nclex

creatine - best indicator of kidney function

0.6 - 1.2 abnormal do nothing

lithium

decreases mania toxic above 2 tremors, metalic taste and severe diarrhea pee, poop, and parastesia increase fluids and watch sodium low sodium makes more toxic if high sodium lithium wont work

names of ccb

dipine verapamil cardizem iv drip

calcemias

do the opposite of the prefix

Magnesemias

do the opposite prefix

Dumping syndrome

drunk, shock, abdominal distress symptoms looks drunk: staggering gate, slurred speech , impaired judgement, labile emotions shock signs; hypotension, pale cold clammy acute abdominal distress; cramping pain, guarding, bobirigimi, diarrhea

subtotal thyroidectomy

excision of part of the thyroid glandAt risk for thyroid storm 2. S/S thyroid storm: a. Very high fever >104 F b. Very high V/S c. Psychotic Delirium *life threatening priority

hyperthyroidism - metabolim

fast metabolism/graves disease

frequent urination

first and third trimester void every 2 hours

due date

first day of lmp add 7 days subtract 6 months

INR-monitor warfarin levels

2-3 administer vit k

heparin

give iv or sq not to exceed 3wks antidote is protamine sulfate`

teach pregnant

hemoglobin will fall first trimester 11 second 10.5 third 10

hypothyroid

high tsh low t4

dumping syndrome

hob flat on side to eat decrease fluids low carbs when everything is low the stomach empties slow high protein

add i sone

hyper pigmented, any stress can cause shock, glucose goes down and bp goes up

your going to run your self into the grave

hyperthyroid

lie

is spine of mom and spine of baby vertical is good

kalemias

kalemias do the same as the prefix except for heart rate and urine output

kusmal breathing only seen with

mac kusmal - metabolic acidosis

in a tie never pick

magnesium

magnesium sulfate IV to an alcoholic client with hypomagnesemia. Prior to the initiation of IV magnesium, which assessment data would be important for the nurse to document?

magnesium acts like a sedative. Since we know that magnesium can cause respiratory depression, the nurse should always have a baseline respiratory assessment prior to initiating an infusion of magnesium. Muscle tone and DTRs can also become depressed, so a baseline assessment of DTRs would be very important. The nurse should always assess kidney function and urinary output prior to and during IV magnesium administration because of the risk of magnesium toxicity if it is being retained.

prolonged vomiting or suctioning pick

metabolic alkalosis

zep

minor tranquilizers

Dumping syndrome

move in the right direction at the wrong rate

myasthenia gravis

muscle grave

growth development test

normal, older, easier

fundus of uterus

not palpable til wk 12

parasthesia

numbness and tingling in extremities

pistitonic child place in what position

on side

Pattern of Office Visits for prenatal care

once a month til wk 28 once every 2 wks until wk 36 every wk until delivery

coumadin

only po antidote vitamin k

valid sign in labor

onset of regular progrssive contrations

hypocalcemia. Which treatment would the nurse anticipate for this client?

po calcium, vitamin d, sevelamer hydrochloride

critical labs stay with patient

potassium greater than six hold med access patient prepare kexelate ph belox 6 co2 below 60 platelet less than 40

A client was admitted with reports of prolonged diarrhea. The client's admission potassium level was 3.3 mEq/L (3.3 mmol/L) and is receiving an IV of D5 ½ NS with 20 mEq KCL at 125 mL/hr. The UAP reports an 8 hour urinary output of 200 mL. The previous 8 hour urinary output was 250 ml. What should be the nurse's priority action?

potassium is excreted by the kidneys. If the kidneys are not working well, the serum potassium will go up! You always monitor the urinary output before and during IV potassium administration. Since the urine output has decreased below 30 mL/hr, we know that the urinary output is not adequate. Therefore, the client could start retaining too much potassium. The priority action would be to stop the infusion and then follow this action by notifying the healthcare provider.

Spironolactone

potassium sparing diuretic

what hormone causes ammenorhea

progesterone

hiatal hernia

regurgitation of acid. acid come back up.gastric content move in wrong direction at normal rate

myasthenis and cholinergic crisis is

respiratory arrest

Cushing's disease

same symptoms as side effects of steroids: high glucose, moon face, hirsutism, big body, buffalo hump, gynecomastia, lose potassium

haldol long acting im

side effects A B C D E F G medical emergency NMS from overdose neuroleptic malig syndrom which is high temp, tremors and anxiety elderly half adult dose

24 -48 for subtotal

storm

tetany (tetanus)

sustained APs > continuous calcium release prevents relaxation

tocolytic - ob medication

terabutaline, magsulfate - stop labor terabultaline increase heart rate mag sulfate - everything goes low

24 - 48 hrs post total thyroidectomy

tetany

Weight gain in pregnancy

total weight 28 lbs plus or minus 3 first trimest 1 pound each month 2nd and 3rd is 1 pound per week wks pregnant minus 9 is how much she should of gained

potassium

3.5 - 5.3

qrs depolirazation

ventricular

hiatal hernial treatment

want to empty faster place hob in high position increase fluids high carbs protein low

mitral valve

5th inter costal spcae at mid clavicular line apical pulse

ccb treat

A A A

prozac ssri

Anticholinergic Blurred vision Constipation Drowsy and euphoria and insomnia do not give at bed time when changing dosage watch for suicidal ideation

A client is admitted following a severe burn. What changes related to fluid status would the nurse anticipate?

Causes of fluid volume deficit (hypovolemia) include loss of fluid from anywhere as well as third spacing of fluid that occurs with such things as burns. Burns can result in fluid loss from the burn area as well as the third spacing, which increases the risk for hypovolemia and shock. As the fluid volume decreases, the BP and CVP both decrease. Remember, less volume, less pressure. Also, when the fluid volume becomes depleted, the urine output will decrease in an effort to hold on to the fluid (compensate) or the kidneys are not being perfused. You will see the urine specific gravity increase because the small amount of urine being produced will be very concentrated.

hiatal hernia sign and symptom

GERD if you lie down after you eat heart burn and indigestion

presentation

ROA or LOA

Zoloft (sertraline)

cause insomnia but can give at bedtime increase toxicity because not broken down sad head sweat apprehensive dizzy headache

Cushing's disease

will be retaining sodium and water due the increased amount of aldosterone

Hypothyroidism (Hypo-Metabolism)Signs & Symptoms

↑ weight♦ cold♦ sluggish♦slow♦ decreased BP♦bradycardia♦ hair and nails brittle♦decreased E

Treatment of hyperthyroidism

- Radioactive iodine (I131) works by destroying the thyroid gland -ptu - Surgery to remove all or part of the thyroid gland - Lifelong thyroid hormone replacement will be needed

ABG Rules (Respiratory or Metabolic)

- Respiratory = <> or >< (opposite) - Metabolic = >> or << (same) - Acidosis = pH < 7.35 - Alkalosis = pH > 7.35

Cirrhosis signs and symptoms

-applicable to any liver problem o Firm, nodular liver is palpable—not usually palpable o Abdominal pain b/c the liver capsule has stretched With a PIH pregnant woman who complains about epigastric pain think SEIZURE b/c pressure is increasing due to liver swelling o Chronic dyspepsia/GI upset or a change in bowel habits o Ascites o Splenomegaly—enlarged spleen due to immune response o Decrease serum albumin levels Get albumin from protein in the diet or the liver b/c the liver synthesizes albumin • Albumin holds fluid in vascular space so when albumin is decreased, fluid is going to leak out and cause ascites in any area so need to check albumin levels o Increase SGOT/AST and SGPT/ALT levels o Anemia b/c liver is sick so increased risk for hemorrhage b/c a healthy liver helps clot blood o Can progress to hepatic encephalopathy/coma b/c ammonia builds up and acts like a sedative also called Reyes syndrome • Protein breaks down to ammonia which the liver converts to urea and the kidneys secrete urea

4 stages

1 labor: latent active transient 2 deliver baby: 3 deliver placenta 4 recovery

IV

15 - 30 minutes after drug is finished

quikening

16 - 20

bmi

19 - 25

high bilirubin levels

20 or greater

when is the fundus at the belly button

22 wks

radioactive iodine

24 hr by themself excreted through urine

pancytopenia

Pancytopenia is a condition in which there is a concurrent leukopenia (a reduction in white blood cells), thrombocytopenia (a reduction in platelets), and anemia (reduction in red blood cells).

saw tooth

a flutter treat with ccb

exophthalmos

abnormal protrusion of the eyeball

can hear heart beat

at 8 to 12 wks

o on abgar means

baby is still born

total thyroidectomy

complete removal of thyroid Need lifelong T3, T4 hormone replacement. At risk for hypocalcemia (bc at risk for loosing parathyroid gland) S/S hypocalcemia: everything go up tetany a. Earliest sign: paresthesia

geodon

prolong qt interval and can cause sudden cardia arrest

difficulty breathing

2nd and 3rd trimester teach them tripod position feet lat arms on table leaning forward

pulmonic

2nd intercostal space at the left sternal border

aortic

2nd intercostal space at the right sternal border

im

30 - 60 minutes

tricuspid

4th intercostal space at left sternal border

sodium level of 149 is too high? The normal sodium level is 135-145 mEq/L (135-145 mmol/L)

Look for neuro changes when the sodium level is not within normal limits. The brain does not like it when the sodium level is messed up. So, performing a neurological assessment on this client would be important

sublingual TAP

T : 30 minutes prior to administration Administer P: 5 - 10 minutes after dissolved

treatment for thyroid storm

Treatment a. Wait out: either die, come out, give O2 and lower body temp b. Tx focuses on saving the brain until they come out of it c. Lowering body temp: i. Ice packs: on axilla, axilla, groin, groin, back, neck ii. Cooling blanket

veal chop

Variable - Cord compression Early - Head Compression Acceleration - Okay Late - Placental insufficiency

Ammenorhea

absent period

ph down

acidosis

ph low

acidosis

4 rules of priority

acute beats chronic fresh post op beats medical or other surgical unstable vs stable

post op risk with thyroidectomy first 12 hrs

airway and hemmorage

ph high

alkalosis

ph up

alkalosis

hemophillia

bleeding disorder in which clotting does not occur or occurs insufficiently

if skeletal muscle or nerve blame on

calcium

Chvostek's sign

irritable from low calcium

bun 8 -25

monitor for dehydration below 8

station

negative is above the tight squeeze engagement is station zero

Potassium

never push it iv

ptu

propylthiouracil (hyperthyroidism) puts thyroid under risk for amino suppressant watch wbc

rn do it that way

regular before

ENFACEMENT

thinning

effacement

thinning of the cervix

clozaril / clozapene

used to treat severe schitzo side effect a granulocytosis lower wbc

variable

very . bad

chaotic sguilly line

vfib treat with dfib

shap peaks and jags

vtach use amiodarone