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NCLEX > Mark K Lectures 4-6 > Flashcards

Mark K Lectures 4-6 Flashcards

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1
Q

When would a patient use 2 point crutches?

A

Both legs are mildly bad

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2
Q

When would a pt use 3 point crutches?

A

One leg is bad, but can bear weight

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3
Q

When would a pt use 4 point crutches?

A

Both legs are very bad

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4
Q

How would a pt go up and down the stairs with crutches?

A

Up with good leg first
Down with bad leg first

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5
Q

Which side does a pt hold a cane?

A

On the strong side

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6
Q

What does it mean if a pt has neurosis?

A

They are not psychotic
They still have good insight and are reality based

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7
Q

What is a delusion?

A

False belief but cant be sensed

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8
Q

What is a hallucination?

A

Sensing something that isnt there

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9
Q

What is an illusion?

A

Misinterpretation of reality (sensory)

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10
Q

Which types of psychosis are functional?

A

Scitzophrenia
Scitzo-effective disorder
Major depression
Manic

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11
Q

How should you treat functional psychosis types?

A

They have the potential to learn reality so you teach them reality:
1st acknowledge their feeling
2nd present reality
3rd set limit (ex: that topic is off limits)
4th enforce limit (end convo if they don’t stop)

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12
Q

How should you treat a pt with dimensia?

A

Cannot learn reality so
1st acknowledge feeling
2nd redirect them (to something they can do)
But can do reality orientation (person, place, time)

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13
Q

What is delirium?

A

Temporary, sudden, dramatic, secondary loss of reality (usually due to chemical imbalance)

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14
Q

How should you treat a pt with delirium?

A

The focus is on removing the cause and keeping the pt safe
Communication:
1st acknowledge feeling
2nd reassure

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15
Q

What is flight of ideas?

A

Phrases don’t make sense together

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16
Q

What is neoglism?

A

Made up words

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17
Q

What is a narrowed self concept?

A

Functional psychotic won’t leave room or change clothes because it terrifies them (they don’t know who they are anymore)

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18
Q

What is ideas of reference?

A

They think everyone is talking about them

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19
Q

Main concepts about T2DM diet

A

Calorie restriction
6 small meals

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20
Q

When should you check glucose levels?

A

At the insulin’s peak

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21
Q

Which insulin can be given IV?

A

Regular insulin

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22
Q

Onset, peak, duration of regular insulin

A

Onset 1 hr
Peak 2 hr
Duration 4 hr

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23
Q

What type of insulin is regular insulin?

A

Short rapid acting

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24
Q

What type of insulin is NPH insulin?

A

Intermediate
(N = Not so fast & No IV)

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25
Q

Onset, peak, duration of NPH insulin

A

Onset 6 hr
Peak 8-10 hr
Duration 12 hr

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26
Q

What type of insulin is Lispro?

A

Fastest acting

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27
Q

Onset, peak, and duration of lispro insulin

A

Onset 15 min
Peak 30 min
Duration 3 hr

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28
Q

When should Lispro be given?

A

Give WITH meals (Not AC = before meal)

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29
Q

What type of insulin is Glargine?

A

Long acting

30
Q

Onset, peak, and duration of Glargine

A

Onset 2 hr
No peak
Duration 12-24 hr

31
Q

When should glargine be given?

A

No risk of hypoglycemia so can safely give at bedtime

32
Q

Pt teaching for insulin

A

Need to check expiration date - ok for 30 days after opened
Refrigeration of insulin in hospital not necessary, but pt should refrigerate at home
Exercise acts as extra insulin shot
Sick days: keep taking insulin as usually (glucose raises due to stress of illness)

33
Q

S/s of hypoglycemia

A

Pt acts drunk and in shock
(Staggering, emotionally liable, slurred speech, slowed judgement, low BP, tachycardia, tachypnea, cold and clammy)

34
Q

Treatment for hypoglycemia

A

If conscious: sugar/rapid carb AND starch or protein
If unconscious: glucagon IM or IV Dextrose (D10 or D50)

35
Q

Does DKA occur with T1 or T2 DM?

A

T1DM

36
Q

What is the number one cause of DKA?

A

Acute viral upper respiratory infection in last 2 weeks

37
Q

S/s of DKA

A

D = dehydrated
K = ketones (in blood), Kussmauls, high K (potassium)
A = acidosis, acetone breath (fruity), anorexia (r/t nausea)

38
Q

Treatment of DKA

A

IV fluids with regular insulin in it very rapidly

39
Q

Can T1 or T2 DM get HHNK/HHS

A

Only T2DM

40
Q

How should you treat HHNK?

A

Treat as dehydration
(2nd priority but more people die)

41
Q

A1C ranges

A

< or = to 6 is in control
> or = to 8 is out of control
7 is on the border so check for infection, tell to diet and exercise

42
Q

What is lithium used for?

A

Bipolar mania

43
Q

Therapeutic and toxic levels of lithium

A

Therapeutic: 0.6-1.2
Toxic: > or = 2

44
Q

What is digoxin used for?

A

Treats Afib and CHF

45
Q

Therapeutic and toxic levels for digoxin

A

Therapeutic: 1-2
Toxic: > or = 2

46
Q

What is Aminophylline used for?

A

Airway antispasmodic

47
Q

Therapeutic and toxic levels of Aminophylline

A

Therapeutic: 10-20
Toxic: > or = 20

48
Q

What is phenytoin used for?

A

Seizures

49
Q

Therapeutic and toxic levels of phenytoin

A

Therapeutic: 10-20
Toxic: > or = 20

50
Q

What is bilirubin?

A

Waste product from breakdown of RBCs (only worry about this level for newborns)

51
Q

Newborn elevated and toxic levels for bilirubin

A

Elevated range: 10-20
Toxic: > or = 20

52
Q

What is Kernicterus?

A

Bilirubin in brain (level around 20 is deadly)

53
Q

What is opisthotonic?

A

Hyperextension of body due to Kernicterus
Emergency

54
Q

What should you do for a pt who is opisthotonic?

A

Put pt on side

55
Q

Difference between pathologic and physiologic jaundice

A

Pathologic: baby born with jaundice = bad
Physiologic: not present at birth = normal

56
Q

What occurs with a hiatal hernia?

A

Regurgitation into esophagus because stomach is herniated into esophagus
(Stomach contents move in wrong direction at normal speed)

57
Q

What occurs with dumping syndrome?

A

Usually occurs after gastric surgery (gastric contents move in correct direction too quickly)

58
Q

S/s of hiatal hernia

A

GERD that occurs when lying down after eating ONLY

59
Q

Treatment of hiatal hernia

A

HOB high
Liquid with meals
High carb content

60
Q

S/s of dumping syndrome

A

Drunk symptoms (due to decreased blood flow to brain)
Shock symptoms
Acute abdominal distress (cramping, gurgling, diarrhea, borborigmy, etc.)

61
Q

Treatment of dumping syndrome

A

HOB flat (head to side)
Liquid between meals only
Low carb content

62
Q

What happens to the body with a potassium imbalance?

A

Kalemias do the same as the prefix except for HR and urine output

If symptoms are other than skeletal and muscular, pick kalemia

63
Q

What happens to the body with a calcium imbalance?

A

Calcemias do the opposite of the prefix
With more skeletal/muscular symptoms

64
Q

What happens in the body when magnesium imbalances?

A

Magnesium as do the opposite of the prefix

65
Q

What is a Trosseau sign and when does it occur?

A

Hand spasm with BP cuff
Low calcium

66
Q

What is chevostek sign and when does it occur?

A

Cheek spasm
Low calcium

67
Q

Symptoms of hypernatremia

A

Dehydration

68
Q

Symptoms of hyponatremia

A

Overload

69
Q

1st s/s of electrolyte imbalance

A

Paresthesia (esp. circumoral paresthesia)

70
Q

What is one symptom all electrolyte imbalances have?

A

Paresis (muscle weakness)

71
Q

Things to remember when treating hypokalemia

A

Never push IV
Never > 40 of potassium

72
Q

Treatment for hyperkalemia

A

Give D5W with regular insulin (to drive K into cell)
Polystyrene sulfonate (Kayexalate)

*both are given at the same time

NCLEX (4 decks)

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