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NCLEX!!! > Lu's Study Guide > Flashcards

Lu's Study Guide Flashcards

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1
Q

DO NOT delegate what you can

A

EAT

E-valuate
A-assess
T-each

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2
Q

Addison’s vs. Cushing’s

A 
Addison's = down, down, down, up, down
Cushing's = up, up, up down, up

Addison’s = hyponatremia, hypotension, decreased blood volume, HYPERkalemia, hypoglycemia
(need to “add” hormones)

Cushing’s = hypernatremia, hypertension, increased blood volume, HYPOkalemia, hyperglycemia
(have extra “Cushion” of hormones)

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3
Q

Do not give potassium unless

A

have adequate urine output

no pee, no K

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4
Q

for better perfusion then elevate and dangle

A

eleVate Veins

dAngle Arteries

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5
Q

APGAR

A 
A = appearance (color all pink, pink and blue, blue (pale) 
P = pulse (>100,
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6
Q

Airborne precautions:

A

MTV =
Measles
TB
Varicella - chicken pox/herpes Zoster-Shingles

Private Room - negative pressure with 6-12 air exchanges/hr, Mask (N95 for TB)

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7
Q

Droplet

A 
sepsis
scarlet fever
Streptococcal pharyngitis
Parvovirus B19
Pneumonia
Pertussis
Influenza
Diptheria (pharyngeal)
Epiglottitis 
Rubella
Mumps 
Meningitis
Mycoplasma or meningeal pneumonia
An - Adenovirus

Private Room or Cohort Mask
Door Open 3 ft distance

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8
Q

Contact

A

MRS. WEE

M - multi drug resistant organism 
R - respiratory infection 
S - skin infections 
W - wound infection
E - enteric infection - clostridium difficle
E - eye infection - conjuctivitis 
Skin infections - VCHIPS
Varicella zoster
Cutaneous diptheria
Herpez simplex
Pediculosis
Scabies
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9
Q

air/pulmonary embolism

A

s/s - chest pain, difficulty breathing, tachycardia, pale/cyanotic sense of impending doom

turn pt to LEFT side and LOWER the head of bed

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10
Q

Woman in labor with un reassuring FHR

A

(late decels, decreased variability, fetal bradycardia_

turn pt on LEFT side

give O2, stop Pitocin, increase IV fluids

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11
Q

Tube Feeding with Decreased LOC

A

position pt on RIGHT side (promotes emptying of stomach) with HOB ELEVATED (to prevent aspiration)

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12
Q

During Epidural

A

side-lying

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13
Q

After lumbar puncture

A

pt lies FLAT supine (to prevent headache and leaking of CSF) for 4-12 hrs

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14
Q

pt w/ heat stroke

A

lie FLAT with LEGS ELEVATED

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15
Q

During continuos bladder irrigation

A

catheter is taped to thigh so leg should be kept straight

no other positioning restrictions

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16
Q

after myringotomy

A

(ear tubes)

position on side of AFFECTED EAR after surgery (allows drainage of secretions)

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17
Q

after cataract surgery

A

pt will sleep on UNAFFECTED side with a night shield for 1-4 weeks

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18
Q

after Thyroidectomy

A

low or semi-fowler’s, support head, neck and shoulders

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19
Q

infant with spina bifida

A

position PRONE (on abdomen) so that sac does not rupture

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20
Q

Buck’s traction

A

(skin traction)

elevate foot of bed for counter-traction

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21
Q

After total hip replacement

A
  • don’t sleep on operate side
  • don’t flex hip more than 45-60 degrees
  • don’t elevate HOB more than 45 degrees
  • maintain hip abduction by separating thighs with pillows
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22
Q

Prolapsed Cord

A

knee-chest position or tredelenburg

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23
Q

Infant w/ cleft lip

A

position on back or in infant seat to prevent

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24
Q

to prevent dumping syndrome

A

post-operative ulcer/stomach surgeries

  • eat in reclining position
  • lie down after meals to decrease peristalsis
  • restrict fluids during meals
  • low CHO and fiber diet, small frequent dumping
  • increase fat and protein
  • small frequent meals
  • wait 1 hr after meals to drink
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25
Q

above knee amputation

A

elevate for 1st 24 hrs on pillow, position prone daily for hip extension

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26
Q

below the knee amputation

A

foot of bed elevated for 1st hrs, position prone daily to provide for hip extension

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27
Q

Detached retina

A

area of detachment should be in the dependent position

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28
Q

Administration of Enema

A

position pt in LEFT SIDE LYING (Sim’s) with knee flexed

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29
Q

After Supratentorial Surgery

A

(incision behind hairline)

elevate HOB 30-45 degree

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30
Q

After Infratentorial Surgery

A

(incision at nape of neck)

position pt FLAT and lateral on either side

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31
Q

During internal radiation

A

on BEDREST while implant in place

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32
Q

Autonomic Dysreflexia/hyperreflexia

A

(S/S pounding headache, profuse sweating, nasal congestion, goose flesh, bradycardia, hypertension)

SITTING position (ELEVATE HOB) first before any other implementation

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33
Q

Shock

A

bedrest with extremities elevated 20 degrees, knees straight, head slightly elevated (modified Trendelenburg)

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34
Q

Head injury

A

elevate HOB 30 degrees in decrease intracranial pressure

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35
Q

Peritoneal Dialysis when outflow is inadequate

A

turn pt from side to side BEFORE checking for kinks in tubing

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36
Q

pain med for pancreatitis

A

Demoral, NOT morphine sulfate

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37
Q

myasthenia gravis

A
  • caused by a disorder in the transmission of impulses from nerve to muscle cell
  • worsens with exercise improves with rest
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38
Q

myasthenia crisis

A

positive reaction to Tensilon

will improve symptoms

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39
Q

Cholinergic crisis

A

caused by excessive medication - stop med giving Tensilon will make it worse

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40
Q

Head injury medication:

A

Mannitol (osmotic diuretic) - crystallizes at room temp so ALWAYS use filter needle

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41
Q

prior to a liver biopsy its important

A

to be aware of the lab result for prothrombin time

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42
Q

metabolic acidosis vs metabolic alkalosis

A

From the ass (diarrhea) = metabolic acidosis

From the mouth (vomitus) = metabolic alkalosis

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43
Q

Myxedema/hypothyroidism

A

slowed physical and mental function, sensitivity to cold, dry skin and hair

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44
Q

Grave’s disease/hyperthyroidism

A
  • accelerated physical and mental function

- sensitivity to heat, fine/soft

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45
Q

Thyroid storm:

A

increased temp, pulse and HTN

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46
Q

Post-thyroidectomy:

A

semi-fowler’s prevent neck flexion/hyperextension, trach at bedside

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47
Q

Hypo-parathyroid:

A

CATS - convulsions, arrhythmias, tetany, spasms, stridor (decreased calcium)
-high Ca, low phosphorus diet

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48
Q

Hyper-parathyroid:

A

fatigue, muscle weakness, renal calculi, back and joint pain (increased calcium)
- low Ca, high phosphorus diet

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49
Q

Hypovolemia

A

increased temp, rapid/weak pulse, increased respiration, hypotension, anxiety, urine specific gravity >1.030

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50
Q

Hypervolemia

A

bounding pulse, SOB, dyspnea, rales/crackles, peripheral edema, HTN, urine specific gravity

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51
Q

Diabetes Insipidus

A

(decreased ADH)

- excessive urine output and thirst, dehydration, weakness, administer Pitressin

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52
Q

SIADH

A

(increased ADH)

  • change in LOC, decreased deep tendon reflexes, tachycardia, N/V, HA
  • admin declomycin, diuretics
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53
Q

Hypokalemia

A

muscle weakness, dysrhtmias, increase K (raisins, bananas, apricots, oranges, beans, potatoes, carrots, celery)

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54
Q

Hyperkalemia

A

MURDER - muscle weakness, urine (oliguria/anuria), respiratory depression, decreased cardiac contractility, ECG changes, reflexes

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55
Q

Hyponatremia:

A

nausea, muscle cramps, increased ICP, muscular twitching, convulsion
- osmotic diuretics, fluids

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56
Q

Hypernatremia:

A

increased temp, arrhythmias, tetany, spasms and stridor

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57
Q

Hypocalemia:

A

CATS - convulsions, arrhythmias, tetany, spasms and stridor

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58
Q

Hypercalcemia:

A

muscle weakness, lack of coordination, abdominal pain, confusion, absent tendon reflexes, sedative effect on CNA

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59
Q

HypoMg:

A

tremors, tetany, seizures, dyrshythmias, depression, confusion, dysphagia
- dig toxicity

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60
Q

HyperMg:

A

depresses the CNS, hypotension, facial flushing, muscles weakness, absent deep tendon reflexes, shallow respirations, emergency!

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61
Q

Addison’s

A

hypoNa, HyperK, hypoglycemia, dark pigmentation, decreased resistance to stress, fractures, alopecia, weight loss, GI distress

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62
Q

Cushing’s

A

hyperNa, hypoK, hyperglycemia, prone to infection, muscle wasting, weakness, edema, HTN, hirsutism, moonface/buffaloe hump

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63
Q

Addisonian crisis:

A

N/V, confusion, abdominal pain, extreme weakness, hypoglycemia, dehydration, decreased BP

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64
Q

Phechromocytoma

A

hypersecretion of epi/norepi, persistent HTN, increased HR, hyperglycemia, diaphoresis, tremor, pounding HA

  • avoid stress, frequent bating and rest breaks, avoid cold and stimulating foods, surgery to remove tumor
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65
Q

neuroleptic malignant syndrome

A
  • you get hot (hyperpyrexia)
  • stiff (increased muscle tone)
  • sweaty (diaphoresis)
  • BP, pulse, and respirations go up
  • start to drool
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66
Q

dangerous when pregnant rubeola or rubella?

A 
regular measles (rubeola) or german measles (rubella)
- never get pregnant with a German (rubella)
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67
Q

when drawing up drawing up insulin

A

regular and NPH together
remember: RN
regular comes before NPH

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68
Q

Tetralogy of fallot

A 
think DROP (child drops to floor or squats)
Defect, septal
Right ventricular hypertrophy
Overriding aorts 
Pulmonary stenosis
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69
Q

MAOI’s that are used as antidepressants

A

(think Pirates take MAOI’s when depressed and pirates say ARRR)

MAOI’s used for depression all have an arrr sound in the middle
(Parnate, Marplan, Nardil)

PANAMA
(PArnate, MArplan, NArdil)

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70
Q

Autonomic dysreflexia

A

potentially life threatening emergency

  • elevate HOB to 90 degrees
  • loosen constrictive clothing
  • assess for bladder distention and bowel impaction (trigger)
  • admin antihypertensive meds (may cause stroke, MI, seizure)
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71
Q

With Digoxin

A

check pulse, if less than 60 hold, check dig levels and potassium levels

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72
Q

Amphojel

A

tx of GERD and kidney stones

  • watch out for constipation
  • long term use: binds to phosphates, increases Ca, robs the bones - leads to increased Ca resortion from bones = WEAK BONES)
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73
Q

Vistaril

A

tx of anxiety and itching

watch for dry mouth

commonly given preoperative

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74
Q

Versed

A

given for conscious sedation

watch respiratory depression and hypotension

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75
Q

PTU and Tapazole

A

prevention of thyroid storm

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76
Q

Sinemet

A

tx of parkinson

sweat, saliva, urine may turn reddish brown occasionally

causes drowsiness

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77
Q

Artane

A

tx of parkinson

sedative effect

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78
Q

Cofentin

A

tx of parkinson and extrapyramidal effects of other drugs

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79
Q

Tigan

A

tx of postop n/v and for nausea with gastronenteritis

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80
Q

Timolol (Timoptic)

A

tx of gluacoma

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81
Q

Bactrim

A

antibiotic

don’t take if allergy to sulfa drugs

diarrhea common side effect
drink plenty of fluids

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82
Q

Probenecide (Benemid)

A

tx gout

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83
Q

Colchicine

A

tx gout

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84
Q

Allopurinol (Zyloprim)

A

tx gout

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85
Q

Apresoline (Hydralazine)

A

tx of HTN or CHF

  • report flu-like s/s
  • rise slowly form sitting/lying position
  • take with meals
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86
Q

Bentyl

A

tx of irritable bowel

  • assess anticholinergic s/e
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87
Q

Calan (verapamil)

A

Ca channel blocker

tx of HTN, angina

assess for constipation

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88
Q

Carafate

A

(Sulcrafate)
tx of duodenal ulcers
coats the ulcers

take before meals!!
- S/E: constipation

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89
Q

Theophylline

A

tx of asthma or COPD
therapeutic level 10-20

  • increases the risk of digoxin toxicity
  • decreases the effectiveness of lithium and Dilantin
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90
Q

Mucomyst

A

antidote to tylenol administered orally

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91
Q

Diamox

A

tx of glaucoma, high altitude sickness

don’t take if allergy to sulfa drugs
- can cause hypokalemia

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92
Q

Indocin

A

(NSAID) tx of arthritis (osteo, rhematoid, gouty), bursitis, and tendonitis

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93
Q

Synthroid

A

tx of hypothyroidism

  • make take several weeks to take effect
  • notify MD of chest pain
  • take in AM on empty stomach
  • can cause hyperthyroidism
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94
Q

Librium

A

tx of alcohol withdrawal

  • don’t take with alcohol
  • very bad n/v
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95
Q

Oncovin (vincristine)

A

tx of leukemia

-given IV only

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96
Q

kwell

A

tx of scabies and lice

  • apply lotion once and leave on for 8-12 hrs for scabies
  • lice - use shampoo and leave on for 4 mins with hair uncovered and rinse with warm water and comb with a fine tooth comb
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97
Q

Premarin

A

tx after menopause, estrogen replacement

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98
Q

Dilantin

A

tx of seizures

therapeutic level 10-20

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99
Q

Navane

A

tx of schizophrenia

-assess for EPS

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100
Q

Ritalin

A

tx ADHD

  • assess for heart related side effects report immediately
  • may need drug holiday because stunts growth
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101
Q

dopamine (intropine)

A

tx of hypotension, shock, low cardiac output, poor perfusion to vital organs

-monitor EKG for arrhythmias, monitor BP

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102
Q

FHR patterns (remembering technique)

A

VEAL CHOP

V C
E H
A O
L P

V = variable decels; C = chord compression caused
E = early decels; H = head compression caused
A = accels; O = okay, no problem!
L = late decels; P = placental insufficiency , can't fill
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103
Q

For cord compression

A

-place the mother in TRENDELENBERG position because this removes pressure of the presenting part off the cord

(the baby is no longer being pulled out of the body by gravity)

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104
Q

If prolapsed cord then

A

cover it with sterile saline gauze to prevent drying of the cord and to minimize infection

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105
Q

for late decels then

A

turn mother to her LEFT side to allow more blood flow to the placenta

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106
Q

for any kind of bad fetal heart rate pattern, you would

A

give O2 often by mask

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107
Q

with epidural anesthesia what is a priority before hand

A

hydration

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108
Q

hypotension, bradypnea/bradycardia in pregnancy are

A

major risks and emergencies

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109
Q

Never do what before assessing pt

A

check monitor or machine as first action
- always assess pt 1st

for example, if trying to decide to check mother or baby 1st and one answer involves a machine then it is a wrong answer

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110
Q

if baby is posterior presentation the sounds are heard

A

at both sides

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111
Q

if the baby is anterior the sounds are heard

A

closer to midline, between the umbilicus and where you would listen to a posterior present

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112
Q

if the baby is breech the sounds are

A

high up in the fundus near the umbilicus

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113
Q

if the baby is certex the sounds are

A

a little bit above the symphysis pubis

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114
Q

remembering ventilator alarms

A

HOLD
High alarm - Obstruction due to increased secretions, kink, pt coughs, gag or bites
Low pressure alarm - Disconnection or leak in ventilator or in pt airway cuff, pt stops spontaneous breathing

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115
Q

to remember blood sugar

A

hot and dry - sugar high

cold and clammy needs some candy - low sugar

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116
Q

ICP and shock have opposite vitals

A

ICP - increased BP, decreased pulse, increased respirations

shock - decreased BP, increased pulse, decreased respirations

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117
Q

cor pulmonae

A

right sided heart failure caused by left ventricular failure
(s/s: fluid overload - so edema, and JVD)

caused by pulmonary disease: bronchitis or emphysema

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118
Q

herion withdrawal neonate

A

irritable, poor sucking

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119
Q

Jews food

A

no meat and milk together

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120
Q

test child for lead poisoning around

A

12 months of age

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121
Q

potassium food

A

bananas, potatoes, citrus fruits

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122
Q

before starting IV antibiotics need

A

cultures

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123
Q

pt with leukemia may have

A

epitaxis because of low platelets

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124
Q

best way to warm a newborn

A

skin to skin contact covered with blanket on mom

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125
Q

when pt comes in that is in active labor 1st thing to do

A

listen to fetal heart tone/rate

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126
Q

phobic disorders use

A

systemic desensitization

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127
Q

with lower amputations pt is placed

A

in prone position

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128
Q

LPN cannot give what

A

blood

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129
Q

amynoglycosides cause

A

nephrotoxicity and ototoxicity

like vanco

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130
Q

IV push should never go over

A

2 mins

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131
Q

cardinal sign of ARDS

A

hypoxemia

ARDS (fluid in alveoli)

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132
Q

in pH regulation the 2 organs of concern

A

lungs/kidneys

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133
Q

edema is in the

A

interstital space not the cardiovascular space

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134
Q

biggest indicator of dehydration

A

weight

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135
Q

aspirin when given to children can cause

A

Reye’s syndrome (encephalopathy)

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136
Q

cold/heat for pain

A

cold - acute pain (sprain ankle)

heat - chronic (rheumatoid arthritis)

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137
Q

pneumonia s/s

A

fever and cils usually present

elderly - confusion

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138
Q

administering antibiotics

A
  • always check for allergies before (especially PCN)

- make sure culture and sensitivity has been done before

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139
Q

COPD vs pneumonia

A

COPD is chronic

pneumonia is acute

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140
Q

emphysema and bronchitis are both

A

COPD

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141
Q

in COPD pts

A

the barorecptors that detect the CO2 level are destroyed

therefore, the O2 level must be low because high O2 concentration blows the pts stimulus for breathing

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142
Q

What kind of syringe for epi

A

TB syringe

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143
Q

exacerbation:

A

acute, distress

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144
Q

cushing’s syndrome

A

prednisone toxicity

buffalo hump, moon face, high glucose, hypertension

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145
Q

4 options for cancer management

A

chemo, radiation, surgery, allow to die with dignity

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146
Q

neutropenic precautions

A

no live vaccines, no fresh fruits, no flowers , NO MILK

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147
Q

chest tubes are placed in

A

the pleural space

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148
Q

angina vs. MI

A

angina - low oxygen to heart tissues (no dead heart tissues

MI - dead heart tissues present

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149
Q

mevacor

A

(anticholesterol med)

must be given with evening meal if it is QD (per day)

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150
Q

nitroglycerin

A

administered up to 3 times every 5 mins
if chest pain does not stop then go to hospital
- do not give when BP

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151
Q

preload

A

affects the amount of blood that goes into the R ventricle

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152
Q

afterload

A

is the resistance the blood has to overcome when leaving the heart

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153
Q

calcium channel blockers affect

A

the afterload

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154
Q

during CABG operation

A

the great saphenous vein is taken and turned inside out due to the valves that are inside

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155
Q

dead tissues of the heart cannot have

A

PVCs

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156
Q

untreated PVCs lead to

A

ventricular fibrillation

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157
Q

angiotension II in the lungs

A

angiotension II in the lungs

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158
Q

aldosterone attracts

A

sodium

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159
Q

reverse agent for heparin

A

protamine sulfate

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160
Q

reverse agent for coumadin

A

vitamin k

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161
Q

reverse agent for ammonia

A

lactulose

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162
Q

reverse agent for acetaminophen

A

n-Acetylcysteine

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163
Q

reverse agent for iron

A

deferoxamine

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164
Q

reverse agent for digoxin

A

digibind

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165
Q

reverse agent for alcohol withdraw

A

librium

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166
Q

methadone

A

opioid analgesic used to treat/detoxify pain in narcotic addicts

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167
Q

potassium does what to dig toxicity

A

potentiates

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168
Q

heparin prevents

A

platelet aggreation

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169
Q

what is elevated when pt on Coumadin

A

PT/PTT

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170
Q

cardiac output decreases with

A

dysryhtmias

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171
Q

dopamine increases

A

BP

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172
Q

med of choice for Vtach

A

lidocaine

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173
Q

med of choice for SVT is

A

adenosine or adenocard

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174
Q

med of choice for asystole

A

atropine

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175
Q

med of choice for CHG is

A

ace inhibitor

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176
Q

med of choice for anaphylactic shock

A

epinephrine

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177
Q

med of choice for status epilepticus is

A

valium

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178
Q

med of choice for bipolar

A

lithium

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179
Q

What is effective in both ventricular and atrial complications?

A

Amiodorone

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180
Q

S3 is normal in _____ but not normal in ____

A

S3 is normal in CHF but not normal in MI

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181
Q

When to give Carafate?

A

Carafate (GI med) is given before meals to coat stomach

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182
Q

Protonix

A

Given prophylactically to prevent stress ulcers

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183
Q

What type of line is TPN given through?

A

Given through subclavian line

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184
Q

Low residue diet means

A

Low fiber diet

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185
Q

Where is pain for diverticulitis

A
  • (inflammation of the diverticulum in the colon)

- pain is around the LL quadrant

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186
Q

Where is appendicitis pain

A
  • (inflammation of the appendix)

- pain is in RL quadrant with rebound tenderness

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187
Q

portal hypertension + albuminemia =

A

ascites

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188
Q

What produces insulin?

A

Beta cells of the pancreas

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189
Q

What is contraindicated in pancreatitis?

A
  • morphine
  • causes spasm of the sphincter of Oddi
  • so give demerol
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190
Q

Trousseau and Tchovoski signs of

A

hypocalcemia

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191
Q

with chronic pancreaitis give what with meals

A

pancreatic enzymes

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192
Q

never give K+

A

in IV push

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193
Q

mineral corticoids are given in

A

Addison’s disease

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194
Q

DKA

A

diabetic ketoacidosis

  • body breaking down fat instead of sugar for energy
  • fats leave ketones (acids) that cause pH to decrease
  • rare in DM type II because there is enough insulin to prevent breakdown of fats
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195
Q

sign of fat embolism

A

petechiae

- treated with heparin

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196
Q

fat embolism treated with

A

heparin

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197
Q

for knee replacement use a

A

continuous passive motion machine

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198
Q

give what before any invasive procedure

A

prophylatic antibiotic therapy

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199
Q

gluacoma pts lose

A

peripheral vision

- treated with meds

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200
Q

catarat =

A

cloudy, blurry vision

- treated by lens removal-surgery

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201
Q

CO2 causes

A

vasoconstriction

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202
Q

most spinal cord injuries are at

A

cervical or lumbar regions

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203
Q

autonomic dysreflexia

A
  • life threatening inhibited sympathetic response of nervous system to a noxious stimulus - pts with spinal cord injuries at T-7
  • usually caused by a full bladder
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204
Q

spinal shock occurs

A

immediately after spinal injury

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205
Q

multiple sclerosis =

A

chronic, progressive disease with demyelinating lesions in the CNA which affects the white matter of the brain and spinal cord

  • myelin sheat destruction, disruption in nerve impulse conduction
  • motor s/s: limb weakness, paralysis, slow speech
  • sensory s/s: numbness, tingling, tinnitus
  • cerebral s/s: nystagmus, ataxia, dysphagia, dysarthria
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206
Q

myasthenia gravis =

A

decrease in receptor sites of acetylocholine
- since smallest concentration of ACTH receptors are in cranial nerves, expect fatigue and weakness in eye, mastication, pharyngeal muscles

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207
Q

tensilon test

A

given if muscle are tense in myasthenia gravis

used to cofirm the diagnosis of myesthenia gravis

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208
Q

gullain-barre syndrome

A

ascending paralysis

- keep eye on respiratory system

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209
Q

parkinson’s

A

RAT
rigidity, akinesia (loss of muscle mvt), tremors
- treat with levodopa

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210
Q

TIA

A

(transient ischemic attack)

- mini stroke with no dead brain tissue

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211
Q

CVA

A

(cerebrovascular accident)

- dead brain tissue

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212
Q

Hodgkin’s disease

A

cancer of lymph is very curable in early stage

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213
Q

Rule of Nines for burns

A 
Head and neck = 9%
Each upper ext = 9%
each lower extremity = 18%
Front truck = 18%
Back trunk = 18%
Genitalia = 1%
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214
Q

birth weight doubles by

A

6 months, and triples by 1 year

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215
Q

do not give dig to children if

A

if heart rate is

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216
Q

first sign of cystic fibrosis

A

may be meconium ileus at birth

- baby is inconsolable, do not eat, and not passing meconium

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217
Q

cyanotic heart defects

A

3Ts - Tof, truncys arteriosus, transposition of the great vessels

  • prevent blood from going to heart
  • if not fix on on, or cannot be corrected surgically CHF will occur followed by death
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218
Q

right sided heart defects

A

look for valve problems

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219
Q

left sided heart defects in adults

A

look for coronary complications

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220
Q

rheumatic fever can lead to

A

cardiac valves malfunctions

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221
Q

cerebral palsy =

A

poor muscle control due to birth injuries and/or decrease oxygen to brain tissues

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222
Q

ICP should be

A
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223
Q

dilantin level

A

10-20

can cause gingival herplasia

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224
Q

for meningitis check

A

for kernig’s/brudzinski’s sings

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225
Q

wilms tumor

A

above the kidneys causing flank pain

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226
Q

hemophilia is

A

x-linked

-mother passes disease to son

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227
Q

when phenylalanine increases

A

brain problems occur

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228
Q

Buck’s traction =

A

knee immobility

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229
Q

Russell traction =

A

femur or lower leg

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230
Q

Dunlap traction =

A

skeletal or skin

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231
Q

Bryant’s traction =

A

children

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232
Q

when putting on traction

A

place apparatus first then place the weight

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233
Q

placenta should be in

A

upper part of the uterus

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234
Q

eclampsia is

A

seizure

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235
Q

a pt with a vertical c-section surgery will be more likely to

A

have another c-section

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236
Q

perform amniocentesis

A

before 20 weeks gestation to check for cardiac and pulmonary abnormalities

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237
Q

Rh- mothers recieve

A

rhogam to protect next baby

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238
Q

anterior fontanelles close

A

by 18 mo

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239
Q

posterior fontanelles close

A

6-8 weeks

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240
Q

caput succedaneum =

A

diffuse edema of the fetal scalp that crosses the suture lines
- swelling reabsorbs within 1-3 days

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241
Q

pathological jaundice =

A

occurs before 24 hrs and last 7 days

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242
Q

physiological jaundice =

A

occurs after 24 hrs

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243
Q

placenta previa =

A
  • there is no pain

- there is bleeding

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244
Q

placenta abruption =

A

pain, but no bleeding

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245
Q

bethamethasone

A

(celestone) = surfactant

- med for lung expansion

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246
Q

dystocia =

A

baby cannot make it down to canal

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247
Q

pitocin

A

med used for uterine stimulation

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248
Q

magnesium sulfate

A
  • used to halt preterm labor
  • contraindicated if deep tendon reflexes are ineffective
  • if pt experiences seizure during magnesium administration get the baby out STAT
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249
Q

do not use what statements when dealing with pts

A

why or I understand

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250
Q

milieu therapy -

A

taking care of pt/environment

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251
Q

cognitive therapy -

A

counseling

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252
Q

crisis intervention -

A

short term

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253
Q

5 interventions for psych pts

A
  • safety
  • setting limits
  • establishing a trusting relationship
  • meds
  • less restrictive methods/environment
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254
Q

SSRI’s

A

antidepressants

take 3 weeks to work

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255
Q

Obsession vs. Compulsion

A

obsession - is to thought

compulsion - is to action

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256
Q

if pt having hallucinations

A

redirect them

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257
Q

if pt having delusions

A

distract them

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258
Q

Thorazine

A

(haldol) - antipsychotic

- can lead to EPS (extrapyramidal side effects)

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259
Q

Alzheimer’s disease

A

chronic, progressive, degenerative, cognitive disorder that accounts for more than 60% of all dementias

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260
Q

drawing up insulin

A

(Nicole Richey, RN)

air into NPH, air into regular, then draw up regular then draw up NPH

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261
Q

HYPERthyroidism

A

(Michael Jackson thriller)

skinny, nervous, bulging eyes, up all night, heart beating fast

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262
Q

atropine

A

used to decreased secretions

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263
Q

phenergan

A

antiemetic used to reduce nausea

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264
Q

diazepam

A

commonly used tranquilizer given to reduce anxiety before OR

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265
Q

Demoral

A

pain control

- do not give to sickle cell crisis

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266
Q

Do not give demoral to

A

sickle cell crisis

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267
Q

give iron IM

A

z track

so they don’t leak into SQ tissues

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268
Q

Heart valves assessment

A

(all people eat too much)
Aorta - 2nd intercostal space right sternal border
Pulmonic - 2nd intercostal space left sternal border
Erbs point - 3rd intercostal space left sternal border
Tricuspid - 4th intercostal space left sternal border
Mitral - 5th intercostal space midclavicular line

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269
Q

Cranial nerves

A

(S = sensory, M = motor, B = both)

I Olfactoary         Some
II Optic                 Say
III Oculomotor     Marry
IV Trochlear         Money
V Trigeminal        But
VI Abducens        My 
VII Facial              Brother
VIII Acoustic         Says
IX Glossopharyngeal     Big
X Vagus                Brain
XI Spinal accessory     Matter
XII  Hypoglossal      More

(Oh, Oh, Oh, To Touch And Feel A Girls Vagina, AHH, Heaven)

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270
Q

Hypernatremia

A 
greater than 145
think salt:
Skin flushed
Agitation
Low grade fever
Thirst
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271
Q

at 2-3 months developmental

A

turns head side to side

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272
Q

at 4-5 months developmental

A

grasps, switch and roll

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273
Q

at 6-7 months developmental

A

sit at 6 and wave bye-bye

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274
Q

at 8-9 months developmental

A

stands STRAIGHT at EIGHT

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275
Q

at 10-11 months developmental

A

belly to butt

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276
Q

at 12-13 months developmental

A

twelve and up, drink from a cup

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277
Q

Hepatitis

A

Hep A - ends in a VOWEL comes from the BOWEL
Hep B - blood and body fluids
Hep C - blood and body fluids

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278
Q

Glasgow coma scale

A

Max 15
below 8 your in a coma!!

Eyes - open spontaneously and uses them correctly to see then 4, if you have to yell then 3, if don’t open them to pain then 1

Verbal - if orientated then 4, confused 3, inappropriate words 3, incomprehensible sounds 2, no verbal 1

Motor - good moves then 6

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279
Q

the person who hyperventilates will experience

A

respiratory alkalosis

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280
Q

avoid what when taking dig and k-supplements

A

salt substitutes - potassium based

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281
Q

signs of hypoxia

A

restless, anxious, cyanotic tachycardia, increased respirations
- monitor ABGs

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282
Q

precautions for herpes zoster

A

disseminated herpes zoster - airborne
localized herpes zoster - contact

  • nurse with localized herpes zoster can care for pt as long as the pts are not immunosuppressed and the lesions must be covered!!
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283
Q

fat soluble vitamins

A

A, D, E, K

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284
Q

drugs given with food

A

NSAIDS, corticosteroids, drugs for bipolar, cephalosporins, and slufanomides

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285
Q

tx of choice for status epilepticus

A

ativan

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286
Q

when using bronchodilator inhaler in conjunction with a glucocorticoid inhaler admin which on first

A

bronchodilator 1st

287
Q

Intal

A

inhaler used to tx allergy induced asthma may cause bronchospasm
- think! INto asthmatic lung

288
Q

Isoniazed

A

causes peripheral neuritis

289
Q

peptic ulcers caused by H. plyori

A
  • tx with Flagyl, Prilosec, and Biaxin

- tx kills bacteria and stops production of stomach acid, but does not heal ulcer

290
Q

weighted NI

A

(Naso intestinal tubes)

  • must float from stomach to intestine
  • don’t tape tube right after placement, may leave coiled next to pt on HOB
  • position pt on RIGHT to facilitate movement through the pylorus
291
Q

Diaphragm birth control

A
  • must stay in place 6 hrs after intercourse

- fitted and must be refitted if you lose or gain weight

292
Q

Best time to take growth hormone

A

PM

293
Q

Best time to take steroids

A

AM

294
Q

Best time to take diuretics

A

AM

295
Q

Best time to take aricept

A

AM

296
Q

Tagamet

A

H2

  • take with food
  • messes with elderly because interacts with a lot of things!!
297
Q

take antacids when

A

after meals

298
Q

long term use of amphojel

A

binds to phosphates, increases Ca, robs the bones - leads to increased Ca resortion from bones = WEAK BONES

299
Q

Cushings ulcers r/t

A

BRAIN injury

300
Q

Cushings triad r/t

A

ICP in BRAIN (htn, bradycardia, irregular resps)

301
Q

Thyroid storm temp

A

HOT - hyperthermia

302
Q

Myxedema coma temp

A

COLD - hypothermia

303
Q

Glaucoma

A

intraocular pressure is greater than normal (22 mm Hg)

  • give miotics to constrict (pilocarpine)
  • NO ATROPINE
304
Q

non dairy sources of calcium

A

Rhubarb, sardines, collard greens

305
Q

to avoid skin irritation with plaster cast

A

petal the rough edges with tape

306
Q

To relieve low back aches

A

bend knees

307
Q

push fluids with Allopurinol to

A

flush the uric acid out of system

308
Q

koplick’s spots

A

red spots with blue center characteristic of PRODROMAL stage of Measles, usually in mouth

309
Q

INH can cause

A

peripheral neuritis, take vit B6 to prevent also hepatotoxic

310
Q

Rifampin

A

for TB

  • Red/orange tears and urine!
  • contraceptives don’t work as well
311
Q

Ethambutol s/e

A

messes with your Eyes

312
Q

applying eye drops

A
  • apply to conjunctival sac

- afterwards apply pressure to nasolacrimal duct/inner canthus

313
Q

for pancreatitis pts

A

put them in fetal position
NPO - let gut rest
get ready for PICC because will get TPN/LIPIDS

314
Q

trendelenburg test

A

for varicose veins, if they fill proximally = varicosity

315
Q

when giving kayexalate need to worry about

A

dehydration!!

K has inverse relationship with Na

316
Q

yogurt has live cultures so don’t give to

A

immunosuppressed pt

317
Q

for itching under cast area

A

cool air via blow dryer
ice pack for 10-15 mins
NEVER use qtip or anything to scratch area

318
Q

Murphy’s sign -

A

pain with palpation of gall bladder area seen with cholecystitis

319
Q

Cullen’s sign -

A

ecchymosis in umbilical area, seen with pancreatitis

320
Q

Turner’s sign -

A

flank grayish blue (turn around to see your flanks)

pancreatitis

321
Q

McBurney’s pint -

A

pain in RLQ indiciative of appendicitis

322
Q

pain in LLQ -

A

diverticulitis, low residue, no seeds, nuts, peas

323
Q

pain in RLQ -

A

appendicitis, watch for peritonitis

324
Q

Gurthrie Test -

A

tests for PKU, baby should have eaten source of protein first

325
Q

Shilling Test -

A

How well one absorbs Vit B12

test for pernicious anemia

326
Q

Allen’s test -

A
  • do prior to doing and ABG to check for sufficient
  • occlude both ulnar and radial artery until hand blanches then release ulnar
  • if the hand pinks up, ulnar artery is good and you can carry on with ABG/radial stick as planned
327
Q

Peritoneal Dialysis cath (tenkhoff) ok if

A

abdominal cramps, blood tinged outflow and leaking around site; if cath was placed in last 1-2 weeks

328
Q

NEVER normal for tenkhoff

A

(peritoneal dialysis) CLOUDY outflow

329
Q

amniotic fluid yellow with particles =

A

meconium stained

330
Q

hyper reflexes

A
  • upper motor neuron issue

“your reflexes are over the top”

331
Q

absent reflexes

A
  • lower motor neuron issue
332
Q

Rhogam

A

given at 28 weeks, 72 hrs post partum, IM
only given to Rh NEGATIVE mothers

  • only give if negative Coomb’s test - if indirect Coomb’s test is positive don’t need Rhogam because she has antibody
333
Q

Magnesium sulfate antidote

A

Calcium gluconate

334
Q

Acetaminophen antidote

A

Mucomyst

335
Q

TPA antidote

A

(given for blood clot/stroke)

Amicar

336
Q

Order of assessment:

A

Inspection, Palpation, percussion, Auscultation

Except with abdomen! (Inspect, ausculate, percuss, then palpate (same with kids)

337
Q

To assess for latex allergies ask if allergic to

A

bananas, apricots, cherries, grapes, kiwis, passion fruit, avocados, chestnuts, tomatoes, peaches

338
Q

Amyotrophic lateral scleorsis

A

(ALS) degeneration of motor neurons in both the upper & lower motor neuron systems

339
Q

Transesopheal Fistula (TEF)

A

esophagus doesn’t fully develop

surgical emergency!!

340
Q

the 3 C’s of TEF in newborn

A
  1. choking
  2. coughing
  3. cyanosis
341
Q

MMR vaccine is given what route

A

SQ not IM

342
Q

Diaster colors

A

Red - unstable, ie occluded airway, actively bleeding, see first
Yellow - stable, can wait up to an hour for treatment, ie burns, see second
Green - stable, can wait even longer to be seen, “walking wounded”
Black - unstable pts that will probably not make it, need comfort measures
DOA - dead on arrival

343
Q

Creek heritage with babies

A

put an amulet or protective charms around baby’s neck to avoid “evil eye” or envy of others

344
Q

4 year old kids cannot interpret

A

TIME
need to explain time in relationship to a known common event
“mom will be back after supper”

345
Q

contraindication for Hep B vaccine

A

anaphylactic reaction to baker’s yeast

346
Q

Ask for allergy to what before flu shot?

A

eggs

347
Q

Ask if what before MMR

A

anaphylactic reaction to eggs or neomycin

348
Q

When on nitroprusside monitor

A

thiocynate (Cyanide)

- normal value should be 1 if greater than 1 heading towards toxicity

349
Q

if a kid has a cold what about immunizations

A

can still give

350
Q

SARS isolation

A

(severe acute resp syndrome)

airbone + contact (just like caricella)

351
Q

hepatitis A precautions

A

contact precautions

352
Q

Standard precautions

A

Tetanus, Hepatitis B, HIV

353
Q

William’s position

A

semi fowlers with knees flexed to relieve lower back pain

354
Q

Signs of a fractured hip

A

external rotation, shortening, adduction

355
Q

fat embolism s/s

A

blood tinged sputum (r/t inflammation), increased ESR, respiratory alkalosis (r/t tachypnea), hypocalcemia, increased serum lipids, “snow storm” effect on CXR

356
Q

Complications of mechanical ventilation

A

pneumothorax, ulcers

357
Q

Paget’s disease

A

tinnitus, bone pain, enlargement of bone, thick bones

358
Q

No what with allopurinol

A

vitamin C

359
Q

IVP requires

A

bowl prep so they can visualize the bladder better

360
Q

Acid Ash diet -

A

cheese, corn, cranberries, plums, prunes, meat, poultry, pastry, bread

361
Q

Alk Ash diet -

A

milk, veggies, rhubarb, salmon

362
Q

orange tag in triage is

A

non emergent psych

363
Q

Greenstick fractures

A

usually seen in kids

bone breaks on one side and bends on the other

364
Q

Insomnia is a side effect of

A

thyroid hormones - increased met rate, body is too busy to sleep

(hypothyroidism report somnolence - decreased met rate, body is slow and sleepy)

365
Q

tx for strabismus

A

(Cross-eyed)
Botox
patch the good eye so that the weaker eye can get stronger

366
Q

Tidal volume

A

7-10 ml/kg

367
Q

COPD pts on oxygen

A

remember 2L NC or less (Hypoxic NOT hypercapnic drive), PaO2 of 60ish and SaO2 90% is normal for them because they are chronic CO2 retainers

368
Q

Use what to reverse effect of pancuronium

A

Neostigmine/Atropine (anticholinergic)

369
Q

Ampho B causes

A

hypokalemia

- gotta premedicate before giving, pts will most likely get a fever

370
Q

Before the administration of asparginase

A

test for hypersensitivity

371
Q

Take what with high fat diet

A

Vermox (increases absorption)

372
Q

kidney glucose threshold is

A

180

373
Q

Amphogel and Renegal take

A

with meals

374
Q

stranger anxiety is greatest

A

7-9 months

375
Q

separation anxiety peaks in

A

toddlerhood

376
Q

What is best for asthma and arthritis

A

swimming

377
Q

If asthma has intercostal retractions

A

be concerned

378
Q

Tardive Dyskinesia

A
  • irreversible, involuntary movements of the tongue, face, and extremities
  • may happen after prolonged use of antipsychotics
379
Q

Akathisia

A

motor restlessness, need to keep going

- tx with antiParkinson meds, can be mistaken for agitation

380
Q

When drawing ABG

A

put blood in a heparinized tube, make sure no bubbles, put on ice immediately after drawing, with a label indicated if the pt was on room air or how many liters of O2

381
Q

Before a pulmonary function test

A

a pt’s bronchodilator will be with-held and they are not allowed to smoke for 4 hrs prior

382
Q

For a lung biopsy

A

position pt lying on side of bed or with arms raised on pillows over bedside table, have pt hold breath in mid expiration

  • chest xray done immediately afterwards to check for complication of pneumothroax
  • sterile dressing applied
383
Q

For lumbar puncture

A

pt position in lateral recumbent fetal position, keep pt flat for 2-3 hrs afterwards, sterile dressing, frequent neuro assessments

384
Q

For EEG

A

hold meds for 24-48 hrs prior, no caffeine or cigarettes or stimulants for 24 hrs prior, pt can eat, pt must stay awake night before exam, pt may be asked to hyperventilate for 3-4 mins and watch a bright flashing light
- after EEG assess for seizures, pts will be at increased risk

385
Q

Dexedrine

A
  • used for ADHD
  • may alter insulin needs
  • avoid taking with MAOI’s
  • take in morning (insomnia possible side effect)
386
Q

Cytovene

A
  • used for retinitis caused by cytomegalovirus
  • pt will need regular eye exams
  • report dizziness, confusion, or seizures immediately
387
Q

INH

A
  • used to tx and prevent TB
  • do not give with dilantin
  • can cause phenytonin toxicity
  • monitor LFT’s
  • give B6 along with
  • hypotension will occur initially then resolve
388
Q

When mixing antipsychotics with fluids (Haldol, Throazine, Prolixin)

A

incompatible with caffeine and apple juice

389
Q

preferred anti-psychotic in elderly

A

Haldol

  • but high risk extrapyramidal s/e (Dystonia, tarditive dyskinesia, tightening of jaw, stiff neck, swollen tongue - swollen airway)
  • monitor for early s/s of reaction and give IM Benadryl
390
Q

Risperdal

A

antipsychotic

  • doses over 6mg can cause tarditive dyskinesia
  • first line antipsychotic in children
391
Q

Levodopa

A
  • tx parkinsons

- contraindicated in pts with glaucoma, avoid B6

392
Q

Sinemet

A
  • tx parkinsons

- contraindicated with MAOI’s

393
Q

Hydroxyurea

A

for sickle cell

  • report GI symptoms immediately
  • could be signs of toxicity
394
Q

Zocor

A

for hyperlipidemia

  • take on empty stomach to enhance absorption
  • report any unexplained muscle pain, especially if fever
395
Q

Decorticate vs. Decerebrit

A

Decorticate - towards the core (cortex involvement)

Decerebrit - the other way ( out) (cerebellar, brain stem involvement)

396
Q

Botulin Toxin

A

(Botox) used with strabismus also to relax vocal cords in spasmodic dysphoria

397
Q

Muchausen Syndrome

A

is a psychiatric disorder that causes an individual to self-inflict injury or illness or to fabricate symptoms of physical or mental illness in order to receive medical care or hospitalization

398
Q

Muchausen by proxy (MSBP)

A

individual (typically mother) intentionally causes or fabricates illness in child or other person under care

399
Q

Huntington’s Chorea

A

50% genetic, autosomal dominant disorder

  • s/s: chorea - writhing, twisting, movements of face, limbs, and body
  • gait deteriorates to no ambulation
  • no cure, just palliative care
400
Q

WBCs and pyelonephritis

A

(kidney infection) WBC shift to the left, neutrophils kick in to fight infection

401
Q

Definitive diagnosis for abdominal aortic aneurysm

A

CT scan

402
Q

Don’t use Kayexalate if

A

pt has hypoactive bowel sounds

403
Q

Uremic fetor

A

smell urine on the breath

404
Q

Hirschsprung’s

A
  • bile is lower obstruction, no bile is upper obstruction

- ribbon like stools

405
Q

When to take pancreatic enzymes

A

WITH each meal, not before or after

406
Q

Can’t eat what before occult blood test

A
  • cantaloupe - high in vitamin C and vit C causes false positive
407
Q

Hypospadias

A
  • abnormality in which the urethral meatus is located on the ventral (back) surface of the penis anywhere from the corona to the perineum
  • remember hypo, low (lower side or underside)
408
Q

Epispadias

A

opening of the urethra on the dorsal (front) surface of the penis

409
Q

Priapism

A

painful erection lasting longer than 6 hrs

410
Q

Anticholinergic effects assessment

A
  • dry mouth - can’t spit
  • urinary retention - can’t piss
  • constipated - can’t s***
  • blurred vision - can’t see
411
Q

When see coffee brown emesis think

A

peptic ulcer

412
Q

Anytime see fluid retention think

A

heart problems first

413
Q

an answer that delays care or tx then

A

is always wrong

414
Q

For peripheral vascular disease …

A

legs dependent for arterial and veins elevated

415
Q

Never release traction unless

A

have an order form the MD to do so

416
Q

If a question is about a halo then

A

safety first have screwdriver close by!

417
Q

Compartment syndrome

A

emergency!

  • paresthesias and increased pain are classic symptoms
  • neuromuscular damage is irreversible 4-6 hrs after onset
418
Q

Infancy (0-18mo) behavior motivated by

A

others will satisfy needs

419
Q

Childhood behavior motivated by

A

learn to delay need gratification

420
Q

Juvenile (6-9) behavior motivated by

A

learn to relate to peers

421
Q

Preadolescence (9-12) behavior motivated by

A

learns to relate to friends of opposite sex

422
Q

Early adolescence (12-14) behavior motivated by

A

learn independence and how to relate to opposite sex

423
Q

Late adolescence (14-21) behavior motivated by

A

develop intimate relationship with person of opposite sex

424
Q

fetal alcohol syndrome s/s

A

upturned nose
flat nasal bridge
thin upper lip
small for gestational age

425
Q

IM admin site for 6 mo infants

A

vastus lateralis

426
Q

IM admin site for toddlers above 18 mo

A

ventrogluteal

427
Q

Im admin site for children

A

deltoid and gluteus maxims

428
Q

OU

A

both eyes

429
Q

OS

A

left eye

430
Q

OD

A

right eye (think dominant right eye)

431
Q

walking with a cane

A

(remember coal)

Cane Opposite Affected Leg

432
Q

Red injuries

A

Immediate: injuries are life threatening but survivable with minimal intervention
Ex. hemothorax, tension pneumothorax, unstable chest and abdominal wounds, INCOMPLETE amputations, OPEN fractures of long bones, 2nd/3rd degree burn with 15-40% of total body surface

433
Q

Green injuries

A

Minimal: injuries are minor and tx can be delayed to hrs or days, individuals should be moved away from teh main triage area
Ex. upper extremity fx, minor burns, sprains, small lacerations, behavior disorders

434
Q

Black injuries

A

Expectant: injuries are extensive and chances of survival are unlikely, separate but don’t abandoned, comfort measures if possible
Ex. unresponsive, spinal cord injuries, burns with 60% body surface area, seizures, profound shock with multiple injuries, no pulse, bp pupils fixe or dilated

435
Q

Thoracentesis prep

A
  • take VS
  • shave area around needle insertion
  • position pt with arms on pillow over bed table or lying on side
  • no more than 1000cc at one time
436
Q

Thoracentesis post -

A
  • listen for bilateral breath sounds
  • VS
  • check leakage
  • sterile dressing
437
Q

Before CT assess for

A

allergies

438
Q

Before MRI assess for

A

claustrophobia, no metal, assess pacemaker

439
Q

Cardiac cath prep

A
  • NPO 8-12 hrs
  • empty bladder
  • check pulses
  • tell pt may feel heart palpitations or desire to cough with dye injections
440
Q

Cardiac cath post

A
  • vital signs
  • keep leg straight
  • bedrest 6-8 hrs
441
Q

cerebral angio prep

A
  • well hydrated
  • lie flat
  • sire shave
  • pulses marked
442
Q

cerebral angio post -

A
  • keep flat 12-14 hrs
  • check site
  • check pulses
  • force fluids
443
Q

Lumbar puncture

A
  • fetal position
  • neuro assessment q15-30 mins until stable
  • flat 2-3 hr
  • encourage fluids
  • oral analgesics for headache
  • observe dressing
444
Q

Myelogram prep

A
  • NPO 4-6 hrs
  • allergy hx
  • phenothiazines, CNS depressants, and stimulants withheld 48 hrs prior
  • table will be moved to carious positions during test
445
Q

Myelogram post

A
  • assess neuro q2-4 hrs
  • water soluble HOB up, oil soluble HOB down
  • oral analgesics for h/a
  • encourage PO fluids
  • assess for distended bladder
  • inspect site
446
Q

liver biopsy prep

A
  • admin vitamin K
  • NPO 6 hrs
  • teach pt that will be asked to hold breath for 5-10 seconds
  • supine postion, lateral with upper arms elevated
447
Q

liver biopsy pot

A
  • position on right side
  • frequent VS
  • report severe abdominal pain stat!!
  • no heavy lifting 1 week
448
Q

Paracentesis prep

A
  • semi fowlers or upright edge of bed

- empty bladder

449
Q

Paracentesis pot

A
  • VS
  • report elevated temp
  • observe for signs of hypovolemia
450
Q

laparoscopy prep

A

CO2 used to enhance visual, general anesthesia foley

- post: walk pt to decrease CO2 build up for procedure

451
Q

pyelogram prep

A

assess for allergies

452
Q

Sengstaken Blakemore tube used

A

for tx of esophageal varices

- keep scissors at bedside!!

453
Q

TB key symptom

A

low grade afternoon fever

454
Q

pneumonia key symptom

A

rusty sputum

455
Q

Asthma key symptom

A

wheezing on expiration

456
Q

Emphysema key symptom

A

barrel chest

457
Q

Kawaski syndrome key symptom

A

strawberry tongue

458
Q

Pernicious anemia key symptom

A

red beefy tongue

459
Q

Down syndrome key symptom

A

protruding tongue

460
Q

Cholera key symptom

A

rice watery stool

461
Q

Malaria key symptom

A

stepladder like fever with chills

462
Q

Typhoid key symptom

A

rose spots in abdomen

463
Q

Diptheria key symptom

A

pseudo membrane formation

464
Q

Measles key symptom

A

koplik’s spots

465
Q

Lupus key symptom

A

butterfly rash

466
Q

Liver cirrhosis key symptom

A

spider like varices

467
Q

Leprosy key symptom

A

lioning face

468
Q

Bulimia key symptom

A

chipmunk face

469
Q

Appendicitis key symptom

A

rebound tenderness

470
Q

Dengue key symptom

A

petechiae or positive herman’s sign

471
Q

Menigitis key symptom

A 
Kernig's sign (leg flex then leg pain on extension)
Brudzinski sign (neck flex = lower leg flex)
472
Q

Tetany key symptom

A

hypocalemia;

Trousseau’s sign/carpopedal spasm; Chvostek sign (facial spams)

473
Q

Tetanus key symptom

A

rius sardonicus

474
Q

Pancreatitis key symptom

A

Cullen’s sign (ecchymosis of umbilicus); Grey turner’s spots

475
Q

Pyloric stenosis key symptom

A

olive like mass

476
Q

Patent ductus arteriosus key symptom

A

machine like murmur

477
Q

Addison’s disease key symptom

A

bronze like skin pigmentation

478
Q

Cushing’s syndrome key symptom

A

moon face appearance and buffalo hump

479
Q

Hyperthyroidism/Grave’s disease key symptom

A

exopthalmuse

480
Q

Intussusception key symptom

A

sausage shaped mass, Dance sign (empty portion of RLQ)

481
Q

MS key symptom

A

Charcot’s Triad (IAN)

hyperactive deep tendon reflexes, vision changes, fatigue and spasticity

482
Q

MG key symptom

A

Descending muscle weakness

483
Q

Gullain Barre key symptom

A

ascending muscle weakness

484
Q

DVT key symptom

A

Homan’s Sign

485
Q

Chicken pox key symptom

A

Vesicular Rash (central to distal) dew drop on rose petal

486
Q

Angina key symptom

A

crushing stubbing pain relieved by NTG

487
Q

MI key symptom

A

crushing stubbing pain which radiates to left shoulder, neck, arms, unrelieved by NTG

488
Q

LTB key symptom

A

inspiratory stridor

489
Q

TEF key symptoms

A

4Cs - coughing, choking, cyanosis, continuos drooling

490
Q

Epiglotitis key symptom

A

3Ds - drooling, dysphonia, dysphagia

491
Q

Hodgekin’s DSE/Lumphoma key symptom

A

painless, progressive enlargement of spleen & lymph tissues, Reedstenberg Cells

492
Q

Infectious Monoucleosis key symptoms

A

sore throat, cervical lymph, adenopathy, fever

493
Q

Parkinson’s key symptom

A

pill-rolling tremors

494
Q

Fibrin Hyalin key symptom

A

expiratory grunt

495
Q

Cystic fibrosis key symptom

A

salty skin

496
Q

DM key symptoms

A

polyuria, polydypsia, polyphagia

497
Q

DKA key symptom

A

Kussmauls breathing (deep rapid RR)

498
Q

Bladder Ca key symptom

A

Painless hematuria

499
Q

BPH key symptom

A

reduced size and force of urine

500
Q

Pemphigus Vulgaris key symptom

A

Nikolsky’s signs (separation of epidermis caused by rubbing of the skin)

501
Q

Retinal Detachment key symptom

A

visual floaters, flashes of light, curtain vision

502
Q

Glaucoma key symptom

A

painful vision loss, tunnel/gun barrel/ halo vision (peripheral vision loss)

503
Q

Cataract key symptom

A

painless vision loss, opacity of the lens, blurring of vision

504
Q

Acromegaly key symptom

A

coarse facial feature

505
Q

Duchenne’s Muscular Dystrophy key symptom

A

Gower/s sign (use of hands to push one’s self from the floor)

506
Q

GERD key symptom

A

Barretts esophagus (erosion of the lower portion of the esophageal mucosa)

507
Q

Hepatic Encephalopathy key symptom

A

flappy tremors

508
Q

Hydrocephalus key symptom

A

Bossing sign (prominent forehead)

509
Q

Increased ICP key symptoms

A

HYPERtension, BRADYpnea, BRADYcardia, (chushing’s triad)

510
Q

Shock key symptoms

A

HYPOtension, TACHYpnea, TACHYcardia

511
Q

Meniere’s Disease key symptom

A

Vertigo, Tinnitus

512
Q

Cystitis key symptom

A

Burning on urination

513
Q

Hypocalemia key symptoms

A

Chvostek & Trosseaus

514
Q

Ulcerative Colitis key symptom

A

recurrent bloddy diarrhea

515
Q

Lyme’s Disease key symptom

A

Bull’s eye rash

516
Q

otorrhea sign of what kind of fracture

A

basilar fracture

517
Q

orbital fracture s/s

A

battles sign and raccoon eyes

518
Q

Take iron elixir with

A

juice or water

NEVER with milk

519
Q

Kawaski’s leads to

A

cardiac problems

- coronary artery aneurysm r/t the inflammation of blood vessels

520
Q

Dilantin

A

10-20

521
Q

Theophyline

A

10-20

522
Q

Acetaminophen

A

10-20

523
Q

Lithium

A

0.5-1.5

524
Q

Digoxin

A

0.5-2.0

525
Q

Ostemyletitis

A

infectious bone disease

  • give blood cultures and antibiotics
  • if necessary surgery to drain abscess
526
Q

Nephrotic syndrome

A

characterized by massive PROTEINURIA (looks dark and frothy) caused by glomerular damage

  • s/s edema + hypotension
  • corticosteroids are mainstay
  • turn and reposition (risk for impaired skin integrity)
527
Q

To access role relationship pattern focus on

A

image and relationships with others

528
Q

Labs for renal impairment

A

elevated serum creatinine and decreased urine clearance

529
Q

normal serum creatinine

A

men 0.8-1.8

women 0.5-1.5

530
Q

Atropine Overdose

A

Hot as a hare (TEMP), mad as a hatter (LOC), red as a beet (FLUSHED FACE), dry as a bone (THIRSTY)

531
Q

normal hemoglobin neonates

A

18-27

532
Q

normal hemoglobin 3 mos

A

10.6-16.5

533
Q

normal hemoglobin 3 years

A

9.4-15.5

534
Q

normal hemoglobin 10 years

A

10.7-15.5

535
Q

glomerulonephritis

A
  • take vitals q4

- daily wts

536
Q

vaccines for age 4-5 years old

A

DPT/MMR/OPV

537
Q

cystic fibrosis tx

A
  • low fat diet, high sodium, fat soluble vitamins ADEK, aerosol bronchodilators, mucolytics, and pancreatic enzymes
538
Q

Zoloft s/e

A

agitation, sleep disturbance, and dry mouth

539
Q

Clozapine s/e

A

agranulocytosis, tachycardia, and siezures

540
Q

Blood tests for MI

A

Myoglobin, CK and Troponin

541
Q

salt substitutes may contain

A

potassium

542
Q

Placental abruptio

A

bleeding with pain

- don’t forget to monitor volume status (I&O)

543
Q

Meningeal irritation s/s

A

nuchal rigidity, positive Brudzinski + kernig signs, PHTOTPHOBIA

544
Q

Babinski sign

A

toes curl — GREAT!

toes fan — BAD!

545
Q

glucose tolerance test for pregnancy women

A

result of 140 or higher needs further evaluation

546
Q

Assessing extra ocular eye movements check cranial nerves

A

3,4, and 6

547
Q

dusky stoma means

A

poor blood supply

548
Q

protruding stoma means

A

prolapsed

549
Q

sharp pain and rigidity with stoma means

A

peritonitis

550
Q

mucus in ileal condult with stomas

A

is expected

551
Q

Dilantin s/e

A
  • rash (Stop med)

- gingival hyperplasia (good hygiene)

552
Q

Dilantin toxicity

A

poor gait and coordination, slurred speech, nausea, lethargy, and diplopia

553
Q

Phenobarbital vs. Dilatin during pregnancy

A

Phenobarbital can be taken during pregnancy but Dilatin is contraindicated

554
Q

Tension pneumothorax trachea

A

shifts to opposite side

555
Q

change in color is always

A

a late sign

556
Q

amininoglycocide s/e

A

(MYCIN) (except erythromycine)

- nephrotoxic to kidneys and ototoxic to ears

557
Q

MRSA precautions

A

contact only

558
Q

VRSA precautions

A

contact AND airborne (private room, door closed, negative pressure)

559
Q

lithium

A

L-level of therapeutic affect 0.5-1.5
I - indicate mania
T - toxic level is 2-3 - N/V, diarrhea, tremors
I - increased UO and dry mouth
U - uh oh - five mannitol and Diamox if toxic s/s are present
M - maintain Na intake of 2-3g

560
Q

Blood transfusion sign of allergies

A
  1. flank pain
  2. frequent swallowing
  3. rashes
  4. fever
  5. chills
561
Q

All psych meds (except Lithium) same side effects

A

decreased BP, Increased HR and RR (dilated bronchioles), dilated pupils (blurred vision), Decreased gut (urinary retention), GIT (constipation), constricted blood vessels, and dry mouth

562
Q

thrombocytopenia - bleeding precautions

A
  • soft bristled toothbrush
  • no insertion of anything (suppositories, douche)
  • no IM meds
563
Q

PO iron give with

A

vitamin C or on empty stomach

564
Q

pernicious anemia will take what for life

A

Vitamin B12

565
Q

Degree of burns

A

1st degree - red and painful
2nd degree - blisters
3rd degree - no pain because of blocked and burned nerves

566
Q

Meniere’s disease

A
  • admin diuretics to decrease endolymph in the cochlea, restrict Na, lay on affected ear when in bed
  • triad: vertigo, tinnitus, N/V
567
Q

gastric ulcer pain

A

occurs 30 mins to 90 mins after eating, not at night, and doesn’t go away with food

568
Q

What is an intraosseous infusion?

A

IN pediatric life threatening emergencies, when iv access cannot be obtained, an osseous (Bone) needle is hand drilled into a bone (usually the tibia), where crystalloids, colloids, blood products and drugs can be administered into the marrow

  • is temporary, life saving measure,
  • when venous access is achieved it can be dced
  • isoproterenol (beta agonist) only med that cannot be administered
569
Q

2 interventions during a sickle cell crisis

A

fluids and pain relief

570
Q

glomerulonephritis should consider what to be most important assessment

A

blood pressure

- dietary restrictions fluids, protein, sodium, and potassium

571
Q

congenital cardiac defects result in

A

hypoxia

  • labs that support - increased hamatocrit, hemoglobin, and rbc count
  • body tries to compensate for with influx of immatures rbcs
572
Q

if infant has low set ears assess

A

for renal anomalies

think kidney and ears are shaped the same

573
Q

school aged kids and surgery

A

kids 5 and up should have explanation of what will happen a week before surgery

574
Q

What to do if a toddler says no to medicine

A

leave and come back in five mins, don’t give a choice

575
Q

first sign of pyloric stenosis in a baby

A
  • mild vomiting that progresses to projecting vomiting

- later may be able to palpate a mass, the baby will seem hungry often, and may spit up after feedings

576
Q

a child with a ventriculoperitoneal shunt

A
  • will have small upper-abdominal incision - where shunt is guided into the abdominal cavity and tunneled under the skin up to the ventricles
  • watch for abdominal distention - since fluid from the ventricles will be redirected to the peritoneum
  • watch for signs of increasing ICP such as irritability, bulging fontanels, and hight pitched cry in infant; toddler watch lack of appetite and headache
577
Q

bed placement after child with ventriculoperitoneal shunt

A

FLAT!

  • so fluid doesn’t reduce too rapidly
  • if see s/s of increasing ICP then raise HOB 15-30 degrees
578
Q

What causes bronchopulmonary dysplasia?

A
  • dysplasia - abnormality or alteration
  • mechanical ventilation can cause it
  • premature newborns with immature lungs are ventilated and over time it damages the lungs
  • other causes could be infection, pneumonia, or other conditions that cause inflammation or scarring
579
Q

it is essential to maintain nasal patency with children

A

they are obligatory nasal breathers

580
Q

kids drinking 3-4 cups of milk each day

A

bad! too much milk reduces intake of other essential nutrients, especially iron
- watch for anemia with milkaholics!!

581
Q

what can go in kids bottles for naps/overnight

A

nothing but water!!

- juice or milk will rott teeth

582
Q

What traction is used in a school aged kid with a femur or tibial fracture with extensive skin damage?

A

99

- angles of the joints, pin is placed in the distal part of the broken bone, and the lower extremity is in a boot cast

583
Q

Bryant’s traction for kids

A

a kid’s hinder should clear the bed

584
Q

white patches from the mouth of a baby

A
  • if can remove then its just formula

- if cant remove then its candidiasis

585
Q

What vaccines come later

A

MMR and Varicella immunizations (15 mo)

586
Q

Cryptorchidism

A

undescended tesis

- risk factor for testicular cancer later in life

587
Q

teach boys testicular self exam starts when

A

12, because most cases of testicular cancer occur during adolescence

588
Q

Give what pain relief med to kids

A

Tylenol!!

- aspirin is associated with Reye’s syndrome - no NSAIDS (ibuprofen)

589
Q

CSF in meningitis will have

A

high protein and low glucose

590
Q

when thinking about child abuse

A

always correct to report suspected abuse

591
Q

No nasotracheal suctioning in kids with

A

with head injury or skull fracture

592
Q

feed babies upright to avoid

A

otitis media

593
Q

position kids how with GERD

A

prone with HOB elevated

- everyone else lay kid on his bac (Back to sleep - SIDS)

594
Q

when installing eardrops for kids

A

pull pinna down adn back

595
Q

kids with RSV and nurses

A

no contact lenses or pregnant nurses in rooms where ribavirin is being administered by hoot/tent

596
Q

ribavirin

A

for RSV

- no contact lenses or pregnant nurses in rooms where ribavirin is being administered by hoot/tent

597
Q

positioning with pneumonia for kids

A

lay on the affected side to splint and reduce pain

- if trying to reduce congestion the sick lung goes up (think stuffy nose side goes up and then it clears)

598
Q

a positive ppd confirms

A

infection, not just exposure

599
Q

a sputum test will confirm

A

active disease

600
Q

kids coughing withou other s/s is suggestive of

A

asthma

- know if wheezer stops wheezing could mean its worsening

601
Q

Before administering dig

A

DO VITALS

apical pulse for one full minute

602
Q

Tet spells treated with

A

morphine

603
Q

group a strep precedes

A

rheumatic fever

  • chorea is part of the sickness (grimacing, sudden body movements) embarrasses kids
  • they have joint pain
  • watch for elevated antistreptolysin O to be elevated
  • Penicillin!!
604
Q

Signs of CHF in infant

A

don’t pick cough over TACHYCARDIA

605
Q

tylenol poisoning

A

liver failure possible for about 4 days!

- close observation required during this time frame as well as tx with Mucomyst

606
Q

radioactive iodine

A
  • key word FLUSH
  • flush substance out of body w/ 3-4 liters/day for 2 days
  • flush the toilet twice after using for 2 days
  • limit contact w/ pt to 30 mins a day
  • no pregnant visitors and no kids
607
Q

main hypersensitivity reaction seen with anti platelet drugs

A

bronchospasm (anaphylaxis)

608
Q

common sites for metastasis

A

liver, brain, lung, bone, and lymph

609
Q

orthostatisis is verified by

A

a drop in pressure with increasing heart rate

610
Q

Bence jones protein in the urine confirms

A

multiple myeloma

611
Q

priority with small bowel obstruction

A

not reestablishing a normal bowel pattern

maintaining fluid balance!! comes first because the pt can’t take in oral fluids

612
Q

pernicious anemia s/s

A

pallor, tachycardia, and sore red tongue

613
Q

flecainide (Tambocor)

A

antiarrythmic

- limit fluids and sodium intake - because Na increases water retention which could lead to heart failure

614
Q

Basophils release histamine during

A

an allergic response

615
Q

adenosine

A

the tx of choice for paroxysmal atrial TACHYCARDIA

616
Q

Iatragenic means

A

caused by tx, procedure, or meds

617
Q

G-tube and J-tube

A

usually given as a continuous feeding

618
Q

If pt getting radiation be most concerned about?

A

not skin but infection because of the leukopenia caused by radiation

619
Q

breast cancer pt tx with tamoxifen should report

A

changes in visual acuity because adverse effect could be irreversible

620
Q

Pneumovax 23 gets administered

A

post splenectomy to prevent pneumoccal sepsis

621
Q

potassium normal value

A

3.5-5.0

622
Q

if pt on dig and lasix make sure

A

getting enough potassium because low potassium potentiates dig and can cause dysrhythmias

623
Q

ask every new admission if

A

they have an advanced directive

if not then explain it and ask if they want to sign it

624
Q

if someone is going through anaphylaxis then

A

implement before assess

- give epinephrine stat (especially if difficulty breathing, increasing anxiety )

625
Q

if disaster triage who last

A

the person who is most likely to not survive

626
Q

Potassium and alkalosis/acidosis

A

alKaLOsis - K is LOW

acidosis - k is high

627
Q

vital sign you should check first with high potassium is

A

pulse (due to dysrhythmias)

628
Q

Neostigmine

A
  • give to pts with myesthenia gravis about 45 mins before eating so it will help with chewing and swallowing
629
Q

Anectine

A

used for SHORT term neuromuscular blocking agent for procedures like intubation and ECT

630
Q

Norcuron

A

used for LONG term neuromuscular blocking agent for procedures like intubation and ECT

631
Q

parathyroid gland relies on

A

vitamin D to work

632
Q

Immediate intervention after a sucking stab wound

A

dress the wound and tape it on 3 sides which allows air to escape

  • do not use occlusive dressing - converts the wound from open pneumo to closed one, and a tension pneumothorax is a worse situation
  • after that then chest tube tray, labs, iv
633
Q

when is an occlusive dressing used

A

if chest tube is accidentally pulled out

634
Q

When see PE think

A

oxygen first!!

  • when O2 is deprived the body compensates by causing hyperventilation (resp alkalosis)
  • pt should not breathe into a paper bag)
  • if paO2 is well below 80 need OXYGEN
  • look at ABG values
635
Q

adverse reaction to oral hypoglycemics

A

rash

photosensitivity

636
Q

serum acetone and serum ketones ris in

A

DKA

- as treat the acidosis and dehydration expect the potassium to drop rapidly so be ready with potassium replacement

637
Q

fluids most important intervention with

A

HHNS as well as DKA

- with HHNS no ketosis, and no acidosis, potassium is low r/t diuresis

638
Q

Atropine blocks

A

acetylcholine

it reduces secretions

639
Q

Dantrium

A

for spasticity

may take WEEK to be effective

640
Q

Decreased acetycholine is r/t

A

senile dementia

641
Q

after removal of the pituitary gland must

A

watch for hypocortisolism and temporary diabetes insipidus

642
Q

position how after appendectomy

A

on right side with legs flexed

643
Q

Hirschsprung’s

A
  • diagnosed with rectal biopsy looking for absence of ganglionic cells
  • cardinal sign in infants is failure to pass meconium, later the classic ribbon like and foul smelling stools
644
Q

Intussusception

A
  • common in kids with CF
  • Obstruction may cause fecal emesis, currant jelly like stools (blood and mucus)
  • barium enema may be used to hydrostatically reduce the telescoping
645
Q

with omphalocele and gastroschisis

A

(herination of abdominal contents)

- dress with LOOSE SALINE DRESSING covered with plastic wrap, and keep eye on temp - kid can lose heat quickly

646
Q

After a hydrocele repair

A

provide ice bags and scrotal support

647
Q

No phenylalanine with a kid positive for

A

PKU (no meat, no diary, no aspartame)

648
Q

Never give potassium if

A

the pt is oliguric or anuric

649
Q

Most accurate when testing for ketones and glucose

A

second voided urine

650
Q

positive western blot in child

A
  • presence of HIV antibodies
  • indicates only the mother is infected
  • 2 or more positive p24 antigen test will confirm HIV in kids
651
Q

For HIV kids

A
  • avoid OPV and Varicella vaccinations (live) but give pneumococcal and influenza
  • MMR is avoided only if the kid is severely immunocompromised
  • parents should war gloves for care, not kiss kids on the mouth, and not share eating utensils
652
Q

Hypotension and vasoconstricting meds may alter the accuracy of

A

O2 sats

653
Q

What if the aspirate of NG tube is

A

give antacid

- aspirate should be checked at least every 12 hrs

654
Q

ambient air contains how much oxygen

A

(room air) 21% oxygen

655
Q

first sign of ARDS

A

increased respirations

- later dyspnea, retractions, air hunger, cyanosis

656
Q

normal pulmonary capillary wedge pressure (PCWP)

A

8-13

-18-20 hihg

657
Q

first sign of PE is

A

sudden chest pain followed by dyspnea and tachypnea

658
Q

with carbon dioxide narcosis expect

A

high potassium

  • hydrogen floods the cell forcing potassium out
  • carbon dioxide narcosis causes increased intracranial pressure
659
Q

pulmonary sarcoidosis leads to

A

right sided heart failure

660
Q

when pt going home with NG tube teach family

A

to irrigate with cola

661
Q

Digitalis

A

increases ventricular irritability

could convert a rhythm to vfib following cardioversion

662
Q

if normally lucid pt starts seeing bugs then you

A

should check respiratory status firs

  • 1st sign of hypoxia is restlessness, then agitation then delirium, hallucinations and coma
  • so check O2 sat and get abgs
663
Q

biggest concern with cold stress and the newborn is

A

respiratory distress

664
Q

ends with -ide

A

diuretic

665
Q

Lasix side effect

A

cause pt to lose hi appetite (anorexia) due to reduced potassium

666
Q

If water breaks and pt is at any minus station then

A

risk of prolapsed cord

667
Q

CPR 5 yr old

A

breathe once for every 5 compressions

668
Q

Cephalhematoma (caput succindianium)

A

resolves on its own in a few days

- type of edema that crosses the suture lines

669
Q

after g-tube placement

A

the stomach contents are drained by gravity for 24 hrs before it can be used for feedings

670
Q

during the acute stage stage of Hep-A what is required

A

gown and gloves

- convalescent stage no loner contagious

671
Q

low magnesium and high cretinine signals

A

renal failure

672
Q

highest priority with RA

A

pain

673
Q

if TB pt is unable/unwilling to comply with tx then

A

may need supervision (direct observation , TB is a public health risk

674
Q

Most important assessment with status epilepticus

A

LOC

675
Q

crackles suggest

A

pneumonia

- most likely to be accompanied by hypoxia - manifest as mental confusion

676
Q

can’t cough =

A

ineffective airway clearance

677
Q

Absence of menstruation leads to what in the anorexic

A

osteoporosis

678
Q

Toddlers need to express

A

autonomy (independence)

679
Q

a pt with low hemoglobin and/or hematocrit should be evaluated for

A

signs of bleeding (ie dark stools)

680
Q

What is given the night before IVP

A

a laxative in order to better visualize the organs

681
Q

a pt with liver cirrhosis and edema may do what to mobilize the edema

A

ambulate then sit with legs elevated

682
Q

Most important assessment with Addison’s

A

blood pressure - severe hypotension

683
Q

What is important thing to do with adrenal insufficiency

A

Managing stress because if the adrenal glands are stressed further it could result in Addisonian crisis

684
Q

After pain relief what is most important in pancreatitis

A

cough and deep breathe because of fluid pushing up in the diaphragm

685
Q

Depressed pts need what

A

safety over nutrition

686
Q

prolonged hypoxemia is a likely cause of what in a child

A

cardiac arrest

687
Q

Fluid volume overload and CHF can cause

A

a S3

688
Q

Coarctation of the aorta causes

A

increased blood flow and bounding pulses in the arms

689
Q

Depression often manifests itself in

A

somatic ways, such as psychomotor retardation, GI complaints, and pain

690
Q

newly diagnosed hypertension pt should have

A

BP assessed in BOTH arms

691
Q

the chief concern with CF

A

respiratory problems

692
Q

TB and positive PPD if area of induration is

A

> 5 in an immunocompromised pt
10 in a normal pt
15 in a pt who lives in area where TB is very rare

693
Q

ObA1c

A

test to assess how well blood sugars have been controlled over the past 90-120 days

  • 4-6 responds to blood sugar of 70-110
  • 7 is ideal for DM and corresponds to a blood sugar of 130
694
Q

BSA

A

considered the most accurate method for medication dosing with kids

695
Q

What side to put wheel chair on

A

parallel to the bed on the side of weakness

696
Q

If nurses discovers another nurse has made a mistake then

A

talk to her about it before going to management, if it persist then take it higher

697
Q

Sepsis and anaphylaxis

A

reduce circulating volume by way of increased capillary permeability , which leads to REDUCED PRELOAD (volume in the left ventricle at the end of diastole)

698
Q

amniotic fluid acidosis or alkaline

A

ALKALINE

  • turns nitrazine paper BLUE
  • urine and normal vaginal discharge are acidic and turn it pink!!
699
Q

Is gonorrhea reportable

A

yes gonorrhea is a reportable disease

700
Q

crutches and steps

A

up with the good and down with the bad

701
Q

While treating DKA bringing the glucose down too far and too fast can result in

A

increase intracranial pressure r/t water being pulled into the CSF

702
Q

vasopressin

A

“press in” - vasoconstricts

703
Q

what is common with the hypercalcemia caused hyperparathyroidism

A
  • polyuria
704
Q

water intoxication will be evidenced by

A

drowsiness and altered mental status in a pt with TUR syndrome, or as an adverse reaction to desmopressin (for diabetes insipidus)

705
Q

adveres reactions to Lugol solution

A

(for hyperthyroid)

- burins sensation in the mouth, and brassy tastes and should be reported to MD

706
Q

give synthroid

A

on empty stomach

707
Q

what may be needed for pt taking prednisone

A

extra insulin - steroids causes increased glucose

708
Q

nonfat milk will reduce reflex by

A

increasing lower esophageal sphincter pressure

709
Q

pts with GERD should lay

A

on LEFT side with HOB 30 degrees

710
Q

to prevent dumping syndrome

A

low fowlers during meals and limit fluids while eating

711
Q

in emphysema the stimulus is to

A

breathe low PO2, not increased PCO2

  • so don’t give a lot of O2
  • encourage pursed lip breathing to promote CO2 elimination
  • encourage 3000 ml/day of fluids
  • high fowlers and leaning forward
712
Q

theophylline causes

A

GI upset - give with food!!

h

713
Q

TB drugs are liver toxic

A
  • does the pt have hep B

- adverse reaction is peripheral neuropathy

NCLEX!!! (7 decks)

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