Uworld study set
heparin is to coumadin as?
as tranquilizers are to antidepressants
The priority with fetal bradycardia after suspected rupture of membranes is to:
assess for a prolapsed cord. The nurse should then manually elevate the presenting fetal part off the cord, leave the hand in place, and call for help.
MAOI's must avoid all drugs that are?
avoid all over the counter drugs
Azathioprine (Imuran) is an immunosuppressant drug that can cause
bone marrow depression and increase the risk for infection. Leukopenia (white blood cell count <4,000/mm3 [4.0 × 109/L]) can be a severe adverse effect of the drug and should be reported to the health care provider before administering the medication.
Isoniazid is a first-line antitubercular drug used to treat latent or active tuberculosis. The nurse should question this prescription as increased liver function tests (eg, alanine aminotransferase, aspartate aminotransferase) can indicate development of
drug-induced hepatitis
signs of endometrial infection are
fever, tachycardia, and uterine pain/tenderness.
Bone marrow suppression from chemotherapy can cause decreased red blood cells, white blood cells, and platelets. Erythropoietin is used to increase red blood cell production, and...
filgrastim is administered to stimulate neutrophil production.
Coping mechanisms used by hospitalized toddlers include
following homes rituals and routines, having parents stay with the child (including overnight), and using the playroom for relief of anxiety and fear.
Flumazenil (Romazicon) is the antidote for what?
for Midazolam (Versed) a benzodiazepine
we use "zines" for the...
for the zany
Most clients with heart failure are prescribed a loop diuretic like:
furosemide, torsemide, bumetanide to reduce fluid retention.
#1 lithium intervention is?
get them fluids on lithium and watch sodium
Clients with a health care-associated infection, such as methicillin-resistant Staphylococcus aureus, are placed on contact precautions which include use of a...
gown and gloves and equipment that is designated for use with a single client only (eg, stethoscopes, blood pressure cuffs, glucometer).
if between 2 do's?
if between 2do's position first
5000-11000
is wbc count
Avoid fatal drug interactions: Concurrent use of erectile dysfunction drugs (sildenafil, tadalafil, vardenafil) or alpha blockers (terazosin, tamsulosin) is contraindicated with use of sublingual nitrogen because?
it can lead to potentially fatal hypotension
Elavil (Amitriptyline) does what to your mood?
it elivates your mood
normal central venous pressure is?
it is 3-8
cd4 should be above
it should be above 200 or it's AIDS
high potassium antidote?
kayexalate and D5W and insulin
antibiotics can infect the INR ratio/vitamin k by?
killing off the bacteria in the stomach that produce vitamin K
A nurse on the telemetry unit is preparing client medications in the medication room at the nurse's station. The nurse should perform which actions to be consistent with client safety practices related to medication administration? Select all that apply.
labeling all medications, discarding medications found unlabeled, and taking extra care for clients taking anticoagulant drugs.
Person on lithium give Gatorade cause its linked to
linked to sodium. High sodium lithium wont work, low sodium makes it toxic
set limits with patients in
locked psych units
decanate means?
long acting IM given to non-compliant patients
MAOI's trade names rhymes
mar, nar, par
Metformin is an oral antidiabetic medication that increases insulin sensitivity and inhibits liver glucose production. Metformin does not increase insulin secretion, so the risk of hypoglycemia is minimal even when
meals are skipped.
atypical antipsychotics do what?
measure white counts
Insulin glargine should not be
mixed in a syringe with any other insulin.
Individuals with paranoid personality disorder have a
pervasive distrust and suspicion of others; they believe that people's motives are malicious and assume that others are out to exploit, harm, or deceive them.
The nurse assesses a client who is receiving methotrexate for rheumatoid arthritis. Which statement by the client is most concerning?
petechiae (ie, small, purple hemorrhagic spots), purpura, and/or other signs of bleeding (eg, melena, hematemesis, bleeding gums)
To collect a nonsterile urine specimen from a child who is not toilet trained, the nurse can
place several cotton balls in a dry diaper and later squeeze urine onto a dipstick.
abciximab, eptifibatide, tirofiban) are used as
platelet inhibitors to prevent the occlusion of treated coronary arteries during percutaneous coronary intervention procedures and prevent acute ischemic complications. Hypotension, tachycardia, changes in heart rhythm, blood in the urine, abdominal/back pain, mental status changes, and black tarry stools may also indicate internal bleeding and should be monitored carefully
Benzodiazopines help in
pre-op, muscle relaxant, seizures, ventilator
MAOI's must avoid all tyramine containing food to?
prevent severe hypertensive crisis. avoid aged cheeses, no yogurt, cured or smoked/organ meats or fish, such as sausage or salami. Beer. caffiene. salad bar BAR banannas, avacados, raisins soy products like miso soup, bean curd, or tofu. certain beans, such as fava or broad beans.
race for fires means?
rescue, alarm, confine, extinguish
phenothiazines, typical 1rst gen antipsychotics nursing diagnosis?
risk for injury
Routine catheter care to prevent health care catheter-associated UTIs includes
routine hand hygiene, cleansing the perineal area with soap and water routinely, keeping the catheter bag below the bladder and off the ground, keeping the catheter and tubing free of kinks and facilitating urine into the bag, and using sterile technique when collecting urine specimens.
Theophylline can cause seizures and life-threatening arrhythmias due to its narrow therapeutic range (10-20 mcg/mL). The dose is adjusted based on peak drug levels, obtained 30 minutes after the dose is given. Clients should avoid
caffeinated products and medications that increase serum theophylline levels (eg, cimetidine, ciprofloxacin).
Antidepressants such as selective serotonin reuptake inhibitors (eg, fluoxetine, duloxetine) and tricyclic antidepressants (eg, amitriptyline) can?
can cause suicidal ideation and behaviors, especially during the initial few weeks of therapy.
Signs of ruptured ectopic pregnancy may include
severe abdominal pain, dizziness, and referred shoulder pain.
Rhythms that are ideal for synchronized cardioversion are
supraventricular tachycardia, ventricular tachycardia with a pulse, and atrial fibrillation with rapid ventricular response.
The client should be directed to swish the solution Nystatin within the mouth, making contact with all the mucous membranes, and then...
swallow the solution after several minutes. Swallowing would help to clear any unseen esophageal candidiasis.
MAOI's are...
these inhibitors are antidepressants
phenothiazines, typical 1rst gen antipsychotics end in?
they all end in "zine"
Benzodiazopines all have "ZEP" in them and are
they are anti anxiety meds or minor tranquilizers, zeplin concerts minors on tranquilizers
"lol's" are what class of drug?
they are beta blockers used to slow heart rate
Prescribed orthopedic immobilizers and protective devices used temporarily during routine procedures or examinations are not considered
they are not considered physical restraints and do not require authorization for use from a health care provider.
cogentin and artane are Parkinson's drugs used to treat?
they can also treat EPS
atypical generally ends in
they end in "apine"
NSSRI's/tricyclic antidepressants take how long to work?
they take 2-4 weeks to work
as a PH goes go goes...
your patient
put someone to sleep "zzzz" use?
zeps and zines
Cushing triad is?
hypertension, bradycardia, and irregular respirations
phenothiazines, typical 1rst gen antipsychotics side effects?
Anticolinergic-drymouth/Blurred vision/Constipation/Drowsyness/EPS/fotosensitivity/aGranulocytosis-immunosupression
Normal urine output is
0.5-1 mL/kg/hr or >30 mL/hr.
lithium and creatinine same range is?
0.7-1.4
The Apgar score assessment is performed at
1 minute and at 5 minutes after birth to assess neonatal adjustment to extrauterine life. Most neonates have scores between 7 - 9 and require no intervention. Scores <7 may require further evaluation or resuscitation.
Normal BUN is?
10-20
A normal hemoglobin level is
12-16
hemaglobin values?
12-18
Postoperative hemorrhage from tonsillectomy is uncommon but may occur up to
14 days after surgery. The nurse should instruct this parent that the child should not resume strenuous activity or contact sports for at least 7-14 days post surgery.
A therapeutic INR for most conditions is
2-3 but can be up to 3.5 for heart valve disease.
The normal phosphate level for adults is
2-4
Benzodiazopines is only supposedly to be taken for...
2-4 weeks
A normal blood uric acid level for an adult female is
2-6.5
Histrionic personality disorder
Self-dramatizing, exaggerated or shallow emotional expression Attention-seeking, needs to be the center of attention Overly friendly and seductive, attempts to keep others engaged Demands immediate gratification and has little tolerance for frustration
Anticoagulant injections Heparin should be administered in the abdominal subcutaneous tissue at a 45- to 90-degree angle with a
25 gauge 0.5inch needle. A 45-degree angle is used for clients with minimal adipose tissue to avoid accidental intramuscular injection, which would cause rapid absorption and result in hematoma and painful muscle irritation.
Clients with severe hyponatremia and neurologic manifestations need rapid correction of hyponatremia with
hypertonic saline (3% saline).
Normal pupils are what size?
3-5 mm in diameter
The normal potassium level for adults is
3.5-5
hemoglobin is 3x hemadacrit and is...
36-54
INR 4 or above is?
4 and above is a critical lab value and must be reported immediately
Infants do not start rolling until age
4 months and normally roll front to back at 5 months.
normal WBC count is?
4,500 to 11,000
RBC
4-6 million
A normal blood uric acid level for an adult male is
4-7.5
Signs and symptoms of delirium tremens include
agitation, fever, tachycardia, hypertension, and diaphoresis.
CO2 normal range is 35-45 but critical value is?
60's and O2 in 60's = respiratory failure- prepare to incubate and ventilate. call respiratory then doc
CVP is?
a measurement of right ventricular preload (volume within the ventricle at the end of diastole) and reflects fluid volume problems.
To measure pressures accurately using continual arterial and/or pulmonary artery pressure monitoring, the zeroing stopcock of the transducer system must be placed at the phlebostatic axis. This anatomical location, with the client in the supine position, is at the
4th ICS, at the midway point of the AP diameter (½ AP)of the chest wall.
in a 4-6 month old ______days should elapse before a new food is introduced to observe for allergies
5-7days
a critical value for a PH is what?
6 and below is a critical value for PH
The normal calcium level for adults is
8-10
SAO2 sat should be
93-100 below a 92 is critical
An Apgar score of 10 is unusual as most newborns have acrocyanosis (cyanosis of the extremities) and will receive only 1 point for appearance/color. If the score at 5 minutes is
<7, the Apgar assessment should be repeated every 5 minutes for a maximum of 20 minutes (ie, at 10, 15, and 20 minutes after birth).
Isotretinoin is
a pregnancy category X drug and will cause birth defects if taken during pregnancy. The client must use 2 forms of birth control for 1 month prior to taking the medication as well as during treatment and 1 month afterward. The client must also be enrolled in a risk management program prior to receiving refills.
When caring for clients on droplet precautions,
a surgical mask is needed for routine care, such as assessment or medication administration. If there is risk of contact with body fluids during procedures (eg, wound care, suctioning), gloves, gown, and face shield are used.
therapeutic lithium levels
between 0.6-1.2
The nurse assesses a client for the development of peritonitis following a perforated gastric ulcer. Which of the following assessments support development of this complication? Select all that apply.
Abdominal rigidity on palpation (Option 3) Observable abdominal distension and "guarding" behavior Rebound tenderness during abdominal palpation (Option 2) Tachycardia, tachypnea, fever (Option 1) Acutely worsening, diffuse abdominal pain (Option 5) Nausea and vomiting
The hospice nurse is caring for an actively dying client who is unresponsive and has developed a loud rattling sound with breathing ("death rattle") that distresses family members. Which prescription would be most appropriate to treat this symptom?
Anticholinergic medications such as transdermal scopolamine or atropine sublingual drops effectively treat this symptom by drying up the excess secretions.
________ have a high risk (15%-50%) for ACE inhibitor-related cough.
Asians, especially those of Chinese descent,
The Glasgow Coma Scale score of 15 (range: 3-15) indicates
complete orientation.
foods that contain gluten?
BROW-barley, rye, oats, and wheat
Clozapine (Clozaril) is an atypical antipsychotic medication used to manage schizophrenia in clients who have not improved with other antipsychotic medications. Clozapine is highly effective at controlling schizophrenia; however, it has many severe, life-threatening adverse effects, including
agranulocytosis-low wbc, cardiac disease (myocarditis), and seizures.
A 7-month-old infant is admitted to the unit with suspected bacterial meningitis after receiving an initial dose of antibiotics in the emergency department. Frequent assessment of which of the following is most important in the plan of care?
Bulging/tense fontanels and increasing head circumference are important early indicators of increased ICP in children and should be monitored to prevent long-term complications.
The normal CVP is
is 2-8 mm Hg. An elevated CVP can indicate right ventricular failure or fluid volume overload.
the nurse should intervene when the student uses sterile saline from a bottle that was opened
opened more than 24 hours ago.
Meparidine/Demoral is a?
opiod narcotic pain killer
vanco or amnioderone priority?
amnioderone priority
The clinic nurse evaluates a client who was prescribed lithium therapy a month ago for bipolar disorder. Which client statement would cause the most concern?
Dehydration and sodium loss from vomiting and diarrhea can lead to toxic lithium levels in clients receiving lithium therapy.
Benzodiazopines prototype?
Diazepam/ Valium
Nausea, vomiting, or slow pulse rate can indicate?
Digoxin toxicity
A client comes to the emergency department in acute decompensated heart failure. The client is very anxious, with a respiratory rate of 30/min and pink, frothy sputum. After placing the client on oxygen via nasal cannula, which of these actions is the next priority?
Diuretics (eg, furosemide) are prescribed and administered to remove excess fluid in pulmonary edema
A client is admitted to the emergency room with right lower quadrant pain and suspected acute appendicitis. Which health care provider prescription should the nurse implement first?
Ensure patent airway and administer oxygen if hypoxic Obtain IV access and administer prescribed fluids (Option 4) Draw blood samples for complete blood count (CBC), electrolyte levels, clotting studies, and type and cross as prescribed (Option 2) Insert indwelling urinary catheter and obtain urine sample for urinalysis, if prescribed (Option 3) Insert a nasogastric (NG) tube if necessary
The nurse removes personal protective equipment (PPE) after completing a wound dressing change for a client in airborne transmission-based precautions. Which PPE should the nurse remove first?
Face shield/goggles, gown, and mask/respirator can be removed after gloves, which are considered the most contaminated piece of PPE.
Primary open-angle glaucoma is characterized by
an increase in intraocular pressure and gradual loss of peripheral vision (ie, tunnel vision).
Zines are the majors and
and zeps are the minors-tranquilizers
C's are...
INR 4+, hemoglobin below 8, O2 below 93
what falsifies an SAO2 reading?
anemia falsifies it will read high or a dye procedure in the last 48 hrs
Antibodies acquired from the IVIG therapy will remain in the body for up to 11 months and may interfere with the desired immune response to live vaccines so do not give?
MMR and varicella vaccines. they are live
Serious adverse reactions to aminoglycosides (eg, gentamicin, tobramycin, amikacin) include
ototoxicity and nephrotoxicity
The nurse is assessing a client with severe mitral valve stenosis for the presence of a murmur. Select the best site to auscultate a murmur in this client.
Mitral valve stenosis often produces a diastolic murmur heard best at the apex of the heart (5th intercostal space, midclavicular line) with a stethoscope.
Protonix/Pantoprazole is?
Proton-Pump inhibitor treats gastroesophageal reflux disease (GERD) and a damaged esophagus. It can also treat high levels of stomach acid caused by tumors.
BNP indicates chronic should be under 100 and...
over means CHF
Isotretinoin is an oral acne medication derived from vitamin A. advise clients to?
Not take Vit A suppliments
Glasgow coma scale
Note that a motor response in any limb is acceptable. The scale is composed of three tests: eye, verbal and motor responses. The three values separately as well as their sum are considered. The lowest possible GCS (the sum) is 3 (deep coma or death), while the highest is 15 (fully awake person).
The public health nurse has received a referral to make a follow-up home visit to a 1-year-old recently diagnosed with failure to thrive (FTT). Which intervention is the priority nursing action for this child?
Observation of the child while being fed may provide information related to the cause of inadequate dietary intake, including disturbances in feeding behavior and psychosocial factors.
Misoprostol prevents gastric ulcers in clients receiving long-term nonsteroidal anti-inflammatory drug therapy. It should not be taken with
antacids but can be taken with food to reduce gastrointestinal upset. Women of childbearing age should be educated on using reliable birth control methods as misoprostol can induce labor.
To measure the urinary output of an infant in diapers
One (1) gram of weight is equal to one (1) milliliter of fluid. subtract the weight of the diaper when dry from its weight when wet.
5 D's are...
Ph in the 6's, potassium in 6's, CO2 in 60's, O2 in 60's, platelet count of less than 40,000
A nurse is assessing a 12-month-old who has recurrent otitis media. Which risk factors should the nurse discuss with the infant's parents? Select all that apply.
Recurring exposure to tobacco smoke Regular pacifier use, particularly after age 6 months Drinking from a bottle while lying down Lack of immunizations, particularly the pneumococcal vaccine series
The following steps should be instituted to ensure accuracy of invasive pressure readings (ART lines):
Position the client supine, flat, prone, or with the head of the bed <45 degrees Confirm zero reference stopcock (port of the stopcock nearest to the transducer) to be at the level of the phlebostatic axis (4th intercostal space, midaxillary line), which approximates the level of the atria of the heart Zero the system after initial setup, with disconnection of the transducer or when accuracy of the measurements is questioned Perform a dynamic response test (square wave test) every 8-12 hours, when the system is opened to air or when accuracy of measurements is questioned Measure pressures at the end of expiration
The general steps for chest tube removal include:
Premedicate the client with analgesic (eg, IV opioid, nonsteroidal anti-inflammatory drug [ketorolac]) 30-60 minutes before the procedure to promote comfort as evidence indicates that most clients report significant pain during removal (Option 1). Provide the health care provider (HCP) with sterile suture removal equipment (Option 5). Instruct the client to breathe in, hold it, and bear down (Valsalva maneuver) while the tube is removed to decrease the risk for a pneumothorax. Most HCPs use this technique to increase intrathoracic pressure and prevent air from entering the pleural space (Option 2). Apply a sterile airtight occlusive dressing to the chest tube site immediately; this will prevent air from entering the pleural space (Option 4). Perform a chest x-ray within 2-24 hours after chest tube removal as a post-procedure pneumothorax or fluid accumulation usually develops within this time frame. The client should be placed in semi-Fowler's position or on the unaffected side to promote comfort and facilitate access for tube removal.
geodon prolongs?
QT interval and can cause cardiac arrest. shoulnt use with heart probs
The nurse initiates a norepinephrine infusion through a client's only IV access into a large peripheral vein. The client reports severe pain at the IV site shortly after the infusion is started, and blanching is visible along the vein pathway. Which nursing interventions are appropriate? Select all that apply.
Stop the infusion immediately and disconnect the IV tubing (Option 5). Use a syringe to aspirate the drug from the IV catheter; remove the IV catheter while aspirating. Elevate the extremity above the heart to reduce edema (Option 2). Notify the health care provider and obtain a prescription for the antidote phentolamine (Regitine), a vasodilator that is injected subcutaneously to counteract the effects of some adrenergic agonists (eg, norepinephrine, dopamine) (Option 4).
A child's arm is burned from accidentally spilling boiling water on it, and the parent calls the clinic. The nearest emergency department is an hour away. Which instructions would be appropriate to give the parent? Select all that apply.
Soak area briefly in cool water to stop the burning process (Option 2). Remove any clothing or jewelry around the burn to avoid constriction as edema develops. This also allows for quick assessment of the burn by clinicians. Only a health care provider may remove clothing that is stuck to the burned area (Option 5). Cover with a clean, dry cloth to prevent contamination, further trauma, and hypothermia
EPS/side effect and NMS difference?
Take a temperature. if raised call code or ems with tremors and anxiety
Monoamine oxidase inhibitors (MAOIs) (eg, selegiline [Emsam]) interact with many medications, including many
antidepressants. MAOIs and selective serotonin reuptake inhibitors should not be given within 2 weeks of each other to prevent adverse reactions (eg, serotonin syndrome, neuroleptic malignant syndrome, hypertensive crisis).
Inform parents of the pulse rate at which to hold the medication Digoxin based on HCP prescription. In general...
digoxin is held if pulse <90-110/min for infants and young children or <70/min for an older child. less than 60 in adults
A client is admitted with palpitations. The ECG shows supraventricular tachycardia (SVT) with a rate of 220/min. The nurse has received an order to administer adenosine 6 mg IV. Which action should the nurse take?
The half-life is <5 seconds, so adenosine should be administered rapidly as a 6-mg bolus IV over 1-2 seconds followed by a 20-mL saline flush. Repeat boluses of 12 mg may be given twice if the rapid rhythm persists. The injection site should be as close to the heart as possible (eg, antecubital area). The client's ECG should be monitored continuously. A brief period of asystole is due to adenosine slowing impulse conduction through the atrioventricular node. The client should be monitored for flushing, dizziness, chest pain, or palpitations during and after administration.
Angina is chest pain due to myocardial ischemia. A client with chronic stable angina experiences intermittent chest pain relieved with rest or
administration of nitroglycerin. The priority action for acute angina is administration of rapid-acting (1-3 minutes) sublingual nitroglycerin to restore cardiac perfusion.
The nurse is preparing to perform cardioversion in a client in supraventricular tachycardia shown in the exhibit that has been unresponsive to drug therapy. The client has become hemodynamically unstable. Which step is most important in performing cardioversion?
The synchronizer switch must be turned on
Pap testing is generally started at
age 21, regardless of sexual history.
ANC needs to be...
above 500
The charge nurse must assign rooms to 4 clients who are scheduled for admission. Which client has the highest priority for a private room assignment?
active MRSA client
APGAR is scored how?
activity, pulse, grimace, appearance, respiration 0-3 for each
is the first-line drug of choice for the treatment of paroxysmal supraventricular tachycardia (SVT; a rapid rhythm exceeding 150/min)
adenosine/Adenocard
Regular insulin is the only insulin that can be
administered IV push.
Guillain-Barré syndrome results in?
bilateral, ascending paralysis. The ascent can be rapid and it is unknown at what level of the client's body the ascension will stop. This client is unstable. A key concern is the paralysis ascending to the diaphragm and causing respiratory failure.
platelets trigger values
below 90,000 bleeding precautions, less than 40,000 is critical
Indications of a need for IV isotonic fluids include:
capillary refill more than 3 seconds and mottling, prehydration before an epidural anesthesia, and inadequate urine output and tachycardia due to hyperemesis gravidarum.
The synchronizer switch must be turned on when
cardioversion is planned.
Peripheral IV sites should be selected in the hand or forearm to reduce the risk of
catheter-related bloodstream infections. Sites on the upper extremities located at flexion sites (eg, wrist, bend of arm) and the lower extremities should be avoided.
The client being considered for thrombolytic therapy should be screened for absolute and relative contraindications. The nurse should immediately notify the HCP if the client reports a history of
cerebral aneurysm, as it is an absolute contraindication to the use of thrombolytics such as alteplase (Activase) streptokinase (Streptase) tissue plasminogen activator. urokinase (Kinlytic)
Codeine is a narcotic analgesic used for acute pain or as a cough suppressant. Depressing the cough reflex can cause an accumulation of secretions in the presence of
chronic obstructive pulmonary disease (COPD), leading to respiratory difficulty. In general, sedatives (eg, narcotics, benzodiazepines) can also depress the respiratory center and effort; therefore, they should not be given to clients with respiratory diseases (eg, asthma, COPD).
Chest tubes should not be ________ during transport of a client.
clamped
When determining which nursing diagnosis to address first, the nurse should consider factors that affect
client safety. Risk for falls is an immediate safety concern (Option 4). Nursing diagnoses that relate to chronic conditions (eg, anxiety, chronic pain) are addressed after risk for falls.
Regular flushing of the NG tube with water prevents
clogging and allows the suction apparatus a clear pathway to decompress the suction.
A client with diabetes receiving peritoneal dialysis experiences chills and abdominal discomfort. The nurse assesses the client's abdomen by pressing one hand firmly into the abdominal wall. The client experiences pain when the nurse quickly withdraws the hand. The client's most recent blood glucose level is 210 mg/dL (11.65 mmol/L). What is the priority action by the nurse?
collect peritoneal fluid for culture and sensitivity
Shingles lesions that are open may transmit the infection by both air and contact. The client with disseminated shingles that are not crusted over will require
contact precautions, airborne precautions, and a negative airflow room to prevent transmission of the infection to others in the hospital.
Administration of IV narcotics in active labor (eg, nalbuphine, butorphanol, meperidine) during the peak of
contractions can help decrease sedation of the fetus and subsequent newborn respiratory depression at birth
INR monitors what drug?
coumadin/warfarin
best indicator of kidney function?
creatinine
The nurse is caring for a client with a balloon tamponade tube in place due to bleeding esophageal varices. The client suddenly develops respiratory distress, and the nurse finds that the tube has been partially pulled out. Which intervention should be the nurse's priority?
cut tube with scissors
A bitter almond smell on the client's breath is a classic sign of
cynaide poisoning
Discharge education for the client with chronic heart failure should include
daily weights, drug regimens, diet, and exercise plans. The use of any NSAIDS is contraindicated in heart failure as these contribute to sodium retention, and therefore fluid retention.
If the nurse observes a spontaneously wedged waveform on the PA catheter monitor, the balloon port should be
deflated immediately and locked to prevent accidental re-inflation. The nurse should contact the HCP only after independently performing the appropriate corrective actions.
Major depressive disorder (also known as unipolar depression) is a subtype of depressive disorder, classified by specific symptoms that interfere with the ability to perform activities of daily living, work, sleep, and enjoy activities that are usually pleasurable to the client. For the diagnosis to be made, 5 or more of the following symptoms must be present almost every day for at least 2 weeks, and 1 of the symptoms must be
depressed mood or loss of interest or pleasure.
Oxytocin is a high-alert medication requiring precise administration via
electronic infusion pump and frequent maternal/fetal assessment. Adverse effects may include maternal hypotension and water intoxication.
Laboratory results that support a vaso-occlusive crisis (pain crisis) in a client with sickle cell disease include
elevated reticulocytes, elevated bilirubin, and anemia.
Left-to-right cardiac shunts (eg, patent ductus arteriosus, atrial septal defect, ventricular septal defect) result in
excess blood flow to the lungs. Manifestations include heart murmur, poor weight gain, diaphoresis with exertion, and signs of heart failure.
Meniere disease (endolymphatic hydrops) results from
excess fluid accumulation in the inner ear. Clients have episodic attacks of vertigo, tinnitus, hearing loss, and aural fullness. raising all side rails is considered a restraint and would be inappropriate.
iron deficient toddler could be due to?
excessive milk intake
Which subjective or objective assessment finding would the nurse expect to find in a client with severe aortic stenosis?
exertional dyspnea, anginal chest pain, and syncope.
when you go hypoxic what rate goes up first?
heart rate goes up first in hypoxia
ADHD monitor?
height, weight and blood pressure
Clinical manifestations of acute otitis media- AOM- include
high fever; ear pain; irritability; pulling on the affected ear; and bulging, red tympanic membranes.
high BUN assess for?
in high BUN assess for dehydration
antiemetics are antconvulsants but also in high doses they are?
in high doses they are phenothiazines, typical 1rst gen antipsychotics
Statin drugs (eg, simvastatin, atorvastatin, rosuvastatin) are prescribed to lower cholesterol are taken in the
in the evening or at bedtime
changing prosac dosing in adolescent or young adult watch for
increase suicidal idealization
Clients who are immunosuppressed from chemotherapy should not be cared for by a health care provider who is
infectious, pregnancy doesn't matter
Bumetanide does what?
inhibits reabsorption of sodium and water from the tubules and promotes renal excretion of water and potassium. The nurse should question the bumetanide prescription as the client with heart failure has hypokalemia (potassium <3.5 mEq/L [3.5 mmol/L]) and is already at increased risk for life-threatening cardiac dysrhythmias associated with this electrolyte
prosac SSRI causes ?
insomnia. give before noon
lithium decreases mania and it stabilizes...
nerve cell membranes. Peein, poopn and parathesia-side effects
In Hirschsprung's disease, a portion of the colon has
no innervation and must be removed.
As a stimulant, methylphenidate/Concerta/Ritalin may interfere with sleep and should be given
no later than around 6:00 PM
During a blood transfusion reaction, the nurse should immediately stop the transfusion and initiate
normal saline to maintain IV access and prevent hypotension and vascular collapse.
closaril/clozapine-
prototype 2nd gen atypical antipsychotic. schizophrenia. does not have side effects abcdef. does have side effect agranularcytosis. trashes bone marrow
The client has increased intracranial pressure with cerebral edema, and mannitol is administered. Which assessment should the nurse make to evaluate if a complication from the mannitol is occurring?
pulmonary edema.
Selective serotonin reuptake inhibitors (SSRIs) are commonly used to treat major depression and anxiety disorders. SSRIs (eg, fluoxetine, paroxetine, citalopram, escitalopram, sertraline) are generally well tolerated except for
sexual dysfunction. This can be a decrease in sexual desire, arousal, or orgasm and may vary by gender. The nurse should discuss this with the client.
P02 should be?
should be 78-100
MAOI's side effects
side effects are... Anticolinergic &dry mouth/Blurred vision
NSSRI's/tricyclic antidepressants side effects are? elavil only goes through "E"
side effects are... Anticolinergic &dry mouth/Blurred vision/Constipation/drowsiness/euphoria
When walking with a client who is legally blind, the nurse uses the
sighted-guide technique by walking slightly ahead of the client with the client holding the nurse's elbow. The nurse should describe the environment while ambulating the client.
A client suspects she is pregnant and comes for prenatal evaluation. Which assessment findings indicate definitive evidence (positive signs) of pregnancy? Select all that apply.
signs include ultrasound visualization of the fetus, a distinguishable fetal heartbeat heard by Doppler device, and fetal movement palpated or observed by the health care provider.
A client with deep vein thrombosis (DVT) is receiving a continuous infusion of unfractionated heparin. The client asks the nurse what the heparin is for. How should the nurse respond?
slows the time it takes blood to clot, thereby keeping the current clot from growing bigger and preventing new clots from forming.
The neurological unit staff is composed of an experienced registered nurse (RN), a new graduate RN, a licensed practical nurse (LPN), and an unlicensed assistive personnel (UAP). Which are appropriate assignments for the charge nurse to give to the new graduate RN? Select all that apply.
stroke, MS and teaching patients
Levetiracetam is an anticonvulsant prescribed for seizure disorders. It may have depressing effects on the central nervous system (eg, drowsiness) as the body adjusts to therapy. Serious adverse effects include
suicidal ideation and Stevens-Johnson syndrome. Clients with seizure disorders must meet the guidelines of their department of transportation and receive permission from their health care provider prior to legally operating a motor vehicle.
Clients with borderline personality disorder are at very high risk for
suicide. Suicidal gestures and attempts must be taken seriously and evaluated for suicidal intent.
The nurse should encourage clients with posttraumatic stress disorder to
talk about the experience at their own pace, listen actively to build trust, and allow clients to vent. This will assist in decreasing their feelings of isolation.
The nurse is caring for a client in the intensive care unit who suffered partial-thickness burns to 36% of the body. During the first 24 hours, the nurse would anticipate which of the following assessments?-Clients with hyperkalemia experience?
tall, peaked T waves, shortened QT interval), and cardiac arrhythmias
An adult diagnosed with celiac disease 3 weeks ago was placed on a gluten-free diet. The client returns for ambulatory care follow-up, reports continuation of symptoms, and does not seem to be responding to therapy. Which is the best response by the nurse?
tell me what you ate yesterday
Use of fluoroquinolones (ciprofloxacin, levofloxacin, moxifloxacin, norfloxacin, ofloxacin), especially ciprofloxacin, places clients at increased risk for
tendinitis and tendon rupture that most often occur in the Achilles tendon.
Losartan is an angiotensin II receptor blocker (ARB) prescribed to treat hypertension. ACE inhibitors (eg, lisinopril, enalapril) and ARBs are
teratogenic, causing renal and cardiac defects or death of the fetus. ARBs and ACE inhibitors have black box warnings that indicate contraindication in pregnancy.
poassium at 6+ is ERT the possibility of death is within
the next two minutes
A balloon tamponade tube (eg, Sengstaken-Blakemore, Minnesota) is used?
to temporarily control bleeding from esophageal varices. It contains 2 balloons and 3 lumens.
NSSRI's/tricyclic antidepressants
treat depression, elivil, Tofranil, Vivactil
Defibrillation is used for
treating ventricular fibrillation and pulseless ventricular tachycardia.
toxic effects lithium...
tremors metallic taste diarrhea
haldol has decanate form...side effects abcdefg and is a
typical 1rst gen antipsychotics. NMS is overdose is neuroleptic malignant syndrome-hyperpyrexia. dose for elderly patients should be half adult dose
the muscles required for rolling over do not develop?
until age 4-5 months. Additionally, spiral femur fractures indicate that pressure was applied to the leg in opposite directions (torsion), which is an unlikely accidental injury in a nonambulatory child.
A client is receiving chemotherapy for acute myeloid leukemia. The health care provider prescribes allopurinol to prevent tumor lysis syndrome (TLS). Which laboratory value indicates a therapeutic response to the medication?
uric acid level
violent patent do what?
use clear, thorough communication to prevent violence. The nurse should provide undivided attention to the client while explaining all activities of care in a calm tone.
warfarin/coumadin antidote?
vitamin K
Large amounts of vitamin K-rich foods can decrease the anticoagulant effects of
warfarin therapy. Clients are not instructed to remove those foods from their diet but are encouraged to be consistent in the intake of foods high in vitamin K, including leafy green vegetables, asparagus, broccoli, kale, Brussels sprout, and spinach.
The nurse should not document that an incident report..
was filed, or refer to the incident report in the medical record.
