bupropion Hydrochloride be administered?

PO. Cannot be crushed, chewed, or cut due to risk of seizures or other adverse effects caused by rapid absorption and resulting higher serum level of the drug

What does a first degree AV block look like?

PR interval >20 secs > 5 small squares. P wave is far from R interval

What is seen in early digoxin toxicity?

PVCs

What are s/s of mechanical bowel obstruction?

Pain. Distention. N/V

When feeding a patient with a trach, what can reduce the risk for aspiration?

Partially or fully deflating the cuff. Upright position. Monitoring for wet cough or voice quality. Monitor v/s

What is behaviors of antisocial personality behavior?

Pattern of disregard for and violation of others and rules. Manipulate others for personal gain and lack empathy

What is hypospadias with chordee?

Penis is curved downward due to a fibrous band. Looks like a cobra head.

What are procedures for acute pericarditis?

Pericardiocentesis. Pericardial window

What is an expected finding from calcium channel blockers?

Peripheral edema.

What are manifestations for right sided heart failure?

Peripheral edema. Jugular vein distention. Increased abdominal girth. Hepatomegaly. Splenomegaly.

What can Vitamin B12 deficiency cause?

Peripheral neuropathy. Cognitive impairment

What is expected after a ischemic stroke?

Permissive htn that autocorrects within 24-48 hrs.

What is the nursing interventions to prevent complications from an external fixation?

Pin care with an antimicrobial solution. Regular assessment of pin tightness. Notify MD if pins are loose or have signs of infection

What is a complication of the pin insertion site for a skeletal traction?

Pin moves slightly

What is an example of Penicillin?

Piperacillin and tazobactam. Amoxicillin. Ampicillin

What are manifestations if serum albumin is low?

Pitting edema. Periorbital edema. Ascites

What problems are common after major surgery?

Possible memory impairment. Problems with concentration, language concentration, social integration, and emotional lability. Symptoms are resolve in 4-6 weeks or when healing is complete

A sustained tachycardia (>160 over >10 mins) indicates what in a neonate?

Possible sepsis. Respiratory distress. Congenital heart abnormality.

When do the fontanelles fuse?

Posterior fontanelle fuses by 2 months. Anterior fontanelle fuses by 18 months

When are you allowed to give the MMR vaccine to a pregnant patient?

Postpartum

When is Magical thinking occuring?

Preschool period. 3-6 years old

What is seen in sepsis?

Presence of infection along with systemic manifestations of infection

What does the Z track technique do?

Prevents leakage of medications into the SQ from an IM injection

What is Palifermin?

Prevents oral mucositis in clients diagnosed with hematologic malignancies. DOES NOT HELP WITH PAIN

What are contraindications for Thrombolytic therapy?

Prior intracranial hemorrhage. AV malformation. Ischemic stoke within 3 months. Active bleeding. Uncontrolled hypertension

What are s/s of systemic scleroderma?

Priuritus. Raynaud's phenomenon. Difficulty swallowing.

What are s/s of Hep A?

RUQ pain. Clay colored BM. Dark/brown urine. Fever. Jaundice. Anorexia. N/V. Fatigue

What is the treatment for retinoblastoma?

Radiation therapy. Enucleation (Removal of the eye)

What action must be done for a infant with meningitis whose fontanel is more tense than last assessment?

Raise the head of the bed.

What is the next line of treatment should a pessary not work?

Reconstructive surgery

What should be avoided if a spinal injury is suspected?

Rectal examination. Assess neck range of motion

What should be avoided with necrotizing enterocolitis?

Rectal temperatures to prevent perforation.

What is the route of administration for drugs that can be destroyed in the GI and can't be taken orally?

Rectally even though the absorption is slower.

What is the treatment for compartment syndrome?

Removal of tight bandages/casts. Fasciotomy

What is the sequence should a nurse have a needlestick injury?

Remove gloves. Wash area with soap. Notify supervisor. Go to clinic. Take postexposure prophylaxis.

What are manifestations of fat embolism syndrome?

Respiratory distress. Mental status changes. Petechiae on chest, axillae, and soft palate. Fever. Thrombocytopenia

How do you know Albuterol treatment is effective?

Respiratory rate will decrease and peak flow will be increased

What position should a patient with neonatal abstinence syndrome be placed after feeding?

Right side to promote gastric emptying and reduce risk of vomiting

What are the 5 rights of delegation?

Right task. Right circumstance. Right Person. Right direction/communication. Right supervision/evaluation.

Where is the placement of an Adult AED pad on a patient >8 years old?

Right upper chest and Lower left rib

What is s/s of HELLP syndrome?

Right upper quadrant/Epigastric pain. Nausea. Vomiting. Malaise

What is a serious complication with infectious mononucleosis?

Ruptured spleen

What is the order if you give short acting beta agonist (SABA) and Inhaled corticosteroid (ICS) inhalers?

SABA first to open the airways and ICS second.

What are risk factors for suicide?

SAD PERSONS. Sex (male kill themselves more, women make more attempts). Age (Teenagers/young adults, age >45). Depression. Prior history of suicide attempt. Ethanol or durg abuse. Rational thinking loss (hearing voices). Support system loss (living alone). Organized plan. No significant other. Sickness (Terminal illness)

What is Duloxetine be used for?

SNRI. Used for Depression, Generalized anxiety disorder, Neuropathy, Fibromyalgia.

What manifestations do you see if the hemoglobin and hematocrit is decreased?

SOB with activity. Tachypnea. Tachycardia. Resulting from decreased oxygen carrying capacity and transport

What are s/s of asthma?

SOB. High pitched expiratory wheezing.

What are s/s of acute pulmonary edema?

SOB. Pink frothy sputum. Tachypnea >30. Crackles on ausculation

What are the safety measures for preeclampsia?

Seizure precautions. Decreasing environmental stimuli (Avoid bright lights)

What are signs of ruptured ectopic pregnancy?

Severe abdominal pain. Dizziness. Referred shoulder pain. Hypotension. Tachycardia.

What is a complication of acute glomerularnephritis?

Severe hypertension

What is Toxic megacolon?

Severe inflammatory colon distention

What is Riluzole?

Slows progression of Amyotrophic Lateral Sclerosis (ALS)

What is patient teaching for fibrocystic breast changes?

Symptom management (cold compresses, vitamins, support bra, NSAIDs like ibuprofen. Breast self examination. Importance of regular breast examinations (>40 yo). Reporting of noncyclic breast changes may indicate malignancy and need to report to MD

What can a massive PE cause?

Syncope. Hemodynamic instability.

What is a bishop score?

System for assessment and rating of cervical favorability and readiness for induction of labor. >8 is considered successful induction and subsequent vaginal birth

What medication is given as first line treatment for depression?

TCAs such as Notriptyline

What is the difference between TIA and CVA?

TIA has temporary symptoms while CVA are irreversible.

What is a early sign of hemorrhage?

Tachycardia

What are manifestations of severe asthma exacerbations?

Tachycardia (>120). Tachypnea (>30). <90% on RA. Use of accessory muscles to breathe. Chest tightness. Increased mucus production. Diminished breath sounds. High pitched expiratory wheezing

What are adverse effects of Dopamine?

Tachycardia. Dysrhytmias. Myocardial ischemia.

What are signs of severe anemia?

Tachycardia. Shortness of breath. Pallor

What is proper care for a short acting beta agonist (SABA) (Albuterol)?

Take apart and rinse mouthpiece with warm water 1-2 times a week.

What is proper care for Inhaled corticosteroid (ICS)?

Take apart and rinse mouthpiece with warm water daily. Rinsing the mouth and throat after use to prevent Candida infection (thrush)

What can be done with prenatal vitamins to prevent nausea?

Take with food or a bedtime.

What can testicular torsion lead to?

Testicular ischemia and necrosis

Why is incentive spirometer not used for COPD?

The client needs help to expel the air, not get more air into the lungs.

What is Dabigatran?

Thrombin inhibitors

What is the treatment for epitaxis?

Tilt child's head forward. Apply direct, continous pressure to the nose for 5-10 mins. Hold a cold cloth to the nasal bridge

What is the earliest sign of Aspirin toxicity?

Tinnitus

What will be the first sign of hearing impairment?

Tinnitus

What is veracity?

To tell the truth

What is the height on a cane?

To the level of the greater trochanter

What is the tx for cord compression?

Trendenlenberg

What position is contraindicated for a patient with cirrhosis?

Trendenlenberg due to ascities and exacerbate shortness of breath

What is the shape of the posterior fontanelle if palpating the presenting fetal part?

Triangular. Seperated by the anterior fontanelle by the sagittal suture.

What is the cause of systemic scleroderma?

Triggered by exposure to chemicals or fetal cells circulating in the maternal blood. Limited genetic link

What is the most comfortable position for a patient with epiglottis?

Tripod position, which opens the airway and helps air flow. The position is seated with trunk leaning forward, mouth open, and neck and chin extended

What are symptoms of Tardive Dyskinesia?

Twisting tongue movements. Lip smacking. Piano playing finger movements. Head twisting from neck contracting. Puffing of cheeks. Blinking of the eyes.

What should a patient with a tracheostomy tube always carry?

Two spare tubes. One the same size and one a size smaller

What medication is acceptable for pain control prior to surgery?

Tylenol

What is given prior to infusions?

Tylenol. Benadryl

What is Rosiglitazone used for?

Type 2 diabetes

What should be done with a patient with a life threatening hemorrhage like placenta accreta?

Type and crossmatch and an 2 large bore patent IV sites.

What confirms Oligohydramnios?

Ultrasound

What diagnostic test confirms a AAA?

Ultrasound

What tests are done at 18-20 weeks gestation?

Ultrasound screening, which accurately dates the pregnancy. Anatomic screening, which checks for congenital and anatomic abnormalities

What is the risk of (Artificial rupture of membranes) AROM?

Umbilical cord prolapse which could lead to fetal bradycardia.

What are the symptoms of V-Fib?

Unresponsive. Pulseless. Apneic

How do you change a surgical dressing?

Use a clean glove to remove the dressing, and a sterile glove to apply the new one.

How do you use crutches when standing up and sitting down from a chair?

Use an arm rest and 2 crutches with one hand. Use the unaffected leg to rise from the chair.

How would you speak with a client with an Alzheimer's Disease?

Use clear and simple explanations

When preparing to instill dialysate for a client with peritoneal dialysis, what can be done to prevent infection?

Use sterile technique

What is proper gait for crutches?

Used on partial or no weight bearing on the affected extremity. Injured extremity and crutches are moved simultaneously. The client rehabbing from a lower extremity injury goes from a 3 point gait (non weight bearing) to a 2 point gait (partial weight bearing) then finally to a 4 point gain (full weight bearing)

What IV technique can be used for fragile veins from older adults?

Using 24-26 gauge IV catheters. IV insertion of 5-15 degree angle into fragile veins

What must be done if the feeding tube becomes clogged?

Using a large barrel syringe to flush and aspirate warm water in a back and forth motion. If it doesn't work, use a digestive enzyme solution

Excess frequency, resting tone, contraction duration can result in what?

Uteroplacental insufficiency

What can Heparin-Induced Thrombocytopenia (HIT) lead to?

Venous and/arterial thrombosis and less commonly bleeding.

What is the most lethal dysrhytmia?

Ventricular fibrillation (Vfib)

A holosystolic murmur (heard during entire systole phase) at the lower sternal border is indicative of what?

Ventricular septal defect (VSD)

What are examples of a high flow oxygen system?

Venturi mask. Ventilator

A newborn with pyloric stenosis and a order of IVF of sodium and potassium for a K 3.4, should first do what?

Verify that newborn has urinated to see if the newborn has the ability to excrete potassium through the urine.

How is the rotavirus spread?

Viral infection that is spread by fecal oral route by touching contaminated objects, foods, and hands.

Who should TB be reported to?

WHO. CDC

What is expected findings after a tonsillectomy/adenoidectomy?

White or odorous throat cavity. Low grade fever. Pain referred to the ear when swallowing for 5-10 days afterward

What are s/s of oral candidiasis?

White patches on the oral mucosa, palate, and tongue. Difficulty sucking/feeding. Patches are nonremovable and tend to bleed when touched.

What is said during situation in SBAR?

Who you are. Who the patient is. What's abnormal.

How quickly must a gastric lavage be done when ingested a poisonous substance?

Within 30 mins, then followed up with Actidose to remove any leftovers.

When should antiviral meds be given?

Within 48-72 hours.

When can therapeutic hypothermia be done?

Within 6 hours of arrest and maintaining it for 24 hrs

What are examples of Antiviral medications?

ZanAMIVIR. OseltAMIVIR

What herbal tx causes increased bleeding risk?

"G's" Garlic, Ginger, Gingko, Ginseng

What requires emergency intervention in a patient with asthma?

"Silent chest" which is the inability to hear any breath sounds or wheezing. Onset in wheezing is actually an improvement because it means air is moving in the lungs

What is documentaion that will not provide legal malpractice?

"Will continue to monitor" is meaningless

What are beta blockers?

-lol. Metoprolol. Bisoprolol. Carvedilol

What are calcium channel blockers?

-pine with a mil zem's

What are ace inhibitors?

-pril

Direct (conjugated) bilirubin

0-0.3

Total Bilirubin

0-1

Lipase

0-110

What is a normal decibel hearing level?

0-15 db

Indirect (unconjugated) bilirubin

0.1-1

TSH

0.4-6

What is normal urine output?

0.5-1 mL/kg/hr

Lithium

0.5-1.5

Serum Creatinine

0.6-1.2

What IVF is compatibale with blood transfusions?

0.9% NS ONLY

If a patient is full weight bearing, what is the transfer method?

1 person standby

What is the incubation period for meningitis?

1 week

How often should a albuterol inhaler be washed?

1-2x/wk under warm water

What is the incubation period influenza?

1-4 days with peak transmission starting at about 1 day before symptoms appear and lasting up to 5-7 days after the illness stage begins.

What is the fourth stage of labor?

1-4 hours after birth, maternal physiologic readjustment

When are therapeutic effects expect to be seen with Selective Serotonin Reuptake inhibitors (SSRIs)?

1-4 weeks

Urine Specific Gravity

1.003-1.030

PT on warfarin

1.5-2 times normal range: 16-31

PTT on Heparin

1.5-2 times normal range: 46-70

How long should the PA catheter balloon be inflated for?

10 - 15 seconds then allowed to deflate passively.

What is the 2nd stage of labor?

10 cm (complete) dilation to birth

When is a fetal heart rate detected by doppler?

10-12 weeks

How long should a IV port be cleaned?

10-15 seconds

How long should a IV port be scrubbed for?

10-15 seconds with chlorhexidine/alcohol

Vanco Trough

10-20

BUN

10-20. 5-18 for children

ALT

10-40

How long should you preoxygenate a vent patient?

100% oxygen for 30 seconds before suctioning

Where should the SBP of a post carotid endarterectomy be maintained at?

100-150 mm Hg

What is normal heart rate for an infant (1-12 mos)?

100-160/min

How many hours of sleep does a 5 year old require?

11 hours of sleep.

If BMI is >30 prepregnancy what is expected total weight gain?

11-20 lbs. 1.1-4.4 lb/ 1st tri. 0.5lbs/wk/2nd & 3rd tri.

What age can you introduce whole milk?

12 months

When can MMR, Varicella Zoster, and Hep A be given?

12 months

Female Hgb

12-16

What is a normal Glascow coma scale?

15

What is the optimal time for aspart to be given?

15 mins before meals

If BMI is 25 - 29.9 prepregnancy what is expected total weight gain?

15-25 lbs. 1.1-4.4 lb/ 1st tri. 0.6lbs/wk/2nd & 3rd tri.

What is the peak level of an opioid?

15-30 mins

When are fetal movements felt?

16-20 weeks gestation

What gauge is acceptable for blood transfusion?

18 G

What IV catheter size is acceptable for surgery?

18 G or 20 G

Genu varum (bowlegs) is common until what age?

18 months

How long is a brace for scoliosis worn?

18-23 hours per day. Only removed for bathing and exercise

When dealing with a ankle sprain, how long do you need to rest it before starting rehab treatment?

24-48 hours

If BMI is 18.5 - 24.9 prepregnancy what is expected total weight gain?

25-35 lbs. 1.1-4.4 lb/ 1st tri. 1#/wk/2nd & 3rd tri.

What is a normal intensity of uterine contractions in the first stage of labor?

25-50 mm Hg

What are the symptoms of a patient with Post-traumatic stress disorder (PTSD)?

3 categories. Reexperiencing the event (Loss of control). Avoiding reminders of the trauma (Feeling detached). Increased anxiety and emotional arousal (Persistent anger and/or fear)

What is proper fit and measurement for crutches?

3-4 finger width space between axilla and axillary pad. Support body weight on hands and arms not on axillae. Handgrip location should allow 20-30 degrees of flexion at the elbow. Wear and tear on the crutch pads indicate an improper fit.

What is the glascow coma scale of a comatose patient?

3-8

Potassium

3.5 - 5

Albumin

3.5-5

What is the interval for rapid assessment and decision making for NRP (Neonate Resuscitation Program)?

30 seconds

What is the normal RR for an infant (1-12 mos)?

30-60/min

How much pressure is correct for a pressure bag?

300 mm Hg

How much pressure must be applied to a pressure bag to maintain patency of a arterial BP monitoring system?

300 mm Hg

How much fluid must be consumed to help calcium overload?

3000 ml/day

PaCO2

35-45

Male HDL

35-65

T4

4-12

Do newborns born to HIV positive clients need treatment after birth?

4-6 weeks of ART after birth

When can postpartum depression can begin?

4-6 weeks postpartum or up to 12 months

What is the therapeutic level of magnesium for preeclampsia-eclampsia treatment?

4-7 mEQ/L (2.0-3.5 mmol/L)

What age can you introduce solid foods?

6 months

When can seperation anxiety occur?

6-30 months. Starts at 6 months. Peaks at 10-18 months. Can last until 3 years old

How long is TB treatment?

6-9 months

For a closed wound drainage system, how much drainage is expected after surgery?

80-120 mL of serosanguineous or sanguineous drainage per hour during the first 24 hours after surgery is expected.

When indicated by a renal system diagnostic testing (bladder scan), how much urine is detected to be considered urinary retention?

>100 mL

How much of the chest drainage must happen to report to MD?

>100 mL/hr

What is an abnormal glucose result that could indicate gestational diabetes?

>140

What is a normal Prealbumin level?

>16

What levels are considered theophylline toxicity?

>20

What are the symptoms of Melanoma?

A- Asymmetry. B - Irregular border. C - Color. D - Diameter (6mm or more, about the size of an eraser). E - Evolving.

What is universal receipent?

AB pos

What happens if there is a positive Allen's test?

ABG can be performed. If negative, brachial or femoral artery must be used.

What type of medication must be discontinued when planning pregnancy?

ACE inhibitors. ARBs

What is the drug of choice for diabetics with hypertension or proteinuria?

ACE inhibitors. Protective of diabetic neuropathy

What is the scope of practice for CNA/UAP?

ADLs. Hygiene. Linen change. Routine stable vital signs. Documenting output/input. Positioning. Feeding. Reporting changes in ability to eat or difficulty swallowing. Reporting changes in behavior. Placing bed alarms. Test urine. fingersticks

What diagnostic test is done to confirm TB?

AFB sputum culture every early morning for 3 straight days

What are common OTC drugs that can cause bronchospasm in clients with asthma?

ASA. Ibuprofen

What should be patient teaching regarding Wilm's tumor?

Abdomen should not be palpated until after the diagnosis is suspected or confirmed as this can disrupt the tumor and cause dissemination of tumor cells.

What is the factors for metabolic syndrome?

Abdominal obesity. Triglycerides >150. HDL<40. HTN>130/85. Fasting blood glucose >100

What is Ortolani manuever?

Abduction with anterior lifting of the hip

What does a newborn at 28 weeks gestation show?

Abdunant lanugo. Flat areolae without palable breast bids. Smooth pink skin with visible veins.

What is the goal for long acting nitrate therapy?

Ability to perform ADLs without chest pain

What is resilience?

Ability to prevent and recover from mental illness to manage daily stressors. Practicing appropriate coping skills.

For a post CABG patient, how do you know you are clear for sex?

Able to walk 1 block. Climb 2 flights of stairs w/o symptoms.

What is pleural effusion?

Abnormal collection of fluid (15-20 mL) in the pleural space between the parietal and visceral pleurae that prevents the lung from expanding

What is placenta accreta?

Abnormal placentation that involves implantation in the myometrium.

When a patient is on a heparin drip, and the plan is to start warfarin, how many days can both be given at the same time.

About 5 days so that warfarin can reach its therapeutic level

What is an indicator of GBS progression?

Absence of gag reflex

What is expected early in the course of GBS?

Absence of knee reflexes

If a client has a sexual transmitted infection (STI), what is patient teaching regarding sexual activity?

Abstain from sexual intercourse for 1 week after initiation of drug therapy

What does a child with moderate intellectual disability expect to have?

Academic skills at a 2nd grade level and may be able to work in a sheltered workshop. Performs self-care activities with some supervision. Participates in simple activities. Limit speech capabilities

What are examples of Alpha Glucosidase Inhibitors?

Acarbose. Miglitol

What are you checking for when doing a suicidal ideation assessment?

Access to psych meds. Availability of help. Future goals and plans. Home and work environment risks. Overall affect and level of energy. Possible access to weapons.

What must you be cautious of if you give sedative to patients with respiratory diseases?

Accumulation of secretions in patients with COPD that can lead to respiratory distress

What is pH of a woman's vagina during pregnancy?

Acidic state

What is transference?

Act of unconsciously transferring feelings and behaviors related to a person in the client's past onto the nurse. Can disrupt therapeutic nurse-client relationship.

What is given for ingestion of poison and overdoses?

Actidose (Activated Charcoal)

When can opioid agonist-antagonist meds be given for labor?

Active phase of stage 1 labor when labor contractions are well established and cervix is dilated at least 4 cm.

What type of room should a patient with a increased risk for infection not be placed in?

Actual (Cellulitis, Osteomyelitis) or Potential (Skeletal traction, Fasciotomy) infections

If an Abdominal aortic aneurym tears, where will the pain be felt?

Acute onset abdominal pain that radiates to lower back

What is the criteria for Delirium?

Acute onset of confusion. ALOC. Fluctuating course. Reversible prognosis. Complete impairment. Short term memory loss. Increasing lethargy

What are manifestations of Autonomic dysreflexia?

Acute onset of throbbing headache, nausea, and blurred vision. Hypertension. Bradycardia. Sweating and skin flushing above the level of injury

When is transdermal fentanyl patch not the best choice?

Acute post-op, Temporary or Intermittent pain does not provide immediate pain relief

What are patients with acute pancreatitis at risk for?

Acute respiratory distress syndrome

What are manifestations of cauda equina syndrome?

Acute spinal/back pain. Inability to walk. Saddle anesthesia (motor weakness/loss of sensation to inner thighs and buttocks). Bowel/bladder incontinence

What are symptoms of epiglottis?

Acutely ill, drooling forward, dyspnea. Dysphonia (muffled voice)

What medications are used to treat herpes infection?

Acyclovir. Famciclovir. Valacyclovir.

What are examples of tumor necrosis factor inhibitors?

Adalimumab (Humira). Etanercept (Enbrel). Infliximab (Remicade)

What is Barlow manuever?

Adduction with posterior pressure on the hip

What are strategies to prevent postoperative pneumonia?

Adequate pain management. Positioning. Coughing and deep breathing. Mobilization and early ambulation. Twice daily chlorhexidine mouth care. Fowler's position

What is a central venous catheter used for?

Administer fluids for incompatible drugs, TPN, and Hemodynamic monitoring.

What is phentolamine?

Administered SQ to induce vasodilation, increase blood flow, and help avoid tissue impairment.

What is the treatment for rhabdomyolysis?

Administering large volumes of IV fluids

What should be done when giving Oxytocin?

Administration via electronic infusion pump. Continuous maternal/fetal assessment. Given on a secondary line via proximal port.

What are the risk factors of pneumonia?

Advanced age (>65). Any condition that compromises the respiratory system's protective mechanical or immune mechanisms to maintain sterility of the lower airway

What are risk factors for developing Tardive Dyskinesia with metoclopramide?

Advanced age. High dosage. Long term use.

What are risk factors for hospital induced delirium?

Advanced age. Underlying neurodegenerative disease. Infx. Medical illness. Surgery. Impaired mobility. Inadequate control. Untreated pain

What are the interventions of a near drowning patient?

Advanced airway management. Aggressive oxygenation. IV access. Warm IV fluids if cold. Monitor for cardiac arrhythmia and fluid imbalances.

What are interventions for a near drowning patient?

Advanced airway management. Aggressive oxygenation. Warmed IVF. Monitor for cardiac arrthymias and fluid imbalances

When are symptoms of ovarian cancer usually detected?

Advanced stage due to lack of routine screening guidelines.

What is the most significant and strongest risk factor for late onset AD?

Advancing age

What position must be the patient after a myringotomy?

Affected side

What position should you place the patient after a kidney biopsy?

Affected side for 30-60 mins. Bed rest for 24 hours

How long after MMR vaccine are you allowed to get pregnant?

After 3 months

When is a patient screened for colorectal cancer?

After 50 years old

When should chest physiotherapy best performed at?

After administration of bronchodilators

When does chest circumference exceed abdominal circumference?

After age 2

What can happen if development dysplasia of the hip (DDH) goes untreated?

After age 3 months, limited hip abduction and limb shortening on the affected side are evident. Pelvic tilt is noted when the child learns to walk. Positive trendenlenberg sign, where the pelvis tilts down on unaffected side when standing on the affected leg.

When should fundal massage be performed?

After expulsion of the placenta to increase uterine tone and decrease bleeding.

When can Cow's milk be introduced to a infant's diet?

After first year

What is "pc"?

After meals

When can uterine inversion occur?

After the birth of an infant and traction is applied to the umbilical cord too soon or pressure is applied to the uterine fundus when the fundus is not contracting.

When should pap screening for cervical cancer begin?

Age 21

What are factors that place a client at increase risk of falls?

Age > 65. Assistive ambulation devices. Orthostatic hypotension. Taking sedatives or antiparkinson meds.

What are 5 signs of alzheimer's disease?

Agnosia. Apraxia. Amnesia. Aphasia. Anomia.

Which isolation takes priority over the others?

Airborne

What is supportive care for Chicken Pox?

Airborne and Contact Isolation. Antihistamines for itching. Tylenol (Not ASA) for fever. Nails cut short to prevent excoriation and secondary bacterial infection.

What type of isolations does Varicella require?

Airborne and Contact if open lesions are present

What is nursing interventions for a Ebola patient?

Airborne isolation room. Restriction of visitors. Log of individuals who enter and exit room.

What are s/s of a anaphylactic reaction?

Airway and Oral swelling. Stridor. Wheezing. Chest tightness. Shock. Dizziness. Loss of Consciousness

What takes priority in a patient with cystic fibrosis?

Airway. O2 Sat. Pneumothorax is a complication of cystic fibrosis

What is a colloid solution?

Albumin. Dextran

What should people on metronidazole avoid?

Alcohol

What should patients taking Isoniazid avoid?

Alcohol. Aluminium antacids (Maalox)

What is patient teaching should a family member get head lice?

All family members must be treated

When should annual gonorrhea and chlamydia be done?

All sexually active females 25 years and older

How often is the Pavlik harness worn?

All the time for the first few weeks

What can trigger an asthma exacerbation?

Allergies

What do you need to monitor for when taking sulfa meds such as (Trimethoprim-sulfamethoxazole?

Allergies to sulfa drugs. Sulfonylurea meds (glyburide) due to potential cross sensitivity reactions.

How do you apply otic medication?

Allow medication to drop against the wall of the canal without the applicator touching the ear. A child should remain with the affected ear up for several minutes to allow full coverage of the ear

What is Terazosin used for?

Alpha-adrenergic blocker that can relieve urinary retention in patients with BPH.

What is seen in a patient who is nearing death?

Alterations in breathing patterns (Cheyenne-stokes). Impaired perfusion (cool, dusky arms and legs). Slack, relax jaw muscles (Open mouth). Eyelids half open

What is a concern with patients with a permanent ostomy?

Altered body image

Following a vasectomy, when can you have sex without protection?

Alternative birth control must be used until HCP confirms free of sperm

What are subjective (presumptive) sign of pregnancy in the first trimester?

Amenorrhea. N/V. Breast tenderness. Quickening. Excessive fatigue

What symptoms from a woman in regards to pregnancy ALWAYS requires review?

Amenorrhea. Pelvic/Abdominal Pain. Subsequent vaginal bleeding.

What is the treatment for stable Ventricular Tachycardia (VTach) with a pulse?

Amiodarone. Procainamide. Lidocaine

When must a physician be notified of rupture of membranes?

Amniotic color is yellow (which means blood incompatibility) or meconium stained (dark colored)

What is the treatment of choice for Acute Otitis Media?

Amoxicillin

What conditions are contraindicated for MRIs?

Aneurysm clips. Metallic implants (Hearing aids, ICD). Pregnancy. Allergy to gadolinium if using a contrast agent

What are signs of respiratory infection for cystic fibrosis?

Anorexia. Weight loss. Decreased activity levels

What are side effects of Methylphenidate?

Anorexia. Weight loss. Growth delays. Restless. Insomnia. HTN. Tachycardia. Vocal/Motor tics

What can Glucosamine not be given with?

Antidiabetic medications because it can cause hypoglycemia

What is treatment for oral candidasis?

Antifungal (Nystatin). Oral care

How is Tinea Corporis (ringworm) treated?

Antifungal shampoos. Creams. Oral meds.

What medications should be held prior to dialysis?

Antihypertensives. Furesomide. Antibiotics. Digoxin. Water soluble vitamins (B, C, and folic acid)

What is on the beers criteria?

Antipsychotics. Anticholi. Antihistamines. AntiHTN. Benzos. Diuretics. Opioids. Sliding Insulin scales.

What is parent teaching for febrile seizures?

Antipyretics. Cool compresses. Seizures safety precautions. Avoidance of shivering.

How do you reduce spread of VAP?

Antiseptics. Avoid PPI except for patients at high ulcer risk. Change circuit only if visibly contaminated.

What are the symptoms of opioid withdrawal?

Anxiety/Restlessness. N/V. Pupillary dilation. Tachycardia

What are symptoms of pulmonary embolism?

Anxiety/restlessnes. Pleuritic chest pain/tightness. SOB. Tachycardia. Tachypnea. Hypoxemia. Hemoptysis

What must Actidose not be given with?

Any antidote to prevent neutralizing the antidote. This is before, with, or after giving Actidose.

What are foods that patients with Chronic Kidney Disease (CKD) can eat?

Apples. Pears. Grapes. Pineapple. Blackberries. Plums

What is done for a labor admission intervention?

Application of external fetal monitoring. Performance of a nitrazine pH test to determine if membranes have ruptured.

What are the instructions for applying a clonodine patch?

Apply to dry hairless area like a chest or upper arm. Do not shave. Rotate sites. Fold old patch in half

What is nursing education for a patient receiving Nitroglycerin patches?

Apply to upper arm or body. Rotate sites daily. Remove patch at night. Taking no erectile dysfunction meds. Informing that headaches are common. Patches do not need to be removed when taking a shower. Applied once a day. Worn for 12-14 hours then removed.

What is the intervention for back labor in a laboring client?

Applying counterpressure to the sacrum during contractions. Placing on hands and knees helps decrease back pain and facilitates fetal rotation.

What is the proper breastfeeding technique?

Approximately 15-20 minutes on each breast for 8-12 times a day. Held tummy to tummy at nipple level. Nipple and areola should be grasped in the infant's mouth. If infant needs to removed from breast or latches incorrectly, insert finger to break the suction.

What does a invasive arterial line measure vs a manual cuff reading?

Arterial line measures flow of blood past a catheter while a manual cuff applies pressure to the artery.

What is an amniotomy?

Artificial rupture of membranes (AROM)

When should Methylphenidate be given?

As it is a stimulant, should be given before 6pm

When should growth hormone replacement start?

As soon as delays are noted and continues until bone growth stops despite replacement therapy.

What is the best response to a client/family who expresses doubts about ECT?

Ask about their concerns

What causes Reye Syndrome?

Aspirin (salicylate). Follows varicella or influenza

What are examples of antiplatelets?

Aspirin. Clopidogrel. Prasgurel. Ticagrelor. Dipyridamole

What is the interventions if there is a reduction in chest tube drainage?

Assess breath sounds. Encourage deep breathing and coughing. Reposition the client.

How does a nurse produce culturally competent care?

Assess client's belief regarding cause of current illness

How do you perform an ear irrigation?

Assess for contradictions (fever, ear infection, tympanic membrane injury. Place patient in a sitting position with head tilted to affected ear. Place towel and emesis basin under the ear. Straighten ear canal by pulling up and back. Gently irrigate with a solution at room temperature with a slow, gentle rate. Aim at top of ear canal until clear.

What is the tx for fetal bradycardia after rupture of membranes?

Assess for prolapsed cord. Elevate presenting fetal part off the cord then call for help.

What are interventions to help prevent aspiration in critically ill high risk patients?

Assess gastric residual volumes and level of sedation at regular intervals. Check tube placement. Administering continual not bolus tube feeding. If intubated, keep tracheal cuff at appropriate pressure. Be cautious with sedatives.

What are the interventions if compartment syndrome is suspected?

Assess neurovascular status. Report to MD. DO NOT ELEVATE AFFECTED EXTREMITY

What does the nurse anticipate with an amniotomy?

Assess the fetal heart rate before and after. Note the characteristics of the amniotic fluid. Assist client to upright position after procedure. Check temp every 2 hours after AROM

What are interventions to do after a kidney biopsy?

Assess vital signs frequently. Asses the biopsy site and dressing.

What is the sequence if a patient is found to have fallen?

Assess. Inspect for injuries. Help back to bed. Notify MD. Incident report.

What does a unit quality improvement committee do?

Assesses process standards (guidelines, systems, and operations) and problems with the systems and standards (eg late delivery of medications from pharmacy) created to ensure delivery of quality care. Not concerned with administrative or management issues (eg client satisfaction surveys, individual performance reviews)

What is the priority nursing action if urinary retention is suspected?

Assessing client's suprapubic area

What do you need to monitor for in a total hip replacement?

Assessing the dressing and drainage device to check for blood loss. Has a priority over positioning an abduction pillow

What is the priority intervention for a child with ADHD who is engaging in aggressive behavior?

Assist child in calming down and gaining control. Example is deep breathing or blowing a balloon

What is a Austin Flint murmur?

Associated with Severe aortic regurgitation. Low pitched and rumbling that can be heard mid to late diastole. Best heard over the apex.

What is a umbilical cord with one artery and one vein indicate?

Associated with heart or kidney malformation

What is proper care of a non rebreather mask?

Assure continual inflation during inhalation. Monitoring the 2 exhalation (flutter) valves that cover the ports (must be occluded) on each side of the mask. Keeping mask secured to face by adjusting straps

What is the green zone for a peak flow meter?

Asthma is under control

What are characteristics of Osteoarthritis?

Asymmetrical pain in the weight bearing joints and with weight bearing exercises. Crepitus, especially over the knee joints. Morning stiffness lasting 10-15 mins

What are the symptoms for Human papillomavirus (HPV)?

Asymptomatic

How many hours should a patient be NPO before a Magnetic Resonance Cholangiopancreatography (MRCP)?

At least 4 hours to allow better visualization

How long should patients with sustained submersion injury be monitored for?

At least 6 hours for new or worsening respiratory failure.

What is fine crackles an indication of?

Atelectasis

What causes a abdominal aortic aneurysm?

Atherosclerosis

What are examples of statins?

AtorVASTATIN. RosuVASTATIN

What is Trisomy 21 associated with?

Atrioventricular (AV) canal defect

What is the medication for symptomatic bradycardia?

Atropine.

What explains why narcissistic personality acts the way they do?

Attempt to maintain a fragile self esteem

What behaviors are present with a borderline personality disorder?

Attempt to prevent abadonment. Control their environment. May flatter and cling to one staff member while making derogatory remarks about another.

What are milestones for a 1 month old?

Attempts to hold head up when prone. Maintains fisted hands. Cries when upset. Gazes at parent's face when parent speaks

What are coping strategies for compassion fatigue?

Attending a memorial service. Taking time off work. Regular exercise. Adequate rest. Proper nutrition

What are behaviors for histrionic personality disorder?

Attention seeking. Flirting. Exaggerated emotions. Demands immediate gratification and little tolerance for frustration.

How do you assess for a Bruit?

Ausculate

What is the first step when there is a drop in oxygen saturation? First intervention?

Ausculate lung sounds. Confirm proper tube placement.

What are the steps for assessment of a infant?

Auscultation. Palpation and Percussion occur with head to toe. Traumatic procedures (Eyes, ears, mouth). Elicitation of Moro reflex

What is Marfan syndrome?

Autosomal dominant disorder affecting the connective tissues of the body. Appears very tall and thin with disproportionately long arms, legs, and fingers.

What is discharge teaching for a patient with pneumonia?

Avoid OTC cough suppressants because they impair secretion clearance. Schedule follow up with MD and plan to get a CXR. Use a cool mist humdifier at night. Use incentive spirometer at home. Encourage fluids. Avoid smoking

What is patient teaching for Metronidazole?

Avoid alcohol, which can make urine darker and cause a metallic taste. Partner must be treated simultaneously.

What is patient teaching for Mitral Valve Prolapse?

Avoid caffeine and alcohol

What is patient teaching for DVT?

Avoid caffeine and alcohol. Drink plenty of fluids. Elevate legs. Dorsiflex often. Exercise program. Stop smoking. Avoid restrictive clothing. Avoid cross legged sitting.

What is a priority when teaching a patient with Marfan syndrome?

Avoid contact sports due to abnormalities of the aorta which can cause cardiac injury and sudden death

What is the treatment after inguinal hernia repair surgery?

Avoid coughing and heavy lifting. Turn and deep breathe every 2 hours. Stand when voiding. Scrotal elevation and ice help decrease pain and swelling. Ambulate early

What should be done for neutropenic precautions?

Avoid exposure to those currently sick. Avoid all fresh fruits, vegetables, and flowers. Provided a private room.

How can you promote toddler health promotion?

Avoid giving options that allow toddlers to say no. Refrain from forcing toddlers to eat. Allow 15-30 minute period to calm down before meals. Use time outs for management of temper tantrums.

What is patient teaching regarding lupus?

Avoid harsh sunlight and UV light exposure. Avoid harsh soaps and chemicals (antibiotic soap). Receive killed vaccines such as flu shot. Avoid situations that cause emotional and physical stress.

What is patient teaching to increase the appetite of a patient having radiation of the neck and head?

Avoid irritants. Consume liquid supplements.Using artificial saliva or sipping water. Perform frequent (before/after meals, bedtime) oral care

What is discharge teaching for a patient with an ICD?

Avoid lifting arm on the ICD side until approved by MD to prevent dislodging the wires. Patient needs to be aware that the firing of the ICD is painful

What is patient teaching for a patient who just had a pacemaker implanted?

Avoid lifting heavy objects. Avoid above the shoulder exercise until cleared by MD. Wear a pacemaker ID and medic alert bracelet. Avoid MRIs. Never place a cellphone over the pacemaker. Inform airline personnel. MICROWAVE OVENS ARE SAFE. Handheld screening wand should not be held directly over the pacemaker

What is patient teaching for genital herpes?

Avoid sexual activity when lesions are present.

What is advice given to Pregnant patients regarding the Zica virus?

Avoid travel til the baby is born

How can epitaxis be avoided?

Avoiding local trauma. Nasal spray or humidifier

What should be done if a spontaneously wedged waveform shows on the PA catheter monitor?

Balloon port should be deflated immediately and locked to prevent accidental reinflation.

What are sources of potassium?

Banana. Potatoes. Citrus fruits. Avocadoes. Pudding. Yogurt. Raw carrots. Tomatoes. Orange juice. Watermelons

What can High levels of PEEP cause?

Barotrauma to the lungs causing pneumothorax and hypotension

What are measures to prevent skin breakdown?

Barrier cream

What is a contraindication for insertion of a NGT?

Basiliar skull fracture due to risk of penetrating skull through the fracture site. After gastric surgery due to potential for distrubing the surgical site.

What are the nursing recommendations for a client with placental previa that is less than 36 week gestations?

Bed rest. Bathroom privileges. Nonstress test or biophysical profile once or twice a week. Pelvic rest to prevent disruption of the cervix. Cesarean section. Pad counts. Type and screen. Large bore IV access.

What provides a list of harmful drugs to avoid for the elderly?

Beers criteria

When is fifth disease "Slapped face" communicable?

Before the onset of symptoms like rash and joint pains. No isolation required

What is the ABG for ASA poisoning?

Begins with respiratory alkalosis then becomes metabolic acidosis.

What is delusions of grandiose?

Belief about self-worth, power, knowledge, identity, or a special relationship to a deity or famous person

What is delusions of persecutory?

Belief of being mistreated

What is a delusion of erotomanic?

Belief that another person, usually someone famous or powerful, is in love with the individual

What are Delusions of Somatic?

Belief that client has some disease

What can be done for bladder spasms?

Belladonna-opium suppositories. Antispasmodics (Oxybutyin)

Where should lipids be be hanged when giving tpn?

Below the infusion filter because it cannot pass through the filter.

What is used to heart rate in tachyarrhythmias?

Beta Blocker. Metoprolol.

What do you need to avoid with Acute Decompensated Heart Failure?

Beta blockers

What are causes of orthostatic hypotension?

Beta blockers. Alpha blockers (terazosin). Antipsychotic. Antidepressant. Diuretics. Vasodilator. Narcotics

What are causes of Bradycardia?

Beta blockers. Vagal stimulation. Hypothyroidism. Inferior wall myocardial infarction. Increased intracranial pressure.

What does green vomit from a newborn indicate?

Bile from the intestine, which could indicate a bowel obstruction

What are behaviors of bulimia nervosa?

Binge eating followed by self induced vomiting. Use of laxatives. Intense exercise.

What is patient teaching for a patient with osteoporosis?

Biphosphate meds. Calcium and Vitamin D supplements. Smoking cessation. Alcohol avoidance. Weight bearing exercise

What is the third stage of labor?

Birth of baby to expulsion of placenta

How fast is birth weight during the first year?

Birth weight doubling by 6 months. Tripling by age 12 months

When can Hep B shots be given?

Birth, 1 month, and 6 months

What is an example of a medication that can cause Reye Syndrome?

Bismuth subsalicylate

What herbal tx is used for menopausal hot flashes?

Black cohosh

What is a side effect of Actidose?

Black stools. GI distress. Constipation.

What races are most likely to get Thalassemia major?

Black. Mediterranean. Southeast Asian.

What would be treatment for a patient experiencing Autonomic dysreflexia?

Bladder catherization. Remove restricting clothing. Raising HOB

What is the meaning if the fundus is elevated above the umbilicus and deviated to the right?

Bladder distention, must encourage client to void.

What are common triggers of Autonomic dysreflexia?

Bladder or rectum distention. Pressure ulcers.

What is an expected finding of a patient with a catheter following a prostatectomy?

Bladder spasms

What are nursing interventions for stress incontinence?

Bladder training (void every 2 hours). Pelvic floor exercises (Kegel exercises). Weight loss. Reduction of dietary bladder irritants. Smoking cessation. Pessaries

What does Raynaud's disease show?

Blanching of the fingers and toes in response to cold or emotional stress

What is a major complication with a kidney biopsy?

Bleeding

What do you need to watch out for after a cardiac catherization?

Bleeding at catheter site. Decreased perfusion (One extremity cooler than the other)

What must be reported following a prostatectomy?

Bleeding. Blood clots. Decrease in urine. Urinary retention. S/S of UTI

What are symptoms of Abruptio Placentae?

Bleeding. Rigid boardlike abdomen. Rigid uterus. Tender uterine with pain. Uterine contractions.

What are symptoms of patient with ovarian cancer?

Bloating. Early satiety. Pressure on the bladder and pelvis

What is the danger with Polycythemia Vera?

Blood clots development

What must be done prior to starting antibiotics?

Blood culture

What should you monitor for within the first 24 hours of a carotid endarterectomy?

Blood pressure because HTN could strain the surgical site and cause a hematoma, hemorrhage, or airway obstruction.

What is the management for Thalassemia major?

Blood transfusions to keep Hgb at 9-10

What does currant jelly stool consist of?

Blood. Mucus

What are signs of near complete dilation?

Bloody show. Urge to push. Must be coached in breathing techniques to avoid pushing until fully dilated

What is Acrocyanosis?

Bluish coloration of the hands and feet in the newborn.

What would be an appropriate toy for a school age child to help developmental skills?

Board games

What is osteomalacia?

Body is unable to use calcium and phosphorus for bone calcification due to Vitamin D deficiency.

What do you need to watch out for with a patient receiving chemo?

Bone marrow suppression (Anemia, Leukopenia, Thrombocytopenia). Immunosuppression. WATCH OUT for even a low grade fever

What is the main problem with methotrexate?

Bone marrow suppression. Hepatotoxicity. Congenital abnormalities. Fetal Death

What type of personality disorder is high risk for suicide?

Borderline

What type of isolation is required for open shingles lesions?

Both air and contact with negative airflow

What needs to be done prior to surgical or diagnostic procedures with colorectal cancer?

Bowel cleansing

What are patients with a large body cast at risk for

Bowel obstruction (Paralytic Ileus) due to Cast syndrome (Superior mesenteric artery [SMA] syndrome) or Decreased peristalsis

Where should you check the HR for a child <1 year old?

Brachial artery

What do you expect to assess after vigoursly suctioning a neonate?

Bradycardia

What is Cushing triad?

Bradycardia. Irregular respirations. HTN with wide pressure pulse. Hyperthermia

What is the only forms of hydration an infant needs for the first 6 months?

Breast milk. Formula feedings

What are common side effects of oral estrogen contraceptives?

Breast tenderness. Spotting

What is contraindicated in a HIV mother who has a newborn?

Breastfeeding

What is focused assessments?

Breath sounds. Bowel sounds. Neurovascular checks.

What is the assessment for perineal and cervical lacerations after the placenta is delivered?

Bright red bleeding. Firmly contracted fundus

When giving acetylcysteine (Mucomyst) to a asthma client, what do you need to watch out for?

Bronchospasm

What are examples of a positive immune response?

Bronchospasm. Dyspnea. Tachypnea. Hypotension. Angiodema

What is the findings of a normal lung?

Bronchovesicular, vesicular breath sounds. Normal tactile fremitus. Resonance upon percussion

What is battle's sign?

Bruising around the ear

What are the symptoms of a abdominal aortic aneurysm?

Bruit heard in the abdomen. Pulsating feeling in the abdomen. Abdominal or lower back pain, which feels like a tearing pain.

What is an indicator that there is a air leak in the water seal chamber?

Bubbling

What is the not an expected appearance of a water seal chamber in a chest tube drainage system?

Bubbling, indicating a air leak

What is horizontal violence?

Bullying/harassment between coworkers

What are common side effects of a laser lithotripsy procedure?

Burning on urination and hematuria

What are symptoms of Cystitis?

Burning on urination. Frequency. Urgency. Suprapubic discomfort. Hematuria.

What is expected after a cystoscope?

Burning sensation when voiding due to irritation of the urethral and bladder lining

What is common after applying Capsaicin?

Burning. Stinging. Erythema.

What are commonly used opioid agonist-antagonist meds in labor?

Butorphanol Tartrate and Nalbuphine Hydrochloride

What are manifestations of Systemic Lupuse Erythematosus (SLE)?

Butterfly rash. Nephritis. Arthritis. Vasculitis. Recurrent oral ulcers

What is done to prevent transmission of herpes to the neonate, especially with active lesions?

C-Section

What is the tx for asystole?

CPR. Oxygenated ventilation. ACLS measures

What needs to be done after a chest tube removal?

CXR to check for pneumothorax

What is a drug to drug interaction with theophylline?

Caffeine. Cimetidine. Ciprofloxacin

What is medication for Raynaud phenomenon?

Calcium Channel blockers

What is the antidote for magnesium toxicity?

Calcium gluconate

If there are ECG changes with hyperkalemia, what is the treatment?

Calcium gluconate to stabilize cardiac muscle

Should a pregnant patient with a hx of HTN develop a severe headache and blurred vision, what is the home nurses action?

Call 911 asap

What position must the patient be placed for an arterial line?

Can be placed supine, flat, prone, or HOB <45 degrees as long as the zero reference stopcock is level with phlebostatic axis.

What are normal MMRV vaccine reactions?

Can occur within 5-12 days after vaccination. Mild fever and rash, irritability and restlessness. Swelling and erythema at the injection site.

What is a good alternative for calcium and vitamin D in patients who are lactose intolerant?

Canned sardines

What kind of restriction does Orthodox Jews have with medication?

Cannot consume capsules made from gelatin due to it being nonkosher. Ask the pharmacist for an alternative form

What are indications of isotonic fluids?

Capillary refill more than 3 seconds. Patches of pink, pale, cyanotic skin (Mottling). Prehydration before an epidural anesthesia. Burn clients. Poor urine output and tachycardia due to Hyperemesis gravidarum. Hypovolemic shock. Dehydration. N/V. Diarrhea. Anaphylaxis

What are interventions for Hypothermia?

Cardiac monitoring. Gentle handling to prevent V-fib. Anticipate defibrillation

What is a complication of acute pericarditis?

Cardiac tamponade

What does Sulfonylureas (eg Glyburide) do to Geriatric population?

Cause prolong hyperglycemia due to delayed elimination

What can happen if you give an opioid agonist-antagonist medication to opioid dependent patients?

Cause withdrawal

What is subdural hematoma?

Caused by bleeding into the subdural space outside the brain

What can cause metabolic acidosis?

Caused by loss of bicarb or build up of acids. Lactic acidosis. Diarrhea. Renal failure. Ammonium intoxication. Diabetes. Alcoholism. Starvation. Sepsis. Dialysis. Salicylate toxicity

What does Autonomic dysreflexia do?

Causes an exaggerated sympathetic nervous system response resulting in uncontrolled hypertension.

What is amyotrophic lateral sclerosis (ALS)?

Causes progressive loss of motor neurons, resulting in weakness and spasticity. Muscles involved in respiration and swallowing are affected leading to aspiration and ultimately respiratory failure.

Why must a trendelenburg position not be used to visualize airway?

Causes shift in abdominal organs causing an increase in the work of breathing.

What is the yellow zone for a peak flow meter?

Caution. Further medication or a change in medication is needed.

What are medications given for a client with an open fracture to prevent infection and to treat pain and muscle spasm?

Cefazolin (prophylactic for Staph aureus). Cyclobenzaprine (muscle spasm). Tetanus and diphtheria toxoid (prophylactic for C-Diff). Ketorolac (inflammation and pain). Opiods (pain)

In combination with penicillin, what will cause a anaphylactic reaction?

Cephalosporins (Ceftraxione, Cefazolin). Carbapenem (Meropenem)

What are s/s of Dissociation identity disorder?

Change in appearance. Change in voice. Loss of time. Unremembered behaviors.

What is a inffective breathing pattern?

Change in rate, rhythm, timing, depth, or chest and abdominal wall excursion during inspiration and/or expiration that affects a patient's ability to maintain adequate ventilation

What are signs of impending respiratory failure?

Changes in respiratory pattern or rate, oxygen saturation, and level of consciousness. Paradoxical breathing. Inability to cough. Hypoxia. Inabililty to lift head or eye brows

What should not be done to oxygen for patients with COPD?

Changing to a higher rate because it does not help and can decrease the drive to breathe

Describe squamous cell carcinoma

Characterized by local invasion, fast growing, infrequent metastasis. Looks like red nodules with crust or ulceration.

What are 3 checks done during med pass?

Check MAR when obtaining the med. Check during medication prep. Check bedside before administering

What tests are done at 24-28 weeks of gestation?

Check for gestational diabetes with a one hour glucose challenge test.

Where is the placement of an Adult AED pad on a patient <8 years old?

Chest and Back

When following NRP (Neonate Resuscitation Program), what is the intervention if the HR is <60 after 30 seconds of quality PPV?

Chest compressions

What are s/s of SLE?

Chest pain with inspiration. Fatigue. Fever. Hair loss. Mouth sores. Photosensitivity.

What must be airborne isolation?

Chicken Pox. TB. Measles. Herpes Zoster. Varicella. Shingles

What is Kawasaki disease?

Childhood condition that causes inflammation of arterial walls (vasculitis)

What are common misunderstandings of ADHD?

Children will outgrow it, but it continues into adulthood. Dietary modifications will improve the symptoms

What should be used when bathing a patient with MRSA or other drug resistant organisms?

Chlorhexidine solution

What is Trisomy 18?

Chromosome anomaly characterized by severe cardiac defects and multiple muscloskeletal deformities.

When can Isotonic solutions not be given?

Chronic renal failure and Hypertension because it can exacerbate fluid overload.

What are common triggers of asthma attacks?

Cigarette smoking. NSAIDs. Emotional stress. GERD

What are examples of Fluoroquinolones?

CiproFLOXACIN. LevoFLOXACIN. MoxiFLOXACIN. NorFLOXACIN. oFLOXACIN

What are foods high in Vitamin C?

Citrus fruits. Potatoes. Tomatoes. Green Veggies.

What are the interventions of a suspected air embolism?

Clamp catheter. Place left side trendenlenberg. Administer O2. Notify MD. Stay with client to provide reassurance

What must not be done to a chest tube upon transport?

Clamping is contraindicated

What must you teach pregnant clients to avoid?

Cleaning cat litter boxes, gardening and not fully washing produce due to toxoplasmosis

How can you prevent CAUTI?

Cleanse periurethral area with soap and water. Ensure a seperate, clean container is used to collect, empty, and measure urine.

What are the 4 C's when giving direction and communication?

Clear. Concise. Complete. Correct.

What is the main goal when withdrawing life support?

Client comfort

What is the most important aspect of a client's refusal of treatment?

Client is informed of the potential results of the refusal

What does Cognitive behavioral therapy(CBT) teach?

Client learns about the disorder and engage in self observation and monitoring. Relaxing techniques. Desensitization activities, and changing negative thoughts.

What is patient teaching when applying Capsaicin?

Client should wait 30 minutes before washing the affected area to ensure adequate absorption

What needs to be assessed when elder abuse is suspected?

Client'e general hygiene. Clothing. Nutritional and hydration status. Presence of other injuries. Inappropriate medication administration. Signs of depression, and statements of neglect.

What is the most reliable indicator for the client's pain?

Client's self report of symptoms

What is the most reliable indicator of client pain?

Client's self report of symptoms

Who is at risk for uterine rupture?

Clients attempting vaginal birth after a Cesarean delivery.

What is patient teaching for a pessary?

Clients can remain sexually active. Increased vaginal discharge is a common side effect. It is fitted by the MD. Clients can remove and insert the pessary themselves.

What is a delusion of reference?

Clients feel as if songs, newspaper articles, and other events are personal to them

Who is a venturi mask best used for?

Clients who cannot tolerate changes in oxygen concentration (COPD)

When is a non rebreather mask best used?

Clients with low saturation resulting from asthma, pneumonia, trauma, and severe sepsis. Emergency situations

What is the scope of practice for RNs?

Clinical assessment. Initial client education. Discharge education. Clinical judgement. Initiating blood transfusion.

What is the treatment for Toxic megacolon?

Close monitoring. NGT for decompression. IV fluids. Antibiotics. Emergency surgery may be required

How do bed bugs travel?

Clothing. Bedding. Furniture. Misconception that it comes from dirty environments

What is a Halo sign? How can you determine it?

Coagulated blood surrounded by CSF. Dextrose testing if drainage is clear.

What do clients with fluid overload show?

Coarse crackles. Elevated JVD. Peripheral edema. Rapid breathing.

What is a concern for adolescents when wearing a brace for scoliosis?

Compliance. Body image and socialization are issues that adolescents face when wearing the brace

What does hemoglobin do for the body?

Component of red blood cells that carries oxygen to the body tissues

What is a School aged(6-12yo) stage Piaget's cognitive development?

Concrete operational. Able to reason if concrete objects are used to teach.

What are symptoms of Delirium tremens?

Confusion. Agitation. Fever. Tachycardia. HTN. Sweating. Hallucinations.

What are signs of lidocaine toxicity?

Confusion. Restlessness

What are late signs of hypoglycemia?

Confusion. Seizures. Loss of consciousness. Death.

What is bladder exstrophy?

Congenital anomaly in which the bladder is abnormally formed outside the abdominal wall and requires surgery to correct.

What is Pica?

Constant craving and consumption of nonfood and/or nonnutritive food substances that may occur in pregnancy.

What are signs of increased intracranial pressure?

Constant headache. Decreased mental status. Sudden onset emesis

What can cause insufficient outflow from peritoneal dialysis?

Constipation

What is a long term side effect of opioid use?

Constipation

What is a frequent side effect of calcium supplementation?

Constipation.

What are examples of a abnormal bowel function?

Constipation. Fecal Impaction. Post surgery.

What are common adverse effects of codeine?

Constipation. N/V. Orthostatic Hypotension. Dizziness

Upon assessment, If a patient is taking a herbal supplement daily, what must be done?

Contact pharmacy to see if there are any drug to drug interactions.

What is the cause of Hep A?

Contaminated food

What is the cause of pinworms?

Contaminated food, drinks, toys, and linens.

What is Dystonia?

Continuous muscle spasms and contractions

Why is NSAIDs contraindicated for heart failure?

Contribute to sodium retention

What does Alpha Glucosidase Inhibitors do?

Control diabetic blood level by delaying absorption of carbohydrates

What is Albuterol used for?

Control symptoms of airway obstruction. Promote bronchodilation

What is metaplasia?

Conversion of one mature cell into another

What are nursing measures to promote comfort from Kawasaki Disease?

Cool compresses. Unscented lotions. Loose fitting clothing to deal with the rash

What is the role of the nurse as a manager?

Coordinates care of the client among different members of the interdisciplinary team.

What is the treatment for chemical burns to the eye?

Copious eye irrigation with water or NS/LR

What can umbilical cord prolapse cause?

Cord Compression. Fetal heart rate deceleration. Disruption of fetal O2

What is the most serious complication with Kawasaki disease?

Coronary Artery Aneurysms if condition untreated.

What is the tx for Bell Palsy initially?

Corticosteroids within 72 hours of symptom onset

What are characteristics of Pertussis?

Cough lasting 2 weeks with either paroxysms of cough, inspiring whooping cough, posttussive vomiting

What are the classic symptoms of TB?

Cough. Sputum production. Dyspnea.

What are interventions to mobilize secretions?

Coughing and deep breathing. Chest physiotherapy. Fowlers or side lying with good lung down. Hydration.

What is a yellow trauma status?

Could wait 1-2 hours without loss of limb or life.

What is the assessment for pneumonia?

Crackles. Increased vocal/tactile fremitus. Unequal chest expansion. Bronchial breath sounds.

What is an age appropriate toy for preschool age (3-6)?

Crayons

What is the weight of a 30 month old child?

Current weight should be 4 times birth weight

What condition requires chest physiotherapy before meals?

Cystic fibrosis

What is an example of hypertonic fluids?

D10W. D5 NS. D5 1/2 NS.

What can be used for treatment of hyperkalemia?

D50 and Insulin

What is tx for Late decelerations?

DC Oxytocin (FIRST ACTION). Position to left side. O2 at 8-10L/min via NRBM. IVF bolus of LR/NS. Terbutaline may be given.

What is the difference between drug-induced thrombocytopenia (DIT) and heparin-induced thrombocytopenia (HIT)?

DIT can cause bleeding. HIT has an added risk of thrombosis

How often should a inhaled corticosteroid(ICS) inhaler be cleaned?

Daily

How long do SIGECAPS have to be present to be considered Major Depressive Disorder?

Daily for at least 2 weeks

What are interventions for Ankylosing Spondylitis?

Daily stretching. Stop smoking. Manage pain with NSAIDs and moist heat. Immunosuppressants. Anti-inflammatory. Rest during flare ups. Sleep on backs with a firm mattress.

What can show a severe brain damage?

Decerebrate posturing which shows arms and legs straight out, toes pointed down, and head/neck arched back

What is management for lymphedema?

Decongestive therapy (massage). Compression sleeves or intermittent pneumatic compression sleeve. Elevation of arm. Isometric exercises. Avoidance venipuncture. Injury and infection prevention

When would Bipap therapy be best used?

Decrease CO2 levels in clients with hypercapnic (PCO2 80) respiratory failure.

What is Propantheline bromide used for?

Decrease biliary spasm

How would you check the effectiveness of treatment for Hospital acquired pneumonia (HAP)?

Decrease in WBC

What is s/s of psychomotor retardation?

Decrease movement. Slowed speech. Impaired cognitive function.

What should be monitored for in Heparin-Induced Thrombocytopenia (HIT)?

Decrease of >50% of platelets from baseline. Drop below 150,000

What do H1 receptor antagonists do?

Decrease the inflammatory response by blocking histamine receptors

What is the importance of condoms with Human papillomavirus (HPV)?

Decrease, but do not eliminate, the risk of transmission

What can subdural hematoma lead to?

Decreased cerebral perfusion and herniation

What are abnormal findings in a newborn assessment?

Decreased muscle tone. Sacral dimple. Single artery in the umbilical cord. Jaundice. Not voiding or pooping in 24 hours. Nasal flaring. Chest wall retractions. Grunting with respirations

What is the findings of Atelectasis?

Decreased or absent breath sounds. Decreased tactile fremitus. Dullness upon percussion

What is the findings of Pleural effusion?

Decreased or absent breath sounds. Decreased tactile fremitus. Dullness upon percussion

What is the findings of Pneumothorax?

Decreased or absent breath sounds. Decreased tactile fremitus. Hyperresonant upon percussion

What are signs of magnesium toxicity?

Decreased or absent deep tendon reflexes. Respiratory depression. Decreased urine output. Cardiac arrest

What are manifestations of cold stress?

Decreased temperature. Altered mental status. Bradycardia. Hypoxia. Hypotonia. Weak cry/suck

What is the biggest risk for patients with the rotavirus?

Dehydration

Hyperemesis gravidarum resembles what condition?

Dehydration with s/s of Poor skin turgor, decreased urine output,Tachycardia, Low blood pressure, Dry mucous membranes. Moderate urine ketones

What are risk factors for lithium toxicity?

Dehydration. Decreased renal function. Low sodium diet. Drug to drug interactions (NSAIDs and Thiazide diuretics).

What are catatonic schizophrena patients at risk for?

Dehydration. Malnutrition.

What can impair wound healing?

Dehydration. Nutritional deficiencies

What does the Right Task mean?

Delegating a task to a specific patient that requires little supervision that is repetitive.

What foods should a pregnant client avoid?

Deli meats. Hot dogs. Liver. Unpasteurized milk products. Unwashed fruits and vegetables. Raw fish and fish high in mercury (swordfish).

What is Assault?

Deliberate threat with the power to carry out the threat

What s/s occur from Alcohol withdrawal syndrome within 48-96hrs of last drink?

Delirium tremens. Confusion. Agitation. Fever. Tachycardia. HTN. Sweating. Hallucinations.

What is synchronized cardioversion?

Delivers a shock at the R wave of a QRS complex. CANNOT be used for VFIB

What are delusions of jealous?

Delusions that the sexual partner is unfaithful

What is the most common defense mechanism for alcoholism?

Denial

What are the manifestaitons of opioid intoxication?

Depressed mental status. Decreased respiratory rate (<12). Constricted (miotic) pupils. Decreased or absent bowel sounds.

What is St. John's wort used for?

Depression. Anxiety.

What is Somatization?

Describes physical symptoms that cannot be explained by a medical condition

What can be given for hemphilia in children?

Desmopressin

What can be given for noctural enuresis for ages >5?

Desmopressin. Tricyclic antidepressants

What is Leopold's maneuvers used for?

Determining the presentation and position of the fetus

What are people taking oral estrogen contraceptives at risk for?

Developing blood clots

What is a stork bite?

Developmental vascular abrnomality that will disappear within 1 year. Can be seen on the neck, eyelid, upper lip, or between the eyes. NORMAL

What is a frequent side effect of Amoxicillin?

Diarrhea. If develops fever and abdominal pain with diarrhea, could indicated C-Diff, need to report to MD

What are symptoms of Acetycholi inhibitor poisoing?

Diarrhea. Urination. Miosis (Pupillary constriction). Bronchospasm. Bradycardia. Crying (Lacrimation). Behavioral excitation. Drooling. Sweating.

What is the tx for acute seizures?

Diazepam. Lorazepam

What should you watch out for with patients who take Warfarin?

Diet high in Vitamin K (Green leafy veggies) may decrease anticaogulant effect. Most antibiotics will increase INR by causing a vitamin K deficiency. Green tea, cranberry and fruit juice may alter anticoagulant effects. Avoiding ASA and NSAIDs

What is the diet for cystic fibrosis?

Diet high in fat, calories, and proteins

What is needed with patients with altered body image from an ostomy?

Dietary consult. Emotional support.

How do you listen for pulsus paradoxus?

Difference between the pressure heard at the Korotkoff sound during expiration and the Korotkoff sounds heard throughout inspiration and expiration

What is an observation that hearing is impaired?

Difficulty following conversations

What will a EKG of a patient with pericarditis show?

Diffused ST elevation. T wave inversion

What kind of electrolyte imbalance may occur in heart failure.

Dilutional hyponatremia caused by excess of total body water in relation to total sodium content.

What should be done to a patient with hallucinations?

Directed toward reality-oriented activities rather than discussing hallucinations

What is parent teaching for a child with Group A beta hemolytic streptococcus?

Discard toothbrush 24 hours after starting antibiotics in order to not harbor bacteria. Test siblings age < 3 years old. May return to school 24 hours after treatment and afebrile.

What must be done if infiltration is suspected at the IV site?

Discontinue the IV site and restart at another site

What is hyperemesis gravidarum?

Disorder in pregnant clients that causes severe nausea and vomiting.

How do Toddlers react to hospitalization?

Display of intense emotions, regressive behaviors, and manifestations of separation anxiety.

What port is used to measure CVP?

Distal port

What does a BNP over >100 indicate?

Distinguishes cardiac from respiratory causes of dyspnea.

What is a common side effect of TCAs?

Dizziness. Drowsiness. Dry mouth. Constipation. Photosensitivity. Urinary retention. Blurred vision

What must not be done with a cast?

Do not put anything inside the cast. If itchy, use a blow dryer with cool air. Autographs are not allowed if cast is fiberglass because it is a porous substance.

What is the life of Scabies mites?

Do not survive away from human skin for more than 2-3 days

What actions should staff do about lateral violence

Documenting and keeping a file of incidents. Reporting incidents to immediate supervisor. Letting the bully know that behvaior will not be tolerated. Observing interactions between the bully and other colleagues. Seek support from within the facility or from an external source

What is a screening question you can ask to see for an latex allergy?

Does your lips swell when blowing up balloons? Does your hands itch or burn after wearing rubber gloves?

What would be an appropriate toy for a preschooler to help developmental skills?

Dolls. Puppets. Dress up clothes. Cars. Planes.

What is care for a patient in a Pavlik harness?

Dressing the child in a shirt and knee socks under the harness. Keeping the skin dry. Avoiding lotions and powders. Regularly assessing for skin breakdown. Massaging the skin to promote circulation. Applying diapers under the straps. Wearing only 1 diaper at a time because multiple diapers increases risk of incorrect hip placement. Do not adjust strap placements.

What should be done to the newborn immediately after birth?

Dried and placed skin to skin on the mother's abdomen at uterine level to promote warmth.

What is patient teaching for Allopurinol?

Drinking with a full glass of water. Increase water intake to prevent renal stones and promote diuresis and uric acid excretion. Monitor for rash

What should patients on Levetiracetam avoid until cleared by the MD?

Driving. Operating heavy machinery.

What is nursing care for a client that is suspected meningococcal meningitis?

Droplet precaution. NPO if somnolence to prevent aspiration. Minimize stimuli. Raising HOB. Removing pillow.

What are nursing interventions for Influenza?

Droplet precautions. Have client wear mask when being transported. Don't cough or sneeze within 3 feet of others.

What are expected side effects of Levetiracetam?

Drowsiness. Somnolence. Fatigue. Symptoms are expected to improve in 4-6 weeks

What takes priority in a triage?

Drug overdose

When giving medications for patient with acute renal failure, what do you need to assess for?

Drug toxicity due to most drugs being excreted by kidneys.

How can Group B Streptococcus be transmitted to the newborn?

During labor and birth.

What are manifestations of ineffective breathing pattern?

Dyspnea. Tachypnea. Bradypnea. Altered chest excursion. Shallow breathing with 2-3 periods of apnea. Use of accessory muscles. Paradoxical breathing. Orthopnea. The use of tripod position

What is the most common complication following myocardial infarction?

Dysrhythmias

When is fetal sex determined on ultrasound?

Early as the end of 12 weeks gestation.

What can help reduce the need for surgical intervention in a patient with scoliosis?

Early detection. Prompt treatment

What can cause a infant under the age of 1 to get botulism?

Eating raw honey

How can morning sickness be relieved?

Eating small meals during the day that are high in protein or carbs and low in fat. Drinking cold, carbonated beverages between meals. High protein snack before bed time or on awakening. Eating/drinking foods that contain ginger (ginger tea, ginger lollipops) and Vit B6 (nuts, seeds, legumes)

What is used to monitor cardiovascular problems for Kawasaki disease?

Echocardiography

What is a complication of Preeclampsia?

Eclampsia. Placental Abruption. HELLP (Hemolysis, Elevated Liver enzymes, Low Platelets)

What are signs of IV infiltration?

Edema. Coolness to touch around insertion site

What is extravasation?

Edema. Pain. Erthymea. Blistering. Mottling. Ulceration. Blanching

What labs will you see with a patient that has Rheumatoid Arthritis (RA)?

Elevated ESR and rheumatoid factor levels

What are the lab results of a patient with sickle cell disease have a vaso-occulsive crisis (pain crisis)?

Elevated reticulocytes. Elevated bilirubin. Anemia

What is the lab look like for carbon monoxide poisoning?

Elevated serum carboxyhemolobin levels (<5% in non smokers, <10% in smokers).

What can increase the risk for postoperative kidney injury?

Elevated serum creatinine level

What are signs of endometrial infection?

Elevated temp > 100.4. Chills. Malaise. Excessive pain. Foul smelling lochia.

What are manifestations of Sepsis neonatorum?

Elevated temperature or hypothermia. Irritability. Increased sleepiness. Poor feeding.

What is patient teaching for Duchenne Muscular Dystrophy (DMD)?

Eliminate floor clutter to prevent injury. Encourage to participate in regular gentle recreation based exercises and swimming to avoid disuse muscle atrophy and social isolation.

What is testicular torsion?

Emergency condition in which blood flow to the testes (scrotum) has stopped.

What is the treatment for testicular torsion?

Emergency surgery

What are techniques to prevent pressure injuries?

Emollients and pressure creams. Foam padding. Reposition. Keep skin clean and dry

What are the symptoms of postpartum blues?

Emotional lability. Mild sadness. Irritability. Insomnia.

What are nursing priorities during active labor?

Emotional support and encouragement. Breathing techniques. Avoid pushing until fully dilated to prevent cervical trauma

What is patient teaching for CABG?

Encourage daily showers. No lotions or creams. No lifting < 5#. Light house work in 2 weeks. No driving for 4-6 weeks until cleared by MD.

What are the step of the physical assessment of the renal system?

Encourage emptying bladder before assessment. Inspect then ausculate immediately. Percuss then palpate. Document

What are interventions for a nurse for a stillbirth?

Encourage family members to hold and name the infant. Mementos such as hand/foot prints and pictures

What are measures to prevent UTI?

Encourage fluids. Avoid holding in urine. Cotton underwear recommended. No bathing a child with scented soaps, bubble baths and antibacterial soaps. Hair should be washed last. Voiding immediately after sex

What are nursing interventions to alleviate seperation anxiety?

Encouraging the presence of favorite items. Establishing a daily routine. Providing oppurtunities for play. Phone calls with parents. Providing support when the child is upset.

What is patient teaching for a child with hemophilia?

Encrouage noncontact sports. Avoid Ibuprofen and ASA. Medic alert bracelets. Soft toothbrushes. Avoid IM and SQ injections. Know how to control the bleeding

What must be done be for a child born with Trisomy 18?

End of life issues should be discussed.

What should someone with a anaphylactic allergy always carry?

Epipen

What are assessment findings of a 12 month old infant?

Equal head and chest circumference. Sit and stand without assistance

What are signs of phlebitis?

Erythema. Edema. Warmth. Pain. Palpable venous cord

What are examples of Macrolides?

Erythromycin. Azithromycin. Clarithromycin

How can you promote adequate sleep time for school age children?

Establish bed time hours

How do you perform an assessment with a toddler?

Establish rapport with parent then attempt to gain child's trust. Play with the child. Least invasive first such as measuring height and weight. then ausculate. Then most invasive last such as measuring vital signs

What infusing medications is paused when drawing blood from the PICC?

Everything including TPN EXCEPT Vasopressors

When giving a intradermal injection, what is a sign of proper technique?

Evidence of a bleb or wheal

What is pulsus paradoxus?

Exaggerated fall in systemic BP > 10 mm Hg during inspiration indicated cardiac tamponade. Below <10mm Hg is normal.

What kind of symptoms will nerve agents (sarin) cause?

Exces acethycholine with copious secretions.

What are complications of post circumcision of a newborn?

Excess bleeding bigger than the size of quarter. Unusual swelling. Redness. Discharge. Odor. Infection. Decreased urine output.

When would peritoneal dialysis be used?

Excess fluid and solutes are removed at a gradual rate. It is more helpful with patients who want dialysis at home or in a ambulatory setting as it requires multiple exchanges per day.

What should be monitored for a patient recovering from a vaginal hysterectomy?

Excess vaginal bleeding (>1/hr saturated perineal pad). Urinary retention. Backache. Decreased urianry output. S/S of DVT.

What can be done to prevent skin excoriation for a newborn?

Excessive movement. Newborn should be tightly swaddled with arms flexed to minimize irritation.

How can client falls be prevented?

Exercise programs. Good lighting. Handrails. Hourly rounds

What are ways to prevent falls at home?

Exercise regulary. Well lit, clutter free environment. Grab bars. Fall alert device.

What can prevent venous complications?

Exercise. Elevation. Elastic Hose Compression

How do you obtain a reading on a peak flow meter?

Exhaling forcibly and quickly as possible through the mouthpiece of the device

What is the physician's role in informed consent?

Explaining the procedure. Ensure correct understanding and all risks involved. Describing alternate treatments. Reinforcing that the client has right of refusal.

What are risk factors of skin disorders?

Exposure to chemicals/radiation sun. Corticosteroid use. Cosmetics. Harsh soap. Nutritional deficiencies

What are nontherapeutic communication techniques?

Expressing approval or disapproval. Giving advice. Asking WHY

What are manifestations of a hip fracture?

External rotation. Abduction. Muscle spasm. Shortening of the affected extremity

What are manifestations of infants age <2-3 months with developmental dysplasia of the hip (DDH)?

Extra inguinal or thigh folds. Laxity of the hip joint

What causes HHNS?

Extreme hyperglycemia causes severe dehydration, increased osmolarity, and coma or death.

What are the symptoms of postpartum depression?

Extreme sadness. Irritability. Emotional outbursts. Severe mood swings.

What are manifestations of anorexia nervosa?

Extreme weight loss. Intense exercise. Self induced vomiting. Amenorrhea. Bradycardia. Cold intolerance. Dry skin. Lanugo

What is decorticate posturing?

Extremities are pointing towards the "core" meaning severe brain damage

What do patients on ethambutol must have routinely checked?

Eye exams because of optic neuritis

What is considered a normal FHR pattern?

FHR of 110-160/min. Occasional accelerations. Early decelerations.

What is seen on a patient with Thalassemia major?

Facial deformities

What is the goal of a nurse case manager?

Facilitate provision of quality care across a continuum, decrease fragmentation of care across various settings. Helps to coordinate care and communication between health care providers.

What can be given for Hemophilia A to promote clotting should a bleeding episode occur?

Factor VIII

What should nursing documentation include?

Factual, descriptive, and contain objective information that the nurse sees, hears, feels, or smells.

What is somatic delusion?

False belief that the body is diseased or abnormal.

What are risk factors for colorectal cancer?

Family history of inflammatory bowel disease. History of obesity. Diet high in red meat. Cigarette smoking. Alcohol consumption

Who is at risk for Acetycholi inhibitor poisoning?

Farmers.

What is a square wave test?

Fast flush of the arterial line that verifies if the arterial line is functioning properly

What do you monitor for when giving allergy immunotherapy injection?

Fatal anaphylactic reaction which can happen 30 mins after injection

What are symptoms of Mononucleosis?

Fatigue. Fever. Sore Throat. Splenomegaly. Hepatomegaly. Swollen lymph nodes.

what are sumptoms of Goodpasture syndrome?

Fatigue. SOB. Hemoptysis.

What must be done for a newborn that has a low blood glucose level?

Feed immediately

What is the best approach for caregivers of a patient with Alzheimer's Disease who has eating problems?

Feed one half at meal time and the other half later. Also to give clients something to eat when they say they are hungry

What is reaction formation?

Feeling one way but acting another. Example: Looking optimistic but feeling sad.

What is Projection?

Feeling uncomfortable with an impulse or feeling and easing the anxiety by assigning to another person. Example: Husband having thoughts of cheating then accuses his wife of being unfaithful

How do you test for a Romberg test?

Feet together. Eyes closed. Hands on the side. Watch for lost of balance.

What are non modifiable breast cancer risks?

Female sex and age >50. First degree relative with history of breast cancer. BRCA1 and BRCA2 mutation.

What should female patients avoid to prevent UTI?

Feminine perineal products. Vaginal douches. Spermicidal contraceptive jelly.

What can cause a ectopic pregnancy?

Fertilized egg grows in the fallopian tube which can cause rupturing of the tube leading to significant blood loss.

What can consumption of alcohol during pregnancy lead to?

Fetal alcohol syndrome.

What can be palpated in a breech presentation?

Fetal buttocks. Legs or feet. Fetal buttocks doesn't feel as soft or round as a fetal head.

What are positive (diagnostic) signs of pregnancy?

Fetal heartbeat heard with doppler. Fetal movement palpated by health care provider or visible fetal movements. Visualization of fetus by use of ultrasound.

What is acceleration in FHR indicate?

Fetal movement

What is the best indicators of fetus health?

Fetal movement. Fetal HR

What does minimal variability indicate?

Fetal sleep. Effects of CNS depressants.

What are symptoms of Hepatic Enceph?

Fetor Hepaticus (musky, sweet odor breath). Tremors when arms extended (asterixis). Altered mental status. Sleep distrubances

What does meconium stained amniotic fluid indicate?

Fetus passed first stool in utero.

What are s/s of Peritonitis?

Fever. Abdominal Rigidity. Guarding. Rebound Tenderness.

What are characteristics of Reye syndrome?

Fever. Acute encephalopathy. Altered hepatic function

What is the ultimate outcome after restraining a patient is complete and everyone is safe?

Figure out the improvement of restraint procedures

What is Lanugo?

Fine terminal hair seen in anorexia nervosa patients

What is an indication of a low bishop score?

Firm and posterior cervix

What is present on a abdominal assessment for cirrhosis?

Firm mass on the right coastal margin

What is the assessment for a vaginal hematoma?

Firm, midline uterine fundus with minimal or unchanged vaginal bleeding.

What should the fundus be after placental delivery?

Firm, midline, and at or slightly below the umbilicus

How much of the hand is affected by Carpal Tunnel Syndrome (CTS)?

First 3 and a half fingers

What time after being born does a newborn have a high risk of hypoglycemia?

First 6 hours

What is the recovery position used in?

First aid measure for an unconsious client who is still breathing

When should a EpiPen be used?

First notice of any anaphylactic symptoms. Once used, should go to the ER immediately

What is nursing interventions for a patient with intermittent claudication?

First palpate the presence of the posterior tibial and dorsalis pedis pulsus

What can cause a false positive for occult stool?

Fish. Cantaloupe

What is seen on patient's eye with acute glacuoma?

Fixed and mid dilated pupil Cloudiness on the pupil. Conjuctival redness

What can cause thermal burns?

Flames. Hot liquids. Steam. Hot objects

What is congenital dermal melanocytosis (Mongolian Spots)?

Flat bluish discolored areas on the lower back and/ or buttock. Usually resolves by school age.

What are side effectss of Alpha Glucosidase Inhibitors?

Flatulence. Diarrhea. Anemia. Cramps.

What are the steps for withdrawing medication from a glass ampule?

Flick upper stem of the glass ampule to ensure medication drops to the bottom. Use a barrier and break neck of ampule towards you. Withdraw meds using a filter needle. Remove filter needle and apply regular needle for injection

What can hyperemesis gravidarum lead to?

Fluid and electrolyte imbalances (Hypokalemia/Hyponatremia). Weight loss. Nutritional deficiencies. Ketonuria. Increased urine specific gravity. Metabolic alkalosis.

What is a reason for increased urine specific gravity?

Fluid deficit

What is hydrocele?

Fluid filled testicular mass that usually resolves before the first birthday

What are patients with chronic kidney disease at risk for?

Fluid overload. Hyperkalemia

What will not prevent transmission of infection when drawing blood from a central line?

Flushing the port. Discarding the initial 10mL of blood taken.

What are the symptoms of Red Man Syndrome?

Flushing. Erythema. Pruritus on the face, neck, and chest.

What are codependent people?

Focus on others at the expense of their own sense of self.

What can Ventricular Bigeminy lead to?

Following a myocardial infarction, Ventricular Bigeminy indicates a risk for developing ventricular tachycardia or ventricular fibrillation.

When is vaccination available for the rotavirus?

For children less than 8 months old.

What is Hospice?

For individuals who have 6 months to live.

When is the best time for perform a breast self examination?

For women with regular periods, 5-7 days after the period ended. For women who are post menopausal or irregular menses, should be the same day of each month. For women who take oral contraceptives, each time a new package is started.

What is the leading cause of accidental injury and death in small children?

Foreign body aspiration especially those that are round, slippery, stick, hard, or rough. Examples are hot dogs, hard candies, grapes, and cherries

What is Shaken Baby Syndrome?

Form of child abuse resulting from violent shaking an infant by the extermities or shoulder that causes bleeding within the brain or eyes.

What is a Adolescent (12-18yo) stage Piaget's cognitive development?

Formal operational. Abstract thinking and reasoning

What are some teaching regarding formula preparation?

Formula must never be diluted or microwaved. Unused formula can be refrigerated for up to 48 hours. Wash tops of formula cans prior to opening.

What are symptoms of Endometriosis?

Foul smelling lochia. Cramping. Uterine tenderness

What are the interventions for necrotizing enterocolitis?

Frequent abdominal measurements. Placed supine and undiapered.

What is a sign of "silent" asthma?

Frequent cough, especially at night

What are dietary guidelines for a patient in a manic state?

Frequent reminders to eat. Increase fluid intake. Increased caloric intake. Increased protein intake. Offer finger foods.

What is an environmental intervention for reducing exposure to dust mite allergen?

Frequently washing linens with hot water and using special mattresses and pillow covers

What are late signs of hyperglycemia?

Fruity breath odor. Coma. Abdominal pain.

What type of weight bearing should a patient with a knee arthoplasty be?

Full weight bearing by discharge. Length of hospital stay is 3-5 days

What must be done after the expulsion of the placenta?

Fundal massage to increase uterine tone and decrease bleeding.

What is the initial nursing action for uterine atony with a midline fundus?

Fundal massage, which stimulates contraction of the uterine smooth muscle.

What is seen during uterine inversion?

Fundus is not palpable in the abdomen. Large gush of blood comes gushing out of the vagina.

What is expected of the fundus after placenta delivery?

Fundus should be firm, midline, at or slightly below the umbilicus

How is Tinea Corporis (ringworm) spread?

Fungal infection spread by contact with infected skin, shared surfaces, and personal items (hair brushes)

What is used to decrease left ventricular preload in a client with cardiogenic shock?

Furosemide

What are examples of loop diuretics?

Furosemide. Torsemide. Bumetanide

What are complications of ASA tx?

GI bleeding. Bruising. Tinnitus. Tachycardia. Tinnitus (FIRST SIGN)

What are milestones for a 2-3 month old?

Gains head control when held. Holds rattle when placed in hand. Makes cooing sounds. Smiles in response to smiling and talking

What should be avoided if a patient has neutropenia and living at home?

Gardening. Contact with fresh flowers and plants due to potential exposure to pathogens

How is MI symptoms seen in women, the elderly, and diabetics?

Gastrointestinal distress

What can NSAIDs cause?

Gastrointestinal toxicity. Kidney injury. Exacerbation of fluid overload/hypertension. Bleeding risk

What are the steps to perfoming trach care on a patient with a disposable inner cannula?

Gather supplies and place client at Semi fowlers. PPE. Remove soiled dressings and clean gloves. Wear sterile gloves and remove old cannula and put new one. Clean around stoma with sterile water or saline. Dry and replace sterile gauze pad.

What are examples of Fibrates?

GemFIBrozil. FenoFIBrate

What can cause Malignant hyperthermia?

General anesthesia

What is used prior to ECT treatment?

General anesthesia. Skeletal muscle relaxant.

What is a functional disorder?

General diagnosis for a medical issue

What is Thalassemia major (Cooley's anemia)?

Genetic disorder that causes a decrease in hemoglobin formation.

What is parent teaching for cystic fibrosis?

Genetic testing and counseling as CF is autosomal recessive. Spirtual support

What are factors for Alzheimer disease?

Genetic. Lifestyle. Environmental factors

What is Human papillomavirus (HPV) associated with?

Genital warts. Cervical cancer

What are examples of Aminoglycosides?

Gentamycin. Tobramycin. Amikacin.

What is the expected appearance of a suction chamber in a chest tube drainage system?

Gentle continous bubbling

What is an indicator that the suction control chamber is working?

Gentle, continuous bubbling

What is a known side effect of Phenytoin?

Gingival hyperplasia

What is the goal in a hypertensive crisis?

Give IV vasodilators and lower the BP slowly no more than 25% of the current MAP and maintain MAP at 110-115

What is parent teaching for amoxiciillin?

Give with or without food. Common S/E are N/V and diarrhea. If experiencing diarrhea, give with food. Shake well.

What is the first step to do when a nitroglycerin patch falls off?

Given a rapid acting dose of Nitroglycerin sublingual. Transdermal meds have a delayed onset, and may be replaced once oral dose of Nitro given

When giving an injection to a school age child, what approach should the nurse give?

Giving child sense of control. Allowing child to participate. Distraction

What is the order of removing PPEs?

Gloves to prevent contamination. Goggles/Face shield. Gown. Mask

What is Tangentiality?

Going from on one topic to another without finishing the current topic.

What are the leading causes of pelvic inflammatory disease and infertility?

Gonorrhea. Chlamydia

What are objective (probable) signs of pregnancy?

Goodell/Chadwick/Hegar sign. Uterine enlargement. Palpable Braxton hicks contractions. Ballottement. Fetal outline palpation. Uterine and funic souffle. Skin pigmentation changes like chloasma, linea nigra, and areola darkening. Striae gravidarum. Positive pregnancy tests.

What is the criteria for Depression?

Gradual onset. Fully conscious. Episodes. Reversible prognosis. Moderately impaired focus/concentration.

What should patients who take statins be taught to avoid in their diet?

Grapefruit due to myopathy

What should patients who take calcium channel blockers be taught to avoid in their diet?

Grapefruit due to the severe hypotension.

What color drainage is acceptable following a abdominal surgery?

Green bile

What are 2 signs of Status epilepticus?

Grunting. Dazed appearance

What are the symptoms of postpartum psychosis?

Hallucinations. Deleusions. Impulsitivity. Hyperactivity. Confusion. Delirium.

What is signs of Postpartum psychosis?

Hallucinations. Paranoia. Severe mood swings. Feelings of harm towards baby.

How do you perform foley catheter insertion on a female?

Hand hygiene. Apply sterile gloves. Use nondominate hand to spread labia. Cleanse labial fold with antiseptic swab. Wipe meatus with antiseptic swab. Insert catheter

What are the steps to preparing a sterile field for a wet to damp dressing?

Hand hygiene. Open sterile package with ungloved hand. Hold the inverted opened gauze 6" (15 cm) above the sterile field. Place sterile gauze dressing more than 1" (2.5 cm)of the sterile field. Only use sterile NSS from a recapped bottle that was opened <24 hrs ago

What is mandatory PPE for meningitis?

Hand washing. Surgical Mask. If bodily fluids is expected face shield, mask, gloves are required.

What IV site is used to reduce the risk for infection?

Hand. Forearm. Avoid wrist, bend of arm, and lower extermities.

How to prevent the spread of Tinea Corporis (ringworm)?

Handwashing. Cleaning shared surfaces. Don't share personal items.

What must be worn for droplet precautions?

Handwashing. Surgical mask.

What are techniques to prevent transmission of infection while doing a blood draw from a central line?

Handwashing. Use of disposable gloves. Cleaning the specimen bag with a disinfecting wipe. Immediate transport to lab. Avoiding placing specimen in clean area.

What is a symptom for Couvelaire uterus?

Hard, boardlike uterus

What is Atherosclerosis?

Hardening of vessels caused by fat

What are the steps to take orthostatic BP?

Have the client lie down for at least 5 mins. Measure BP and HR. Have the client stand. Repeat BP and HR measurements after standing 1- and 3 minute intervals

What are interventions the nurse can do for a elderly patient that hasn't urinated since having a surgical procedure?

Have the patient stand up. Bladder scan

What is an intervention for a patient who is post op general anesthesia with a Low O2?

Head tilit and chin lift

What are side effects of calcium channel blockers (CCB)?

Headache. Bradycardia. Constipation. Dizziness. Flushing

What are signs of myopia in children?

Headache. Dizziness. Poor school performance. Eye rubbing not to a point of redness. Frequent blinking or squinting when viewing objects.

What are signs of hypertensive disorders during pregnancy?

Headache. Facial edema.

What are the typical symptoms of meningitis?

Headache. Fever. Photophobia. Nuchal rigidity (Stiff neck)

What is considered normal after a mild Traumatic Brain Injury (TBI)?

Headache. Trouble Thinking. Irritability for up to 6 weeks

What is a HMO?

Health Maintenance Organization. Health insurance with a fixed payment rate

What are complications of Acute Otitis Media?

Hearing loss. Spread of infection.

What is the effect if NSAIDs are taken long term?

Heart attack. Stroke. High blood pressure. Possible heart failure. Chronic kidney disease. Peptic ulcers

What are symptoms of left to right cardiac shunts?

Heart murmur. Poor weight gain. Diaphoresis with exertion. Signs of heart failure

What is the nurse's role for a dying patient?

Help with communication. If a dying child asks about dying, the nurse should tell the parents the child's question.

If a COPD has difficulty breathing with normal assessment findings, what is the next step?

Help with controlled breathing and relaxation

What blood levels would indicate a pregnant patient has anemia?

Hemoglobin < 11 on the first or third semester. Hgb < 10.5 in the second trimester.

What can cause a high potassium level in the lab?

Hemolysis. Clotting

What should the nurse watch for when receiving a post bronchoscopy patient?

Hemoptysis. Hypoxemia. Hypercarbia. Hypotension. Laryngospasm. Bradycardia. Pneumothorax.

What does a patient with placental previa put you at risk for?

Hemorrhage

What are patients who is s/p tonsillectomy and adenoidectomy at risk for?

Hemorrhage and airway compromise up to 14 days after surgery

What can placenta accreta cause?

Hemorrhage from attempted seperation

What are complications to a Flail chest?

Hemothorax. Pneumothorax.

What other drugs can Abciximab, Eptifibatide, and Tirofiban be used in combination with?

Heparin. Aspirin

Where are medications usually metabolized at?

Hepatically (Liver)

What are common side effects of rifampin?

Hepatotoxicity. Red discoloration of body fluids (urine, sweat, tears). Decrease effectiveness of some drugs (oral contraceptives, hypoglycemics, warfarin)

What are serious adverse effects of Isoniazid?

Heptatoxicity. Peripheral neuropathy. Drug-induced hepatitis

What is the difference between a hernia and incarcerated hernia?

Hernia can be returned to the peritoneal cavity by pressure. Incarcerated cannot.

What are normal lab results during third trimester?

Hgb >11. Hct >33%. RBC 5-6.25. WBC 5-10. Platelets 150000-400000

What is -cytosis?

High

What is the best position to improve gas exchange?

High Fowlers

What position is not recommended for a patient with hypovolemic shock?

High fowlers because it can cause the BP to drop

Where is the FHR of a baby in a breech (feet first) presentation?

High in the fundus near the umbilicus

What can untreated hypertensive encephalopathy (HE) lead to?

High mortality due to the risk of acute myocardial infarction, stroke, and kidney injury.

What are signs of ICP for infants?

High pitched cry. Vomiting. Bulging fontanelles. Fever

What type of priority does a full sharps container have?

High priority because it will reduce work related injuries

What does a low Braden scale mean?

High risk for pressure ulcer

What is the personal best on a peak flow meter?

Highest peak flow reading the client can attain in a 2 week period when asthma is in good control.

What are characteristics of a child abuser?

History of growing up with domestic violence. Hx of substance abuse. Teenage parents are more vunerable to abuse their children.. Low self esteem. Low tolerance for frustration and poor impulse control

What are the symptoms of a anaphylactic reaction?

Hives. Angioedema. Wheezing. Respiratory distress

What should you assess for with a patient with FTT?

How the patient eats

What are risk factors of endocarditis?

Hx of mechanical heart valve replacement (Prosthetic valves). Rheumatic fever. Dental procedures. Oral surgeries. IV drug use. Immunosupression. Hx of congenital heart disease. Elevated INR (2.0-3.0)

What are the core symptoms of ADHD?

Hyperactivity. Impulsiveness. Inattention

What are s/s of multiple myeloma?

Hypercalcemia. Renal failure. Anemia. Bone breakdown/absorption.

What are s/s of malignant hyperthermia?

Hypercapnia(FIRST). Generalized muscle rigidity. Hyperthermia(LATER)

What is happening to the body in DKA?

Hyperglycemia >250. Body breaks down fat into ketones causing low pH and low HCO3.

What causes Steven Johnsons Syndrome?

Hypersensitivity reaction to antibiotics such as Penicillin, cefixim, barbituates, lamotrigine, phenytoin, trimethoprim, levetiracetam. Alluprinol.

What is a risk of infants of diabetic mothers?

Hypoglycemia. Hypocalcemia.

What can happen if water is used to dilute feedings for infants?

Hyponatremia secondary to water intoxication.

What labs should you be aware of if a patient has Cdiff?

Hyponatremia. Hypokalemia. Elevated BUN.

What is an adverse effect of Positive pressure ventilation (PPV)?

Hypotension

What should be monitored when performing a catherization?

Hypotension and Bradycardia due to rapid decompression of the bladder

What factors can lead to hypovolemia?

Hypotension and Tachycardia in the presence of blood loss.

What does a low pressure alarm signal in a radial arterial line?

Hypotension.

What are symptoms of neurogenic(distributive) shock?

Hypotension. Bradycardia. Pink/Dry skin.

What is a presenting feature of sepsis for elderly clients?

Hypothermia

What does a low CVP indicate?

Hypovolemia

What are the 5 H's of reversible causes of asystole/PEA?

Hypovolemia. Hypoxia. Hydrogen Ions(acidosis). Hypo(Hyper)kalemia. Hypothermia.

What can an AAA rupture lead to?

Hypovolemic shock from bleeding

When would hypertonic IVF be given?

ICP. Severe hyponatremia.

What type of questions should be used to get a brief history for potential neonatal resuscitation?

ID multiple gestations. Preterm gestational age. Color of fluid. Recent narcotic or drug use.

What are medications used for bacterial pneumonia?

IV Abx. Expectorants. Mucolytics. Antipyretics. Analgesics. Anti-inflammatories

What is medication for a patient with community acquired bacterial pneumonia?

IV antibiotics. Expectorants. Mucolytics. Antipyretics. Analgesics. Antiinflammatories

What is the treatment for osteomyelitis?

IV antibiotics. Surgical debridement.

What is important to remove when a patient is leaving the hospital?

IV catheter to prevent infection and drug use

When is heparin given for dialysis?

IV heparin is added to the blood.

What is used to treat tumor lysis syndrome?

IV hydration and Allipurinol

What medications are used to prevent complications from Kawasaki disease?

IV immunoglobulin. ASA

What are standard interventions for a MI?

IV insertion. 2-4L O2. Cardiac monitoring. Nitro. Morphine

What medication is given to patients with alcohol intoxication?

IV thiamine with or before IV glucose to prevent Wernicke encephalopathy.

What are is the treatment for Acute Pancreatitis?

IVF. Pain mgmt. NPO

What are complications of thoracentesis?

Iatrogenic pneumothorax. Hemothorax. Infection

What are nursing measures after a tonsillectomy/adenoidectomy?

Ice collar to reduce bleeding and pain. Analgesics should be given IV or rectally. Acetaminophen is used instead of ASA because of Reye Syndrome. Suctioning should be done when the child is fully awake and on their stomach or side lying. Serve cool liquids without a straw. Citrus juice will cause burning sensation. Chewing gum can reduce spasms in the muscles around the throat. Avoid clearing the throat, blowing the nose, and coughing

What way to relieve discomfort of breast engorgement?

Ice packs for 15-20 mins every 3-4 hrs. Apply chilled, fresh cabbage leaves. Antiinflammatory analgesic. Support bra.

What should be assessed when a patient has rheumatic fever?

If streoptococcal throat infection was recently present

What must be done if phlebitis is present?

Immediate removal of the catheter is necessary as the condition can lead to a serious blood stream infection or thrombophlebitis

What are major adverse effects for tumor necrosis factor inhibitors?

Immunosuppression. Infection. TB reactivation

What is the most common death in posttransplant patients?

Immunosuppressive therapy. Hand hygiene

What are factors that can cause tissue dehiscence?

Impaired circulation. Tissue oxygenation. Stress on the wound. Obesity. Diabetes. Steroid use.

Who is the nurse required to report to the appropriate authorities?

Impaired coworker. Suspicious death. Elder abuse

What is the ND for an asthma patient with a decreased O2 sat, high pitched wheezing, and diminished breath sounds?

Impaired gas exchange

What is the best ND for a patient with ARDS?

Impaired gas exchange

What are negative symptoms of schizophrenia?

Impaired interpersonal functioning. Social Isolation. Regression

What are negative manifestations of ADHD?

Impaired social skills. Poor self esteem. Increased substance abuse.

What is osteogenesis imperfecta?

Imperfect bones which make them brittle and fracture easily.

What is a IVC filter for?

Implanted in the inferior vena cava. Used to trap floating emboli in the vena cava. Can be temporary or permanent.

What is nursing management for Osteomalacia?

Implementing safety measures. Encouraging activity. Increasing intake of Vitamin D, calcium, and phosphorus.

What will happen if you attempt to reinsert a tube that was placed < 7 days ago?

Improper placement into the peritoneal cavity leading to peritonitis and sepsis.

Where does botulism come from?

Improperly canned or stored food

What is the goal of tx for Late Decelerations?

Improve fetal perfusion and oxygenation

What is the goal of therapeutic hypothermia?

Improve neurologic outcomes. Decrease mortality.

What is the best indicator of treatment effectiveness for an acute asthma attack?

Improvements in oxygen saturation and peak inspiratory flow

What are examples of MAOIs?

In the middle, sounds like arrrr

What is apraxia?

Inability to perform familiar tasks such as grooming or dressing.

What is presbyopia?

Inability to see things up close

Waht needs to be reported if a patient experiences these symptoms after a cystoscopy?

Inability to void. Gross hematuria. Blood clots. Fever. Chills. Severe pain

Which vaccines are acceptable during pregnancy?

Inactivated influenza. Tetanus, Diptheria, and Pertussis (Tdap).

What are children of cleft lip at risk of?

Inadequate intake. Aspiration.

What is best used post operative to prevent or improve atelectasis?

Incentive spirometer

What is recommended after a renal arteriogram?

Increase fluid intake in order to excrete the contrast medium that was injected in order to prevent kidney injury

What can help reduce viscosity of mucus?

Increase fluids to 2-3L. Cool mist humidifer. Guaifenesin, an expectorant. Huff coughing

What is discharge teaching for a patient who just had a extracorporeal shock wave lithotripsy (ESWL)?

Increase fluids to wash out stone fragments. Ambulate as much as possible after recovery from anesthesia

What causes heartburn during pregnancy?

Increase in the hormone progesterone, which causes the esophageal sphincter to relax

What is patient teaching regarding the side effects of anticholinergic medications?

Increase intake of fluids and bulk forming foods. Avoiding locations or activities that can lead to hyperthermia.

What is a dietary guideline for lithium therapy?

Increase intake of sodium otherwise lithium can be absorbed leading to toxic lithium levels.

What is the findings of lobar pneumonia (consolidation)?

Increased crackles. Increased tactile fremitus. Dullness upon percussion

What do you need to monitor for with a patient taking Selective Serotonin Reuptake inhibitors (SSRIs)?

Increased energy with little or no reduction of depression. Would need to be reassessed for suicide risk

What can cause stress incontinence?

Increased intrabdominal pressure.

What can grunting from an infant indicate?

Increased respiratory exertion

Where does fluid overload manifest from?

Increased right atrial pressure or CVP. Consequence to delayed emptying or filling of right ventricle.

What do you need to monitor for when taking Fluoroquinolones?

Increased risk for tendinitis and tendon rupture especially the Achilles Tendon

What can COX-2 inhibitors (celecoxib) and NSAIDs (Ibuprofen) lead to?

Increased risk of cardiovascular risk

What is the risk of taking Tamoxifen?

Increased risk of endometrial cancer and venous thromboembolism (VTE).

A patient with alcoholic cirrhosis is at risk for?

Increased risk of hemorrhage due to esophageal varices and caogulation disorders.

What is the rate of growth for head circumference?

Increases by 1 inch during the second year then slows to 0.5 inches per year until age 5

What may occur if the INR of a patient on warfarin isn't reaching therapeutic levels?

Increases the risk for atrial thrombus formation with subsequent embolization and stroke. Excess anticoagulation (INR> 3.4) increases risk for bleeding.

What is a strategy to help distract from internal voices?

Increasing external auditory stimulation

What are interventions to prevent the adverse effects of codeine?

Increasing fluid intake and bulk in diet. Taking meds with food. Change position slowly

What would help a patient with a ND of ineffecive airway clearance?

Increasing oral and intravenous hydration

When do you expect to see symptoms of measles?

Incubation period is 7-21 days

What is a reactive nonstress test?

Indicates that a fetus is well oxygenated and establishes fetal well being

What is social anxiety disorder?

Individuals fear being scrutinized, observed, or embarassed in social or performance settings.

Which NSAIDs are nephrotoxic?

Indomethacin. Ibuprofen. Naproxen. Ketorolac

What is oxytocin used for?

Induce labor

What is Erikson's stage of development for school age children (6-12 years)?

Industry vs inferiority

What can a breech presentation cause?

Ineffective dilation of the cervix. Increased risk of umbilical cord prolapse.

What is mucositis?

Inflammation of the mouth, esophagus, and oropharynx

What is seen in SIRS?

Inflammatory response like fever, tachycardia, tachypnea

What is important during a nurse hand off report?

Information regarding current condition. Examples are current vital signs.

What are nursing responsibilities prior to surgery?

Informed consent is in the chart. Encourage the patient to void to reduce risk of retention. NPO to avoid aspiration. Witness and document correct surgical site. Monitor for any existing infection

How do you do pursed lip breathing?

Inhale through the nose for 2 seconds with the mouth closed. Exhale through pursed lips for 4 seconds (twice as long as inhalation)

What is Beclomethasone?

Inhaled corticosteroid(ICS) used as a long term, first line drug to control chronic airway inflammation

How is pinworm spread?

Inhaling or swallowing microscopic pinworm eggs.

What type of medications are Abciximab, Eptifibatide, and Tirofiban?

Inhibits platelet aggregation

What is Tamoxifen used for?

Inhibits the growth of estrogen receptive breast cancer cells

What should you monitor with Ritalin?

Initially, Tics

Where can you check the temperature of a formula?

Inner wrist.

What can cause Acetycholi inhibitor poisioning?

Insecticide.

What is the practice for obtaining blood from a patient?

Insert needle at 15 degrees. Limit attempts to 2. Avoid side of mastectomy, as it places risk for lymphedema and infection. Only get blood from side of finger bed. Never draw a specimen above an IV infusion

What are side effects to Albuterol?

Insomnia. N/V. Palpitations from tachycardia. Mild Tremor. Hypokalemia

How do you perform the Allen's test?

Instruct pt to make a fist. Apply pressure to radial and ulnar artery. Instruct client to open fist. Palm should be white. Release pressure on ulnar artery. If palm returns to pink, then ulnar artery is patent meaning Positive Allen's test.

What are manifestations of fetal alcohol syndrome?

Intellectual disability. Development delay. Distinct facial characteristics such as indistinct philtrumm, thin upper lip, epicanthal folds, flat midface, and short palpebral fissures

What is Agoraphobia?

Intense anxiety being in a situation which there may be difficulty escaping in the event of a panic attack. May avoid open spaces, riding in public transportation. Going outside the home, bridges/tunnels, and crowds

What is Battery?

Intentional touching without the person's consent. Examples are performing a procedure despite a competent client's refusal or without obtaining proper consent from a competent client.

What do you need to monitor for when a patient has a fractured pelvis?

Internal hemorrhage, which manifests by abdominal distention and paralytic ileus.

What is brachytherapy?

Internal radiation used for cervical and endometrial cancer by direct application of a radioactive implant

What are life threatening complications with incarcerated hernia?

Intestinal obstruction. Strangulated Bowels.

What is bloody effluent in a peritoneal dialysis patient mean?

Intestinal perforation. Client may be menstruating

What does shoulder pain in ectopic pregnancy mean?

Intraabdominal bleeding

What is the tx for group B beta-hemolytic streptococcus for pregnant clients?

Intrapartum prophylactic tx with IV penicillin during delivery

What contraceptions are not effective for sexual transmitted infection (STI)?

Intrauterine devices. Diaphragms

What should be available at beside during a Gastric Lavage?

Intubation and suction supplies. Large bore 36-42 Fr orogastric tube for water/saline.

What is Psychogenic dystonia?

Involuntary muscle contractions that cause slow, repetitive movements such as twisting and abnormal postures

What is patient teaching for anorexia that is related to end of life?

Involve patient in meal planning. Include family and friends. Offering preferred foods. Frequent oral care.

What can overconsumption of milk along with little or no consumption of other foods cause what in young children?

Iron deficiency milk anemia

What will be seen in Thalassemia major?

Iron overload due to the overproduction of a protein responsible for iron absorption.

What would premature infants require after 2-3 months?

Iron supplementation due to maternal storage depleting. Appropriate sources are oral iron drops.

What are the signs of false labor?

Irregular intervals, no increase in frequency, duration, or intensity, may dissipate over time. Discomfort in lower abdomen and groin. Contractions may lessen or dissipate with comfort measures. No cervical change.

What are symptoms of Kawasaki disease?

Irritability. Desquamation (skin peeling) of the hands and feet.>5 days of fever. Bilateral nonexudative conjunctivitis. Mucositis. Cervical lymphadenopathy. Rash. Extermity swelling.

What are clinical manifestations of withdrawal in infants?

Irritability. Jitterness. High pitched cry. Sneezing. Diarrhea. Vomiting. Poor feeding. Stuffy nose

What are symptoms of hyponatremia?

Irritability. Lethargy. Hypothermia. Seizure.

What does bluish discoloration of a penis during priapism indicate?

Ischemia

What is most common in children with sickle cell disease?

Ischemic strokes

What kind of fluid is used for HHNS?

Isotonic fluid

What is the priority in neurogenic(distributive) shock?

Isotonic fluids to maintain vital organ perfusion.

What happens if Jaundice is present at birth?

It is pathological within the first 24 hours

When will the umbilical cord be detached?

It will be come dry and darker within 24 hours and detach from the body within 2 weeks

How does Actidose work?

It works by binding to toxins and decreases exposure time in the stomach.

What is expected after a CABG?

Itching. Tingling. Numbness. Comes from damage to the local nerves.

If the airway is occluded for a patient with possible spine injury, what technique can you use?

Jaw thrust technique. The head tilt/chin lift technique might compromise the cervical spine

What can be used to visualize an airway if patient has an unstable spine?

Jaw-Thrust manuever with a backboard

What are signs of hypoglycemia for a newborn?

Jitterness. Irritability. Lethargy. Tremors

What is the primary goal of umbilical cord care?

Keep cord clean and dry.

What are nursing interventions for acrocyanosis?

Keep infant warm by placing skin to skin with the mother under a radiant warmer.

What must be done for umbilical cord care?

Keep umbilical area dry. Not apply antiseptics to the stump. Report any signs of infection

What is Repression?

Keeping unacceptable thoughts or traumatic events buried in the unconscious

What is a infant sleep sack?

Keeps the infant warm while preventing the head from being covered.

What is nursing interventions for acute pancreatitis?

Kept NPO with suction. Dietary changes.

What do you need to monitor for when taking Cisplastin?

Kidney injury. Assessment of renal function includes labs and urinary output.

What is Wilm's tumor?

Kidney tumor that occurs in children < 5 years old

What does the body do to compensate for respiratory acidosis?

Kidneys absorb bicarb

Where does compensation occur for respiratory alkalosis?

Kidneys excrete bicarb

What are the causes of posteroperative pain from a Transurethral resection of the prostate (TURP)?

Kinked blocked catheter. Bladder spasms.

What intervention can you do if a patient has Tetralogy of Fallot has hypoxia and cyanosis?

Knee chest position

What movement will relieve pain from a herniated disk?

Knee flexion

What are basic client rights?

Knowing the identity of their health care providers. Access to the information in their medical records. Having pain assessed and addressed appropriately

What is seen in DKA?

Kussmaul respirations (fruity/acetone smell)

What is the first stage of labor?

LATENT: 0-5 cm dilation. ACTIVE: 6-10 cm dilation.

What do you need to monitor for when taking Alpha Glucosidase Inhibitors?

LFTs, may cause elevated levels. Hypoglycemia.

How can you improve patient safety during medication pass?

Labeling all meds. Discard any meds that unlabeled. Do not need to wear gloves to open meds

What is the meds for an acute stroke?

Labetalol/ Nicardipine

What can negatively impact a adolescent pregnancy?

Lack of family support. Sexual abuse. Poor nutritional status

What is cystic fibrosis?

Lack of sodium and chloride causes secretions to be thicker and stickier than normal.

What is Hirschsprung disease?

Lack of specialized nerve cells in portions of the distal large intestine, this renders the internal sphincter unable to relax.

What is the solution of choice for fluid resuscitation of a burned client?

Lactated Ringer

What is the tx for a tension pneumothorax?

Large bore needle decompression following by chest tube placement

What kind of treatment can be done on lesions with boundaries seen or to remove tissue for biospy?

Laser treatment

What is Scoliosis?

Lateral curvature of the spine and spinal rotation

What is a "Mal De Ojo"?

Latin American cultural belief that is caused when a stranger admires a child without touching the child at the same time or immediately afterward.

What are preventive measures for bed bugs?

Launder apparel in hot water. Dry them using the hottest temp. Store tightly in a sealed plastic bag.

What must be done after a barium enema?

Laxatives. Clear Liquid Diet

What position should a patient with an ongoing seizure be placed in?

Left lateral

What should be done to fasciotomy sites?

Left open to immediate postoperative period to allow assessment of tissue viability and pressure release.

What position do you place a patient for an enema?

Left side lying. Sims

What position do you place a patient with an air embolism?

Left side. Trendenlenberg

Which sided heart failure is worse?

Left sided heart failure

What are symptoms of Shaken Baby Syndrome?

Lethargy. Vomiting. Seizures. Irritability. Inability to eat. Inconsolable crying. Breathing difficulty. Lifelessness.

What herbal remedy should not be with thiazide diuretics such as Lasix or HCTZ?

Licorice root because it increases potassium loss.

What is necrotizing enterocolitis?

Life threatening compliction in premature infants due to underdeveloped intestine and gut immunity.

What is Couvelaire uterus?

Life threatening condition in which abruptio placetae causes blood to infiltrate the uterine myometrium and peritoneal cavity.

What is a complication if Nitrates are used with Sildenafil?

Life threatening hypotension

What is a red trauma status?

Life-threatening injury that will survive if treated in next hour. Example: Open long bone fx. Second or higher degree burns covering 15-40% body surface area. Flail chest

How long is immunosuppressive therapy?

Lifelong

What are post splenectomy patients at risk for?

Lifelong risk for rapid sepsis

What is patient teaching for a patient taking Bupropion Hydrochloride?

Limit alcohol. Never double up if missed dose. Take medication same time each day. Weight loss may occur

What should is nursing care for a patient with brrachytherapy

Limit staff time exposure to 30 mins by clustering care. All staff and visitors must maintain 6 ft from patient. Wear lead aprons when providing direct client care.

What is seen on a patient with Herpes Zoster (Shingles)?

Linear rash distribution and can present with severe pain.

What is Caput Succedaneum?

Localized soft tissue edema of the scalp. Resolves within the first week of life.

What is Tiotropium (Spriva)?

Long acting, 24 hour anticholinergic. It comes in a powder inside a capsule that uses a special inhaler.

What is Fluticasone/Salmetrol used for?

Long term control of asthma containing Fluticasone (Corticosteroid) and Salmetrol (Bronchodilator)

What should be avoided when doing patient teaching for crutches?

Looking at feet while walking. Should always look forward.

What type of med would need to be increased if a patient with CHF has increasing weight gain and edema?

Loop diuretic

What type of dressings are used when dealing with frostbite?

Loose, nonadherent, sterile dressings.

What can cause metabolic alkalosis?

Loss hydrogen ions caused by gastric suction, prolonged vomiting, extreme sweating. Administration of alkali (sodium bicarb)

What are common side effects of Selective Serotonin Reuptake inhibitors (SSRIs)?

Loss of appetite. Weight loss or weight gain. Sexual dysfunction. Diarrhea. N/V. Headaches. dizziness. drowsiness. Insomnia. Increased risk of suicide when starting treatment. Serotonin syndrome

What is seen for a positive Romberg test?

Loss of sense of self in space

What is reflex incontinence?

Loss of urine when bladder reaches a specific level.

What should be avoided in phototherapy for newborns?

Lotions and ointments because it can absorb heat and cause burns.

What symptoms are seen for a patient with Trisomy 21 (Down Syndrome)?

Loud murmur that requires no immediate action when vital signs are stable.

What is -cytopenia?

Low

What is the labs to look for with someone with ascites?

Low albumin

When is a colloid solution used?

Low albumin. Cirrhosis with ascites.

What is Oligohydramnios?

Low amniotic fluids

What are characteristics of Ankylosing Spondylitis?

Low back pain. Stiffness that is worse in the morning and improving as the day progresses.

What can cause an irregular pulse oximetry?

Low blood flow. Low perfusion such as cardiac dysrhythmias, heart failure, peripheral vascular disease, edema, hypotension, hypovolemic shock, vasoconstriction. Carbon monoxide poisoning.

What are signs of developing peritonitis in a patient having peritoneal dialysis?

Low grade fever. Tachycardia. Cloudy outflow (effluent). Abdominal pain. Rebound tenderness

What does SIADH show?

Low osmolality. Low Na. High specific gravity

What is home management for Nephrotic syndrome?

Low sodium diet. Infection prevention by limiting social interactions. Fluid restriction for severe edema. Monitoring of weight gain and proteuria to detect relapse.

What is a renal diet include?

Low sodium. Low Potassium. Low Protein.

What are signs of dehydration?

Low urine output. Tachycardia. Narrow pulse pressure. Decreasing SBP and rising HR with position change

What is a priority when there is signifanct blood loss?

Lower HOB to supine to maintain blood perfusion to the brain

What is Nadir?

Lowest point of WBC depression after chemotherapy.

What is recommended skin care for a patient receiving teletherapy?

Lukewarm shower daily. Avoiding rubbing or scratching the skin. Using only approved lotions. Shielding the skin from the effects of the sun. Avoiding extremes in temperature

What is refractory hypoxemia?

Lungs are adequately perfused but gas exchange is disrupted due to atelectasis and fluid in the alveoli. Inability to improve oxygenation with increases in oxygen concentration

What is the best positions for instilling eye drops on a child?

Lying down. Sitting with the head tilted back

How does hyperthryroidism look like?

MJ in Thriller

What should be noted when a patient has a history of seizures and is going to receive a MMRV vaccine?

MMR and Varicella vaccine should be seperate.

If there is an measle exposure to a child that is <12 months old, what is the next step?

MMR vaccine is safe for <12 mos. As long as given within 72 hours of exposure. Must be revaccinated between age 12-15 months and between 4-6 years old.

What are live vaccinations?

MMR. Varicella

What will you hear with Patent Ductus Arterisus?

Machine like murmur from blood flow from the aorta to the pulmonary arteries

What is the treatment for Torsades de pointes?

Magnesium

Why does normal saline need to be started after a blood transfusion reaction?

Maintain IV access. Prevent hypotension. Vascular collapse

What is the goal for permissive htn?

Maintain SBP>170. Tx should be >220/120

What are interventions for a fractured mandible

Maintain airway patency. Administration of oxygen and analgesia. Application of ice to the face.

What does the Pavlik harness do?

Maintains the infant's hips in a slightly flexed and abducted position to allow for proper joint development.

What are codependent behaviors?

Making excuses for a patient's drug/alcohol use. Not allowing client to suffer the consequences of actions. Putting a patient's needs before their own.

What does a hard or firm lymph node mean?

Malignancy

What is Retinoblastoma?

Malignancy of the eye typically dx under the age of 2

What are common findings in newborns which is a response to transplacental maternal estrogen exposure?

Mammary gland enlargement. Non-purulent vaginal discharge (leukorrhea). Mild uterine withdrawal bleeding (pseudomenstration). Provide reassurance

What is the primary diagnostic test for breast cancer?

Mammography

What is palliative care?

Managing symptoms rather than life prolonging treatment. Provide psychosocial support. Coordinating care. Provided by interdisclipinary palliative assessment. Is not a hospice.

What is the drug of choice for ICP?

Mannitol

What is not recommended to prevent skin breakdown?

Massage bony prominences

What do you not do to frostbitten extremities?

Massage. Ambulate

What must not be done to affected areas of frostbite?

Massage. Rub. Squeeze. Avoid heavy blankets or clothing to prevent sloughing

What can stimulate milk production?

Massaging breasts.

What are manifestations of Nephrotic syndrome?

Massive proteinuria. Edema. Hypoalbuminemia. Hyperlipidema

What are indications for prophylactic antibiotics during labor?

Maternal GBS positive status. Unknown GBS status with fever >100.4. Preterm gestation. Prolonged rupture of membranes

What are the main concerns with Placental abruption?

Maternal blood loss leading to hypotension, shock, and fetal compromise.

What are adverse effects of Oxytocin?

Maternal hypotension. Water intoxication. Unnecessary cesarean birth. Fetal death. Postpartum hemorrhage. Placental abruption

What are the interventions for a Placental abruption?

Maternal stabilization. Expedited birth.

What do you need to watch out for with children who ingest a foreign body?

May be asymptomatic in the beginning but is life threatening.

When is emergency contraception most effective?

May be used up to 5 days to reduce the risk of pregnancy. Most effective if used within 3 days (72 hours)

What does an Apgar score of 4-6 mean?

May need supportive or resuscitative measures

What are milestones for a 10-12 month old?

May walk with help or take independent steps. Crawls up stairs. Uses 2-finger grasp. Hits 2 objects together. Says 3-5 words. Uses non-verbal gestures (waving goodbye). May have seperation anxiety. Searches for hidden objects.

Who needs negative pressure isolation rooms?

Measles, TB, and Varicella Roster (airing MTV)

What interventions are done for a patient with ascites?

Measure abdominal girth. Monitor daily weights.

What is the nursing action for congenital dermal melanocytosis (Mongolian Spots)?

Measure and document area for reference

What may a UAP do if a patient is going to have a blood transfusion?

Measure vital signs prior to starting and at the end of the transfusion. Pick up blood from the blood bank.

What is a thermistor port used for?

Measures core blood temperature. Looks like a white box with a red plug

What are foods high in iron?

Meats. Shellfish. Eggs. Green leafy veggies. Dried fruits or beans. Brown rice. Oatmeal. Whole grains

Meconium stained amniotic fluid places the newborn at what risk?

Meconium aspiration syndrome

What is the red zone for a peak flow meter?

Medical alert and needs immediate medical treatment if the level doesn't reach yellow after taking rescue medication.

What must be droplet isolation?

Meningitis. Parvovirus B19. Mumps. Rubella. Diptheria. Pertussis. RSV

What are the most common side effect of Tamoxifen?

Menopausal symptoms such as vaginal dryness or hot flashes.

What are symptoms of Neuroleptic Malignant Syndrome?

Mental status changes. Fever. Muscle rigidity. Autonomic instability. Sweating

What are symptoms of serotonin syndrome?

Mental status changes. Hyperthermia. Sweating. Tachycardia. Tremor. Muscle Rigidity. Clonus. Hyperreflexia

What is medication is contraindicated for a patient who is going to have a CT scan or cardiac catherization with iodine contrast?

Metformin because it can worsen lactic acidosis in the presence of kidney injury

What is the given for the management of Opioid withdrawl?

Methadone. Buprenorphine

What is the drug of choice for Trichomoniasis?

Metronidazole

Where is the FHR of a baby in a anterior presentation?

Midline

What type of soap can be used for cleaning rashes for a SLE patient?

Mild soap only for cleaning rashes

What s/s occur from Alcohol withdrawal syndrome within 6-24hrs of last drink?

Mild withdrawal. Anxiety. Insomnia. Tremors. Sweating. Palpitations. GI upset. Intact orientation.

What is Lacto-vegetarian?

Milk and milk products

How do you prevent VAP?

Minimize sedation. Sealing the endotracheal tube cuffing with >20 cm H20. Oral care with chlorhexidine. Extubate as soon as tolerated

What can help reduce the risk of a fat emboli?

Minimizing movement of a fractured long bone. Early stabilization

What is a Word Salad?

Mix of words and phrases having no meaning execpt to the client.

What is bloody show?

Mixture of mucus and pink/dark brown blood

What is the most effective strategy to prevent patients with dementia from wandering?

Modifications to secure their environment. Locks below or above eye level. Hiding exits. Black mat in front of exits. Doorknob covers. Motion detectors. Alarms

What can be done if there is insufficient outflow from peritoneal dialysis?

Monitor and administer stool softeners. Check tubing for kinks or clots. Maintain drainage bag below the abdomen. Placing clients at side lying or assist with ambulation

What do you need to watch out when dealing with alcohol and diabetes?

Monitor blood glucose. Alcohol causes hypoglycemia.

What is an important assessment in a client with low platelets?

Monitor for any change in consciousness because it can indicate intracranial bleeding and increased intracranial pressure

What are interventions for bulimia nervosa?

Monitor for signs of hidden purging, esp after meals. Monitor for electrolyte balances like hypokalemia from excessive vomiting

What is the scope of practice for LVNs?

Monitoring RN findings. Reinforce education. Routine procedures. Ostomy care. Tube patency and enteral feeding. Specific assessments. Monitoring for behavioral changes

What are signs that the child has hearing impairment?

Monotone and loud voice. Delay in intelligible speech. Appears shy, timid, withdrawn and inattentive.

What are common side effects of a patient on corticosteroids?

Mood swings. Irritability

When should diuretics be given?

Morning to prevent nocturia and interrupted sleep.

What is prevention for West Nile Virus?

Mosquito repellent. Keeping arms and legs covered with light colored clothing. Avoid activities and dusk and dawn

How is the Zika virus transmitted?

Mosquitoes. Bodily fluids. Sexual contact.

When taking care of a Muslim woman, what are considerations?

Most body parts are covered. Female workers must be present when providing care.

Describe malignant melanomas

Most deadly form of skin cancer. Appears black or brown with irregular borders.

What is misinformation that mothers believe in about colostrum?

Mothers of Southern Asia, sub-Saharan Africa, Pacific Island, Native American, and Hispanic ancestry believe colostrum is harmful and must be informed of the antibodies and laxatives that they provide.

What are signs of cardiac tamponade?

Muffled heart sounds. Jugular vein distention. Decreased BP. Pulsus paradoxus. Dyspnea. Tachypnea. Tacycardia.

What are strategies for physiologic anorexia?

Multiple food options. Set schedule for eating. Avoid TV during meal time. Do not force feed.

What can cause uterine distension?

Multiple gestation. Polyhydramnios (excessive amniotic fluid). Big baby (>8lbs 13oz)

The use of statins and fibrates could cause what complicaiton?

Muscle cramping and aching (Myopathy). Hepatotoxicity. Rhabdomyolysis

What can botulism lead to?

Muscle paralysis starting from the face leading to dysphagia and respiratory failure due to relaxation of skeletal/smooth muscle. Constipation. Respiratory Failure.

What are manifestations of crutch paralysis?

Muscle weakness over the forearm, wrist, and hand.

What is the intervention with an impaled object is present?

Must be stabilized to prevent further trauma and bleeding.

What is the antidote for Acetaminophen?

N-acetylcysteine, which can be given within 8 hours of Acetaminophen ingestion.

What are symptoms of Pyelonephritis?

N/V. Fever and chills. Flank pain. Costovertebral tenderness.

What are manifestations of Dialysis Disequilibrium Syndrome (DDS)?

N/V. H/A. Restlessness. ALOC. Seizure activity.

What are early signs of methadone toxicity?

N/V. Lethargy

What is the PPE for a TB patient?

N95. Gown is not necessary.

What should you do with the blue pigtail lumen after insertion of a NGT?

NEVER connect to suction. NEVER use for flushing. NEVER clamp/plug. Leave open to help GI decompression.

What is patient teaching for a pharmacologic nuclear stress test?

NPO for at least 4 hrs. Avoid caffeine and decaf for 24 hours. No theophylline 24-48 hrs prior to the test. Consult MD about diabetic meds. No nitrates. No Dipyridamole. No beta blockers

What do clients with asthma and nasal polyps have a drug interaction with?

NSAIDs

What is NSAIDs relation to blood pressure and diuretic medication?

NSAIDs decrease the effectiveness

What are client identifiers?

Name. Medical record number. Birth date

What are common contraindications for anticholi?

Narrow angle glaucoma. Urinary retention. BPH. Ileus. Bowel Obstruction

What is a low flow oxygen system?

Nasal cannula. Simple face mask.

What is the treatment for bronchiolitis?

Nasal suctioning using saline nose drops to ease breathing and a suction bulb. Additional fluids and breastfeeding is encouraged due to the risk of dehydration

What are complications of enteral feedings?

Nausea. Vomiting. Diarrhea. Symptoms can be relieved by slowing down the feeding rate.

What does an Apgar score of <3 mean?

Need resuscitative measures

What is behavior of a dependent personality disorder?

Need to be taken care by another person. Fear of seperation.

What is a Anencephaly?

Neural tube defect resulting in little to no brain tissue or skull formation. Newborn may be stillborn or born alive with death occuring shortly thereafter.

What can happen if Valproate is taken while pregnant?

Neural tube defects such as spina bifida

What is a life threatening complication for when taking Clozapine?

Neuroleptic Malignant Syndrome. Agranulocytosis

What is the most common cause of mortality in clients?

Neurologic injury

What kind of symptoms will be seen with biological agents (botulinum toxin)?

Neurologic symptoms

What is symptoms of chronic lithium toxicity?

Neuromuscular excitability. Confusion. Tremor. Ataxia. Polyuria. Polydipsia

What is the most life threatening complication of a new onset of Guillan-Barre syndrome?

Neuromuscular respiratory failure

What is a priority after cast application?

Neurovascular integrity

What are common side effects of Oxybutyin?

New onset of constipation. Dry mouth. Flushing. Heat intolerance. Blurred vision. Drowsiness. Sedation

What are the s/s of UTI in pregnancy?

New onset of dysuria. Sediment/cloudy, foul smelling urine.

What are s/s of Gestational hypertension?

New onset of elevated blood pressure at >20 weeks gestation. No proteinuria or end organ damage.

What is neonatal abstinence syndrome?

Newborn experiences opioid withdrawal typically within 24-48 hours after birth.

What are the nursing actions for phototherapy for an newborn?

Newborn should ONLY be wearing a diaper. Eye shields. Monitored for hydration and urine output.

What are later signs of breast cancer?

Newly retracted nipple. Orange peel appearance of breast tissue

What is the order of insulin given?

Nicole Ritchie RN

What is the most beneficial treatment for Carpal Tunnel Syndrome (CTS)?

Nighttime wrist splinting

What is the interventions to prevent the spread of Pediculosis capitis (Head lice)?

Nit comb every 2-3 days for 2 weeks. Vaccum frequently. Beddings should be washed in hot water and dried in the hottest setting. Nonwashable items are placed in sealed plastic bag for 2 weeks. All hairbrushes, hair ornaments, combs should be soaked in boiling water for 10 mins or lice killing products for 1 hour

What is used to confirm amniotic fluid leak?

Nitrazine paper tests

Can equipment be shared between contact precaution patients?

No

Can you give warfarin to a pregnant client?

No

Do orthodox jews allow autopsies?

No

Can you wrap a soiled dressing with a paper towel for disposal?

No because infectious waste can seep through. Using a glove to enclose the soiled dressing is acceptable.

Can the placenta be removed if still attached?

No because it creates a large surface area of bleeding.

What are safety precautions when using oxygen at home?

No smoking. Electrical devices in good condition and plugs grounded. Avoiding volatile, flammable products and materials that generate static electricity. Staying at least 5-10 feet away from open fires. Keeping extinguishers available. Regularly test smoke detectors.

Can a patient with osteomyelitis ambulate?

No, affected part must be immobilized

Can ARBs and Ace inhibitors be given to pregnant patients?

No, they are teratogenic

Can Ipratropium bromide be given for acute bronchospasm?

No. Must be given in combination with a short acting beta 2 agonist such as albuterol. Albuterol by itself, can be given for correcting acute bronchospasm and brochoconstriction

What is the "death rattle"?

Noisy rattling noise with breathing that occurs when a patient is dying and cannot manage their oral secretions

What type of anesthesia is used for laser therapy?

None

What OTC decongestants are effective for Acute Otitis Media?

None. Can delay recovery process.

What is contraindicated with asthma patients?

Nonselective beta blockers causes bronchial smooth muscle constriction

What is an S3 hear sound in a child considered?

Normal

What is physiologic anorexia?

Normal period of decreased appetite that occurs around age 18 months as a result of decreased metabolic needs. They become picky

What kind of vital signs do you expect in the fourth stage of labor?

Normal vital signs. WBC can be as high as 30,000.

How does lasix work for pneumonia?

Not appropriate tx for the dx

What would require further assessment of a toddler?

Not enjoying interactions. Expressing themselves verbally. Hearing problems

Anti embolism stockings should not be altered how?

Not rolled down. Folded down. Cut or altered in anyways

How long should uterine contraction duration be in the first stage of labor?

Not to exceed 90 secs.

What must be done if a gush of dark red drainage from the chest tube occurs after a cough, turn, or is repositioned following a minimal drainage?

Nothing. It is most likely retained blood due to a partial blockage in the tube. BRIGHT RED BLOODY DRAINAGE indicates active bleeding and is an immediate concern

If pain is not relieved after pain medication r/t applying a cast, what is the next step?

Notify MD

What are the symptoms of peripheral neuropathy?

Numbness. Tingling of extremities

What is countertransference?

Nurse unknowingly displacing feelings and behaviors about someone in the nurse's past onto the client. Can disrupt therapeutic nurse-client relationship.

What is compassion fatigue?

Nurses who care for dying children experience many of the same feelings that the child's family does.

What do you need to do for anorexia nervosa patients who resist refeeding or severly ill?

Nutrition support with intense monitoring

What is the tx for a bad FHR?

O2

What should outcomes of a quality improvement program be?

Objective. Measurable

What are reasons for a foley catheter?

Obstruction. Retention. Surgery use. Prolonged immobilization. Sacral wound

What is the priority care for a patient with pyelonephritis?

Obtain blood and urine cultures before starting antibiotics

What is the optimal position for fetal rotation and birth?

Occiput anterior position

What is the "Letting go" phase of Rubin theory?

Occurs after the 10 days of giving birth. The mother becomes comfortable with the new role.

What does a PVC look like?

Occurs after the P wave, it is wide and distorted. Points in the downward direction

What is the "Taking hold" phase of Rubin theory?

Occurs during the first 2-10 days of giving birth. The client is learning the skills to care for the infant but not quite comfortable. Nursing focus should be on teaching and positive reinforcement

What is the "Taking in' phase of the Rubin theory?

Occurs during the first 24-48 hours of giving birth. The client is recovering from giving birth. Nursing focus should be on the client's needs

Who is most risk for pressure injuries?

Older adults. Quadriplegic. Critically ill. Fracture of long bone or hip. Incontinence. Oxygenation and circulation problems. Infection. Fever

Should blood stains on a cast be reported?

Only if it gets bigger. Needs to be circled with date and time to monitor

What are signs of retroperitoneal bleeding?

Onset of back pain or hypotension after Angiography always requires further assessment for internal bleeding

What does a umbilical cord look like?

Opaque or whitish blue with 2 arteries and 1 vein covered with Wharton's jelly.

If a patient is under procedural sedation and begins snoring, what is the intervention?

Open the airway

What is treatment for Pertussis?

Oral antibiotics. Droplet precaution. Supportive measures such as humidfication and oral fluids.

What are risk factors for cervical cancer?

Oral contraceptions for five years or more. Smoking. HIV. HPV. Sexual activity before 18. Multiple sexual partners. Immunosuppression. History of STI.

What will be seen in a patient with radiation contamination?

Oral mucosa ulceration (Oral mucosa). Vomiting and diarrhea (GI). Low blood cell counts (Blood marrow)

How is Actidose given?

Oral or NG tube ASAP

How can you give oral medications to infant?

Oral syringe. Hold child in a self reclining position. Medications should be given in a slowly in small amounts toward the back or inside of the cheek.

What can worsen nausea?

Orange juice due to its acidity

When caring for a patient that is blind, what are ways to promote self independence?

Orient client to surroundings. Announce room entry and exit. Offering an elbow and walking slightly in front. Asking client directly for preferences. Using a clock face description to orient client to the location of objects

What is a common side effect of Terazosin?

Orthostatic hypotension and it should be given at nighttime.

What is seen in autonomic dysfunction?

Orthostatic hypotension. Paralytic ileus. Urinary retention. Diaphoresis

What is a postmenopausal woman at risk for?

Osteoporosis. Heart disease

What do Whites have a high incidence of?`

Osteoporosis. Skin cancer (Melanoma)

What are adverse reactions to Aminoglycosides?

Ototoxicity. Nephrotoxicity

How fast should hydromorphone be given IV?

Over 2-3 mins

Where do you listen for a bruit where a abdominal aneurysm occured?

Over the periumbilical or epigastric area

What is the most effective pain management for sickle cell crisis?

PCA of morphine or dilaudid

What are clinical manifestations of impending respiratory failure?

PaCO2 >45. PaCO2 <60. Paradoxical breathing. Mental status changes. Absence of wheezing and silent chest. Single word Dyspnea

What is the ABG values for a patient with Acute Respiratory Failure (ARF)?

PaO2 < 60. PaCO2 >50. pH <7.30

What does a Atrial paced rhythm look like?

Pacemaker spike then followed immediately by the PQRS.

What are nonpharmacological pain management strategies for an infant?

Pacifier. Concentrated sucrose solutions. Skin to skin contact with a parent. Swaddling

What is treatment for vaso-occulsive crisis (pain crisis) sickle cell crisis?

Pain management. Bed rest

Where is the pain for a herniated disk?

Pain radiating down the posterior thigh and leg via the sciatic nerve. May also radiate to the foot. Weakness will be noted when attempting to raise the big toe or ankle.

What are characteristics of gout?

Pain, swelling, and redness of one or more extremity joints (usually the great toe)

What are manifestations of a fractured mandible?

Pain. Edema of the face and jaw. Difficulty speaking. Drooling. Bleeding

What is the major symptom of bladder cancer?

Painless hematuria

A placental previa client will be reporting what after 20 weeks gestation?

Painless vaginal bleeding

What are clinical signs of Placenta Previa?

Painless vaginal bleeding, ultrasound with placenta covering os (opening)

What are the symptoms of cataracts?

Painless, gradual loss of visual acuity with blurry vision. Decreased color perception. Scattered light on lens producing glare and halos. Opaque lens

What are clinical findings during a Testicular self examination that should be reported?

Painless, hardened lump on testes. Scrotal heaviness or swelling. Dull ache in pelvis or scrotum

What is Milrinone used for?

Palliative treatment of end stage heart failure

How do you assess for Thrill?

Palpate

How is radial artery checked?

Palpating with fingertips

Why must you ausculate before percussion and palpation in an assessment?

Palpation and percussion may increase bowel motility and interfere with sound transmission during ausculation.

What are beta blockers used for?

Palpitations. Chest pain

What medication can be mixed with food?

Pancreatic enzymes, for cystic fibrosis, can be mixed with applesauce

What does Ptosis of the right eyelid during a neonate assessment indicate?

Paralysis of the oculomotor nerve (CN 3).

What type of patients is Dicyclomine is contraindicated for?

Paralytic Ileus

What is toxoplasmosis?

Parasitic infection acquired by exposure to infected cat feces or ingestion of undercooked meat or soil contaminated fruits/vegetables.

Can the parents of minor leave AMA?

Parents may not refuse limb-, life-, or organ-saving treatment for a minor child based on their own personal beliefs.

What is parent teaching for a newborn that has been circumcised?

Parents should clean the area with warm water (without soap) to remove urine and feces and prevent infection

What is intussussception?

Part of the intestine telescopes into another adjacent part and causes a blockage.

What is Trisomy 13?

Patau syndrome. Can result in early death.

What are examples of Left to Right cardiac shunts?

Patent ductus arteriosus. Atrial septic defect. Ventricular septic defect.

What is directly observed therapy (DOT)?

Patient centered strategy that ensures drug therapy adherence such as watching the patient swallow every prescribed medication

When a patient has a positive TB skin test, what does it mean about TB?

Patient has the infection but further tests to see if its active or latent

What isolation patients must never be placed together?

Patients infected with different organisms. Infectious client and immunocompromised pt

What is the priority concern after trauma (fall) to a patient for the nurse to do?

Perform a glascow coma scale to assess neurological impairment

What is patient instructions for a testicular self exam?

Perform monthly on the same day. Perform while taking a warm shower. Use both hands to test each testis seperately. Palpate each testicle gently using thumb and first 2 fingers. Check that the testicle is normally egg shaped and movable with a smooth surface. IT IS NORMAL TO HAVE ONE BIGGER THAN THE OTHER OR HANG SLIGHTLY LOWER THAN THE OTHER

What are modifications needed for CPR for a pregnant client?

Performing chest compressions slightly higher on the sternum. Displacing the uterus to the client's left side by doing it manually or placing rolled towel or wedge under right hip. If CPR not successful for 4 mins, emergency C-section is necessary. Delivery must be done within 5 mins of CPR

How do you prevent prosthesis dislocation following hip arthoplasty?

Performing leg exercises to strengthen the muscles around the hip and avoiding excessive hip flexion (>90 degrees) when sitting, dressing, and toileting. Not cross legs. HOB <60. Abduction pillow

Where is ST elevation in all ECG leads common?

Pericarditis

What is the ictal phase of a seizure?

Period of active seizure activity

What is required with Polycythemia Vera?

Periodic phlebotomy, which is the removal of 300-500 mL of blood to reduce blood count and have Hct <45%

What are manifestations of acute glomerularnephritis?

Periorbital and facial/generalized edema. Hypertension. Oliguria. Tea colored and cloudy urine

What is raccoon eyes?

Periorbital bruising

What can occur from a intussussception?

Peritonitis. Bowel obstruction. Decreased blood supply leading to Tissue death. Perforation

What are clients with hemophilia more at risk for?

Permanent joint destruction due to frequent bleeds into the joint spaces

What is an indication for a patient with ineffective endocarditis that treatment isn't working?

Persistent temperature elevations. Slurred speech. Weakness. Paralysis. Painful, cold extremity

What are the s/s of a patient with vaginal hematoma?

Persistent, severe vaginal pain. Feeling of fullness. S/S may not be felt under epidural.

What is Munchausen syndrome?

Person inflicts injury to fake an illness

What is displacement?

Person shifts uncomfortable feelings or impulses about one situation or person to another person

What is a common manifestation of Immune thrombocytopenic purpura (ITP)?

Petechiae

What is the nursing plan for acute mania patients?

Physical activity. Quiet, structured environment. Limit contact with others. Finger foods with high nutritional value.

To whom should elder abuse reported to?

Physician. Within 24 hours

What is discharge teaching for Enoxaparin therapy?

Pinch skin and insert at 90 degree angle. Continue to hold skin and remove needle. Do not rub site with hand. Ice cube on injection site can provide relief. Avoid ASA and NSAIDs. Monitor CBC for thrombocytopenia

What is the steps for a patient aspirating?

Place in high fowlers. Perform oral suctioning. Administer 100% oxygen by NRBM. Assess lung sounds. Notify MD

What are the steps to suctioning a patient?

Place in semi fowlers. Preoxygenate for 30 secs. Insert catheter. Withdraw once resistance is felt. Intermittent suction when withdrawing 5-10 seconds to prevent damage. Wait 1-2 mins between each pass. Medium suction pressure should be set at 100-120 mm Hg for adults

What should you do with recently extubated patients?

Place on humidified O2. Monitor for aspiration, airway obstruction, and respiratory distress. Remain NPO til swallow eval. Routine oral care. Deep breathe and cough. Use of incentive spirometer. Place in High Fowlers

What is the position of a neonate during resuscitation?

Placed on back with neck slightly extended. A blanket or towel can be placed below the shoulders. Blanket or towel placed under the head would cause neck flexion and decrease air entry

What must be done for a client with a prolapsed umbilical cord?

Placed on hands and knees or trendenlenberg to relieve pressure on cord. Manual elevation of the cord with sterile, gloved hand.

How do you prevent SIDS?

Placed on the back with a firm mattress without loose bedding or toys. Smoke free environment. Avoiding overheating. Promotion of breastfeeding. Pacifier use. Avoid crib bumper pads. Sleep sack. Crib slats no more than 2 1/4 inches apart. Smoking cessation. Up to date immunizations

What can cause couvelaire uterus?

Placenta seperating at the center.

What are complications of HELLP syndrome?

Placental abruption. Stroke. Death

What position can help in preventing aspiration pneumonia?

Placing a client with a decreased level of consciousness in a side lying position uses gravity to help drain secretions

How do you warm baby formula?

Placing in a pan of hot water for several minutes. Never microwave

What are expected findings of for a term newborn?

Plantar creases up the foot. Presence of the babinski reflex. and Epstein's pearls

How should can potassium medication be taken?

Plenty of water (>4 oz/12mL). Sit upright after ingestion to prevent pill induced esophagitis. NOT on empty stomach

What is a complication of Pneumonia?

Pleurisy

What is a therapeutic approach to a client with OCD that is performing rituals?

Pointing out the amount of time the client has spent performing an activity. Redirecting the client to another activity.

What lab level is expected from a patient with severe COPD?

Polycythemia. COPD causes hypoxemia so to compensate the body produces more blood cells to carry oxygen to the cells

What do you need to monitor for with cyanotic cardiac defects (eg Tetralogy of Fallot)?

Polycythemia. Elevated Hgb levels that can increase viscosity. Need to STAY HYDRATED

What are s/s of hyperglycemia?

Polyphasia. Polyuria. Polydipsia (excess thirst). Dry mouth. Blurred vision. N/V. Weight loss

What can a hypertonic uterine lead to?

Poor blood and oxygen exchange for the fetus.

What doesn't contribute to COPD?

Poor nutrition. Obesity

What are the steps to ensure accuracy of invasive pressure readings?

Position client flat, prone, supine, or HOB 45. Confirm zero reference stopcock with phlebostatic axis. Zero the system after initial setup. Perform a square wave test. Measure pressures at end of expiration

How do you perform a huff cough?

Position upright. Inhale through the nose using abdominal breathing and prolong the exhalation through pursed lips for 3 breaths. Hold breath for 2-3 seconds following an inhalation, keep the throat open. Deeply inhale and while leaning forward, force the breath out gently using the abdominal muscles while making a "ha" sound (huff cough), repeat 2 more times (eg ha, ha, ha). Inahle deeply using the abdominal breathing and give one forced huff cough

When following NRP (Neonate Resuscitation Program), what is the intervention if the HR is <100?

Positive pressure ventilation

What can increase digoxin toxicity?

Potassium. Sulcrafate

Why must Purpura and Petechiae be further assessed?

Potential serious condition such as blood dyscrasia

What are socioeconmic risk factors for FTT?

Poverty. Social or emotional isolation. Caregivers with cognitive disabilities or mental health disorders. Lack of nutrition education.

What must not be used to prevent skin breakdown on sedated babies?

Powder. Donut Pillow

What are s/s of Eclampsia?

Preeclampsia. New onset of grand mal seizures.

What is a reason for a Chorionic Villus Sampling?

Pregnancy at a advanced age of >35. Abnormal quad screen. Hx of child with chromosomal abnormalities. Congenital anomaly detected on first tri ultrasound.

What are risk factors for growth and developmental delays in children?

Premature birth (<38 week). Recurrent respiratory infections

What is Abruptio Placentae?

Premature seperation of Placentae after 20 weeks of gestation.

What should you instruct the patient to do with the removal of a chest tube?

Premedicate client with analgesic. Place in semi fowlers. Provide sterile suture removal equipment. Hold breath and bear down (Valsalva maneuver) to decrease risk of pneumothorax. Apply sterile airtight occulsive dressing. Perform CXR within 2-24 hours to check for pneumothorax

What is a Preschool (3- 6yo) stage Piaget's cognitive development?

Preoperational. Improved language. Magical thinking. Unable to understand cause and effect. Example is blaming self for being adopted.

What must be done in the event of a patient having epiglottis?

Prepare for an emergency airway

What must be done in the event of a Abruptio Placentae?

Prepare for vaginal delivery

What is the criteria for systemic inflammatory response syndrome (SIRS)?

Presence of 2 or more of these findings: Temperature (hyper/hypothermia) >100.4 or <97. RR > 20. HR > 90. WBC > 12000 or < 4000.

What does CK-MB indicate?

Presence of myocardial tissue injury.

What is Babinski's reflex?

Present at birth and disappears after 1 year. Toes fan out when the sole is stroked upward.

What is the most therapeutic response to a client experiencing hallucinations?

Present reality and acknowledge how the client may be feeling. Focus on the nature of the hallucination and assess for suicidal or homicidal themes.

What is a intervention for Disturbed body image r/t Anorexia Nervosa?

Presenting situation realistically and discussing weight in terms of the client's health.

What is the treatment for a dressing that is sanguineous (bright red) after a surgical procedure?

Pressure dressing to provide hemostasis. Catherization of a blood vessel. Fluid replacement

What are risks from a Abruptio Placentae to a neonate?

Preterm birth. Intrauterine growth restriction. Hypoxia. Anoxia. Neurological injury. Fetal death.

What is the immediate postoperative priority goal for a client with a newly placed tracheotomy?

Prevent accidental dislodgement

What are nitroglycerin patches used for?

Prevent angina

What is the purpose of a closed wound drainage system?

Prevent fluid backup in a closed space.

Why is contact sports avoided if patient has Mononucleosis?

Prevent injury to spleen and liver from splenomegaly and hepatomegaly. Example is soccer

Why is magnesium given for severe preeclampsia?

Prevent seizures. CNS depressant.

What is Abciximab, Eptifibatide, and Tirofiban used for?

Prevent thrombotic events. Acute coronary syndrome. Subcutaneous coronary intervention.

What does a brace for scoliosis do?

Prevent worsening of spinal deformities

What type of isolation does a neutropenia patient need?

Private reverse isolation room equipped with a HEPA filter

What type of room would a child with autism spectrum disorder (ASD) need?

Private room away from overstimulation such as a playroom or a nurse's station

What can macrolides cause?

Prolonged QT which can lead to arrythmias. Hepatotoxic

What is crutch paralysis?

Prolonged and continual excessive pressure on the axillae can damage the radial nerve

What type of expiratory response will you see with patients with a obstructive lung disease (asthma, COPD)?

Prolonged expiratory phase as a physiologic response to hyperinflation and trapped air

Who is at risk for Pulmonary Embolism (PE)

Prolonged immobilization. Obesity. Recent surgery. Varicose veins. Smoking. Heart failure. Advanced age. History of Venous Thromboembolism (VTE)

What are interventions for acute glomerularnephritis?

Promote rest. Restrict sodium/fluids/protein. Antihypertensives. Diuretics. Abx

What position must be the patient with spina bifida?

Prone

What position would a lower leg amputation be in?

Prone

What position should a patient who just had an above the knee amputation be placed in?

Prone to prevent hip flexion contractures for 30 minutes 3 or 4 minutes per day.

What are preventive measures for development dysplasia of the hip (DDH)?

Proper swaddling with hips bent and out. Using infant carriers or car seats with wide bases

If a laboring client whose Group B Streptococcus status is unknown, and there is a rupture of membranes, what is the next step?

Prophylactic antibiotics. Guidelines are membranes ruptured >18 hours, Maternal temperature is 100.4, Gestation is <37 weeks

What are nonselective beta blockers?

Propranlol. Nadolol

What is the antidote for Heparin?

Protamine sulfate

What should be done to Phenylephrine?

Protected with a opaque cover to protect it from light exposure

What is Vernix caseosa?

Protective substance secreted by the sebaceous glands that covers the fetus during pregnancy. Appears white and cheesy, most likely seen in the axillary or genital area.

What do you see in preeclampsia?

Proteinuria. New onset of HTN at >20 weeks gestation. Signs of organ failure. H/A. Visual disturbances. Facial swelling.

What type of meds can be given for acute pancreatitis?

Proton pump inhibitiors. Albumin. Pain mgmt such as Morphine. Lactated ringer solution. Abx

What are symptoms of Acromegaly?

Protruding jaw.Large lips/nose. Tongue enlargement leads to speech difficulties. Hearing loss. Enlargement of hands/feet. Vision changes. HA. Joint pain. Peripheral neuropathy. Hyperglycemia

What is the focus of hospice?

Provide comfort measures. Help client die naturally and as pain free as possible. While on hospice, the client cannot receive treatment designed to cure the illness

What is the nursing treatment for a newborn born with anencephaly?

Provide newborn comfort care such as warmth and oxygen

How does colostrum benefit the infant?

Provides high concentration of protein, sugar, fat, water, minerals, and vitamins. Also contains maternal antibodies, lymphocytes, and laxative effect to help pass first stool (meconium), which helps clear bilirubin and prevent jaundice.

What is Al-Anon?

Provides support for spouses, significant others, friends, family by sharing stories

What is Alateen?

Provides support to adolescent children of alcoholics

What happens if you provide care to a visitor emergency?

Providing care establishes a legal caregiver obligation/relationship. The nurse has a duty to continue the care. If proper care is not given, the nurse can be accused of negligence

What port must be used to monitor CVP?

Proximal port is connected to a pressure monitoring system to measure CVP because its lumen exits in the right atrium

What is the aural phase of a seizure?

Pt experience visual or other sensory changes

What is an expected finding of Myasthenia Gravis?

Ptosis. Diplopia. Difficulty breathing. Bulbar signs (Difficulty speaking or swallowing)

What is the action if there is an accidental exubation on a new tracheotomy (<1 week)?

Pull retention sutures apart. Insert a curved hemostat to hold the stoma open. If desaturation continues, apply a sterile occlusive dressing over the stoma and ventilate the patient with a bag valve mask over the nose and mouth.

What are the steps for a Z track IM injection?

Pull skin laterally and away from the infection site. Hold skin taut with non dominant hand. Insert needle at 90 degrees. Inject medication slowly with dominant hand while maintaining traction. Wait 10 seconds after injecting and withdraw needle. Release hold on skin. Apply pressure at injection site, but DO NOT MASSAGE

What is a complication of DVT?

Pulmonary Embolism

Which is worst, Pulmonary edema or peripheral edema?

Pulmonary edema

What are major complications with Oligohydramnios?

Pulmonary hypoplasia. Umbilical cord compression

What is the main sign of retinoblastoma?

Pupil will reflect a white color instead of typical red eye reflex. Second sign would be Strabismus (Misalignment of the eye)

What foods can be introduced at at age 6-8 months?

Pureed fruits and vegetables

What is Purpura?

Purplish blotches indicating bleeding underneath the skin.

What are characteristics of VAP?

Purulent secretions. Positive sputum cultures. Leukocytosis. Elevated temperature. New or progressive infiltrates on CXR

What must be taken with Isoniazid to prevent neuropathy?

Pyridoxine

How often should TPN tubing be changed?

Q 24 hrs

Why must a patient with methadone toxicity be on cardiac monitoring?

QT interval prolongationm which can lead to cardiac arrhythmia

What do you need to monitor for with Ziprasidone hydrochloride?

QT prolongation. Hypotension. Seizures

What is the goal for of any institutional or policy change?

Quiality of care. Improved patient outcomes.

How should restraints be tied?

Quick release knot. Not a square knot.

What must be done if there a fire on the floor?

RACE first. Discourage visitors from using the elevator

What is symptom management techniques for Rheumatoid Arthritis (RA)?

ROM. Allowing periods of rest. Moist heat for stiffness. Cold packs for joint pain

What are typical findings of a neonate within 1-3 hours of life?

RR 30-60. Milia (white papules). Glucose levels 40 - 100.

What is the treatment for HHNS?

Rapid fluid infusion

What is tumor lysis syndrome?

Rapid lysis of cells causing release of potassium and phosphorus into serum

What is loose associations?

Rapid shifting from one idea to another with no connection of logic.

What are characteristics of Splenic Sequetration Disease?

Rapidly enlarging spleen. Hypotension.

What is Dialysis Disequilibrium Syndrome (DDS)?

Rare but life threatening complication that can occue in the initial stages of hemodialysis.

What is Cast syndrome (Superior mesenteric artery [SMA] syndrome)?

Rare complication of an overly tight cast that involves compressiong of the duodenum by the SMA.

What are manifestations of fifth disease "Slapped face"?

Rash on the cheeks. Spreads to extriemeties and maculopapular rash develops. General malaise and joint pain.

What should patients with neutopenia avoid?

Raw fruits/vegetables. Standing water. Undercooked meat.

What is proper car seat use for infants?

Rear facing seat in the back of the seat. Harness should be snug and locked near the armpit. If the preterm is small , rolled blankets or car seat inserts may be used to support the trunk and reduce slouching. Infant should be positioned at 45 degree angle.

What can occur from cystic fibrosis?

Recurrent lung infections. Pneumothorax. Decreased O2 sat. Hemoptysis. Constipation

What are major manifestations from cystic fibrosis?

Recurrent sinus and pulmonary infections. Pancreatic malabsorption. Defiency of fat soluble vitamins (ADEK). Infertility.

What is a complication of IV vancomycin?

Red Man Syndrome caused by rapid infusion.

What must a nurse do to a family if they are causing anxiety in the patient?

Redirect family to calm patient

What is dexamethasone used for?

Reduce or prevent cerebral edema

What are common findings in major depressive disorder?

Reduced appetite. Low energy levels

What is most important outcome of effective communication among care givers?

Reduced number of medical errors

What is management of a paitent having a thyroid storm?

Reducing fever. Maintaining hydration. Preventing cardiac compromise

What are 3 categories of PTSD symptoms?

Reexperiencing the traumatic event. Avoiding reminders of the trauma. Increased anxiety and emotional arousal.

What is a hallmark symptom of ARDS?

Refractory hypoxemia

What are signs of true labor?

Regular intervals, frequency, duration & intensity increase over time. Discomfort that begins in lower back, radiates to abdomen. Contractions increase despite comfort measures. Increase in cervical dilation and effacement.

What is rhythm look like for a Supraventricular Tachycardia (SVT)?

Regular narrow-complex (QRS) tachycardia with no visible P Wave.

What are the steps to administering opthalmic medication?

Remove secretions by wiping inner to outer. Pull eyelid downward. Having client look up. Instill drops into the sac. Apply pressure to the lacrimal duct for 30-60 seconds

What do you do for postmortem care?

Remove soiled linens. Cleaning the body and room. Placing head on pillow. Pad under perineum. Mouth and Eyes closed. Don't remove dentures

What is most serious complication of scleroderma?

Renal crisis that causes malignant hypertension

What do you need to watch out for with a abdominal aortic aneurysm repair?

Renal status

What must be done after a negative on a HIV test?

Repeat test in 6 months

What is Perseveration?

Repeating the same words or phrases in response to different questions.

What is Echolalia?

Repetition of words, usually uttered by someone else

What are interventions when dealing with a client who is hearing impaired?

Rephrase misunderstood statements. Have them repeat what was said. Be face to face and speak clearly. Be aware of sign language use. Speak at normal volume to unaffected ear. Touch the person before speaking. Make sure hearing aids are functional

What is Duchenne Muscular Dystrophy (DMD)?

Replacement of muscle fibers with connective tissue resulting in lower extremity weakness.

What is patient teaching for patients on oral estrogen contraceptives?

Report any leg pain, vision loss, chest pain. No smoking

What is patient teaching for a patient with a AV Fistula?

Report numbness or tingling. Avoid restrictive clothes or jewelery. Do not carry heavy objects. Check function by palpating for a thrill. Don't sleep on affected arm.

What is patient teaching for COPD?

Report signs of infection because infection is a primary cause of excaerbation. Pneumococcal and influenza vaccines are required

What must be done if patient has painful genital lesions?

Reported to MD. C-Section to reduce risk of transmission

What should the nurse do if there is an occulsion of a central venous access device?

Reposition client to adjust catheter tip location.

When is Ipratropium used?

Rescue medication for COPD and asthma.

How is fifth disease "Slapped face" spread?

Respiratory secretions

What is the best nonpharmacologic intervention for inflammation of an injured area?

Rest from aggravating activities. Do not apply heat pad due to promotion of inflammation.

What are signs and symptoms of hemorrhaging from tonsillectomy and adenoidectomy?

Restlessness. Frequent swallowing. Throat clearing. Vomiting of blood. Pallor

What is the short term priority goals for anorexia nervosa?

Restoring caloric intake. Promoting gradual weight gain. Treating medical conditions from starvation.

What are the priorities when dealing with a chemical contamination emergency response?

Restrict clients/staff. PPE. Decontaminate patients outside before starting tx. Assess symptoms

What can happen during a ectopic pregnancy?

Result in a loss of the fetus if not treated immediately.

What do left to right cardiac shunts do?

Result in excess blood flow to the lungs. Pulmonary congestion

How does the body compensate for metabolic alkalosis?

Retain carbon dioxide. Hypoventilation

When the fundus is 1 cm above the umbilicus, slightly firm, deviated to the left side, and noted with a moderate amount of lochia rubra, what is the assessment?

Retained placental fragments. Patient will continue to bleed until all fragments are removed.

What needs to be done to a child with school phobia?

Return to classroom immediately by gradual exposure

What is the purpose of Naloxone?

Reverse CNS and respiratory depression

How does a 3-5 year old child see death?

Reversible

What is a concern with Abruptio Placentae in relation to mother and fetus blood?

Rh Incompatibilities. Rhogam must be given if mother is Rh negative and fetus is Rh positive..

What is position of the fetus if the laboring client is experiencing back labor?

Right occiput posterior

Where can you give a subcuanteous injection

Right or left side of abdomen, at least 2 inches from the umbilicus

What position should the patient be in after a liver biopsy?

Right side lying to prevent hemorrhage for 3 hours

What does CVP measure?

Right ventricular preload. Reflects fluid volume status

What are interventions for a cervical spine injury?

Rigid hard collar. Backboard. Logrolling

What tests are done to check for hearing impairment?

Rinne's test. Weber's test.

What are measures to minimize oral mucositis?

Rinsing mouth with normal saline. Brushing with a soft bristled toothbrush. Using a water soluble lubricant liquid. Avoidnace of hot, spicy, acidic foods. Application of prescribed viscous lidocaine.

Where is the fundus at 12 weeks gestation?

Rises about the symphisis pubis

What are the labs for Tumor Lysis Syndrome (TLS)?

Rising blood uric acid, potassium, and phosphate levels.

What are young adults at risk for when initally starting Selective Serotonin Reuptake inhibitors (SSRIs)?

Risk for Suicide

What is a risk of Abruptio Placentae for mothers?

Risk for hypovolemic shock due to bleeding.

What is a concern with patient who has a metastatic tumor in the epidural space?

Risk for spinal cord compression. As evidenced by localized, persistent back pain, motor weakness, sensory changes (numbness, paresthesia). Bowel and bladder dysfunction.

What is a risk for Chorionic Villus Sampling?

Risk of miscarriage

When does a pacificer or thumb sucking start being detrimental to a child's teeth?

Risk of teeth misalignment and malocculsion occurs after the eruption of permanent teeth.

What is the psychosocial development for adolescence?

Risk taking behaviors. Sense of invincibility. Need for independence. Strong connection to peers

What are milestones for a 4-5 month old?

Rolls front to back, then back to front. Holds objects with palmar grasp. Puts things in mouth. Begins to laugh. Makes some consonant sounds. Becomes calmed by parent's voice

What must be done in postmortem care for the family?

Room should be cleaned as much as possible. Unnecessary equipment should be removed

What are s/s of Chronic hypertension in pregnancy?

SBP > 140. DBP > 90. Prior to conception or 20 weeks of gestation.

What is considered abnormal when measuring orthostatic BP?

SBP > 20. DBP > 10. Experience lightheartedness or dizziness

What are s/s of major depression?

SIGECAPS. Sleep (increased or decreased). Interest deficit (anhedonia). Guilt. Energy deficit. Concentration deficit. Appetite (increased or decreased). Psychomotor retardation or agitation. Suicidality.

What can St. John's wort not be given with?

SSRI due to serotonin syndrome

When can synchronized cardioversion be used?

SVT. Unstable Vtach with a pulse. Afib

What must be done when IVF are discontinued?

Saline lock. D/C IV or KVO needs an order

What are acceptable blood product alternatives for Jehovah Witness?

Saline. LR. Dextran. Hetastarch. Albumin Free epogen

What kind of interpreter should be used for sensitive material?

Same sex interpreter, not family.

What test do you take for pernicious anemia?

Schilling Test

What is an example of industry vs inferiority?

School work to show competence

What are symptoms of Hepatotoxicity?

Scleral and skin jaundice. Vomiting. Dark urine. Fatigue

What will you hear upon ausculation of pericarditis?

Scratching, grating, high pitched sound

What tests are done at 35-37 weeks of gestation?

Screened for Group B beta-hemolytic streptococcus at the vagina and rectum. Infent can be infected during the birth canal.

A patient who is 50 years old has a new onset of anemia, what is the next step?

Screened for colorectal cancer because a early sign is anemia

What test can be done to check for infection resolution for Acute Otitis Media?

Screening for hearing impairment

Where is the best place to hear a pulmonic stenosis?

Second intercostal space on the left sternal border

What is the best place to hear an aortic stenosis?

Second intercostal space on the right sternal border

What are risks for lung cancer for non smokers?

Secondhand smoke. Air pollution. Genetic predisposition. Exposure to radon, asbestos, and chemicals in the workplace.

What is Propofol used for?

Sedate the client receiving mechanical ventilation to provide ventilator control, prevent extubation, and promote comfort.

What is the priority assessment in narcotic administration?

Sedation precedes Respiratory depression.

What are side effects of Opioid analgesics?

Sedation. Respiratory depression. Hypotension. Constipation.

What is seen on a Flail chest?

See saw movement with respirations. Supplementation oxygenation. Trach. Chest tube

What is a patient with a ventriculoperitoneal shunt risk for?

Seizures

What are the most serious consequences of theophylline toxicity?

Seizures. Cardiac arrhythmias

If hypoglycemia does not get treated, what can happen?

Seizures. Coma

What s/s occur from Alcohol withdrawal syndrome within 12-48hrs of last drink?

Seizures. Single or multiple generalized tonic clonic. Alcoholic hallucinosis. Visual, auditory, or tactile. Intact orientation. Stable vital signs.

What can Acute hypocalcemia lead to?

Seizures. Tetany (laryngeal stridor, tingling). Cardiac Arrythymias. Positive Trousseau or Chvostek sign)

What position should a patient with cirrhosis be placed?

Semi Fowler or Fowler due to Ascites. Side lying with head elevated

What position must a post mastectomy patient be placed?

Semi Fowlers with affected arm and hand elevated on pillows to promote drainage and prevent lymphatic pooling (lymphedema)

What is a Infant (birth- 1yo) stage Piaget's cognitive development?

Sensorimotor. Learning by senses and movement

What is a Toddler (1- 3yo) stage Piaget's cognitive development?

Sensorimotor/Preoperational. Exploration, early verbal skills.

What are categories for the Braden Scale?

Sensory. Moisture. Activity. Mobility. Nutrition. Friction

When can antacids be given with other medications?

Seperate by at least 2 hours.

What is seen in septic shock?

Sepsis induced hypotension despite tx with IVF

What is seen in MODS?

Septic shock + 2 or more multiple organ failure

How do you check for early ventilation?

Serial bedside forced vital capacity

What is Peritonsillar?

Serious complication that can result from tonsillis

What is expected drainage color after a surgical procedure?

Seroanguineous (Pink)

What are nursing interventions for a patient with manipulative behaviors?

Setting behavioral limits. Using a neutral tone of voice when discussing rules and consequences of unacceptable behavior. Ensuring consistency from staff members in enforcing limits

What are nursing interventions for antisocial personality behavior?

Setting firm limits. Making clients aware of the rules and acceptable behaviors

How soon will a AV graft or AC fistula be ready to use?

Several days or weeks to mature

How long will Bupropion Hydrochloride take to be effective?

Several weeks

What are manifestations of hypertensive encephalopathy (HE)?

Severe hypertension. N/V. H/A. Visual disturbances. Altered mental status. Seizures

What is the initial feeling of an Abruptio Placentae?

Severe onset of abdominal pain

What are manifestations of septic arthritis (septic joint)?

Severe pain. Limited range of motion. Fever. Joint swelling with effusion

What is a main symptom of acute pericaditis?

Severe, sharp chest pain that radiates to neck, clavicle and traps. Comes from being supine. Pain upon inspiration.

What is Trichomoniasis?

Sexually transmitted infection

What is the sequence for using a metered dose inhaler?

Shake cannister well for 3-5 secs. Tilit head back and slowly exhale for 3-5 secs. Place mouthpiece in mouth. Compress cannister while inhaling for 3-5 seconds. Hold breath for 10 seconds before exhaling. Wait 1-2 minutes before taking second puff

What is the sequence for BLS?

Shake the patient. Call a code/help. Assess for pulse and breathing for no more than 10 seconds. Start CPR if no pulse. Then notify MD

What are signs of hypoglycemia?

Shakiness. Sweating. Coldness. Hunger. Palpitations. Anxiety. Restlessness. Pallor

What type of breathing is seen in respiratory acidosis?

Shallow due to pain causing a buildup of carbon dioxide

What manifestations will you see with a type 2 cytotoxic hypersensitivity?

Sharp rise in temperature. Chills. Back pain. Tachycardia. Hypotension

What is McRoberts maneuver?

Sharply flexing the thigh onto the maternal abdomen to straighten the sacrum. Used for shoulder dystocia

What is the action should a foreign object get embedded in the eye?

Shield both eyes. DO NOT flush eye, add eye drops or attempt to remove foreign object.

When is the best time to use a nasal cannula?

Short term treatment in responsive postoperative clients to treat hypoventilation and reverse hypoexima effectively

What is the time frame to correct testicular torsion?

Short. 4-6 hours

What do medications do for the herpes infection?

Shorten the duration and severity of the active lesions.

What is normal when it comes to fontanelles?

Should be soft and flat. slight pulsations may occur in the anterior fontanelle when the infant cries, coughs, or is lying down.

What is patient teaching for the yellow exudate from a circumcision?

Should be taught not to wipe or forcefully remove the exudate for 2-3 days.

When is a patient with meningitis taken off droplet precaution?

Should continue 24 hours after appropriate medication.

After 20 weeks gestation, where should fundal height be?

Should correlate closely with number of weeks pregnant

What are atypical symptoms of a myocardial infarction for a elderly woman?

Shoulder pain. Nausea

What must be known if attempting to room a patient with another patient that has sickle cell disease?

Sickle cell disease has some level of immunosuppression due to the spleen not being able to carry out protective phagocytosis.

What position should a patient with neonatal abstinence syndrome be placed?

Side lying position while swaddled to minimize stimulation and promote nutritive sucking.

What position should the patient be placed for a gastric lavage?

Side or HOB elevated to minimize risk of aspiration

Where is the FHR of a baby in a posterior presentation?

Sides

How do you ambulate a legally blind patient?

Sight guided technique. By walking slightly ahead with the client holding the nurse's elbow

What should patients on immunosuppressant drugs be monitoring for?

Signs of infection.

Following a thoracentesis, what should the nurse monitor for?

Signs of pneumothorax such as level of alertness, repiratory rate, symmery of chest expansion, respiratory effort, O2 sat, and lung sounds.

What can Terazosin not be given with?

Sildenafil or Vardenafil because it can worsen hypotension

What are appropriate play activities for a child with moderate intellectual disability?

Simple puzzles. Coloring books and crayons. Simple card and board games. Playing with a large ball

What are main symptoms of Trisomy 21 (Down syndrome)?

Single crease on the palm. Short neck with excess skin (nuchal fold)

How much heparin is used to flush CVCs?

Single dose vials of 2-3 mL of 10 units/mL or 100 units/mL

What do you tell the patient to do to alleviate the chest pain from pericarditis?

Sit up and lean forward.

What are milestones for a 6-9 month old?

Sits without help. Begins to crawl. May pull to a stand. Moves objects between hands. Uses crude pincer grasp. Babbles and imitates sounds. May say "mama". Recognizes familiar faces. May have stranger anxiety

What position can relieve symptoms of emphysema?

Sitting and leaning forward on a bedside table.

What is the care for a patient with cirrhosis?

Skin care. Air Mattress. Distraction from discomfort.

What is seen for a patient with Peripheral Arterial Disease?

Skin that is thin, shiny, and taut. Hair loss

What are developmental milestones for 5 year old?

Skips. Walks backward. Uses a jump rope. Draws a triangle. Ties shoe laces. Prints letters, numbers, or words. Counts to 10. Speaks full sentences. Names coins and days of the week. Independently dresses and bathes. Identifies real from pretend.

What may a child of 5 years old do in regards of pain?

Sleep. Playing around as a distraction for pain.

What is the steps to using a peak flow meter?

Slide indicator to 0 and instruct client to stand or sit as upright as possible. Instruct client to breathe in deeply, place mouth around mouthpiece and form a seal. Exhale quickly and forcibly as possible not the reading on the scale. Repeat 2 more times with a 5-10 second rest period between exhalation. Record the highest reading achieved

Where can a pulsating mass be felt when assessing for an AAA?

Slightly left to the midline of the abdomen

What is the criteria for Dementia?

Slow onset. Fully conscious. Progressive course. Irreversible prognosis. Some memory intact.

What does unfractioned heparin do for DVT?

Slow the time it takes the blood to clot by keeping the existing clot from getting bigger and preventing new clots from forming.

What is the steps to prevent an air embolism when removing a central venous catheter?

Slowly pull the line. Have the patient a supine position. Have the patient bear down or exhale. Apply an air occlusive dressing (gauze with tegaderm).

What does Memantine do to Alzheimer disease?

Slows progression of AD symptoms, cognitive functioning, ability to perform ADLs.

What is stress incontinence?

Small loss of urine during activities

What is Petechiae?

Small pinpoint red/purple spots on mucus membrane or skin.

What are epstein pearls?

Small white cysts found on the hard palate of newborns. Disappears within a few weeks

What is the treatment of GERD for infants?

Small, frequent feeds. Burped frequently during feeding. Kept in an upright position during and after feeding. Not be rocked or agitated at least 30 mins after feeding.

What can be done for age related macular degeneration (AMD)?

Smoking cessation. Increased antioxidant (green, leafy veggies, carotene) intake. Reading large print books. Driving only at daytime at low speeds

What are prevention strategies for Community Acquired Pneumonia (CAP)?

Smoking cessation. Vaccination for influenza and pneumococcal pneumonia. Avoidance of contact with individual with viral respiratory illness

What is the primary cause of bladder cancer?

Smoking then occupational carcinogen exposure

What are modifiable breast cancer risks?

Smoking. Alcohol consumption. Sedentary lifestyle. Dietary fat intake. Post menopausal weight gain. Hormone Therapy

What are risk factors for COPD?

Smoking. Prolonged exposure to chemicals and dust. Air pollution. Genetics

What activities should glaucoma patients avoid?

Sneezing because it increases intraocular pressure

What do you clean the periurethral with to prevent CAUTI?

Soap and water

What would be an appropriate toy for a toddlers to help developmental skills?

Soap bubbles. Stacking. Nesting toys

What is behaviors of schizoid personality disorder?

Social detachment. Inability to express emotion. Prefer to be isolated and does not enjoy close relationships.

What is a concern for an older adult with diminished hearing and vision?

Social isolation

What would a prolapsed cord feel like?

Soft. Rubbery on palpation. Maybe pulsating.

Which cranial nerves are sensory, motor, or both?

Some Say Marry Money But My Brother Says Big Boobs Matter More

What is an example of suspected child abuse with a newborn?

Spiral fracture from rolling off the bed. Not possible with a nonambulatory child.

What is a life threatening emergency when dealing with sickle cell disease?

Splenic sequetration disease

What are Braxton-Hicks contractions?

Sporadic uterine contractions that sometimes start around six weeks into a pregnancy. However, they are not usually felt until the second trimester or third trimester of pregnancy.

What are manifestations of Pleurisy?

Stabbing chest pain that increases on inspiration caused by inflammation of the visceral and parietal pleura

What is the priority for amnesia patients?

Stabilize client physically before psychosocial needs are addressed

What patients can use a low flow oxygen system?

Stable COPD

What are the parameters for safe administration of a systemic analgesia for a laboring client?

Stable maternal vital signs. Fetus with heart rate of 110-160. Well established labor contractions. Cervix dilated to at least 4-5 cm in primipara and 4 cm in multipara

What is the sequence to examine an abdomen?

Stand on right side. Inspect. Ausculate. Percuss. Palpate

What is nursing management for a newborn?

Standard contact isolation with blood or fluids. Maintain airway. Administering Vitamin K given IM in the vastus lateralis and prophylactic eye ointment.

What can be done to prevent epiglottis in children?

Standard immunization. Epiglottis is caused by Haemophilus influenza type B.

When should be the first visit to the dentist for a child?

Start within first 6 months of eruption or by first birthday

What are physical activities that a patient with Juvenvile Idiopathic Arthritis (JIA) can do?

Stationary biking. Swimming. Throwing or kicking a ball. Yoga.

What is an alternative to a Mobile walker for infants?

Stationary walkers. Play areas

What is the priority nursing action for a client experiencing a panic attack?

Stay with the client in a calm environment and offer support and reassurance that the client is safe and secure.

What is the process for the nurse if a patient is falling already?

Step slightly behind the patient. Place hands around waist or under axillae. Move one foot back and extend the front leg forward. Let patient slide down the extended leg to the floor.

How do you prevent infections with a laboring client with ruptured membranes?

Sterile glove for vaginal examinations.

What kind of wound treatment is used for burns?

Sterile saline soaked gauze. Silver based dressing. Vaseline gauze and bacitracin. After 24-48 hours, negative pressure can be used.

What type of drug is Ritalin?

Stimulant

What does Filgrastime do?

Stimulate neutrophil production

What are ways to prevent dehiscence?

Stool Softners. Antiemetics. Abd binder. Tight glucose control <180

What is done if extravasation is suspected?

Stop infusion and aspirate fluid. Immbolize and elevate affected extremity. Contact MD. Administer Phentolamine. DO NOT flush the catheter. Reinsert IV on unaffected extremity or central line

What are the steps when a blood transfusion reaction occurs?

Stop the blood transfusion. Using new tubing infuse normal saline into the vein. Administered prescribed vasopressor. Collect urine specimen. Document the occurrence

What not must be done with vasoactive medications?

Stopped abruptly, it can cause hemodynamic instability. These type of meds need to be tapered slowly.

What is contraindicated in a patient who have had a open radical prostatectomy?

Straining. Suppositories. Enemas. These will add stress to suture line and problems with healing

What is the cause of acute glomerularnephritis?

Streptococcal infection

How do you check for rooting reflex?

Stroke the infant's cheek

What are important parts in caring for a client with autism spectrum order?

Structure and consistency. Example is a daily schedule of activities. Limiting number of visitors and choices can help avoid overstimulation

What is a important nursing intervention for a child with ADHD?

Structured, consistent, and organized environment. Example is a written schedule

What is Dissociation?

Subconscious defensive mechanism that makes someone involved in a traumatic event forget they were there.

How is growth hormone replacement therapy given?

Subcutaneous injections

What is distractable speech?

Subject is changed mid speech in response to a stimulus

What is the next step if a chest tube disconnects from the chest drainage system and cannot be reattached quickly or the unit cracks?

Submerge the distal end of the tube in a bottle of sterile water/saline.

How do you remove the infant from the breast during breastfeeding?

Suction should be broken using a finger inserted beside the gums

What is symptoms of a ruptured spleen?

Sudden onsent of severe abdominal pain in the upper left quadrant

What is retinal detachment?

Sudden onset of floaters or a curtain appearing in the vision. Gnats/hairnet/cobweb effect throughout the visual field

What is the most common symptom of an ischemic stroke in children?

Sudden onset of numbness or weakness of an arm and/or leg

What are clinical signs of Uterine rupture?

Sudden onset vaginal bleeding, constant abdominal pain, cessation of uterine contractions, loss of fetal station, fetal deterioration. Abnormal fetal heart rate pattern. Maternal Tachycardia.

What is a classic sign of renal stones?

Sudden onset, right sided flank pain radiating to the groin.

What are the clinical signs of Placental abruption?

Sudden-onset vaginal bleeding, abdominal pain, hypertonic/tender uterus, tachysystole (frequent uterine contractions)

What is said during Recommendation in SBAR?

Suggestions from yourself

What do you need to monitor for with taking anticonvulscents like Levetiracetam?

Suicidal ideations. New or increased agitation or anxiety. Mood changes. Depression. Rash, blistering, conjunctivitis as it is associated with Steven Johnson syndrome

What are contraindications for sulfa meds?

Sulfa drugs. Pregnancy. Breastfeeding

What position must be the patient after a lumbar puncture?

Supine

What position should a patient be in after a femoral cardiac catherization?

Supine

If patient is on restraints, what position is not beneficial?

Supine increases aspiration risk

What are nursing interventions for a patient on Buck's traction?

Supine position or at most 20-30 degrees. Assess for neurovascular status and skin integrity. Providing a fracture pan. Weights are free hanging. Staff may support weight when patient is being repositioned up the bed. Do not turn the patient.

What can affect the mother's ability to breastfeed exclusively?

Supplemental formula feedings. Artificial nipples.

What are preventive measures for Polycythemia Vera?

Support stockings. Elevating legs when sitting. Hydrating properly. Monitor for swelling in the legs. Avoid hot showers/baths

What is a priority for bladder exstrophy?

Surgical Repair. Placing a protective film of plastic over the exposed bladder before surgery will keep the tissue moist and help prevent infection.

What are interventions for colorectal cancer?

Surgical colon resection. Chemo. Radiation

What is the treatment for a subdural hematoma?

Surgical evacuation of the hematoma is necessary to relieve the pressure on the brain.

When transporting a patient with airborne precautions, what should the patient wear when outside the room?

Surgical mask

If there is tube dislodgement <7 days from placement, what must be done?

Surgical or endoscopic replacement

What FHR requires a follow up?

Sustained fetal tachycardia >160/min for >10 mins

What is the early signs of Hypoglycemia?

Sweating. Weakness. Tachycardia. Tremor. Hunger. Without tx can lead to seizures or coma.

What is Volkmann contracture?

Swelling of the antecubital tissue causes pressure within the muscle compartment, restricting arterial blood flow (brachial artery). It is a Medical emergency

What should patients with Polycythemia Vera monitor for?

Swelling, tenderness, redness of the legs.

What are the symptoms of testicular torsion?

Swelling. Severe pain. One testicle more elevated than the other.

What are features of Rheumatoid Arthritis (RA)?

Symmetrical pain and swelling that affects small joints of the hands and feet. Morning joint stiffness that lasts 60 minutes to several hours.

When does precipitous birth occur?

Takes place < 3 hours after the onset of contractions

What is a serious complication of metoclopramide?

Tardive Dyskinesia.

What is common during the first 24 hours of postpartum?

Temperature and WBC are normally elevated.

What are symptoms of tennis elbow?

Tenderness over the lateral epicondyle

What test must be done for Myasthenia Gravis if muscles are tense?

Tensilon Test

What are the 5 T's of reversible causes of aystole/PEA?

Tension pneumothorax. Tamponade (cardiac). Toxins (drugs). Thrombosis. Trauma.

What is the Romberg test used for?

Test ataxia.

What is the first sign of puberty for boys?

Testicular enlargement. THEN appearance of pubic, axillary, facial, and body hair. Voice changes.

What does a PAC look like?

The P wave goes up higher than a regular P wave

When palpating the the presenting fetal part, and you feel a soft diamond shaped structure, what are you touching?

The diamond shaped anterior fontanelle, which places the fetus at cephalic (head down)

What position should a patient with pneumonia be placed?

The good lung down to improve V/Q matching and gas exchange.

What are the CDC recommendations for someone to get a private room?

The infection is colonized and the bacteria can be transmitted to others.

What is important when caring for a patient with Gonorrhea?

The need for the partner evaluation and treatment to prevent reinfection and disease transmission

What must be done in the event of a visitor emergency?

The nurse must implement facility protocol to help get the visitor to the emergency department

When a parent tells the nurse than an infant cries all the time, what should be assessed?

The pattern, frequency, and quality of the child's crying.

What cranial nerve abnormalities are present at time of birth?

There should be none present.

What type of burn would show singed body hair?

Thermal burns

What is the practice of mothers of Arabian ancestry regarding breastfeeding.

These women value privacy and modesty. They will bottle feed at the hospital and begin breast feeding when discharged.

What do American Indians and Asians have in common when communicating with them?

They will avoid eye contact because in their culture it would be rude to make eye contact

What is leukorrhea?

Think, milky white vaginal discharge that is NORMAL during pregnacy due to increased levels of progesterone and estrogen.

Which trimester should NSAIDs be avoided?

Third due to risk of premature closure of the fetal ductus arteriosus.

What stage is the placenta delivered?

Third stage

When is supine hypotensive syndrome seen?

Third trimester

What can Clopidogrel cause?

Thrombocytopenia and increase risk of bleeding

How should IV potassium be given?

Through a pump to prevent cardiac arrest. Slowing down the rate will help with the irritation

How is an EpiPen used?

Through clothing in the mid outer thigh area and held for 10 seconds then massaged for additional 10 seconds.

How does HIV transmit to mother and child?

Through the placenta. During delivery. Through breast milk

What is a concern for COPD patient when receiving oxygen?

Too high a level of inspired oxygen can depress the respiratory drive to breathe. Therefore if a patient is on oxygen prn, you should reevaluate the O2 sat with oxygen off.

What is Capsaicin used for?

Topical analgesic to relieve minor peripheral pain.

What is management for Psoriasis?

Topical/Systemic medications (Moisturizers). Phototherapy (UV light, Sunlight). Avoidance of triggers and alcohol.

How is genital herpes spread?

Touching the lesions and then rubbing or scratching another part of the body can spread the infection.

What can ulcerative colitis put a patient at risk for?

Toxic megacolon

What are TORCH infections?

Toxoplasmosis. Other (Parvo B19/Varicella). Rubella. Cytolomegavirus. Herpes Simplex. These group of infections can lead to fetal abnormalities

What is the main sign of a tension pneumothorax?

Tracheal deviation.

What medication would you give for the "death rattle"?

Transdermal scopolamine or Atropine sublingual drops to dry out secretions

What is Sublimation?

Transforming unacceptable thoughts or needs into acceptable actions

What would the herbal supplement, Saw Palmetto, be used for?

Treat BPH

What is Benztropine (congentin) used for?

Treat Extrapyramidal symptoms

How do you triage radiation contamination patients?

Treat the farthest from the source first. Most damage is internal.

What is the goal of acute pericarditis therapy?

Treat the underlying cause.

What is indicative of spina bifida occulta?

Tuft of hair at the base of the spine. Sacral dimple

What can Primary open angle glaucoma cause?

Tunnel vision

What is the initial intervention for supine hypotensive syndrome?

Turn client to the left or right side to relieve pressure on the vena cava.

What are tips to reduce the risk for aspiration for a patient with dysphagia?

Turn head from time to time. Flexing chin slightly downward. Place food at strong side of mouth.

What are the steps for defibrillation?

Turn on. Place pads. Charge up. Ensure all clear. Shock.

What position must be a patient with Air/Pulmo Embolism?

Turn pt to the left and lower head

What must you do for a peritoneal dialysis if outflow is inadequate?

Turn side to side

How are twins counted in the GTPAL system?

Twins or triplets count as 1 of the term or preterm category but counted seperately in the living child.

Where is the fundus at 20-22 weeks gestation?

Umbilicus

What is agnosia?

Unable to recognize familiar objects, tastes, sounds, and other sensations

What is anomia?

Unable to remember names of things

Is falling asleep during conversation following narcotic administration good?

Unacceptable. Means no additional narcotics should be administered.

What is a contraindication to epogen therapy?

Uncontrolled hypertension

How does a 10-12 year old child see death?

Understands that death affects everyone

How does a 6-9 year old child see death?

Understands that death is permanent but has difficulty in perceiving one's own death

What is cryptorchidism?

Undescended testes on newborns that usually descend by first year of life.

What is assessment for DVT?

Unilateral edema. Calf pain or tenderness to touch. Warmth and erythema. Low grade temp

Besides CAUTION, what are other signs of cancer?

Unintentional weight loss (<10). N/V. Dysgeusia (Altered taste sensation)

What is the cause of schizophrenia?

Unknown. Probably a combination of genetic, biochemical, structural, and developmental factors

What is the patient's appearance to Vfib?

Unresponsive. Pulseless. Apneic

What patients can use a high flow oxyen system?

Unstable COPD

What is a manifestation of Wilm's tumor?

Unusual bulging/swelling on one side of a child's abdomen

What is Psychogenic gait?

Unusual standing postures and walking

What is correct technique for instilling ear drops to child > 3 yo?

Up and back. In a prone or supine position

What is expected at the water seal chamber?

Up and down movement of the fluid

How soon would allergic reactions occur after a allergy shot?

Up to 24 hours after. Redness and swelling at injection site is expected

Where is the preferred central line access for adult clients?

Upper body to minimize the risk of infection. If placed in the femoral due to emergency situations, should be removed asap due to high risk of contamination and infection.

What are nursing strategies to help feed a child with cleft lip?

Upright position. Pointing nipple away from the cleft. Feeding no more than 30 mins. Using special nipples or bottles. Feeding every 3-4 hours. Burped at regular intervals to reduce gastric distention.

What position should a patient be in for a paracentesis?

Upright. High fowlers with empty bladder

What is hypospadias?

Urethral opening below the penis

What is epispadias?

Urethral opening on top of penis

What is the tx for a mechanical bowel obstruction?

Urgent surgical intervention

What does Phenazopyridine hydrochloride (Pyridium) do?

Urinary analgesic relieve symptoms of dysuria associated with a UTI

What are normal findings of an infant?

Urinary output of 2mL/kg/hr. Flat fontanel

What do you need to monitor for with a patient who had surgery for Hypospadias?

Urinary output. Absence for an hour indicates obstruction.

What is a complication of Tolterodine?

Urinary retention

What are factors for UTI?

Urinary stasis. Constipation. Infrequent voiding

What is best indicator for patient hydration?

Urine output

What must you look for post op from Hypospadias?

Urine output

What is the best indication that the bladder irrigation is running at a adequate rate?

Urine output is light pink in color

What is a expected side effect from Phenazopyridine hydrochloride (Pyridium)?

Urine will turn orange and red

What should be included in patient teaching for crutches?

Using a small bag to hold personal items to keep hands free.

What are some techniques to help insomnia patients?

Using bed only for sleep. No reading or watching television. Avoiding caffeine, stimulants, or exercise within 6 hours of bedtime. Avoiding going to be hungry. Keeping room cool and dark. Get out of bed if not asleep within 20 mins

What are teaching strategies for low literacy clients?

Using pictures and simplified text. Including a family member. Professionaly produced programs.

What techniques are used for changing central line dressing changes to prevent complications?

Using sterile gloves and masks. Instruct to turn head away to prevent respiratory secretion contamination. Instruct patient to hold their breath.

If a patient has a foley catheter, how may you collect a urine specimen?

Using sterile technique

When do side effects go away when taking Selective Serotonin Reuptake inhibitors (SSRIs)?

Usually 3 months

What are some indicators that for toilet training readiness?

Usually occurs 18-24 months. Child's ability to express the urge to defecate or urinate. Understand simple commands. Pull clothing up and down. Walk to and sit on toilet.

Describe basal cell carcinomas

Usually on sun exposed areas. Translucent, smooth, and raised. Rarely metasizes

What does a boggy uterus indicate?

Uterine atony

What is the most common cause of early Postpartum hemorrhage?

Uterine atony (boggy uterus)

What are risk factors of postpartum hemorrhage?

Uterine distention. Uterine fatigue >24 hrs. High parity. Certain meds (Mag sulfate, Prolonged use of oxytocin, Inhaled general anesthesia)

What do clients who have had a cesarean delivery before and would like a vaginal delivery now put themselves at risk for?

Uterine rupture

What does having tachysystole put the patient at risk of?

Uterine rupture

What does late decelerations with minimal variability indicate?

Utero-placental insufficiency. Further assessment

What do late decelerations indicate?

Uteroplacental insufficiency

What is the next step if the uterus fails to become or remain contracted after massage?

Uterotonic administration

What is prevention against Human papillomavirus (HPV)?

Vaccination preferably before sexual activity begins. Safe sex practices.

What can cause vaginal hematomas?

Vaccum or forceps assisted delivery. Epistomy.

What is used to treat SVT?

Vagal maneuver initially then Adenosine

What is the treatment for SVT?

Vagal maneuvers. Adenosine. If unstable, synchronized cardioversion.

What is a pessary?

Vaginal support device recommended for pelvic organ prolapse

What are labs for nephrotoxicity that need to be reported to the MD?

Vanco trough >20. Creatinine >1.3. BUN >20

What is VEAL CHOP?

Variable FHR (cord compression). Early Decel (Head compression). Accels (OK No problem). Late decel (Placental insuff)

What should be avoided when using oxygen at home?

Vaseline. Using cooking oils and grease. Nail polish remover. Synthetic and wool fabrics causes static.

What does Phenylephrine do?

Vasoconstrict to increase blood pressure

Where are IM injections given for children < 7 months?

Vastus lateralis

What is the site of IM injection for toddlers?

Vastus lateralis. Located on the upper outer quadrant, between the greater trochanter and the knee.

Who is at most risk for macrocystic (B12/Folate) anemia?

Vegans

What can trigger Goodpasture syndrome?

Viral infections. Surgeru of the lungs or kidneys

What is Middle east respiratory syndrome?

Viral respiratory illness caused by Coronavirus. Spread by respiratory secretions

What does a renal arteriogram do?

Visualize renal blood vessels to detect abnormalities such as renal artery stenosis or aneurysm

What is macrocystic anemia?

Vitamin B12 or folic acid deficiency

What can help iron absorption?

Vitamin C foods

What will increase the absorption of Iron?

Vitamin C. Empty stomach

What can be used for secondary parathyroidism to help absorption of calcium?

Vitamin D

What is the antidote for Warfarin?

Vitamin K

What can compartment syndrome lead to?

Volkmann contracture as a result of ischemia from compartment syndrome.

What are signs of hypercalcemia?

Vomiting. Polyuria. Weakness. Fatigue. Constipation. Polydipsia. Nephrolithiasis (Kidney stones)

What is the expected WBC of Acute cholecystitis?

WBC > 11000

What is a green trauma status?

Walking wounded.

What are developmental milestones for 4 year old?

Walks down stairs with alternating feet. Balances on 1 foot. Catches a ball. Draws a square. Cuts with scissors. Ties a simple knot. Names 2+ colors. Likes telling stories. Begins imaginative/ group play. Recognizes analogies. Often focused on self.

What are developmental milestones for 3 years old?

Walks up stairs with alternating feed. Pedals a tricycle. Jumps forward. Draws a circle. Feeds self without help. Grips a crayon with fingers instead of fist. 3-4 sentences. Asks "why" questions. States own age. Begins associative play. Toilet trained, except wiping.

What are the developmental milestones of 2 years old?

Walks up/down stairs alone 1 step at a time. Runs without falling. Kicks ball. Builds 6-7 block tower. Turns 1 book page. Draws a line. 300+ word vocabulary. 2-3 word phrases. States own name. Begins parallel play. Begins to gain independence from parents.

What are the developmental milestones of 18 months old?

Walks up/down stairs with help. Throws a ball overhand. Jumps in place. Builds 3-4 block tower. Turns 2-3 book pages. Scribbles. Uses cup/spoon. 10+ word vocabulary. Identifies common objects. Has temper tantrums. Understands ownership ("mine"). Imitates others.

What are interventions for a patient with moderate Alzheimer?

Wander alarm. Household devices (Gas stoves) should be removed. Water temp lowered to prevent injury. Keyed deadbolts

What is given to patients with prosthetic valves?

Warfarin

How do you clean a recently circumcised newborn?

Warm water. Avoid soap and alcohol based wipes.

What should be done to otic medication when taken from the refridgerator?

Warmed to room temperature by holding bottle in palm of the hand. Instilling cold drops cause a reaction leading to dizziness and vomitting.

What will childbirth classes cover during early pregnancy?

Warning signs of complications. Nutrition. Anatomy. Fetal development.

What is the prodromal phase of a seizure?

Warning signs that precede a seizure

What is patient teaching for ACE inhibitors?

Watching for development of a dry cough. Taking several minutes to get out of bed. Possible allergic reactions (rash, angioedema). Tetratogenic effects of the drug.

What is a characteristic of urolithiasis?

Wavelike flank pain

What kind of pulse is expected from a near drowning patient?

Weak and thready pulse

What will you see with coarctation of the aorta?

Weak lower and strong upper extremity pulses/BP

What are symptoms of a rotator cuff injury?

Weakness. Severe pain when the arm is abducted between 60-120 degrees (painful arc)

What is patient teaching for a patient with a brace for scoliosis?

Wear a cotton t shirt under the brace.

What is treatment for strabismus?

Wear a eye patch over unaffected eye to strengthen the weaker eye

What is client teaching for Raynaud phenomenon?

Wearing gloves when holding cold objects. Dress warm. Avoid extremes and abrupt changes in temperature. Avoid vasoconstrictive drugs (Cocaine, Drugs, Pseudoephedrine). Avoid excessive caffeine. No smoking. Stress management techniques (yoga)

What is the duration of Naloxone?

Wears off in 1-2 hours

What are interventions for a patient on Methylphenidate?

Weighed regularly at home or school. Monitored for weight loss. Monitor BP and cardiac rhythms

What are life modifications to prevent gout episodes?

Weight Loss. Increase fluid intake. Low purine diet by avoiding organ meats and certain seafoods. Limiting alcohol. Low fat diet

What are signs of third spacing?

Weight gain. Decreased urinary output. Tachycardia. Hypotension.

What is Failure to Thrive (FTT)?

Weight less than 80% of ideal for age

When can DTaP be given?

When can DTaP be given?

When is post exposure prophylaxis for HIV infection the most effective?

When given within 2 hours

What is an infection precaution that patients in droplet isolation should follow?

When outside the room, the client must wear a mask

What increase the absorption of calcium?

When taken within an hour of meals. Vitamin D also enhances the absorption

What can affect the absorption of calcium?

When taking an excess of 500mg/dose

When can a central line dressing be changed?

When the dressing no longer covers the line. Loose corners may be reinforced with tape.

What are common findings on the first trimester?

Whitish vaginal discharge, unless accompanied by foul odor, redness, or itching. Cramping in the lower abdomen and inguinal region. Systolic murmur. Urinary frequency.

What unacceptable blood product alternatives for Jehovah Witness?

Whole blood. PRBCs. White cells. Platelets. Plasma

What is macrobiotic diet?

Whole grains. Veggies. Fruits. Seaweed. Occasionally Fish and seafood.

What are manifestations of Hirschsprung disease?

Will not pass meconium within 24-48 hours. Distended abdomen. Bilious emesis. Difficulty feeding

When should pancreatic enzymes be given?

With all meals and snacks. Should not be chewed or crushed. Swallowed whole or sprinkled in acidic food (applesauce, yogurt)

What is the time line for gastric lavage to be done to be effective for a drug overdose?

Within an hour of overdose

When is a Pavlik harness most successful?

Within the first 6 months of life.

What is the nurse's role in informed consent?

Witness signature and client signed voluntarily. Competent to provide consent. Received necessary information and has any further questions.

Who does not to be Pap screened?

Women >65 with previous normal results do not need testing. Women who had a hysterectomy with cervical removal

How often should women be be pap screened?

Women age 21-65 are screened every 3 years. Women >65 with previous normal results do not need testing

What can cause carbon monoxide toxicity?

Wood/Coal stoves or appliances used in poorly ventilated settings

What is dysarthria?

Worsening ability to speak. Scanning speech due to weakened muscles used for speech

What is manifestations from Volkmann contracture?

Wrist contracture. Inability to extend the fingers

Where is the xyphoid process at 36 weeks gestation?

Xyphoid process.

What is expected after circumcision of a newborn?

Yellow exudate indicates a healing process and should not be removed forcefully

What are symptoms of Trichomoniasis?

Yellow green, frothy discharge with a fishy odor and an accompanying itch.

What color is breast milk within the first 3-4 days of giving birth?

Yellow, watery colostrum before the real breast milk kicks in.

Can you shave the area with hair when inserting IV?

You may trim because shaving can leave portals of entry for microorganisms.

Who is at most risk for nosocomial infections?

Young children. Elderly. Immunocompromised clients, esp with indwelling catheters, surgical incisions, long hospital stays.