Cram Sheet Flashcards
When answering questions on the Nclex what words should you avoid? (MEANO)
Avoid answers with absolutes such as:
Must Every, Except Always, All Never, None, No Only
What are the vital sign norms for: Heart Rate Resp Rate Blood Pressure Temperature
Heart Rate: 80-100
Resp Rate: 12-20
Blood Pressure: 110-120/60 mmHg
Temperature: 37c (98.6F)
What are the hematology values for: RBC's WBC's Platelets Hemoglobin Hematocrit
RBC’s: 4.5-5.0 million
WBC’s: 5000-10000
Platelets: 200,000-400,000
Hemoglobin (Hgb): 12-16 gm (female) , 14-18gm (male)
Hematocrit (Hct): 37-47 (female); 40-54 (male)
What are the serum electrolyte values for: Sodium Potassium Calcium Magnesium Phosphorus
Sodium: 135-145 mEq/L Potassium: 3.5-5.5 mEq/L Calcium: 8.5-10.9 mEq/L Chloride: 95-105 mEq/L Magnesium: 1.5-2.5 mEq/L Phosphorus: 2.5-4.5 mEq/L
What are the ABG values for: pH HCO3 CO2 PaO2 SaO2
pH: 7.36-7.45 HCO3: 24-26 mEq/L CO2: 35-45 mEq/L PaO2: 80%-100% SaO2: > 95%
What are the key thing to remember for Acid-Base Balance?
Remember ROME!
Respiratory Opposite
Metabolic Equal
Remember that in respiratory acid base disorders the pH is opposite to the other components.
What are the Chemistry values for: Glucose Specific Gravity BUN Serum Creatinine LDH Protein Albumin Bilirubin Total Cholesterol Triglyceride Uric Acid CPK
Glucose: 70-110mg/dL Specific Gravity: 1.010-1.030 BUN: 7-22 mg/dL Serum Creatinine: 0.6 -1.35 mg/dL LDH: 100-190 U/L Protein: 6.2-8.1 g/dL Albumin: 3.4-5.0 g/dL Bilirubin: < 1.0 mg/dL Total Cholesterol: 130-200 mg/dL Triglyceride: 40-50 mg/dL Uric Acid: 3.5-7.5 mg/dL CPK:21-232 U/L
What are the Therapeutic Drug Levels for:
Carbamezpine (Tegretol) Digoxin (Lanoxin) Gentamycin (Garamycin) Lithium (Eskalith) Phenobarbital (Solfoton) Phenytoin (Dilantin) Theophylline (Tobrex) Valporic Acid (Depakene) Vancomycin (vancocin)
Carbamezpine (Tegretol): 4-10 mcg/ml Digoxin (Lanoxin): 0.8-2.0 ng/ml Gentamycin (Garamycin): 5-10 mcg/ml Lithium (Eskalith): 0.8-1.5 mEq/L Phenobarbital (Solfoton): 15-40 mcg/mL Phenytoin (Dilantin): 10-20 mcg/dL Theophylline (Tobrex): 10-20 mcg/dL Tobramycin (Tobrex): 5-10 mcg/mL (peak) 0.5-2.0 mcg/mL (Valley) Valporic Acid (Depakene): 50-100 mcg/ml Vancomycin (vancocin): 20-40 mcg/ml (peak), 5 to 15 mcg/ml (trough).
Conversions: 1 teaspoon (t) =? 1 tablespoon (T) =? 1 oz=? 1 cup=? 1 quart=? 1 pint=? 1 grain (gr)=? 1 gram (g)=? 1 Kilogram=? 1 lb = ? Convert C to F=? Convert F to C=?
1 teaspoon (t) = 5ml 1 tablespoon (T) = 3t = 15ml 1 oz = 30ml 1 cup = 8 oz 1 quart = 2 pints 1 pint = 2 cups 1 grain (gr) = 60 mg 1 gram (g = 1000mg 1 Kilogram= 2.2 lbs 1 lb = 16 oz C+40 multiply by 9/5 and subtract 40 F+40 multiple by 5/9 and subtract 40
What are the Maternal Normal values for the following? Fetal Heart Rate Variability Amniotic fluid Contractions APGAR scoring: AVA:
Fetal Heart Rate: 120-160 bpm
Variability: 6-10 bpm
Amniotic fluid: 500-1200ml
Contractions: 2-5 min apart with duration of < 90 seconds
APGAR scoring: Appearance, Pulses, Grimace, Activity, Reflex irritability. Done at 1-5 min with a score of zero for absent, 1 for decreased, and 2 for strongly positive. Scores 7 and above are generally normal, 4-6 fairly low, and 3 and below are critically low.
AVA: The umbilical cord has two arteries and one vein.
What steps does the nurse take when you must STOP -Treatment for maternal hypotension after an epidural anesthesia
Stop infusion of Pitocin
Turn Pt. on left side
Administer Oxygen
If hypovolemia is present push IV fluids
List the Pregnancy Category of Drugs
Category A: No risk in controlled human studies.
Category B: No risk in other studies. i.e. Amoxicillian, Cefotaxime.
Category C: Risk not ruled out i.e. Rifampicin ( Rifampin) Thephyline.
Category D: Positive evidence of risk. i.e Phenytoin, Tetracycline.
Category X: Contradicted in pregnancy. i.e. isotretinoin (Accutane). Thalidomide (immunoprin). etc.
Pregnancy Category N - Not yet classified.
List the various drug schedules
Schedule I - no currently accepted medical use and for research use only i.e herion, LSD, MDMA
Schedule II - drugs with high potential for abuse and requires written prescription i.e. ritalin, hydromorphone (dilaudid), meperidine (demerol) and fentanyl.
Schedule III- Requires new prescription after six months of five refills. i.e. codeine, testosterone, ketamine.
Schedule IV- Requires new prescription after six months i.e. Darvon, Xanax, Soma, and Valium.
Schedule V- dispensed like any other prescription or without prescription i.e. cough preparations, Lomotil, Motofen.
List all 15 Medication Classifications
Antacids- reduces hydrochloric acid in stomach.
Antianemics- increases blood cell production
Anticholinergics-decreases oral secreations
Anticoagulants- prevents clot formation
Anticonvulsants- used for management of seizures and bipolar disorders.
Antidiarrheals-decrease gastric motility and reduce water in the bowel.
Antihistamines-block the release of histimine.
Antihypertensives- lower blood pressure and decrease blood flow.
Anti-infectives-used for the treatment of infection.
Bronchodilators-dilates large air passage is asthma or lung diseases i.e. COPD
Diuretics- decreases water/sodium from the loop of henle.
Laxatives- promotes the passage of stool.
Miotics- constricts the pupils.
Mydriatics - dilates the pupils
Narcotics/analgesics- relieves moderate to severe pain.
What are the Rules of Nines for calculating Total Body Surface Area (TBSA) for burns.
Head 9% Arms 18% ( 9 each) Back 18% Legs 36% (18% each) Genitals 1%
Medications
Digoxin ( Lanoxin)- Assess pulses for a full minute, if less than 60 BPM hold dose. Check digitalis and potassium levels.
Aluminum Hydroxide (Amphojel)- treatment of GERD and kidney stones. WOF constipation.
Hydroxyzine (vistrail) - treatment of anxiety and itching. WOF dry mouth.
Midazolam (versed)- given for conscious sedation. WOF respiratory depression and hypotension.
Amiodarene (Cordarone) -WOF diaphoresis, dyspena, lethargy,. Take missed dose anytime in the day of to skip it entirely. Do no take double dose.
Warfarin (Coumadin) - WOF for signs of bleeding, diarreah, fever, or rash. Stress importance of complying with prescribed dosage and follow-up appts.
Methylphenidate (Ritalin)- Treatment of ADHD. Assess for heart related side-effects and reported immediately Child may need drug holiday because the drug stunts grow.
Dopamine-Tx of hypertension, shock, and low cardiac output. Monitor ECG for arrhythmia’s and blood pressure.
Rifampicin- causes red-orange tears and urine.
Ethambutol-causes problems with vision and liver.
Isoniazid- can cause peripheral neuritis, take vitimin B6 to counter.
List the following developmental milestones: 2-3 mths 4-5 mths 6-7 mths 8-9 mths 10-11 mths 12-13 mths
2-3 mths: able to turn head up, and side to side and to sound. Makes cooing or gurgling noises.
4-5 mths: grasps, switch and roll over on tummy to back. can babble and mimic sounds.
6-7 mths: sits at 6 mths and waves bye. Can recognize familiar faces and knows if someone is a stranger. Passes things back and forth b/w hands.
8-9 mths: stands straight at 8 mths, has favorite toy, plays peek-a-boo.
10-11 mths: belly to butt
12-13 mths: 12> drinks from a cup. Cries when parents leave, uses furniture to cruise.
Cultural Considerations: African Americans
May believe that illness is caused by supernatural causes and seek advice and remedies from faith healers; family oriented; have higher incidence of HBP, obesity and lactose intolerance.
Cultural Considerations: Arab Americans
May remain silent re: health probs, such as, STI’s, substance abuse, and mental illness; a devout muslim may interpret illness as a will of Allah, a teat of faith; may rely on ritual cures or alternative therapies before seeking help from health care provider; after death, the family may want to prepare the body by washing and wrapping the body in unsewn white cloth, postmortem examinations are discouraged unless required by law. May avoid pork and alcohol if muslim islamic pt. observe month long fast of Ramadan ( mid Oct). Ppl suffering from chronic illnesses, pregnant women breastfeeding of menstruating don’t fast. females avoid eye contact with males; use same sex family members as interpreters.
Cultural Considerations: Asian Americans
May value ability to endure pain and grief with silent stoicism; typically family oriented, extended family should be involved in care of dying pt., believes in “ hot-cold” yin/yang often involved; sodium intake is generally high because of salted and dried foods. May believe prolonged eye contact is rude and an invasion of privacy; may not without necessarily understanding; may prefer to maintain a comfortable physical distance b/w the pt. and HCP.
Cultural Considerations: Latino Americans
May view illness as a sign of weakness, punishment for evil doing; may consult with a curandero or voodoo priest; family members are typically involved in all aspects of decision making such as terminal illness; may see no reasons to submit to mammograms or vaccines.Cultural Considerations:
Cultural Considerations: Native Americans
May turn to a medicine man to determine the true cause of an illness; may values the ability to endure pain or grief with silent stoicism; diet may be deficient in vit. D and calcium because many suffer from lactose intolerance or don’t drink milk; obesity and diabetes are major health concerns; may divert eyes to the floor when praying or paying attention.
Cultural Considerations: Western Culture
May value technology almost exclusively in the struggle to conquer diseases; health is understood to be the absence, minimization, or control of disease process; eating utensils usually consists of a knife, fork and spoon; three meals a day is typical.
Common Diets: Acute Renal Disease
Protein restricted, high calorie, fluid-controlled, sodium and potassium controlled.
Common Diets: Addison’s Disease
Increased sodium, low potassium diet
Common Diets: ADHD and Bipolar
High calorie and provide finger foods.
Common Diets: Burns
High protein, high caloric, increased in vitamin C
Common Diets: Cancer
High calorie, High Protein.
Common Diets: Celiac Disease
Gluten Free diet no BROW ( barley, rye, oat, wheat).
Common Diets: Chronic Renal Disease
Protein restricted, low sodium, fluid restricted, potassium-restricted, phosphorus restricted.
Common Diets: Cirrhosis (stable)
Normal protien
Common Diets: Cirrhosis with hepatic insufficiency
Restrict protein, fluids and sodium.
Common Diets: Constipation
high fiber increased fluids
Common Diets: COPD
Soft, high calorie, low carb, high fat, small freq feedings
Common Diets: Cystic Fibrosis
Increase in fluids
Common Diets: Diarreah
Liquid low-fiber, regular, fluid and electrolyte replacement.
Common Diets: Gallbladder Diseases
Low-fat, calorie restricted, regular
Common Diets: Gastitis
low fiber, bland diet
Common Diets: Hepatitis
regular high calorie, high protien
Common Diets: Hyperlipidemia
Fat controlled, calorie restricted
Common Diets: hypertension, heart failure, CAD
Low sodium, calorie restricted, fat controlled
Common Diets: Kidney stones
increased fluids, calcium controlled, low oxalate
Common Diets: Nephrotic Syndrome
High calorie and Protein. Potassium and Sodium restricted
Common Diets: Obesity, Overweight
Calorie restricted, high fiber
Common Diets: Pancreatitis
Low - fat, regular, small frequent feedings; tube feeding or total parenteral nutrition
Common Diets: Peptic Ulcer
Bland Diet
Common Diets: Pernicious Anemia
Increase vitamin B12 ( Cobalamin), found in high amounts of shellfish, beef liver, and fish
Common Diets: Sickle Cell Anemia
Increase fluids to maintain hydration since sickling increases when Pt. becomes dehydrated.
Common Diets: Stroke
Mechanical soft, regular or tube feeding
Common Diets: Underweight
High calorie, high protien
Common Diets: Vomiting
Fluid and Electrolyte replacement
Positioning Clients: Asthma
Orthopneic position where Pt. is sitting up and bent forward with arms supported on the table or chair arms
Positioning Clients: Post Bronchoscopy
Flat on bed with head hyperextended
Positioning Clients: Cerebral Aneurysm
High Fowlers
Positioning Clients: Hemorrhagic Stroke
HOV elevated 30 degrees to reduce ICP and facilitate venous drainage.
Positioning Clients: Ischemic Stroke
HOB flat
Positioning Clients: Cardiac Catheratization
keep site extended
Positioning Clients: Epistaxis
lean forward
Positioning Clients: Above knee amputation
Elevate for the first 24 hrs on pillow, position on prone daily for hip extension.
Positioning Clients: Below knee amputation
Foot of bed elevated for the first 24 hrs, position pone daily for hip extension.
Positioning Clients: Tube feeding for patients with decreased LOC.
Position pt. on right side to promote emptying of the stomach with head of bed elevated to prevent aspiration;
Positioning Clients: Air pulmonary embolism
Turn Pt. to left side and lower side of bed
Positioning Clients: Prolapsed cord
Knee chest position or trendelenburg.
Positioning Clients: Postural Drainage
Lung segment to be drained should be in uppermost position to allow gravity to work.
Positioning Clients: Post lumbar puncture
Pt. should lie flat in supine to prevent headache and leaking of CSF
Positioning Clients: Continuous bladder irrigation ( CBI)`
Catheter should be taped to thigh so legs should be kept straight.
Positioning Clients: After Myringotomy
position on the side of effected ear after surgery- allows drainage of secretion
Positioning Clients: Post cataract surgery
Patient will sleep on unaffected side with a night shield for 1-4 weeks
Positioning Clients: Detached Retina
Area of detachment should be in dependent position
Positioning Clients: Post thyroidectomy
low or semi fowlers, support head, neck and shoulders.P
Positioning Clients: Thoracentesis
Sitting on the side of the bed and leaning over the table
during procedure). Affected side up ( after procedure
