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More Nclex Info Flashcards

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1
Q

Secondary prevention

A

Detect early to reduce impact-

tests, screenings exercise programs

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2
Q

Primary prevention

A

-prevent from getting

Education
Immunizations

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3
Q

Tertiary prevention

A

Improve quality of life after getting disease

Support groups
Rehabilitation

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4
Q

Cholinergic crisis

Med to give?

Also for bradycardia

A

Atropine

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5
Q

Decreases oxygen to areas of the body due to crescent shaped cells

A

Sickle cell anemia

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6
Q

Tx of sickle cell

Cure?

A

HHOP

Heat, hydration, oxygen, pain relief

Blood transfusions

Rest periods

No contact sports

Cure- bone marrow transplant

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7
Q

Vas occlusive crisis?

A

Severe pain- give fluids!!

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8
Q

Thicker than normal blood

Client at risk for MI , CVA, bleeding, abnormal platelets

A

Polycythemia

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9
Q

Determines b12 defiency blood disorder and how well your body absorbs it

A

Schillings test

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10
Q

Potassium foods- neural functioning

A

Potatos
Tomato’s
Oranges

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11
Q

Iron foods - oxygen to hemoglobin

A 
Cream of wheat 
Oatmeal 
Greens
Clams 
Chilli beans
Brown rice 
Dried apricots 
Tofu 
Seseme seeds
Lentils 
Red meat
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12
Q

Magnesium foods

A

Spinach

Legumes

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13
Q

Where is the mitral valve loudest at?

A

S1

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14
Q

Statins (Lipitor/atrovastatin)

How to take? What to monitor ?

A

Tx of high cholesterol

Take at HS

No grapefruit juice

Monitor liver enzymes

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15
Q

What is rhabdomyolysis

Linked to what med

Report what?

A

Muscle waisting

Linked with statins / report dark colored urine and muscle soreness

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16
Q 
Category 
A
B
C
D
X
A 
A-okay for fetus
B- be careful on using 
C- see doc before using 
D- do not use unless benefits outweigh risks 
X-x-Nay on use
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17
Q

Control 1 meds

Control 2

Control 3

A

Illegal drugs such as heroin, meth- only research

2- morphine, oxycodone, methadone, aderall, Ritalin

3- tramadol , Ativan, diazepam, xanax

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18
Q

Face mask- most precise airflow

Use what if can’t tolerate mask

A

Venturi mask

Nasal canula

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19
Q

Aminophylline (bronchodilator-copd our asthma) therapeutic range?

A

10-20

If out of range could cause increase pulse , decrease bp, shock, coma, death

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20
Q

First class tx for copd =Saba and laba

A

Aminophylline

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21
Q

Who should receive pneumonia vaccine

A

People 65 and up

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22
Q

Who to receive flu shot?

A

?

Not if sick

Not if allergic to egg protein

Baby 3 m and up?

Pregnant moms

Elderly

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23
Q

Who should not receive tetracycline?

A

Pregnant women/breast feeding, small kids

-damages bone development/teeth

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24
Q

Risks for pulmonary embolism

A

Three Fs

Fat
Femur
Football player

(Overweight, broken femur, male ages 18-25)

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25
Q

Cor pulmonale =?

A

Right heart failure

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26
Q

Rt vs left heart failure ?

A

Rt- dependant edema- legs, hands , distended jugular veins, ascities (big stomach), enlarged liver and spleen, may be due to left sided, anorexia/gi issues, weight gain

Lt- pulmonary congestion, wheezes, cough, crackles tachypnea, confusion, dyspnea, tachycardia, fatigue, cyanosis

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27
Q

Increased serum creatine means what

A

Rental issues

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28
Q

Children with persistent anemia may experience increased what

A

Otitis media (ear infection)

Respiratory infections

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29
Q

Ataxia

A

Involuntary movements / uncoordinated

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30
Q

How to give imferon (iron)

A

IM z track method

Oral iron- oj- no milk/dairy, straw , stool black

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31
Q

Buffers in body that regulate ph

Which is best?

A

Kidneys and lungs and chemical

-Chemical- first line of defense

Kidneys are slowest but most effective

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32
Q

Always check what lab before giving potassium

Give how

A

Rental function

IV pump controller - too rapid can cause heart arrhythmias

-IV give with IV fluids to prevent increase potassium and burning of vein

Never IV push

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33
Q

Early signs of hypoxia (decreased o2)

Late?

A

Tachycardia
Tachypnea

Late?
Cyanosis

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34
Q

S/s of dehydration vs fluid overload

A

Over load- confusion (low sodium/ diluted), loc change, seizures, pulmonary congestion, dependant edema (ble), anorexia, n/v, strong bounding pulse , jugular vein distention, increased BP, tachycardia ,s3

Dehydration- dry skin, dry/sticky mucus membrane , poor skin turgor , vomiting/loose stools, hypovolemia, weak but increased pulse rate , confusion, postural hypotension

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35
Q

Purpose of percussion and how to perform?

A

The purpose of percussion is to break up thick secretions in the lungs so they can more easily be removed.

Percussion is performed on each lung segment for one to two minutes at a time.

Upon rising, before meals and at HS -

Use cup hand method

Offer oral care after

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36
Q

Trousseaus sign

Chvosteks sign

A

Troussous- Bp cuff arm spasms

Chvosteks-Tap facial nerve c7 -twitch

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37
Q

Regulation of potassium is done primarily by which body organ

Check which lab before giving

A

Kidneys

Creatine

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38
Q

Keep water heaters at or below what temperature

A

120 degree f

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39
Q

Burn- blisters present - burn through all dermis layers epidermis and dermis

A

Superficial Partial thickness -2nd degree

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40
Q

Give what with burns

A

*Pain meds IV

Fluids IV

Oxygen

Cover site with sterile gauze

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41
Q

What to monitor with electrical burns

A

Cardiac status for 24 hours

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42
Q

Epidermis- red and no blisters

A

Superficial burn/ 1st degree

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43
Q

burns destroy the epidermis and dermis. They may go into the innermost layer of skin, the subcutaneous tissue.

The burn site may look white or blackened and charred.

May or may not be painless

A

Third-degree -deep partial thickness

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44
Q

burn additionally involves injury to deeper tissues, such as muscle, tendons, or bone.

The burn is often black and frequently leads to loss of the burned part

No feeling

A

A fourth-degree/full thickness

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45
Q

Which type of burn may result in myoglobinuria (burgundy dark urine output)

Tx?

A

Fourth degree /full

May need dyalisis to prevent renal failure

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46
Q

Emergency phase of burns

Intermediate phase

Last phase - rehabilitation phase

Lasts how long

A

Resuscitative 24-48 hr

Acute -48-72 hr

Rehabilitation- from closure of burn to level of optimal functioning

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47
Q

Dietary with burns ?

A

Increase calories to decrease shock/sepsis

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48
Q

Rule of 9s with burns

A

Legs- 18% (9 front and 9 back)

Arms 9% (4.5 front and 4.5 back)

Chest/stomach- 18%

Back-upper/lower= 18%

Perineum- 1%

Head 9% (4.5 each side)

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49
Q

What is soot?

A

Dusty smog coming from mouth - can mean lung damage

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50
Q

Parkland formula -

A

RL- 4ml x kg body weight x %

TBSA - infuse half amt over 8 hrs

Remaining over next 16 hours

From the time of burn - not time at ER

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51
Q

Lab to check with burn patients

A

Hemoglobin - May determine carbon dioxide poisoning

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52
Q

Pvd s/s?

A

Ankle swelling

Can elevate

Pain decreased with walking

Warm to touch

Brown/ruddy coloration

Edema

Pulse present; drainage

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53
Q

Pad s/s

A

Cool to touch

Top of feet and tip of toes

Claudication pain - with walking

Pallor with elevation

No pulse ; no edema

Hairless

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54
Q

1 g IV q 8 hr. 50mL bag of 5% over 30 min. Administer 15gtt/mL

How many drops per minute are required to properly administer this medication to the client

A

50mL x 15 gtt = 750 gtt in 30 min; 750 gtt divided by 30 min = 25 gtt/minutes

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55
Q

Priorities in burn patients

A

ABCs , blisters in mouth, soot around mouth/nose

Decreased cap refill

Abnormal bp

Decreased urine output-shock

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56
Q

Burns-

CHF failure may occur in burns if what organ systems do not return to normal?

What else to give?

A

Renal and heart function

Increased fluids

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57
Q

Avoid systemic antibiotics with burns unless needed

A

True

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58
Q

Types of skin grafts

Ones own skin-

Twin skin

Corpse skin

Pig skin

A

Auto graft

Isograft

Homograft

Xenograft

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59
Q

What type of skin graft are Jews ok with?

A

Xenograph -pig

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60
Q

Place clients ankles in what position for burn to BLE/ankles?

A

Dorsiflexion to decrease contractures

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61
Q

Baby should be able to follow an object visually by how old?

A

3 months

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62
Q

Gradual-Blurry, hazy, glare , discoloration vision

A

Cataracts

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63
Q

Increased IOP caused by decreased aqueous humor

Halos around lights, decreased peripheral vision?

-increased severe headache around eyes, pupil dilation

A

Glaucoma

Acute dilation

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64
Q

Normal IOP?

A

10-21

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65
Q

Avoid otc meds that increase IOP

Avoid what

A

Atropine = IOP

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66
Q

Which vision disorder decreases central vision

A

Macular degeneration

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67
Q

Painless , flashes of light/floaters

Place pt in what position

A

Retinal detachment

Place in prone position, facing opposite side down

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68
Q

What to do if you have metal fragments in eye

A

Don’t remove

No MRI

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69
Q

Otitis media (ear infection)- most common cause ?

A

Influenza - associated with mastoiditis

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70
Q

Hearing loss associated with dizziness, vertigo, decreased sodium and nicotinic acid

A

Ménière’s disease

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71
Q

Affects ability to hear high frequency sounds (T, S, th, ch, b, f, p, pa

Tx

A

Presbycusis

Dont raise voice , use lower tones

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72
Q

Ptosis

A

Droopy eyelid

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73
Q

Post tympanoplasty

Place client in what position

A

Flat; head turned to post op ear facing up

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74
Q

Breast cancer metastasis leads to?

Lung cancer metastasis-

A

Bone and brain

liver and brain

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75
Q

Cancer warning s/s?

A

CAUTION

C- change in bowel or bladder 
A- a sore throat that doesn’t heal 
I- uncontrolled bleeding 
T- thickening or lump in throat 
I- indigestion or hard to swallow 
O- obvious mole/wart changes 
N-nagging cough/hoarseness
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76
Q

TNM- tumor , node, mastitis

Way to stage tumors

T1= small tumor T2- T3 T4=large tumor

T4N1Mx =?

A

T4-large tumor

N1-Single node

Mx- unable to assess metastasis

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77
Q

Internal radiation precautions

Implant

A

Lead aprons

Dosimeters- have your own-patient doesn’t need

Lead shields

No pregnant women should care

Visitors 6 feet away

30 min at a time

No kids In room

Body fluids are not radioactive

Don’t remove markings

Avoid sun on area for 12 months after

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78
Q

N/v interventions

A

Give carbs in AM - before getting out of bed , zofran before and after chemo, ginger, oral care, repo slowly, room temperature food and drink, eat what want

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79
Q

If a chemo pt is often fatigued- how to intervene

A

Prioritize care

Give time to rest

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80
Q

Stages of labor

1-4

A

1- closed cervix to 10cm

2-deliver baby

3- deliver placenta

4- recovery period

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81
Q

Phases of labor 1-3

A

1- 0-3cm early labor
2- 4-7cm active labor
3- 8-10 cm transitional labor

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82
Q

Dystocia

A

Painful labor

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83
Q

Effacement

A

Thinning of cervix

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84
Q

The part of the fetus that shows first with delivery

A

Presentation

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85
Q

Who is the passenger in pregnancy

A

Baby

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86
Q

Position- LOA

A

Head pointed down to pelvis, head facing to moms back,

And angled to the left side

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87
Q

Determined by leopolds manuveour (feeling of stomach/fetus while in belly)

A

Lie

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88
Q

How far the baby is from coming out,

0 is at Ischial spines= push

A

Station

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89
Q

Push button when baby moves

Normal FHR?

A

Non stress test

Normal increased FHR of 15 bpm

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90
Q

Oxytocin/ Pitocin does what

Always use how?

A

Induces labor / stops bleeding 🩸

Use with pump controller

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91
Q

Prostaglandin?

A

Ripens or softens cervix

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92
Q

Veal chop -what each means and what to do?

V- variable (looks like a V or W)

E-early decelerations (Mirror contractions)

A-accelerations (okay)

L- late decelerations (contraction after peak)

A

Chop

C- cord compression: # 1 change position

H-head compression : decreased pulse- ready for delivery

O- okay 👌

P-placental insufficiency- turn to left side to increase perfusion, give oxygen-nonbreather, and stop oxytocin

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93
Q

With epidural - client education?

A

Lay flat for 8 hours after delivery and increase fluids

Headache may occur with CSF-
Tx-blood patch

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94
Q

Patient teaching/ interventions after epidural

A

Lay supine for 8 hr after delivery and increase fluids

A headache may occur with spinal fluid leak- tx blood patch

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95
Q

Post partum discharge

  • bright red for about 3 days- no more than 1 an hour? Inform doc
  • Serious and blood for 3 to 4 days
  • White discharge for several weeks
A

Lochia

Serosa

Alba

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96
Q

May not have a bm for how long after birth

A

1-3 days

Encourage walking, fluids, etc

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97
Q

What does APGAR stand for?

0-2

Zero absent - 1- weak but present- 2 present

A 
Appearance 
Pulse
Grimace 
Activity 
Respirations

10 perfect

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98
Q

Rh in compatibility

What test results will see?

Tx?

A

Mom-RH negative
Fetus rh positive

Blood between to do not mix until the third stage of labor/if they do mix it will destroy red blood cells/RBCs

Give rhogam As early as 20 weeks or post partum 48 to 72 hours

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99
Q

Baby with jaundice tx

A

Cover eyes- ensure they are closed under

Keep diper on - cover genitals

Do not apply lotions or creams

They can feed between

Watch for loose stools/ dehydration/rash

Turn q two hours

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100
Q

Mature lung sounds ratio =

A

2:1 ratio

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101
Q

Hyper somnolence

A

Sleepy

May be due to mag sulfate

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102
Q

Nursing interventions with hypotension with epidural

A

Increase IV normal Saline

Turn to side

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103
Q

Caput succedaneum

A

Edema that crosses suture line on scalp

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104
Q

Cephalohematoma

A

Blood that does not cross the suture line on head

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105
Q

Birth weight average

Doubles by

Triples by

A

7-9 pounds

6 months

A year

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106
Q

Average birth length

How fast do they grow per month

A

19 to 21 inches

1 inch per month for six months

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107
Q

Head circumference at birth

A

13-14 inches

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108
Q

Posterior fontanelle closes by?

A

Two months

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109
Q

Anterior fontanelle closes by when

A

18 months

Triangle shaped?

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110
Q

Moro reflex

A

Stretch arms out

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111
Q

Tonic neck reflex

A

Head side to side

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112
Q

Babinski reflex

A

Fanning toes

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113
Q

Stepping reflex

A

Bares weight

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114
Q

Rooting reflex

A

Stroke cheek - turns head to side and opens mouth

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115
Q

When are head and chest usually the same size

Which one is bigger at birth?

A

One year

Head is bigger at birth

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116
Q

Age baby can lift head and grasp and hold

A

1-3 m

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117
Q

Age baby can sit with support and lower incisors erupt

A

3-6m

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118
Q

When baby’s can start introducing new foods- every few days to a week apart

A

6months

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119
Q

Baby can sit with support, pull to stand, upper incisors erupt, say mama, crawl

A

9 months

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120
Q

Standing by self , turn book pages, 6-8 teeth erupt , blow kisses

A

12 months

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121
Q

Kick ball , wall up steps , build tower of 2-4 cubes , uses spoon , scribbles , uses push and pull toys , removes clothes , drink with cup

A

1 year- 18 months

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122
Q

Run, jump in place, throw ball overhead, knows 300 words

A

19-24 months

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123
Q

Balance on 1 foot, can ride a tricycle, potty trained, tiptoe, knows 900 words

A

2 to 3 years old

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124
Q

Can ride a tricycle

A

3 years

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125
Q

Can balance on 1 foot for five seconds, walk heel to toe, use scissors

A

4 years old

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126
Q

Skips and hops, catches ball, jump ropes, balances on feet, ties shoes, nose letters, copies shapes

A

5 years old

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127
Q

Eriksons theory

Learning to trust and to take care/feeding

Basic trust vs mistrust

Ages ?

A

0-1 year

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128
Q

Eriksons theory

Automony vs shame - Promote independence/potty train

Ages?

A

1-3 years

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129
Q

Eriksons

Initiative vs guilt - encourage decision making - explores things -

Ages?

A

3-6 years old

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130
Q

Eriksons

Industry vs inferiority - encourage questions and learning - school

Ages?

A

Ages 6-11

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131
Q

Identity versus role confusion/encouraged to be yourself/social relationships are important

Age?

A

12-18

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132
Q

Intimacy versus isolation/develop relationships

Age?

A

19-40

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133
Q

Generativity vs stagnation - work and parenthood are most important

Age?

A

40-65

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134
Q

Ego vs despair - reflection of life - need to feel sense of fulfillment

Ages?

A

Ages 65+

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135
Q

What to assess with cleft palate?

Tx? Why?

A

Assess mother/infant bonding and interaction

Lip repair should be done first to increase feeding of infant

Assess respiratory status of infant postoperatively

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136
Q

Multidisciplinary team for cleft palate

A

Pediatrician, plastic surgeon, nurse, orthodontist, speech therapist, language pathologist, social worker, otolaryngologists (ear and throat therapist)

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137
Q

Fever, bloody diarrhea, lethargic, emergent

A

Entercolitis

Don’t use tapwater, salt solutions, phosphate preps, can lead to water and Toxification if non-isotonic and dilute electrolytes

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138
Q

This is the most common Moscow skeletal disorder

A

DHD - hip dysplasia- and club foot

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139
Q

Foot in turned inward

Tx

A

Club foot

Cast as applied and isChanged weekly as well as the limb manipulated weekly For the first 6 to 12 weeks for 2 to 3 months then a brace is worn

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140
Q

What my increase Bilirubin indicate

A

Jaundice

Biliary atresia

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141
Q

Who is dhd most common in

How to correct/tx

A

Infants that use papcose boards (cradles)

Use pavlik harness in infant < 6m to prevent hip extension or adduction - wear for 3-6 months and check q 1-2 weeks for adjustments d/t rapid growth or vascular nerve damage may occur

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142
Q

Hot tubs may cause what in pregnancy

A

May cause neural tube defects -avoid

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143
Q

Spins bifida Nursing interventions post op

How soon to have surgery?

A

Prevent injury to/drying of sack/cover with sterile non-adherent dressing, moist and with normal Saline, change dressings every 2 to 4 hours,

Keep prone with hips flexed and low Trendelenburg to prevent nerve stretching,

usually surgery is within 24 to 72 hours of life to prevent infection

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144
Q

Signs and symptoms of meningitis in an infant

A

Increase temperature, poor feeding, High pitched cry, bulging fontanelles, Nausea and vomiting, headache, visual issues

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145
Q

Heart murmur with infants

When is it common to diagnose

A

All infants usually have increased heart rate and many have benign murmur for first few days of life which delays diagnosis of CHD/congenital heart defect

Usually diagnosed at several weeks old due to this

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146
Q

Early signs and symptoms of CHF in infant

A

Increased pulse with sleep,

sweating on scalp or head,

irritability,

fatigued,

respiratory distress,

and WT gain

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147
Q

Tetralogy of fallot

A

Heart defect with child

Please child and he just position, providing oxygen

TOF may cause embolism, seizures, loss of consciousness, anoxia, death

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148
Q

Test for PKU- what is pku

Tx-

S/s

A

your body can’t break down an amino acid called phenylalanine.

Amino acids help build protein in your body

Guthrie test- heel stick on side of heel to avoid nerve damage. Most reliable after 24 hours old with protein.

Tx- Decrease food high in protein, Artificial sweeteners/aspartame is avoided

S/s- Head banging, screaming, arm biting, psychotic behaviors, may result in brain damage

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149
Q

Galactosemia - what is it?

S/s

Tx

A

Genetic disorder were one can’t convert galactose to glucose

Signs and symptoms include vomiting weight loss, liver damage, spleen damage, jaundice, hypertension

Avoid meds that contain lactose such as bc and acid reflux pills

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150
Q

Acute otitis media sign and symptoms (ear infection) in child

Tx

What if child refuses to take schedule antibiotics regularly

A

Rubbing ear, turning head from side to side, due to shorter Estachian tubes in ear

Tx Antibiotics, acetaminophen, placement of tubes surgically placed

-May do single dose injection if a child refuses to take medication or parents fail to comply with oral therapy for 7 to 10 days

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151
Q

Tonsillectomy postop nursing interventions/assessment

A

Look for continual swallowing which means possible bleeding of surgical site

Occurs most likely 7 to 10 days after

Note for any loose teeth, provide ice collar, provide pain medication IV or rectal for the first 24 hours, provide ice chips, provide clear liquids

Avoid citrus foods, red orange or brown foods, avoid food with roof textures, avoid crowds

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152
Q

Laryngotracheobronchitis (croup) s/s

Tx

When to provide emergent care STAT

A

Restless, irritable, worse and brassica, inspiratory strider

Tx. Really babe high humidity with cool mist, increased fluids

Provide Immediate care with labored breaths, continuous straighter, intercostal retractions, or refusal of oral fluids

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153
Q

Acute epiglottis - sign

Who is the only one to assess the throat?

What to have available at bed side?

What vaccine at how old is given to prevent this?

A

Cherry red epiglottis

Only the doctor says it’s a throat because it can create an immediate airway obstruction,
therefore have tracheostomy or intubation set ready and available in case of needed support

Hib Vaccine is given at two months old to help prevent

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154
Q

How to treat Rsv /bronchiolitis

Who should not work with patients being treated for this? Why

A

Treat with cool mist vaporizer’s and ribavirin/virazole -Should be given within three days of infection

Pregnant workers should not work with these patients who use this medicationBecause it can cause birth defects and surgical mask do not provide filter ration

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155
Q

How to diagnose cystic fibrosis

S/s

Tx

A

Sweat test- It shows increase sodium and chloride levels

SignsInclude fatty /steatorrrhea stools, mucus, weight loss

Tx With antibiotics, increased carbohydrates, increase protein, Moderat fat, extra salt is allowed due to sweating out salt excessively, vitamins ADEK, aerosol treatment, percussion, postural drainage, pancreatic enzyme is based on age and stool consistency and given with a snack

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156
Q

Gastroenteritis- what is it

A

Diarrhea disease

Treatment includes increased hydration, Pedialyte, BRAT diet (Banana, rice, applesauce, toast) which is high in fiber, decreased sugars, clear liquids first then go to BR a T diet

Infants should receive 1/2 or full strength soy formula

May need potassium replacement if urinating

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157
Q

Olive shape mass in upper right abdomen

Tx

A

Pyloric stenosis

Pyloromytomy

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158
Q

Sausage shaped mass in abdomen and jelly like stools

May cause abdominal pain, bloody stools, irritability, lethargic, vomiting, diarrhea, constipation, fever, dehydration, shock

A

Intussusception

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159
Q

A disease where you cannot eat gluten which include grains of wheat, oats, barley, rye

A person may have abdominal distention, fatty stools, Development of small intestine lymphoma-serious issue

What May decreases chances of developing small intestine lymphoma

A

Celiac disease

Sticking to proper diet can decrease development of small intestine lymphoma which is a serious issue

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160
Q

Group A streptococcus infection

Affects skin, joints, brain, heart, mitral valve

Signs and symptoms include murmur, swollen joints, turkey red rash,

Tx

A

Rheumatic fever

Treatment is to ensure good dental hygiene as well as medication

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161
Q

Damage to heart, arteries and results in aneurysm

Signs may include Increased fever, not responding to antibiotics or antipyretics

A

Kawasaki disease

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162
Q

Best place to check for skin turgor in the elderly

A

Sternum

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163
Q

What food can decrease effectiveness of tetracycline?

A

Milk and dairy (yogurt)

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164
Q

Wound dehiscence

A

Wound closure -opens up

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165
Q

Wound evisceration

Nursing interventions?

A

Wound opens up and insides protrude out

-apply sterile moist 4x4 gauze and then notify dr.

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166
Q

Steatorrhea

A

Fatty feces

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167
Q

Normal level of amylase (turns start haha/glycogen into simple sugars)

Organ it affects?

High or low with pancreatis

A

200 or below

Affects pancrease

Usually High

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168
Q

Gluten free diet- no grains such as pasta , beer, bread , rye, barley, wheat (can have rice)

A

Celiac diet

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169
Q

What confirms a fracture dx

A

X-ray

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170
Q

Fracture with open skin surface- increases risk of infection and osteomyelitis

A

Compound fracture

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171
Q

Type a fraction used with hip fractures

5 to 10 pound weights from feet hanging off the end of the bed

A

Bucks traction

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172
Q

Type of traction that uses 15 to 30 pound weights and is maintained by using pins or wires inserted into bone

A

Skeletal traction

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173
Q

Maintained by using more than one force of pole to establish alignment

Type of traction

A

Balanced suspension

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174
Q

What are the five Ps of compartment syndrome

(Increased pressure and decreased circulation in certain compartments of the body and decreased perfusion t/o)

Tx?

A

Pain, pallor (pale), paresis, (weakness) paralysis, (unable to feel) pulselessness, Polar (cool)

  • watch for distal Pulselessness
  • tx fasciotony
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175
Q

Inflammatory arthritis due to uric acid

Foods to avoid?

Tx for acute

Tx for chronic

A

Gout

High in purine - Fish, beans, meat, oatmeal, peas, spinach, asparagus

Acute- colchicine

Chronic -allopurinol

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176
Q

What is Tophi- where does it often form on the body?

A

Growth of irate crystals

On outer ears,
joints, skin, cartilage, hands/knuckles

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177
Q

When should one not take fish oil

A

With anticoagulants

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178
Q

Device that helps increase circulation and range of motion of knee joint after knee replacement

It is usually placed at the foot of the bed away from reach of patient

A

CPM or continuous passive motion machine

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179
Q

Nursing interventions after amputation

A

Elevate the extremity for the first 24 to 48 hours, wrap extremity with figure 8 technique

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180
Q

Crutches patient education on how to use

A

Go up the stairs with good leg first and down the stairs with bad leg first

Up- good

Down-bad

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181
Q

Use of a cane- patient education

A

Hand grip level with trochanter (below hip)

Tip of cane to heel

Use gait belt with initiation of walker and cane

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182
Q

Fractured femur/long bone= risk of what

A

Fat embolism

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183
Q

Test used for carpel tunnel

A

Phalens maneuver

-flexing the wrist to 90 degrees for 1 minute

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184
Q

Tests used for meningitis

A

Kernig -having the person lie flat on the back, flex the thigh so that it is at a right angle to the trunk, and completely extend the leg at the knee joint back toward the head

Brudzinski-laying supine - push head upward- pain will result in flexing or picking up knees and hips

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185
Q

Anti-diuretic hormones ADH that comes from the posterior pituitary

A

Vasopressin - used for DI

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186
Q

Comes from the posterior pituitary aids in uterine contractions and mammary function (Milk production and sweat )

A

Oxytocin

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187
Q

Too much antidiuretic hormone

Which causes stomach pain, anorexia, n/v, seizures

Tx?

Check labs

A

SIADH

Tx- diuretics, fluid restriction, IV hypertonic solution (pulls fluid out of cell and into the blood) , daily weights , monitor sodium, give declomycin to replace electrolytes

Specific gravity - 1.010-1.030

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188
Q

HDL levels (good cholesterol )

LDL levels

Total cholesterol normal level

A

50 or above

LDL- less than 100

Less than. 200 or 125-200

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189
Q

Type of fat that can improve cholesterol

A

Unsaturated

Saturated=bad

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190
Q

How to change Celsius to Fahrenheit

A

1.8 * C degree
+ 32
=F degree

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191
Q

ABGs

Bicarb HC3- alkalosis
CO2- acidosis
Ph -

A

Bicarb HC3- 22-26
CO2- 35-45
Ph -7.35-7.45

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192
Q

If PH is normal what does that mean?

if co2 or HCO3 is in normal range ?

if CO2 or Hco3 is abnormal (far apart)?

A

Normal ph - fully compensated

Uncompensated if co2 or HCO3 is in normal range

Partially compensated if CO2 or Hco3 is abnormal (far apart)

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193
Q

If BP decreases after epidural - use STOP acronym

S
T
O
P

A

Stop the oxytocin

Turn client to left side

Oxygen to face

Push IV fluids

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194
Q

TORCHs

A

A syndrome that includes toxoplasmosis, rubella, cytomegalovirus, Herpes, and syphillis

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195
Q

Nucleus lost in egg d/t rapid cell growth. Cell growth

Don’t get pregnant for 6-12 months after because it could stimulate cancer cell growth

A

Hydatidiform mole

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196
Q

Signs of this include increased BP, Oliguria (low urine output) , blurry vision, edema, epigastric pain , HELLP syndrome (hemolysis, elevated liver enzymes , and low platelets = Large liver and bleeding

Tx?

A

Early delivery of the fetus if help syndrome, elevated hepatic enzymes

Managed by bedrest, decrease sodium, give me a museum sulfate which would decrease blood pressure

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197
Q

Complications of magnesium sulfate

A

Decrease urine output

Decrease BP

DTR decrease (deep tendon reflexes)

Apnea

Hot flashes

Check levels every 6 hours

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198
Q

Normal DTR

A

2 +

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199
Q

Tx for pregnant client with only HTN

A

Bed rest

And or meds

200
Q

Expelled umbilical cord with ruptured membranes

Tx?

A

Cord prolapse

Knee to chest position or trendelenburg position

Oxygen

IV fluids- NS/RL

C-section

201
Q

How to dx HIV

A

Western blot test

202
Q

How to dx chlamydia

A

Gram stain

203
Q

T4N1MX =

T4N1M0=

A

Large tumor (1-4)
Single node
Unable to asses mastasis

T4N1M0= same + no mastasis

204
Q

Drugs used for preterm labor?

A

Terbutaline (brethine) - can increase HR and BS

Magnesium sulfate-decreases Bp- May need cath For I &O

205
Q

Preterm labor is considered when?

What will you see on baby?

Tx?

A

Before 37 weeks

Decreased amt of lanugo (fine hair)

Increased heat loss

Undecended testes

Tx? Surfactant (helps keep the airway open- they may not have developed enough yet) and ventilation

206
Q

One with withdrawal from barbiturates should stop taking how? Why?

A

By tapering to avoid fatal seizure

207
Q

Opiods do what to the pupils

A

Constrict

208
Q

Stimulants or amphetamines do what to pupils

A

Dilate pupils

May have violent outbursts

209
Q

Disorder

have great difficulty following rules, respecting the rights of others, showing empathy, and behaving in a socially acceptable way.

Provide them with what

A

Conduct disorder

Provide rules

210
Q

Akathesia

A

Rocking back and forth

211
Q

Dystonia

A

Abnormal postures / movement/tremor

212
Q

Given for alcohol withdrawal

A

Tranxene (chlorazepate)

213
Q

Give for opiod withdrawals

A

Methadone

214
Q

Give for opioids and narcotic overdose

A

Narcan

215
Q

Give for tx of alcoholism

A

Antabuse (disulfiram)

216
Q

Presumptive signs of pregnancy

A

No period (Amenorrhea)

Breast sensitivity

Weight gain

Quickening

N/V

Polyuria

Fatigue

217
Q

Probable signs of pregnancy

A

Ballottement (pushing on stomach and hard fetus return)

Chadwicks sign - bluish coloration of cervix/vagina

Goodels sign- soft cervix

Hegars - soft cervix

Positive pregnancy test (increased hcg)

McDonald’s- increases uterine size

Mask of pregnancy - rash on face d/t hormones

218
Q

Positive s/s of pregnancy

A

Fetal heart tones

Leopolds maneuver

Ultrasound

219
Q

B9 =

When to take with pregnancy

A

Folic acid

6months-1year before pregnancy

220
Q

How much weight is ok to gain if not overweight

If overweight?

A

35 pounds

Over wt- 15-20 lbs

221
Q

When is amniocentesis usually performed

What is it ?

Educate pt to do what b4 procedure ?

A

20 weeks

Tests for development disorders

After 20 weeks- void before procedure

Do not void if before 20 weeks so that full bladder helps to push up the uterus in the abdomen

222
Q

Vaginal ultrasound pt education

A

Void before exam

223
Q

Abdominal ultra sound or education

A

Don’t void before exam

224
Q

Mental Disorder where everything is about the person, thinking you are superior to others, entitled to things and deserve special treatment.

They rationalize or blame others for being self-centered

A

Narcissistic

225
Q

Mental disorder where one doesn’t learn from mistakes, they have multiple or many violations with the law.

They are often cruel to animals and to people, start fires, running away from home, truancy, early substance abuse, breaking in entering. May be very charming, smooth talker, intelligent.

Do not feel remorse.

Use defense in denial when confronted

A

Antisocial personality disorder

226
Q

Mental disorder That often affects females who were sexually abused

They often have difficulty identifying their feelings

Splitting behavior-Often see people as either all good or all bad

This can lead to self mutilation and suicidal behavior

A

Borderline personality disorder

227
Q

Timid, withdrawn, hyper sensitive to criticism.

Avoid situations where they may be rejected.

Desire relationships and challenges.

They often lack self-confidence and seen as helpless.

Often do not speak up.

A

Avoidant

228
Q

The extreme need to be taken care of by others

Clingy, fear of separation from the perceived caretaker.

See self as inferior and incompetent

Often involved in abusive relationships

A

Dependent

229
Q

Perfectionist,Procrastinator, does good work but not very productive

A

Obsessive compulsive disorder

230
Q

Schizophrenia - positive vs negative signs of it

A

Positive- any thing added to personality (hallucinations, delusions, paranoia, abnormal movement, errors in thinking)

Negative- anything that takes away from personality- (lack of motivation, decrease in hygiene, withdrawn, unable to experience pleasure)

231
Q

What to monitor when starting 1st and second generation antipsychotics such as Thorazine (chlorpromazine) and clozaril (clozapine)

A

Fever or reactions

232
Q

What med to give to lower temp / mild reaction if occurs when starting 1st and second generation antipsychotics such as Thorazine (chlorpromazine) and clozaril (clozapine) ?

What to give for severe reactions

A
  • parlodel (bronociotine)

- severe- dantrium (dantrolene)

233
Q

Med that treats bipolar 1 (full manic episodes), acute mania , and severe depression

A

Lithium

234
Q

Lithium normal levels

How often to check levels

Toxicity s/s

Tx for toxicity

A

0.5-1.5- anything above may indicate toxicity

Check q 2-3 months in the AM

S/s- Weakness, confusion, ataxia, seizures, cardio respiratory changes, multiple organ failure

Tx- Gastric Lavage, treatment with urea, mannitol (decrease IOP), hemodialysis, aminophylline

235
Q

Don’t use SSRI with what other drugs? Why?

A

MAOIs

St. John’s Wort

Tryptophane

  • serotonin syndrome may occur
236
Q

S/s of serotonin syndrome

What to do?

A 
Agitation 
Confusion 
Hot 
Tremors
GI upset

D/c med ASAP

237
Q

Alcohol with drawl can start as soon as when till when?

Stage 1,2,3,4

A

6-8 hours to 3-5 days

Stage 1: 6 to 8 hours/anxiety, nausea vomiting, sad, headache, sweating

Stage 2: 8-12 hours- Confusion, tremors, hyper activity

Stage 3- 12-48 hours- increases Bp, sweaty, siezures

Stage 4- 3-5 days- increases pulse , delirium, hallucinations, death

238
Q

The withdrawal assessment that is used to assess the clients withdrawal status

A

CIWA (clinical institute withdrawal assessment)

239
Q

Patient education if taking Antabuse (disulfiram)

A

Avoid alcohol or it can cause sx such as headache, nausea and vomiting , increased pulse , angina, convulsions, cardio respiratory collapse and death

240
Q

A legal wrong against a person or their property

A

Tort

241
Q

The intent to mislead one in any form

A

Fraud

242
Q

Who determines the laws in each state

A

Nurse practice act

243
Q

Do not assign a nursing assistant to

calculate hourly I&O

take post-op vitals

care for unstable patient

A

True

244
Q

Cushings May suppress immune system due to what

A

Increased cortisone

245
Q

Who should be notified of serious or narcotic med errors

A

BON

246
Q

Digoxin levels

A

0.5-2.0

247
Q

Lithium levels

A

0.6-1.5

248
Q

Dilantin levels

A

10-20

249
Q

Aminophylline levels

A

10-20

250
Q

HR normal

A

80-100 bpm

251
Q

Normal HR of newborn

A

100-180

252
Q

Normal fetal HR

A

120-160

253
Q

Normal variability of fetal HR

A

6-10

254
Q

Normal respirations

A

12-20

255
Q

Newborn normal respirations

A

30-60

256
Q

Bp normal

A

110-120/

60-90

257
Q

normal temp

A

98.6 + or - one degree.

258
Q

Normal Coumadin-PT (protime)

A

11-13.8

259
Q

Normal Coumadin INR (international normalizing ratio)

A

2-3 or 3-4.5

260
Q

Antidote for Coumadin

A

Vitamin K

261
Q

Heparin aPTT levels

Platelets on heparin

A

30-40 seconds

1.5-2.5 x the control

262
Q

Heparin antidote

A

Protamine sulfate

263
Q

Amniotic fluid amt normal

A

500-1200mL

264
Q

Normal frequency of contractions

A

Every 2-5 minutes

265
Q

Normal duration of contractions

A

Less than 90 seconds

266
Q

Normal intensity of contractions-

A

Less than 100

267
Q

Normal Amt of post partem bleeding

A

500-1000mL

The average amount of blood loss after the birth of a single baby in vaginal delivery is about 500 ml (or about a half of a quart).

The average amount of blood loss for a cesarean birth is approximately 1,000 ml (or one quart)

268
Q

Anthrax tx

A

Antibiotics- cipro

269
Q

Tularemia tx

A

Gentamicin 10-14 days

270
Q

Smallpox tx

A

immune globulin IM

271
Q

Botulism tx

A

Anti-toxin

272
Q

Iron poisoning antidote

A

Deferoxamine

273
Q

Nuclear warefare-

EXTERNAL:

Contamination:

Incorporation:

A

No isolation or contamination

Immediate medical management

Internals -kidneys, bones, liver , thyroid took up the radioactive material

274
Q

Don’t assume one is angry if they are speaking loud or make no eye contact

A

True

275
Q

Religion- Believe in reincarnation and being cold after giving birth

A

Asians

276
Q

Religion -No meat on Fridays and priest is called at death

A

Christian ✝️

277
Q

Cremation is preferred in this religion

A

Mormon

278
Q

Priest is called for consultation before tx such as amputations of limbs may be refused.

Believe that prayers, rituals, and death is a cycle of life

A

Hindu

279
Q

Religion- kosher foods, pork is not allowed, don’t eat dairy and meat at the same meal

Fasting with Passover

Assess dehydration and constipation due to unleavened bread

Get circumcised on 8th day of life

Rabbi is called at death , body is washed , someone remains with body until burial

A

Judaism

280
Q

Religion - May refuse blood transfusions, surgery’s or tx

Prayer will save

A

Jehavah witness

281
Q

During lent - all animal products including dairy are forbidden

A

Russian Orthodox Church

282
Q

Restrict meats and do not eat beef

A

Chinese / buddhist

283
Q

Don’t eat most fruits

A

Japanese

284
Q

Don’t drink alcohol- May refuse cough syrup

Position facing homeland at death

A

Muslims/Arab

285
Q

Believes that the left hand is very dirty and used for toileting

Right hand is clean and used for eating and touching others

A

Islam ☪️

286
Q

Illegal wrongdoing such as carelessness with hot and cold packs, med error, failure to asses life threatening s/s

A

Malpractice

287
Q

Gardisil vaccine decreases chAnces of what std

Age to get

Caution with what allergy

A

HPV

Ages 11-12 - can get as early as 9 years old - 3 doses with in 6months

Caution with latex or yeast allergy

288
Q

Lab test to determine increased progression of cancer in prostate

Continued elevation require biopsy to assess cells

A

PSA

289
Q

Skin lesions abnormalties

A
b
C
D

A

Asymmetrical shape
Borders irregular
Color are multicolored
Diameter more than 5mm

290
Q

When to get Pap smear

A

Ages 21-65

Q 3years

291
Q

When to get colonoscopy

A

Ages 50- q 10 years

292
Q

When to get breast exams

Education

A

Q 3 years in 20s and 30s

No deodorant or powder b4 exam

Malignant areas are usually in upper areas

Biopsy for dx

293
Q

Radiation implant education

A

Visitors 30 minutes a day

Client emits radiation- bodily fluids are not radioactive

6 ft apart from pt

Don’t remove marks from radiologist

Avoid sun to areas of tx During and for 12 months after

294
Q

ALOPECIA

A

Hair loss

295
Q

What is required for TPN

  • if behind on feeding do what?
  • if infusion isn’t not available -do what for time being?
A

Central line and pump controller

Do not try to catch up and double dose

Hang D10W solution until obtaining TPN

296
Q

If air enters central line-do what?

A

Clamp catheter

Lt trendelenburg

Give oxygen

297
Q

How to D/C TPN

A

Taper off

298
Q

Severe adverse affect of transplantation patient?

A

Increased temperature (even 0.5 degrees)

299
Q

NSAIDs and steroids - give with what?

Steriod May increase what

A

Good

Bs

300
Q

Ulcers - Eat What foods

A

Fiber

301
Q

Gastric surgery : NG drainage post surgery 12-24 hours?

After 24 hours?

Education ?

A

Small but bright red

Dark

Do not irrigate or move NG tube after surgery

302
Q

Rapid emptying of food from stomach into jejunum

A

Dumping syndrome

303
Q

Prevent what with ileostomy patients

A

Skin breakdown

304
Q

No seeds, nuts, grains, bareum , enema is contraindicated

Increased fluids and fiber (fruits and veggies)

A

Diverticulitis

305
Q

Precancerous cells that may turn into esophageal cancer

A

Barrett’s esophagus

306
Q

Fecal oral route - of hepatitis

No long-term effect or chronic effect

A

Hep A

307
Q

Hepatitis transmitted by sex, IV drug users , HBV routine vaccination in children

Another is same but no vaccine

A

Hep B

Hep C

308
Q

Only ppl with hep B can get ?

A

Hep D

309
Q

What is restricted with end stage cirrhosis

Main causes?

A

Protein

(Liver failure) causes- hepatitis and alcohol

310
Q

Chloelithiasis risk factors ?

A

Gallstones -

Four Fs:

Fat
Forty
Female
Fertile

311
Q

Cdiff precautions

A

Private rooms

Soap and water

312
Q

Under cooked meat , with fetal matter

A

E-coli

313
Q

Raw eggs

Contaminated food and drinks for 8/24 hours

A

Salmonella

314
Q

Improperly canned fruits and veggies

A

Botulism

315
Q

Development of physical symptoms in response to emotional distress

A

Conversion reaction

316
Q

Failure to Regard an event or feeling

A

Denial

317
Q

Transfer of emotions to another other than the intended

A

Displacement

318
Q

Transferring of feelings to another

A

Projection

319
Q

Dismissal of one’s responsibility by placing faults on another

A

Rationalization

320
Q

Expression of feelings opposite to one’s true feelings

A

Reaction formation

321
Q

Return to previous state of security

A

Regression

322
Q

Forgetting unpleasant memories

A

Repression

323
Q

Channeling unacceptable behaviors into behaviors that are socially acceptable

A

Sublimation

324
Q

The conscience forgetting of undesirable memory

A

Suppression

325
Q

Bone marrow transplant diet ?

A

Cool and peel and wash all foods

No salad bars or foods grown from the ground , cultured foods

Neutropenic ?

326
Q

Celiac /gluten causes what

What can eat

What to avoid

A

Diarrhea

Rice, Buttermilk, meats, eggs, cheese, peanut butter, corn, corn bread, soy beans, potatoes, broth

Can’t- Malted milk, fatty meats, lunch meat, wheat, salmon, prunes, plums, rice, oats, barley, soups, thickened with gluten grains

327
Q

1 dram = ? Grains

A

60

328
Q

30 mL = ? Tbs or oz?

A

2 tbs

1oz

329
Q

5 mL = ? Tsp

A

1

330
Q

1 cup = ? Oz

A

8

331
Q

1kg= ? Lbs?

A

2.2

332
Q

1lb = ? Oz

A

16 oz

333
Q

1grain= ? Mg

A

60 mg

334
Q

Needles - info

A

Do not :

Recap
Bend
Break needles

Do:
Put in sharps container immediately

335
Q

HIV patient info - transmission?

Can be transmitted through:

Can not be transmitted through unless blood is present :

A

Do not breastfeed

Can be transmitted through: 
Breastmilk 
Spinal fluid
Semen/vaginal fluid/secretions
Blood
Amniotic fluid 
Can not be transmitted through unless blood is present :
Saliva (unless oral surgery) 
Feces 
Nasal secretions 
Vomit 
Sweat
Tears 
Urine
336
Q

Airborne Diseases?

Type of room?

PPE?

A

TB
Measles (rubella)
Chickenpox

Private room

HEPA or N95 mask

337
Q

Droplet precautions ?

Diseases ?

Can travel how many feet

A

Can travel 3 feet - door can be left open

Mask/face shield

Influenza 
Mumps 
Pertussis 
Rubella (German measles)
Diphtheria 
Pneumonia 
Scarlet fever
Streptococcal pharyngitis 
Meningitis
338
Q

Contact precautions

Diseases

Type of room

A

Gloves and gown

Leave same equipment in room to use each time

Use antimicrobial soap

Rsv
Scabies
MRSA
VRE

Private room

339
Q

Defense mechanisms

A

????

340
Q

What is the first indication of a neurological issue

A

Changes in LOC

341
Q

Posture that indicates brain stem dysfunction.

On back, hands to side and hands bent back and up facing head

A

Decerebrate

342
Q

is an abnormal posturing in which a person is stiff with bent arms, clenched fists, and legs held out straight.

The arms are bent in toward the body and the wrists and fingers are bent and held on the chest.

This type of posturing is a sign of severe damage in the brain.

A

Decorticate posture

343
Q

Tx of decorticate posturing

S/s ?

What can mask signs and symptoms and make assessments inaccurate?

A

Tx- increase ICP = mannitol , elevate HOB 30 degrees, diuretics, anticonvulsants, hydrate

Sx-Opposite of shock - increase temperature, low pulse, increased blood pressure

Pain medication can mask signs and symptoms which can make assessments inaccurate

344
Q

What scale to use with LOC/coma

Severe coma score?

Moderate coma?

Minor?

Normal?

A

Glasgow coma scale

Severe- 8 or below

Moderate- 9-12

Minor 13-14

Normal- 15 and up

345
Q

What increases ICP

A 
Coughing
Blowing nose 
Bending 
SneeZing 
BM
Valsalva maneuver (forceful breath)  
Sleeping flat
346
Q

Contraindicated meds for client with hemorrhagic stroke

A

Anticoagulants and thromolytics

347
Q

Primary cause of death in high level cord injuries

A

ARF

Acute respiratory failure

348
Q

Proper spinal cord alignment if important in cord injuries

What is needed to turn the client?

A

A doctors order

349
Q

Giuliani bare

A

Weakness / paralysis

350
Q

Normal ICP rating is less than what?

If higher than this what to do?

A

20

Notify doctor

351
Q

Carbidopa adverse effects

A

Spasmic eye winking

352
Q

Myasthenia gravis

A

Condition causing Weakness in muscles

353
Q

Gravida

Para

GTPAL

A
  • Number of pregnancies one has had
  • Number of births after 20 weeks

Gravidity (number of pregnancies including current),

Term (number of pregnancies carried to 37+ weeks),

Preterm (number of pregnancies carried between 20 and 37weeks ),

Abortion (number of losses prior to 20 weeks), and

Living (number of living children).

354
Q

Check for what in spinal cord injuries

A

Urine retention

355
Q

Epistaxis

A

Bleeding

356
Q

Homework sign and symptoms of increased ICP

A

Papilledema

357
Q

Sumatriptan can do what for someone with a migraine or angina

A

Make it worse because it is constrictive

358
Q

Psychiatric disorder/use cognitive behavioral methods to decrease anxiety

A

OCD

359
Q

Feelings of detachment, flashbacks, guilt, numb, blunt emotions, sleep disturbances, memory problems or concentration issues, anxiety, self-destructive, suicide attempts or drugs use

Clients who use meth cocaine for stimulants are more vulnerable to paranoia and psychosis

A

PTSD

360
Q

Acute versus delayed PSTD

A

Acute as within six months of event

Delayed is six months or more after the event

361
Q

Don’t know how you got somewhere, multiple personalities

A

Dissociative

362
Q

Appearance of physical symptoms when there is no psychological cause such as hypochondria and neurologic disorder

A

Somatic

363
Q

Personality disorder where one has controlled anger, suspicious, delusions

A

Paranoid

364
Q

Personality disorder or one is shy, withdrawn, distant (aloof), hermit, reality oriented but often daydreams

A

Schizoid

365
Q

Females are more common in this personality disorder

Seductive, immature, theatrical emotions

A

Historionic

366
Q

Most reliable glucose test

Nothing by mouth 12 AM the night before/day of test

Drink glucose drink and test blood glucose two hours later

Glucose should be less than 200

A diagnosis of diabetes is made if glucose is above 200

A

Glucose tolerance test

367
Q

Type of glucose test were normal glucose is 70 to 110

Diagnosis of diabetes if 140 or above

A

Fasting

368
Q

Ketonuria if BS is above what

A

240

Don’t exercise until decrease BS

369
Q

Best indicator of average blood glucose within the last 90 to 120 days

What equals noncompliance in diabetics in diet and medication/insulin regimen?

A

A1C Glucosylated and hemoglobin assays (HBA1c)

An increase of 7%

370
Q

Regular insulin peaks in how many minutes

A

90-120

371
Q

NPH (long acting) peaks when?

A

8-12 hours

372
Q

How to draw up insulin

A

Cloudy air, clear air , clear insulin , then cloudy insulin (NpH)

373
Q

What insulin should never be mixed together? It would decrease bs significantly

A

Lantus (insulin glargine) and levemir

374
Q

Hot and dry (skin dehydrated) sugar high

Increased BS

3 Ps - Polyphagia, polydipsia, and polyuria (hungry, thirsty, peeing)

A

High BS

375
Q

Cold and clammy need some candy, decreased blood sugar, irritability, confused, pale, weak

A

Low BS

376
Q

Decrease in blood sugar during the night around 2-3 am

Eat a snack at HS such as milk, peanut butter sandwich,

A

Somogyis effect

377
Q

Glucose test before meals

A

Dextrostix

378
Q

Med to help

Lower bs -May affect kidneys - eat with med and report urinary changes

A

Metformin

379
Q

Vitamin secreted by parathyroid

A

Vitamin D

380
Q

Acromegaly

A

Bone pain, enlarged limbs , tongue , etc

381
Q

Increased TSH levels

Decrease blood pressure and decreased pulse, decreased temperature/cool skin, tired, edema, hair loss, weight gain, thick skin

A

Hypothyroidism

382
Q

Increased pulse and blood pressure, tremors, sweaty, increased activity, insomnia, a fib, weight loss, bulging eyes, thyroid storm which is a medical emergency

A

Hyperthyroidism

383
Q

Where is the thyroid is located

A

Trachea

384
Q

Monitor what in thyroid storm

A

Larnyx swelling

Keep tracheostomy set up bedside and call doctor if changes in voice or stridor occurs

Keep head and neck as straight as possible and support neck when getting out of bed

385
Q

Decreased calcium and phosphorus in the blood

Give forteo

A

Hypoparathyroidism

386
Q

Increase calcium and phosphorus in the blood, ECG changes, increased urine output and stones, osteoporosis

A

Hyperparathyroidism

387
Q

Bronze like pigmentation of skin, decrease blood sugar, weight loss, thin hair, increased urination, depression, decrease blood pressure, weakness

A

Addison’s disease

388
Q

Buffalo hump, moon phase, hirsutism/facial hair , osteoporosis, increased bs , Extended belly, decreased potassium, decreased chloride, ruddy complexion, decreased eosinophils and lymphocytes,Increase blood pressure

A

Cushing’s disease

389
Q

Polyphagia

A

Increased hunger

390
Q

Severe decreased blood pressure, cyanosis, shock

A

Addisons crisis

391
Q

Polyuria

A

Increased urination

392
Q

Oliguria

A

Decreased urination

393
Q

Anuria

A

No urination

394
Q

Polydipsia

A

Increased thirst

395
Q

Increased bs contributes to what other issues in diabetes ?

A

Poor wound healing and insulin resistance

396
Q

Normal bs

A

70-110

397
Q

A balance test - Standing with feet together, eyes open, eyes closed

A

Romberg test

398
Q

Hypertension without known cause

A

Primary HTN

399
Q

High blood pressure due to contributing illnesses

A

Secondary HTN

400
Q

Tx of HTN

A

Diuretics

Beta blockers (lol)

Calcium ch blockers (ipine, zem , amil)

Ace inhibitors (pril, sartans)

401
Q

Pacemakers - education

A

Report hiccups

5 ft away from microwaves

Do not apply pressure to site

402
Q

Temporary lack of O2 to myocardium- pain relieved by nitro, aspirin

A

Angina pectoris

403
Q

Nitro - patient education

A

Nitro every 5 minutes, take to hospital if not relieved.

Patches - remove/shave/clip hair with cream and patches

Keep in dark bottle at room temp

Renew q 6 months

404
Q

What ecg to defibrillate?

A

V-fib

v-tach with no pulse

405
Q

Afib can lead to what?

Tx

A

CVA (heart attack)

Tx- anticoagulants to decrease clots

406
Q

What lab to check with anticoagulants

Therapeutic level ?

No specific time for what? What to check before giving ? If air in syringe?

A

PTT-normal 30-60 seconds

1.5 x- 2x control

Lovenox- best- check platelet count before, Do not expel air from syringe before giving it.

407
Q

Heparin antidote

A

Protamine sulfate

408
Q

Artificial valves for endocarditis

A

Porcine (pig) rejected by jewish

Bovine (cow) valve rejected by Hindu

409
Q

If scheduled to have dental work with pericarditis or endocarditis what may be given prior

A

Prophylactic antibiotics to prevent exacberation of condition

410
Q

INR normal range before tx of anticoagulants?

Normal

Range to observe for bleeding

A

Before- 1-2

Normal- 2-3

7 and up

411
Q

Vascular issues related to cold exposure

Wear mittens outside and don’t smoke

A

Raynaud’s disease

412
Q

Ballooning of artery

Rupture and bleeding risk

A

Aneurysm

413
Q

Aortic aneurysm pt education

A

Do not palpate abdomen

414
Q

Saturated fat good or bad?

Kind of food?

A

Bad= shrimp, beef, cheese

415
Q

Unsaturated good or bad?

Type of food

A

Good= turkey

416
Q

To absorb calcium you need what?

A

Vitamin D

417
Q

Take your calcium and magnesium separately. How?

A

Take your calcium with meals and your magnesium 1 hour before or 2 hours after meals.

usually) suggest taking magnesium at bed time. Also, the co factor to absorb magnesium is Vitamin B6.

Calcium constipates and magnesium -is cholinergic

418
Q

Is it okay to give diuretics and bp mess together such as ace inhibitors

A

Yes

419
Q

Best method for evaluating amount of peripheral edema ?

A

Measure extremity

420
Q

Best indicator for general edema

A

Daily weights

421
Q

Can be any type of sensory sensation before a seizure such as smell, seeing lights.

It is a signal that a seizure is about to occur

A

Aura

422
Q

Type of seizure that can last up to 5 minutes

A

Tonic clonic

423
Q

Tonic means what?

Clonic means what?

A

Tonic- stiffness

Clonic - jerking/twitching

424
Q

Type of seizure - blank stare, mouth twitching

A

Absence seizure

425
Q

Indicators of brain injury (CSF leakage)

A

Halo sign - blood stain that develops yellowish circle around it

Drainage that test positive for glucose

Infection risk - may need antibiotics/surgery/cleansing and debridement with skull fracture

426
Q

Strawberry tongue, cracked lips, increased platelets

Assess for CHF and MI

In child

A

Kawasaki disease

427
Q 
Abdominal pain 
Crying 
Shock 
Restless 
Decreased urinary output 
CHF
Increased pulse

Sx of what in infant ?

A

MI

428
Q

Tx of MI in infant

Ensure what before giving

A

IV GG (gamma globulin) and aspirin

Ensure IV patency before giving IV GG because extravasation can cause tissue damage

429
Q

Symptoms of aspirin toxicity

When to d/c it?

A

Tinnitus
Dizzy
HEADACHE
CONFUSIION

D/c if child is exposed to influenza or chickenpox.

430
Q

Position to test for scoliosis

A

Adams position- bend at waist and arms hang and asses curve of spine

431
Q

Loses ability to walk by 9-12 years old

Uses growers maneuver to stand errect (places hands on knees and moves hands and legs up until standing erect

Parent education

A

Muscular dystrophy

Encourage independence

432
Q

Leading cause of death in kids below 15 years old

A

Cancer

433
Q

renal cancer

To one side (unilateral)

Firm

Non tender

Encapsulated and responsive to chemotherapy

Do NOT palpate abdomen

A

Wilms tumor

434
Q

Leukemia tx

Sx

A

Cytotoxic drugs and bone marrow transplantation

Monitor platelets

Watch for increased bloody noses

435
Q

Cancer Most common in long bones (femur)

A

Osteogenic sarcoma

436
Q

What to do before giving antidote when a child ingests hazardous substances

A

Call poison control first

437
Q

Acid base imbalance -such as aspirin/salicylate overdose tx =

A

emesis , lavage , or charcoal

Sodium bicarbonate, diazepam, vitamin k, hemodialysis

438
Q

Acetaminophen overdose tx

Sx

4 hours later

A

IV acetylcysteine

Sx- increases plasma levels

4 hours later- liver damage /hepatoxicity

439
Q

Lead overdose tx

Houses from what year have lead

A

Cheltation therapy

1950

440
Q

Iron overdose tx

If severe

A

Emesis or gastric lavage

Chelation therapy with deforoxamine

441
Q

Clay colored stools and abdominal distention, dark urine, and enlarged liver , jaundice

condition in infants in which the bile ducts outside and inside the liver are scarred and blocked. Bile can’t flow into the intestine, so bile builds up in the liver and damages it. The damage leads to scarring, loss of liver tissue and function, and cirrhosis.

A

Biliary atresia

442
Q

Cystic fibrosis effects what in the body?

A

Exocrine glands (mucus secreting glands) of the body

443
Q

Toy appropriate for a 15 month old with a heart defect?

A

Shape sorter

444
Q

disease that can result from inadequately treated strep throat or scarlet fever. Group A

causes inflammation, especially of the heart, blood vessels, and joints.

A

Rheumatic Fever

445
Q

Nephrectomy

A

Remove kidney - d/t wilms tumor -prevents UTIs

446
Q

is a neurological disorder of childhood resulting from infection via Group A beta-hemolytic streptococcus (GABHS), the bacterium that causes rheumatic fever.

It is characterized by rapid, irregular, and aimless involuntary jerking movements of the arms and legs, trunk, and grimacing facial muscles, as well as rapidly changing mood

A

Sydenham chorea (SC)

447
Q

For one with c-spine immobilization - what to do before opening airway of suspected injury?

A

Jaw thrust maneuver

448
Q

What score on Glasgow coma scale do you need airway management

A

Less than 8

449
Q

a contusion resulting from the brain contacting the skull on the side opposite from where impact occurs.

Temporal and frontal areas of brain - result in injury

A

Contrecoup

450
Q

Avoid what meds with head injury?

Avoid what with skull fracture

A

Opiods - depresses CNS

NG tube - with skull fracture

451
Q

Multiple rib fractures, scapular fracture’s, and pulmonary contusion, unequal chest movement

A

Flail chest

452
Q

Cullens sign

A

Bruising or discoloration due to bleeding around umbilicus

453
Q

Turners sign

A

Bruising on flank into abdominal wall

454
Q

Fullness over right flank may mean what?

A

Spleen rupture

455
Q

Kehrs sign

A

Pain in left shoulder that may indicate ruptured spleen

456
Q

If one is sexual assaulted, want to educate the patient?

A

Do not shower, bathe, or change clothes.

Rape kit is used, swabs.

Specimens are evidence.

Photo should include and reference ruler and one without

457
Q

Never induce vomiting with one who has ingested what?

A

Corrosive or petroleum distillates

458
Q

Animal bites patient education

A

If the animal or snake is dead, you should bring it into the ER to help identify the species

459
Q

What medication is contradicted in snakebites For the first 6 to 8 hours Because they interfere with the anti-venin

A

Corticosteroids

460
Q

What to perform before giving anti-venin

A

Perform skin or eye test

461
Q

Antidote for acetaminophen overdose

A

Mucomyst (acetylcholine)

462
Q

Antidote for carbon monoxide poisoning

A

Oxygen

463
Q

Antidote for opioid or narcotic overdose?

A

Nalaxone

464
Q

Antidote for benzodiazepine overdose

A

Romazicon (flumazenil)

465
Q

Digoxin toxicity antidote

A

Digibind (digoxin immune fab)

466
Q

Cyanide overdose antidote

A

Amyl nitrate

467
Q

Poisonous bites antidote

A

Antivenin

468
Q

Nutrition for congestive heart failure

Food to avoid?

A

Eat lean meats, breads, starches, fruits, sweets, veggies, dairy, meat slow and cholesterol and fats

Avoid salty foods, canned foods, frozen meats, cheeses, eggs, organ meats, fried foods, alcohol

469
Q

IBS/IBD diet

Avoid?

A

Eat meats, brands, fruits, veggies, dairy

Avoid whole grains, legumes, nuts, veggies with skins, prune juice, stringy meats

470
Q

Full liquid diet’s-Require decreasing gastric mobility

Eat?

Avoid?

A

Eat milk, ice cream, soups, broth, pudding’s, custard’s, plain yogurt, strained meats, strained fruits and veggies, fruit and veggie juice, cereal gruel, butter, margarine, combos of clear liquids

Avoid all solid foods

471
Q

What consists of a lacovegetarian diet

Avoid what?

A

They do eat dairy products, such as milk, yogurt, and cheese. Protein, dairy products, peanut butter, legumes, soy analogues

Avoid animal products and eggs
do not eat meat, poultry, fish, or eggs.

472
Q

Lacto-ovo-vegetarians eat?

Avoid?

A

They do eat eggs and dairy products.

Avoid meat, poultry, or fish.

473
Q

Peptic ulcer or hiatal hernia diet

Avoid?

A

Eat meats, brands, starches, fruits, veggies, dairy products

Avoid alcohol, coffee, chocolate, black red pepper, chili powder, peppermint/spearmint, garlic, onions, cinnamon

474
Q

Renal transplant diet

Avoid?

A

Eat meats, dairy products, breads, starches, veggies, sweets

Avoid eggs, organ meats, fried or fatty foods, salty foods, dried foods, salt substitutes, fruits

475
Q

Mineral that promotes bone density found in dairy, seaweed, Almonds, sesame, spinach, okra, quinoa

A

Calcium

476
Q

Mineral that turns oxygen to hemoglobin

Foods include lentils, red meat, poultry, beans, leafy vegetables, sesame seeds, tofu

A

Iron

477
Q

Supports neural functioning

Found in foods such as tomatoes, potatoes, oranges

A

Potassium

478
Q

Generates energy and builds muscle found in foods such as legumes, nuts, greens, eggs, meat

A

Protein

479
Q

Eat small amounts of saturated fat is recommended by who

Food such as dairy, meat, coconut oil, chocolate

A

The CDC in American heart Association

480
Q

Combats blindness and promotes vision

Vitamin found in dairy, eggs, poultry, liver, fish

A

Vitamin A

481
Q

Cobalamin =

A

B12

482
Q

Riboflavin=

A

B2

483
Q

Biotin =

A

B7

484
Q

Niacin =

A

B3

485
Q

Vitamin that promotes cell metabolism

A

Vitamin b

486
Q

Vitamin promotes immune health
And needed for the growth and repair of tissues in all parts of your body

Found in foods such as fruits, veggies, orange juice, apple juice-most

A

Vitamin c

487
Q

Vitamin that promotes bone health which is found in liver, fish, daily sunlight

A

Vitamin d

488
Q

Vitamin that decreases anemia

Found in foods such as nuts, greens, sesame seeds

A

Vitamin E

489
Q

Vitamin that decreases bleeding produced by intestinal bacteria

Babies need this at birth so they do not bleed out

A

Vitamin K

490
Q

Mineral -enzymatic reaction catalyst

Food - Lamb, beef, liver

A

Zinc

491
Q

Normal BMI or body mass index

Underweight?

Overweight?

Obese?

A

Normal - 18.5-24.9

Under- less than 18.5

Over- 25-29.9

Obese- 30 and up

492
Q

Prevent neural defects in pregnancy found in foods such as legumes , Asparagus, eggs, leafy greens, citrus fruit, beets

A

Folic acid

493
Q

These prevent oxidation of other molecules found in fruits veggies, sesame seeds

A

Antioxidants

494
Q

Triggered by foods and or food additives, air particles, aspirin or NSAIDs

A

Asthma

495
Q

Chronic bronchitis, emphysema, asthma Are all considered what?

What type of mask is preferred

A

Copd

Venturi mask

496
Q

Hep B immunization allergy?

A

Bakers yeast

Nclex (5 decks)

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