NCLEX ATI Reddit
Atypical anxiolytics
Buspirone (BuSpar) → Used for anxiety, panic disorder, OCD, PTSD S/E include dizziness, nausea (take w/ meals to decrease), headache NO SEDATION. Dependency not likely so long-term use is ok. Full effect not felt fr several wks
Cane Walking
COAL (Cane, Opposite, Affected, Leg)
Atypical antidepressants side effects
Common S/E - appetite suppression, wt loss, GI distress, agitation, seizure, headache Headache and dry mouth may be severe and pt should notify provider if this occurs
Agonists
Drugs that allow the body's neurotransmitters, hormones, and other regulators to perform the jobs they are supposed to perform
Hypokalemia
Dysrhythmias, muscle weakness/cramps, constipation/ileus, hypotension, weak pulse
Venous disorder
Elevate legs Make a v with your 2 fingers (the 2 fingers being the legs) to help remember care for pt with arterial vs venous disorder
Sodium bicarbonate
Given orally as an antacid or via IV Numerous incompatibilities with IV form
Calcium citrate (Citrical)
Implement seizure precautions during administration and have emergency equipment on hand
Order of Assessment
Inspection, palpation, percussion, auscultation Except with abdomen it is IAPP-inspect, auscultate, percuss and palpate.
Incentive Spirometer Use
Instruct pt to keep a tight mouth seal around mouthpiece and to inhale and hold breath for 3-5 secs
Contact Precautions
MRSA, VRSA, RSV, skin infection (herpes zoster, cutaneous diphtheria, impetigo, pediculosis, scabies, and staphylococcus), wound infections, enteric infection (C diff), eye infections (conjunctivitis) Management → gown, gloves, goggles, private room
Hemoglobin Lab Value
Male 14-18, Female 12-16
RBC Lab Value
Male 4.7-6.1, Female 4.2-5.4
Hematocrit Lab Value
Male 42-52%, Female 37-47%
HDL Lab Value
Male > 45 mg/dL, women > 55 mg/dL
Magnesium sulfate
Monitor BP, pulse and respirations with IV administration Decreased/absent deep tendon reflexes indicates toxicity Have injectable calcium gluconate on hand to counteract toxicity when giving magnesium sulfate via IV
Normal PT/Normal INR Lab Value
Normal PT = 11-12.5 sec, Normal INR = 0.7-1.8 (Therapeutic INR 2-3) PT on Coumadin should be 2-3x higher INR of 3.9 means it is 3.9x higher than normal person
Normal PTT Lab Value
Normal PTT = 30-40 sec (Therapeutic PTT 1.5 - 2 x normal or control values) PTT on heparin should be 1.5-2x higher
Latex Allergies
Note that clients allergic to bananas, apricots, cherries, grapes, kiwis, passion fruit, avocados, chestnuts, tomatoes, and/or peaches may experience latex allergies as well
Potassium Chloride (K-Dur)
Oral or IV administration NEVER give IV push to avoid fatal hyperkalemia Dilute potassium and give no more than 40 mEq/L per IV to prevent irritation of vein Administer no faster than 10 mEq/L per IV Concurrent use with potassium-sparing diuretics or ACE inhibitors can cause hyperkalemia
Arterial disorder
Place legs in a dependent position (dangling legs down)
Antagonists
Prevent the body from performing a function that it would normally perform (narcan)
Hypomagnesemia
c
Dysphasia
difficulty speaking
Dysphagia
difficulty swallowing Aspiration precautions; Avoid thin liquids and sticky food and provide oral care prior to eating (helps to enhance taste of food)
Hyperkalemia
dysrhythmias, muscle weakness, numbness/tingling, diarrhea
surgical asepsis
sterile technique
Hypernatremia
↑HR, muscle twitching/weakness, GI upset
Hyponatremia
↑HR, ↓BP, confusion, fatigue, N/V, headache
Hypercalcemia
↓ DTR, kidney stones, lethargy, constipation
Hypermagnesemia
↓BP, muscle weakness, lethargy, respiratory/cardiac arrest
Airborne Precautions
"My chicken hez TB" Measles, chicken pox, herpes zoster, TB Management → Neg pressure room, private room, mask, n95 for TB
Venturi Mask
(4-10L/min) is most precise O2 delivery. Best for pt w/ chronic lung disease (i.e. COPD)
Trendelenburg position
(legs in the air) → Used to promote venous circulation
SSRIS definition and names
(selective serotonin reuptake inhibitors) - inhibits serotonin reuptake (↑ serotonin) Citalopram (Celexa), Sertraline (Zoloft), Fluoxetine (Prozac), Paroxetine (Paxil) End in "ine" so think of how its stressful to have a teen in the house - these meds are used for anxiety and depression Full effects not felt for up to a month
Hypocalcemia
+Chvostek's & Trousseau's signs, muscle spasms, numbness/tingling in lips/fingers, GI upset, ↓BP, ↓HR
AST Lab Value
0-35 units/L
Digoxin Lab Value
0.5 to 2.0ng/mL
Creatinine Lab Value
0.6 - 1.2mg/dL M, 0.5 - 1.1 F
Lithium Lab Value
0.8 to 1.4 mEq/L
Total Magnesium Lab Value
1.3-2.1 mg/dL
Theophylline Lab Value
10 to 20 mcg/mL
Dilantin Lab Value
10-20 mcg/mL
BUN Lab Value
10-20 mg/dL
Sodium Lab Value
136-145 mEq/L
Platelet Lab Value
150,000-400,000/mm3
HCO3 Lab Value
21-28 mmol/L
Phosphorous Lab Value
3.0 -4.5 mg/dL
Albumin Lab Value
3.5-5.0 g/dL
Potassium Lab Value
3.5-5.0 mEq/L
pC02 Lab Value
35 to 45 mm Hg
ALT Lab Value
4-36 units/L
WBC Lab Value
5,000-10,000/mm3
Home oxygen education
Avoid synthetic or wool fabrics (encourage wearing cotton) Educate to apply a water-soluble lubricant to soothe irritation of the mucous membranes
Atypical antidepressants
Bupropion (Wellbutrin), Trazodone Used for depression and as an aid to quit smoking (be APPROPRIATE and don't smoke) Avoid use in pt w/ seizure disorders
pH Lab Value
7.35-7.45
Glucose Lab Value
70 -105 mg/dL
p02 Lab Value
80-100 mmHg
Total Calcium Lab Value
9.0-10.5 mg/dL
LDL Lab Value
< 130 mg/dL
Total Cholesterol Lab Value
< 200 mg/dL
HbA1c Lab Value
<6.5%
Sodium Supplementation
Administer isotonic IV therapy of 0.9% normal saline or Ringer's lactate
Renewal of restraint prescription
Adults - q4h, 9-17 y/o - q2h, under 9 y/o - q1h Staff member must remain continuously w/ pt or view the pt via camera
3 point gait
Allows pt to be mobile without bearing weight on affected extremity Used when pt is non-weight bearing on a leg
Benzodiazepines
Alprazolam (xanax) → antidote is flumazenil
restraints
Assess and document pt physical needs, safety and comfort q 15-30 mins
SSRI Patient education
Avoid st. john's wort. Ensure a healthy diet
Delegation
RNs DO NOT delegate what they can EAT (Evaluate, Assess, Teach) A nursing assistant can perform tasks such as taking vital signs, range of motion exercises, bathing, bed making, obtaining urine specimens, enemas and blood glucose monitoring. Nursing assistants cannot interpret results or perform any task beyond the skill level of the certification they received. (Performing gastrostomy feeding thru an established gastrostomy tube) The PN is managed under the supervision of the RN. Certain higher level skills can be delegated after competency has been established by the RN (e.g., dressing changes or suctioning).
Crutch Walking
Remember the phase "step up" when picturing a person going up stairs with crutches. The good leg goes up first followed by the crutches and the bad leg. The opposite happens going down the stairs....OR "up to heaven...down to hell"
SSRI side effects
S/E include insomnia (paroxetine), nausea, fatigue, sexual dysfunction, wt gain Watch for serotonin syndrome!! S/S → agitation, hallucinations, fever, diaphoresis, tremors
Droplet Precautions
SPIDERMAn Sepsis, scarlet fever, strep, pertussis, pneumonia, parvovirus, influenza, diphtheria, epiglottitis, rubella, mumps, adenovirus Management → private room, mask
antidotes
chemical that counteracts the effects of another drug or poison Muscarinic agonists, cholinesterase inhibitors → Bethanechol, Neostigine Atropine Anticholinergic drugs (Atropine) → Phyosostigmine Digoxin, digitoxin → Digibind Warfarin (Coumadin) → Vitamin K Heparin → Protamine sulfate Insulin-induced hypoglycemia → Glucagon Acetaminophen (Tylenol) → Acetylcysteine
Medical Asepsis
clean technique
aerosol mask/face tent
good for pt w/ facial trauma or burns