RN Nclex study- Mark Klimek
What drug should NOT be given to the patient with chemotherapeutic thrombocytopenia? 3 s/s of thrombocytopenia?
ASA epistaxis, ecchymosis & petechiae
OVER 40
AT WHAT AGE SHOULD A PERSON HAVE A YEARLY WORK UP EXAM FOR CANCER DETECTION
virulence means
Ability of an organism to produce disease
Piaget: 12-15 yrs old: formal operations. ____ thinking, teach like an ____. They can manage care.
Abstract, adult
What is dependancy
Abuser gets sig other to do things for them, harmless
What causes the itching seen in renal failure?
Accumulation of wasted in the blood and the associated signs. This occurs in the end stage renal failure.
Drug used to treat herpes
Acyclovir
Benzodiazepines: anti- _____. Mild tranquilizers. "zep" in name. "Zzzzz"= sleep (tranquilized). Ex: diazepam- valium, lorazepam. Works ___ but shouldn't be on for longer than 2-____ weeks
anxiety, quickly, 4
AWS room assignment
anywhere, semi private
artery widened in a thoracic aneurysm
aorta
auscultory areas of heart
aortic, pulmonic, erbs points, tricuspid mitral
INFLAMMATION, OBSTRUCTION
appendicitis is an _______ of the appendix due to ______
15-35
appendicitis occurs most in what age group?
hot spot RLQ
appendix, colon, ovary, fallopian tube, ureter
no - only those contaminated with secretions
are all articles used by AIDS patietns double bagged
Mongolian spots
areas of deep bluish-gray pigmentation most commonly on the sacral aspect of a newborn
What does the cervical spinal cord control
arms & diaphragm
Cervical vertebrae/neuro damage: affects diaphragm and ____. Monitor respirations. Thoracic: monitor cough and ____. Lumbar monitor bladder and ____.
arms, bowels, legs
Ex: pt withdrawing from cocaine: Respirations < 12, difficult to ____, etc. Need ____
arouse, narcan
URETHRA , RETENTION
as the prostate enarlges it compresses the _____ and causes urianry _____
med surg if you dont know pick
assess LOC, establish airway
is sao2 is under 93
assess resp, give o2
begin nursing on the side that the baby finished on the last feeding
assuming no mastitis, on which side should the breastfeeding begin
lethal arrythmias
asystole
subtotal thyroidectomy
at risk for thyroid storm/crisis/thyroidtoxicosis stay with pt S&S of thyroid storm: 1-hyperpyrexia (high fever 104+) 2-really high VS (HR 200, BP 210/190) 3-psychotic delirium treatment: high flow rate O2, decrease temp with ice packs (5), spare the brain
2 years old
at what age are accidental poisonings most common
MEN OVER 50 YEARS OLD
at what age does BPH occur
P wave
atrial
V fib: you D fib (defibrillation). Asystole treatment: epinephrine first then _____.
atropine
AsystolE
atropine, epi
Clozapine is a .....
atypical tranq
Hallucinations: sensory, most common is ____- voices telling them to hurt self. Illusion: sensory, a referent in reality- something to which a person ____- actually something there
auditory, refers
The inheritance pattern of sickle-cell anemia is _____ _____.
autosomal recessive homozygous - has a defective gene from each parent
Antabuse/Revia is
aversion therapy
Tyramine foods: "BAR" B- bananas, A- ____, R- raisins (or dried fruit). Also, aged ____, yogurt, alcohol, ____
avocado, cheese, chocolate
Pt teaching antabuse
avoid all alcoholic products
MAOI
avoid tyramine foods like: avocado, smoked meats, cheeses, fruits and veggies with tyramine -- remember salad BAR --> Bananas, Avocados, Raisins no organ meats: liver, kidney, tripe, heart, etc no preserved meats: smoked, dried, cured, pickled, hot dogs no aged cheeses, no yogurt no alcohol, elixirs, tinctures, caffeine
which aminoglycosides are not mean old mycins
azithro, clarithro, erythro
what is milia, epstein pearls, mongolian spots, erythema toxicum
baby acne, spots on gums, blue bruises, rash
Compensated means pH is
back to normal
Permanent restrictions for a laminectomy?
Do not lift by bending at the waist No crazy activities... jerky rides, horseback riding
Draw trough 30 min before next ____. Draw peak: sublingual 5-10 min after drugs is _____. IV 15-30 min after drug is finished. IM 30-____ min
Dose, dissolved, 60
Acidosis pt goes... K goes
Down, Up, hypo, decreased, suppressed
s/s of lead poisoning
Drowsiness, clumsiness, ataxia, seizures, coma, resp. arrest
In males, what is the most common sign of gonorrheal infection?
Dysuria or purulent discharge
When weakness is distributes, use these gaits
EVEN (2/4)
FALSE
EVERYONE WITH ANGINA NEEDS BYPASS SURGERY T/F?
When stuck between two answers go ____ and read question. When you don't know what something is- Re- read question ____ what it is you don't know.
back, without
What happens to the kidney in AGN (acute glomerulonephritis)?
It becomes clogged with antigen-antibody complexes which then cause inflammation and loss of function.
What is a voiding cystogram? do you need a catheter?
It is a series of X-rays taken as the person with a full bladder is asked to void. The X-rays show any reflux of urine back up the ureters (a dye if injected prior to this) YES
Hard plastic toys don't harbor ____, easy to clean. 0-6 months old: best toy is a mobile or something ____. 6-9 months: teaching object permanance, best toy- ____ uncover toys. Ex: jack in box, window books
bacteria, soft, cover
ALTERED BODY IMAGE
a major mental/ emotional nursing diagnosis seen in anorexia nervosa _____
Aminoglycoside is
a mean old mycin
What is pylonephritis? what organism often causes it? treatment?
bacterial infection of the kidneys E. coli treatment - IV antibiotics for 1-2 wks; urine culture 2 wks after antibiotics are over
FHR late decels, what to do
bad!, hr slows at end or after contr, LION
late decelerations
bad, HR slows at beginning of contraction
FHR low variability, what to do
bad, LION
Fetal HR monitoring, low hr <110, what to do
bad, LION
Low baseline variability? (aka heart rate not changing)
bad, lion
Chest tube: intermittent bubbling in suction control is ____, means suction is not high enough in container- turn suction ___. Never clamp a tube longer than ____ seconds without doctor order
bad, up, 15
what do if tube disconnected&on floor
bag tube, call resp for replacement, reconnect
Preschoolers: finger dexterity and ____. Cooperative play, ____ play. School age: 3 C's- creative (legos), _____, competitive (don't like losing). Adolescents: _____ and friends are main focus
balance, pretend, collective, socializing
tyramine is in what foods(not bad)
banana avocado raisins
2 ways to correct intussusception major complication of intussusception?
barium enema or surgery complication - necrosis
s/s of croup
barking cough, hoarseness, inspiratory stridor, labored respiratory pattern
HH why does acid come back
bc stomach herniates through diaphragm
activity order for pt w/severe pre-eclampsia? best position?
bed rest left side lying
haldol SE, ABCDEFG
anticholinergic, blurred vision, constipation, drowsiness, EPS(fake parkinsons), fotosensitivity, agranulocytosis
prozac SE ABCDE
anticholinergic, blurred vision, constipation, drowsiness, euphoria
tricyclic antideppresant SE, ABCDE, teaching
anticholinergic, blurred vision, contstipation, drowsiness, euphoria, takes 2-4 weeks to work
pts on what class of drugs should use an electric razor?
anticoagulants
SSRI Prozac is a
antidepressant
phenothiazine in low doses is a
antiemetic
AWS and DT get what med
antihypertensive and vit B1 to metabolize alcohol
CCB treats
antihypertensive, antianginal, anti atrial arythmias
drug class for pts w/an aneurysm
antihypertensives
CCBs treat
antihypertensives, antianginals, anti atrial, arrythmia
Deconoate is a , what form, used for
antipsychotic long acting, IM, court ordered
what causes cast syndrome? major s/s? treatment?
anxiety & stress leads to sympathoadrenal shutdown of the bowel s/s: N & V due to bowel obstruction treatment: NPO, NG tube for decompression
what are benzos used for
anxiety, preop anesthesia, relax muscles, seizures, aws,
most important intervention in treating AGN
bedrest can walk IF hematuria, edema & HTN are gone
classic & unique s/s of pernicious anemia
beefy red tongue, numbness & tingling of hands, sores in mouth, chest pain
PAIN MEDS, ENEMA LAXATIVE AND FOOD ! NPO
before the client with suspected appendicitis sees the physician what should be avoided?
OB: baby must have ID band on ____ leaves delivery area. Placental delivery (stage 3): make sure its ___ there, check for 3 vessel cord. "AVA"- two arteries one ____
before, all, vein
somatic delusion
belief that something highly unusual is happening to one's body or internal organs
Pregnancy: positive station- presenting part is ____ ischial spines. Negative station- part is above spines. 0 station- part is at ischial spines. ___: the position of babys spine to mothers spine
below, Lie
what principle states that it is right to take positive action to help others
beneficence
The tremors of Parkinson's will get better or worse when they purposefully move or perform a task?
beter, they tremor more when not performing an action
cornictorus means
bilirubin in CSF
lithium is for, its a
bipolar, antimania
nevus, nevi
birthmark
Vtach is
bizzarre and tachy wide QRS
What does the lumbar spincal cord control
bladder and legs
mustard gas
blisters
hemothorax, chest tube removes
blood
hep B is through
blood
routes of transmission of HIV AIDS
blood sexual contact breastfeeding placenta in utero
probable signs of pregnancy
blood and urine tests, Chadwick's sign, Goodell's sign, Hegar's sign
what is idiopathic thrombocytopenia purpura? cause? 2 major complaints r/t ITP? which organ is often removed?
blood disease in which there is a severe decrease in platelets cause: autoimmune s/s: epitaxis & bleeding gums spleen is often removed; it destroys old platelets
what is polycythemia vera? complexion of pt? diet of pt?
blood disease in which there is an inc in erythrocytes, leukocytes & platelets complexion -- ruddy red, almost purple diet: low iron
if youre given anything related to _____, select calcemia
blood pressure
Probable/Presumptive signs(explkain)
blood/urine test, chadwicks(cervical color), goodells(cervix soft), hegars(soft uterus)
When pulmonary edema is severe what does the sputum look like?
bloody and frothy
Congenital heart defects: either trouble or no trouble. Remember TROUBLE- use consanants. T- trouble, R- right, B- ____, L- left. "Trouble, blue, shunts blood right to ____"
blue, left
first s/s of MS
blurred or double vision
Phenothiazines s/e: ABCDEFG. A-anticholingergic, dry mouth. B- _____ vision. C- constipation. D- drowsiness. E- ____. F- Fotosensitivity. G- agranulocytosis. At risk for ___
blurred, EPS, injury
Active Stage Labor
cm dilated = 5-7 cm Contraction frequency: 3-5 minutes duration: 30-60 seconds intensity: moderate
Transition Stage Labor
cm dilated: 8-10 cm contraction frequency: 2-3 min duration: 60-90 seconds
hot spot LLQ
colon, ovary, fallopian tube, ureter
what criteria of APGAR score will a baby get a 1 on?
color - most have acrocyanosis (blue extremities) on the 1 min test
Obtunded: almost _____. Calcemias do the _____
comatose, opposite
what is autonomic dysreflexia? Vital signs? what do you do first? then what do you check?
common complication of quad in response to a full bladder or bowel vs: sweating, headache, N/V, SEVERE HTN first- raise HOB next: check bladder & bowel
MacKussmaul is...P
compensatory
Dumping Syndrome
complication of p/o gastric surgery in which gastric contents dump too quickly into the duodenum
piaget 7-11yr, what period, focus, when what how teaching
concrete thinkers, rule oriented one way to do something, teach days before, what you are gna do with skills, audio/visual reading materials
Piaget: 7-11- ____ operations. Rule oriented, teach ___ ahead. Teach what your going to do plus ____, with age appropriate reading and demonstration.
concrete, days, skills
What type of hearing loss is associated with otosclerosis?
conductive
Hearing aids are more useful in sensory or conductive hearing loss?
conductive hearing aids only AMPLIFY sounds, do NOT clarify
dromotropic
conductivity
how to treat denial
confront it, point out difference bw what they say and do
Denial treatment- _____ (for abuse) Don't say "you" say "I" Ex: I'm having trouble interpreting this. Loss and grief: DABDA- denial, ____, bargaining, depression, acceptance. Treatment- ______
confrontation, anger, support
Signs of O2 toxicity
confusion headache
Flight of ideas: ideas all other the place, phrases are coherent but not tightly ____. By themselves they are coherent but together ____ coherent.
connected, not
downers
constricted pupils
isolation precautions for meningitis
contact & respiratory precautions
Syrups and elixirs are of particular concern to diabetic clients because....
contain sugar
Dumping syndrome what happens and when
content dumps too quickly, post op compl. after gastric surgery
treating wheezes
continuous, narrowing of the airways treated with bronchodilator, albuterol
When is bubbling good in the suction control chamber?
continuously
oxytoxic med methergine causes....to.... SE
contraction to stop bleeding, high BP
Late decelerations: heart rate slows down near the end or after _____- BAD. Do LION. Early decels: fetal heart rate slows ____ or at beginning of contraction- not bad
contraction, before
Sub total thyroidectomy/ thyroid storm treatment: get temp down- ice and ____ blanket. O2 at 10 liters. ____ with patient, wait till come out of it.
cooling, stay
blood test for rh factor
coombs test
Variable decels: VERY BAD. Prolapse ____- push baby head up, put mom in knee chest position. Fetal HR tracings that begin with letter "L" do ____, they are bad
cord, LION
VEAL CHOP- write vertical, next to each other. V- variable= ____ compression. E- Early decel= H- head compression. A- acceleration (high fetal HR)= O-___. L- Late decels= P-_____ insufficiency
cord, OK, placental
Important assessment of pre-op thoracic laminectomy
coughing & bowel sounds
what movements should be avoided post cataract surgery?
coughing, sneezing, bending at waist, straining at stool, rubbing or touching eyes, rapid head movements
if a chest tube comes out, then you...
cover the hole, put on Vaseline, dry sterile dressing
if chest tube comes out?
cover with gloved hand, put vaseline gauze on and tape on three sides
6-9mo what toy
cover/uncover
General guessing: When want to answer all of the above- choose an answer that ____ all others.
covers
to prevent UTIs, diet should be acidic. This includes:
cranberry juice, apple juice, breads & meats
school age 7-11
creative, collective, competitive
7-11y what kind of play
creative, competitive, collective
what is the common name for laryngotracheobronchitis? are antibiotics helpful?
croup NO; helpful for epiglottis
4 point gait
crutch, leg, opposite crutch, opposite leg
swing thru gait
crutches planted and swing thru
over secretion of ACTH know as
cushing's disease
difference between cystitis & pyelonephritis which precedes the other? 5 s/s that pyelo had that cystitis does NOT
cystitis involves the bladder/urethra, pyelonephritis involves the kidney cystitis precedes pyelo s/s of pyelo: fever, flank pain, chills, inc WBC & malaise
How do you assess fluid excess in the child with AGN?
daily weights
When a stump is wrapped, the bandage should be tightest _____________ and loosest _____________.
distally; proximally
what drug class is used first to treat HTN
diuretics
3 drugs classes used to treat CHF
diuretics digitalis vasodilators
Pediatric dose: always _____ by 2.2. Crutches: length of crutch- 2 to ____ finger-widths below the anterior ____ fold to a point lateral or slightly in front of the ____. Hand grip- elbow will be about ___ degrees
divide, 3, axillary, foot, 30
who do you NOT give tetracyclines to? and what can you NOT have it WITH
do NOT give to pregnant women or kids <8 NOT with milk products
what instruction is most important to give the pt undergoing thoracentesis
do NOT move or cough
psych and gift giving
do not give/receive gifts from patient
precaution with hypothyroid
do not sedate! & always need thyroid med before surgery
yes - vast majority of all clients recover completely from it
do people recover from AGN
haldol is a ...form(route, duration), same as the....
doconate form, im long, zines
yes - if wbc counts are low
does AIDS require a single room
no
does a first degree burn have vesicles
yes
does stress make acne worse
Aminophylline: airway antispasmotic. When bronchodilator _____ work give a phylline then bronchodilator. Range: 10-20. ____ is toxic
doesn't 20
sythetic/natural narcotics
done youre done with pain
pain medication rules in labor
dont administer a systemic pain medication if baby likely to be born when med is peaking
psychotics have narrow self concept so...
dont force them to do anything
infant's birthwt should _____ in 6 months & ______ in 12 months
double; triple
with downer things go?
down, hr, decreased, hypo
Magnesium sulfate: hypermagnesemia- does opposite, everything goes ____- heart rate, BP, Respirations, ____ and reflexes. Want +2 reflexes, if +1 need to ____ magnesium down, if + 3 need to increase it.
down, loc, slow
Crutches and stairs- up with the good, ____ with the bad. Hold cane on ____ side. Advance cane and bad leg at same time. Walkers- pick them up and set them down, then ____ to them.
down, strong, walk
Withdrawal from upper: not enough upper makes everything go ____. Not enough downer makes everything go ___. Boroborigmy: increased bowel sounds
down, up
constricted pupil
downer
#1 treatment for autonomic dysreflexia
drain the bladder & empty the bowel
phenothiazine teaching, Dx
drink, chew gum, safety, sunscreen, report infections, stool softeners, Safety!
Children at highest risk for seizure activity after ingestion are those who have swallowed _____________ and ______________.
drugs and insecticides
S2
dub, closure of aortic and pulmonary valves
3 adult stages of development (w/age range)
early adulthood: 19-35: intimacy vs isolation middle adulthood: 35-65: generativity vs stagnation late adulthood: 65 to death: ego integrity vs. despair
Lantis is ...acting and ..... absorbed, no risk for, duration
fast, slowly, hypoglycemia, 10-24hr
Hiatal hernia treatment: you want the stomach to empty _____ so it doesn't regurgitate. Dumping syndrome treatment: want stomach to empty _____.
faster, slower
Delirium tremors: can be _____, unstable. NPO or clear ____, private room near nurses station. restricted bed ____, must be restrained. Very dangerous. Both Al with syndrom and delir trem get antihypertensive, tranquilizers and vit ____
fatal, liquids, rest, B1
A, D, E, K
fats carry vitamins
9
fats provide _____ Kcalories per 1 gram
Contact precautions: for anything interic- _____, oral. C-diff, Hep A (anus) and ____ infections, herpes. RSV is a droplet but kids touch everything so its ____.
fecal, staph, contact
Teach reality: 1st acknowledge ____. 2nd present reality, 3rd set a limit. Last ____ the limit. Ex: presenting reality- "I know that you see that demon but I don't see that demon" Setting a limit- "we're not gonna talk about that"
feelings, enforce
positive signs of pregnancy
fetal skeleton on xray, fetal heartrate, fetal US, fetal palpation/movement
top signs of rejection
fever/malaise
what principle claims that it is right to keep promises
fidelity
preschool 3-6 yrs
fine motor skills balance cooperative play pretend play
3-6y what work on, what kind of play
finger dexterity, balance, cooperative/pretend
Chest tubes: if tube comes out: 1st put gloved ____ over hole on patient. 2nd cover hole with vaseline ____.
finger, gauze
Nutrition: Toddlers- ____ foods even if not healthiest answer. Preschoolers- 1 meal a day is ____, leave them alone
finger, ok
postpartum uterus should be, fundus height is, what is involution
firm and midline, equal to day postpartum below belly button, contracting
L&D recovery fundus should be.....if not.....
firm and midline, if boggy massage, if displaced go to bathroom
in a patient with hypercalcemia which monitor pattern would be the most likely threat?
first degree heart block with decreased ST segment and inverted T waves
12-18 y what kind of play, not if....
group, not in post op, immunocompromised, contagious
what is endometriosis? most common s/s? major complications?
growth of endometrial tissue outside of uterus s/s: dysmenorrhea, painful menstruation complications: infertility
psychotic patients have
hallucinations, illusions, delusions
she inserts her little finger into the side of the infants mouth
how does the mother break the suction of the breast feeding infant
AT WHATEVER RATE IT TAKES TO KEEP THE URINE FLOWING AND FREE OF CLOTS
how fast do you run the CBI
c-section
how is an infant delivered when abruptio placenta is present
to the lateral thigh or abdomen
how is the Catheter taped in a male client
to the upper thigh
how is the catheter taped in a female client
2-3 weeks after initial infection
how long after strep infection does AGN develop
less than 1/2 hour
how long can a unit of blood be on the unit before it must be started
6 months
how long can breast milk be frozen
24 hours
how long can breast milk be refrigerated
24 hours
how long does it take a cast to dry
7-14 DAYS
how long does it take for the umbilical stump to fall off
4-6 MONTHS
how long is complete recovery from the paralysis of bells palsy
at least 1 week
how long must women with CD of pregnancy be on bed rest after delivery
1-3 hours
how long should it take for one unit of blood to infuse
12-24 hours
how long should the stump be elevated to prevent post op swelling
15-30 mins
how long should you stay with the patient after beginning a transfusion
4-6 weeks
how long will it take for the person to see results when acne is being treated
2
how many nurses are required to check the blood
Q4H with blood pressure
how often are vital sign measurement taken in AGN
every 30 to 10 mins
how often must you assess the lung sounds during the first stage of labor? during active labor? during transition labor?
DAILY
how often should a stump be washed
BID
how often should the client with acne wash his face each day
Q8H
how often should the drainage bag be emptied?
Q5-15 minutes for bleeding, maternal VS and continuous fetal monitor
how often should you measure the VS, vaginal bleeding, fetal HR during abruptio placenta
DROPPING WATER ON INSIDE SURFACE OF YOUR FOREARM
how should the temperature of the water be tested if no thermometer is available
natremias do what
hypEr dehyration, hypO overload
tocolytic mag sulfate can cause, in which....
hypermagnesemia, everything goes down, resp depression, reduced LOC, reflexes depressed,
cushing pt will have ____ natremia, _____ kalemia & _____ glycemia
hypernatremia, hypokalemia & hyperglycemia
what do addisons pt have, they look....
hyperpigmentation, brown
NMS vs EPS
hyperpyrexia with NMS, 104-108
Symptoms of thyroid storm
hyperpyrexia, VS in 200s, psychotic delirium
Cushing's syndrome
hypersecretion of cortisol moon face hirsutism acne retain water buffalo hump central obesity osteoporosis irritability, high BP, high sugar
common electrolyte imbalance after thyroidectomy
hypocalcemia - due to accidental removal of parathyroids
total thyroidectomy at risk for? why?
hypocalcemia, no parathyroid
what is the #1 cause of infant illness when the mother has DM? when is it likely to occur? why is it a problem?
hypoglycemia most likely to occur in the hours following delivery brain cells die w/o glucose, brain damage
call for medical help
if a child swallows a potentially poisonous substance, what should be done first
urine and blood
if a transfusion reaction is suspected what two sample are collected and sent to the lab
sto blood flow and run saline
if a transfusion reaction occurs what should the nurse do first
warmed
if a unit of blood is infused through a central line it must be _____
PHANTOM LIMB SENSATION ( WHICH IS NORMAL)
if after a right BKA, the client c/o pain in his right toe, he is experiencing ______
what is umbrella strategy
if all answers are right, ppick most broad one
1:10 solution of bleach and wter
if an aids patients blood contaminated a counter top, with what do you clean
ALL SIGNS OF SHOCK - DECREASED LOC , RESTLESSNESS, TACHYCARDIA, HYPOTENSION
if an aneurysm is ruptured how would you know it
GET THEM TO THE OPERATING ROOM ASAP
if an aneurysm ruptures what is the #1 priority
how to you know if HH or GERD
if happens when you lie down after eating its gerd if not HH
staff management interventions
if its illegal --> tell supervisor if the pt or staff is in immediate danger or harm --> confront and take over if the behavior is simply innapropiate --> counsel them later on
80mmHg
if my BP is 190/110 what is my pulse pressure
protective (reverse) isolation
if the AIDS patient has leukpenia they will be on_____
sudden onset of SOB (dyspnea)
if the client with CD of pregnancy experience sudden heart failure what is the most common thing you will see
NO BED REST UNTIL THE CLIENT IS STABLE
if the client with aneurysm is physically unstable should you encourage turning coughing and deep breathing
PRONE ( TO PREVENT FLEXION CONTRACTURE)
if the patient had an AKA they should lie ______ several times a day
hot
if there is inflammation under a cast, it will be evident in a ____ spot
high venous congestion makes the arterial pressure higher
if you deflate a cuff too slowly the reading will be too high or too low ? why ?
consistency of stool for ileostomy, transverse & descending
ileostomy - liquid transverse - soft stool descending - formed stool
phenothiazines reduce
illusions, hallucinations, delusions
Piaget: 3-6 yrs- preoperational. _____, teach shortly before or after. Teach what you are ____ to do. Use ____
imaginative, going, play
the #1 goal in emergency treatment of spinal cord injury is....
immobilization of the spine
working phase nursing
implementing plan of care - focused ,directive, tough, stern, set limits
DECREASED
in BPH the force of the urinary stream is _____
INCREASED
in BPH, the man has _____, frequency of urinartion
TASTE
in addition to facial paralysis , what sense is also affected by bells palsy
gi , hematologic, integumentary
in general, cancer drugs have side effects in which three body systems
empathy question put yourself and then
in pt shoes and ask how you would feel, pick answer
If the bubbling is _______ in a chest tube, it is BAD.
in the water seal, bubbling continuously OR intermittently in suction control chamber
semi fowlers with knee gatched
in what position should the bed bed if the patient is in pelvic traction
third
in what trimester does abruptio placenta most commonly occur?
sealed plastic bags
in what type of container should breast milk be frozen
semi recumbent, head of bed up
in which position should a woman with CD in labor be
high
in you use too narrow of a cuff the reading will be too high or low
ENURESIS
inability to control the flow of urine and involuntary urination
define meniere's disease & its triad of s/s
inc in endolymph in the inner ear, causing severe vertigo s/s: vertigo, sensorineural hearing loss & tinnitus
If you see clots in the tubing (CBI) you would first ____________.
increase the flow rate
if the blood pressure falls below 80 systolic, what would you do first in hypovolemic shock?
increase the oxygen flow rate
As in most inflammatory diseases the client has an ____ erythrocyte sedimentation rate in rheumatoid arthritis
increased
What force causes the pulmonary edema in left ventricular failure?
increased hydrostatic pressure in the pulmonary capillaries
increase or widen
increased intracranial pressure will _____ the pulse pressure
what triggers high pressure vent alarms
increased resistance to air (caused by obstructions)
Pregnancy (decreases/increases) the body's insulin requirements.
increases
thoracic complications
ineffective cough, paralytic ileus
amount of suction for the following: -infant -child -adult
infant: <80 mmHg child: 80-100 adult: 120-150
danger with premature rupture of membranes? labor begins within how many hours?
infection labor within 24 hours
most common side effect of accutane
inflammation of the lips
PERITONITIS
inflammation of the peritoneum
what is mastoiditis? s/s? unusual post-op complication from mastoidectomy vs common side effect?
inflammation/infection of the mastoid process s/s: drainage from ear, high fever, headache & ear pain, tenderness over mastoid process facial nerve paralysis vs dizziness
plague
inhalation 3 H's: hematemesis, hemoptysis, hematochezia
anthrax
inhalation resp. failure treat w/ cipro, pcn, streptomycin
CCB is negative ___, ____, ____
inotropic(force), chronotropic(rate), Dromotropic(conductivity)
which are the Cs(8)
inr high,low/high K, low co2,low po2, low saO2, low Na, low WBC, low Plts
define EGD. is the pt sedated? discomforts common during procedure vs complications?
insertion of a fiber optic scope to visualize the esophagus, stomach & duodenum pt sedated w/valium discomforts: vomiting & gagging complications: perforation of gut, aspiration secondary to emesis & resp arrest (from valium)
remove ppe
inside, alpha order, gloves,goggles,gown,mask
A non psychotic person has
insight and is reality based
prozac can cause,,,, so take it,,,,
insomnia, in the morning
sertraline causes...but give at
insomnia, night
Prozac: s/e: ABCDE. Causes ____- do not give at bedtime. Adolescents and young adults watch for ____ ideation when change dose
insomnia, suicidal
Complications of diabetes: low sugar (glucose)- hypoglycemic shock. Causes: not enough food or too much ____ and too much exercise.
insulin
DM type 1
insulin dependant
type I diabetes
insulin dependent, ketosis prone
Exercise does the same thing as ____. In questions- replace exercise with insulin. Ex: pt went to store and exercised- Pt went to store and got another shot of insulin. More exercise ____ insulin, less exercise more insulin
insulin, less
suction control bubbling
intermittent bad need to increase suction, continous is good
bubbling in h2o seal?
intermittent good like soda, continuous bad
When is bubbling good in the water seal?
intermittently
newborn addiction/withdrawal
intoxicated at birth-24hrs withdrawl after 24 hrs
drug abuse in new borns, within first 24 hours always assume
intoxication
Downers: everything goes down. Every drug not an upper is downer. Drowsiness, _____, etc. Can go into respiratory ____.
lethargy, arrest
what is the first thing you assess in a med surg situation
level of consciousness do: evaluate airway, breathing, circulation
common name for pediculosis
lice
PVCs +VTACH treat with
lidocaine, amiodarone
treatment for vent arythmias
lidocaine, amiodarone
activity restriction after a lumbar puncture
lie flat for 6-12 hours
The MORE colon is removed the more _________ the stool.
liquid
humalog insulin
lispro
AMENORRHEA
list of the most common gynecologic symptoms of anorexia nervosa
Psych: Don't use slang- they take everything ____. Empathy: nurse excepts the pts ____. Never say "I know how you feel" Empathy questions always have a ___ in question part.
literally, feelings, quote
hot spots in RUQ
liver, gall bladder, pancreas, upper colon, kidney
aminoglycosides
mean old mycins, all end in this ex. cleomycin, clindamycin, gentamycin, etc BUT NOT "thros"
airborne is for
measles, chicken pox(varicella), tb, sars
addisons pt need a .... bc they can go into.... from .....
medic alert bracelet, crisis/shock, stress
Do not delegate these to an AID (UAP): charting about the pt- can chart what they did. Give ____- except for topical OTC skin barriers. Assessments- except vitals and ____. Treatments- except ____. Cannot evaluate
meds, accuchecks, enemas
What intellectual ability is impaired after ECT?
memory
at what age does BPH occur?
men over 50 years of age
droplet is for
meningitis, influenza, kid illness(mumps, pertussis, diptheria)
Droplet precautions: ____, H flu. Private room. Mask, gloves, handwashing. Pt wear ____ when leaving room, dedicated equipment, disposable supplies.
meningitis, mask
bilirubin is csf leads to
meningitis/encephalitis
If ph & bicarb and in same direction then
metabolic
If the pH and the BiCarb are both in the same direction then it is?
metabolic
Kussmaul respirations
metabolic acidosis
if it is NOT LUNG, and is NOT GASTRIC LOSS, always pick this
metabolic acidosis
the most common cause of ALL acid-base imbalances; this is like the liver in that if you don't know the answer and this is an option, pick this one!!!
metabolic acidosis
Which acid-base disorder is MOST commonly associated with hypovolemic shock?
metabolic acidosis due to lactic acidosis
ABG's: if not lung its ______. Prolonged vomiting, or gastric ____= metabolic alkalosis. "Alk, alk" noise when vomiting. If ph and bicarb are in same direction its _____
metabolic, suctioning, metabolic
sertraline messes with
metabolism of other meds
thyroid is responsible for what
metabolism regulation
fetal lung meds, 2 examples
metamethasone, survanta(beractant)
biguanides
metformin, oral hypoglycemic
What part of the ear is involved in otitis media? 2 subjective & objective s/s treatment?
middle ear subjective - hearing loss, feeling of fullness in ear objective - hyperpyrexia (fever), drainage from ear treatment - systemic antibiotics & antibiotic ear drops
tissues from live donors
middle ear, heart valve, skin, bonw, cartilage, tendons/ligaments.corneas
3 groups of people who cannot give legal consent
minor unconscious client mentally ill
benzodiazepines
minor tranquilizers always end in pam/lam prototype: diazepam indications: induction of anesthetic, muscle relaxant, alcohol withdrawal, seizures, facilitates mechanical ventilation
FHR early decels, what to do
mirrors cont, slows down before or at start of cont, document
what is an illusion
misinterpretation of reality they see same thing but think different
Illusion
misleading appearance; false impression; misconception SENSORY experience, reference to reality (unlike hallucination)
tricyclic antidepressants are.., 4 examples
mood elevators, elavil, decaril, torphanil, avantil
MAOIs are...., work on....
mood elevators, neurotransmitters
NSSRI's: ____ elevators. Ex: elevil, toprodil, avotil, desoril. Elevil- elevate. S/E: anticholingergic, blurred vision, constipation, drowsiness, ____. Take for 2-___ weeks to achieve full effects.
mood, euphoria, 4
cush man has
moon face, acne, retains h2o, muscle atrophy, hirsutism, irritable, immunocompromised, gynecomastia, buffalo hump, central obesity, straie, gynecomastia, stretch marks, easy bruising, loses K, glucose stays
Be concerned about PVCs when
more than 6 per minute, more than 6 in a row, PVC falls in T wave previous
Ventilators: high pressure alarm: when needs to pump ____. Could have a kink or ____. Low pressure alarm: could have _____. Respiratory alkalosis: ventilator setting too _____
more, blockage, disconnection, high
discomforts of pregnancy
morning sickness, urinary incontinence, dyspnea, back pain
What is cleft lip and cleft palate? #1 complication?
most common forms of cngential defect affectng the mouth, they occur alone or together lip - open to nares palate - open to nasopharynx complication - ASPIRATION
PI's (protease inhibitors)
most potent of antiviral med. inhibit cell protein synthesis that interferes with viral replication. does not cure but slow progression of AIDS. prolongs life, used prophylactically and used in AIDS to decrease viral load and opportunistic infections
tyramine is in what foods very bad
organ meats, no smoked pickkled etc, no aged chees, no alcohol/elixir, no caffiene, no OTCs
what is Prevner 13? who should get PVC13? type of immunity?
pneumococcal conjugated vaccine people over 60 active immunity
pneumonia of AIDS is caused by
pneumocystic carinii
cervical complications
pneumonia
When a pt hates someone but then expresses the opposite emotion, it is called ____
reaction formation you form the opposite reaction
if you dont know med question then
read without med
Psychotic patients lack
reality and insight
introductory orientation phases nurse/patient
should be tolerant, accepting, explorative probing, nosy, be warm and fuzzy
FORCED
should fluids be forced or restricted in BPH
no the patient should not ambulate independently depth perception is altered
should the client ambulate independently after cataract surgery
no
should the drainage bag ever touch the floor
no risk of radiation hazard
should the nurse provide perineal care for the client with a cesium implant
no - not for gas or any other petroleum products
should vomiting be induced after ingestion of gasoline
no
should you cover a wet cast
NO FOLD THE DIAPER DOWN
should you cover the unhealed umbilical site with the diaper
NO NOT UNTIL FORESKIN RETRACTS NATURALLY AND WITHOUT RESISTANCE -- THEN IT SHOULD BE RETRACTED, CLEANSED AND REPLACED
should you retract the foreskin of a 5 week old male uncircumcised infant to cleanse the area?
NO RECTAL TEMPERATURES, YES STOOL SOFTENERS
should you take a rectal temp after prostatectomy? give stool softeners?
fan
should you use a heat lamp, hair dryer or fan to help dry a cast
no it may cause sneezing also should avoid pepper
should you use talcum powder with a post operative cataract client
most common tested area in pharm
side effects - choose side effect in the same body system where drug acts
what is codependancy
sig other gets self esteem from it
what is the difference between structural and functional scoliosis
structural - born with it functional - get it from bad posture
FRUTIS, VEGGIES
sucrose is a sugar found in _____ and _____
what is meant by paroxysmal nocturnal dyspnea? what does orthopnea mean?
sudden episodes of difficulty breathing SOB while lying flat
psychotic delirium
sudden, dramatic, temporary loss of reality d/t chemical imbalance, acknowledge then reassure
key words to avoid in psych
suggest that... advise the patient tooo..... tell the patient to..... if i were you, i would.... you ought to.... you should... you should not do..... dont do.... recommend that.....
Inappropriate behavior from staff: are they doing anything illegal? if yes- tell ____. Is anyone in physical or psychological harm? if yes- ____ and take over. Is this legal, not harmful but simply inappropriate? if yes- talk later on with them. Never choose ____ it
supervisor, confront, ignore
Denial from loss
support
the cause of respiratory distress syndrome (infant) is lack of _______
surfactant
beractant (ACTANT)
surfactant -- give to baby, breathed in, after baby is born
trouble hear defects need
surgery, monitors, med,
ectomy
surgical removal
-ectomy
surgical removal of
pts with RA have a deformity of the wrist/hand called
swan-neck deformity
what is caput succedaneum, hyperbilirubinemia, vernix caseosa, acrocyanosis
swelling bw skin and skull, crosses suture line, jaundice for 1 week, cheeslike on baby, limbs blue
amputation needs what gait
swing thru
alkolitic, low potassium
tachy, hyper, exaggerated, rising
teaching for a pt on tetracycline
take on a empty stomach & avoid sunlight
auto graft
take tissue form self
MOA inhibitors
takes 2-4 weeks to work monoamine oxidase is the enzyme responsible for breaking down norep, dopamine, serotonin *IF IT DEALS WITH DEPRESSION and IT ASKS ABOUT DIET ---> ALWAYS MAOI
warfarin
takes days to work only oral antidote: vitamin K LABS: PT, PTT cannot give to pregnant women
Ideas of reference: think people are ____ about them.
talking
laminectomy
teats nerve root compression s/s: pain, presthesia, paresis locations: cervical, thoracic, lumbar
staff mgmt 3 things you can do for inappropriate behavior
tell supervisor, intervene and take over, discuss later
ACRPCYANOSIS
temporary cyanotic condition, usually in newborns resulting in a bluish color around the lips, hands, fingernails, feet, and toenails. may last for a few hours and disappear with warming
what is delirium
temporary episodic dramatic secondary onset of loss of reality due to chemical imbalance
2 ways to determine if drainage post craniotomy is CSF
test for glucose halo effect on gauze
FLEXION, HIP
the #1 contracture problem in AKA is _____ of the _____
T-lymphocytes (or CD4 cells)
the AIDS virus invades helper....
2nd diastolic sound
the cessation of sounds is known as
pulse pressure
the difference between the SBP and DBP
20
the goal is for the infant to breast feed for _____ minutes per side
off the bed enough to slop a hand between the sacrum and bed
to ensure bryants traction is working the childs hip/ sacrum should be in what position
why do you use a CBI after TURP? what solution do you use? How fast of a rate?
to keep the catheter clear of clots and to drain urine. use normal saline at whatever rate it takes to keep the urine flowing & free of clots
FOLWERS (A SITTING POSITION) (ALSO USE POST OP)
to lessen the pain, place the client with appendicitis in _____ position
call MD because blood is often held with an elevated temp
what would you do if the client had an increasing temperature and was to get blood
systolic
when 2 values are given in a blood pressure the first is the _____ measurement
cessation of sound
when 2 values are given in a blood pressure, the bottom number stands for the change in sounds or cessation of sounds
unaffected
when a patient is in bucks traction they may turn to the _____
DISTALLY (FAR FROM THE CENTER), PROXIMALLY (NEAREST TO THE POINT)
when a stump is wrapped, the bandage should be tightest _______ and loosest _____
Manipulation is
when abuser gets sig other to do things for them that are harmful
first 10-15 minutes
when are hemolytic transfusion reaction likely to occur
when to use 2-4 points gait
when both legs affected, 2 for mild, 4 for severe
swing thru when used
when both legs braced or amputation
FALSE INNER TO OUTER
when cleansing an infants eye, cleanse from outer to inner canthus? T/F
if you are going to get contaminated with secretions
when do you need a gown with aids ?
not unless they have an infection caused by an airborne bug
when do you need a mask with AIDS?
suctioning, central line start, arterial procedures
when do you need goggles with aids
whenever a client is to get a blood product. it is only good for 24 hours
when does typing and cross matching need to be done
Tips for pediatrics questions
when in doubt choose "this is normal behavior" when it doubt, pick the older age when in doubt, choose the easier task
within 30 minutes of beginning the transfusion
when is a febrile reaction likely to occur
3 point gait used when?
when one leg affected
systolic
when pressure is auscultated the first sound heard is the systolic measurement
after feeding from each breast
when should the breast feeding infant be burped
when you see bright thick blood, persistent clots, persistent urine on dressing ( dont call MD for transitory clots and urine on dressing)
when should you call the MD after TURP
98.6F
when sponge bathing with tepid water the correct temp is _____
suspected poison
when taking a child to the ER after accidental poisoning has occurred what must accompany the child to the ER
bleeding precautions; no IM;s no rectal temperatures, other bleeding precautions
when the AIDS patient has a low platelet count, what is indicated
PROTEIN, FAT
when the body does not recieve enough carbs it burns _____and _____
if an introcular lens is implanted they will not need glasses if no lens is implanted then contact will be fitted for 3 months post op, temporoary thick glasses given immediately but will get a different prescription in 2-3 months
when the client asks about the use of glasses or contacts after cataract surgery what would you say
mydriatics, dilator, antibiotic drugs
when the lens is to be extracted for cataracts what drugs are given preoperatively
wet
when using silver nitrate the dressings must be kept ______
IN A FEW MONTHS
when will phantom limb sensation subside
RLQ
where does the pain of appendicitis finally end up ?
head of bed
where should the nurse provide care to the client with cesium implant
THE ABDOMINAL IS MOST OFTEN "SILENT"
which aneurysm is mostly likely to have no symptoms
brachial
which artery is most commonly used to measure blood pressure
lower only
which extremities are affected by buergers disease
Prioritization
which patient or unstable answers have 4 parts: ignore age and gender the modifying phrase is more important than the diagnosis/surgery ACUTE VS CHRONIC
males
which sex does buergers disease affect the most often
fluoride and iron
which two nutrients is breast milk low in
undifferentiated is worse to have (highly differentiated is better to have)
which type of tumor is more malignant? differentiated or undifferentiated?
THE PULSE AND BLOOD PRESSUR
which vital signs are most important to measure in clients aneurysm
total thyroidectomy removes
whole thing
35-64
wht is the age range for middle adulthood
prevent thrombophlebitis due to venous congestion usually in legs
why are anticoagulants (heparin only) given to women with CD of pregnancy
to promote diuresis - lowers circulating blood volume, decrease preload, decrease the amount of blood the heart pumps
why are diuretics given to women with CD of pregnancy
to increase the strength of the heart and to decrease the rate, rest the heart while making it more efficient
why is digitalis given to women with CD of pregnancy
PVC are
wide bazzare periodic qrs
V-tach
wide bizzare qrs
HTN, because of fluid retention
will the client have hypo or hyper tension with AGN? why?
NOCTURIA AND MAYBE HEMATURIA, NOT ENURESIS
will the man with BPH have enuresis , nocturia or hematuria
NO
will the patient with bells palsy be able to close their eye on the affected side
TURP-no impotence; PERINEAL PROSTATECTOMY- yes
will the post prostectomy patient be impotent
yes
will the woman with cesium implant have a foley
what time of day do you give NSAIDS
with meals
what time of day do you give steroids
with meals TAPER DOSE TOO
plain water, before and after each feeding
with what solution and when should a breast feeding mother cleanse the areola
EYES ALWAYS
with which body part do you begin when bathing an infant
Drug addiction in newborn: always assume intoxication not _____ at birth. After ____ hrs it can be withdrawal
withdrawal, 24
stand precautions or blood and body fluid precautions
without leukopenia the aids patient will be on _______
Empathy: Do not choose answer that reflects their ____, choose one that reflects what pt FELT. Ex: "your killers, you killed my mom" she feels scared, pick answer about her being scared.
words
heparin
works right away, IV and SQ antidote: protimean sulfate LABS: PTT can be given to pregnant women
If your not interrupting patients meal to give Lispro your doing it ____. Do not give it before, only with meals
wrong
HH which direction and rate
wrong direction right rate
SSRI antidepressant
x out depressions, xet/xep/pramine, xet, xep, pramine
if Vfib then...
Dfib
What is Chadwick's sign?
Blue-tint to the cervix
what do miotics do for the eye?
Constrict the pupil
2nd biggest problem in abuse
Dependancy/Codependancy
PLATELETS
WHICH CELLS ARE LOW IN THROMBOCYTOPENIA
asystole
a lack of QRS depolarizations (flat line)
treatment for cushings
adrenectomy
CD4 under _______ is associated with the onset of AIDS related s/s
500
Chadwick's sign
Bluish-purple coloration of the vaginal mucosa and cervix
Treatment for DM type 2
Diet, activity, oral hypoglycemic
trouble heart defects all start with .... and....
T left hyperplastic vent syndrome
ASA
WHAT DRUG SHOULD NOT BE GIVEN TO THE PATIENT WITH CHEMOTHERAPEUTIC THROMBOCYTOPENIA
NITROGLYCERIN
WHAT DRUG TREATS ANGINA PECTORIS
HAIR LOSS
WHAT IS ALOPECIA
BRUISING
WHAT IS ECCHYMOSIS
NOSE BLEEDS
WHAT IS EPISTAXIS
METASTASIS
WHAT IS IT CALLED WHEN CANCER SPREADS?
ALOPECIA
WHAT IS THE #1 INTEGUMENTARY SIDE EFFECT OF CHEMOTHERAPY
CD4 COUNT
WHICH TEST IS THE BEST INDICATOR OF THE PROGRESS OF HIV DISEASE
Paranoid/Persecutory Delusion
falsed, fixed belief that people are out to harm you
another name for hyperthyroid
grave's disease
aminoglycoside treats
mean old infections like life threatening, resistant
thyroidectomy
risk for hypocalcemia s/s hypocalcemia = TETANY, numbness, tingling,
homograft
tissue form another human
xeno graft
tissue from another species, only temporary
CRIES VIGOROUSLY
A HIGH SCORE OF 2 IS GIVEN FOR RESPIRATORY EFFORT IF THE NEWBORN ______
NO MOVEMENT LIMP
A NEWBORN RECEIVES A SCORE OF 0 ON MUSCLE TONE WHEN THERE IS 0 MOVEMENT
as the pH goes, so goes my patient. what does this mean?
-as the pH goes up, so do chemical rxn in the body (hyper) -as the pH goes down, so do chemical rxn in the body (hypo)
FEMALES, 25
ANOREXIA ARE USUALLY ____ UNDER THE AGE OF ______
milia
Distended sebaceous glands which appear as tiny white spots on the baby's face. NORMAL.
BENIGN PROSTATIC HYPERTROPHY
what does BPH stand for ?
TRANSURETHRAL RESECTION OF THE PROSTATE
what does TURP stand for ?
check for surface antigen on the red blood cell
what does blood typing mean
All congenital heart defects that are trouble start with a ?
T: tetralogy of fallot, etc
answers that are generally true are NEVER specifically wrong. what does this mean?
-do not run from general answers -run from specific answers
Unstable: acute illness, post op less than ___ hrs, general anesthesia, Newly ____- less than 24 hrs ago newly diagnosed, ____ assessment
12, admitted, changed
How do you remember aminoglycosides?
"A mean old mycin" all drugs will end in "mycin"
tricyclic antidepressants
"A trip" A trip makes you happy
intermittent claudication
what does the buergers patient experience upon walking
Sub Q: "S" looks like a "5" so pick answer with two ___'s in it. Ex: 25 guage 5/8 inch. Heparin: given ___ or sub q. Coumadin: given PO ONLY.
5, IV
3 types of obstructions that trigger high pressure vent alarms and their interventions IN ORDER
-kink in the tube (check for kink) -water in the tube (empty it out) -mucous in the airway (TCDB 1st) (suction-last resort NI)
cloudy, milky white pupil
what does the eye look like when a client has cataracts
active phase of labor, dilation, duration, strength, freq
5-7cm, 30-60sec, 3-5min, moderate
EGO INTEGRITY
"if i had to do it over agin, id live my life just about the same is an example of _____ -- the result of positive resolution of the final life crisis. viewed as the key to harmonious personality development; the individual view their whole life with satisfaction and contentment
PHRASES TO AVOID IN PSYCH QUESTIONS
"refer patient to" "have you spoken to your...about this?" why dont you talk to ____ about this?
preinteraction phase nurse right answer
"the nurse will explore his/her own feelings about"
Drugs that end in "mycin" that arent aminoglycosides have what?
"thro" in the middle of the name so you "thro" them out
antiviral
"virs"
Diabetic Ketoacidosis (DKA)
#1 cause is acute viral upper respiratory infection within the last week
When one leg is ODD, use these gaits
(1,3) ODDS
6-9 months life toys
(object permanence) best toy: cover/uncover toy second best: large and firm
postop care for spinal cord
*LOG ROLL for spinal cord!!!* dont dangle limit sitting 30 min
four defects in tetralogy of Fallot.
*VarieD PictureS Of A RancH* ventricular defect pulmonary stenosis overriding aorta right hypertrophy
DROPLET ISOLATION
*all influenzas, all meningitis, diptheria, purtussis, mumps* -private room, gloves, mask, handwashing, pt wears mask when leaving room, disposable supplies
CONTACT ISOLATION
*herpes, MRSA, VRE, C-diff (enteric), RSV (droplet also)* private room, gloves, gown, handwashing, disposable supplies
AIRBORNE ISOLATION
- Measles (Rubella) - Tuberculosis - Varicella virus chicken pox, HZV shingles - private room, mask, gloves, gown, handwashing, respirator for TB, negative air flow
the ONLY exception to the above rule and what it means
-potassium is the only exception to the rule -as pH goes up (alkalosis), K levels go down -as pH goes down (acidosis) K levels go up
if CO2 is the only value given, what do we know and what must we do?
-we know it is ALWAYS respiratory -just look at pH to determine alkalosis or acidosis
3 names for CCBs
-zem -dipines isoptin "Iso zam dipine in the calcium channel"
Pt med question: take each option and ask "if I didn't do this what's worse that could happen" choose the ____ outcome. Ex: which is highest priority for suicidal pt? Give tranquilizer, orientate to unit, put on suicide precautions, introduce to staff. If no suicide precautions they could die so best answer.
...
QRST: ventricular _____
...
engagement is station
0
latent phase of labor, dilation, contraction, duration, strength, freq
0-4cm, 15-30sec, 5-30min, mild
Therapuetic level & toxic level of Lithium
0.6 - 1.2 >2
creatinine level
0.6-1.2
lithium ther level, toxic level
0.6-1.2, >2
creatinine lab, which priority? if dye used?
0.6-1.2, A, B
Therapuetic level & toxic level of digitalis
1 - 2 >2
If a women forgets to take pill one day, what should she do? forgets 2 days? forgets 3 days?
1 day: take it as soon as she remembers 2 days: 2 pills for 2 days in a row then resume schedule 3 days: throw pack away & start new; use back up for 7 days
IM injection, how long, how thick
1&1, 1 inch, 1mm
Grief stages
1) Denial 2) Anger 3) bargaining 4) depression 5)Acceptance
Priorities maslow
1) Physiological 2)Safety 3)Comfort 4)Psychological 5)Socialogical 6)Spiritual
3 characteristics of wernickes
1) preventable (take Vit B1) 2) arrestable(can stop it by taking vit B and cut down drinking) 3)irreversible(cant fix dementia)
symptoms of wernickes
1) psychosis from vit B1/thiamine deficiency(dementia bc brain damaged) 2) amnesia with confabulation(making up stories)
hyperglycemia in type 2(HHNK)
1)hyperosmolar 2)dehydration
Regular insulin: big "R" on bottle. Onset ____ hour, peak 2 hrs, duration 4 hrs. Its _____ so its a solution, can IV drip. Rapid short acting. R-rapid and ____ (in IV)
1, clear, run
DKA: high glucose. In type ___ diabetic. Diabetic coma can occur. Causes: too much ____, not enough exercise, not enough medication
1, food
digoxin level
1-2
bilirubin in neonate?
1-20 is elevated
Maslow
1. Physiological 2. Safety 3. Comfort 4. Psychological 5. Social 6. Spiritual
best way the nurse can check if the NG is in the stomach (in order)
1. measure external length of tube 2. test pH of gastric contents 3. auscultate gastric air bubble
4 point gait
1. one crutch 2. opposite foot 3. other crutch 4. other foot
haldol and elderly...need... what can happen
1/2 of adult dose, can get NMS(neuroleptic malignant syndrom)
Therapuetic level & toxic level of phenytoin
10 - 20 > 20
Hyperbilirubinemia level & toxic level
10 - 20 >20
Therapuetic level & toxic level of aminophylline
10 - 20 >20
thyroid storm happens after
10 hrs
How fast does the dialysate usually flow into the peritoneum? how long does it remain in abd? how long does it take to drain? if it does not drain well, what do you do first?
10 min to flow IN 30 min STAYS in ABD 10 min OUT have pt turn side to side
what age does an infant walk holding onto furniture?
10 to 11 months
therapeutic blood level of theophylline? s/s of toxicity
10-20 s/s: N/V (coffee ground emesis), tachycardia & tremors
Things always unstable regardless of whether its expected or not: hemorrhage, high fevers over ____, hypoglycemia, pulselessness or ____
105, breathlessness
Low fetal heart rate: below ___ do LION- this is bad.
110
Low fetal heart rate: below ___ do LION- this is bad. High fetal heart rate: above ____- not bad, monitor it and take moms temp, probably has ____
110, 160, fever
Fundus isn't palpable until week
12
fundus not palpable until
12 weeks
what lead levels needs intervention drugs used to treat lead posioning
50-60 micrograms/dl chelating agents
Rules for prioritization: ACUTE BEATS CHRONIC. Fresh post op- up to ___ hrs after beats medical or other surgical. 2 hr post op ___. UNSTABLE BEATS STABLE.
12, highest
Thyroidectomy post op: first ___ hrs top priority is airway, second is hemorrhage. 12-48 hrs after: totals can get ____ (larangeal) due to low calcium. Sub totals (partial): can get ____.
12, tetany, storms
What age does an infant stand alone?
12-13 months
hemoglobin value
12-18
na value, if change in LOC priority , do , in hypo
135-145, D, assess dehyydration, assess overload
what age does an infant walk alone
14-15 months
When to draw PEAK levels for IV route
15 - 30 min after drug is finished
handwash for..., with...
15 sec,soap water
never clamp for more than
15 seconds without dr order
Dx of anorexia made w/wt loss of ____%
15% hospitalize if 30% wt loss
Lispro and Humalog insulin: FAST ACTING. Onset ___ min, peaks 30 mins, duration 3 hrs. Give with ____.
15, meals
Humalog(fast), onset peak duration, take with what
15min, 30min, 3h, with meals
gauge of needle to give blood
18
if your are the nurse starting the iv on the client with abruptio placenta, what gauze needle should you use
18
Hemoglobin: 12-____. If its 8-11 its low priority. If below 8 its ____ priority- assess for bleeding
18, high
When does the anterior fontanel close?
18-24 months
plt value <, then
19000, bleeding precaution
If an AIDS pt blood contaminants a counter top, with what do you clean?
1:10 solution of bleach & water
Regular insulin, onset,peak,duration, route
1hr, 2hr, 4hr, iv(rapid and run)
when and what to do urinary incontinence
1st & 3rd, void q2h
A first degree burn is pale or red? a second degree burn is pale or red? dull or shiny? has vesicles? wet or dry? a third degree burn is white or red? wet or dry? hard or soft?
1st - red 2nd- red & shiny; has vesicles & is wet 3rd- white, dry & hard
Nagele's Rule
1st day of last period + 7 days - 3 months
when and what to do for morning sickness
1st tri, eat dry carb before leaving bed
pregnancy dr visits time
1x a month til 28 weeks, 1x every two weeks til 36, 1x a week til delivery/42
2 point gait
2 things move at once, crutch and opposite leg
Onset and duration of disulfaram
2 weeks
antabuse onset and duration
2 weeks
Lithium: 0.6-1.2. ____ is toxic. Lanoxin (digoxin): treats A fib and congestive HF, range ____-2, toxic level is 2.
2, 1
Labor: Recovery (4th stage): first ___ hrs after placenta delivered. 4 things every 4 hrs in 4th stage: Vitals (look for signs of shock), Check fundus, Check ____, and Roll (to check bleeding under)
2, roll
how to measure for crutches
2-3 fingers below armpit to any point in front of foot
if NG is used for long period of time, it must be replaced every ________
2-3 weeks
INR value, used for,
2-3, coumadin,
prozac takes... to work, you use it how long
2-4 weeks, for life
sertraline takes.... to work and take it for
2-4 weeks, life
scrubbing hands for, with, above
2-7 mins, bact agent, elbow
digitalis toxicity exists when blood levels exceeds ______ earlies s/s of dig toxicity
2.0 mg/dl s/s: nausea & vomiting w/headache
When does pre-eclampsia usually begin in pregnancy (week)?
20 wks
Fundus reaches umbilical level at week
20-22
Fundus typically reaches the umbilical level at week ____
20-22
CD4 under _______ is associated with the onset of opportunistic infections
200
Ph: 7.35-7.45. Bicarb (HCO3): ____-28. PACO2: 35-____
22, 45
Bicarb
22-26
Al.With.Syn. happen after ___ hours
24
how long does it take a cast to dry
24 hours
Grave disease (hyperthyroidism): radioactive iodine- pt by themselves for ___ hrs, careful with urine (if spill call hazmat). PTU- "puts thyroid under", S/e: _____.
24, immunosuppresion
Stable: ready for discharge, admitted longer than ___ hrs ago, unchanged assessment, chronic illness, post op ___ than 12 hrs, local or regional anesthesia
24, longer
maximum suction level used to decompress the GI tract via NG?
25 mmHg
Weight gain during pregnancy
28 lbs plus or minus 3 lbs
Total weight gain during pregnancy
28 lbs plus or minus 3 pounds
Pregnancy weight gain: total- ___ pounds, plus or minus 3. ___ trimester: 1 lb a month- 3 months so gain 3 lbs. 2nd and third trimester: 1 lb a ___
28, first, week
when and what to do dyspnea
2nd &3rd, tripod position
when and what to do back pain
2nd and 3rd, pelvic tilt/rock, foot on stool
red
2nd degrees burn - red or pale?
weight control
2nd to rest what is very important for CD of pregnancy
Heart sounds: Aortic- 2nd intercoastal space, right side, Pulmonic- ____ intercoastal space on left side, Tricuspid- 4th intercoastal space, Mitral (apical)- ____ intercoastal space, left side
2nd, 5th
What test confirms the diagnoses of gestational diabetes?
3 hour glucose tolerance test
cloudiness, diplopia, photophobia
3 most common visual defects that occur with cataract
3 phases of burn. in shock phase: is K inc or dec? what is the #1 therapy in this stage? what acid-base imbalance is seen in this stage?
3 phases- shock, diuretic & recovery K is inc; GIVE FLUIDS; metabolic acidosis is seen
distance, shielding, time
3 principles to protect yourself from radiation hazard
3 point gait
3 things move at once, both crutches and bad leg then good leg
bucks, bryants, pelvic
3 types of skin traction
Labor: Active phase: dilate 5-7 cm, every ___-5 min, lasts ____-60 sec. *Memorize this phase only, anything less=latent, anything more= transition.
3, 30
Heparin: works immediatly, cannot be given for longer than ___ weeks (except lovenox). Antidote- protamine sulfate. Lab test- ___. Can be given to ____ women.
3, PTT, pregnant
Creatinine: 0.6-1.2, not a priority. INR: coumadin level, 2-____. 4 or less is high priority. Hold med, ____ pt, prepare to give (antidote-vit k), then ____ doctor
3, assess, call
K+ value
3.5-5
When to draw PEAK levels for IM route
30 - 60 min after administered
When to take trough levels for all routes of medications
30 min before next dose
Insulin: peak= when pt can get hypoglycemia. Check expiration dates. Minute its opened expiration date is ____ days after- write on bottle when opened and date or when _____
30, expired
CO2 value
35-45
Pregnancy: urinary incontinence- 1st and ____ trimester, Not 2nd because the baby is up ___ of bladder. Need to void every ___ hrs
3rd, high, 2
hematocrit value is ...hg, if abnormal
3x, assess bleeding,
no small toys kids under
4
formula to calculate fluid replacement for 1st 24 hrs after a burn?
4 ml x kg x % burned each day
profuse vaginal discharge, elevated temp, nausea, vomiting
4 symptoms in a patient with a cesium implant should be report to physician
how long does it take for someone to completely recover from bell's palsy?
4 to 6 months
No small toys for children under ___ yrs old. No metal (diecast) toys if O2 is in use- can spark. Stuffed animals harbor ____- non living object that harbors bacteria
4, fomites
What age can an infant roll over?
4-5 months
How long will it take for the person to see results when acne is being treated?
4-6 wks
incubation period for TB
4-8 weeks
A person should have a yearly work up exam for cancer detection over the age of __________.
40
Bicarb: 22-26. Not a priority. Co2: 35-____. In 50's= high priority- have pt do pursed ____ breathing (gets rid of Co2) In ____= highest priority- respiratory failure, prepare to intubate and ventilate.
45, lip, 60's
Once you have stopped the bleeding into the joint, how long should the hemarthrosis patient wait before bearing weight or doing range of motion?
48 hours
how often check vitals in recovery of L&D, why, what vitals
4x an hour, q15min, check for shock, bp down, hr up
What CN is affected in Trigeminal Neuralgia? #1 s/s of tic douloureux triggers
5 episodic, severe one sided facial pain triggers - breezes, hot/cold foods, chewing, touching the face, talking
When to draw PEAK levels for SL route
5 - 10 min after drug dissolved
HOMOSEXUAL/BISEXUAL MEN, IV DRUG USERS, HEMOPHILIACS, HETERO PARTNERS OF INFECTED PEOPLE, NEWBORNS OF INFECTED WOMEN
5 RISK GROUPS OF AIDS
WBC: total wbc 5,000- 11,000. ANC (absolute neurophil count): needs to be above ___. CD4: needs to be above ___- if below= AIDS, if above = ____. All WBC labs below levels= high priority
500, 200, HIV
Hematocrit: 36-____. Is hemoglobin x3, Ex: 12x3=36, 18x3=54. High= low priority, monitor pt for ____.
54, dehydration
Potassium: 3.5-5. Low or high potassium is high priority but if it get to ___ or more its highest priority
6
concerned with pvc if
6 in min, 6 in row, if falls on twave
What age can an infant sit up unassisted?
6 to 8 months
discharge teaching of laminectiony
6 weeks: dont sit longer than 30 min, lie flat and log roll, no driving for 6 weks, no lifting more than 5 lbs for 6 wks
Whenever you don't know how long something restricted pick ____ weeks. Lamenectomy with fusion: bone ___ from ileac crest.
6, graft
PVC: more than ___ pvc's per minute or more than 6 PVC's in a row or if the PVC falls on the T wave of the ____ beat= change priority from low to _____ priority
6, previous, moderate
sickle cell anemia s/s do NOT appear before the age of ______ months due to presence of _____ ______
6; fetal hemoglobin
normal pH
7.35-7.45
normal ph
7.35-7.45
ph value
7.35-7.45
Delirium Tremens happens after ___hours
72
Never pick infection before ____ hrs post op, as an answer. Deonate = long acting.
72
Po2: ____-100. In 70's= high priority, assess respirations, give o2. When hypoxic heart rate goes up ___ then when heart can no longer compensate respiratory rate goes up. In 60's= highest priority- respiratory ____
78, first, failure
What CN is affected in Bells Palsy
7: facial
which weeks for visit
8, 12, 16, 20, 24, 28, 30, 32, 34, 36, 37,38,39,40
NPH insulin: intermediate acting. Onset 6 hrs, peak ____ to 10 hrs, duration 12 hrs. Cloudy so its a _____, No IV drip. N= not fast acting and not hung (in IV)
8, suspension
transition phase of labor, dilation, duration, strength, freq
8-10com, 60-90sec, 2-3min, strong
bun value, if low mean, what to do
8-30, dehydrated, rehydrate
What age does an infant crawl?
8-9 months
Calculate ideal pregnancy weight gain: take week of gestation and subtract ___. Fundal height: NOT _____ until week 12. At umbilicus at ___-22 weeks
9, palpable, 20
Contractions should be no longer then ____ and no closer then_____.
90 minutes 2 minutes
Platelets: below ____= high priority. Below 40,000= highest priority. RBC's: 4-___ million. Abnormal= low priority
90,000, 6
what elbow flexion for crutches
<45
what qualifies a positive mantoux?
>10 mm induration (hardness) redness does NOT impact test results
oxytoxic med pitocin, stop if contactions are...
>90sec, closer than 2min
bicarb value 22-26, if abnormal priority
A
APGAR scale - 5 parts, overall total vs max for each criteria
A - activity (muscle tone) P - pulse G - grimace (reflex irritability) A- appearance (skin color) R - respiration each criteria - max of 2 = 10 total
side effects of of phenothiazines and Haloperidol
A - anticholinergic (dry and dilated) xerostemia B - bladder retention + blurred C - constipation D p drowsiness E - EPS, extraparamidal F - fotosensitivity G agranulocytosis
BAD, BABY IS STILLBORN
A 0 ON THE APGAR IS ....
500
A CD4 COUNT OF UNDER ____ IS ASSOCIATED WITH THE ONSET OF AIDS RELATED SYMPTOMS
200
A CD4 COUNT OF UNDER ______ IS ASSOCIATED WITH THE ONSET OF OPPORTUNISTIC INFECTIONS
Adrenal Cortex Diseases start with
A or C: Addisons and Cushings
best predictor of long term blood glucose control
A1c (<7)
Setraline SE
ABCDE
decrease pH (urine is acid) , cheese, eggs, meat, fish, oysters, poultry, bread, cereal, whole grains, pastries, cranberries, prunes, plums, tomatoes, peas, corn, legumes
ACID ASH DIET
DS symptoms
ADS, Abdominal distress, drunk, shock
BLOOD, SEXUAL CONTACT, BREAST FEEDING, ACROSS PLACENTA IN UTERO
AIDS IS TRANSBISSIBLE THROUGH WHAT FOUR ROUTES
true
AIDS patients get lymphomas T/F?
#1 contracture in AKA vs BKA? how do you prevent each of these?
AKA - flexion of the hip - lie prone BKA - flexion of the knee - straighten leg while standing
THEY DONT BREATHE
AN INFANT IS GIVEN A SCORE OF 0 FOR RESPIRATORY EFFORT
SLOW OR IRREGULAR
AN INFANT IS GIVEN A SCORE OF 1 IF THEIR RESPIRATIONS ARE ______ OR _____
500
ANC (ABSOLUTE NEUTROPHIL COUNT) BELOW _____ THE PERSON ON CHEMOTHERAPY WILL BE PLACE ON REVERSE ISOLATION
which arythmias are 3rd priority
Aflutter and Afib
maoi se ABCD
Anticholinergic, blurred vision, constipation, drowsiness
antiseptic vs disinfectant
Antiseptics used for skin, disinfectant is for surfaces
Drugs contraindicated for glaucoma pts
Any drug that dilates the eyes Ex: mydriatics
Raynaud's is an arterial or venous disease? 3 things precipitate an attack? s/s of attack
Arterial disease characterized by spasms triggers: exposure to cold, emotional stress & tobacco use s/s: pain, numbness & tingling
How soon after cell damage does troponin increase?
As soon as 3 hours (can remain elevated for 7 days) NOT present in a healthy person
Signs and symptoms of acid-base imbalance principle
As the pH goes, so goes my patient except for potassium
assault vs battery
Assault = placing a person in fear or immediate bodily harm Battery = unlawfully touching a person
which arythmias are 1st priority
Asystole and Vfib
Most serious complication of opthalmia neonatrorum (gonorrhea in infant's eyes)
Blindness
When are urine pregnancy tests positive? presence of what hormone?
At the time of the first missed period HCG
Disulfaram
Aversion therapy for alcoholics; causes patient to dislike alcohol by making them sick if ingest it
if hg 8-11 priority, what to do
B, assess bleeding, prepare to transfuse, notify MD
Wernicke's encephalopathy and Korsakoff's (psychosis) usually together, induced by vit _____ or thyamin deficiency. Extreme psychotic symptoms. Go _____, amnesia, confabulation. Usually permanent. Can't learn _____
B1, insane, reality
Methergine: causes high ___. Mag- "magnum ____ shot lowers bp" Meth- "methamphetamine raises BP"
BP, 45
SUBLINGUAL
BY WHAT ROUTE DO YOU TAKE NITRO
bacteriostatic vs bacteriocidal
Bacteriostatic- inhibit growth of bacteria cidal - kill bacteria
hemangimas
Benign tumor of the capillaries.
Kernicterus
Bilirubin in the CSF/brain
Aneurysm: monitor ____- hypertension could cause it to enlarge or rupture
Bp
what four organs does HTN affect most?
Brain (stroke) Eyes (blindness) Heart (MI) Kidney (renal failure)
How can AGN be prevented?
By having all sore throats cultured for strep and treating any strep infections
Rate by priority A:spiritual distress B:denial C:L arm fx D: safety issues E: L arm pain F: dysfunctional family
C, D, E, B, F, A
if co2 is in 50's priority, what to do, if pt has copd
C, assess resp status, pursed lip breathing, call MD, dont care
low K is priority, what to do
C, give K, call md
high K is priority, what to do
C, hold k, assess heart, give kayexalate or d5w with insulin, call md
if INR is bigger than 4 its priority..., do...
C, hold, assess bleeding, give vit k, call md
When the spinal cord injury is between _____ and _____, there is permanent respiratory paralysis.
C1 to C4
IN SOME CASES YES
CAN ICE PACKS TO THE SCALP PREVENT CHEMOTHERAPY ALOPECIA
IN SOME CASES , YES
CAN SCALP TOURNIQUETS PREVENT CHEMOTHERAPY ALOPECIA
4TH
CARDIOVASCULAR DISEASE RUNS ___ AMONG THE LEADING CAUSE OF MATERNAL DEATH
tocolytic nifedipine is a..... SE are....
CCB, H&H headache, hypotension
best indicator of progress of HIV disease
CD4 count
Mycins are toxic to which nerve
CN 8
How to remember symptoms of calcium imbalance
Calcemias do the OPPOSITE the prefix but do anything to the blood pressure
Diet for type 2 DM
Calorie restriction & need to eat 6x a day
what are characteristics of dementia
Can see it on ct, they cant learn reality
3 most common reasons for a colostomy
Cancer Diverticulitis Ulcerative Colitis
Newborn complications: ____ succidana "CS= crosses suture" Cephalo hematoma doesn't ____ sutures. Physiologic jaundice appears after ___ hrs
Caput, cross, 24
The most common visual field defect in glaucoma is loss of _________.
Central vision
Open angle glaucoma vs closed = which is painful
Closed is painful
-atresia
Condition of occlusion
caput succedaneum
Crosses the suture lines
Drug given to hemophiliacs
Cryoprecipitate
if ph 6.99 or less, priority
D, assess if alive, check vs, call rapid
high k(>6) is priority, what to do
D, hold K, assess heart/EKG, if heart changes call rapid
is CO2 is in 60's what priority what to do
D, resp failure, assess, pursed lip breathing, prepare to intubate, call resp and md
What IV solution is used during labor for the diabetic?
D5W
Signs and symptoms of DKA
D: dehydration K: ketones, kussmauls, high ketones A: anorexia, acidosis, acetone breath
DKA symptoms
D:dehydration, K:ketones, kussmaul, high K, A:acidosis, acetone breath, anorexia
CRUSHING SUBSTERNAL CHEST PAIN THAT MAY RADIATE
DESCRIBE THE PAIN OF ANGINA PECTORIS
3 common complications of craniotomy?
DI, increased ICP & meningitis
how to treat type 1 dm
DIE, diet, insulin, exercise
how to treat dm type 2
DOA, diet, oral meds, activity
PPE includes
DONNING: GOWN, MASK, GOGGLES, GLOVES REMOVING: GLOVES, GOGGLES, GOWN, MASK (alphabetical!)
S/S of DKA
Dehydrated - hot, dry, flushed Ketones in blood; Kussmauls; Increased K Acidosis, acetone breath, anorexia from nausea
MS is a progressive _____ disease of the CNS. with demyelination the nerve impulses become ______ & _______
Demyelinating slow, uncoordinated
Stages of grief
Denial Anger Bargain Depression Acceptance
intimacy vs isolation
Erickson stage in which individuals form deeply personal relationships, marry, begin families
Hemophilia A is a deficiency of Factor # __________. Inheritance pattern?
Factor 8 Sex linked recessive
Why is cleft lip repaired early?
Feeding is easier after repair and appearance after repair is more acceptable to parents. at 10wks - 6 months
positive signs of pregnancy
Fetal skeleton on X-ray Fetal presence on ultrasound Auscultation of FHR (heard at week 8, most likely at 10 and should be heard by 12) Examiner palpates fetal movement
First s/s of GBS Biggest danger?
First- clumsiness in ambulation Danger of respiratory arrest
AV shunt vs AV fistula
Fistula -between artery & vein; nothing exits the skin; used indefinitely Shunt- plastic tube that connects artery to vein is outside the skin; used for weeks
Early stage hepatitis often looks like the _______.
Flu
if the drug is PO, choose
GI
3 physical symptoms of rape trauma syndrome
GI irritability, itching or burning on urination, skeletal muscle tension do NOT forget PAIN
Pharmacology: if you have no clue what the drug even is: If its po pick ____ side effect. Never tell children meds are ____.
GI, candy
cancer drugs have side effects in which 3 body systems? 3 most common GI symptoms?
GI, hematologic & integumentary GI: N/V, diarrhea & stomatitis (oral sores)
ANOREXIA, FATIGUE, WEAKNESS, DIARRHEA, NIGHT SWEATS, FEVER
GIVE 6 SYMPTOMS OF HIV DISEASE
symptoms of HH
Gerd, heartburn
What is the most common symptom of gonorrhea in females
Greenish-yellow discharge from the vagina
SE of CCB
H&H, headache hypotension
TRUE
HAIR LOSS DUE TO CHEMOTHERAPY IS USUALLY TEMPORARY T/F?
High Blood sugar in type II Diabetes
HHNK (HHNC) hyperosmolar, hyperglycemic, non-ketotic coma dehydration give fluids
Tx for hiatial hernia
HOB elevated, increased fluids, high carbs
Tx for dumping syndrome
HOB flat, fluids an hour before & after meals, low carb/high protein diet
THE PAIN OF THE TWO IS SIMILAR, THE WAY TO TELL THE DIFFERENCE IS IF NITRO AND REST RELIEVE THE PAIN. ANGINA=NITRO AND REST , RELIEVE PAIN; MI=NITRO AND REST DO NOT RELIEVE PAIN
HOW DO YOU TELL IF A CLIENT HAS ANGINA OR AN MI
5 MINS - TAKE 1 NITRO TAB EVERY 5 MINS 3 TIMES IF NO RELIEF CALL MD
HOW MANY MINUTES SHOULD LAPSE BETWEEN THE NITRO PILLS YOU TAKE
3 TABLETS
HOW MANY NITROGLYCERIN TABLETS CAN YOU TAKE BEFORE YOU CALL MD
variable decelerations
HR up or down, cord compression = VERY BAD
in nephrotic syndrome, the BP will most likely be (hypo/hypertensive)
HYPOtensive in ACUTE glomerulonephritis, the BP is hypertensive
UTI
what is the most common problem due to catheterization
What type of herpes virus causes genital herpes? 2 ways it's transmitted 2 most common sites
Herpes simplex II Sex & birth Sites: genitals & mouth
Glucose long term check
HgA1C
Why would surgeons use cadaver bones?
Hip surgery too problematics, increased recovery rate, less pain, less ifx,
what is the BIG danger in renal failure
Hyperkalemia and it's effect on the heart
Calcium channel blockers: s/e- headache, _____. End in "dipine" "Dipping into the calcium ____. Also varapamil and cardizim. Monitor bp- if systolic is under ____ don't give.
Hypotension, channel, 100
the baby must have this before leaving the mothers side
ID band
EXTREMITIES ARE BLUE (CYANOTIC), PINK
IF THE CHILD'S _____ ARE _____, AND THE TRUNK - FACE ABDOMEN ARE _____, THE CHILD SCORES 1 ON COLOR
GRIMACES
IF THE NEONATE _____, THEY WILL SCORE A 1 ON THE NEUROMUSCULAR IRRITABLITY
CHECK DISTAL EXTREMITY (FAR FROM CENTER), COLOR , TEMP, PAIN, PULSE, ALSO MUST DOCUMENT
IF YOU CARE FOR A CLIENT WHO IS POST - OP FOR A REPAIR OF A FEMORAL POPLITEAL RESECTION WHAT ASSESSMENT MUST YOU MAKE EVERY HOUR FOR THE FIRST 24 HOURS
Route aminoglycosides
IM or IV, never PO, ex. for hepatic encepalopathy
MOVE SPONTANEOUSLY (ACTIVELY)
IN ORDER TO GET A SCORE OF 2 ON MUSCLE TONE THE INFANT MUST _____
0
IN ORDER TO SCORE A 0 ON HR THE INFANT MUST HAVE A RATE OF 0
YES, BUT NOT TRANSMITTED BY ALL, ONLY BLOOD, SEMEN, AND BREAST MILK
IS HIV PRESENT IN ALL BODY FLUIDS
TRUE
IS IT PERMISSIBLE TO GIVE LIDOCAINE VISCOUS BEFORE MEALS IF THE PATIENT HAS CHEMOTHERAPEUTIC STOMATITUS T/F
Treatment of DKA
IV at high flow rate, regular insulin
Mycins administration instructions
IV or IM, every 8 hr
Aminoglycosides: Give IM and ____, Not oral. Doesn't absorb! Hepatic encephalopathy- give oral aminoglycosides since it kills ____ in gut and reduces amonia levels- won't hurt ____ since it doesn't absorb.
IV, bacteria, liver
Potassium imbalance treatment: never push potassium ____. Not more than 40 K. Give D5W with regular ____, quick fix- drives potassium into the ____ out of the blood. Also kayexalate (mouth or rectum)
IV, insulin, cell
Do Not delegate these to LPN: starting an ___, hanging or mixing IV meds. IV ____ meds, administer blood or mess with central lines, No care planning, perform or develop ____ (can re-inforce), take care of unstable pts, can't do the ___ of anything.
IV, push, teaching, first
Heparin rt, onset, duration,lab, antidote, pregnancy?
IV/subq, immediate, 21 days, PTT, protamine, ok in preg
ABG interpretation principle
If the pH and the Bicarb are Both in the same direction, it is metaBolic
word salad
Incoherent mixture of words, phrases, and sentences
in BPH the man has (inc/dec) frequency of urination? in BPH the force of the urinary stream is (inc/dec)?
Increased frequency & decreased force of urinary stream
Glaucoma is an eye disorder in which there is ____________ intraocular pressure in the ___________ chamber.
Increased, anterior Due to imbalance of aqueous humor
botulism
Ingested - Most Lethal Dies from Respiratory Arrest
Treatment for DM type 1
Insulin, exercise, then diet
accutane
what is the most common retinoid given to people with acne
Why does hyperventilation "treat" increased ICP?
It reduces CO2, resulting in vasoconstriction. CO2 is a vasodilator in the brain, vasodilation would occupy more space and thus increase ICP more.
5 Deadly Dangerous lab values
K > 6; pH in 6's; CO2 > 60; pO2 in 60's; Plt < 40,000
what labs are 5 Ds
K >6, ph <6, co2>60, po2 <60, plts <14000
how does kayexalate work
K exits late, needs time to sit in gut
alkalosis does what to K and body processes?
K goes down body processes go up
acidosis does what to K and body processes
K goes up body processes go down
with DKA treatment remember to check
K+
How to remember symptoms of potassium imbalance
Kalemias do the SAME as the prefix except for heart rate & urine output
skin
Kaposi's sarcoma is what type of cancer
slow treatment for hyperkalemia
Kayexalate
3 causes of high pressure alarms
Kink in tubing fluid in tubing mucous in airway
interventions for all other complications
LION Pit left side IV increase oxygenate notify doctor Pit = if pitocin is running and women gets in trouble, stop pitocin
Low fetal baseline variability: fetal heart rate stays the same- BAD, do ____. High baseline variability: fetal heart rate always ____- not bad
LION, changing
Med surge: first thing you assess- _____. First thing you do- establish an _____.
LOC, airway
Hypercalcemia: bradycardia, constipation, decreased ____, flaccid muscles +1 reflexes, bradypnea. Hypocalcemia: +3 +4 reflexes, tachycardia, ____, hyperactive, Chevosteck and trousseaus sign
LOC, diarrhea
Organ locations: liver- RUQ, gall bladder- RUQ, Spleen- ____, pancreas- LUQ, Appendix- ____
LUQ, RLQ
glargine
Lantus (long Acting, Laaargine) can give at bedtime, no rx for hypoglycemia no peak
what is the characteristic lesion of pemphigus
Large vesicular bullae
Scoliosis is a ______ curvature of the ______. what test confirms dx
Lateral, spine xray of spine
DILATES CORONARY ARTERIES TO INCREASE BLOOD SUPPLY (O2 SUPPLY) AND REDUCES PRELOAD
WHAT IS THE ACTION OF NITRO
Late syphilis attacks which 3 body organs?
Liver, heart, brain
Maslow's Hierarchy of Needs
Physiological, safety, comfort, psychological, social, then spiritual
In leukemia the RBC count is (high/low). platelet count is_______
Low, because the bone marrow is going "wild" producing all those immature WBCs--no energy or nutrients left over to make RBCs Low " "
trick for remembering kussmaul and what it indicates
MacKussmaul MAC=Metabolic ACidosis
How to remember symptoms of magnesium imbalance
Magnesemias to the OPPOSITE the prefix and do anything to the BP
what does an EEG measure
Measures electrical activity generated by the brain
MacKussmaul
Metablic Acidosis respirations deep
All other metabolic problems which imbalance
Metabolic acidosis
Prolonged gastric vomiting/suction which imbalance
Metabolic alkalosis
Patients who need interdisciplinary care include those with _____
Multi-Dimensional Needs physical psychological social/vocational intellectual spiritual
PTU med precaautions
N/V, immunosuppressed, watch WBCs
THROMBOCYTOPENIA, LEUKOPENIA, ANEMIA
NAME 3 HEMATOLOGIC SIDE EFFECTS OF CHEMOTHERAPY
CARDIAC STATUS , RESPIRATORY EFFORT, MUSCLE TONE, NEUROMUSCUALR, IRRITABILITY, COLOR
NAME THE 5 CRITERIA THAT ARE RECORDED ON AN APGAR SCALE
do you ever mix medicine in childrens food?
NO
does the pt have to be NPO before an EEG? what should be limited before an EEG?
NO - will alter results due to possible hypoglycemia eliminated for 24 hrs before test
DT diet, why?
NPO, clear liquid, aspiration risk from seizure
2 drug classes for HIV? what do they do? Goal of these drugs?
NRTI's & PTs they prevent viral replication goal = delayed onset of AIDS (10-15 yrs)
what is cast syndrome
Nausea, vomiting and abdominal distention that can result in intestinal obstruction
Calcium Channel Blockers
Negative Ino, Chrono, Dromo (weak, slow, blocks conduction) *hold is systolic <100* *-zems, -dipines, -isotopin
"Who can sterelize my bowel?"
Neo Kan
AWS restraints?
No
HHNS: high glucose in type 2 diabetic. ___- ketonic. Symptom: ____.
Non, dehydration
Congenital heart defects: Trouble defects start with "T". No trouble: _____ life expectancy, can go home, etc. All congenital heart defects have a ____ whether trouble or not. Get echocardiograms.
Normal, murmur
Non reactive non stress test is ____ good. Reactive= reassuring
Not
100
ON HEART RATE OR CARDIAC STATUS , A 2 MEANS THAT THE HR IS ABOVE _____ BPM
GREATER, LESS THAN
ON THE HR CRITERIA AN INFATN SCORES A 1 IF THEIR HR IS_____ THAN 0 AND _____ THAN 100
Regular insulin (Humulin R, Novolin R)
ONSET: 1 hr PEAK: 2 hours Duration: 4 hrs
cushing syndrome is ____secretion of ______ , ______ , & _____ by the ______ ______
OVER of glucocorticoids, mineralocorticoids & androgenic hormones adrenal gland
3 stages of acute renal failure
Oliguric, diuretic, recovery
What is the #1 symptom of Bell's Palsy? what is also affected? Can the pt close their eyes on the affected side>
One sided (unilateral) facial paralysis taste is also affected pt can not close affected eye
NPH Insulin
Onset: 6 hrs Peak: 8-10 Duration: 12 hrs *cloudy, roll not shake, never IV*
What are the toxic effects of aminoglycosides and how are the monitored
Otoxicity = monitor hearing, balance, tinitus Nephrotoxicity = monitor creatinine (24 hr creatinine clearance)
What is otosclerosis?
Overgrowth of spongy bone in the middle ear that doesn't allow the bones of the middle ear to vibrate
Atrial flutter is .... and has....
P wave depol, saw tooth pattern
What is the causative organism of acne?
P. acnes (propionibacterium acnes)
most common arrhythmia after MI drug used to treat this
PVCs lidocaine
what is cycloplegia
Paralysis of the iris/pupil
What may a pt develop in a advanced stage of gonorrhea
Pelvic inflammatory disease
Drug for gonorrhea
Penicillin
Cloudy drainage in the dialysate commonly means...
Peritonitis (Not good, call MD)
what is the BIG danger with pyelonephritis?
Permanent scarring and kidney damage
Normal sinus rhythm: p wave before every QRS. Vfib looks like ____ line. V tach- jagged, Sharp peaks, a ____. Saw tooth- A ____
Squiggly, pattern, flutter
Most aggressive medical therapy for gbs?
Plasmaphoresis
Opisthotonos
Position of extension seen in bilirubin toxicity - sign of impending death
#1 finding with GBS
Progressive ascending paralysis Caused by demyelination of peripheral nerves
When is the only time a patient will have metabolic alkalosis?
Prolonged gastric vomiting or suctioning
Wernicke's (Korsakoff's) Syndrome
Psychosis induced by Vitamin B1 (Thiamine) defiency.
how often should central line dressings be changed?
QOD - every other day
Asystole is lack of ... so no...
QRS, ventricular action
Trouble heart defects blood shunt and baby color
R to L and blue baby
Insulin: injecting air: into N first then ___ (drawing up is opposite-RN) Injections: "I" looks like a 1 (one) so pick answer that has ___ 1's. Ex: 21 gauge 1 inch ( has two ones)
R, two
early signs of hypoxia
RESTLESSNESS AGITATION TACHYCARDIA
what does ROME mean?
RO=Respiratory Opposite (pH and bicarb go in opposite directions) ME=Metabolic Equal (pH and bicarb go in same direction)
infants VS: RR: HR:
RR: 30-60 HR: 110-160
Graves disease is hyperthyroidism and you can
RUN yourself into the grave
erythema toxicum neonatorum
Red papular rash on babys torso which is benign and disappears after a few days.
if overventilating
Resp Alkalosis
Laminectomy discharge teaching
Restrictions for 6 wks: don't sit longer than 30 min, lie flat and log roll, no driving, don't lift more than 5 lbs PERMANENT: never lift by bending at waist, cervical cannot lift above head, no horseback riding, off trail biking, rides etc
QUICK OBJECTIVE WAY TO EVALUATE THE VITAL FUNCTIONS OF THE NEWBORN
WHAT IS THE APGAR SCALE
lochia colors
Rubra: red/dark Series: pink/brown Alba: white creamy Documentation!
seratonin syndrom mnemonic
SAD HEAD, sweating, apprehensive, dizzy, headache
Kalemias: do the _____ except for the heart rate and urine output. Hyperkalemia s/s: irritability, hyperactive, loud, aggitated, ____ heart rate, elevated ST, diarrhea, spasticity +3 +4 ____, low urine output
SAME, low, reflexes
PETECHIA
SMALL DOT LIKE PINPOINT HEMORRHAGES ON THE SKIN
postop risk subtotal thyroidectomy 12-48 hr
SS=subtotal storm
Sertraline (Zoloft)
SSRI - antidepressant insomnia - can be given in evening watch for interaction: st johns wart, sweating, apprehension, dizziness, headache,
fluoxetine
SSRI XET XEP these cause insomnia watch for suicidal ideation
Zapines: new major _____. Zoloft (sertraline): ____. Do not take St Johns ___ with this- can cause seritonin syndrome. On coumadin with SSRI's- increased ____ Zeps, Zines and Zaps= tranquilizers
SSRI, wort, bleeding
Category A biological agents
STAPHB - Smallpox Tularemia Anthrax Plaque Hemmorgagic fevers Botulism
biological agents
STAPHB: smallpox tularemia anthrax plague hemmorhagic botulism
Oxytocics do what to labor?
START
after rape, a woman needs follow up exam for ___ ___ ___
STDs (AIDS, gonorrhea & syphilis)
examples of info you can NOT keep confidential
STIs, abuse, threat to kill/harm self or others
what would you do first if you suspected a transfusion reaction? What else should you do?
STOP the blood & start NS IV call doc, get blood & urine sample, monitor VS & send unit that caused reaction to lab
tocolytics ____ labor
STOPS
ELISA
WHAT IS THE FIRST TEST FOR HIV ANTIBODIES
Epsteins pearls are?
Small,white epithelial cysts on babys gums.
HYDROGEN PEROXIDE
WITH WHAT SOLUTION SHOULD THE CLIENT WITH CHEMOTHERAPEUTIC STOMATITIS RINSE AFTER MEALS
stages of pressure sores
Stage 1: skin in intact, non-blanching, erythema Stage 2: skin is broken, tissue in ulcer is skin color Stage 3: skin is broken, visible yellow masses of fat Stage 4: ulcerated to bone and muscle, visible red + white
Which organism most commonly causes mastitis? application of ______ is the preferred treatment for breast engorgement
Staph ice packs to decrease swelling
what is glycogen
Storage form of glucose in liver
Cephalohematoma
Swelling caused by bleeding between the osteum and periosteum of the skull. This swelling does not cross suture lines.
Special filter mask for ____, negative air room. Always take PPE off in _____ order- Gloves, goggles, gown, mask. OFF ALPHABETICAL. On in _____ alphabetical for G's but mask is ____- Gown, mask, goggles, gloves (GMGG)
TB, alphebetical, reverse, second
AN ADEQUATE WEIGHT GAIN
THE BEST GOAL TO EVALUATE THE PROGRESS OF THE CLIENT WITH ANOREXIA NERVOSA IS ....
FALSE
THE CAUSE OF CANCER IS KNOW T/F?
15 ( PT WEIGHS LESS THAN 85% OF NORMAL BODY WEIGHT)
THE DX OF ANOREXIA NERVOSA IS MADE WHEN THERE IS A WEIGHT LOSS OF _____% OR MORE OF BODY WEIGHT
2
THE MAXIMUM SCORE AN INFANT CAN RECEIVE ON ANY ONE OF THE CRITERIA IS ....
NG TUBE FOR DECOMPRESSION OF BOWEL
THE POST OP ABDOMINAL ANEURYSM REPAIR CLIENT IS MOST LIKELY TO HAVE WHICH TYPE OF TUBE
CHEST TUBE, BECAUSE THE CHEST WAS OPENED
THE POST-OP THORACIC ANEURYSM IS MOST LIKELY TO HAVE WHICH TYPE OF TUBE
0-10
THE TOTAL APGAR SCORE CAN RANGE FROM ...
TOTALLY BLUE, PALE
TO GET A 0 ON COLOR THE INFANT IS _____
FLEXION
TO GET A SCORE OF 1 ON THE APGAR FOR MUSCLE TONE THE NEWBORN MUST PLACE THEIR EXTREMITIES IN _____
NO RESPONSE
TO RECEIVE A 0 ON REFLEX (NERUOMUSCULAR), IRRITABILITY THE NEONATE MUST EXHIBIT....
TOTALLY PINK
TO SCORE A MAX SCORE OF 2 ON COLOR THE CHILD MUST BE _____
CRY
TO SCORE THE MAXIMUM OF 2 POINTS ON NUEROMUSCULAR REFLEX IRRITABILITY THE INFANT MUST _____
tricyclic antidepressants
TRIP -- tricyclic antidepressants
Salt substitutes contain Potassium (T/F)
TRUE - BEWARE!!!!
postop risk total thyroidectomy 12-48hr
TT=tetany
Naegele's Rule
Take the first day of the woman's LMP, subtract 3 months, add 7 days and add 1 year. -Fetal heart sounds heard w/ Doppler 10-12wks or by 17-19wks w/ fetal stethoscope
INTAKE OF ENOUGH FOOD TO KEEP THEM ALIVE, HAVE THEM GAIN WEIGHT
WHAT IS THE TOP PRIORITY IN THE CARE OF THE CLIENT WITH ANOREXIA NERVOSA
KY JELLY
WHAT LUBRICANT CAN SAFELY BE APPLIED TO THE CRACKED LIPS OF CHEMOTHERAPY STOMATITIS?
GLOVES, NURSE MAY GET A DOSE OF THE MED
WHAT PRECAUTION MUST THE NURSE TAKE WHEN ADMINISTERING TOPICAL NITRO
WESTERN BLOT
WHAT TEST CONFIRMS THE ELISA
AT 1 MIN AND AGAIN AT 5 MIN AFTER BIRTH
WHEN IS APGAR SCORING PERFORMED ON INFANTS
ONLY WHEN THEIR PLATELET COUNT IS DOWN
WHEN SHOULD THE NURSE WITHHOLD IM INJECTIONS IN THE CLIENT ON CHEMOTHERAPY
NRTI'S (NUCLEOSIDE REVERSE TRANSCRIPTEASE) INHIBITORS AND PI'S (PROTEASE INHIBITORS)
WHICH 2 CLASSES OF DRUGS ARE GIVEN IN COMBINATION FOR HIV SERO-POSITIVITY
vermix caseosa
Thick, white, cheesy substance that covers and protects the skin from amniotic fluid in the uterus; present at birth
what is a TIA
Transient Ischemic Attack Warning sign of impending CVA (transient neurologic deficits of any kind can last 30 seconds to 24 hours)
Why are ACTH and prednisone given during acute MS?
To decrease edema in the demyelination process
PETECHIA, EPISTAXIS, ECCHYMOSIS
WHAT ARE THE 3 OBJECTIVE SYMPTOMS/ SIGNS OF THEOMBOCYTOPENIA
HYPOTENSION AND HEADACHE
WHAT ARE THE TOP 2 SIDE EFFECTS OF NITRO
WBC
WHAT BLOOD CELL IS LOW IN LEUKOPENIA
DECREASED BLOOD SUPPLY TO MYOCARDIUM RESULTING IN ISCHEMIA AND PAIN
WHAT CAUSES ANGINA PECTORIS
TERRIFIC HEALTH
WHAT DOES A 10 ON THE APGAR MEAN
two special things in hypocalcemia
Trossaues(bp cuff hand spasm) and chvosteks(tap cheek face spasm)
Diabetics: need to eat carbs before exercise. When sick GLUCOSE GOES ____. Need to take insulin even though not ____. Take sips of water to prevent dehydration, stay active as possible
UP, eating
Alkalosis pt goes... K goes
Up, down... hyper, pronouced, increased, irritable
What is Hegar's sign?
Uterine softening
Causes of FHR patterns
VEAL CHOP, variable-compression, early-head compression, Acceleration-Ok, late decel-placental insufficiency
Calcium channel blockers: Are like ____ for your heart. Cardiac _____. Treat: AAA & AAA. Antihypertensives, anti _____, anti atrial arrhythmias.
Valium, depressants, anginas
Calcium channel blockers: Are like ____ for your heart. Cardiac _____. Treat: AAA & AS A. Antihypertensives, anti _____, anti atrial arrhythmias.
Valium, depressants, anginas
3 drugs for acne
Vitamin A Antibiotics Retinoids - Isotretinoin (accutane)
which arythmias are 2nd priority
Vtach
blood level that is elevated in appendicitis? what is this called?
WBC - leukocytosis
Before PD it is important the client be...
Weighed, to assess water loss or gain
test for confirmation of HIV
Western Blot, PCR
resonant
a dry cast is dull or resonant to percussion
shiny
a dry cast is dull or shiny?
what does lightening mean?
When the fetal head descends into the pelvis
Ideas of reference
When you think everyone is talking about you
white
a dry cast is gray or white?
Delusion
a false belief, often of persecution or grandeur, that may accompany psychotic disorders
K wasting diuretics, what do they do, end in what? & which one
X out K, end in x, except diuril(HCTZ)
clozapine
ZAP - used to treat severe schizophrenia does NOT have side effects: ABCDEF does have a agranulocytosis
what vaccine prevents shingles? who should get it?
Zostavax pts over 60 who are not immunosuppressed
toddlers eat what kind of food
`finger
Delirium Tremens
a disorder involving sudden and severe mental changes or seizures caused by abruptly stopping the use of alcohol -- private, NPO, restricted bedrest, restrain
neuroleptic malignant syndrome
a potentially fatal hyperpyrexia with temp of over 104, looks like EPS except for temp
crackles are, wheezes have
a sound, a note
in an AV fistula you should hear
a whoosh(bruit)
What does the thoracic spinal cord control
abd. muscles & gut
thoracic priorities
abdominal muscles, cough, gut, bowel sounds
hypertension
abnormally high blood pressure
HA1C: best test for glucose. Need to be 6 or lower. 8 and ___ out of control. "<7 no ____, 8 see the gate" (of heaven)
above, heaven
How is the bleeding of Abruptio Placenta different from that in placenta previa?
abruptio = pain, bleeds less previa = less pain, bleeds more
35
abruptio placenta ususally occurs in multigravida over the age ______
for cushings what do you need to check
accucheck bc steroids=glucose
DM sick days
accucheck, drink water bc dehydrated
2/3
accurate BP is obtained by using a cuff that has a width of _____ of the arm
What neurotransmitter is problematic in MG?
acetylcholine
mucomyst
acetylcystiene antidote to acetaminophen poisoning- notice both have acet in the name
Hiatal Hernia what happens
acid regurgitates into esophagus
Kusmals: "Mac Kusmal" (someones name) MAC= metabolic ______
acidosis
diarrhea
acidosis
under ventilating
acidosis
four steps to functional psychosis
acknowledge present reality set a limit enforce the limit
what to do with delirium
acknowledge feeling and reassure they are safe and its temporary
When dementia pt get angry what to do
acknowledge feeling, redirect
steps to deal with functional
acknowledge feeling, say its not true, set limit(no more talking), come back if not ready
Stages of labor: stage 1: labor, phases- Latent, ____, transition. Stage 2: delivery of ____. Stage 3: delivery of placenta. Stage 4: recovery, lasts ___ hrs
active, baby, 2
Diabetes type 2: treatment: DOA, D- diet, O- oral hypoglycemic A- _____. Diet is most important, _____ restriction- best answer. Need ___ small meals a day.
activity, calorie, 6
4 rules in prioritization
acute beats chronic, fresh post op 12hrs beats med surg, unstable beats stable, tie breaker is which organ
Unstable vs stable, unstable is(7 things)
acute illness, postop less than 12hr, after anesthesia, assmt changed, newly admitted or diagnosed, atypical S&S, complication
#1 cause of DKA
acute upper resp infection
Uppers: caffeine, coaine, pcp/lsd, meth, _____. Everything goes up- uphoria, restlessness, hyperreflexia +3, +4, ____, etc. Could arrest and cease. Need _____.
adderall, diarrhea, suction
under secretion of adrenal cortex otherwise known as
addison's disease
Adrenal cortex which two disease
addisons and cushings
Atrial arhythmias treatment 4 meds
adenocard, adenosine(give 8 sec, asystole 20 sec), betablockers, ccb, digoxin
Atrial: treat with ABCD. Treatment: A- _____ (IV push, FAST) B- beta blockers, C- calcium channel blockers, D- _____ (lanoxin, digoxin) "Adeno-______- calcium- Didge"
adenocard, digoxin, beta
supraventricular arrythmia
adenosine, betablockers, cardiac depressants, calcium channel blockers, digitalis
treatment for low blood sugar type I
administer carbs, sugar, if unconscious give glucagon/IV dextrose
termination phase begins on
admission
Psych: Don't give or except gifts. Don't give _____ or guarantees in psych. Pick answers that keeps pt ____. Don't pick refer to social services even if appropriate.
advice, talking
BOWEL SOUNDS (PERISTALSIS)
after appendectomy, document in the nurses notes the return of _____
Prioritization 4 things, two imp
age gender dx modifying phrase, last 2
Cholozaril (clozapine): for severe schizophrenia. S/e: _____. Geodone: prolongs QT interval and can cause cardiac ____
agranulocytosis, arrest
continuous bubbling in water seal means
air leak, find and tape
Besides a thrombus what else can cause an embolus in the lung?
air, fat, tumor cells
smallpox
airborne no treatment rash mouth first
#1 danger of epiglottis? what organism causes it? s/s?
airway obstruction hemophilia influenza B muffled voice, drooling, stridor, fever >102
analophin for? level?
airway spasms, 10-20
post op risk thyroidectomy first 12 hrs
airway, bleeding
Antibuse and Revia (disulfiram): when drink ____ makes pt really sick. Onset ____ weeks. No mouthwash, aftershave, extracts, Nyquill etc.
alcohol, 2
who gets wernickes/korsakoffs
alcoholics
amniotic fluid is (acidic/alkaline)
alkaline
over ventilatin
alkalosis
vomiting
alkalosis
ABG's: first thing you ask- Is it lung? Overventilating: ______. Underventilating: acidosis. Ventilation= gas exchange not respiratory ____. Ventilation= ______
alkalosis, rate, SAO2
Mycin troughs
all 30min before dose
phenothiazines
all end in 'zine Ex: Thorazine, Compazine, they are major tranquilizers so think safety
Chadwick, goodell and hegar signs occur in ____ order. Chadwick sign: cervical color turns blue- from ____.
alphebetical, cyanosis
peds dont know bw two tasks
always pick easier task
dementia conditions
alzheimers, head injury, wernickes, senile
psychosis dementia
alzheimers, wernickes acknowledge, then redirect, DONT PRESENT REALITY
Primary symptom of Korsakoff's
amnesia with confabulation
INFECTION, SYPHILIS
an aneurysm can result from an _____ and from _____
WIDENING ( IT IS ALSO WEAKENING)
an aneurysm is an abnormal ____ of the wall of an artery
THE PULSE -- MANY TIMES THE ANEURYSM WILL RUPTURE AND MUCH BLOOD WILL BE LOST BEFORE THE BLOOD PRESSURE STARTS TO CHANGE
an aneurysm will most affect which of the following. the blood pressure or the pulse?
NRTI (nucleoside reverse transcriptease inhibitors)
an antiviral drug used against HIV -- its incorporated into the DNA of the virus and stop the building process. results in incomplete DNA that cannot create a new virus. often used in combination with other drugs
high, due to poor eyesight , high
an elderly client is a ________ risk for accidental poisoning? what about a school age child ?
20
an individual is obese if they weigh _____ % above the ideal weight
10
an individual is overweight if they are ____ % above the ideal weight
What other disease can be confused with pernicious anemia?
angina pectoris
symptoms associated with HIV
anorexia fatigue weakness night sweats fever diarrhea
benzo side effects ABCD
anti cholinergic, blurred vision, constipation, drowsiness
dry/dilated
anti-cholinergic
3 things calcium channel blockers are used for
anti-hypertensives anti-anginals anti atrial arrythmias
Side effects of tricyclics
anticholinergic blurred vison constipation drowsiness euphoria must take med 2-4 weeks before beneficial effects
side effects phenothiazine, ABCDEFG
anticholinergic(dry mouth), blurred vision, constipation, drowsiness, extra pyramidal syndrome(false parkinsons), fotosensitivity, aGranulocytosis
side effects benzos
anticholinergic, blurred vision + bladder retention, constipation, drowsiness
MAOI side effects
anticholinergic, blurred vision and bladder retention, constipation, drowsiness
Pharmacology: if you know what a med does but don't know s/e: pick side effect in same ____ system where the drugs working. Ex: GI drug- choose diarrhea
body
the uterus feels ____ after rupture of a fallopian ectopic pregnancy first s/s that a fallopian ectopic pregnancy has ruptured
boggy (tender too) sharp abd pain
what will the results of the rinne test in otosclerosis
bone conduction will better than air
tissues from live donor
bone marrow, stem cells, blood and blood products
in nclex if two answers are the same
both are wrong
Don PPE
bottom to up, gown, mask, goggles, gloves
Wernickes, Korsakoff: Need B1 to metabolize alcohol so if not metabolized then goes to _____. Treatment: redirection. Is preventable and ______
brain, irreversible
Important assessment of pre-op cervical laminectomy
breathing & function of arms
High ventilatory pressures result in what chronic lung problem in infants?
bronco-pulmonary dysplasia
Cushings s/s: are also side effects of steroids. Moon face, gynocomastia, striae, ____, atrophy, high ____ sugar, full of sodium and water, _____ hump, hirsutism, immunosuppression. (draw moon man)
bruises, blood, buffalo
iliac bone fusion
cadaver bone bc less complications
Which drugs are uppers
caffiene, cocaine, psp/lsd, methamphetamines, adhd drugs
If electrolytes has to do with skeletal, muscle, nerves pick
calcium
if the symptom involves nerve or skeletal muscle, choose
calcium
Nifedipine (Procardia)
calcium channel blocker maternal headache, hypotension, bradycardia
Assessing for Thrombophlebitis
calf size, uneven, wrong
what would you do if the pt complains of flank pain after hysterectomy
call the HCP ureter may have tied off in surgery
diet for diabetes
calorie restriction, 6 meals
yes unless WBC's are very low
can AIDS patients leave the floor
they should not use ocp during first 6 week after birth
can a woman on oral contraceptives breastfeed
yes, should be given to relieve anxiousness which is bad for the patient
can a woman with CD of pregnancy be given analgesics during labor
no it has to be warmed first for only about 20-30mins
can blood be given immediately after removal from refrigeration
teaching for accutane
can cause birth defects
oxytocin (pitocin)
can cause uterin hyperstimulation (contractions longer than 90 seconds)
yes when lye or caustic agesnts have been ingested
can impaired skin integrity ever be an appropriate nursing diagnosis when poisoning has occured
yes, even though it negatively affects the fetus morphine decreases preload and pain which rests the heart
can morphine be given to a woman with CD during labor?
yes
can skin traction be removed for skin care
no
can the client be removed from skeletal traction
yes but rare
can the thigh ever be used to obtain blood pressure
yes , 45 degrees
can the woman with a cesium implant have the HOB elevated
never
can you microwave frozen breast Milk in order to warm/ thaw it out
NO, THIS IS DANGEROUS
can you use cotton swabs to clean the eyes, nares, or ears of an infant
NO IT WOULD CROSS CONTAMINATE
can you use the same cotton ball/ washcloth edge for both eyes
Functional psychotic: ___ function in ADL's. "skeezo skeezo major manics" Schizophrenia, schizo effective disorder, major ____, manic
can, depression
Transverse lie: babys spine is diagonal to moms. Presentation: part of baby that enters birth ____ first. ROA and LOA most ____
canal, common
PTU med reduces thyroid and can be used for
cancer
Increasing dietary fiber lowers the risk of ___________ of the __________.
cancer; colon
NEVER tell a child that medicine is
candy
with kids dont tell them med is
candy
laminectomy permanent restrictions
cant lift to bend at waist, if cervical, no lift above head, no roller coaster, no horse riding, no mountain biking
how many Kcal/g in carbs, fats & protein
carb - 4 fats - 9 proteins - 4
major source of energy for the body
carbs
4
carbs provide _____ kcalories per 1gm
Hypoglycemic shock treatment: rapidly metabolized ____- sugar, starch or protein. Ex: fruit juice, pop, candy, ____, honey, icing, jelly, crackers, cheese. If unconscious give ____ IM or IV dextrose
carbs, milk, glucogon
V tach: potentially life threatening, has _____ output. Ventricular: treat with ____ and amioderone.
cardiac, lidocaine
3 most common complications after MI
cardiogenic shock, arrhythmia & CHF
2 major complications of obesity
cardiovascular disease & DM
pulses areas
carotid, brachial, radial, femoral, tibial, popliteal, posterior tibeal, dorsalic pedis
Labor 4th stage: Boggy fundus: massage. Displaced fundus: _____. Check perineal pad: if bleeding excessively will saturate 100% of pad in ___ minutes or less. Roll her over and check for bleeding
catheterize, 15
cephalosporin antibiotic
cephalexin, ceph, cef, cephion, keph
post-op laminectomy complications
cervical = pnuemonia thoracic = pnuemonia & parlytic illeus lumbar = urinary retention
important assessments for laminectomy
cervical: breathing characteristics, functioning of arms and hands thoracic: cough mechanism and bowel shutdown lumbar: last time voided, bladder scan + legs
postop complications of laminectomy
cervical: pneumonia Thoracic: aspirational pneumonia and paralytic ileus Lumbar: urinalysis retention
first s/s of CVA?
change in LOC
the earliest s/s of increased ICP
change in LOC
first diastolic cound
change in character of the sound is known as _____
atrial fibrillation
chaotic p depolarizations
Afib is...
chaotic p wave depol
Ventricular fibrillation (V-fib)
chaotic qrs
Vfib is
chaotic qrs depol
Paranoid delusion
characterized by beliefs that others are out to harm them
DO NOT DELEGATE THESE TO UAP
charting your doings assessments giving medications treatments
when you dont know what to pick in L&D pick
check FHR
RESTRAINT RULES
check every 15minutes, release/rotate q2, restrain renewal order: child 1hr, teen 4hr, adult 24hr
With OB, ace of spade answer is
check fetal heart rate
best answer for fetal monitoring questions is
check fetal heart rate
Chevosteck sign: rub ____ go into spasm. Trousseaus sign: hand spasm when put BP ____ on. Gay French Guy named Trousseo doing gay wrist flick.
cheek, cuff
tularemia
chest sx, resp, failure,
pneumothorax
chest tube removes air
Painful back labor: position her in knee ____- on hands and knees with butt up. Push your hand into sacrum. Prolapse cord: push the head up off ___, put her in knee chest position.
chest, cord
with nutrition, in a tie either pick
chicken or fish never pick casserole for children
to guess in nutrition pick, for kids no..., dont do what with kid med, for toddlers pick, preschoolers dont need what why
chicken or fish, casseroles, mix in food, finger food, that much food bc not growing fast
Nutrition: In a tie pick ____ (not fried), if not an answer then pick fish (not shellfish). Never pick casserole for ____. Never mix meds in childrens food.
chicken, children
What other disease is related to shingles?
chickenpox
drugs, insecticides
children at highest risk for seizure activity after ingestion are those who have swallowed ______ and _______
chlorine
choking
wet constricted
cholinergic
anticholinesterases will have (sympathetic/cholinergic) side effects
cholinergic will mimic parasympathetic nervous system
to guess in pharm for SE.... if you dont know at all and med is PO pick
choose in same body system, GI effect
stable vs unstable, stable is(7 things)
chronic illness, postop >12h, regional local anesthesia, unchanged assmt, ready for discharge, admitted over 24hr, expected symptoms
Bactericide Vs Bacteriostatic:
cide - destroy microorganisms static - prevents/inhibits growth
if water seal breaks on chest tube, you
clamp, cut, submerge, unclamp
Chest tubes: surgery- always assume bilateral. If drain container comes open: 1st ____, 2nd cut broken container off, 3rd put end of tube under ____ water, then unclamp. Use rubber tipped double clamps.
clamp, sterile
lose weight
client with AIDS ______ weight
false
clients receiving chemotherapy must be NPO T/F?
door is
closed
s/s of infection in a foley catheter
cloudy urine, foul smelling urine & hematuria
Nph insulin, what color, not so... not in....., onset, peak, duration
cloudy, fast, bag, 6h, 8-10hr, duration 12hr
Latent Phase Labor
cm dilated = 0-4 contraction frequency: 5-30 minutes duration: 15-30 seconds intensity: mild
Psychosis of dementia: brain is _____. Functional psychotic: has potential to learn ____. If not psychotic pick best _____ communication as answer
damaged, reality, therapeutic
DT pt is...and needs....
dangerous, restraints
interventions for pt with bell's palsy
dark glasses artificial teats cover eye at night
To care for the pt with exophthalmos the pt should wear ____ _____ and use ____ _____.
dark sunglasses; artifical tears
Coumadin: PO only, takes a few ____ to a week to work. Can be given for rest of ___. Antidote- vitamin K. Lab test- ___ (INR). Not given to pregnant women.
days, life, PT
V-fib
de-fibrillation
S/S of aneurysm rupture
dec LOC, inc HR, dec BP (s/s of shock)
Dependency: abuser gets significant other to do things for them or make _____ for them. Co-dependency: when significant other derives _____ self esteem for doing things for abuser
decisions, positive
the neurotransmitter imbalance that causes Parkinson's is a ______ in __________
decrease ; dopamine activity
if the pt is not yet out of control, what is the #1 strategy to treat beginning violence?
decrease environmental stimuli
What do carbonic anhydrase inhibitors do to the eye? most common side effect
decrease production of aqueous humor & thus decrease intraocular pressure side effect: diuresis
leukopenia
decreased in WBC, indicated viral infection
what triggers low pressure vent alarms
decreased resistance to air
Lamenectomy post op complications: Cervical- trouble breathing _____, ie pneumonia. Thoracic- pneumonia and ____. Lumbar- urinary retention and leg problems
deeply, ileus
osteoarthritis is a _______ disease of ______
degenerative; joint
Diabetes: don't metabolize glucose. Insipidus: polyuria, polyphagia, polydipsia,- leading to _____ due to low adh
dehydration
hypernatremia causes
dehydration
stage 2 of L&D is.... goes in .....order
delivery of baby, alpha, deliver head, suction mouth, suction nose, check nuchal cord, deliver shoulders body, ID band
third stage of labor and delivery
delivery of placenta make sure its all there, make sure it has 3 vessels, 2 arteries, 1 vein, if there arent, expect congenital defects
#1 Problem in abuse
denial, wont accept reality of problem
Diabetes melitus type 1: insulin ____, ketosis prone. If don't get treatment could DIE. D-diet, I- _____, E- exercise.
dependent, insulin
MAOI's: anti-____. Beggining of names are Mar, Nar and Par- brand names. Pt must avoid tyramine ____.
depressants, food
DKA treatment, why
dextrose(to rehydrate) and reg insulin high flow
Prioritization: questions will always have age, gender, ____ and modifying phrase. Don't need age and gender.
diagnosis
cervical priorities
diaphragm, breathing, upper extrem., feeling in arms
type II treatment insulin
diet, oral hypoglycemia, activity
false
dietary indiscretions and uncleanliness are cases of acne . t/f
What is pulse pressure? shock will ______ the pulse pressure
difference between systolic and diastolic pressure DECREASE
Sesame street rule: only when NO other way. Right answer tends to be ____ than others. Wrong answers are similiar. When something really ____ right it probably is- go with your gut
different, feels
how do you screen for BPH
digital rectal exam
uppers
dilated pupils (caffeine, cocaine, etc)
action of nitro
dilates coronary arteries to inc blood supply & reduce PRELOAD
what does anticholinergics (mydriatic) do as an "eye drug"? when do you NOT use it? ex?
dilates pupil do NOT use for glaucoma ex: atropine
what 3 things do CCB end in
dipine, zem, verapamil
what is a cystoscopy? what do you do if pt's urine has red blood post-test?
direct visualization of the urethra and bladder through cystoscope; performed under local anesthesia call MD if pt has red blood
lie of baby, which one good, which bad
direction of baby spine vs mom spine, vertical, transverse(trouble)
LPN cannot do these assessments: admission, ____, transfer, first assessment after there's been a ____
discharge, change
low pressure alarm ventilator caused by
disconnected tubing
what causes decreased resistance to air
disconnection of the tubing
Low pressure alarm caused by
disconnection, disconnected 02 sensor
treating crackles
discontinuous, fluid in airways, treat with diuretic, furosemide, lasix
Hiatal hernia s/s: GERD only when lay down after ____. Dumping syndrome s/s: shock and "drunk": staggering, slurred ____ etc. Also, abd cramping, _____, boriborigmy. Decreased cerebral blood flow, all blood is going to the ___.
eating, speech, diarrhea, gut
postpartum what to check with legs
edema, pulses, thromboembolism with bilateral calf circumfrence
SCRUBBING procedure
elbows below hands, minutes, immunosuppressed, chlorahexidine
LITHIUM
electrolyte decreases mania side effects: P: polyuria P: diarrhea P: paresthesia (numbness and tingling)
2 most common complications of hyperemesis gravidarum
electrolyte imbalance & starvation
amputation: stump should be _____ for _____ to ______ hours
elevated; 12 to 24 hours
Sao2: o2 sat. 93-100. Less than 93= high priority. Anemia falsely ____ o2 sat. ____ procedure in last 48 hrs falsely elevates it.
elevates, dye
if child has jaundice and extends neck
emergency call MD!
if chest tube water seal breaks?
emergency, clamptube and cut off, stick in water, unclamp
prolapsed cord protocol, need a, what to do
emergency, cord comes first, csection, push head off cord, knee chest or trendelenburg, make hips up
in psych dont know always pick ans that has , not
empathy, dont worry i would feel that too
what time of day do you give antacids
empty stomach 1 hr before meals
HH treatment
empty stomach faster, up hob, up fluids, up carbs
DS treatment
empty stomach slower, low hob, low fluids, low carbs
Timing contractions: frequency: begining of one to beginning of next. Duration: beginning to ____ of one contraction. Intensity: the ____ of contraction. Teach to palpate with one hand over ____ with pad of fingers
end, strength, fundus
Kayexalate route
enema or NG
Why is the child with CF receiving pancreas/viokase/pancreatin?
enzymes that aid absorption of nutrients - take with meals!!!
asystole
epinephrine
GENERATIVITY VS STAGNATION
erikson stage of social development in which middle aged people begin to devote themselves more to fulfilling ones potential and doing public service
what is diabetes
error of glucose metabolism(body wont run bc no fuel)
Vital signs are measured _______ in the recovery room.
every 15 minutes
standard precautions are for
everyone
hypercalcemia what happens
everything down
Ksparing diuretics are?
everything else
which drugs are downers
everything else
hypermagnesiemia what happens
everything goes down
AWS what happens
everything goes up
hypomagnesiemia what happens
everything goes up
symptoms of hypothyroid
everything low, weight gain, cold, flat affect, lethargy
hypocalcemia what happens
everything up
hyperkalemia what happens
everything up, hr and uo down
glands affected in CF? 2 organ systems most affected? appearance of stool?
exocrine glands lungs & pancreas stool is fat, frothy, foul-smelling, floating steatorrhea
Stable: pt experiencing typical ____ signs and symptoms of the disease with which they were diagnosed. Unstable: ____ signs and symptoms
expected, unexpected
to guess in psych pick 2
explore feelings, establish trust relationship
For which type aphasia is careful listening and needs anticipation most useful?
expressive - pt has difficulty responding verbally correctly
3 parts of GCS? highest & lowest score possible?
eye opening, verbal response & motor response 15; 3
decompensation
failure of the heart to maintain adequate circulation
what happens to hg in pregnancy
falls but its ok
what are delusions
false fixed beliefs
Hallucination
false fixed sensory experience
what are hallucinations
false fixed sensory feeling
Somatic delusion
false, fixed belief about a body part
Grandiose delusion
false, fixed belief that you are superior
first s/s of appendicitis? what follows it? where does it end up & the name of that point? most common complication of appendicitis
first s/s: periumbilical pain then: N/V next: RLQ pain aka McBurney's point complication - peritoneal inflammation
Aids/ UAP's can do: ADL's but never the ____. Do Not delegate ____ responsibilities to family
first, safety
respiratory pattern seen when ICP is increased what happens to the pupils
first: central hyperventilation at the end: cheyne stokes at first pupils are unilaterally dilated with sluggish reaction --> eventually fixed and dilated
S/S of meningitis - first s/s? - visual s/s? - musculoskeletal s/s?
first: irritable visual - photophobia (sensitivity to light) ms: stiff neck/nuchal rigidity
- pexy
fixation of something
3 things for black tags in un-witnessed accident: pulselessness, breathlessness, ____ dilated pupils. Unless there when happened, unwitnessed at scene of death= ____ priority
fixed, lowest
Lithium: #1 intervention is ___ intake. Need normal sodium for lithium.
fluid
hyponatremia causes
fluid overload
SIADH is opposite of diabetes insipidus. Retain ____ and not thirsty. If urine output goes down, specific gravity goes ____.
fluid, up
Hiatal hernia: elevate HOB, high _____- to go through stomach faster, high carbs- digested fast. Dumping syndrome: HOB ____, lay on side to eat, low fluids- 1 to 2 hrs before or after ____, low carbs
fluids, flat, meals
air drying of the nipples is best
for a woman who doesn't have retracted nipples, is towel drying or air drying better?
wernickes korsikoffs syndrome
for of dementia, induced by vitamin d1 deficiency make up stories and amnesia *never pick improve, choose maintain*
piaget 12-15yr, what period, focus, when what how teaching
formal thinkers, abstract, like adults, med surg, manage care
assessment of contractions
frequency: beginning to beginning duration: beginning to end of one intensity: strength of contraction
prioritization rule #2
fresh post op (12 hours after) beats medical or older surgical
How long can breastmilk be refrigerated? frozen? can you microwave frozen breast milk??
fridge for 24 hrs frozen for 6 months CAN NOT BE MICROWAVED
entrance to the room
from where should the nurse talk to the client
what can you eat with MAOIs
fruits, veggies, grains, meat
what is accomplished during the first stage of labor? how long does this stage last?
full effacement and dilation 6-12 hours (prima vs multigravida)
3 types of psychotics
functional, dementia, delirium
Side effects of a high fiber diet include__________ and malabsorption of ____________.
gas; minerals
what s/s is most common in nephrosis
generalized overall edema
treatment for hypokalemia
give K
if peds dont know abt development always
give more time
First thing the nurse does when a thyroid storm occurs
give oxygen
Treatment hypoglycemia
give rapid carbs and slow, sugar and protein, milk
cloudy urine, foul smelling urine, hematuria
give signs of infection in a Foley catheter
urinary retention, to check for residual, to monitor hourly output
give three appropriate indication for bladder catheterization
DARK GLASSES, ARTIFICIAL TEARS, COVER EYE AT NIGHT
give three eye interventions for the client with bells palsy
restore blood volume secondary to hemorrhage, maintain hemoglobin in anemia, replace specific blood components
give three reason for a blood transfusions
hypothyroid treatment
give thyroid meds
what time of day do you give allopurinol
give w/meals & w/lots of water
lantus
glargine
sulfonylurea oral hypoglycemia
glib, glyb, glip, glyp, glib, GI as in glucose
STERILE GLOVING PROCEDURE
glove dominant first grasp outside cuff touch only inside of glove surface fingers inside second glove cuff keep thumb ubducted remove glove to glove skin to skin
remove sterile gloves
glove touches glove, skin touvhes skin
hypoglycemia unconcious
glucagon or iv dextrose d50
FHR high variability, what to do
good, document
Chest tube: intermittent bubbling in water seal is ____, just document it. Continuous bubbling in water seal is bad, it means a ____. Like buying a bottle of pop- don't want broken ____
good, leak, seal
ppe needed
gown gloves mask, filter mask for tb
sterile gloving on
grab inside of glove, out of cuff, then inside of cuff, outside of glove,
which of the following is highest in fiber - grains, fruits, veggies & nuts
grains - esp bran
another name for second intention
granulation
Handwashing procedure
hands below elbows, seconds, entering or leaving a room, before after gloving soiled hands, soap and water dry cleanest to dirtiest
Paranoid delusion: believe people are out are out to ____ them. Grandios delusion: believe they are _____. Somatic delusion: false belief about _____ part
harm, superior, body
what is a nonpsychotic
has insight and same reality
dont answer something that you
have never heard of
3 things to do with negative air flow rooms:
have own HVAC system exchange air 6-12x per hr only room needs to be vented 3 feet above hospital roof
3 main side effects of CCBs
headache, hypotension, bradycardia
CCB side effects
headache, hypotension, bradycardia
cranial nerve 8
hearing nerve
BNP (brain naturetic peptide): best indicator of congestive ____ failure. Sodium: 135-145. If abnormal= low priority. If sodium abnormal and pt has decreased ____= high priority.
heart, LOC
Thyroidism= metabolism. Hyperthyroidism: hyperactivity, ___ intolerance, cold tolerance, weight ____, exopthalmous, high pulse and BP, skinny. This is graves disease
heat, loss
Postpartum assessment: "BUBBLE HEAD": B- breasts, U- uterine fundus- check ____ and firmness, B- bladder, B- bowel. L- ____. E- episiotomy, H- hemoglobin, hematocrit, E- ____ check, A- affect (emotion), D- discomforts
height, lochia, extremity
Pts are always unstable if they have 5 things
hemmorhage, hypoglycemia, fever over 104, pulse gone, not breathing
The #1 complication of thyroidectomy in the first 8 to 12 hours is __________.
hemorrhage
most common complication of retinal reattachment
hemorrhage
labs for: -Heparin -warfarin
heparin - PTT warfarin - PT/INR
when to sterilize bowel with mycin
hepatic encephalapothy, preop bowel surgery
When can an aminoglycoside be given orally?
hepatic encephalopathy & pre-op bowel surgery
3 causative agents of acne
hereditary bacterial hormonal diet does NOT play a factor
contact precautions are for
herpes, enteric(cdiff, rv, hep A(anus), ecoli), staph(mrsa), rsv
Location and use of apical chest tube
high (apex of lung), removes air
Hypokalemia
high HR, high UO
Dt is what priority
high bc can kill
hypocalcemia
high blood pressure, chvosteks sign AND Ttrousseaus sign
bipolar disorder
high calorie fingers, open everything, gross motor activity with competition, unintentional self harm
Depression treatment protocols
high fiber foods, prepare everything as the nurse, group activity but no interaction, - watch for self destructive behavior, q15 checks
Schizophrenia
high fiber, prepare nothing for them, group interaction, other directed violence
apical chest tube
high for air, top of lung
position the child with pyloric stenosis should be in during feedings? should the feedings be thick or thin position after feedings?
high fowlers thickened feeds right side w/HOB up
HOLD - acronym
high obstruction, low disconnected
examples of delirium
high on upper, withdrawl, fever, alcohol, drugs,
treatment of hiatal hernia
high position, big amount of liquids, high carbs
prolapsed cord
high priority - OB emergency, C- Section push the head up off the cord, dont touch the cord, position her in knee chest, hips up
Asytole: _____ priority. V fib: high priority. Both have no cardiac ____ which equals no brain perfusion. Patient dead in ____ minutes.
high, output, 8
hip incisions laminectomy have
higher chance of infection, more pain, more bleeding
back incision laminectomy has
higher chance of rejection
Cane gait
hold cane on strong side, advance cane with WEAK side
bilateral adrenectomy needs and can go into
hormone replacement, shock
Total thyroidectomy: lifelong ____ replacement. At risk for hypocalcemia- impossible to spare ____ during procedure
hormone, parathyroid
in hyperthyroidism everything is up
hot, excited, nervous diarrhea, hyper symptoms, tremors, exopthalmos
by having all sore throats cultured for strep and treating strep infections
how can AGN be prevented
side to side
how can the woman with cesium implant move in bed
daily weight
how do you assess fluid excess in the child with AGN
REMIND THE PATIENT TO STRAIGHTEN THEIR KNEE CONSTANTLY WHILE STANDING
how do you prevent flexion contracture of the knee after BKA
Graves disease (hyperthyroidism): " your gonna run yourself into the grave" Treatment: radioactive ____, PTU (proplethyouricil) and ______
iodine, thyroidectomy
The one nutrient that commercial formulas are typically low in is __________.
iron
no
is a c-section mandatory for delivery of a woman with CD of pregnancy
yes absolute bed rest
is bed rest necessary when a woman has cesium implant in place
not usually, however if there is severe azotemia then it may be restricted
is dietary protein limited in AGN (acute glomerulonephritis)
YES, THIS IS ONE WAY TO TOUGHEN A STUMP SO IT WILL NOT BREAKDOWN DUE TO THE WEAR OF THE PROSTHETIC LEG; HITTING IT WITH PILLOS IS ANOTHER GOOD METHOD
is it acceptable for the patient to push the stump against the wall
staff mgmt chart
is it illegal, yes then tell supervisor, if no ask is it immediate danger if yes then intervene, if no discuss later, if illegal and harmful intervene then tell
no
is it ok to routinely irrigate indwelling catheters
Choosing appropriate toys:
is it safe? is it age appropriate? is it feasible?
no they wait until it interferes with ADL's
is surgery done immediately upon diagnosis of cataract
higher
is there a higher or lower incidence of fetal death with abruptio placenta compared to placenta previa
YES, IF AVAILABLE YOU CAN GET THEM INTO ANTI SHOCK TROUSERS BUT NOT IF THIS CAUSES A DELAY IN GETTING THEM TO THE OPERATING ROM
is there anything that can be done for the client with a ruptured aneurysm before they get to the operating room
no
is urinary incontinence an indication for catherization
Calcium Channel Blockers
isop, zem, dipin (i saw zem dippin in the calcium channel)
h2 receptor antagonist
itidine, to treat and prevent GI ulcers
Hypoglycemic shock s/s: "drunk in shock" slurred speech, staggering gait, poor ____, delayed reaction time, labile mood (all over place), ____, loud. Shock- low blood pressure, tachycardia, tachypnea, cold, ____, clammy skin
judgement, obnoxious, pale
flight of ideas
jumping from thought to thought rapidly
what principle states that actions should be fair?
justice
potassium wasting diuretics
k wasters have zide
#1 cancer that AIDS pts get
kaposi's sarcoma - cancer of the skin
thyroid storm treatment
keep temp down with ice and cooling blankets, keep o2 up 8-10 liters with mask, 2 staff members
DKA s/s: 1 D, 3 K's, 3 A's: D- dehydration. K- _____ (in blood). K- kusmauls (deep rapid breathing) K- high K (potassium) A- ____ (due to nausea), A- acidotic (metabolic) A- acetone ____
ketones, anorexia, breath
4 stages of L&D
labor, delivery of baby, delivery of placenta, recovery
Oxytoxics: stimulate ____. Ex: pitocin and _____. Pitocin- can cause uterine hyperstimulation, is longer than ___ seconds and closer than 2 minutes.
labor, methergine, 90
what surgery is done for meniere's? what disease often follow the surgery? drugs given for this disease (2)
labyrinthectomy bell's palsy antihistamines & diuretics
MILK
lactose is a sugar found in ?
The 2 most common surgeries used to treat spinal cord injury are ____ and ______.
laminectomy & spinal fusion
2 nonsurgical treatments done for retinal detachment
laser photocoagulation cryosurgery - freezing
Diuretics: Semides end in X. Ex: fourosemide- ____. Baclofen: muscle relaxer. S/e- fatigue, muscle ____. Don't drink, don't ___, don't operate heavy machinery. "Back loafin' " Flexeril: muscle relaxer
lasix, weakness, drive
how long does an ovarian cycle last? how many days after ovulation does menstruation begin
last 28 days menstruation 14 days after start of cycle
Woman's due date: 1st day of ____ menstrual period, add 7 days and 1 yr and subtract ___ months.
last, 3
Tetrology of fallot (trouble): "varied pictures of a ranch" use the first and ___ letter of each word. VD: ventricular defect, PS: pulmonary ____, OA: overriding _____, RH: right hypertrophy
last, stenosis, aorta
phases of labor
latent, active, transition
laxatives
lax
9-12 months life toys
learning verbalization best toy: verbal toy purposeful activity with objects building, sorting, stacking, making, constructing
how are NI performed for acid-base imbalances
least invasive to most invasive
vent alarms: order of NI
least invasive to most invasive
preschoolers when eating, you
leave them alone
LION protocol, if on pitocin
left side, increase fluids, oxygen, notify MD, stop it
If its not back pain or prolapse cord treat with: LION. L- turn on ____ side. I- increase IV. O- oxygen. N- notify ___.
left, doctor
If you exercise you need ______ insulin?
less
Chest tube questions: look at reason for why it was placed and _____. Pneumothorax: tube removes ____. Hemothorax: removes blood. Apical: up high, removes air. ____: bottom, removes blood
location, air, Basilar
Post op laminectomy care
log roll, no dangle, sit for only 30min, walk/stand/lay down
Lantis and Glargine insulin: _____ acting. So slowly absorbed has no peak. Little risk for hypoglycemia. Can give at ____. Duration 12- _____ hrs
long, bedtime, 24
unstable contractions are
longer than 90 sec, closer than 2 mins
Contractions should not be ____ than 90 seconds or closer than every ___ minutes. If they are than can= problems. Can be a sign of uterine ____ or uterine hyperstimulation- would need to turn down or stop ____
longer, 2, tetany, pitocin
Overdose downer
look down
withdrawal upper
look down
overdose upper
look up
withdrawal downer
look up
Psychotic delirium: temporary sudden dramatic secondary ____ of reality. From meds or _____ imbalances. Acknowledge feelings and re-_____ that its temporary.
loss, chemical, assure
Hyperthyroidism
loud, tachy, spasms, tremors, hot, irritable, heat intolerant, cold tolerant, HTn, bulging eyes, ex. Graves Disease
Location and use of basilar chest tube
low (base of lung), removes blood
all psych drugs cause
low BP and weight gain
hyperkalemia
low HR, low UO
common s/s of large ovarian cysts
low back pain pelvic pain abnormal bleeding
psychotropic drugs se, what do they do
low bp and weight changes usually gain, reduce symptoms
acidosis, potassium up
low everything
basilar chest tube
low for blood, base of lung
hypothyroid means
low metabolism
treatment of dumping syndrome
low position, low fluids, solid food low carbohydrates
Lithium and lanoxin: go _____= 2 (toxic levels) all others go high= _____ (toxic level)
low, 20
Hiatal hernia: "everything high". Dumping syndrome: "when you wanna go slow make everything ____." High carbs= low ____
low, protein
lumbar priorities
lower extrem, feeling in leg, bladder, check UO
fast treatment for hyperkalemia
lower hr, give d5w w/ r insulin,
extremities affected by buerger's disease? highest incidence in which group? upon walking, the pt experiences ________ ________
lower only highest in smokers intermittent claudication
hypercalcemia
lowers blood pressure
Trough level: drug at ____. Peak level: drug at _____. "TAP" levels: T- check trough level, A- administer drug, P- draw ____. Draw when drug has a _____ therapeutic window
lowest, highest, peak, narrow
S1
lub, closure of mitral and tricuspid valves
chemicals that can cause burns to oral mucosa when ingested
lye, caustic cleaners
what body system is attacked in mono? average recovery time? which organ should NOT be palpated? why?
lymphatic 3 wk recovery time do NOT palpate the spleen --> it may rupture
neologisms
made up words
if you have a tie with electrolytes dont pick
magnesium
OB meds: Tocolytics- stop labor Ex: turbutaline, and ____ sulfate. Turbutaline: ____ maternal heart rate
magnesium, increases
Violent Clients
make sure you have 5 people before you take down a psych patient only one person talks give them a chance to de escalate
neologism?
making up new words
Celiac's disease is a __________ disease person can NOT tolerate _______ and absorb what mineral
malabsorption gluten (which is a protein) iron; can not absorb fat soluble vitamins either
Haldol: is a deconate (long acting) S/e: ABCDE. Can cause NMS- neuroleptic ____ syndrome, high fever, medical emergency.
malignant
Lithium: for bi-polar disorder. Decreases ____. S/e: peeing, pooping, parasthesia, ____, metallic taste, severe diarrhea.
mania, tremors
fetal lung med baractent survanta is a..., who gets it, when, via the....
manmade surfactant, baby, after born, trachea
examples of MAOIs
mar, nar, par, marplan, nardil, parnate
droplet PPE pt needs... when....
mask, out of room
Terbutaline
maternal tachycardia
tocolytic terbutaline brethine can cause
maternal tachycardia
Fetal lung meturing meds: betamethasone- given to ___, IM, before baby is born. Servanta- surfactant- given to neonate, trans tracheal (blown into trachea), after baby is ____
mother, born
Piaget: stages of thinking: 0-2 yrs old- sensory ____. Present oriented. Teach them ____ you to it. Teach what you are doing, verbally
motor, while
3-point gait
move 2 crutches and bad leg together move good foot *3 points touch down at once
2-Point Gait
move one crutch and opposite foot together move other crutch and other foot together 2 points together for 2 point gait
Syphilis first infects the _____ ______.
mucous membranes
Abruptio Placenta usually occurs in (prima/multi) gravida over the age of ____________.
multigravida 35 (other risk factors: HTN, trauma, cocaine)
Airborne precautions: measles, ____, rubella, TB and ____ (chicken pox). Private room, mask, gloves, handwashing.
mumps, varicella
all kids with CHD will have these 2 things
murmur and echocardiogram
all heart defects have .... and need .....
murmur echocardiogram
baclofen
muscle relaxant, causes drowsiness, muscle weakness, dont drink alcohol, dont drive car, dont be responsible for child under 12
Baclofen is a , it potentiates, mnemonic
muscle relaxant, downers, relax on ur back
class of drugs given with ECT
muscle relaxants
the universal sign of electrolyte imbalance is
muscle weakness
flexaril, two se, 3 pt teaching
muscle weakness, drowsiness, dont watch kids, dont drive, no alcohol
aminoglycoside
mycins, mean mycins
hypothyroidism is also called
myexdema
Hypothyrothyroidism: another name is _____. Treatment: thyroid hormone- ____, levothyroxin. Do not ____, can put into a coma ie ambien. Do Not hold thyroid ____ before surgery.
myxedema, synthroid, sedate, med
vitamin a, antibiotics, retinoids
name 3 drugs given for acne
cranberry juice, apple juice, (avoid citrus juices they make alkaline urine )
name food that make acid urine
CARB, FATS, PROTEINS, VITMAINS, MINERALS, WATER
name the five/six essential nutrietns
MILK & CHEESE, MEAT & LEGUMES, VEGGIES & FRUITS, BREAD & CEREAL
name the four basic food groups
cranial tongs, thomas splints, with peason attatchments 90 degrees to 90 degrees
name3 types of skeletal tractions
70/30 insulin mnemonic
nancy reagan RN, nph regular, first regular then nph
what will you see/hear when you observe the neck, heart & lung of pt w/CD of pregnancy
neck - JVD heart - murmurs lungs - crackles/rales
opistonus
neck hyperextended
big danger of torsion of ovary s/s of rupture
necrosis & rupture s/s: pain, abd distention & abd rigidity
addisons treatment
need corticosteroids (end in sone)
droplet PPE
needs mask, gloves, gown for pt care, goggles for suction, special equipment
airborne needs what room, what to do in room
negative airflow, close windows, door stopper
the purpose of chest tubes is to re-establish
negative pressure
Chest tube: creates _____ pressure in pleural space, this is good and lets lung ____ while chest wall moves.
negative, expand
if two answers mean the same thing,
neither is the right answer
which mycins sterilize bowel
neomycin, canomycin
true
neoplasm refers to benign and malignant tumors T/F?
why do you need laminectomy
nerve compression
wbc <5000
neutropenic precautions
HEAT (IT CAUSES RUPTURE)
never apply ______ to the area of the appendix
Electrolyte treatment rules
never push potassium no more than 40 k per liter IV give d5w and insuline to decrease K
azotemia
nitrogenous wastes in the blood ( increased creatinine, BUN)
Should vomiting be induced after ingestion of cleaning products?
no will damage esophagus again
should basalar be bubbling
no bc no air
patient teaching about organ donation
no cost for donation or harvesting number one goal for donor is comfort and dignity all major religions support it no advantage being rich donation does not delay funeral plans donation does not interfere with open casket
unilateral adrenectomy needs
no hormone
rn in contact PPE
no mask goggle filter mask, need gloves, gown w pt care, disposable supplies, dedicated toys
1/2 hour
no nurse should attend the client with a cesium implant more than ______/ day
Crutch gaits: 2 point gait- move a foot and ____ crutch together, moving two together. 3 point- move two ____ and bad leg together. 2 point mild problem, 4 point- _____ problem
opposite, crutches, severe
discharge teaching laminectomy
no sitting >30min for 6 weeks, lie flat and log roll, no driving, no lifting more than 5 lbs
safety considerations for toys
no small toys for children under 4 no metal toys if oxygen is in use
Dependency treatment: teach co-dependent person to say ____ and that they're a good person. Manipulation: the nature of the act is _____ or harmful. Treatment- set _____ and enforce them
no, dangerous, limits
patient leaves room
no, if yes then mask and clear hallway
Pain meds, systemic for labor, why, when do IV and IM meds peak
none if baby born when med peaks, baby can have resp failure, IV15-30min, IM 30-60mins
Type II Diabetes
noninsulin dependent, nonketosis prone
high baseline variability
normal
Acrocyanosis
normal cyanosis of the baby's hands and feet. Appears intermittently over the first 7-10 days
Peds: always give child more time (to grow and develop), don't rush. When in doubt- call it ___. Ex: 6 yr old can't read- call it normal. When in doubt pick the ____ task. Ex 6 month old rolling over or sitting up- rolling over is easier to do
normal, easier
hyperbilirubinemia
normal, physiologic jaundice appears after 24 hours of age and disappears at about one week of age
FHR accelerations
normal, record
Alcohol withdrawal syndrom
not dangerious semi private room, regular diet, UAL, do not restrain
painful back labor protocol
not emergency, position and push, position knee-chest, push on back, doggy style
when you give K how
not iv push, no more than 40mg
sertraline and warfarin causes
not metabolized, increases INR x2
clamping rules
not more than 15sec and rubber clamps
lithium how it works
not on neurotransmitters, stabilizes nerve impulses
Aminoglycosides (antibiotics): don's use unless _____ else works. "A mean old mycin" ALL END IN _____. Treat infections that are: serious, life threatening, resistant, gram _____.
nothing, MYCIN, negative
earliest sign of any electrolyte disorder is
numbness and tingling
bear down
nurse should limit the clients effort to _____ during labor when CD is present
Safety of toys, no metal if
o2 used
High pressure alarm caused by
obstruction, kink, water in tube, mucus in airway
Name the 2 things for which stool specimens are tested
occult blood, fat, ova and parasites
FHR, high hr >160, what to do
ok, document
beta adrenergic blockers
olol, like valium for your heart
what time of day do you give antibiotics such as penicillin and erythryomycin
on a empty stomach
how to use cane
on strong side and bad leg does with cane
office visits for pregnancy
once a month until week 28, once every 2 weeks until 36, once a week until delivery or week 42
unilateral pneumothorax
one chest tube, apical
if two answers are opposites,
one is probably right
organs from live donors
one kidney, one lung, portion/part of liver, pancreas and intestine
remember sesame street rule
one of these things is not like the others!
how many nitro pills should you take before calling
one tablet - can take up to 3 though
how can the women with cesium implant move in bed
only from side to side
Lispro (Humalog)
onset: 15 min peak: 30 min duration: 3 hr administer with meals or 15 min before
What is a catarct? major s/s? what does their eye look like
opacity of the crystalline lens s/s: cloudiness, diplopia & photophobia eye is cloudy, milky-white pupil
cataract
opacity of the crystalline lens results to blurred vision
what is esophageal fistula #1 & #2 problems associated with this condition
opening between the esophagus & trachea esophagus is connected to the stomach & trachea is connected to the lungs #1 - aspiration #2 - malnutrition
dilation
opening of cervix (0-10cm)
#1 priority for ruptured aneurysm
operating room ASAP
what do calcemias do
opposite of prefix except bp
what do magnesiums do
opposite of prefix except bp
Magnesemias do the _____. In a tie don't pick magnesemias. Skeletal muscle or nerve= _____. Heart = potassium.
opposite, calcium
Meats HIGHEST in cholesterol 3 meats LOWEST in cholesterol
organ meats, liver, heart, brains & kidneys lowest - chicken, pork & mutton
Tie breaker only: the more vital the ____ the higher the priority- organ of the modifying phrase. Order of organ vitality: Brain, ___, heart, liver, ____, pancrease
organ, lung, kidney
Aminoglycosides: "mycin"- mice, mice have big ears. Ears- _____. Monitor pts hearing, ringing, dizziness. When you draw an ear connect it it looks like a ____- nephrotoxic, monitor ____ (best indicator of renal function), also a #8 fits in the ear drawing- cranial nerve ____ (hearing) and administer q8h
ototoxic, kidney, creatinin, 8
Aminoglycosides side effects
ototoxicity and nephrotoxicity
Labor: Stage 1: dilate and efface. Stage 2: purpose of contractions- push baby ____. Stage 4: contractions to stop ____.
out, bleeding
Airborne precautions, mask needs to be removed
outside room
ectopic pregnancy is implantation of a fertilized ovum _____ the _____ most common site & s/s
outside; uterus fallopian tubes s/s: unilateral pelvic pain
Hypernatremia= dehydration. Hyponatremia= fluid _____. Earliest sign of electrolyte disorder is numbness and ____(parasthesia). Circumoral parasthesia: numbess, tingling around _____
overload, tingling, lips
cushings is
oversecretion of adrenal hormone(extra cushion)
In resp alkalosis what ventilation? Vent setting too..?
overventilation, high
Psych questions: best answer- nurse will examine her ___ feeling about it. Also, establishing ____ relationship
own, trust
the only info needed to interpret ABGs
pH and bicarb
normal pH and bicarb levels
pH= 7.35-7.45 bicarb= 22-26
signs of needing laminectomy
pain, parasthesia(numbness/tingling), paresis(weakness)
3 signs of increased intraocular pressure (r/t cataract surgery)
pain, restlessness & increased pulse rate
3 protocals for complications
painful back labor, prolapsed cord, LION
classic s/s of placenta previa? best/safest way to confirm?
painless 3rd trimester bleeding ultrasound
contraction intensity how to measure
palpate over fundus pads of fingers
denzodiazepine
pam/lam/zep, pam/lam/zepp
3 possible causes of hyperemesis gravidarum
pancreatitis, multiple pregnancy, hydatidiform mole
1-3y what kind of play
parallel
what kind of delusions are there
paranoid/persucatory(out to get them), grandiose(they are better), somatic(body part)
first sign of electrolyte disturbance
paresthesia numbness tingling and paresis muscle weakness
presentation
part of baby that enters birth canal first
presentation of baby
part of baby the enters canal first
subtotal thyroidectomy removes
part of thyroid
If all abgs are abnormal
partially compensated
thrombophlebitis
patients in russells traction are particulaly proned to _____
lithium SE, 3 P, what to do
pee, poop, paresthesia, treat
adolescents 12-18
peer group association allow adolescents to be in each others rooms unless one of them is: immunosuppressed contagious fresh post-op
treatment of syphilis
penicillin
EGO INTEGRITY VS DESPAIR
people in late adulthood either achieve a sense of integrity of the self by accepting the lives they have lived or yield to despair that their lives cannot be relived
Diabetes long term complications: Poor tissue ____ and peripheral neuropathy. Ex: eye damage, hurting ____ because can't feel pain, gang green
perfusion, self
PVCs
periodic wide
DM long term compl
peripheral neuropathy, MS bc myeline digest, poor tissue perfusion(vessels calcify)
hemorrhagic illneses
petechiea, eccymosis
Piaget's stages of cognitive development
pg 66
procedure done to relieve s/s in polycythemia vera? describe it
phlebotomy - drain 200-500 mL of blood from body
If the kidney stone is calcium phosphate the diet must be low in _____ too.
phosphorus
loose association, flight of ideas?
phrase after phrase dont relate
xanthine bronchodilators
phylline -- releive airway spasm
sesame street is last resort
pick answer that is most different
subcutaneous
pick answer with 5 in gauge and length
IM injecitions
pick answer with a 1 in gauge and length dont use dorsogluteal (with insulin)
in peds if you dont know bw two right ages always
pick older age
how to use walker
pick up set down, keep things on side
stage 3 of L&D is.... 2 things to do why
placenta delivery, make sure its intact bc can hemmorhage and get infection, make sure 3 vessel cord AVA
the dyspnea of pulmonary embolism is accompanied by ____ _____
pleuritic pain
Pre-op bowel surgery: give aminoglycoside _____ route to sterilize the bowel. PO kills bacteria in gut and doesn't get _____, or hurt liver. "Who can sterilize my bowels?" "Neo Can!" ______ and canimycin.
po, absorbed, Neomycin
coumadin rt, onset, duration, lab, antidote, pregnancy?
po, few days, lifetime, INR/pt , vit k, not in pregnancy
QRST: ventricular _____. P wave = atrial. A lack of QRS segment= _____. Bizzar in question= tachycardia.
polarization, astystole
3 Ps of diabetes
polyuria, polydipsia, polyphagia
symptoms of diabetes
polyuria, polydipsia, polyphagia
painful back labor you...
position knee-chest, on hands and knees, shoulders dowm. push down on her sacrum
Acidosis: Ph goes down: everything goes down except ____ goes up. Hyporeflexia, lethergy, _____, etc. "As Ph goes down so goes my pt" Respiratory ____ can occur
potassium, bradycardia, arrest
if electrolytes have to do with everything else pick
pottasium
proton pump inhibitor
prazole - prazole to treat and prevent GI ulcers
drugs given pre-op vs post-op for cataract surgery
pre-op: mydriatics, dilators & antibiotics post-op: stool softners, antiemetics & analegics
30-50%
pregnancy requires a __________ incrase in the cardiac output
piaget 3-6yr, what period, focus, when and what and how teaching,
preoperational, fantasy, teach day of, what your gna do, with play
fetal station, negative means, positive means
presenting part to ischial spines, bad not out, good almost out
peripheral anti-hypertensives
press notice blood pressure
steps for 70/30 insuline
pressurize N, pressurize, R, draw up R, draw up N
ACE Inhibitor
pril ACE inhibitor for BP, cough and angioedema
(multi/prima)gravida pts are more likely to get PIH
primagravida
Dt pt needs ...room
private near RN station
airborne needs
private room, cohort
contact precautions need ... room or ....
private, cohort
droplet needs ...room unless....
private, cohort
Lamenectomy: removal of spinous ____ of vertebrae. To relieve nerve root ____. S/s: pain, prastesias, paresis- muscle weakness. Location in any neuro problem will determine symptoms and ____
processes, compression, treatment
4 symptoms that should be reported to the physician for a pt with cesium implant?
profuse vaginal bleeding elevated temp N & V these indicate infection & perforation
the ONLY situation that will cause metabolic alkalosis
prolonged gastric suction/vomiting
what med can treat hyperthyroid
propylthyioruracil, PTU
What nutrient is lost in highest amounts during PD?
protein
4
proteins provide 4 Kcalories per 1gm
ideas of reference
pt thinks everyone is talking about them
if a pt has MG, what will be the results of the tensilon test what other dx test can be done
pt will show a dramatic sudden increase in muscle strength EMG
first s/s of AGN
puffiness of face, dark urine (tea colored)
position infant with intussusception will be in? stool description?
pull legs up to chest/abd w/piercing cry jelly stool, bloody mucous
Toddlers 1-3 yrs old: push ____ toys. Gross motor skills- running, walking. No finger dexterity objects ie ____, scissors. Parallel play: play along side not with
pull, pencils
common s/s of abd aneurysm
pulsating mass above the umbilicus
important VS in pts w/aneurysms
pulse & BP will affect pulse first/more -- tachycardia happens BEFORE hypotension
Toddlers 1-3 years
push pull toys work on gross motor skills *parallel play* - alongside but not with
1-3y what toys
push pull, gross motor
benzos work..., but dont,..
quickly, take more than 6 weeks
What is the big danger to staff when caring for a client with cesium implant?
radiation hazard
hyperthyroidism treatment
radioactive iodine
3 tx for hyperthyroidism & side effects
radioactive iodine = radioactive urine PTU = decreased WBC surgical removal
Treatments for hyperthyroidism
radioactive iodine = watch urine! PTU = watch for low WBC thyroidectomy
FHR variable decels, means what, what to do
random, very bad, cord compression, push and position
atrial flutter
rapid P-wave depolarizations in a saw-tooth pattern (flutter)
chronotropic
rate
IN OB: check fetal heart ____ is answer that always wins. Delivery (stage 2): Goes alphabetical order- head, then ____, then nose. Then check for nuchal ___, deliver shoulders, then body
rate, mouth, cord
Can't learn reality: 1st acknowledge feelings, 2nd _____. Dementia: you can do reality orientation, ______ do PRESENTING REALITY.
re-direction, CANNOT
Non-psychotic: insight is ____ based, need good therapeutic communication, recognize their problem. Psychotic: no insight, don't think they have a ____, not reality based
reality, problem
thyroid storm symptoms
really high fever and VS and really crazy(psychotic delirium, reassure)
For which type of aphasia are slow, short, simple directions most useful?
receptive - pt has difficulty understanding your questions/comments
Blood that is a universal recipient? donor?
recipient: AB donor: O
fourth stage of labor and delivery
recovery stage 4 things 4 times and hour in 4th stage: 1. Vital signs assess shock 2. fundus - if boggy, massage 3. look for bleeding, excessive lochia pad saturated in <15min 4. roll her over - check for bleeding under pad
stage 4 of l&d is.... lasts.... four things to do....
recovery, 2hrs, vitals, fundus, pads, roll on side
Wean means?
reduce numbers to get to 0
Benzodiazepines: "zeps" Indications: mild tranquilizers, post- op to ____ so much anesthesia, muscle relaxer, ____ withdrawal, seizures, help people relax when fighting ____. Side effects: ABCD (see phenothiazines)
reduce, alcohol, ventilator
what do chest tubes do
reestablish neg pressure, keep lung expanded, and connected to chest wall
When a pt becomes demanding and self-centered and attention-seeking, the defense mechanism used is ____
regression
AWS Diet
regular
most valid sign of labor
regular contactions
3 signs of labor & explain
regular contractions that get longer stronger closer, dilation cervix opens0-10, effacement cervix thins 0-100%
Truest, most positive sign of labor: the onset of _____ progressive contractions. Effacement: thinning of cervix, up to ____%. Station: fetal presenting part in relation to ischial ____
regular, 100, spines
Humulin 70 D30: 70% N, 30% ____. Top # Numerator- N (NPH) 70/30. Drawing up insulin: want to be RN= regular first then ____.
regular, NPH
anxiety disorder
regular, gross motor activity with competition, low safety risk
Hiatal Hernia
regurgitation of acid into esophagus because upper stomach herniates upward gastric contents move in the wrong direction at correct rate
HHNK treatment
rehydrate and insulin will drop
lie
relationship between spine of baby and spine of mom
station
relationship of fetal presenting part to moms ischial spines
Surviving --- Select-All-That-Apply
remember PRINCIPLE not list never select one, rarely select all pay attention to what causes it vs what results
heat vs cold for rheumatoid arthritis: in remission you should apply in exacerbation " "
remission - heat exacerbation - ice
treatment of cushings
removal of adrenalectomy
Laminectomy is
removal of vertebral processes
what to do for pneumothorax and where to put tube
remove air with tube, apical high for air
what to do for hemothorax and where to put tube
remove blood with tube, basalar for blood
if they don't give you hco3
repiratory
what do you teach all pts on drugs that have agranulocytosis (ex: PTU) as a side effect?
report any sore throat immediately
when a person is unconsciously choosing to disbelieve the truth, they are using _____
repression ** this mechanism is most suspected of causing psychosomatic illness ***
If underventilation
resp acidosis
Is it lung
respiratory
under-ventilation will cause this
respiratory acidosis
What acid/base disorder is seen in Respiratory Distress Syndrome?
respiratory acidosis (CO2 is retained)
increased pH and normal bicarb
respiratory alkalosis
over-ventilation will cause this
respiratory alkalosis
what blood gas disorder is most common in pneumonia
respiratory alkalosis hyperventilation blows off more CO2 than the consolidation traps in the blood
DKA: treatment- regular insulin, IV. #1 cause: acute viral upper ____ infections within the last 2 weeks. After recovery they start going ____.
respiratory, downhill
3 reasons for a blood transfusion
restore blood volume in a hemorrhage maintain HGB in anemia replace specific blood components
DT activity
restricted, bed rest
Within in minutes of birth, what 3 respiratory difficulties occur? (IN RDS)
retractions, nasal flaring & grunting
what is the #1 cause of cardiovascular disease of pregnancy? what is the #1 cause of maternal death in CD of pregnancy?
rheumatic heart disease decompensation - failure of the heart to maintain adequate circulation
if the patient has right hemiplegia, he cannot move his ____ and ____ the stroke was on the ___ side of the brain
right arm & right leg on left side of brain
DS what direction and rate
right direction wrong rate
Post op lamenectomy: log ___. any spinal cord injury pick log roll as an answer. Do not let ___ dangle. Do not let sit for longer than ____ min. May walk, stand, and lie down ____ restrictions
roll, feet, 30, without
Contact precautions: Private room or cohart- same disease same ____. Gloves, ____, handwashing, dedicated equipment, disposable ____.
room, gown, supplies
3 types of parasites abnormally found in stool
roundworm, tapeworm & pinworm
postpartum lochia colors
rubra red, serosa pink, alba white
when pain goes away in appendicitis, this means... treatment for appendicitis
rupture occurred SURGERY do NOT apply heat to area --> can cause rupture
Subq, how long, how thick
s looks like 5, 5/8 inch, 5/8 mm
do not delegate to the family
safety responsibilities, they can only do what you teach them to do
Never let family of pt do....they can only do something if you....
safety, teach them
body fluid used for rapid HIV test
saliva
what do kalemias do
same as prefix except hr and uo
cush man are
same as se of sones
penecillin antibiotic
same ending
General guessing: rule out absolutes. If two answers say the ____ thing neither one is right. If two answers are ____, one of them is probably right.
same, opposite
drug: ARB
sartans angiotensin receptor blockers low BP, cough and angioedema
Function Psychosis
schizophrenia, schizoaffective, major depression, manic potential to learn reality
functional psych. are which 4
schizophrenic, schizoaffective, major depression, mania
sealed vs unsealed radiation
sealed - solid object in body cavity unsealed - substance injected in liquid form into a vein
Of sealed internal, unsealed internal, and external radiation treatment, which is MOST dangerous for the nurse?
sealed internal --> unsealed internal external radiation is of no danger as long as nurse is NOT in treatment room
what type of precautions will be in effect for a pt w/severe preeclampsia? #1 assessment finding to look for???
seizure precautions reflexes -- looking for hyper-reflexia
pt w/meningitis is at risk for developing
seizures
dilantin for? level?
seizures, 10-20
Dilantin (phenytoin) for _____. Range: 10-20, 20 is toxic. Billirubin: newborn- range 10-20 and ____ is toxic. Level 10 or above need to come to hospital. Billirubin in _____- kernicterus.
seizures, 20, brain
best position for pts with emphysema under normal circumstances? flow rate? position during dyspneic episode?
semi fowlers or higher low flow (<2.5 L) sitting upright w/arms folded on overbed table
in which labor position should a women with CD labor be?
semi recumbent, HOB up
best pt position for airway suctioning
semi-fowlers
0-6 months life toys
sensorimotos best: musical mobile second: large and soft
0-6mo what toys
sensory like music mobile
piaget 0-2yr,what period, focus, teaching, what kind of teaching
sensory motor, what happens now, teach as happens, verbal
Crutch gaits: 4 point- move everything _____. Swing through- for non- _____ bearing. "even for even, odd for odd" Use even numbered when have an even number of ____ messed up
separately, weight, legs
sertraline and st johns wort causes
seratonin syndrome
What do aminogycosides treat
serious life threatening resistant infections
Postpartum: lochia- "real slimey accumulation" R- rubra, red color. S- ____- "rosa- rosey cheecks", pink. A- alba, (albino) ____ color
serosa, white
zoloft generic is, its a
sertraline, SSRI
best indicator of renal function
serum creat GFR better but $$$$
is chest tube container knocked over do what?
set it up tell pt to take deep breaths
to treat manipulation
set limits and enforce
how to treat dependancy/codependancy
set limits and enforce, work on self esteem
the best staff approach to control impulsive outbreaks of violence is...
setting limits and doing it consistently
clozapine used for.... SE, monitor
sever schizo, agranulocytosis, WBC every week for 1 mo
#! sign of MG early s/s of MG
severe muscle weakness early s/s: difficulty swallowing, visual problems (BULBAR signs)
after a hysterectomy how long should the pt wait to: - have sex - lift heavy objects - drive
sex: 4-6 wks heavy objects: 2 months drive: 3-4 wks
S/S of hemolytic transfusion reaction? when does this occur?
shivering, HA, low back pain, inc resp, dec BP, oliguria & hematuria occurs within 10-15min of administration
decrease
shock will _____ BP
no
should a pregnant staff care for a client with cesium implant
wheter the clients blood and donor blood are compatible
what does a type and cross match indicate
Lamenectomy discharge teaching: do not ___ longer than 30 min. Lie flat or log roll. No _____ or lifting more than 5 lbs all of these for ___ weeks.
sit, driving, 6
Peaks of meds for SL, IV, IM, PO
sl=5-10min after given, IV 15-30mins after finished, IM 30-60min after given, PO dont worry
CCB does what to heart
slow down relaxes
As the Ph goes....
so goes my pt except for K & MacKussmaul
L&D recovery pads what is excessive bleeding? why roll pt on side?
soaking in 15min or less, to check for blood
lithium is closely linked to
sodium
Potassium imbalance treatment: Kayexalate: is full of ____ (if high sodium, potassium goes down) lasts longer but takes longer to achieve effects. "K exits late" D5W, Regular insulin: "K enters ____"
sodium, early
fomites are on, so use
soft toys, hard toys
Gooddell sign
softening of the cervix
Hegar's sign
softening of the lower uterine segment
Goodell sign: cervical ____. Hegar sign: ____ softening. During pregnancy Hemoglobin will fall- thats ____. Morning sickness: dry carbohydrates before get out of ___.
softening, uterine, normal, bed
The toddler and preschooler will think that illness is caused by_____________.
something they did wrong
steroids
sone/olone side effects are cushings
the pt with spinal cord injury will have (flaccid/spastic) muscles
spastic
9-12 months old: ____ toys are best, purposeful activity. Never pick answers with these words before 9 months old: ____, sort, stack, make, construct.
speaking, build
what organ will be enlarged in polycythemia vera?
spleen - its destroying the excessive RBCs
four stages of labor and delivery
stage 1: labor (Iatent, active, transitional) stage 2: delivery of baby stage 3: delivery of placenta stage 4: recovery (2 hrs after placenta delivery)
oxytoxic meds do what 2 examples
start labor, pitocin, methergine
contraction duration how to measure
start of one to end of one
contraction freq how to measure
start of one to start of second
DO NOT DELEGATE THIS TO A LPN
starting IV hanging or mixing IV meds evaluating changes giving IV push meds giving blood transfusion performing admission, discharge, or if there has been a change, unstable plan of care initial teachingg taking verbal orders from MD
cervidil (prostaglandin)
starts labor
anticholesterol
statin; no grapefruit juice
engagement
station 0 - babys head is in ischial spines
lithium pt teaching, nurs tasks
stay hydrated, if sweating drink sodium(gatorade), monitor Na
lubricant used on suction catheter solution used to clear the tubing during suctioning
sterile water soluble sterile saline
Cant give mycin PO except to
sterilize bowel
Betamethasone (Celestone)
steroid to mature babies lungs: give to mother IM before baby is born
fetal lung med metamethasone is a .... it increases... who gets it, when, what form
steroid, glucose, mom, before baby born 24-36 weeks, IM shot
Addison's treatment: _____ (glucocorticoids), end in "sone". Need to "add a son (sone)"
steroids
2 drug classes with nephrosis
steroids & diuretics
post transplant antirejection drugs
steroids, azathoprine, any drug ending in limus, if a dose is missed must go to doctor immediately, most patients one immunosuppressant for rest of lives, number one problem is rejection
hot spot LUQ
stomach, spleen, pancreas, kidney, upper colon
Hiatal hernia: regurgitation of acid into esophagus, upper part of ____ herniates into diaphragm. Dumping syndrome: gastric contents dump ____ quickly into duodenum
stomach, too
what are tocolytics, examples
stop labor, terbutaline brethine, mag sulfate, nefedipine
When alcohol pts ____ drinking alcohol within 24 hrs= withdrawal symptoms. Within ____ hrs= delirium tremors. Alcohol withdrawal syndrome- not life threatening. Not dangerous. Regular diet, up ad lib, no _____
stop, 72, restaints
In an OB crisis if pitocin is running ____ it. Do not give pain meds to woman in labor if baby is likely to be ____ when the med peaks
stop, born
what is telaniectatic nevi(what happens), nevus flammeus, hemangiomas,cephalohematoma(suture line?)
stork bite(blanchs), port wine stain(doesnt blanch), birthmark of vessels, swelling bw skull and skin, one side, doesnt cross suture line
Sub total thyroidectomy: thyroid ____. S/s: temp 105 and above, extremely high ____, severe tachycardias, psychotic delerium, _____- can cause brain damage
storm, BP, hypoxia
Inotropic
strength of heartbeat,
What is Curlings ulcer? What drug prevents it?
stress GI ulcer - get w/physical stress drugs - H2 receptor antagonists (-tidine) & PPIs (-zole)
word salad?
string random words
CARBS
the major source of energy for the body is _____
FORKED
the man with BPH has a _____ stream of urine
DIFFICULT STARTING TO VOID
the man with BPH has hesitancy. what does this mean
A PULSATING MASS ABOVE THE UMBILICUS
the most common symptom of abdominal aneurysm is _____
FATS
the most concentrated source of energy for body is _____
PERINEAL
the most radical prostate surgery is the _____ prostatectomy
PROTEIN (2ND BEST IS VITAMIN C)
the nutrient needed most for growth and repair of tissues is _____
ABRUPTIO PLACENTA
the placenta separates from the uterine wall prematurely
FALSE, THE PRIAMRY PURPOSE OF DRAPING IS TO PREVENT CHILLING.
the primary reason why an infant is draped during the bath is to provide privacy T/F
BRADYCARDIC
the pulse rate of anorexics is tachycardic or bradycardic
When taking a child to the ER after accidental poisoning has occurred what must accompany the child to the ER?
the suspected poison
pneumocystic carinii
the typical pneumonia of AIDS is caused by ________
Lithium Levels
therapeutic: 0.6 - 1.2 Toxic: > 2
Digitalis (Digoxin)
therapeutic: 1-2 toxic: >2
aminophylline
therapeutic: 10-20 toxic: >20
phenytonin
therapeutic: 10-20 toxic: >20
what do you do for a nonpsychotic
therapuetic communication
kayexalate 2nd problem
there will be a lot of NA since it give up the K which goes into the med and is excreted with stool then rehydrate to fix Na
functionals how to treat
they can learn reality so educate
Why do the crescent-shaped RBCs cause occlusion of the vessels? 3 priorities in a sickle cell crisis
they clump together and create a sludge 3 priorities - oxygenation, hydration & pain control
ideas of referance
think people are talking about them
effacement
thinning of the cervix
tubes for post-op aneurysm -- thoracic vs abd
thoracic - chest tube abd - NG tube for decompression
macrolide antibiotic
thromycin
total thyroidectomy need lifelong
thyroid replacement
subtotal thyroid is at risk for? doesnt need?
thyroid storm, hormone replacement
3 principles to protect yourself from radiation hazard
time distance shielding
DESPAIR
time is too short to start another life, though i wish i could is an example of _____
2 purposes of a spinal tap
to measure or relieve pressure & obtain a CSF sample
what is the purpose of restricting activity after spinal tap? does the pt have to be NPO before a spinal tap?
to prevent headache due to CSF loss NO
ELEVATED
to prevent post-op swelling, the stump should be ____ for 12-24 hours
petaled
to prevent skin irritation of the skin ear the edges of a cast the edges should be _____
Hypothyroidism (myxedema): s/s: cold intolerance, heat _____, flat affect, tired over weight, low ___ and pulse, longer thinking times, slow.
tolerance, BP
uterus postpartum assessment
tone: firm, if its boggy massage, height: fundal height, day post partum location: midline, if not, catheterize or have her pee not midline: full bladder
if pt has respiratory alkalosis, what will the vent setting most likely be
too high
if pt has respiratory acidosis, what will the vent setting most likely be
too low
DKA (type 1)cause
too much food or not enough insulin, infection or illness
Complication of DM hypoglycemia, why, can cause what, symptoms
too much insulin/not enough food, brain damage, drunk and shock
Cushings syndrome: if you have a cushy couch or cushy tushy you have ____ much. Over secretion of adrenal cortex. Treatment: ____
too, adrenalectomy
tylenol
toxic liver - monitor ALT
what is methotrexate toxic to
toxic to almost every organ EXCEPT the heart toxicity made worse with ASA
aminoglucosides are so mean they are
toxic, ear and kidney
St johns wart (not with SSRI's) can increase drug ____ cause it doesn't allow meds to be broken ____. Seritonin syndrome s/e: "SAD head" S- sweating, A- apprehension, D- ____, head ache.
toxicity, down, drowsiness
maoi
tran/sel/phenel, tran---, sel--- phenel
large dose phenothiazine is like a
tranquilizer
drug class given to people with retinal detachment
tranquilizers
What does TENS stand for? used for acute or chronic pain?
transcutaneous electrical nerve stimulation both - based on the gate control theory of pain
treatment & drugs for CD during pregnancy
treatment - REST drugs - diuretics, heparin & digitalis
the s/s of lithium toxicity must watch for a decrease in _____
tremor nausea & vomiting sodium
lithium toxic SE, what to do
tremors, metallic taste, severe diarhea, neuro signs, hold med call md
hold lithium when pt has these symptoms
tremors, metallic taste, severe diarrhea, any other neuro symptoms besides paresthesia KEEP THEM HYDRATED
earliest s/s of hypocalcemia
tremors/tingling
Pregnancy: difficulty breathing- 2nd and 3rd trimester. Teach _____ position- flat with arms on table, leaning forward. Back pain- 2nd and 3rd trimester. Treatment- pelvic ___ exercises to tilt pelvic forward.
tripod, tilt
erikson stages: infancy toddler pre-schooler school age teen
trust vs mistrust autonomy vs shame initiative vs guilt industry vs inferiority identity vs role confusion
When changing central line tubing the patient should be told to_________?
turn head away from site, hold breath & perform valsalva maneuver
bilateral pneumothorax
two chest tubes, apical
laser , surgical removal (intraocular or extraocular lens extractions)
two common treatment of cataract
organs that can be donated from deceased donors
two kidneys, heart, two lungs, pancreas, liver, intestines decently: hand and face
SOB, PALPITATIONS
two most common subjective complaints of woman who is decompensating during labor
What blood test must be done before a blood transfusion what does this test tell you?
type & cross match tells you if the pt's blood & donor's blood are compatible
MAOI what foods bad why
tyramine, can cause hypertensive crisis
purpose of upper GI series? how much barium do they swallow?
ulcerations 8 oz of barium
Bruit: swooshing sound. AAA: hear a bruit over peri _____ area
umbilical
false
uncleanliness is a cause of acne?
How long can a unit of blood be on the unit before it must be started?
under 30 minutes
under what age should you NOT take a oral temp? oral temp okay for pt w/NG?
under 4 yrs old NOT OKAY
Adrenal cortex: disorders begin with "A" or "C". Addison's: ____ secretion of adrenal cortex. S/S: hyperpigmented, don't adapt to ____. If don't have adequate adrenal cortex when in stress can go into ____
under, stress, shock
Addison's disease
undersecretion of adrenal cortex, not enough hormone, BRONZE/tan, go into shock very easily. STRESS can trigger. treatment: steroids
Addisons is
undersecretion of adrenal hormone
In resp acidosis what ventilation? setting too...?
underventilation, low
BMI #s underwt overwt obese
underwt: <18.5 overwt: 25-29.9 obese: >30
what do you need after chest surgery
unilateral hemo pneumo tubes
bruits
unusual sound, usually abnormal, heard in auscultation
AWS activity level
up ad lib
using stairs with crutches
up with good, down with bad
Alkalosis: ph goes up: everything goes _____ except potassium goes down. Can cease and ______.
up, aspirate
with upper things go?
up, hr, elevated, hyper
Word salad: babble random words. Neologism: making ____ words. Narrowed self concept: psychotic refused to ____ room or change clothes. Believe clothes define who they are.
up, leave
pillows no plastic covers
upon what do you support a cast while it dries
wide eyes
upper
test to dx pyloric stenosis
upper GI series (barium swallow)
Position for Thoracentesis
upright, lean forward over bedside table with arms supported on pillow
As the prostate enlarges it compresses the ___________ and causes urinary ________.
urethra; retention
lumbar complications
urinary retention
3 appropriate indications for bladder catheterization
urinary retention, to check for residual, to monitor hourly output NOT USED FOR URINARY INCONTINENCE
precautions with radioactive iodine
urine is radioactive, flush 2x, double glove, hazmat for spill, private room 24h
How will you know the patient has entered the fluid mobilization or diuretic phase?
urine output will increase pt will be on hourly urine output & daily wts
Probable and presumptive signs of pregnancy: are maybes. All ____ and blood tests. Positive pregnancy test is ___ a positive sign of pregnancy.
urine, not
what is ECT? what does it treat? is the pt awake?
use of electrical shock current delivered to the brain to induce a seizure that treats DEPRESSION pt is under general anesthesia - artificially ventilated
STABLE PATIENT
use of the word stable, chronic illness, post op >12 hours, local or regional anesthesia, unchanged assessment, to be discharged
UNSTABLE patients
use of unstable, acute illness, <12 hours, general anesthesia, changed assessment, newly/just admitted, lab values C/D unstable patients are experiencing: unexpected always unstable: hemorrhage, hypoglycemia, hyperexia, pulselessness, breathlessness
how is the bleeding of abruptio placenta different from that in placenta previa
usually painful; bleeding is more voluminous in placenta previa
3 things to check pospartum
uterus, lochia, legs
potentially life threatening
v tach
CCBs are... for the heart
valium
anxiety first 6 weeks use... then use....
valium, elevil
increase
vasoconstriction will ______ BP
decrease
vasodilation will _____ BP
preferred IM injection site for kids <3
vastus lateralis
When cardiac output fails, name three ways the heart will try to compensate.
ventricle will hypertrophy, dilate & heart rate will increase
If there is QRS depol it is
ventricular
QRS Depolarization
ventricular
Tetralogy of Fallot 4 characteristics
ventricular defect pulmonary stenosis overriding aorta right hypertrophy
what principle states that the greatest good comes from telling the truth
veracity
9-12mo what toy
verbal
lamina
vertebral spinous processs
most common visual defect w/retinal detachment? common causes of retinal detachment
visual defect - veil or curtain in the line of sight common causes - trauma, aging & cataract surgery
Tie breaker in prioritization is based on... order is...
vital organ, brain, lung, heart, liver, kidney, pancreas
the more _____ the _______, the higher the priority
vital/organ brain, lungs, heart, liver, kidney, pancreas
PH: 7.35-7.45. Ph in 6's= highest priority. Assess ____, and call doc asap. BUN: 8-____. If high assess for ____
vitals, 25, dehydration
mixing a little of the clients blood with the donor blood and looking for agglutination
what does blood cross matching mean
What vitamin is not absorbed in a patient with pernicious anemia? what happens as a result? can you replace (the vitamin) it orally?
vitamin B12 -- can NOT be replaced orally as it will no be absorbed RBCs do NOT mature & become severely anemic
FALSE - THEY ARE NECESSARY FOR A BODY'S CHEMICAL REACTIONS
vitamins and minerals provide energy for the body
Important assessment of pre-op lumbar laminectomy
voiding & leg function
Lamenectomy permanent restrictions: NEVER lift object by bending at ___. Cervical- no allowed to lift anything over ____. No off trail biking, carnival rides, jerking motions, etc.
waist, head
with elders and delirium
wait to see if dementia
anticoagulant/platelet
war/dog
what should the pt do (self care) before and after the EEG?
wash their hair
when changing prozac dose
watch for suicide
50-60%
water accounts for __________ of an adults total weight
70-75%
water accounts for __________ of an infants total weight
TRUE (EVEN BONE)
water is present in all body tissues
Neutropenic precautions: don't drink ____ been sitting longer than 15 mins- no pitchers. ____ bottles of water good for 1 hr, unopened good for 4 hrs.
water, opened
Hypokalemia s/s: bradypnea, tachycardia, polyuria, flaccid, +1 reflexes. (+2 is normal), _____, lethargy, decreased _____, constipation
weakness, LOC
hypothyroidism
weight gain, tired, lethargy, low BP, low glucose, bradycardia, brittle hair, cold intolerance Hashimotos treatment: pills
All psych drugs cause low bp and ____ changes. Phenothiazines: "we use zines for the zanny" In large doses= anti-psychotics. In small doses= anti-____. They are major ____, the "big guns"
weight, emetics, tranquilizers
0.9 normal saline no glucose
what IV solution is hung with a blood transfusion
BEDREST . DO NOT GET THESE PEOPLE UP
what acivity order is the client with an aneurysm supposed to have
asses lung sounds frequently
what additional assessment must you make for a woman with CD
soap and water
what agents are best for catheter care
blackheads and white heads
what are comedones
low back pain, wheezing, fever, hives
what are signs of transfusion reaction
hereditary, bacterial, hormonal
what are the 3 causative factors in acne vulgaris
n/v, diarrhea, stomatitis (oral sores)
what are the 3 most common chemotherapeutic GI side effects
puffiness of face, dark urine
what are the first signs of AGN
severe pain, restlessness
what are the post operative signs of hemorrhage into the eye
shivering, headache, low back pain, increased pulse and respiration, decreasing BP, oliguria, hematuria
what are the signs and symptoms of a hemolytic transfusion reaction
low back pain, shaking HA, increasing temp, confusion, hemoptysis
what are the signs and symptoms of febrile transfusion reaction
hives - urticaria, wheezing, pruritus, join pain ( arthralgia)
what are the signs of symptom of an allergic reaction to transfusion
diuretics, heparin, digitalis
what are the three most common drugs given to women with CD in pregnancy
pain moderate to severe , restlessness, increased pulse rate
what are the three signs of increased intraocular pressure
#1 potential for infection, potential impairment of urethral tissue integrity
what are the top 2 diagnosis for a client with a catheter which is #1
HEMATURIA, PROTEINURIA +3-+4, SPECIFIC GRAVITY UP
what are the urinalysis finding on AGN
hemolytic, febrile, allergic
what are three types of transfusion reaction that can occur
THE AORTA
what artery is widened in a thoracic aneurysm
WBC
what blood count is elevated in WBC?
typ and cross match
what blood test must be done before a transfusion
O
what blood type is the universal donor
AB
what blood type is the universal recipient
anxiety and stress leading to sympathoadrenal shut down of the bowel
what causes cast shut down
ANTIHYPERTENSIVES
what class of drugs is the client with an aneurysm most likely to be on
red
what color is a first degree burn pale or red?
7 , FACIAL NERVE
what cranial nerve is affected in bells palsy
prevent viral replication
what do NRTI's and PI's do
PULL CAREFULLY ON THE CATHETER TO APPLY LOCAL PRESSURE ON THE PROSTATE WITH THE FOLEY BALLOON
what do you do if you see an increase in blood content of urine coming out of catheter
INCREASE FLOW RATE
what do you first if you see clots in the tubing
ABOVE THE KNEE AMPUTATION
what does AKA mean
BELOW THE KNEE AMPUTATION
what does BKA mean
a delayed onset of AIDS for as long as possible ( usually can delay onset for 10-15 years)
what does the physician hope to acheive with NRTI's and PI's for HIV
B&O SUPPOSITORIES
what drug is use to treat bladder spasm
PERINEAL EXERCISES, START AND STOP STREAM OF URINE, BECAUSE DRIBBLING IS A COMMON BUT TEMPORARY PROBLEM POST OP
what exercise should the post prostectomy patient do upon discharge? why?
N/V
what follow the RUQ abdominal pain of appendicitis?
large gauge, 18 gauge
what gauge needed is used with a blood transfusion
smokers
what group of people has the highest incidence of buergers disease
it becomes clogged with antigen-antibody complexes which then cause inflammation and loss of function
what happens to the kidney in AGN
the cells clump together and dont flow well
what happens when blood is administered with dextrose IVs
take on empty stomach and avoid sunlight ( photosensitivity)
what instruction do you give to a client taking tetracycline
thromboangiitis obliterans
what is another name for buergers disesase
it is a stress GI ulcer , you get these with any severe physical stress,. tagamet, zantac, pepcid, protonix, prilosec (h2 receptor antagonist)
what is curlings ulcer? why is it problem in burn patients ? what drug prevents it?
lowest force of blood on artery walls
what is diastole
LANUGO (SOFT DOWNY HAIR)
what is found over the body of the client with anorexia nervosa
IT IS A STORED FORMED OF GLUCOSE/ ENERGY MANUFACTURED BY THE LIVER
what is glycogen
never have the bag at a higher level than the bladder
what is important about the level of the urinary drainage
pain in calf upon walking
what is intermittent claudication?
PERITONEAL INFLAMMATION
what is present when rebound tenderness is present?
maximal force of blood on artery walls
what is systole
Kaposi's sarcoma
what is the #1 cancer that AIDS patients get
decompensation
what is the #1 cause of maternal death in cardiovascular disease of pregnancy
FLEXION OF THE KNEE
what is the #1 contracture problem after BKA
LOWER BODY TEMPERATURE DURING FEVER
what is the #1 purpose of a tepid sponge bath
ONE SIDED UNILATERAL FACIAL PARALYSIS
what is the #1 symptom of bells palsy
nausea and vomiting r/t bowel obstruction
what is the #1 symptom of cast syndrome
rest
what is the #1 treatment of CD during pregnancy
NPO and NG tube for decompression
what is the #1 treatment of cast syndrome
you can easily move the patient around in bed
what is the advantage of balance counteraction
19-35
what is the age range for early adulthood
64+
what is the age range for late adulthood
tetracycline
what is the antibiotic most commonly given to clients with acne
serum creatinine
what is the best indicator of renal function
DIGITAL RECTAL EXAM
what is the best way to screen men for BPH
radiation hazard
what is the big danger to staff when caring for a client with cesium implant
RUPTURE LEADS TO SHOCK AND DEATH
what is the big danger with aneurysms of any type
p. acnes (propionibacterium acnes)
what is the causative organism of acne
EGO INTEGRITY VS DESPAIR
what is the developmental task for LATER adulthood
intimacy vs isolation
what is the developmental task for early adulthood
generativity vs stagnation
what is the developmental task for middle adulthood
packed cells have less volume and plasma than whole blood
what is the difference between whole blood and packed cells
RUQ PAIN
what is the first sign of appenicitis?
102 F
what is the highest that the temp will be in appendicitis?
to prevent pressure in or on the eyes
what is the major objective in caring for a client after surgical cataract removal
number of pill taken in 24 hours can be overwhelming. frequency also makes it hard to remember an alarm wristwatch is used
what is the most challenging aspect of combination of drug therapy for HIV disease
AZT (zidovudine)
what is the most common NRTI used?
PERITONITIS
what is the most common complication of appendicitis?
decrease sodium and water (restriction)
what is the most common dietary modification for the woman with CD who shows signs of decompensation ?
moderate Na+ restriction. fluid restriction is #2 if edema is severe
what is the most common dietary restriction for AGN
E.COLI
what is the most common organism to cause UTI with catheterization
up through the catheter in the days following catheterization
what is the most common route for organism to enter the bladder when a catheterization is used
inflammation of the lips; causes birth defects
what is the most common side effect of accutane? and what is most important in health teaching in administration
keep drainage system closed, do not disconnect junction of tubing
what is the most effective way to decrease UTI with catheters
bed rest - they can walk if hematuria, edema and HTN are gone
what is the most important intervention in treating AGN
LEUKOCYTOSIS
what is the name for an elevated WBC?
MCBURNEY POINT
what is the name of the RLQ abdominal pain where appendicitis pain finally localizes?
12/80
what is the normal adult blood pressure
rheumatic heart disease
what is the number 1 cause of Cardiovascular Disease of pregnancy
SURGERY - APPENDECTOMY
what is the only treatment recommended for appendicitis?
TO KEEP CATHETER CLEAR OF CLOTS AND TO DRAIN URINE
what is the primary purpose of a 3 way continuous bladder irrigation ( CBI) after TURP
before admnistration, Q15MIN x2 after administration begun, Q1 x1 after transfusion has stopped
what is the routine for vital sign measurement
reduce and immobilize fracture, relieve muscle spasms, and prevent deformities
what is traction used for
decreased RBS, WBC, and platelets
what lab findings are present in AIDS
coughing, sneezing, bending at the waist, straining at stool, rubbing or touching eyes, rapid head movement
what movements are to be avoided after cataract surgery
iron, folic acid - prevent anemia (anemia always make the heart work more)
what nutrients should be supplied in the diet of the pregnant woman with CD
group 1 beta hemolytic strep
what organism causes acute glomerular nephritis
call MD, get blood sample, get urine sample, monitor vitals, send blood to lab
what other things are appropriate after a blood transfusion reaction
palm
what part of your hand do you use to handle wet cast
lying face down, also do not lie on operative side for a a month
what position are to be avoided after cataract surgery
do not lie on operative side do not lie on back
what positions are okay after cataract surgery
numbness, tingling, burning, pallor, unequal or ablset pulse, unequal coolness
what s/s would you report if they were present after cast application
keep it open with saline
what should the nurse do with the IV line if transfusion reaction is suspected
vital signs
what should the nurse measure before starting a transfusion
PLAIN WATER, COTTON BALLS, WASHCLOTHS
what solution and material are used to cleanse the eyes of an infant
70% ALCOHOL TO PROMOTE DRYING (TREND IS TOWARD SOAP AND WATER )
what solution is commonly used for care of umbilical cord
NORMAL SALINE (0.9NACL)
what solution is used for continuous bladder irrigation
0.9 normal saline
what solution should blood be transfused
sebaceous glands
what structures are involved in acne vulgaris
100-105
what temperature is appropriate for the water used to bathe an infant
coombs test detects antibodies to Rh
what test identifies Rh factor
body cast
what type of cast causes cast syndrome
low residue (decrease bowel motility )
what type of diet is this woman with a cesium implant on
ACID ASH
what type of diet is used in BPH
candida
what type of oral / esophageal infections do AIDS patients get
bucks
what type of traction is most commonly used for hip fracture in adults
bryants
what type of traction is most commonly used for hip fractures in children
lye, caustic cleaners
what types of chemicals cause burns to oral mucosa when ingested
acidity, low pH
what urinary pH prevent UTI
HIV
what virus causes AIDS
safety
what will be a high priority nursing diagnosis for a client post cataract surgery
LYING PRONE SEVERAL TIMES A DAY
what will prevent hip flexion contracture after AKA
a protective patch for 24 hours then a metal shielt at night only for 3 weeks
what will the client be wearing after cataract surgery
murmurs
what will you hear when you auscultate the heart of the client with CD of pregnancy
crackles-rales
what will you hear when you auscultate the lungs of the client with CD of pregnancy
distended neck veins - JVD
what will you see when you observe the neck of client with Cardiovascular disease of pregnancy
pick up with forceps
what would you do if the cesium implant came out
PTT: draw two lines on TT and it makes an "H" for heparin. Diuretics: any diuretic ending in letter __ exes out potassium= wastes potassium. And Diurill included. Diurill sounds like "die you will" when your dying- ____ away.
x, wasting
Positive signs of pregnancy: fetal skeleton on ____, fetal presence on ultrasound, auscultation of fetal heart ____-hear it between 8-12 weeks. Examiner ____ fetus
xray, rate, palpates
do you still take insulin on sick days?
yes
does the pt need to empty their bladder before an IVP? is dye used?
yes & yes
should apical chest tube be bubbling
yes good like soda
FALSE, IT CAUSESE DAMANGE/ BRUSING
you may use friction to remove vernix caseosa from an infants skin T/F
what is meant by the phrase "advance the drain 1 inch"
you pull the drain 1 inch out
grandiose delusion
your are superior
phenothiazines are for the , it is a....what dose
zanys, crazies, antipsychotic, large
atypical antipsychotics
zap
phenothiazine
zine
Aminoglycosides: 3 drugs that end in mycin that are not these: arythromycin, ______ and clarithromycin. If it has "thro" in it, than throw it _____.
zithromycin, out