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NCLEX > Mark K Lectures 7-9 > Flashcards

Mark K Lectures 7-9 Flashcards

1
Q

Treatments for hyperthyroidism and what to remember for each one

A
  • Radioactive iodine (private room for 1st 24 hrs, be very careful with urine)
  • PTU (puts thyroid under) (*watch WBC count)
  • Thyroidectomy (total or subtotal/partial) (*needs lifelong hormonal replacement, *At risk for thyroid storm, *emergency)
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2
Q

S/s of thyroid storm

A

Temp >105
Stroke level BP
Severe tachycardia
Psychotic delirium

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3
Q

Treatment for thyroid storm

A

Get O2 up (O2 mast at 10L/min)
Get temp down (ice, cooling blanket)

Pt will come out of it on their own (self-limiting)

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4
Q

Biggest concerns for 1st 12hrs post op partial and full thyroidectomy

A

1: airway

#2: hemorrhage

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5
Q

Biggest concerns for 12-48 hrs post op partial and full thyroidectomy

A

Total: tetany (low Calcium)
Partial: thyroid storm

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6
Q

Risk for 72 hrs after partial or full thyroidectomy

A

Infection

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7
Q

Another name for hypothyroidism

A

Myxedema

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8
Q

Treatment for hypothyroidism

A

Give thyroid hormone
Do not sedate (risk of myxedema coma)
Question NPO orders before surgery (*must give thyroid meds)

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9
Q

What is Addison’s disease?

A

Under secretion of adrenal cortex

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10
Q

S/s of addison’s disease

A

Hyperpigmented
Cannot adapt to stress (makes glucose and BP go down = risk of shock)

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11
Q

Treatment of addison’s disease

A

Glucocorticoids (ending in -sone)

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12
Q

What is Cushing’s syndrome?

A

Over secretion of Adrenal Cortex

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13
Q

S/s of Cushing’s syndrome

A

(Think of cushman)

Moon face
Hirsutism (hair growth)
Gynecomastia
Truncal obesity
Striae
Bruise easily
Losing potassium
Full of water
Buffalo hump
Too much glucose

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14
Q

Treatment for Cushing’s syndrome

A

Adrenalectomy
(Bilateral adrenalectomy = addison’s)

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15
Q

Key safety rules for children’s toys

A

No small parts for < 4
No metal toys if O2 in use
Beware of fomites (non-living object that harbors microorganisms)

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16
Q

Stage of 0-6 month old and best toy

A

Sensory motor
Musical mobile, soft and large toys

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17
Q

Stage and best toy for 6-9 months

A

Working on object permanence
Cover-uncover toy, hard and large toys

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18
Q

Stage and best toy for 9-12 mo old

A

Learning to speak, purposeful movements
Talking toys/books, build, sort, stack, make

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19
Q

Stage, type of play, and best toy for toddler (1-3 yrs)

A

Working on gross motor skills
Parallel play
Push/pull toys

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20
Q

Stage, type of play, and best toy for preschool (3-6 yrs)

A

Working on fine motor skills and balance
Cooperative play, pretend play
Tricycles, tumbling class

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21
Q

Stage, type of play, and best toy for school age (6-12)

A

Creative
Collective
Competitive
Enjoys collecting things

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22
Q

What is a laminectomy?

A

Removal of vertebral spinous processes to relieve nerve root compression

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23
Q

What should you assess after a pt has cervical spine surgery?

A

Diaphragm and arms (breathing and arm/hand function)

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24
Q

What should you assess after a pt has thoracic spine surgery?

A

Cough and bowels

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25
What should you assess after a pt has lumbar spine surgery?
Bladder and legs
26
Mobilization of patients after spinal surgery
Must logroll Do not dangle Do not sit for more than 30 min May walk, stand, and lie down without restriction
27
Main post op complication of concern after cervical spine surgery
Pneumonia (b/c not breathing well)
28
Main post op complication of concern for a pt after thoracic spine surgery
Pneumonia (b/c can’t cough) Ileus (b/c trouble with bowel)
29
Main post op complication of concern for a pt after lumbar spine surgery
Urinary retention Problems with legs
30
Discharge teaching for a pt post spinal surgery
For first 6 weeks: Do not sit for more than 30 min Lie flat and log roll No driving No lifting more than 5 lbs Permanent: Do not lift by bending at waist Cervical: no lifting above head No jerky movements (horseback riding, amusement park rides, etc.)
31
List of lab values what are the highest priorities
Potassium >6 PH in 6’s CO2 > or = 60 O2 < or = 60 Platelets <40,000
32
Treatment for potassium >6
Hold potassium Assess heart Prepare to administer sodium polystyrene sulfonate (kayexalate) Call provider
33
Treatment for pH in 6’s
Assess vitals (will be going way down) Call provider ASAP
34
Treatment for CO2 > or = 60
Assess respiratory status Prepare to intubate and ventilate Call respiratory therapy Call provider
35
Treatment of O2 < or = 60s
Assess respiratory status Prepare to intubate and ventilate Call respiratory therapy Call provider
36
List of next highest priorities
INR >4 Potassium <3.5 Hemoglobin <8 CO2 in 50’s SaO2 < or = 92 Abnormal sodium with change in LOC Total WBCs < 5,000 ANC <500 CD4 count <200 (AIDS)
37
Treatment for INR >4
Hold Coumadin Assess for bleeding Prepare to give vit k Call provider
38
Treatment for potassium <3.5
Assess heart Prepare to give potassium Call provider
39
Treatment for potassium between 5.4-5.9
Hold potassium Assess heart Prepare to give sodium polystyrene sulfonate and D5W and regular insulin Call provider
40
Treatment for hemoglobin <8
Assess for bleeding Prepare to administer blood Call provider
41
Treatment for CO2 in 50s
Assess respiratory status Have pt do pursed lip breathing (usually solves problem)
42
Treatment for SaO2 < or = 92
Assess respiratory status Give O2 (usually corrects problem)
43
Treatment for low WBC counts
Assess for s/s of infection Initiate neutropenic precautions
44
Main side effects of all psych drugs
Low BP Weight changes (usually weight gain)
45
What are phenothyazines?
1st gen antipsychotics
46
Ending for phenothyazines
All end in -zine
47
Actions of meds ending in -zine
(-zines for the Zaney) Major tranquilizers (Do not cure, just reduce symptoms) Large dose treats psychosis, small dose treats nausea
48
Side effects for -zine drugs
(A-G) A: anticholinergic (dry mouth) B: blurred vision C: constipation D: drowsiness E: EPS (extra pyramidal syndrome) F: photosensitivity G: aGranulocytosis (low WBC count)
49
Biggest nursing diagnosis for pt taking a -zine
Risk for injury b/c of side effects
50
Action of tricyclic antidepressants (NSSRIs)
Mood elevators to treat depression
51
Ways to remember tricyclic antidepressants and a couple of examples
Ending in -triptyline, -ine or -line Amitriptyline Imipramine
52
Side effects of tricyclic antidepressants
Tricycles have 5 things that make them go (3 wheels and 2 pedals) = 5 symptoms (A-E) A: anticholinergic (dry mouth) B: blurred vision C: constipation D: drowsiness E: Euphoria
53
Pt teaching for tricyclic antidepressants
Takes 2-4 weeks to start working
54
Actions of benzodiazepines
Anti-anxiety Minor tranquilizers (at Led Zeppelin, minors are on tranquilizers & Zefs and zines are tranquilizers) *Cannot take for >2-4 weeks
55
Side effects of benzodiazepines
(A-D) A: anticholinergic (dry mouth) B: blurred vision C: constipation D: drowsiness
56
Action of MAOIs
Antidepressants
57
Pt teaching for MAOIs
*Pt must avoid all foods with Tyramine
58
Examples of foods with tyramine in them
Fruits and veggies EXCEPT (salad BAR): bananas, avocados, raisins (or other dried fruit) No organ meat or processed meat No preserved meat No aged cheese or yogurt No alcohol No caffeine (chocolate, soy sauce) No OTC meds
59
Action of lithium
(Is an electrolyte) Decreases mania (bipolar) Stabilizes nerve cell actions (which changes its SE)
60
Side effects of lithium
(3 Ps) Peeing Pooping Paresthesia
61
Toxic effects of lithium
Tremors Metallic taste Severe diarrhea
62
Number 1 nursing intervention for lithium toxicity
Ample IV fluids Watch sodium level and for s/s of dehydration (Low sodium = lithium more toxic) (High sodium = lithium ineffective)
63
Example of SSRIs
Fluoxetine
64
Side effects of SSRIs
(A-E) (similar to NSSRIs) A: anticholinergic (dry mouth) B: blurred vision C: constipation D: drowsiness E: euphoria
65
Nursing considerations for SSRIs
Causes insomnia so give before noon Watch for suicidal ideation in adolescents and young adults only and only when dose is changed
66
What type of drug is haloperidol?
1st gen antipsychotic Very similar to Thorazine
67
Side effects of haloperidol
(A-G) A: anticholinergic (dry mouth) B: blurred vision C: constipation D: drowsiness E: EPS F: photosensitivity G: aGranulocytosis (low WBC count)
68
What is NMS?
Neuroleptic malignant syndrome From overdose Occurs in elderly and young white pts with schitz
69
How should you determine the difference between EPS and NMS?
Take pt’s temperature EPS is ok but NMS is deadly
70
What type of drug is Clozapine?
2nd gen atypical antipsychotic
71
Action of clozapine
Treats zaney Tranquilizer
72
Side effects of clozapine
Agranulocytosis
73
Nursing priority for pt taking clozapine
Monitor WBC
74
What is ziprasidone used for?
Schizophrenia Bipolar disorder
75
Side effect of ziprasidone
Prolongs QT interval Can cause sudden cardiac arrest
76
What type of drug is sertraline?
SSRI
77
Patient teaching for sertraline
Causes insomnia, but can give at bedtime Taking with certain other drugs increases toxicities (St. John’s wort causes serotonin syndrome, warfarin/Coumadin dose must be lowered - watch for increased bleeding)
78
S/s of serotonin syndrome
(SAD HEAD) Sweating Apprehension (impending sense of doom) Dizziness Headache

NCLEX (4 decks)

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