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