NCLEX Study Questions

Pleural effusion

A buildup of fluid between the tissues that line the lungs and the chest.

catheter ablation

A catheter ablation is a procedure used to treat arrhythmias, especially SVT. A catheter is inserted through the femoral vein or artery, and threaded to the conduction fiber in the heart causing the arrhythmia. A radiofrequency energy uses heat to destroy this fiber, preventing further arrhythmia. EKG reading should be regular post procedure.

pernicious anemia

A decrease in red blood cells when the body can't absorb enough vitamin B-12.

hypopituitarism

A decrease in secretion of pituitary hormones. If it occurs druing childhood, it results in dwarfism. If it druing adulthood, it can result in infertility; lethargy; dry, thick skin; hypoglycemia; loss of appetite; hypotension; abdominal pain; and intolerance to cold

Meningitis

A high WBC count and decreased level of consciousness are associated with meningitis. Meningitis is most often cause by an infectious organism, increasing the WBC count. One defining feature is an increased Intracranial Pressure (ICP) which presents as a decreased level of consciousness.

toxoplasmosis

A protozoal infection associated raw or undercooked meat and poor handwashing after handling infected cat litter.

compartment syndrome

A serious condition that may develop when swelling exists in one or more of the four compartments of the leg or arm

Heart Failure is treated with

ACE inhibitors and ARB's (sartan's)

DDAVP

ADH analog: synthetic peptide used for pituitary diabetes insipidus

Increase in ICP can lead to

ADH problems (Diabetes Insipidus)

Mineralocorticoid

ALDOSTERONE - Mineralocorticoids are a class of steroid hormones characterized by their influence on salt and water balances. The primary mineralocorticoid is aldosterone

Hyperthyroidism

Graves disease. Too much energy. Agitated, nervous, weight loss, heat intolerance. exophthalmos.

In a CDU (chest drainage unit)

Intermittent bubbling is expected. Continuous bubbling means there is a leak somewhere in the tubing. If bubbling has stopped, the lung has re-expanded.

Mantoux test

Intradermal test to determine tuberculin sensitivity based on a positive reaction where the area around the test site becomes red and swollen. Positive result is an induration of 15 or more millimeters

Intermediate Acting Insulin (cloudy)

Isophane suspension (NPH). Onset: 1-1.5 hours, Peak: 6-12 hours, Duration: 18-24 hours. Cloudy suspension.

why take Vitamin D supplements?

It helps your intestines absorb calcium, which is important for bone formation.

Best solution for shock

Lactated Ringers (more electrolytes)

Monitor for increased lethargy and drowsiness in patients with meningitis.

Lethargy and drowsiness indicate a decreased level of consciousness, which is the cardinal sign of increased ICP (Intracranial Pressure), which can be life-threatening.

Lithium Therapeutic Range

Lithium's therapeutic range is 0.5-1.5mcg

When evaluating the effects of atorvastatin, the nurse should monitor the results of which laboratory test?

Liver function tests including AST should be monitored before, at 12 weeks after initiation of therapy or after dose elevation, and then every 6 months. If AST levels increase to 3 times normal, atorvastatin should be reduced or discontinued. Atorvastatin may increase alkaline phosphatase and bilirubin levels.

The client has just returned from electroconvulsive therapy (ECT) and is very drowsy. What is the position of choice for the nurse to place the client in until full consciousness is regained?

When someone is very sedated and not fully conscious, we want them on their side so the airway remains open and the secretions can drain.

Most frequent causes of hypercalcemia

Primary hyperparathyroidism and malignancy account for about 90% of cases of hypercalcemia

Heparin antidote

Protamine Sulfate

Mannitol

Rapidly working diuretics used for the treatment of early stage Acute Renal Failure (ARF), reduction of intracranial pressure and increased introcular pressure as seen with Glaucoma.

Particle Induced Diuresis

When there is too much sugar in the blood, it causes the patient to pee a lot.

I should not drive my car until I see how the medication affects me.

Xanax

Hyperthyroid diagnosed with

Xray or T4 blood test

Pregnant women showing signs of pre-eclampsia or eclampsia

Should be positioned in left recumbent position to avoid uterine pressure on the vena cava and prevent supine hypotension syndrome.

Common Findings in Sickle Cell Anemia

Yellow-tinged sclera - Jaundice is a common clinical finding of sickle cell disease, caused by bilirubin released from damaged or destroyed RBCs

When you have SIADH

You retain water and your urine output goes down.

If patient's creatinine level is low

You would question a CT of the spine with contrast. The creatinine level of this patient indicates impaired kidney function. Contrast is nephrotoxic and is contraindicated for patients with nephropathy.

Do not lay a pregnant lady on her right side or back

because the uterus can put pressure in the vena cava and cause supine hypotension

Diabetics should never take a beta blocker

because they can mask the signs of hypoglycemia.

check heart rate and BP

before giving heart meds

Enderolol / Propanolol

beta blockers. Decrease myocardial contractility. Decrease HR and BP. Good for hyperthyroid for patients because they also decrease anxiety. Beta blockers suppress epi

Testicular cancer most common

between 15-36

No intramuscular shots on people with

bleeding issues

Hepatitis B is transmitted by contact with

blood and body fluids.

Milk can raise your

blood glucose in the case of hypoglycemia.

Steroids can cause

brittle bones / osteoporosis

Hepatitis A is transmitted

by the fecal/oral route.

High potassium foods

Beans, dark leafy greens, potatoes, squash, yogurt, fish, avocados, mushrooms, and bananas.

Why is benzotropin given to the client receiving chlorpromazine for treatment of schizophrenia?

Benztropin is used to treat drug-induced extrapyramidal reactions seen with chlorpromazine (schizophrenia)

terbutaline

Beta 2 agonist used to suppress premature labor, but cardiac stimulatory effects may be hazardous to mother and fetus

When administering alendronate (Fosamax)

Bisphosphonates are associated with esophageal irritation that can lead to esophagitis. Sitting upright decreases the time the medication spends in the esophagus.

Hypermagnesemia

Confusion dizziness or lightheadedness fast, slow, or irregular heartbeat low blood pressure muscle weakness sleepiness

Hypothyroidism puts patient at risk for

Coronary Artery Disease (CAD)

bimatoprost (Lumigan)

medication for glaucoma. It won't restore vision, but will keep it from getting worse. Glaucoma cannot be cured, just treated.

diabetics should wait until blood sugar normalizes

to start exercise. They should exercise when their glucose is at their highest. Should exercise at same time every day.

Oral potassium causes GI

upset

Thyroid hormones give

us energy.

Pitocin

used to induce labor

The Schilling test is a medical procedure used to determine whether or not you are absorbing vitamin B12 properly

used to test for pernicious anemia

Gestational diabetes

usually screen for between 24-28 weeks, unless patient has a history of diabetes in previous pregancies or in family. Then they are tested at first visit.

Patients radioactive implants

visitors must stay 6 feet away, stay no more than 30 minutes. No pregnant visitors and no visitors under 16.

Hoarseness and weak voice after thyroidectomy

watch for airway issues. Could have nerve damage and airway could be compromised. Also you want patient to have no feelings of pressure.

Parathyroid Gland can be damaged in thyroidectomy

watch for hypocalcemia signs: agitation, stiffness, seizure. Keep a trach at bedside

After removing a foley catheter

watch patient for urinary retention

Insulin dosage based on

weight.

Elevated serum ALT levels

will often signal liver damage.

Flexion is bad

with total hip patients

In pregnancy

women need 2 to 3 times normal amount of insulin

watch for hypoglycemia when

you switch injection sites

If you don't have enough ADH

you'll well lose large volumes of water

Creatinine for women

0.5-1.0 mg.dL

Normal creatinine

0.6 to 1.3

Normal creatinine levels

0.6 to 1.3

Creatinine for men

0.6-1.3 mg/dL

Normal Digoxin Levels in infants

0.8-2.0 ng/mL

The nurse notes that a client has impaired swallowing as a result of a cerebrovascular accident (CVA). Appropriate for the nurse to include in the plan of care?

1. Sit the client up at a 90 degree angle during meals. 3. Encourage the client to sit up for 30 minutes after eating. 4. Educate a family member on the Heimlich maneuver.

Four actions of gluccocorticoids

1. change your mood. 2. Suppress immune system 3. Break down protein and fat. Patient may look thin 4. Alter glucose response. Watch for hyperglycemia.

Report chest tube drainage of

100 ml in one hour to physician

BNP levels should be below

100 pg/mL . higher indicates heart failure.

PT time

11-12.5

Hemoglobin for women

12-16 g/dL

Hemoglobin for men

14-18 g/dL

INR time

1.3-2.0

Normal Magnesium levels

1.5 - 2.5

Creatine kinase (CK) range

10 - 120 micrograms per liter (mcg/L)

Suction for no more than

10 seconds at a time

Normal AST levels

10-34. Higher can indicate liver disease

Normal ALT levels

10-40. Higher than can indicate liver damage

clinical breast exams every 3 years for women

20- to 39

Rh Sensitization affects

2nd baby

Normal CVP (Central Venous Pressure)

3-8 mmHg

Phosphorous

3.0-4.5

Normal Potassium Range

3.5-5.0

Hematocrit for women

38-47

Normal White blood cell count

4,500-10,000

Normal BUN levels

8-20

Normal Calcium Range

8.2-10.5

Acute Coronary syndrome

A TERM USED TO DESCRIBE A GROUP OF SYMPTOMS CAUSED BY MYOCARDIAL ISCHEMIA; INCLUDES ANGINA AND MYOCARDIAL INFARCTION

RBC's for women

4.2-5.4 million/mm3

RBC's for men

4.7-6.1 million/mm3

Hematocrit for men

40-54

Yearly colonoscopy at age

50 if no problems, then every 10 years

Normal ALT

7-40

Reflex score of (0)

Absent

Adrenal Insufficiency

Addison's disease. Signs and symptoms include hypoglycemia, dehydration, weight loss, and disorientation. Additional signs and symptoms include weakness, tiredness, dizziness, low blood pressure.

Not enough aldosterone (mineralcorticoid)

Addison's disease. Will lose sodium and water. Fluid volume deficit.

succinylcholine chloride is used in ECT to relax the muscles to prevent severe muscle contractions during the seizure, thereby reducing the possibility of fracture or dislocated bones.

Adverse effects include malignant hyperthermia, apnea, and arrhythmias.

Atypical Antipsychotics Common examples: Risperidone (Risperdal), Quetiapine (Seroquel), Aripiprazole (Abilify)

Adverse effects include sedation, drowsiness, appetite stimulation with weight gain, orthostatic hypotension, HA, dry mouth, agitation and anxiety.

Mammogram yearly at

Age 40. No lotion or powders on breast before exam.

Contributing factors to cataracts

Age, eye injury, corticosteroids, and unprotected sunlight exposure are contributing factors.

amiodarone

Amiodarone is for use only in treating life-threatening heart rhythm disorders. You will receive your first few doses in a hospital setting, where your heart rhythm can be monitored using an EKG

Hypocalcemia signs and symptoms

Anger. Anxiety. Confusion. Depression. Facial Twitching. Hallucinations. Lightheadedness. Muscle Cramps

Dilantin

Anti-convulsant. Causes hyperplasia of gums - bleeding gums Give extra VIT. D

Which interventions should the nurse include for a client with sickle cell crisis who is experiencing pain?

Apply local massage gently to affected areas which helps reduce muscle tension. This helps to decrease swelling thus decreasing pain. Also, support and elevate the affected joints.

Rapid Acting Insulin

Aspart, Lispro - Onset: 5-15 minutes. Peak: 1-3 hours, Duration: 3-5 hours. Administer with meals. DO NOT administer unless meal is readily available.

The nurse is caring for a trauma client who is receiving a unit of whole blood. The client begins to experience lower back pain. What actions should the nurse take?

Assume the worst, and stop the transfusion first, then continue with the assessment. Low back pain is a sign of an acute hemolytic reaction. This is the most dangerous and potentially life-threatening type of transfusion reaction. It occurs when the donor blood is incompatible with that of the recipient . Lab tests for presence of hemoglobin which indicates hemolytic reaction. Take vital signs. Change IV tubing to remove all blood.

B-type Natriuretic Peptide (BNP) Blood Test

Brain natriuretic peptide - amino acid secreted by the ventricles of the heart in response to excessive stretching of heart muscle cells. Indicates heart failure

bumetanide (Bumex)

Bumex is a loop diuretic and can cause hypokalemia. Ensure potassium is included in the diet.

Bulimia Nervosa

Calluses or scars on the knuckles or hands from sticking fingers down the throat to induce vomiting. Puffy "chipmunk" cheeks caused by repeated vomiting. Discolored teeth from exposure to stomach acid when throwing up. May look yellow, ragged, or clear. Not underweight - Men and women with bulimia are usually normal weight or slightly overweight. Being underweight while purging might indicate a purging type of anorexia. Frequent fluctuations in weight - Weight may fluctuate by 10 pounds or more due to alternating episodes of bingeing and purging.

When administering iron dextran IM

Change the needle after drawing up the medication and before injecting the medication

What dietary education should the nurse provide for client who receives hemodialysis three times a week?

Client can't get rid of sodium and potassium through urine. Restrict sodium to decrease thirst and fluid excess. Restrict potassium to decrease the risk of heart arrhythmias associated with hyperkalemia.

Aldosterone

Steroid that makes you retain sodium and water. Made in the adrenal glands.

gastroenteritis

Stomach flu

florinef (fludrocortisone)

Given for Addison's disease. Replaces aldosterone. It must be taken lifelong and cannot be stopped abruptly (adrenal crisis). It's best taken same time every day. Patient can adjust dose according to weight gain or loss.

Diseases where you have too much aldosterone

Cushing's and hyperaldostronism

Illness in a diabetic can lead to

DKA

Disaster preparedness

Develop a single response plan, educate individuals to the specifics of the response plan, and practice the plan and evaluating the facility's level of preparedness are effective means of implementing emergency preparedness.

Risperidone

Does not require regular blood draws

mebendazole

Drug of choice in treating pin worms in children

Asystole

Epinephrine, atropine, CPR

hyperpituitarism

Excess secretion in child = GIGANTISM; adults = ACROMEGALY

Polyphasia

Excessive hunger

Polydipsia

Excessive thirst

Hypercalcemia signs and symptoms

Excessive thirst and frequent urination. nausea, vomiting and constipation. bone pain. muscle weakness, confusion, lethargy and fatigue.

SIADH

Excessive water retention, hyponatremia

In a fracture

Extremity can shorten.

Insulin needle disposal at home

FDA approved sharps container should be used, however, needles, syringes, and sharps may be disposed of in a hard plastic container.

Atropine

GI - Slows motility, spasm Eyes - Dilates pupils DO NOT GIVE TO GLAUCOME PTS Heart - Increase HR Resp - bronchodilator (Atrovent)

Long Acting Insulin

Glargine (Lantus) - Onset: 2-4 hours. No Peak, Duration: 24 hours.

Xanax withdrawal

Have the patient lie down on a stretcher with bedrails up The 1-4 day period after Xanax withdrawal is the most dangerous. Xanax is a benzodiazepine and withdrawal symptoms include life-threatening seizures. Having the patient lie down with bedrails up is part of seizure precautions and is the first priority

Do not ever aspirate

Heparin or lovenox

Hepatitis A

Hepatitis A is a virus transmitted via the oral-fecal route and lives on human hands. Hand washing is the single most effective way to prevent transmission of Hepatitis A.

Premarin

Hormone Replacement - Estrogen. Treats Menopause symptoms. Can cause headaches. Periods continue

Benzodiazepine

I should not drive my car until I see how the medication affects me.

To treat hyperkalemia

Insulin may be given. It allows potassium and glucose to leave the blood stream and enter the cells, thus lowering serum potassium levels.

Central Venous Pressure (CVP)

Measured in the right atrium

A client with type II diabetes reports normal blood glucose levels at bedtime and high blood glucose levels in the morning for the past week. What instruction would the nurse give the client?

Morning hyperglycemia may be the result of dawn's phenomenon or the Somogyi effect. The client must take their blood sugar between two and three o'clock in the morning for several days to determine the cause of morning hyperglycemia. If the client has decreased blood sugar between two and three o'clock in the morning, suspect Somogyi effect.

Hyperkalemia

Muscle fatigue Weakness Paralysis Abnormal heart rhythms (arrhythmias) Nausea

myasthenia gravis medications

Must be taken on time. Too early can cause complication of weakness and too late can cause extreme weakness to point of paralysis.

Addison's disease signs and symptoms

Not enough hormones - weakness and fatigue. Weight loss and decreased appetite.Low blood pressure.Low blood sugar, Nausea, diarrhea or vomiting

Rh Sensitization

Occurs with an Rh- mom and an Rh+ baby.

parathyroid

Parathyroid hormone (pth) controls calcium. It pulls calcium from bones causing an increase in serum calcium.

A client in the manic phase of bipolar disorder is constantly walking around the day room and refuses to sit down and eat. Which food should the nurse request from dietary?

Pizza Sticks. High protein, high calorie, nutritious finger foods are required when the client will not sit down to eat.

well there be drainage tubes following a pneumonectomy?

Pneumonectomy means the ENTIRE lung has been removed...Where does a chest tube go? Into a pleural space. If your lung, is gone then the pleural space is gone

Spironolactone (Aldactone)

Potassium sparing diuretic

Triamterene

Potassium sparing diuretic

Reflex Score of (1+)

Present, but diminsihed

Short Acting Insulin Regular

Regular - Onset: 30 minutes to 1 hour, Peak: 2-4 hours, Duration: 6-8 hours.

Too much ADH

SIADH. Retention of water only and sends patient into a fluid volume excess. There is a lack of urine output. If client does pee, it will be concentrated.

fluoxetine

SSRI. Prozac

Never recap needles

Safety violation

Magnesium Sulfate acts like a

Sedative, vasodilator, and anticonvusant

The schizophrenic client tells you, "I am Jesus, and I am here to save the world!" He is reading from the Bible and warning others of hell and damnation. The other clients on the unit are upset and several are beginning to cry. What nursing intervention is most appropriate?

Set verbal limits and have the client return to his room. You must set limits of where they are allowed to preach. This is disrupting others and they need to be redirected to their room for a cool down and then another activity shortly thereafter.

Cushing's disease (too much cortisol)

Symptoms are a fatty hump between the shoulders, a rounded face, and pink or purple stretch marks.

myasthenia gravis

Symptoms include muscular weakness and progressively more common bouts of fatigue. Patient can have trouble swallowing. watch for aspiration and choking.

Thyroid gland produces three hormones

T3, T4, Calcitonin. We need iodine to make these hormones.

Mantoux Test

TB test. Bigger than 15mm in normal risk group

Teach school age children

Teach "stop, drop, and roll' in case clothing catches on fire.

What should the nurse teach a pregnant client who comes to the clinic reporting hemorrhoids and constipation?

Teach adequate hydration and increased fiber intake. No meds.

A nurse is conducting an initial admission history on a client who is reporting bone pain secondary to cancer with metastasis to the bone. What does the nurse determine is the most important information to gather during this initial screening?

The most important information to gather during the initial screening is the client's perception and description of the pain. Pain is subjective, based on the client's perception.

The nurse cares for a patient 1 hour after a percutaneous liver biopsy. The nurse is MOST concerned if which of the following is observed?

The patient frequently coughs after deep breathing.

Vanillylmadelic acid test

The vanillylmandelic acid (VMA) test is primarily used to detect and rule out neuroblastomas (pheochromocytoma) Looks for excess levels of epinephrine and nor-epinephrine. Need 24 hour urine collect. Avoid Vanilla for a week before test.

Lithium therapeutic range

Therapeutic range: 1-1.5mEq/L, toxic at levels of 2.0mEq or >

The elderly are at greater risk of developing sensory deprivation because

They have decreased visual, auditory, and gustatory abilities.

Terbutiline

Tocolytic - used to prevent pre-term labor

Cushing's disease

Too many steroids. Symptoms are a fatty hump between the shoulders, a rounded face, and pink or purple stretch marks.

Oxybutynin (Ditropan)

Treats an overactive bladder, such as incontinence or a frequent need to urinate by helping you have more control over the need to urinate

Diazepam (Valium)

Treats anxiety, muscle spasms, seizures, and other medical conditions. This medicine is a benzodiazepine.

Chlordiazepoxide (Librium)

Treats anxiety, symptoms of alcohol withdrawal, and tremor. This medicine is a benzodiazepine.

Allupurinol

Treats gout and some kinds of kidney stones. Lowers the amount of uric acid in blood.

dobutamine

Treats heart failure and helps the heart pump blood.

Hydrochlorothiazide

Treats high blood pressure and fluid retention (edema). This medicine is a diuretic (water pill).

Hydralazine

Treats high blood pressure and heart failure. This medicine is a vasodilator.

Amlodipine

Treats high blood pressure or chest pain and angina

Verapamil

Treats high blood pressure, severe chest pain (angina), and irregular heartbeat (arrhythmia).

Kayexalate

Treats hyperkalemia

Cardinal Signs of Parkinson's disease

Tremors, rigidity, bradykinesia, and postural instability

Sulfasalazine

Ulcerative colitis. Drink lots of fluids REPORT SORE THROAT, RASH IMMEDIATELY.

Diltiazem

Used alone or together with other medicines to treat high blood pressure and angina

chlorpromazine

Used to treat Schizophrenia. Side effect is neuroleptic malignant syndrome. Signs are high fever, extreme muscle rigidity, and fluctuating vital signs. Contact primary health provider immediately.

Eye drop medications

Wait 10-15 minutes between different eyedrop medications to give them time to absorb an avoid one medication washing another one out

Hypokalemia

Weakness Fatigue Muscle cramps Constipation

Cortisone / Steroids

Weight gain, Na+ retention, K+ Loss NEVER STOP SUDDENLY

A client with a history of adrenal insufficiency is placed on fludrocortisone. Which value is most important for the nurse to monitor?

Weight is monitored to determine the dose.

AV shunts should have the presence of

a bruit and a thrill.

pheochromocytoma

a small vascular tumor of the adrenal medulla, causing irregular secretion of epinephrine and norepinephrine, leading to attacks of raised blood pressure, palpitations, and headache.

Akathisia

a state of agitation, distress, and restlessness that is an occasional side-effect of antipsychotic and antidepressant drugs.

yearly clinical breast exams

after age 40

Chest tube in 2nd intercostal space is for

air drainage

You CAN massage an

amputation stump

Rotate insulin shots within

an area first

Osteomyelitis is

an infection in the bone. It can be caused by bacteria reaching your bone from outside or inside your body.

Vancomycin is a nephrotoxic drug

and can cause impaired renal perfusion, which would cause a decreased urine output. This is a serious adverse effect and should be reported to the physician.

Pelvic exams every year for women every year

and pap smears every three years if there has been no problem

You elevate vein problems

and you lower artery problems

Liquid diet for more than 3 days put person

at nutritional risk

Never lay a pregnant lady on her

back

Never push eviscerated organs

back in or put pressure on the organs. cover with sterile 4x4's

Calcitonin forces calcium from blood

back in to bones

Low grade fever in a cancer patient or other immunosuppressed patients

can be a sign of sepsis. Their immune system can't mount a high fever.

hypothyroidism (myxedema)

can be mistaken for depression

Naproxen

can be ototoxic

If you have family members with a history of prostate

cancer, start PSA screenings yearly at 45.

Aplastic Anemia

caused by reduced red blood cell count, due to bone marrow disorders

Magnesium causes vasodilation

causing flushing. Causes BP to come down.

Steroid dosing (florinef)

changes throughout life.

Schizoaffective disorder

characterized by the mania and depression of bipolar disorder with the delusions/disturbed thought process of schizophrenia. Racing thought are a classic symptom of a manic episode, while conspiracies indicate paranoia.

Never clamp a

chest tube.

cardiac tamponade

compression of the heart by an accumulation of fluid in the pericardial sac.

Prempro

conjugated estrogens/medroxyprogesterone

CT/MRI contrast processed in the kidneys

contraindicated in patients with impaired kidney function.

Signs of community-acquired pneumonia include

cough, crackles, egophony, tactile fremitus, fever, dyspnea, sputum production, myalgias, and pleuritic chest pain.

Calcitonin

decreases serum calcium by moving calcium to the bone

Pulseless V-tach and v-fib

defibrillate, defibrillate, defibrillate, epinephrine, lidocaine or amioderone

In diabetes insipidus think

diuresis

First intervention for phantom pain is

diversional activity

When a chest tube is removed

doctor will have patient take a deep breath and hold or valsalva

If hypogylcemic

drink 4-6 ounces of juice or cola. Do not use any foods that have fat in them as it slows absorption of glucose

Any time a client is losing fuid

either as a result of illness or a surgical procedure (thoracentesis, dialysis) they can go in to fluid volume deficit. Watch vitals.

Polyuria

excess urination

Magnesium is

excreted through the kidneys

splints help immobilize

fat emboli and muscle spasms

streptokinase

fibrinolytic. Some people are allergic.

Type I diabetes

first sign is often DKA

Chest tube in 8th or 9th intercostal space

fluid drainage

hypotonic solutions are good

for rehydrating when hypertension is a concern because they do not stay in the vascular space.

Cover open

fractures with something

Hold Glucophage / metformin 48 hours after

heart cath

When a client on crutches is going down stairs

hold the injured foot up in front, and hop down each stair on the good foot.

Reflex score of (4+)

hyperactive

Not enough aldosterone (mineral corticoid) leads to

hyperkalemia. Symptoms include muscle twitching, muscle weakness, flaccid paralysis, decreased bowel sounds.

Taking aldosterone can cause

hypokalemia

re-insert dirty trach

if it is the only option.

Give diuretics

in the morning

neurovascular checks in fractures

include movement and sensation

Reflex Score of (3+)

increased but not necessarily pathological

Normal respiratory rate for 6 month old

is 30 to 45 per minute

Sublingual morphine

is often used in hospice because the patients are unable to swallow, and intravenous access can be painful and not conducive to palliative care.

Calcium gluconate

is the antidote for magnesium toxicity.

With amputations

keep a tourniquet at the bedside

People who take radioactive iodine should not

kiss anyone or be near babies for 24hrs after taking.

H-pylori and pernicious anemia

linked to stomach cancer

worry about shock and fat emboli in

long bone, pelvic, and any crushing injury

After thyroid surgery

look for bleeding on the back of the neck

Not enough ADH (diabetes insipidus)

lots of urine output

left sided heart failure backs up into the

lungs

Wilm's tumor

malignant tumor of the kidney occurring in childhood. Don't massage.

Repeated vaginal infections

may be an indication of type II diabetes in women

What independent nursing interventions should the nurse include when planning care for a client who is in a fluid volume excess?

monitor for shortness of breath (orthopnea), raise head of bead to 45 degrees, elevate edematous extremities. These are independent nursing actions that will increase venous return and decrease edema. Also the nurse should assess for crackles, changes in respiratory pattern.

Diabetics should eat

mostly complex carbs, then fats, then protein because most diabetics have renal disease. Should eat a high fiber diet, which slows down glucose release.

Reflex Score of (2+)

normal

Addison's Disease

occurs when the adrenal glands do not produce enough of the hormones cortisol or aldosterone

Day 7 through 12 are the best days

of menstrual cycle to do self breast exam

Listen for crackles and wet sounding lungs

on the back (posterior) side

Do not store a continuous passive motion machine

on the floor, because of the risk of infection. select a clean surface.

Post heart cath, check for

pain - pain at puncture site, they may be bleading pulse pallor paralysis paresthesia

No sex or douching before

pap smears

Sex can be resumed after a heart attack when

patient can climb a flight of stairs or walk around the block without discomfort.

Never pull out a

penetrating object.

Any food with lost of protein has

phosphorous too.

Antidiuretic hormone is found in the

pituitary

After pneumonectomy

position client on affected side so good lung can breath deeply.

Iron preparations are administered by the z-track technique

preferably in a large, deep muscle such as the ventrogluteal muscle.

Chlorpromazine (Thorazine)

psychotic disorders, schizophrenia, mania, Tourette's syndrome. Thorazine may produce pronounced orthostatic hypotension* Adverse effects include: extrapyramidal reactions, neuroleptic malignant syndrome, seizures, anorexia, urinary retention, dry mouth, leukopenia, agranulocytosis, sedation and tardive dyskinesia after prolonged use.

Watch for rhythm changes, BP increase, and HR increase when

pushing thyroid drugs

If a radioactive implant comes out

put on gloves, pick up with forceps or tongs, and put it in lead lined container. Do not take out of room. Call radiation department to come and get it.

Walking with a walker

put the walker about one step ahead of themselves and walk into it, stepping off on your injured leg.

decrease fiber in person with

radioactive implant. They will also have a foley catheter to avoid bladder distension.

Thyroid storm could be adverse affect of

radioactive iodine

pharmacological iodine

reduces size of thyroid. Given prior to thyroid surgery to reduce the size of the gland. Take in juice or milk with a straw.

Magnesium sulfate in pregancy

relaxes uterus and helps stop pre-term labor

With questions about Addison's (not enough aldosterone)

remember they are losing sodium and water. okay to increase sodium in diet. Daily weights. Should stay within 2-3 lbs or original weight.

pneumonectomy

removal of an entire lung

Insulin syringes and needles should be stored at

room temperature.

Always assess before

selecting an implementation answer

Number one symptom for heart attack in elderly is

shortness of breath

A client who is receiving a prostaglandin agonist for the treatment of glaucoma

should only treat the affected eye. even if the colors of the eyes changes.

when suctioning a trach

stop advancing suction when patient starts to cough or you meet resistance

When a cancer drug extravastates

stop the infusion and put on ice packs.

As a rule, remember clear before cloudy;

that is, draw up the regular (clear) insulin first, and then draw up the intermediate insulin (Isophane - cloudy).

right sided heart failure

the blood backs up into venous system (Edema)

A client on crutches is going up stairs

the client should lead up with the good foot, keeping the injured foot raised behind them.

ADH lives in

the pituitary. Any head trauma or surgery could affect the pituitary. ADH problems are usually secondary to another problem.

Asthmatics should not take beta blockers because

they can precipitate an attack.

What is the relationship between Calcium and Phosphorus?

they have an inverse relationship. increase in phosphorus decreases calcium in plasma

When you see the phrase "respiratory depression"

they mean under 12 breaths a minute.

With Polyuria

think shock

You can delegate a complex, but stable patient

to an LPN. Keep any patients with life threatening or potentially life threatening issue.