NCLEX study questions

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Congenital hypothyroidism is _______ TSH and low ___

Increased; low T4

S3 and S4 are

abnormal

First drug in line for treatment of C-Diff

Metronidazole (flagyl)

What type of medication is contraindicated in patients with HF?

NSAIDs

Nursing considerations for Thiazide Diuretics

Obtain baseline vital signs, give with meals to decrease GI upset, replace K+ if lower than 3.5, avoid giving patients with gout, Monitor renal function

Nursing considerations for loop diuretics

Obtain baseline vitals, administer furosemide SLOWY, replace K+ if less than .5

-tadine (antiviral) Examples; drug class

amantadine; rimantadine antiviral; anti influenza A

Pre-schooler (3 to 5 years): Theorist Freud, type of development and stage

Psychosocial Phallic

JVD, hepatosplenomegaly, splenomegaly, ascites, edema, increased abdominal girth are all signs of

RIGHT sided heart failure

Hodgekins lymphoma would show a presence of what cells

Reedsternberg cells

Which type of insulin is available by IV?

Regular insulin (short acting )

What is the most commonly used DMARD

Rheumatrex

St Johns Wort should be avoided when taking what type of medications?

SSRI's

-cillin Examples; drug class

amoxicillin; ampicillin; dicloxacillin penicillin antibiotic

digoxin toxicity signs and symptoms

anorexia, visual symptoms, nausea vomiting, diarrhea, fatigue, weakness, confusion

Action of spironolactone

antagonizes aldosterone which increases absorption of sodium, excretion of Na+ and H2O, NOT K+

What medications help with the "death rattle"

anticholinergic medications such as a transdermal scopolamine or atropine sublingual drops effectively treat this symptom by drying up excess secretions

What class of meds should not be given while an epidural catheter is in place?

anticoagulants

What is metoclopramide?

antiemetic medication that treats nausea, vomiting, and gastroparesis by increasing GI motility and promoting stomach emptying

Beers criteria for drugs that can be harmful to the elderly include:

antipsychotics, anticholinergics, antihistamiens, antihypertensives, benzodiazepines, diuretics, opioids, and sliding insulin scales

S2 (DUB) is what

aortic and pulmonic valve closure

Carvedilol is what and used for what purpose

a beta blocker; used to improve cardiac output and slow the progression of heart failure

-statin Examples; drug class; special things to remember

atorvastatin; lovastatin; simvistatin; pitavastatin HMG-CoA reductase inhibitor; statins obtain baseline cholesterol levels and notify MD if there are muscle aches or pains, anorexia, GI disturbances, avoid alcohol should be taken with evening meals or at bedtime baseline liver enzymes should be obtained

Hep B is transmitted through...

body fluids; sexual contact and infected blood

-bital Examples and drug class

butabarbital; phenobarbital; barbituate (sedative)

What is used to lower serum phosphorous levels

calcium acetate

Pericarditis can lead to...

cardiac tamponade

-mustine Examples; drug class; special things to remember

carmustine; estramustine; lomustine alkylating agent (antineoplastic)

left side of the heart

carries oxygenated blood from the lungs to the body

a 4 year old should be able to

catch a ball 50% of the time copy or draw a square hop on one foot

cef- ceph- Examples; drug class; important things to remember

cefaclor; cefprozil; cephalexin cephalosporin antibiotic check for PCN allergy due to cross sensitivity

Clients with an allergy to penicillin antibiotics, can possibly experience a cross sensitivity to

cephalosporin antibiotics

HIV, HPV, and multiparity are risk factors for

cervical cancer

Angina pectoris is

chest pain that is caused by myocardial ischemia; chest pain with activity, shortness of breath, fatigue

Pain in the right quadrant that radiates to the right shoulder would be indicative of

cholecystitis

Before an MRI the nurse needs to assess for

claustrophobia Metal Pacemaker

What does intermediate acting insulin look like

cloudy

sign of right to left shunt?

clubbing fingertips

-zepam -zolam Examples; drug class; important things to know

conazepam; diazepam; lorazepam; alprazolam; estazolam; midazolam benzodiazepine commonly administered with haloperidol Flumazenil is the antidote

-tinib Examples; drug class;

crizotinib; dasatinib; erlotinib; getitinib antineoplastic

parin; -parin

dalteparin; enoxaparin; heparin; antithrombotic; anticoagulant should be withheld if significant thrombocytopenia, enoxaparin requires CBC monitoring but not coagulation studies, do not give with epidural catheter in place

-nacin Examples; drug class;

darifenacin; solifenacin muscarinic antagonist (anticholinergic)

infarction =

death

a low pulse pressure can indicate

decreased cardiac output (patient with heart failure)

Peripheral vascular disease is where

deoxygenated blood cant get back to the heart. Pooling of oxygenated blood in the extremities

What is desmopressin used to treat?

diabetes insipidus

NSAIDs decrease effectiveness of

diuretics and drugs that control blood pressure

Grade 3 murmur sounds like

easily heard

what is Hyperopia?

farsightedness-can see far but not close

The nurse is gathering subjective and objective data from a client with a diagnosis of suspected rheumatoid arthritis (RA). The nurse would expect to note which early signs and symptoms of RA? Select all that apply. 1.Fatigue 2.Weight gain 3.Restlessness 4.Morning stiffness 5.Pain with movement only

fatigue, morning stiffness

A client is admitted to the hospital emergency department after receiving a burn injury in a house fire. The skin on the client's trunk is tan, dry, and hard. It is edematous but not very painful. The nurse determines that this client's burn should be classified as which type?

full thickness

After a bronchoscopy absence of ____ ______ is normal for 2 hours post op

gag reflex

What are the adrenal cortex hormones

glucocorticoids, mineralocorticoids, sex hormones

In type 1 diabetes the cells are starved of _______ since there is no ______ to bring it to the cells

glucose; insulin

onset for type 2 diabetes is

gradual

calcium channel blockers + _________ _____ = severe hypotension

grapefruit juice

What foods are rich in vitamin K?

green, leafy veggies and liver

What is pediculosis capitis?

head lice

BNP is ___ in HF

high

After a patient takes a single puff from their MDI, what should they do?

hold it for 10 seconds rinse mouth out with water to remove any leftover medication and spit out water to ensure medication is not swallowed

Side effects of spironolactone

hyperkalemia, diarrhea, gastritis, drowsiness, erectile dysfunction, gynecomastia

Tumor lysis syndrome is a emergency that causes

hyperkalemia, hyperuricemia, hyperphosphatemia, hypocalcemia

Purpose of spironolactone

hypertension, edema, hypokalemia, hyperaldosteronism, cross sex hormonal therapy, spironolactone inhibits testosterone

Endocrine glands 8

hypothalamus; pancreas; pituitary; adreanal; thyroid; ovaries; parathyroid; testes

S/S of a thyroid storm

increased temp; tachycardia; hypertension; nausea/vomiting/diarrhea; agitation/anxiety; delirium/seizures or coma

Oseltamivir (Tamiflu) can be given to clients with symptoms of ______ within the last 48-72 hours

influenza

Action of thiazide diuretics

inhibit reabsorption of NA+ and Cl-; excretion of Na+, Cl- and H20

Action of loop diuretics

inhibit reabsorption of Sodium and Chloride, acts on 3 sites to increase reabsorption

Treatment for malignant hyperthermia

initiate IV dantrolene ASAP; cool the client and treat high potassium levels;

Theophylline is what type of med and what is it used for

it is a methylxanthine, used for long term control of chronic asthma

Azathioprine is contraindicated if _______is present

leukopenia

What is malignant hyperthermia?

life threatening hypermetabolic condition triggered by certain drugs used for general anesthesia

adrenalectomy requires

lifelong glucocorticoid replacement

what is bumetanide?

loop diuretic

Ejection Fraction is ___ in most types of HF

low

Serotonin syndrome is characterized by

mental status change; autonomic dysregulation; neuromuscular hyperactivity

pain assessment scale for ages 5 years and older

numeric scale

Treatment for hyperparathyroidism

parathyroidectomy; administer phosphates, calcitonin and IV oral biphosphonates;

interventions for a thyroid storm

patent airway; non salicylate antipyretics; anti thyroid medications; cooling blanket

liver cirrhosis leads to

portal hypertension and splenomegaly

Digoxin and ________ levels should be assessed with the administration of Digoxin

potassium

Addisonian crisis S/S

profound fatigue; dehydration...shock!; renal failure; vascular collapse; hyponatremia; hyperkalemia

Second degree AV block looks like

progressive lengthening of PR interval until QRS is dropped (long long drop now you got a Wenckebach)

Adolescents (12 to 18 years): Theorist Freud, type of development and stage

psychosocial genital

Why do you push furosemide slowly

rapid administration can cause permanent hearing loss

How should high doses of furosemide be administered and why?

slowly to prevent ototoxicity

What is indicated for someone with dumping syndrom?

small frequent meals consumption of protein and fat at each meal-avoid concentrated sugars restrict lactose intake Consume liquids 1 hr before or after eating instead of with meals

What is the major electrolyte in extracellular fluid?

sodium

bicarbonate replacement therapy

sodium bicarbonate

Medications for hypertensive crisis

sodium nitroprusside labetalol diazoxide fenoldopam trimethaphan

What is the K+ sparing diuretic

spironolactone

Baseline liver enzymes are obtained for clients taking _____ and _____

statins and isoniazid (for TB)

post cardiac catheterization how should the client be positioned and for how long?

supine with affected extremity flat for 2-6 hours

cardiac afterload is clinically measured by

systolic blood pressure

Trachea deviation from midline is a sign of

tension pneumothorax

Parathyroid hormone (PTH) controls what

the levels of calcium in the blood

PR interval is what

the movement of electrical activity from atria to ventricles

What is the SVR

the resistance it takes to push blood through the circulatory system to create blood flow

When someone is AV paced (atrioventricular) where are the pacemaker spikes on an EKG?

there is one prior to the P wave and the second prior to the QRS complex

Why are NSAIDs contraindicated in patients with HF?

they contribute to sodium retention

In a patient with a pleural effusion what should the nurse anticiapte?

thoracentesis

what is chlorpromazine used for

to control shivering in a hyperthermic state

What are HMG CoA reductase inhibitors (statins) used for

to treat primary hypercholesterolemia, for prevention of coronary events, for protection against MI and stroke for clients with diabetes, and to help increase HDL levels in clients with primary hypercholesterolemia

Hyperthyroidism S/S (too much thyroid hormone gives you ENERGY)

too much energy; nervous; irritable; attention span; increased appetite; weight loss; hot; exopthalmos (bulging eyes); enlarged thyroid; goiter; increased BP and pulse

What is the name for a polymorphic ventricular tachycardia

torsades de point

TEF stands for

transesophageal fistula

Drugs in the ACE inhibitor class are used for

treating heart failure, hypertension, MI, diabetic or non diabetic nephropathy

If a clients MAP falls below 65 what are you worried about

underperfusion

Babinkski sign can indicate

upper motor neuron lesion

In individuals affected with gout, the body either produces too much ____ _____ or is unable to excrete enough ____ ____ and it builds up

uric acid

allopurinol prevents what

uric acid production

Levofloxacin is a fluoroquinolone antibiotic prescribed for

urinary tract infections

Uses for Azathioprine

used to prevent organ rejection in people who have received a kidney transplant, also used to treat rheumatoid arthritis. This is an immunosuppressant.

Gynomastia is irreversible or reversible?

usually reversible after spironolactone therapy has stoppped

_________ is usually administered for 3-6 months following PE to prevent further thrombus formation

warfarin

Systolic HF is

weakened heart muscle, the ventricle does not EJECT properly

-statins should be taken

with evening meals or at bed time

How is an unstable ( hypotensive) patient in ventricular tachycardia with a pulse, treated?

with synchronized cardioversion

Is levothyroxine safe during pregnancy?

yes

Drugs for all types of seizures except petit mal-CaPhe mnemonic

CArbamazepine; PHEnytoin/phenobarbital

BNP is a good indicator of what?

CHF

If an infant is grunting during feeding we should be concerned about ?

CHF

Thrombolytic Agents are? (ghostbusters hint)

CLOT BUSTERS! they work quickly to restore circulation, as such they increase risk for bleeding

Memory trick: CO ZY RE D stands for what

CO (contract) ZY (systole) RE (relax) D (diastole)

Replacement therapy for calcium

Calcium citrate Calcium carbonate or calcium acetate

What should be on hand to counteract toxicity when giving magnesium sulfate via IV?

Calcium gluconate

A client admitted to the hospital is taking capecitabine for breast cancer. The nurse should monitor the client for which symptom that is a side or adverse effect of the medication? 1.Dyspnea 2.Dizziness 3.Headache 4.Constipation

Dyspnea

Pneumonic for Left Sided HF..... DROWNING.... means what

Dyspnea, Rales, Orthopnea, Weakness, Nocturnal paroxysmal dyspnea, Increased HR, Nagging cough (frothy, blood tinged sputum), Gaining weight (2-3lbs a day)

Side effects of osmotic diuretic

Edema, blurred vision, nausea vomiting diarrhea, urinary retention

What is expected in SLE (systemic lupus erythematosus) especially during a flare up?

Elevated ESR, Mild leukopenia, thrombocytopenia, butterlfy rash across nose and cheeks,

Urine specific gravity measures

Elevated levels of urea and other nitrogen compounds in the blood.

A postpartum client is diagnosed with cystitis. The nurse should plan for which priority action in the care of the client? 1.Providing sitz baths 2.Encouraging fluid intake 3.Placing ice on the perineum 4.Monitoring hemoglobin and hematocrit levels

Encouraging fluid intake

What med is given during a thyroid storm to reduce the synthesis of the thyroid hormone?

Lugol solution

Left sided heart failure is associated with (L)

Lungs

SSRIs cannot be paired with what? As there is risk of serotonin syndrome

MAOIs

Contact precautions mnemonic- MRS WEE

MRSA RSV Skin infections Wound infections Enteric infections (C diff) Eye infections

Magnesium replacement therapy consists of

Magnesium sulfate Magnesium gluconate or magnesium hydroxide

-triptan Examples; drug class; important things to know

almotriptan; eletriptan; rizatriptan; sumatriptan; antimigraine; selective 5-HT receptor agonist sumatriptan is contraindicated in clients with coronary artery disease and uncontrolled hypertension

-setron Examples; drug class; special things to remember

alosetron; dolasetron; ondanestron Antiemetic and antinauseant May cause seritonin syndrome

-phylline Examples; drug class; special things to remember

aminophylline; dyphylline; oxitriphylline; theophylline xanthine derivative (bronchodilator) it can cause seizures and life threatening arrhythmias; signs of toxicity: headache, insomnia, nausea, vomiting; cimetidine and ciprofloxacin can dramatically increase serum theophylline levels, and should not be used in these clients

-tyline Examples; drug class; important things to know

amitriptyline; nortriptyline; protriptyline tricyclic antidepressant; has neuropathic pain relieving effects anticholinergic effects

-pine Examples; drug class; special things to remember

amlodapine; felodipine; nifedipine calcium channel blocker no grapefruit juice (causes severe hypotension), side effects are dizziness, flushing, headache, peripheral edema and constipation

stroke volume is what

amount of blood pumped out of the ventricle with each beat or contraction

What is a thyroid storm

an acute life threatening emergency with uncontrollable hyperthyroidism

autonomic dysreflexia is what

an acute life threatening response to noxious stimuli (bladder distention, tight clothing) in clients with spinal cord injuries above T6

Sjogrens syndrome is

an autoimmune disease that cause dry eyes and mouth. Use artificial tears, vaginal lubricant. frequent dental exams, lukewarm showers with mild soap and avoid decongestants

Type 1 diabetes is caused by

an autoimmune response

Clients with any form of prosthetic material in their heart valves or who have unrepaired cyanotic congenital heart defects or a prior history of Innefective endocarditis should take what prior to dental procedures?

antibiotics

Atropine is a __________ agent

anticholinergic

what is foscarnet and what do you need to monitor in patients receiving it?

antiviral med that is very toxic to the kidneys; serum creatinine level is monitored 2-3 times weekly

priority action when you have a patient with a sucking chest wound

apply a sterile occlusive dressing taped on 3 sides (petroleum gauze)

When using the nursing process always remember to _____ first

assess

How do female, elderly, and diabetic patients present differently for a myocardial infarction

associated symptoms with no chest pain (diaphoresis, nausea, fatigue, dyspnea, epigastric burning or gas)

Defribrillation is not effective for the treatment of...

asystole or PEA (pulseless electrical activity)

When giving insulin in the abdomen where should it be given

at least 2 inches away from the belly button

-olol Examples; drug class; special things to remember

atenolol; metoprolol; nadolol; propranolol beta blocker can worsen bronchoconstriction; bad with asthma, only good in CHRONIC HF; side effects: bradycardia, bronchospasm, hypertension, depression, impotence

common statin medications

atorvastatin simvistatin lovastatin pravastatin

In PQRST (ecg) the P is what

atrial contraction; DE-polarization; DE-compressing

grade 6 murmur sounds like

audible without the stethoscope directly on the chest wall

prefix -afil. examples; drug class; important things to know

avanafil; sildenafil; tadalafil; phospho-diesterase inhibitor (PDE) no grapefruit juice; cannot take with nitro!

nitroglycerin needs to be stored...

away from light and heat

-mycin -micin Examples; drug class; special things to remember

azithromycin; clarithromycin; clindamycin; erythromycin antibiotic; antibacterial therapeutic range of vanco is 10-20 mg/L; creatinine levels should be monitored, nephrotoxicity and ototoxicity biggest complications; infuse over at least 60 minutes, draw trough levels prior if given IV, can cause prolonged QT interval

Common sites for insulin administration

back of arms; thighs; abdomen;

Left sided heart failure causes fluid to...

back up into the lungs=pulmonary symptoms

Grade 1 murmur sounds like

barely audible

-pril Examples; drug class; special things to remember

benazepril; captopril; enalapril; lisinopril; moexipril ACE inhibitor drugs of choice in diabetic clients with hypertension or proteinuria common side effect is cough, contraindicated during pregnancy, monitor kidney function

two most common classes of bronchodilators are

beta 2 adrenergicagonists; methylxanthines

Treatment for A Fib

beta blockers; calcium channel blockers; digoxin; amiodarone; anticoagulant therapy to prevent clots; Cardioversion

prefix's : -one cort- -onide pred- examples; drug class; important things to know

betamethasone; dexamethasone; clocortolone; fludrocortisone; hydrocortisone; budesonide; desonide; corticosteroid side effect: hyperglycemia, worsen HTN, assess for infection

Normal ranges of pulse pressure

between 40 and 60 mm Hg

ACE inhibitors do what

block the production of angiotensin II which results in vasodilation, sodium and water excretion, and potassium retention

What is polycythemia vera?

bone marrow produced too many RBCs

Hypervolemia signs and symptoms

bounding pulse SOB dyspnea rales/crackles peripheral edema HTN Urine specific gravity <1.010 (low) Place patient in semi fowlers

The ____ artery is used to detect a pulse in an unresponsive client age <1 year

brachial

Nulliparity is a risk factor for....

breast cancer

-fenac -profen Examples; drug class; special things to remember

bromfenac; diclofenac; nepafenac fenoprofen; ibuprofen; ketoprofen (naproxen/ketorolac as well) NSAID should be avoided in those with kidney disease; decreases the effectiveness of diuretics and drugs that control BP; NSAIDS can lead to GI toxicity, kidney injury, hypertension, heart failure and bleeding risk!; Aspirin toxicity can lead to bruising, tinnitus, black tarry stool, hypotension, treat with activated charcoal before sodium bicarb

-iramine Examples; drug class; special things to remember

brompheniramine; chlorpheniramine; pheniramine antihistamine avoid if glaucoma or urinary retention

Methylxanthines cause what

bronchial smooth muscle relaxation resulting in bronchodilation

Nitroprusside may be slightly what color?

brown, however solutions that ae dark blue, red or green should be discarded

-caine Examples; drug class; important things to remember

bupivacaine; lidocaine; mepivacaine local anesthetic signs of toxicity: slurred or difficult speech, altered CNS, muscle twitching, seizures

-sartan Examples; drug class; special things to remember

candesartan; irbesartan; losartan; olmesartan; valsartan angiotensin II receptor antagonist; ARB; recommended for clients unable to tolerate ACE inhibitors contraindicated in prenancy

What would you be worried about with rapidly decreasing chest tube drainage?

cardiac tamponade

Cyloplegics are drugs that

cause paralysis of the ciliary muscle (plegic like paraplegic/paralysis)

Norepinephrine does what to the vessels/heart?

causes vasoconstriction and improves heart contractility/output in hypovolemic shock

-thiazide Examples; drug class; special things to remember

chlorothiazide; hydrochloro-thiazide; methyclothiazide thiazide diuretic consume foods high in potassium, take with food to prevent GI upset, watch weight Good to give with potassium sparing diuretic because it reduces likelihood of hyperkalemia; side effects: hypokalemia, hyponatremia, hyperuricemia, hyperglycemia. interacts with lithium!

-pramine Examples; drug class; special things to remember

clomipramine; desipramine; imipramine; trimipramine tricyclic antidepressant; anticholinergic drugs do not give with St johns wort; side effects: dizziness from orthostatic hypotension, drowsiness, dry mouth, constipation, photosensitivity, urinary retention and blurred vision

Adolescents (12 to 18 years): Theorist Piaget, type of development and stage

cognitive formal operations

Scleroderma is caused by

collagen overproduction

within 24 hours postpartum what should appear?

colostrum

Antineoplastics are used to

combat cancerous cells

occasional PVCs are ____

common

Signs of botulism in pediatrics are

constipation, difficulty feeding, decreased head control, diminished deep tendon reflexes

The presence of an air leak in your clients chest tube is indicated by

continuous bubbling of fluid at the base of the water seal chamber

In clients receiving IV vancomycin, what labs should be closely monitored?

creatinine levels, for signs of nephrotoxicity

-tadine Examples; drug class; (antihistamine)

cyproheptadine; desloratadine; loratadine antihistamine

S/S of hypoparathyroidism

decreased calcium; increased phosphorous; numbness and tingling; muscle cramps; tetany; hypotension; anxiety, irritability and depression; positive trousseaus; chvosteks sign

Signs and symptoms of a pleural effusion

decreased or absent breath sounds decreased tactile fremitus dullness on percussion chest pain during inspiration dyspnea

low Cardiac output = ?

decreased perfusion to the body; decrease LOC; lungs sound wet due to backflow; shortness of breath; skin will be cold and clammy;decrease urinary output

0.45% NS is a hypotonic fluid that _________ circulatory volume ------> use in hypertonic dehydration (e.g., excessive perspiration)

decreases

-cycline Examples; drug class; special things to to remember

demeclocycline; doxycycline; minocycline; tetracycline tetracycline antibiotic teratogenic, should be taken with water, before or after meals, no dairy with it, use additional birth control, photosensitivity

Right side of the heart pumps

deoxygenated blood to the lungs

Common posterior pituitary hormones/antidiuretic hormones

desmopressin; vasopressin

-trel Examples; drug class;

desogestrel; etonogestrel; levonorgestrel female hormone (progestin)

Treatment for CKD

dialysis; kidney transplant

Mydriatics are drugs that

dilate the pupil

Organic nitrates (nitroglycerine) does what

dilates veins and prevents spasms of coronary arteries

______ __________ can occur from fluid volume excess due to reduced renal blood flow

dilutional hyponatremia

Third degree AV block is

disassociation of atrial and ventricular contraction, meaning the P waves are not associated with QRS complexes on EKG

Cushings syndrome is (pneumonic: they "have a cushion")

disorder of the arenal cortex, too many steroids

Prefix: -rubicin Examples; drug class

docorubicin; epirubicin; idarubicin antineoplastic; cytotoxic agent (chemotherapy drugs/anticancer drugs)

serotonin agonists examples (tron to the rescue!)

dolasetron ondanestron (zofran) tropisetron

Newborns ________ their birth weight at 5 to 6 months of age and ______ it by 1 year.

double; triple

grade 4 murmur sounds like

easily heard and associated with a palpable thrill

classic symptoms of nephrotic syndrome

edema, hyperlipidemia, proteinuria

Treatment for PVD

elevate Veins, mediation like aspirin or clopidogrel/cholesterol lowering drugs "statins", surgery such as an angioplasty, CABG, endarterectomy

treatment for cardiac tamponade

emergency pericardiocentesis

A major complication of chronic alcohol abuse is _________, related to...

encephalopathy; poor thiamine absorption

Adrenal medulla hormones

epinephrine and norepinephrine

What can be elevated in a patient with IBD? (inflammatory bowel disease)

erythrocyte sedimentation rate, C reactive protein, white blood cells

-prazole Examples; drug class; special things to remember

esomeprazole; omeprazole; rabeprazole proton pump inhibitor long term effects; decreased bone density, risk of cdiff and pneumonia

When taking bisphosphonates, you should drink extra water and be upright for 30 minutes after, to prevent ________

esophagitis

continuous infusing bag should be changed

every 24 hours

The nurse has been assigned to the care of 4 adult clients who are receiving continuous intravenous (IV) infusions. How often should the nurse plan to check the IV infusions and IV sites of these clients?

every hour

Grade 2 murmur sounds like

faint but immediately audible

S/S of Addisons disease

fatigue; nausea/vomiting/diarrhea; anorexia; hypotension;confusion; decreased sodium and water; increased potassium; hyperpigmentation of the skin; Vitiligo

patho of CAD

fatty plaques develop called atherosclerosis and there is restriction of blood flow to the heart

Hepatitis A is spread through which route

fecal-oral

symptoms associated with hypothyroidism

feeling cold; loss of body hair; persistent lethargy; puffy face

a burn that is dry with blanchable redness; epidermis only is what type of burn?

first degree (superficial)

-nazole Examples; drug class; special things to remember

fluconazole; ketoconazole; miconazole; terconazole antifungal treats vaginal candidiasis

Treatment of HHS

fluid replacement; correction of electrolyte imbalances; possible insulin administration

Elevated CVP (central venous pressure) can indicate what?

fluid volume overload or RIGHT ventricular failure

Management for diverticulitis

focuses on bowel rest, NPO, NG suction, bed rest and drug therapy (IV antibiotics, analgesics)

When taking phenelzine (MAOI) what foods need to be avoided?

foods high in tyramine (aged cheese, cured meats, fermented foods, alcohol, chocolate, avocados)

Why are atrial pacemakers normally placed?

for sinoatrial node dysfunction, such as atrial fibrillation, bradycardia, and heart blocks

-semide Examples; drug class; special things to remember

furosemide; torsemide loop diuretic encourage foods high in potassium; report weight loss, lightheadedness, dizziness, GI distress, watch for orthostatic hypotension, hypokalemia; give slowly when given IV to prevent ototoxicity; the nurse should question the bumetanide prescription as the client with heart failure has hypokalemia and is already at increased risk for life threatening cardiac dysrhythmias

In a child with Kawasaki disease, it is priority to monitor for...

gallop heart rhythm, and decreased urine output- you are monitoring for HF and risk of developing coronary aneurysms

-micin Examples; drug class; special things to remember

gentamicin aminoglycoside monitor kidney function and hearing; muscle cramping may occur with infusion

Adenosine is administered how?

given rapidly over 1-2 seconds

In emergent phase after a burn (first 24-72 hours) what will labs look like?

hematocrit and hemoglobin elevated due to hypovolemia, hyponatremia, hyperkalemia

The two main anticoagulant medications

heparin and coumadin

What type of diet may prevent diverticulitis and diverticulosis?

high fiber

Rapid insulin types

humalog; novolog; apidra

Thiazide diuretics 3 of them

hydochlorothiazide, chlorothiazide, methyclothothiazide

A side effect of corticosteroid therapy is

hyperglycemia

S/S of HHS

hyperglycemia

Purpose of thiazide diuretics

hypertension, heart failure, renal disease, cirrhosis, edema, corticosteroids, estrogen therapy

Purpose of loop diuretics

hypertension, heart failure, renal disease, edema, pulmonary edema

Clients with SIADH often require what repletion to increase serum sodium levels

hypertonic saline

What may indicate hypovolemic shock?

hypotension, tachycardia, and decreased CVP (normal: 2-8 mm Hg)

-ridone Examples; drug class; special things to remember

iloperidone; paliperidone; risperidone atypical antipsychotic benztropine is used in the treatment of extrapyramidal side effects associated with antipsychotic medications; neuroleptic malignant syndrome usually presents with mental status changes, fever, muscle rigidity, and autonomic instability after starting antipsychotic medications; photosensitivity is a side effect

What is hemophilia?

impaired clot formation and increased risk for uncontrollable bleeding

Type 1 diabetes is usually diagnosed when

in childhood

A chest tube is placed where?

in the pleural space

How is symptomatic bradycardia treated?

initially with IV atropine, if ineffective an infusion of dopamine or epinephrine may be considered

During removal of a chest tube what do you do/instruct client to do?

instruct client to perform Valsalva maneuver and cover site with a sterile airtight petroleum jelly gauze/occlusive dressing; post procedural xray after

IV albumin increases ___________ fluid volume and may be used to prevent hypotension associated with paracentesis

intravascular

Epoetin alfa (helps your body make more rbc's) is administered by which route

intravenous or subcutaneous route

What would be the replacement for sodium

isotonic IV therapy of .9%NS or lactated ringer

What can nitroglycerin do to your blood pressure?

it can cause hypotension

amiodarone is used to treat what

it is an antidysrhythmic that is used to treat ventricular dysrhythmias

What does rapid insulin look like

it is clear

5-FU (fluourouracil) is used for

it is one of the oldest chemotherapy drugs and is used against a variety of cancers- WARNING HAZARDOUS DRUG

how does desmopressin work?

it mimicks the effects of naturally occurring ADH which increases renal water absorption and concentrates urine

Common causes of HIGH pressure limit alarm for mechanical ventilator:

kinked tubing water in tubing secretions in tube biting tongue increased airway resistance (bronchospasm, excessive secretions) decreased lung compliance (pneumothorax, atelectasis, pulmonary edema)

What is the fluid of choice for burn injuries, to prevent hypovolemic shock?

lactated ringer

-vudine Examples; drug class;

lamivudine; stavudine; telbivudine; zidovudine antiviral; nucleoside analogues

S4 is what

late diastole and high atrial pressure (forcing blood into a stiff ventricle)

Clients allergic to bananas, apricots, cherries, grapes, kiwis, passion fruit, avocado, and/or peaches may experience an allergy to...

latex

if the EF is 55% the heart is pumping out 55% of whats inside of....

left ventricle

Furosemide can be used to decrease ____ _______ _____ in cardiogenic shock

left ventricular preload

What would be considered a narrow pulse pressure?

less than 440 mm Hg

Signs and symptoms of CKD

lethargy, altered LOC, confusion, seizures, hypertension, Fluid volume excess, heart failure, anorexia, nausea vomiting ,ammonia breath, impaired immune and inflammatory response, anemia, increased risk for bleeding, amenorrhea

clinical manifestations of congenital hypothyroidism in pediatrics

lethargy, enlarged fontanelle, protruding tongue, umbilical hernia, poor feeding, constipation, dry skin, jaundice, hoarse cry, difficult to awaken

Thyroid medications

levothyroxine

When you think "statins" we need to remember to protect...

liver and muscles STAT Monitor liver function tests after 12 weeks and then every 6 months and avoid alcohol risk of myopathy and peripheral neuropathy. CK levels will be monitored periodically

What insulin CANNOT be mixed with any other insulin

long acting

Haloperidol and _______ are commonly administered together to depress the central nervous system and decrease aggressive behaviors

lorazepam

Placentia previa is what

low implantation of the placenta

ischemia =

low o2

What does bicarbonate do for the body?

maintains blood pH to prevent metabolic acidosis

deficiency of B12 can lead to

megaloblastic anemia

Acute glomerulonephritis interventions

monitor daily intake and output; daily weight; fix the cause! (strep); bed rest; diuretics; antihypertensive meds; fluid restrictions; sodium restrictions; decrease in protein; provide a lot of carbs! (stop the breakdown of protein)

what do you need to monitor for when a patient is taking theophylline

monitor serum levels for toxicity (>20mcg/ml)

10 month old client should be able to

move from lying down to sitting position

S/S of cushings syndrome

muscle wasting; moon face; buffalo hump; truncal obesity with thin extremities; weight gain; hirsutism; increased glucose, increased sodium, decreased potassium, decreased calcium, hypertension

-olone Examples; drug class;

nandrolone; oxandrolone; oxymethalone anabolic steroid

What is Myopia?

nearsightedness-reduced visual acuity when viewing objects at a distance

-zodone Examples; drug class; important things to know

nefazodone, trazodone, vilazodone antidepressant

Management for airborne precautions

neg pressure room, private room, mask, n-95 for TB

unstable angina is not relieved by

nitroglycerin

Hypothyroidism S/S (not enough ENERGY)

no energy; fatigue; no expressions; weight gain; cold; amenorrhea; slurred

pain assessment scale used for ages 3-18 years

non communicating childrens pain checklist

peak of long acting insulin

none

Emergency Trauma Assessment (ABCDEFGHI)

o A - airway à clear airway, stabilize cervical spine o B - breathing à give oxygen, prepare to intubate o C - circulation à check pulse, HR, control bleeding o D - disability à check level of consciousness, assess using GCS o E - exposure à remove clothing, prevent heat loss o F - full set of vitals/focused interventions à monitor ECG, place tubes and drains o G - give comfort à assess and treat pain o H - head-to-toe assessment/history à SAMPLE - Signs/Symptoms, Allergies Medications, Past health history, Last meal, Events preceding o I - inspect posterior à logroll & palpate

Warning signs of cancer (CAUTION)

o Change in bowel or bladder habits o A sore that does not heal o Unusual bleeding or discharge from a body orifice o Thickening or a lump in the breast or elsewhere o Indigestion or difficulty in swallowing that does not go away o Obvious change in a wart or mole o Nagging cough or hoarseness

Home interventions to reduce the incidence of tet spells include (Tetralogy of Fallot) :

o Providing a calm environment, particularly on waking o Soothing and quieting the infant when crying or distressed o Offering a pacifier o Swaddling or holding the infant during procedures or times of stress o Providing frequent smaller feedings to reduce frustration due to hunger and limit sucking fatigue

In the case of an air embolism, which is rare, and a life threatening complication of CVC insertion/removal, what would you do?

occlusive dressing, administer oxygen, left Trendelenburg, monitor

Petechiae on African American clients is best detected where?

on the buccal mucosae and the conjuctivae of the eye

When is Type 2 diabetes usually diagnosed

onset is as an adult

What do antiresorptive meds help treat

osteoporosis

pain assessment scale used for 3-13 years of age

oucher

What is Homans sign?

pain in the calf with dorsiflexion

A client has undergone abdominal perineal resection for a bowel tumor. The nurse interprets that the client's colostomy is beginning to function if which sign is noted? 1.Absent bowel sounds 2.The passage of flatus 3.Blood drainage from the colostomy 4.The client's ability to tolerate food

passage of flatus

When doing CPR on a pregnant patient how should it be done?

perform compressions slightly higher on the sternum and displace the uterus to the clients left side (turn client slightly on side)

What is the antidote drug used to treat a norepinephrine extravasation

phentolamine

Gait disturbance (ataxia) is commonly seen with _________ toxicity

phenytoin

Anal itching and disturbed sleep is indicative of what in children?

pinworms

-glitazone Examples; drug class; special things to remember

piogloitazone; rosiglitazone; troglitazone antidiabetic; thiazolidine can worsen HF

Antiplatelets prevent

platelet aggregation= increases clients risk for bleeding

Signs and symptoms of pericarditis

pleuritic chest pain that is sharp and aggravated during inspiration and coughing, ST segment elevation in almost all leads and friction rub is common

Generally speaking, heart failure patients may need which supplement

potassium

Concurrent use with _______ or _______ can cause hyperkalemia

potassium sparing diuretics or ACE inhibitors

NEVER give ______ IV push

potassium. It can cause fatal hyperkalemia

abruptio placenta is what

premature separation of the placenta

What is recommended before suctioning a mechanically ventilated patient?

preoxygenate with 100% oxygen for 30 seconds before

what is the CVP

pressure in the superior vena cava. Shows how much pressure from the blood is returned to the right atrium from the superior vena cava

Biphosphonates are a class of drugs that do what

prevent the loss of bone density, used to treat osteoporosis and similar disease

Biphosphonates do what

prevent the loss of bone mass

Management for droplet precautions

private room, mask

Angiotensin II receptor blockers (ARBS) do what

produce vasodilation by blocking the action of the angiotensin II

To compensate for chronically low oxygen levels in a client with COPD, the body does what.

produces more RBCs to carry needed oxygen to cells which leads to polycythemia and NO supplemental iron

What is an expected adverse effect of using beta blocker drugs for a first degree AV Block? (EKG)

prolonged PR interval

Dopamine agonists examples

promethazine compazine metoclopramide (reglan)

Glucocorticoids and NSAIDs do what in the treatment of RA

provide symptom relief from inflammation and pain

Toddler (12 months to 3 years) Erickson theorist, type of development and stage

psychosocial Autonomy vs shame

Pre-schooler (3 to 5 years): Theorist Erickson, type of development and stage

psychosocial Initiative vs guilt

School-aged (5 to 12 years): Theorist Erickson, type of development and stage

psychosocial industry vs inferiority

School-aged (5 to 12 years): Theorist Freud, type of development and stage

psychosocial latency

Infant (birth to 1 year) Freud theorist, type of development and stage

psychosocial oral

Infant (birth to 1 year) Erickson theorist, type of development and stage

psychosocial trust vs mistrust

A client diagnosed with thrombophlebitis 1 day ago suddenly complains of chest pain and shortness of breath and is visibly anxious. Which complication should the nurse immediately assess the client for? 1.Pneumonia 2.Pulmonary edema 3.Pulmonary embolism 4.Myocardial infarction

pulmonary embolism

upper tract UTI is called

pylonephritis

Signs of HF in children

rapid breathing rate, rapid heart rate at rest, dyspnea, activity intolerance (especially during feeding in infants), pale, cool extremities; weight gain, reduction in wet diapers, puffiness around the eyes

drug therapy for glaucoma is directed at

reducing elevated IOP (intraoccular pressure)

Treatment for pericarditis

relieve pain by putting patient in Fowlers position, NSAIDs+colchicine

scleroderma can lead to

renal crisis which causes malignant hyperthermia

Excessive alcohol ingestion + benzodiazepines ---->

respiratory acidosis

A serious complication of statins is

rhabdomyolysis

Streptokinase (Streptase) needs to be given when

right away!! must be administered within 4-6 hours of onset of symptoms

What medication is used to slow progression of ALS?

riluzole

Lab values of significance in TLS include

rising blood uric acid, potassium, and phosphate levels with decreasing calcium levels

"worst headache of my life" could indicate what?

ruptured cerebral aneurysm

-gliptin Examples; drug class;

saxagliptin; linagliptin; sitagliptin antidiabetic; inhibitor of the DPP-4 enzyme

Implement ______ precautions during calcium administration

seizure

What is phenytoin used for?

seizures

Droplet mnemonic- SPIDERMAn

sepsis scarlet fever strep pertussis pneumonia parvovirus influenza Diphtheria Epiglottis Rubella Mumps Adenovirus

Nephrotic syndrome results in

serum proteins leaking into the urine

Fosamax has been associated with

severe esophagitis and ulcers of the esophagus

a 7 month old client should be able to

sit with minimal support and bear their full weight while standing with caregiver support

DMARDs do what

slow joint degeneration and progression of rheumatoid arthritis

-lactone Examples; drug class; special things to remember

spironolactone potassium sparing diuretic initiate cardiac monitoring for serum potassium great than 5, do not give with K+ supplement, teach to avoid salt subs that have K+, maintain adequate fluids

diastolic HF is

stiff and non compliant heart muscle, the ventricle does not FILL properly

Nephrolithiasis is

stones in kidneys

ureterolithiasis is what

stones in the ureter

If a chest tube disconnects from chest drainage system and cannot be reattached quickly, what do you do?

submerge the distal end of the chest tube 1-2 in below the surface of a 250mL bottle of sterile water or saline solution

sulfa- Examples; drug class; special things to remember

sulfacetamide; sulfadiazine; sulfamethoxazole; sulfasalazine antibiotic; anti-infective; anti-inflammatory yellow orange discoloration of the clients skin and urine is an expected side effect; dehydration is a concern due to risk of crystal formation in kidney; also cause photosensitivity, folic acid deficiency, steven johnson syndrome (stop taking immediately if any rash occurs)

Signs and symptoms of a Left to right shunt (pediatrics)

tachypnea/tachycardia, diaphoresis, heart murmur, signs of CHF, poor weight gain

Treatment for 3rd degree AV block

temporary or permanent pacing is necessary

Bronchodilators are used to treat

the SYMPTOMS of asthma that result from inflammation of the bronchial passages, but they do not treat the inflammation

Calcium channel blockers cafuse vasodilation as a result of...

the blocking of calcium channels in blood vessels

Type 2 diabetes what is happening in the body

the body does not produce enough insulin or produces "bad" insulin that does not work properly

S1 (LUB) is what

the tricuspid and mitral valve closure

Anti parkinson or antiparkinsonian medications, work how?

they increase dopamine activity or reduce acetylcholine activity in the brain. They do not halt the progression of the disease they offer symptomatic relief

How do the meds for hypertensive crisis work?

they provide direct vasodilation of veins and arteries and rapid reduction of BP

______ diuretics are good to give with potassium sparing diuretics because it reduces the likelihood of ______

thiazide; hyperkalemia

Hirschsprung disease in infants signs and symptoms

thin, ribbon like stools, bilious vomiting, foul smelling, diarrhea, abdominal distention, failure to pass meconium

splenomegaly leads to

thrombocytopenia

What should be done before a radioactive iodine uptake test?

thyroid meds should be help 5-7 days before, pregnancy test performed, NPO 2-4 hours prior, remove dentures and jewelry/metal around the neck, drink plenty of fluids after

ST segment is

time between ventricular depolarization and repolarization (ventricular contraction)

QT interval is

time it takes for ventricles to depolarize, contract, and repolarize

Common uses of antagonists

treatment of opioid overdose, reversal of effects of opioids (Naloxone)

What should you try before giving adenosine?

vagal maneuver

What is a fistula

vascular access for HD where they join an artery to a vein

Posterior pituitary hormones/anti diuretic hormone causes what

vaso constriction due to the contraction of the vascular smooth muscle

during the QRS what is happening

ventricle contraction; DE polarization; DE compressing

T wave is what

ventricles; RE-laxing; RE-polarizing; RE-filling with blood

Symptoms of menieres disease

vertigo tinnitus nausea vomiting dizziness

12 month old clients should be able to

walk first steps independently crawl up stairs uses 2 finger pincer grasp hits two objects together says 3-5 words uses non verbal gestures searches for hidden objects may have separation anxiety

18 month old client should be able to

walk up/down stairs with help throws a ball overhand jump in place builds a tower of 3-4 blocks turns 2-3 pages at a time scribbles uses cup and spoon 10+ word vocabulary identifies common objects temper tantrums understands ownership imitates others

3 year old client should be able to

walk upstairs while alternating feet pedals a tricycle jumps forward draws circle feeds self grips crayon with fingers instead of fist 3-4 word sentences asks why questions states own age begins associative play toilet trained except wiping

What is something you need to prioritize as a nurse with a patient who has catatonic schizophrenia?

watch for fluid volume deficit

Syndrome of inappropriate antidiuretic hormone (SIADH) secretion results in

water retention and dilutional hyponatremia

Peripheral Arterial Disease (think bAd) is where

there is a narrow artery where oxygenated blood cannot get to the distal extremities. Ischemia and necrosis of extremities

grade 5 murmur sounds like

very loud, heard with a stethoscope lightly on chest

Complication of Type 2 Diabetes

Hyperosmolar hyperglycemic state (HHS)

Most antibiotics will increase what lab value

INR by causing vitamin K deficiency

-dronate Examples; drug class; special things to remember

alendronate; etidronate; ibandronate biphosphonate; bone resorption inhibitor Drink extra water and be upright for 30 mins after taking

-floxacin Examples; drug class; special things to remember

besifloxacin; ciprofloxacin; levofloxacin; fluoroquinolone antibiotic (treat UTI) can increase theophylline levels so do not use concurrently

best GCS score and worst

best 15; worst is 3

what should the nurse implement pre electroconvulsive therapy?

blood tests and an electrocardiogram

In a client with heart failure related fluid overload, what will you assess first?

breath sounds

What do you immediately report to HCP while taking care of a bronchoscopy patient post op?

bright red blood (blood tinged sputum is normal)

Right Sided HF is

fluid backing up into the venous system

0.9% NS or lactated ringers are isotonic fluids that _______ circulatory volume ----> used in hypovolemic shock

increase

Action of mannitol

increase the thickness of the filtrate so water cannot be absorbed; excretion of Na+ and Cl-

BNP is secreted when there is ___ pressure in the ventricle

increased

S/S of pheochromocytoma

increased BP; increased HR; palpitations; tremors; flushing/diaphoretic; headache; pain in the chest or abdomen; hyperglycemia

S/S of HYPERparathyroidism

increased Calcium; decreased phosphorous; fatigue and muscle weakness; skeletal pain; pathological fractures from the bone deformities; kidney stones; weight loss/anorexia; constipation; hypertension; cardiac dysrhythmias

bradycardia in an infant can be a sign of

increased ICP

Symptoms of hypovolemia

increased temp rapid/weak pulse increase respirations hypotension anxiety Urine specific gravity >1.030 (high)

Ventricular paced rhythms have a pacer spike where?

just before the QRS complex

The nurse is caring for a client diagnosed with tuberculosis (TB). Which assessments, if made by the nurse, are consistent with the usual clinical presentation of TB? Select all that apply. 1.Cough 2.Dyspnea 3.Weight gain 4.High-grade fever 5.Chills and night sweats

cough, dyspnea, high grade fever

Lower tract UTI is called

cystitis or urethritis

Treatment of UTIs

hydration, antibiotics, phenazopyridine

The nurse is instructing a client who is taking levothyroxine and tells the client that full therapeutic benefits will be seen when? 1.Immediately 2.In 1 to 3 weeks 3.Within 24 hours 4.Within 3 to 5 days

in 1-3 weeks

Findings indicative of multiple myeloma are

increased number of plasma cells in the bone marrow, anemia, hypercalcemia caused by the release of calcium from the deteriorating bone tissue, and an elevated blood urea nitrogen level.

BUN is what

normal waste product resulting from breakdown of proteins. high levels can indicate a problem and be toxic to the body

A client in her second trimester of pregnancy is seen at the health care clinic. The nurse collects data from the client and notes that the fetal heart rate is 90 beats/minute. Which nursing action is appropriate?

notify pcp because it is bradycardia

intradermal injection should be given at what angle

15 degree angle

What is a normal MAP

70-105

PaO2 values

75-100

Duration of intermediate acting insulin

8-24 hours

Systemic vascular resistance (SVR) values

800-1200 dynes/sec/cm

What is the treatment for a client that is symptomatic with a 2nd degree AV block?

Atropine and temporary pacing

The generic names of ACE inhibitors end in...

"pril" Captopril enalapril lisinopril

PR interval

.12-.2

uric acid values

.18-.48

ionized calcium values

1.03-1.23

urea values

1.2-3

When should the lab have the peak level specimen drawn for a peak vancomycin level?

1.5 hours after completion of the scheduled infusion

Magnesium values

1.5-2

posterior fontanelle fuses by age

2 months

IV hydromorphone is administered over

2-3 mins

peak of short acting insulin

2-4 hrs

CVP values

2-8 mmHg

bleeding time values

2-9 min

An infant with a diagnosis of hydrocephalus is scheduled for surgery. Which is the priority nursing intervention in the preoperative period? 1.Test the urine for protein. 2.Reposition the infant frequently. 3.Provide a stimulating environment. 4.Assess blood pressure every 15 minutes.

2. reposition the infant frequently

The nurse is conducting a health screening clinic and is preparing to test the visual acuity of a client using a Snellen chart. The nurse educates the client about the procedure. Which statement by the client indicates that the teaching has been effective? 1."Stand 10 ft (3 meters) from the chart and cover 1 eye." 2."Stand 20 ft (6 meters) from the chart and cover 1 eye." 3."Stand 30 ft (9 meters) from the chart and read the largest line on the chart." 4."Stand 40 ft (12 meters) from the chart and read the largest line on the chart."

2."Stand 20 ft (6 meters) from the chart and cover 1 eye."

Cardiac index values

2.5-4 L/min/m2

hematocrit values

40%-52%

What is pheochromocytoma?

A rare condition characterized by an adrenal medulla tumor that produces excessive catecholamines (epinephrine, norepinephrine)

A burn where both the epidermis and dermis are damaged, and there are blisters and shiny fluid filled vesicles, would be classified as?

A second degree (partial thickness burn)

Do not give muscle relaxants with presence of...

hepatic disease

What type of meds are contraindicated during pregnancy?

ACE inhibitors (-pril) ; ARBs (-sartan)

Sodium nitroprusside is a medication used in the management of

ACUTE decompensated heart failure, ACUTE hypertension

What drugs can worsen CO2 retention in a COPD exacerbation?

AVOID morphine and benzodiazepines

Pneumonic ARTS for peripheral arterial disease stands for

Absent pulses, Round red sores, Toes and feet pale or black, Sharp calf pain. GANGRENE may develop

A client is taking lansoprazole. The nurse anticipates that the primary health care provider will advise the client to take which product if needed for a headache? 1.Naproxen 2.Ibuprofen 3.Acetaminophen 4.Acetylsalicylic acid

Acetaminophen

What is the antidote for acetaminophen

Acetylcysteine (Mucomyst)

Clients Who Require Dialysis: AEIOU (The Vowels)

Acid base imbalance Electrolyte imbalances Intoxication Overload of fluids Uremic symptoms

A client who suffered a severe head injury has had vigorous treatment to control cerebral edema. Brain death has been determined. The nurse prepares to carry out which measure to maintain viability of the kidneys before organ donation?

Administering IV fluids

Treatment for Cushings disease

Adrenalectomy, avoid infection, administer chemotherapeutic agents if adrenal tumor is present

What does the term "vasodilators" refer to

drugs that improve oxygenation of tissues by dilating or opening up the body's vascular system

When should all women be able to report feeling the fetus move?

After 20 weeks

A client has a prescription for magnesium citrate to prevent constipation after undergoing barium studies of the gastrointestinal tract. How should the nurse administer the magnesium citrate? 1.With fruit juice only 2.At room temperature 3.With a full glass of water 4.After it is chilled in the refrigerator

After it is chilled in the refrigerator

Shortness of breath causes mnemonic - 4A's+4P's

Airway obstruction Angina Anxiety Asthma Pneumonia Pneumothorax Pulmonary Edema Pulmonary embolus

Complications of using iodine contrast for a cardiac catheterization

Allergic reaction (shellfish) contrast nephropathy (creatinine >1.3 mg/dL should not receive contrast unless absolutely necessary) Lactic acidosis (metformin should be discontinued 4-48 hours prior)

Teach client with gout to avoid the following

Anchovies Sardine in oil fish roe herring yeast organ meats

Anti- parkinsonian drugs include- A Cat Does Like Milk

Anticholinergic agents COMT inhibitors; an enzyme involved in degrading neurotransmitters Dopamine Agonists Levodopa MAO-B inhibitors

What is an antiresorptive med

Antiresorptive medications are designed to slow bone removal and/or improve bone mass

Heart sounds mnemonic- All People Enjoy the Movies

Aortic Pulmonic Erbs point Tricuspid Mitral

Antiplatelet meds to know

Aspirin Plavix Pentoxifylline

Which is the primary goal of crisis intervention therapy? 1.Introduce new, effective coping methods to the client. 2.Assess the client to identify the causative stressors. 3.Establish a sustainable therapeutic nurse-client relationship. 4.Assist the client in returning to the level of pre crisis functioning

Assist the client in returning to the level of pre crisis functioning

PPI's are well tolerated by most clients but can cause what if taken too long?

B-12 deficiency

S3 is what

early diastole in rapid ventricle filling

on an ECG, if someone has an Atrial Pacemaker, where will the pacer spike be?

BEFORE the P wave, followed by the QRS complex

Treatment for a patient that is in Ventricular Fibrillation

CPR, defribrillation, epinephrine, vasopressin, amiodarone

what lab would a nurse monitor for a patient on phenytoin?

CBC

Cane walking mnemonic- COAL

Cane Opposite Affected Leg

What is the one ACE inhibitor affected by food

Captopril; this med should be taken at least 1 hour before meals

School-aged (5 to 12 years): Theorist Piaget, type of development and stage

Cognitive Concrete operations

Infant (birth to 1 year) Piaget theorist, type of development and stage

Cognitive Sensorimotor

Pre-schooler (3 to 5 years): Theorist Piaget, type of development and stage

Cognitive preoperational

Hypocalcemia signs and symptoms mnemonic- CATS

Convulsions Arrhythmias Tetany Stridor and spasms

4Cs of TEF

Coughing Choking Cyanosis Continuous drooling

COUMADIN mnemonic

Coumadin interferes with coagulation factors by antagonizing vitamin K Oral administration is typically used Use is contraindicated in clients with low platelet counts or uncontrolled bleeding Mephyton (vitamin K) is the antidote for coumadin Advise clients to avoid food high in vitamin K Doses are typically once daily INR and PT are monitored for clients on coumadin No coumadin for pregnant women!

Cleft lip pneumonic for post op care (CLEFTLIP)

Crying, minimize Logan bow Elbow restraints Feed with Brecht feeder Teach feeding techniques; two months of age (average age at repair) Liquid (sterile water), rinse after feeding Impaired feeding (no sucking) Position-never on abdomen

In a client with pancreatitis you will see positive ____ and ____ signs

Cullen's and Turner's signs

What is the most common community aquired UTI?

Cystitis

hypotonic fluids

D5W 0.45% NaCl

complication of type 1 diabetes

DKA

What medications help treat Rheumatoid Arthritis

DMARDs, glucocorticoids, and NSAIDs

What is the action of Proton Pump Inhibitors

Decrease stomach acid by inhibiting those gastric proton pumps that make the acid-they stop the acid at the pump!

Side effects of Thiazide diuretic

Decreased hypokalemia, decreased hypotension, decreased hyponatremia, decreased libido, increased hyperglycemia, increased photosensitivity, dehydration, azotemia

Treat pancreatitis with which pain medication?

Demerol! NO morphine! (morphine causes spasm of the sphincter of oddi)

Treatment for type 2 diabetes

Diet and exercise; oral hypoglycemia agents (metformin); possibly insulin

Antidote for Digoxin/digitoxin

Digoxin immune Fab (Digibind)

Epiglottitis 3D's

Drooling Dysphonia Dysphagia

Before a CT scan the nurse needs to

assess for allergies

What food must be avoided when taking MAOI's?

Food high in Tyramines

Theophylline toxicity looks like...

GI distress and restlessness dysrhythmias and seizures

Complication of severe preeclampsia mnemonic (HELLP)

Hemolysis Elevated Liver enzymes Low Platelet count

What is the most common form of congenital heart defect?

Left to right shunt

Hyperthyroidism means ___TSH and ____ T3 and T4

Low; High

Osmotic Diuretic (1)

Mannitol

Toddler (12 months to 3 years) Freud theorist, type of development and stage

Psychosocial Anal

Adolescents (12 to 18 years): Theorist Erickson, type of development and stage

Psychosocial Identify vs role confusion

Right sided heart failure is associated with (R)

Rest of body

Early signs of hypoxia- RAT

Restlessness anxiety tachycardia/tachypnea

What is a normal BNP?

<100 pg/mL

The target blood pressure for a client with diabetes is what

<140/90 mm Hg

a weight gain of 1kg is equal to _____ mL of retained fluid

1,000 mL

onset of intermediate acting insulin

1-2 hours

onset of long acting insulin

1-2 hours

The nurse is caring for a pediatric client who just arrived at the emergency department with an extremity fracture. The nurse uses the 5 "Ps" to assess the extent of the client's injury. What are some of the 5 "Ps"? Select all that apply. 1.Pallor 2.Pain and point of tenderness 3.Paralysis distal to the fracture site 4.Pulses proximal to the fracture site 5.Sensation distal to the fracture site

1.Pallor 2.Pain and point of tenderness 3.Paralysis distal to the fracture site 5.Sensation distal to the fracture site

Free T4 values

10-20

5 areas of auscultating the heart ( All People Enjoy Time Magazine)

Aortic; Pulmonic; ERBs point; Tricuspid; Mitral

Standard testing for visual acuity is at _____ ft. However for children it is a recommended ___ ft.

20 feet; 10 feet

aPTT values

20-40 sec

Suction above ____ cm H20 is generally not indicated when dealing with a chest tube

20cm

bicarb values HcO3

22-26

symptoms of hypothyroidism typically begin to improve approximately ___-____ weeks after initiating levothyroxine?

3-4 weeks. Full therapeutic may take up to 8 weeks

Duration of rapid acting insulin

3-5 hours

The nurse should implement which interventions for a child older than 2 years with type 1 diabetes mellitus who has a blood glucose level of 60 mg/dL (3.4 mmol/L)? Select all that apply. 1.Administer regular insulin. 2.Encourage the child to ambulate. 3.Give the child a teaspoon of honey. 4.Provide electrolyte replacement therapy intravenously. 5.Wait 30 minutes and confirm the blood glucose reading. 6.Prepare to administer glucagon subcutaneously if unconsciousness occurs.

3. Give the child a teaspoon of honey 6. Prepare to administer glucagon subcutaneously if unconsciousness occurs

The nursing instructor asks the student to describe fetal circulation, specifically the ductus venosus. Which statement by the student indicates an understanding of the ductus venosus? 1."It connects the pulmonary artery to the aorta." 2."It is an opening between the right and left atria." 3."It connects the umbilical vein to the inferior vena cava." 4."It connects the umbilical artery to the inferior vena cava."

3. It connects the umbilical vein to the inferior vena cava

RNs DO NOT delegate what they can EAT

Evaluate Assess Teach

WBC values

4-10x

peak of intermediate acting insulin

4-12 hours

Second line of medication for gout (hint: gout is in the med name)

Colchicine (Colgout)

How do you treat Kawasaki disease

IVIG and aspirin

A burn that involves fascia muscle, and/or bone tissue. Would be classified as what type of burn?

Fourth degree (full thickness)

Troponin levels

Less than 0.5 ng/mL

troponin values

0-0.4

Free T3 values

0.2-0.5

The optimal therapeutic range for digoxin is

0.5 to 2.0 ng/mL

TSH values

0.5-5

creatinine values

0.8-1.3

INR values

0.9-1.2

-dazole Examples; drug class; special things to remember

albendazole; metronidazole; tinidazole anthelmintic; antibiotic; antibacterial metallic taste in mouth, treats Cdiff and trichomoniasis

What is Fifth Disease?

a viral illness caused by human parvovirus, that affects mainly school age children

-zosin Examples; drug class; Important things to know

aFDA1fuzosin; doxazosin; prazosin; terazosin alpha blocker; treats BPH orthostatic hypotension is a side effect

How long is influenza contagious?

about a week

Onset for type 1 diabetes is

abrupt

What should be given with nitroglycerine?

acetaminophen or aspirin because headache is common

-lamide Examples; drug class;

acetazolamide; methazolamide; brinzolamide carbonic anhydrase inhibitor

In type 1 diabetes, when the cells break down protein and fat into energy causing ketones to build up what does this cause?

acidosis

Too much Co2 means

acidosis; too much Co2 being retained

tretin-; tretin; -tretin Examples; drug class; important things to know

acitretin; aliretinoin; isotretinoin; tretinoin retinoid; dermatologic agent; form of vitamin A teratogenic, clients need to avoid tetracycline, excess sun, and vitamin A supplements

Treatment in client with aspirin toxicity

activated charcoal, IV sodium bicarbonate.

Sudden onset of unrelenting, severe pain in the left upper quadrant or mid epigastric area of the abdomen that often radiates to the back is most likely indicative of

acute pancreatitis

Examples of ARBs

"sartans" losartan, candesartan, valsartan

Generic names for the inhaled form of beta 2 agonists end in

"terol"

Ejection fraction is

% of blood expelled from the left ventricle with every contraction

QRS intervals

.6-0.12

isotonic fluids

.9% NS, lactated ringer, plasmolyte

How many fingers should you be able to fit under a trach tie?

1 finger should fit under the tie

Steps for mixing regular and NPH insulin

1. inject air into NPH insulin 2. Inject air into regular insulin 3. Draw up dose of regular insulin 4. Draw up dose of NPH insulin

The nurse has reviewed with the preoperative client the procedure for the administration of an enema. Which statement by the client would indicate the need for further instruction? 1."The enema will be given while I am sitting on the toilet." 2."I should try and hold the fluid as long as possible after it is run in." 3."I know that there will be some cramping after the enema solution is run in." 4."I should tell the nurse if cramping occurs when the fluid is running in."

1."The enema will be given while I am sitting on the toilet."

A hospitalized client is diagnosed with type 1 diabetes mellitus. The nurse plans care for the client, understanding that which factors are likely causes of the beta cell destruction that accompanies this disorder? Select all that apply. 1.Viruses 2.Genetic factors 3.Autoimmune factors 4.Human leukocyte antigen (HLA) 5.Primary failure of glucagon secretion

1.Viruses 2.Genetic factors 3.Autoimmune factors 4.Human leukocyte antigen (HLA)

Administer potassium no faster than...

10 mEq/L per IV

Therapeutic range of vancomycin in pediatrics is

10-20 mg/L

In meningitis the HOB shou0ld be elevated between ___-____ degrees

10-30 degrees

Normal pulse range for a 1-year-old

100-160/min

anterior fontanelle fuses by age

18 months

secondary tubing should be changed every _____ hours if not attached to the primary IV infusion set

24

duration of long acting insulin

24 hours

Changing the inner cannula of the trach is not indicated until....

24 hours after insertion

What is the therapeutic INR for a patient with a mechanical heart valve is

2.5-3.5

The nurse is inserting an indwelling urinary catheter into a client. As the catheter is inserted into the urethra, urine begins to flow into the tubing. What action should the nurse take next? 1.Immediately inflate the balloon. 2.Insert the catheter 2.5 to 5 cm and inflate the balloon. 3.Withdraw the catheter about 1 inch and inflate the balloon. 4.Insert the catheter until resistance is met and inflate the balloon.

2.Insert the catheter 2.5 to 5 cm and inflate the balloon.

The nurse should hold warfarin and contact health care provider if the INR is > than....

3.5

potassium values

3.5-5

to increase ICP the HOB should be raised to

30 degrees

peak of rapid insulin

30 mins-3 hours

onset of short acting insulin

30-60 minutes

Types of beta 2 agonists (the brand names of some drugs in this class provide a hint because they contain the words "vent" or "breth")

albuterol (proVENT; VENTolin) formoterol salmeterol (sereVENT) Terbutaline (BRETHine)

The nurse prepares to administer a phytonadione (vitamin K) injection to a newborn, and the mother asks the nurse why her infant needs the injection. What best response should the nurse provide? 1."Your newborn needs the medicine to develop immunity." 2."The medicine will protect your newborn from being jaundiced." 3."Newborns have sterile bowels, and the medicine promotes the growth of bacteria in the bowel." 4."Newborns are deficient in vitamin K, and this injection prevents your newborn from bleeding."

4."Newborns are deficient in vitamin K, and this injection prevents your newborn from bleeding."

A client in cardiogenic shock has a pulmonary artery catheter (Swan-Ganz type) placed. The nurse would interpret which cardiac output (CO) and pulmonary capillary wedge pressure (PCWP) readings as indicating that the client is most unstable? 1.CO 5 L/min, PCWP low 2.CO 3 L/min, PCWP low 3.CO 4 L/min, PCWP high 4.CO 3 L/min, PCWP high

4.CO 3 L/min, PCWP high

Subcutaneous injections should be given at what angle

45 degree

onset of rapid insulin

5-30 mins

new foods should be given to infants how many days apart to assess for food allergies?

5-7 days

duration of short acting insulin

5-7 hours

what is recommended dose of calcium for ages 1-3

500 mg

what is a normal PAWP? (pulmonary artery wedge pressure)

6-12 mm Hg

What is the recommended initial treatment of peptic ulcer disease related to H pylori?

7-14 days of omeprazole, amoxicillin and clarithromycin

intramuscular injection should be given at what angle

90 degree angle

In a massively enlarged spleen, the spleen can hold more than ___% of the total platelet mass in the body

90% (which is why splenomegaly leads to thrombocytopenia)

Primary IV tubing should be changed every

96 hours

An individual with a CD4 lymphocyte percentage of _____% is considered to be severely immunocompromised

<15%

In pediatrics, drainage from a chest tube >____ mL/kg/hr for 3 consecutive hours or >____-____ mL/kg/hr should be reported immediately to a provider

>3mL/kg/hr ; >5-10mL/kg/hr

episodes of bleeding rarely occur with a platelet count greater than...

>50,000

Systolic blood pressure should be >____mm Hg to ensure renal perfusion

>90 mm Hg

-terol Examples; drug class; special things to remember

albuterol; arformoterol; formoterol; beta agonist; bronchodilator SABAs (short acting beta agonist), tremor is a common side effect

Example of a biphosphonate?

alendronate (fosamax)

too little Co2 means

alkalosis

Third line of medication for Gout (hint: PURINE is in the name of the med)

Allopurinol

S/S of hypovolemic shock

Altered mental status, tachycardia with thready pulse, narrowing pulse pressure, cool clammy skin, oliguria, tachypnea, urine output <0.5mL/kg/hr despite fluid replacement (bad)

Newborn assessment components—"APGAR"

Appearance Pulse Grimace Activity Respiratory effort

Permethrin is prescribed for a child with a diagnosis of scabies. The nurse should give which instruction to the parents regarding the use of this treatment? 1.Apply the lotion to areas of the rash only. 2.Apply the lotion and leave it on for 6 hours. 3.Avoid putting clothes on the child over the lotion. 4.Apply the lotion to cool, dry skin at least 30 minutes after bathing.

Apply the lotion to cool, dry skin at least 30 minutes after bathing.

A school nurse is teaching an athletic coach how to prevent dehydration in athletes during football practice. Which action by the coach during football practice would indicate that further teaching is needed? 1. Weighs athletes before, during, and after football practice 2.Asks the athletes to take a salt tablet before football practice 3.Schedules fluid breaks every 30 minutes throughout practice 4.Tells the athletes to drink 16 oz of fluid per pound lost during practice

Asks the athletes to take a salt tablet before football practice

Nursing considerations for spironolactone

Avoid eating foods high in potassium, avoid salt substitutes and potassium supplements, monitor K+levels

What is an effective therapy as treatment to decrease CO2 levels in patients with hypercapnic respiratory failure?

BIPAP

Late signs of hypoxia- BED

Bradycardia Extreme restlessness Dyspnea

nine point postpartum assessment mnemmonic- BUBBLEHER

Breasts Uterus Bladder Bowel Function Lochia Episiotomy Hemorrhoids Emotional Status Respiratory System

Toddler (12 months to 3 years) Piaget theorist, type of development and stage

Cognitive Sensorimotor transition to preoperational

Shock signs and symptoms mnemonic- CHORD ITEM

Cold clammy skin Hypotension Oliguria Rapid shallow breathing Drowsiness confusion Irritability Tachycardia Elevated or reduced central venous pressure Multi organ damage

What is Leucovorin and how does it work when given with fluorouracil? (chemo drug)

Leucovorin, when given in combination with chemo drugs can enhance the binding of the fluorouracil to an enzyme inside of the cancer cells. As a result it may stay in the cancer cell longer and exert its anti cancer effect on the cells

What therapy can be used for a vancomycin resistant enterococcus infection?

Linezolid therapy.

Treatment of CAD

Lipid lowering medications like statins, diet, physical activity, smoking cessation, stress management ,coronary stent, angioplasty, CABG

diagnosis of CAD consists of

Lipoprotein profile; LDL, HDL, Total cholesterol, triglycerides, assess ECG for changes in ST segments or T waves

In someone with type 1 diabetes do they produce insulin?

NO

What is contraindicated when transporting a patient with a chest tube?

NO CLAMPING THE CHEST TUBE. This can lead to a tension pneumothorax

Patho of HHS

NO acidosis present! Simply high amounts of glucose in the blood

A patient with COPD should have no more than ____ Liters Nasal Cannula

NO more than 2 liters!

Intermediate acting insulin types

NPH Humilin N; Novolin NPH

Side effects of ACE inhibitors

Orthostatic hypotension, hyperkalemia, cough, angioedema

Treatment for PAD

Dangle arteries, perform daily skin care with moisturizer, stop smoking, avoid tight clothing, no heating pads, medications such as vasodilators/antiplatelets

Side effects of loop diuretics

Decrease Hypokalemia, decrease hypotension, decrease hyponatremia, increase hyperglycemia, increase photosensitivity, dehydration

Antihistamines examples

Diphenhydramine (benadryl) Dimenhydrinate (dramamine) Meclozine

To prevent Reye syndrome in infants, which of the following instructions should be given to parents?

Do not administer any product containing aspirin or salicylates to a child with a viral infection

What medication is used to treat symptomatic hypotension?

Dopamine

Pain assessment tool for 2 months-7 years

FLACC

pain assessment tool for ages 3 and older

Faces

-mab Examples; drug class; special things to remember

adalimumab; daclizumab; infliximab monoclonal antibody rule out TB prior to therapy, report elevated WBC; the nurse should monitor the clients blood counts, blood pressure, and heart rate and rhythm, as well as watch for signs of bleeding

what is important when evaluating a fistula

Feel the thrill; hear the bruit

A mnemonic to assist you in performing assessments on a pregnant client admitted to the medical surgical unit-FETUS

Fetal heart tones every shift Emotional support Temperature Uterine contractions Sensations of fetal movement (ask about movement)

Signs of septic shock

Fever OR hypothermia, hypotension, prolonged cap refill, tachycardia, WBC count >12,000/mm3

3 Loop Diuretics

Furosemide, Bumex, Demadex

Long acting insulin types

Glargine (lantus); Detemir (levemir)

What is a common medication given for insulin overdose

Glucagon

Classic signs of muscular dystrophy in infants

Gower sign/maneuver, enlarged calves, walking on tiptoes, frequent tripping and falling

management for contact precautions

Gown, gloves, goggles, private room

What drink needs to be avoided when taking a Calcium channel blocker

Grapefruit juice; this can lead to toxicity

GTPAL

Gravida Term Preterm Abortions Living children

What is a critical Troponin

Greater than 1.5 ng/mL

__________________ is a cause of glomerulonephritis

Group A β-hemolytic streptococcal infection

Metabolic acidosis (from the ass- diarrhea) K+ is...

HIGH

HDL you want ___ levels

HIGH levels, this is happy cholesterol

What is the first line of drug used for PSVT (paroxismal supraventricular tachycardia)

adenosine

HEPARIN mnemonic

Heparin sodium prevents thrombin from converting fibrinogen to fibrin. administered IV or SQ Enoxaparin is a low molecular weight heparin, same action as heparin but has a longer half life Protamine sulfate is the antidote for heparin Administer heparin when there is a likelihood of clot formation (MI, DVT) Risk for bleeding is the major side effect Instruct clients to avoid corticosteroid use, salicylates, NSAIDS, green leafy vegetables and foods high in vitamin K Normal activated partial thromboplastin time is 20-36 seconds, but it should be 1.5-2 times the normal value while on heparin

Treatment for Type 1 diabetes

INSULIN ONLY! Oral hypoglycemic agents will NOT work for this pt

Treatment for hypoparathyroidism

IV calcium; phosphorous biding drugs;

Live vaccines should be delayed for up to 11 months after _____ administration

IVIG

After administering a clot buster, what should you administer and why?

administer beta blockers to decrease myocardial oxygen consumption and reduce the incidence and severity of reperfusion arrhythmias

The nurse is describing cardiovascular system changes that occur during pregnancy to a client. Which findings are normal for a client in the second trimester?

Increase in pulse rate increase in red blood cell production

Order of assessment with abdomen

Inspect AUSCULTATE percuss palpate

Order of assessment

Inspection Palpation percussion auscultation

What is IVIG

Intravenous immune globulin- this is a product made up of antibodies that can be given intravenously

How do you calculate a pulse pressure?

It is the difference between the systolic blood pressure and the diastolic blood pressure. Example: systolic 110/diastolic 80 then the pulse pressure would be 30 mm Hg

Hypokalemia signs and symptoms- 6Ls

Lethargy Leg cramps Limp muscles Low shallow respirations Lethal cardiac dysrhythmias Lots of urine

What is sumatriptan and how does it work?

It relieves migraines by constricting dilated cranial blood vessels

What is the treatment for hyperkalemia >5.0 mEq/L

Kayexalate

What medication is often used to treat seizures in various settings?

Keppra

a client with meningitis would have a positive _____ sign

Kernigs sign

Signs and symptoms of DKA

Ketosis and acidosis; hyperglycemia; dehydration; kussmaul respirations; acid breath"fruity breath"

a client with measles would have what kind of spots

Koplik's spots

Cardiomegaly, displaced PMI, S3 sound, pulmonary edema, dyspnea, orthopnea, PND, crackles, frothy sputum and confusion are all symptoms of

LEFT sided heart failure

Metabolic Alkalosis (from the mouth-vomitus) K+ is....

LOW

During acute diverticulitis what diet is prescribed

LOW fiber diet

LDL you want ___ levels

LOW levels, this is bad cholesterol

You want your LDL ______ and your HDL ______

LOW; HIGH

_________ medications should be discontinued two weeks prior to ECT (electroconversion Therapy)

Lithium, MAOIs and all seizure threshold medications

Treatment for menieres disease

administer diuretics to decrease endolymph in cochlea restrict sodium lay on affected ear when in bed

Treatment for Addisons disease

administer glucocorticoid and/or mineralocorticoid; diet high in protein and carbs

`Endocrine system functions

Maintenance and regulation; energy metabolism; response to stress and injury; reproduction; growth and development; fluid, electrolyte and acid base balance; reproduction

Airborne precautions mnemonic- My Chicken Hez TB

Measles Chicken pox Herpes zoster TB

What is a known side effect of Flagyl

Metallic taste in the mouth

Extended use and/or high doses of this drug may lead to the development of Tardive Dyskinesia

Metclopramide

Anti thyroid medications

Methimazole or PTU; iodine compounds; radioactive iodine therapy; thyroidectomy

Congestive heart failure treatment mnemonic- MADD DOG

Morphine aminophylline digoxin dopamine diuretics oxygen gasses (ABGs)

immediate treatment for myocardial infarction (MONA)

Morphine, Oxygen, Nitroglycerin, Aspirin

signs of cardiac tamponade

Muffled or distant heart tones, hypotension, JVD

Hyperkalemia mnemonic MURDER

Muscle weakness Urine Respiratory depression Decreased cardiac contractility ECG changes (peaked T waves) Reflexes

Do you massage the site of inflammation in a patient with a DVT?

NO

Acute pancreatitis interventions

NPO status/NG tube inserted to suction out gastric secretions; pain management IV opioids; IV fluids to prevent hypovolemic shock; semi fowlers or side lying with HOB 45 degrees

First line of medication for gout

NSAIDs and prednisone is first to treat pain and inflammation of gout attacks

Common PPI's (think of the pump in your stomach churning out the acid- Zole is the nice guy who shuts off the pump)

Omeprazole (Losec), Iansoprazole, pantoprozole

Nursing considerations for osmotic diuretics

Only administered IV, may crystalize (check solution before admin), Perform neuro assessment and LOC (if using for cerebral edema)

________ _________ is common with ACE inhibitors and alpha-blockers (-zosin)

Orthostatic hypotension

Phenytoin adverse effects- mnemonic PHENYTOIN

P-interactions Hirsutism Enlarged gums Nystagmus Yellow-browning of skin Teratogenicity Osteomalacia Interference with B metabolism (anemia) Neuropathies: vertigo, ataxia, headache

Arterial occlusion: 4 P's

Pain pulselessness pallor paresthesia

Treatment for hemopilia

administer supplemental IV clotting factors (factor VIII, Factor IX)

Treatment of pheochromocytoma

adrenalectomy (if a tumor is present), tell the patient to not smoke, drink caffeine or change position suddenly; administer anti hypertensives; promote rest and calm environment; diet high in calories. vitamins, and minerals

In a patient with placenta previa what do you immediately do

Place the woman immediately on bed rest in a side lying position

What method can be used to elicit Trosseau's sign?

Placing BP cuff on the arm, inflating to a pressure greater than systolic BP, holding in place for 3 minutes. This will induce a spasm of the muscles in the hand and forearm when hypocalcemia is present

When will there be an intermittent air leak with bubbling in water seal chamber?

Pneumothorax

Signs and symptoms of Type 1 and Type 2 diabetes. 3 P's

Polyuria (excessive peeing), polydipsia (excessive thirst), polyphagia (excessive hunger)

What do you give for potassium replacement therapy?

Potassium chloride

Dystocia general aspects (4P's)

Powers Passageway Passenger Psych

A patient with latent TB should NOT begin treatment with ________ because it increases risk for conversion into active TB

Prednisone

The nurse is caring for a child with hemophilia and is reviewing the results that were sent from the laboratory. Which result should the nurse expect in this child? 1.Shortened prothrombin time (PT) 2.Prolonged PT 3.Shortened partial thromboplastin time (PTT) 4.Prolonged PTT

Prolonged PTT

Short acting insulin types

Regular insulin

What is the only insulin that can be delivered IV Push?

Regular insulin

Right Sided HF pneumonic...SWELLING....stands for

Swelling of legs and hands, Weight gain, Edema (pitting), Large neck veins (JVD), Lethargy/fatigue, Irregular heart rate, Nocturia, Girth (ascites)

S__ heart sound in children is normal when reflecting rapid filling of the left ventricle

S3

Electrical conduction of the heart pneumonic Send A Big Bounding Pulse stands for

SA node; AV node; Bundle of His; Bundle Branches; Purkinje fibers

St johns wort interferes with many prescription medications, such as...when taken with these meds it can cause....

SSRIs; MAOIs or tricyclic antidepressants; when taken with these, it can cause serotonin syndrome

Patients with spinal cord injuries at _____ or above have autonomic dysreflexia/hyperreflexia

T-7 or above

If a client is taking a beta 2 agonist and inhaled glucocorticoid concurrently, how should they be taken?

Take the beta 2 agonist first to promote bronchodilation which will enhance absorption of the glucocorticoid

Heart murmur causes mnemonic- SPASM

Stenosis of a valve Partial obstruction aneurysms septal defect mitral regurgitation

____________ can intensify the effects of warfarin, phenytoin, and sulfonylurea-type oral hypoglycemics (e.g., glipizide, glyburide)

Sulfonamides

Preterm infant anticipated problems mnemonic: TRIES

Temperature regulation (poor) Resistance to infections (poor) Immature liver Elimination problems Sensory perceptual functions

What is a Mantoux test used for? What is indicative of a positive Mantoux test?

This is a skin test used to detect infection by TB. A positive mantoux test is >15mm unless they are less than 4 years old or are a recent immigrant then it is >10

The clinic nurse is preparing to perform a Romberg test on a client being seen in the clinic. The nurse would perform this test for the purpose of determining which status? 1.The client's ability to ambulate 2.The intactness of the tympanic membrane 3.The intactness of the retinal structure of the eye 4.The functional status of the vestibular apparatus in the inner ear

The functional status of the vestibular apparatus in the inner ear

what entails care of a halo external fixation device?

The nurse should clean pin sites with sterile solution to prevent infection, reduce pressure on the halo device (pillow under head), keep vest clean and dry, avoid holding the device frame while moving the client

A burn where the dermis is destroyed and possibly involves subcutaneous tissue, where the skin is dry and inelastic with waxy white leathery, or a charred black color...would be what type of burn?

Third degree (full thickness)

Infections during pregnancy mnemonic (TORCH)

Toxoplasmosis Other (hepatitis B, Syphilis, group B beta strep) Rubella Cytomegalovirus Herpes simplex virus

How to treat tumor lysis syndrome

Treat with aggressive hydration, correction of electrolyte abnormalities

Purpose of osmotic diuretic

Treatment of cerebral edema, decrease intraocular pressure

The nursery room nurse is assessing a newborn infant who was born to a mother who abuses alcohol. Which assessment finding should the nurse expect to note? Select all that apply. 1.Tremors 2.Lethargy 3.Irritability 4.Poor feeding 5.Higher-than-normal birth weight 6.A greater-than-normal appetite when feeding

Tremors Irritability Poor Feeding

Normal values for Troponin I and troponin T

Troponin I <0.5ng/mL and Troponin T should be <0.1ng/mL

LOW pressure limit alarm on mechanical ventilator, causes:

Tube disconnect or leak Loss of airway (total or partial extubation or decannulation)

Thiazolidinediones and pioglitazone are used to treat ________ and can worsen what?

Type 2 diabetes; can worsen heart failure

Drugs for petit mal seizures- ValEt mnemonic

Valproic acid; Ethosuximide

VEAL CHOP

Variable decels-Cord compression (change in mothers position helps) Early decels- Head compression Accelerations- O2 (baby is well oxygenation this is good) Late decels-Placental utero insufficiency (this is bad and means there is decreased perfusion of blood/oxygen/nutrients to the baby)

Who is at highest risk of Megaloblastic anemia?

Vegans

VEINY pneumonic for Peripheral vascular diseased stands for

Very big pulses=warm legs; Edema (blood pooling), Irregularly shaped sores, No intense pain, Yellow and brown ankles

What breath sounds are normal to find when auscultating?

Vesicular breath sounds

Nitroglycerine with concurrent use of _______ can lead to life threatening hypotension

Viagra

The nurse is conducting a dietary assessment on a client who is on a vegan diet. The nurse provides dietary teaching and should focus on foods high in which vitamin that may be lacking in a vegan diet?

Vitamin B12

Megaloblastic anemia is caused by

Vitamin B12 or folic acid deficiency

2 year old client should be able to

Walks up/down stairs alone, 1 step at a time o Builds 6-7 block tower o Turn 1 page at a time o Draw a line o 300+ vocabulary o 2-3-word phrases o States own name o Begins parallel play o Begins to gain independence from parents

The nurse is developing a plan of care for a client in Buck's traction. The plan of care should include assessing the client for which finding indicating a complication associated with the use of this type of traction? 1.Hypotension 2.Weak pedal pulses 3.Redness at the pin sites 4.Drainage at the pin sites

Weak pedal pulses

The school nurse is performing pediculosis capitis (head lice) assessments. Which assessment finding indicates that a child has a "positive" head check? 1.Maculopapular lesions behind the ears 2.Lesions in the scalp that extend to the hairline or neck 3.White flaky particles throughout the entire scalp region 4.White sacs attached to the hair shafts in the occipital area

White sacs attached to the hair shafts in the occipital area

What is a sucking chest wound

a SCW happens when an injury causes a hole to open in your chest (stabbing, gunshot)

what is a left to right shunt?

a back leak of blood from the systemic to the pulmonary circulation. This causes the pulmonary flow to be larger than the systemic

A halo external fixation device stabilizes what

a cervical or high thoracic fracture

Addisons disease is (pneumonic: we need to ADD some)

a disorder of the adrenal cortex, not enough steroids

Define orthostatic hypotension

a drop in systolic BP of >20 mm Hg or in diastolic BP of >10mm Hg

After barium xray what should be given to the client?

a laxative to help expel barium. Retained barium can lead to fecal impaction

Autonomic dysreflexia/hyperreflexia is what

a life threatening inhibited sympathetic response of the nervous system to a noxious stimulus

Isosorbide dinitrate (isordil) is what

a long acting nitrate medication prescribed to prevent angina in clients with CAD

What is an antiemetic

a medication used in treatment and/or prevention of nausea/vomiting

All macrolide antibiotics (azithromycin, erythromycin, clarithromycin) can cause...

a prolonged QT interval

hypomagnesemia can lead to...

a prolonged QT interval, which leads to VTACH which can lead to torsades de point

A client with a documented exposure to tuberculosis is on medication therapy with isoniazid. The nurse is monitoring laboratory results and determines that which laboratory value indicates the need for follow-up? 1.Platelet count 325,000 mm3 (325 × 109/L) 2.Serum creatinine 1.0 mg/dL (88.3 mcmol/L) 3.Blood urea nitrogen (BUN) 20 mg/dL (7.1 mmol/L) 4.Aspartate aminotransferase (AST) 55 U/L (55 U/L)

Blood urea nitrogen (BUN) 20 mg/dL (7.1 mmol/L)

The nurse has provided home care instructions to a client with a history of cardiac disease who has just been told that she is pregnant. Which statement, if made by the client, indicates a need for further instruction? 1."It is best that I rest lying on my side to promote blood return to the heart." 2."I need to avoid excessive weight gain to prevent increased demands on my heart." 3."I need to try to avoid stressful situations because stress increases the workload on the heart." 4."During the pregnancy, I need to avoid contact with other individuals as much as possible to prevent infection."

"During the pregnancy, I need to avoid contact with other individuals as much as possible to prevent infection."

What is Chadwick's sign?

Blue-tint to the cervix

Phosphate values

0.8-1.5

The nurse is providing instructions to the mother of a child with croup regarding treatment measures if an acute spasmodic episode occurs. Which statement made by the mother indicates a need for further teaching? 1."I should place a steam vaporizer in my child's room." 2."I will take my child out into the cool, humid night air." 3."I could place a cool-mist humidifier in my child's room." 4."I will have my child inhale the steam from warm running water."

1."I should place a steam vaporizer in my child's room."

Which interventions are essential to perform when a central venous site is suspected of being infected? Select all that apply. 1.Prepare to administer antibiotics. 2.Notify the primary health care provider (PHCP). 3.Inform the client that blood cultures will need to be obtained. 4.Document the occurrence, the actions taken, and the client's response. 5.Continue to use the central venous catheter until another one is placed.

1.Prepare to administer antibiotics. 2.Notify the primary health care provider (PHCP). 3.Inform the client that blood cultures will need to be obtained. 4.Document the occurrence, the actions taken, and the client's response.

The nurse is caring for a client who has undergone a radical neck dissection and creation of a tracheostomy because of laryngeal cancer and is providing discharge instructions to the client. Which should be included in the instructions? Select all that apply.

1.Protect the stoma from water. 2.Use a humidifier if dryness is a problem. 3.Keep powders and sprays away from the stoma site.5.Apply a thin layer of non-oil-based ointment to the skin around the stoma to prevent cracking.

a normal PT range is

11-12.5 seconds

PTT values

11-14 sec

RBC distribution (RDW) values

11.5-14.5

Hemoglobin for men and women values

13-17 men, 12-15 women

sodium values

135-145

Ammonia values

15-50

platelet values

150-400

Hypertonic fluids

3% NS, 5% NS, 5% albumin, 25% albumin, mannitol

paCO2 values

38-42

normal Cardiac output

4-7 L/min

Normal Cardiac output

4-8 L/min

Normal EF

50%-70%

total calcium levels in a term infant younger than a week

7-12

BUN values

8-21

normal apical pulse for an infant

90-130 bpm

SaO2 values

94-100

chloride values

95-105

The nurse is assisting a primary health care provider (PHCP) during the examination of an infant with developmental hip dysplasia. The PHCP performs the Ortolani maneuver. The nurse determines that the infant exhibits a positive response to this maneuver if which finding is noted? 1.A shrill cry from the infant 2.Asymmetry of the affected hip 3.Reduced range of motion in the right and left hip 4.A palpable click during abduction of the affected hip

A palpable click during abduction of the affected hip

large blood vessel that supplies the anterior wall of the left ventricle

Left anterior descending artery (LAD)

cardiac afterload is what

Pressure that the left ventricle has to pump against

what is cardiac preload

amount of blood returned to the right side of the heart at the end of diastole

A decreased PT may be noted in

arterial occlusion, deep vein thrombosis, edema, myocardial infarction, peripheral vascular disease, and pulmonary embolism

Difference between hemodialysis and peritoneal dialysis

hemodialysis is 3x a week outside the body; peritoneal is inside the body performed at the bedside or operating room

what is agnosia

inability to interpret sensations and hence to recognize things, typically as a result of brain damage.

The nurse is monitoring a client who was diagnosed with type 1 diabetes mellitus and is being treated with NPH and regular insulin. Which manifestations would alert the nurse to the presence of a possible hypoglycemic reaction? Select all that apply. 1.Tremors 2.Anorexia 3.Irritability 4.Nervousness 5.Hot, dry skin 6.Muscle cramps

tremors, irritability, nervousness


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