25855834 Nclex Study Guide (1)

8/13/2019 25855834 Nclex Study Guide (1)

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DO NOT delegate what you can EAT!E - evaluate

A - assessT - teach

addisons= down, down down up downcushings= up up up down up

addisons= hyponatremia, hypotension, decreased blood vol, hyperkalemia, hypoglycemiacushings= hypernatremia, hypertension, incrased blood vol, hypokalemia, hyperglycemia

No Pee, no K (do not give potassiumwithout adequate urine output)

EleVate Veins dAngle Arteries !or better per!usion

A= appearance (color all pink pink and lue lue "pale#$%= pulse (&' ) ' asent$

*= gri+ace (cough gri+ace no response$A= activity (,leed ,laccid li+p$

.= respirations(strong cry weak cry asent$

T.AN/01//1ON-2A/ED %.E3A4T1ON/5A1.2O.NE

0y - 0easles3hicken - 3hicken %o6Varicella

7e8 - 7erpe8 9oster6/hinglesT2

or re+e+er:::

0TV=Airorne0easles

T2Varicella-3hicken %o67erpes 9oster-/hingles

%rivate .oo+ - negative pressure with ;-'< air echanges6hr 0ask N> ,or T2

D.O%?ET

think o, /%1DE.0AN!

/ - sepsis/ - scarlet ,ever

/ - streptococcal pharyngitis

% - parvovirus 2'% - pneu+onia

% - pertussis1 - in,luen8a

D - diptheria (pharyngeal$

E - epiglottitis. - ruella0 - +u+ps

0 - +eningitis0 - +ycoplas+a or +eningeal pneu+onia

An - Adenovirus %rivate .oo+ or cohort

0ask

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3ONTA3T %.E3A4T1ON

0./:@EE0 - +ultidrug resistant organis+

. - respiratory in,ection/ - skin in,ections

@ - wound in,n

E - enteric in,n - clostridiu+ di,,icileE - eye in,n - conBunctivitis

/C1N 1NE3T1ON/

V371%/V - varicella 8oster

3 - cutaneous diphtheria

7 - herpe8 si+ple1 - i+petigo

% - pediculosis/ - scaies

"# Air6%ul+onary E+olis+($%$& chest pain, di!!iculty breathing, tachycardia, pale'cyanotic,

sense o! impending doom) turn pt to le,tside and lowerthe head o! the bed#

*# @o+an in ?aor w6 4n-reassuring 7.(late decels, decreased variability, !etalbradycardia, etc) turn on le,t side (and give +*, stop Pitocin, increase - !luids)

.# Tue eeding w6 Decreased ?O3 position pt on right side (promotes emptying o! thestomach) with the 7O2 elevated(to prevent aspiration)

/# During Epidural %uncture side-lying

0# A,ter ?u+ar %uncture(and also oilbased 1yelogram) pt lies in ,lat supine(to prevent

headache and leaking o! 2$3)

4# %t w6 7eat /troke lie ,latw' legs elevated

5# During 3ontinuous 2ladder 1rrigation(26) catheter is taped to thigh so leg should be

kept straight# No other positioning restrictions#

7# A,ter 0yringoto+y position on side o! a,,ected eara!ter surgery (allows drainage o!

secretions)

8# A,ter 3ataract /urgery pt will sleep on una,,ected sidewith a night shield !or "/

weeks#

"9# A,ter Thyroidecto+y low or semi3owler:s, support head, neck and shoulders#

""# 1n,ant w6 /pina 2i,ida position prone(on abdomen) so that sac does not rupture

"*# 2ucks Traction(skin traction) elevate !oot o! bed !or countertraction

".# A,ter Total 7ip .eplace+ent don:t sleep on operated side, don:t !le; hip more than /049 degrees, don:t elevate


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"0# 1n,ant w6 3le,t ?ip position on back or in in!ant seat to prevent trauma to suture line#>hile !eeding, hold in upright position#

"4# To %revent Du+ping /yndro+e(postoperative ulcer'stomach surgeries) eat in

reclining position, lie down a!ter meals !or *9.9 minutes (also restrict !luids during meals, low2


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*ravesG disease6hyperthyroidis+5accelerated physical and mental !unction sensitivity toheat, !ine'so!t hair

Thyroid stor+5increased temp, pulse and


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*# kept !orgetting which was dangerous when you:re pregnant regular measles (rubeola), or

Berman measles (rubella), so remember&never get pregnant with a Berman (rubella)

.# >hen drawing up regular insulin% NP< together, remember&

?N (regular comes be!ore NP


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6actrim& antibiotic##dont take i! allergic to sul!a drugs###diarrhea common side e!!ect###drink plenty

o! !luids

Bout 1eds& Probenecid (6enemid), 2olchicine, @llopurinol (Lyloprim)

@presoline(hydralaDine)t; o!


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3or cord compression, place the mother in the ?ENAEEN6E?B position because this removes

pressure o! the presenting part o!! the cord# (! her head is down, the baby is no longer beingpulled out o! hte body by gravity)

! the cord is prolapsed, cover it with sterile saline gauDe to prevent drying o! the cord and tominimiDe in!ection#

3or late decels, turn the mother to her le!t side, to allow more blood !low to the placenta#

3or any kind o! bad !etal heart ratepattern, you give +*, o!ten by mask###

>hen doing an epidural anesthesia hydration be!ore hand is a priority#


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"*# a pt with leukemia may have epita;is b'c o! low platelets

".# best way to warm a newborn& skin to skin contact covered with a blanket on mom#

"/# when a pt comes in and she is in active labor###nurse !irst action is to listen to !etal heart

tone'rate

"0# phobic disorders###use systematic desensitiDtion#

N2EO P$

"# >hen getting down to two answers, choose the assessment answer (assess,

collect, auscultate, monitor, palpate) over the intervention e;cept in an

emergency or distress situation# ! one answer has an absolute, discard it#Bive priority to answers that deal directly to the patientHs body, not the

machines'equipments#*# Key words are very important# @void answers with absolutes !or e;ample&

always, never, must, etc#.# with lower amputations patient is placed in prone position#

/# small !requent !eedings are better than larger ones#0# @ssessment, teaching, meds, evaluation, unstable patient cannot be

delegated to an nlicensed @ssistive Personnel#4# -N'PN cannot handle blood#

5# @mynoglycosides (like vancomycin) cause nephroto;icity and ototo;icity#7# - push should go over at least * minutes#

8# ! the patient is not a child an answer with !amily option can be ruledout easily#

"9# n an emergency, patients with greater chance to live are treated !irst""# @?A$ (!luids in alveoli), A2 (disseminated intravascular coagulaton)

are always secondary to something else (another disease process)#"*# 2ardinal sign o! @?A$ is hypo;emia (low o;ygen level in tissues)#

".# in p< regulation the * organs o! concern are lungs'kidneys#"/# edema is in the interstitial space not in the cardiovascular space#

"0# weight is the best indicator o! dehydration"4# wherever there is sugar (glucose) water !ollows#

"5# aspirin can cause ?eyeHs syndrome (encephalopathy) when given to

children"7# when aspirin is given once a day it acts as an antiplatelet#

"8# use 2old !or acute pain (eg# $prain ankle) and


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blows the patientHs stimulus !or breathing#*5# e;acerbation& acute, distress#

*7# epi always given in 6 syringe#*8# prednisone to;icity& cushingHs syndrome= bu!!alo hump, moon !ace, high

glucose, hypertension#.9# / options !or cancer management& chemo, radiation, surgery, allow to

die with dignity#

."# no live vaccines, no !resh !ruits, no !lowers should be used !orneutropenic patients#

.*# chest tubes are placed in the pleural space#

..# angina (low o;ygen to heart tissues) = no dead heart tissues# 1=

dead heart tissue present#./# mevacor (anticholesterol med) must be given with evening meal i! it is

QA (per day)#

.0# Nitroglycerine is administered up to . times (every 0 minutes)# !chest pain does not stop go to hospital# Ao not give when 6P is J 89'49#

.4# Preload a!!ects amount o! blood that goes to the ? ventricle#@!terload is the resistance the blood has to overcome when leaving the heart#

.5# 2alcium channel blocker a!!ects the a!terload#

.7# !or a 2@6B operation when the great saphenous vein is taken it is

turned inside out due to the valves that are inside#.8# unstable angina is not relieved by nitro#

/9# dead tissues cannot have P-2Hs(premature ventricular contraction# !le!t untreated pvcHs can lead to -3 (ventricular !ibrillation)#

/"# " t (teaspoon)= 0 ml" (tablespoon)= . t = "0 ml

" oD= .9 ml" cup= 7 oD

" quart= * pints" pint= * cups

" gr (grain)= 49 mg" g (gram)= "999 mg

" kg= *#* lbs" lb= "4 oD

G o convert 2entigrade to 3# 3= 2R/9, multiply 8'0 and substract /9G o convert 3ahrenheit to 2# 2= 3R/9, multiply 0'8 and substract /9#

/*# angiotensin in the lungs= potent vasodialator# @ldosterone attracts

sodium#/.# ?E-E?$E @BEN$ 3+? +O2F

heparin= protamine sul!ate

coumadin= vitamin kammonia= lactulose

acetaminophen= n@cetylcysteine#ron= de!ero;amine

Aigito;in, digo;in= digibind#

@lcohol withdraw= ibrium# methadone is an opioid analgesic used to deto;i!y'treat pain innarcotic addicts#

Potassiumpotentiates dig to;icity#//# heparin prevents platelet aggregation#

/0# P'P are elevated when patient is on coumadin/4# cardiac output decreases with dysrythmias# Aopamine increases 6P#

/5# 1ed o! choice !or -tach is lidocaine/7# 1ed o! choice !or $- is adenosine or adenocard

/8# 1ed o! choice !or @systole (no heart beat) is atropine

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09# 1ed o! choice !or 2


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3ront trunk= "7S6ack trunk= "7S

Benitalia= "S M89# 6irth weight doubles by 4 month and triple by " year o! age#

8"# i!


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establish trusting relationshipmeds

leas restrictive methods'environment#"*4# $$?Hs (antidepressants) take about . weeks to work#

"*5# +bsession is to thought# 2ompulsion is to action"*7# i! patients have hallucinations redirect them# n delusions distract

them#

"*8# horaDine, haldol (antipsychotic) can lead to EP$ (e;trapyramidal sidee!!ects)

".9# @lDheimerHs disease is a chronic, progressive, degenerative cognitivedisorder that accounts !or more than 49S o! all dementias

"# o remember how to draw up N$N think&

Nicole .ichie .N(a teacher taught us this is school, thought it was

!unny and never !orgot it)@ir into NP


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7yper natre+ia (greater than 'J>$

/kin !lushedAgitation

?ow grade !everThirst

Develop+ental*. months& turns head side to side

/0 months& grasps, switch % roll45 months& sit at 4 and waves byebye

78 months& stands straightat eight"9"" months& belly to butt (phrase has "9 letters)

"*". months& twelve and up, drink !rom a cup

7epatitis

+?A$ (.), she will not like it)), try not to ?E$P+NA >< N2+1P?E


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3or blood types& T+T is the universal donor (remember LoLin donor)

T@6T is the universal receipient

Aisseminated hen using a bronchodilator inhaler inconCuction with a glucocorticoid inhaler, administer thebronchodilator !irst

heophylline increases the risk o! digo;in to;icity and decreases the e!!ects o! lithium and Ailantin

1Ntal, an inhaler used to treat allergy induced asthma may cause bronchospasm, thinkU 1Nto theasthmatic lung

soniaDid causes peripheral neuritis

Peptic ulcers caused by eighted N (Naso intestinal tubes) must !loat !rom stomach to intestine# Aon:t tape the tube

right away a!ter placement, may leave coiled ne;t to pt on


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G .i!ampin .ed orange tears and urine, also contraceptives don:t work as wellGEthambutol messes with your Eyes

G @pply eye drop to conCunctival sac and a!ter wards apply pressure to nasolacrimal duct ' innercanthus

G Pancreatitis patients but them in !etal position, NP+, gut rest, prepare antecubital site !or P22cuD they:ll probably be getting PN'ipids

G rendelenburg test !or varicose veins# ! they !ill pro;imally = varicosity#

?ule o! nines, 8 = head, "7 = arms, .4 = torso, .4 =legs, and "= perineum = "99S

@hen giving Cayealate we need to worry aout dehydration ( C ha ineverse

relationship with Na$

Iogurt has live cultures- dont give to i++unosuppressed pt

1tching under cast area- cool air via low dryer ice pack ,or '- '> +inutes: NEVE. use

Ftip or anything to scratch area

1urphyHs sign I pain with palpation o! gall bladder area seen with cholecystitis

2ullenHs sign I ecchymosis in umbilical area, seen with pancreatitis

urnerHs sign I !lank grayish blue (turn around to see your !lanks) pancreatitis

1c6urneyHs Point I pain in ?Q indicative o! appendicitis

Q I diverticulitis , low residue, no seeds, nuts, peas

?Q I appendicitis, watch !or peritonitis

Buthrie est I ests !or PK, baby should have eaten source o! protein !irst

$hilling est I test !or pernicious anemia' how well one absorbs -it b"*

@llenHs test I occlude both ulnar and radial artery until hand blanches then release ulnar# ! thehand pinks up, ulnar artery is good and you can carry on with @6B'radial stick as planned# @6B$

must be put on ice and whisked to the lab#otHs ok to have abdominal craps, blood tinged out!low and leaking around site i! the Peritoneal

Aialysis cath (tenkho!!) was placed in the last "* wks# 2loudy out!low NE-E? N+?1@#o@mniotic !luid yellow with particles = meconium stained

o


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ensilon is used in myesthenia gravis to con!irm the diagnosis#

1yesthenia gravis is caused by a disorder in the transmission o! impulses !rom nerve to muscle

cell#

@myotrophic lateral sclerosis ( @$ ) is a condition in which there is a degeneration o! motor

neurons in both the upper % lower motor neuron systems#

Transesophageal istula (TE$ esophagus doesn:t !ully develop (this is a surgical emergency)he M 3s o, TEin the newborn&

") 2hoking*) 2oughing

.) 2yanosis

he 11? vaccine is given $Q not 1#

?edunstable, ie, occluded airway, actively bleeding, see !irst

Fellowstable, can wait up to an hour !or treatment, ie burns, see second

Breenstable, can wait even longer to be seen, Twalking woundedT

6lackunstable clients that will probably not make it, need com!ort measures

A+@dead on arrival

Breek heritage they put an amulet or any other use o! protective charms around their baby:s

neck to avoid Tevil eyeT or envy o! others

4 year old kids cannot interpret TIME# Need to e;plain time in relationship to a known 2+11+NE-EN (eg& T1om will be back a!ter supperT)#

GG @naphylactic reaction to baker:s yeast is contraindication !or hen on nitroprusside, monitor thiocynate (cyanide)# Normal value should be ", " is heading

toward to;icityGG! kid has cold, can still give immuniDations

GG$@?$ (severe acute resp syndrome) airborne R contact (Cust like varicella)

GG


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nsomnia is a side e!!ect o! thyroid hormones# $aunders con!irms it# 1akes sense though

ncreased met# rate, your body is Ttoo busy to sleepT as opposed to the !olks with hypothyroidismwho may report somnolence (dec# met rate, body is slow and sleepy)# +k some more !acts#

GG 6++O !or strabismus# Patch the B++A eye so that the weaker eye can get stronger# 3ound a

cool link about its use in peds pt with strabismus# had to look it up cuD heard it was important

Gah hem ah hemG

GG A@ -+1E is 5 I "9ml ' kgGG 2+PA patients ?E1E16E?& *N2 or less (hypo;ic N+ hypercapnic drive), Pa9* o! 49ish and

$a9* 89S is normal !or them b'c they are chronic 2+* retainers# ###GG Neostigmine'@tropine (anticholinergic) to reverse e!!ect o! pancuronium#

GG@mpho 6 causes hypokalemia (amongst many other things##gotta premedicate be!ore giving#

Pts will most likely get a !ever)GG est / hypersensitivity be!ore the administration o! asparginase#

GG ake -ermo; with high !at diet (increases absorption)GG Kidney Blucose threshold is "79

GG @mphogel and ?enegal take with mealsGG $tranger an;ietyis greatest 5 8 months, $eparation an;iety peaks in toddlerhood

GG 11? is a $Q shot

ymes is !ound mostly in 2onneticut

@sthma and @rthritisswimming best

@sthma has intercostal retractionsbe concerned

ardive Ayskinesia irreversible involuntary movements o! the tongue, !ace and e;tremities,may happen a!ter prolonged use o! antipsychotics

@kathisia motor restlessness, need to keep going, t; with antiparkinsons meds, can be mistaken

!or agitation#

>hen drawing an @6B, you need to put the blood in a hepariniDed tube, make sure there are nobubbles, put on ice immediately a!ter drawing, with a lable indicating i! the pt was on room air or

how many liters o! +*#

?emember to pre!orm the @llen:s est prior to doing an @6B to check !or su!!icient blood !low

6e!ore going !or Pulmonary 3uction ests (P3:s), a pt:s bronchodilators will be withheld and theyare not allowed to smoke !or / hrs prior

3or a lung biopsy, position pt lying on side o! bed or with arms raised up on pillows over bedside

table, have pt hold breath in mide;piration, chest ;ray done immediately a!terwards to check !or

complication o! pneumothora;, sterile dressing applied

3or a lumbar puncture, pt is positioned in lateral recumbent !etal position, keep pt !lat !or *. hrs

a!terwards, sterile dressing, !requent neuro assessments

EEB, hold meds !or *//7 hrs prior, no ca!!ine or cigarettes !or */ hrs prior, pt can eat, pt muststay awake night be!ore e;am, pt may be asked to hyperventilate and watch a bright !lashing

light, a!ter EEB, assess pt !or seiDures, pt:s will be at increased risk

Aiamo;, used !or glaucoma, can cause hypokalemia

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hank you, !inally realiDe why a person shouldn:t have cantaloupe be!ore a occult stool test,because cantaloupe is high in vit c and vit c causes a !alse R !or occult blood# Now Cust need to

!igure out why they can:t have !ish#

7ypospadias5 abnormality in which urethral meatus is located on the ventral (back) sur!ace o!the penis anywhere !rom the corona to the perineum (re+e+er hypo low (,or lower side or

under side$

Epispadias5 opening o! the urethra on the dorsal (!ront) sur!ace o! the penis%riapis+5 pain!ul erectionlasting longer than 4 hrs#

@nticholinergic e!!ectsassessment

dry mouth==can:t spiturinary retention=can:t GGGG

constipated =can:t GGGG

blurred vision=can:t see

>hen you see 2o!!eebrown emesis, think peptic ulcer*#@nytime you see !luid retention# hink heart problems!irst#

.#@n answer that delays care or treatment is @>@F$wrong/#3or P-A remember A@-E (egs are Aependent !or@rterial % !or -enous Elevated)

more to come##########

>hen choosing an answer, think in this mannerU i! you can only do +NF one thing to

help this patientwhat would it beM Pick the most important intervention#

! two o! the answers are the e;act opposite, like bradycardia or tachycardia### one is probablythe answer#

! two or three answers are similar or are alike, none is correct#>hen asking patientsH questions NE-E? use VwhyW

questions# Eliminate allVwhyMWanswer options#! you have never heard o! itU please donHt pick itNever release traction NE$$ you have an order

!rom the 1A to do so

Questions about a haloM ?emember sa!ety !irst, havea screwdriver nearby#

?emember compartment syndromeis an emergency situation# Paresthesias and increased painare classic symptoms# Neuromuscular damage is irreversible /4

hours a!ter onset#@lways deal with actual problems or harm be!ore potential problems@lways select a Vpatient !ocusedW answer#@n answer option that states Treassess in "0 minutesT

is probably wrong#

nterpersonal model ($ullivan)

6ehavior motivated by need to avoid an;ietyand satis!y needs"# n!ancy 9"7 months others will satisy needs

*# childhood 4yrs learn to delay need grati!ication.# Cuvenile 48 years learn to relate to peers

/# preadolescence 8"* yrs learns to relate to !riends o! o! opposite se;0# early adolescence"*"/yrs&learn independence and how to relate to opposite se;

4# late adolecence "/*"yrs& develop intimate relationship with person o! opposite se;is this not about communicationM####

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3etal alcohol syndromeupturned nose

!lat nasal bridgethin upper lip

$B@

vastus lateralis is 1 administration site !or 4month in!ants

3or toddlersabove "7 months ventroglutealhe deltoid and gluteus ma;imus are appropriate sites !or children

+ both eyes

+$ le!t eye+A right eye ( dominent ?ight eye Cust a tip to remember)

"#3OA? (cane walking)&3 cane

O oppositeA a!!ected

? leg

?ed mmediate& nCuriesare li!e threatening but survivable with minimal intervention# E;&hemothra;, tension pneumothora;, unstable chest and abdominal wounds, N2+1PEE

amputations, +PEN !;:s o! long bones, and *nd'.rd degree burn with "0S/9S o! total bodysur!ace, etc#

Fellow Aelayed& nCuriesare signi!icant and require medical care, but can wait hrs without threat

to li!e or limb# E;& $table abd wounds without evidence o! hemorrhage, !; requiring openreduction, debridement, e;ternal !i;ation, most eye and 2N$ inCuries, etc#

Breen 1inimal& nCuries are minor and t; can be delayed to hrs or days # ndividuals in this groupshould be moved away !rom the main triage area# E;& upper e;tremity !;, minor burns, sprains,

sm# lacerations, behavior disorders#

6lack E;pectant& nCuries are e;tensive and chances o! survival are unlikely# $eperate but dontabandoned, com!ort measures i! possible# E;& nresponsive, spinal cord inCuries, woulds with

anatomical organs, *nd'.rd degree burn with 49S o! body sur!ace area , seiDures, pro!oundshock with multipe inCuries, no pulse, b#p, pupils !i;ed or dilated#

horacentesis prep ake v#s#, shave area around needle insertion, position patient with ar+s

on pillow on over ed tale or lying on sideno more than "999cc at a one time# Post listen!or bilateral breath sounds, v#s#, check leakage, sterile dressing#

2 assess allergies

1? claustrophobia, no metal, assess pacemaker

2ardiac cath npo 7"*hr, empty bladder, pulses, tell pt may !eel heat palpitations or desire tocough with dye inCection# Post -ital signs keep leg straight bedrest 47hr#

cerebral angio prep well hydrated, lie !lat, sire shaved, pulses markedpost keep !lat "*"/hr, check site, pulses,!orce !luids#

umbar puncture !etal postion# post nuero assess q"0.9 until stable, !lat*.hr, encourage

!luids, oral anlgesics !or headache, observe dressing

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EEB no sleep the night be!ore, meals not withheld, no stimulants !or */hr be!ore,tranquiliDer'stimulant meds held *//7hr be!ore, may be asked to hyperventilate ./min and

watch a bright !lashing light#

1yelogram Npo /4hr, allergy h;, phenothiaDines, cns depressants, and stimulants withheld /7hrprior, table will be moved to various postions during test# Post neuro q*/, water solule 7O2

up oil solule 7O2 downoral analgesics !or h'a, encourage po !luids, assess !or distended

bladder, inspect site#

iver biopsy @dm vit k , npo morning o! e;am 4hr, give sedative, Teach pt that he will easked to hold reath ,or >-'sec supine postion lateral with upper ar+s elevated:

%ost- postion on right side ,reFuent v:s: report severe a pain statno heavy li!ting "wk#

Paracentesis semi !owlers or upright on edge o! bed, empty bladder#

Post v#s#, report elevated temp, observe !or signs o! hypovolemia#

aparoscopy 2+* used to enhances visual, general anesthesia, !oley# %ost- walk patient todecrease 3O< uild up used ,or procedure:

Pyelogram assess allergies

$engstaken blakemore tube used !or t; o! esophageal varices, keep scissors at edside:


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"/# -E? 2??


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/9# N3E2+$ 1+N+N2E+$$ I


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ake iron eli;ir with Cuice or water#### never with milk

Kawasaki:s leads to cardiac problems

Ailantin "9*9heophyline "9*9

@cetaminophen "9*9

ithium 9#0"#0Aigo;in 9#0*#9

+steomyletitis is an in!ectious bone dD# Bive blood cultures and antibiotics, then i! necessary

surgery to drain abscess#

Nephrotic syndrome s's edema R hypotension# urn and reposition (risk !or impaired skin

integrity)

o access role relationship pattern !ocus on image and relationships with others#

?enal impairment& serum creatinine elevated and urine clearance decreased

Norm# $erum creatinine 9#7"#7 (men), 9#0"#0 (women)

Norm# rine clearance 70".0

@tropine +verdose


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$alt substitutes may contain pottasium

Placental abruptio& bleeding with pain, don:t !orget to monitor volume status (%+)

@n ill child regresses in behaviors

1eningeal irritation $'s nuchal rigidity, positive 6rudDinski R Kernig signs and P


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.)No 1 meds as much as possibleGron de!iciency anemia easily !atigued

")3e P+ give with -itamin 2 or on an empty stomach*)3e via 1 n!eron via Ltrack

%ernicious Ane+ia ?ed, 6e!!y tongue will take -it#6"*!or li!e24.N/

"st Aegree ?ed and Pain!ul

*nd Aegree 6listers.rd Aegree No Pain because o! blocked and burned nerves

0enieres Disease @dmin diuretics to decrease endolymph in the cochlea, restrict Na, lay ona!!ected ear when in bed# riad&

")-ertigo*)innitus

.)N'-

*astric 4lcer painoccurs .9 minutes to 89 minutes a!ter eating, not at night, and doesn:t goaway with !ood

Ghink positive and you can achieve great things# hink o! present and !uture, the past is gone#/or,et your past mistakes and focus on your successes encoura,in, yourself to ,reater

achievements in the future.l(ays do your est so you can e proud that you ,ave it your est shot.

/ocus on your achievements rather than your failures. If you do find yourself thinkin, aout ho(you failed then look at (hat you mana,ed to do ri,ht and ho( you could correct (hat you did

net time. mind that is trouled (ith dout (on2t e ale to focus on the victory to e had.

Gake it one day at a time#Gake time !or yoursel!# @ !ried mind can:t !ocus or learn#

Pediatric ips&

>hat is an intraosseous in,usionM n pediatric li!ethreatening emergencies, when iv accesscannot be obtained, an osseous (bone) needle is handdrilled into a bone (usually the tibia),

where crystalloids, colloids, blood products and drugs can e ad+inistered into the +arrow#t is a temporary, li!esaving measure, and have seen it once (Bruesome#) >hen venous access

is achieved it can be d'cHd# +ne medication that cannot be administered by intraosseous in!usionis isoproterenol, a beta agonist# ( donHt know more about that drug it was Cust pointed out on

a practice e;am#)

Auring sickle cell crisisthere are two interventions to prioritiDe& ,luids and painrelie!#

>ith glo+erulonephritisyou should consider lood pressure to be your most important

assessment parameter# Aietary restrictions you can e;pect include !luids, protein, sodium, andpotassium#

?emember yesterday when mentioned how congenital cardiac de!ects result in hypoiawhich

the body attempts to compensate !or (in!lu; o! immature rbcHs)M abs supporting this would show

increased he+atocrit he+ogloin and rc count#

Aid you know there is an association betweenlow-set ears and renal ano+aliesM Now you

know what to look !or i! downHs isnHt there to choose# (Cust to e;pand on it a little, the kidneys and

ears develop around the same time in utero# hich is why whendoing an assessment o! a neonate, i! the nurse notices low set or asymmetrical ears, there is

good reason to investigate renal !unctioning# Knowing that the kidneys and ears are similarshapes helped me remember this)#

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$choolage kids (> and up) are old enough, and should have an eplanationo! what will happena week be!ore surgery such as tonsillectomy#

! you gave a toddler a choiceabout taking medicine and he says no, you should leave the room

and co+e ack in !ive minutes, because to a toddler it is another episode# Ne;t time, donHt ask#

he ,irst sign o! pyloric stenosis in a baby is +ild vo+iting that progresses to proBectile

vo+iting# ater you may be able to palpate a mass, the baby will seem hungry o!ten, and mayspit up a!ter !eedings#

>e know Cawasaki disease causes a heart problem, but what speci!icallyM 3oronary artery

aneurys+s d't the in!lammation o! blood vessels#

@ child with a ventriculoperitoneal shunt will have a small upperado+inal incision# his is

where the shunt is guided into the abdominal cavity, and tunneled under the skin up to theventricles# Fou should watch !or ado+inal distention, since !luid !rom the ventricles will be re

directed to the peritoneum# Fou should also watch !or signs o! increasing intracranial pressure,such as irritability, bulging !ontanels, and highpitched cry in an in!ant# n a toddler watch lack o!

appetite and headache# 2are!ul on a bed position question 6edposition a,ter shunt place+entis ,lat, so !luid doesnHt reduce too rapidly# ! you see s's o! increasing icp, thenraise the hob to

"0.9 degrees#

>hat could cause ronchopul+onary dysplasiaM Aysplasia means abnormality or alteration#0echanical ventilation can cause it# Premature newborns with immature lungs are ventilated

and over time it damages the lungs# +ther causes could be in!ection, pneumonia, or otherconditions that cause in!lammation or scarring#

t is essential to +aintain nasal patency with children ) 'yr# because they are obligatory

nasal breathers#

>atch out !or questions suggesting a child drinks more than ./ cups o! milk each day# (1ilksgood, rightM) oo much milk reduces intake o! other essential nutrients, especially iron# >atch !or

ane+ia with +ilk-aholics# @nd donHt let that mother put anything but water in that kidHs bottleduring naps'overnight# uice or milk will rott that kids teeth right out o! his head#

>hat traction is used in a schoolage kid with a !emur or tibial !racture with e;tensive skinda+ageM Ninety ninety# hile weHre talking about traction, a kidHs hinder should clear the ed when in

2ryantGstraction (also used !or !emurs and congenial hip !or young kids)#

! you can remove the white patches !rom the mouth o! a baby it is Cust !ormula# ! you canGt itscandidiasis#

ust know the 00. and Varicella i++uni8ations co+e later ("0 months)#

ndescended testis or cryptorchidis+is a known risk !actor !or testicular cancerlater in li!e#$tart teaching boys testicular sel, ea+ around '


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3/ in +eningitis will have high protein, and low glucose#

t is always the correct answer to report suspected cases o, child ause#

No nasotracheal suctioning with head inBury or skull ,racture#

eed upright to avoid otitis media#

Position pronew hob elevated with gerd# n almost every other case, though, you better lay that

kid on his back (6ack o $leep $A$)#

Pull pinna down and ack ,or kids ) Myrs# when instilling eardrops#

Kids with ?$- no contact lenses or pregnant nurses in rooms where riavirinis being

administered by hoot, tent, etc#

Positioning with pneumonia I lay on the a,,ected side to splint and reduce pain# 6ut i! you aretrying to reduce congestion the sick lung goes up# (Ever had a stu!!y nose, and you lay with the

stu!! side up and it clearsM)

@ positive ppd con!irms in,ection, not Cust e;posure# @ sputu+test will con!irm activedisease#

3oughingw'o other s's is suggestive o! asth+a# $peaking o! asthma, watch out i! your

whee8er stops whee8ing# t could mean he is worsening#

Fou better pick do vitalsG be!ore administering that dig# (apical pulse !or one !ull minute)#

Tet spells treated with +orphine#

*roup-a strep precedes rheu+atic ,ever# 3horeais part o! this sickness (grimacing, suddenbody movements, etc#) and it e+arrasses kids# hey haveBoint pain# >atch !or elevated

antistreptolysin + to be elevated# Penicillin

AonHt pick cough over tachycardia!or signs o! ch, in an in!ant#

?andom ips&

No +ilk (as well as !resh !ruit or veggies) on neutropenic precautions#

Tylenol poisoning I liver !ailure possible !or about J days# 2lose observation required during

this time!rame, as well as t; with 1ucomyst#

.adioactiveiodine I he key word here is ,lush# 3lush substance out o! body w'./ liters'day!or * days, and !lush the toilet twice a!ter using !or * days# imit contact w'patient to .9

minutes'day# No pregnant visitors'nurses, and no kids#

he main hypersensitivityreaction seen with antiplateletdrugs is ronchospas+(anaphyla;is)#

2ommon sites !or +etastasisinclude the liver, brain, lung, bone, and lymph#

Orthostasisis veri!ied by a dropin pressure with increasing heart rate#

2ence Hones protein in the urine con!irms +ultiple +yelo+a#

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AonHt !all !or Yreestablishing a normal bowel patternH as a priority with small owel ostruction#6ecause the patient canHt take in oral !luids Ymaintaining ,luid alanceGcomes !irst#

%ernicious ane+ia s's include pallor, tachycardia, and sore red tongue#

>ith !lecainide (Ta+ocor), an antiarrythmic, li+it ,luids and sodium intake, because sodium

increases water retention which could lead to heart !ailure#

2asophils release hista+ine during an allergic response#

Adenosine is the treatment o! choice !or paro;ysmal atrial tachycardia#

1atragenic means it was causedby treatment, procedure, or medication#

+ther than initially to test tolerance, *-tue and H-tue !eedings are usually given ascontinuous !eedings#

our side-rails upcan be considered a !orm o! restraint# Even in 2 !acility when a client is a

!all risk, keep lower rails down, and one side o! bed against the wall, lowest position, wheelslocked#

Four cancer patient is getting radiation# >hat should you be most concerned aboutM $kin

irritationM No# n!ection kills cancer patients most because o! the leukopeniacaused by radiation#

@ breast cancer patient treated with Ta+oi,enshould report changes invisual acuity, becausethe adverse e!!ect could be irreversible#

%neu+ova


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Anectineis used !or short-ter+ neuro+uscular blocking agent !or procedures like intubationand E2# Norcuron is !or intermediate or longterm#

heparathyroid gland relies on the presence o! vita+in Dto work#

*lucagonincreases the e!!ects o! oral anticoagulants#

2leedingis part o! the YcirculationH assessment o! the A23DHs in an emergent situation#here!ore, i! airway and breathing are accounted !or, a compound !racture requires assessment

be!ore Blasgow coma scale and a neuro check (A=disability, or neuro check)

he immediate intervention a!ter a sucking sta wound is to dress the wound and tape it onthree sides which allows air to escape# Ao not use an occlusive dressing, which could convert the

wound !rom open pneumo to closed one, and a tension pneumothora; is worse situation# @!ter

that get your chest tube tray, labs, iv#

@n occlusive dressing is used i! a chest tue is accidentally pulled out o! the patient#

>hen o* deprived, as with a %E, the body compensates by causing hyperventilation (respalkalosis)# $hould the patient breathe into a paper bagM No# ! the pao* is well below 79 they

need oygen# ook at all your abg values# @s soon as you see the words PE you should thinko;ygen !irst#

@ typical adverse reaction to oral hypoglyce+icsis rash, photosensitivity#

/eru+ acetone and seru+ ketones rise in DCA# @s you treat the acidosis and dehydration

e;pect the potassiu+ to drop rapidly, so be ready, with potassium replacement#

luidsare the most important intervention with 77N/as well as DCA, so get !luids going !irst#>ith


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>ith o+phaloceleand gastroschisis (herniation o! abdominal contents) dress with loose salinedressing covered with plastic wrap, and keep eye on temp# Kid can lose heat quickly#

@!ter a hydrocelerepair provide ice ags and scrotal support#

No phenylalanine with a kid positive !or %C4(no meat, no dairy, no aspartame)#

/econd voided urine most accurate when testing !or ketonesand glucose#

Never give potassiu+ i! the patient is oliguricor anuric#

Nephrotic syndro+eis characteriDed by massive proteinuria (looks dark and !rothy) caused byglomerular damage# 2orticosteroids are the mainstay# BeneraliDed edema common#

@ positive @estern lot in a child J"7 months (presence o!


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it has something to do with muscle (myo) cancer (sarcoma)# he same thing goes !or drugnames# 3or e;ample, i! it ends in Iide itHs probably a diuretic, as in 3urosemide, and @myloride#

?asican cause a patient to lose his appetite (anoreia) due to reduced potassium#

! your laboring momHs water breaks and she is any +inus stationyou better know there is a

risk o! prolapsed cord#

n a ,ive-year old reathe once ,or every >compressions doing cpr#

@!ter g-tue place+ent the stomach contents are drained by gravity !or


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%rolonged hypoe+iais a likely cause o! cardiac arrest in a child#

luid volu+e overload caused by -2 !luids in!using too quickly (or whatever reason) and 2


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hyperthyroid)# ?eport it to the doc#

Bive synthroidon an e+ptystomach

Etra insulin may be needed !or a patient taking %rednisone(remember, steroids causeincreased glucose)#

Non,at +ilk reduces re,luby increasing lower esophageal sphincter pressure

Patients with *E.Dshould lay on their le,tside with the

25855834 Nclex Study Guide (1)

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