More Nclex Info Flashcards
1
Q
Secondary prevention
A
Detect early to reduce impact-
tests, screenings exercise programs
2
Q
Primary prevention
A
-prevent from getting
Education
Immunizations
3
Q
Tertiary prevention
A
Improve quality of life after getting disease
Support groups
Rehabilitation
4
Q
Cholinergic crisis
Med to give?
Also for bradycardia
A
Atropine
5
Q
Decreases oxygen to areas of the body due to crescent shaped cells
A
Sickle cell anemia
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
7
Q
Vas occlusive crisis?
A
Severe pain- give fluids!!
8
Q
Thicker than normal blood
Client at risk for MI , CVA, bleeding, abnormal platelets
A
Polycythemia
9
Q
Determines b12 defiency blood disorder and how well your body absorbs it
A
Schillings test
10
Q
Potassium foods- neural functioning
A
Potatos
Tomato’s
Oranges
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
12
Q
Magnesium foods
A
Spinach
Legumes
13
Q
Where is the mitral valve loudest at?
A
S1
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
15
Q
What is rhabdomyolysis
Linked to what med
Report what?
A
Muscle waisting
Linked with statins / report dark colored urine and muscle soreness
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
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
18
Q
Face mask- most precise airflow
Use what if can’t tolerate mask
A
Venturi mask
Nasal canula
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
20
Q
First class tx for copd =Saba and laba
A
Aminophylline
21
Q
Who should receive pneumonia vaccine
A
People 65 and up
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
23
Q
Who should not receive tetracycline?
A
Pregnant women/breast feeding, small kids
-damages bone development/teeth
24
Q
Risks for pulmonary embolism
A
Three Fs
Fat
Femur
Football player
(Overweight, broken femur, male ages 18-25)
25
Cor pulmonale =?
Right heart failure
26
Rt vs left heart failure ?
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
27
Increased serum creatine means what
Rental issues
28
Children with persistent anemia may experience increased what
Otitis media (ear infection)
Respiratory infections
29
Ataxia
Involuntary movements / uncoordinated
30
How to give imferon (iron)
IM z track method
Oral iron- oj- no milk/dairy, straw , stool black
31
Buffers in body that regulate ph
Which is best?
Kidneys and lungs and chemical
-Chemical- first line of defense
Kidneys are slowest but most effective
32
Always check what lab before giving potassium
Give how
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
33
Early signs of hypoxia (decreased o2)
Late?
Tachycardia
Tachypnea
Late?
Cyanosis
34
S/s of dehydration vs fluid overload
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
35
Purpose of percussion and how to perform?
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
36
Trousseaus sign
Chvosteks sign
Troussous- Bp cuff arm spasms
Chvosteks-Tap facial nerve c7 -twitch
37
Regulation of potassium is done primarily by which body organ
Check which lab before giving
Kidneys
Creatine
38
Keep water heaters at or below what temperature
120 degree f
39
Burn- blisters present - burn through all dermis layers epidermis and dermis
Superficial Partial thickness -2nd degree
40
Give what with burns
*Pain meds IV
Fluids IV
Oxygen
Cover site with sterile gauze
41
What to monitor with electrical burns
Cardiac status for 24 hours
42
Epidermis- red and no blisters
Superficial burn/ 1st degree
43
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
Third-degree -deep partial thickness
44
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 fourth-degree/full thickness
45
Which type of burn may result in myoglobinuria (burgundy dark urine output)
Tx?
Fourth degree /full
May need dyalisis to prevent renal failure
46
Emergency phase of burns
Intermediate phase
Last phase - rehabilitation phase
Lasts how long
Resuscitative 24-48 hr
Acute -48-72 hr
Rehabilitation- from closure of burn to level of optimal functioning
47
Dietary with burns ?
Increase calories to decrease shock/sepsis
48
Rule of 9s with burns
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)
49
What is soot?
Dusty smog coming from mouth - can mean lung damage
50
Parkland formula -
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
51
Lab to check with burn patients
Hemoglobin - May determine carbon dioxide poisoning
52
Pvd s/s?
Ankle swelling
Can elevate
Pain decreased with walking
Warm to touch
Brown/ruddy coloration
Edema
Pulse present; drainage
53
Pad s/s
Cool to touch
Top of feet and tip of toes
Claudication pain - with walking
Pallor with elevation
No pulse ; no edema
Hairless
54
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
50mL x 15 gtt = 750 gtt in 30 min; 750 gtt divided by 30 min = 25 gtt/minutes
55
Priorities in burn patients
ABCs , blisters in mouth, soot around mouth/nose
Decreased cap refill
Abnormal bp
Decreased urine output-shock
56
Burns-
CHF failure may occur in burns if what organ systems do not return to normal?
What else to give?
Renal and heart function
Increased fluids
57
Avoid systemic antibiotics with burns unless needed
True
58
Types of skin grafts
Ones own skin-
Twin skin
Corpse skin
Pig skin
Auto graft
Isograft
Homograft
Xenograft
59
What type of skin graft are Jews ok with?
Xenograph -pig
60
Place clients ankles in what position for burn to BLE/ankles?
Dorsiflexion to decrease contractures
61
Baby should be able to follow an object visually by how old?
3 months
62
Gradual-Blurry, hazy, glare , discoloration vision
Cataracts
63
Increased IOP caused by decreased aqueous humor
Halos around lights, decreased peripheral vision?
-increased severe headache around eyes, pupil dilation
Glaucoma
Acute dilation
64
Normal IOP?
10-21
65
Avoid otc meds that increase IOP
Avoid what
Atropine = IOP
66
Which vision disorder decreases central vision
Macular degeneration
67
Painless , flashes of light/floaters
Place pt in what position
Retinal detachment
Place in prone position, facing opposite side down
68
What to do if you have metal fragments in eye
Don’t remove
No MRI
69
Otitis media (ear infection)- most common cause ?
Influenza - associated with mastoiditis
70
Hearing loss associated with dizziness, vertigo, decreased sodium and nicotinic acid
Ménière’s disease
71
Affects ability to hear high frequency sounds (T, S, th, ch, b, f, p, pa
Tx
Presbycusis
Dont raise voice , use lower tones
72
Ptosis
Droopy eyelid
73
Post tympanoplasty
Place client in what position
Flat; head turned to post op ear facing up
74
Breast cancer metastasis leads to?
Lung cancer metastasis-
Bone and brain
liver and brain
75
Cancer warning s/s?
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
```
76
TNM- tumor , node, mastitis
Way to stage tumors
T1= small tumor T2- T3 T4=large tumor
T4N1Mx =?
T4-large tumor
N1-Single node
Mx- unable to assess metastasis
77
Internal radiation precautions
Implant
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
78
N/v interventions
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
79
If a chemo pt is often fatigued- how to intervene
Prioritize care
Give time to rest
80
Stages of labor
1-4
1- closed cervix to 10cm
2-deliver baby
3- deliver placenta
4- recovery period
81
Phases of labor 1-3
1- 0-3cm early labor
2- 4-7cm active labor
3- 8-10 cm transitional labor
82
Dystocia
Painful labor
83
Effacement
Thinning of cervix
84
The part of the fetus that shows first with delivery
Presentation
85
Who is the passenger in pregnancy
Baby
86
Position- LOA
Head pointed down to pelvis, head facing to moms back,
| And angled to the left side
87
Determined by leopolds manuveour (feeling of stomach/fetus while in belly)
Lie
88
How far the baby is from coming out,
0 is at Ischial spines= push
Station
89
Push button when baby moves
Normal FHR?
Non stress test
Normal increased FHR of 15 bpm
90
Oxytocin/ Pitocin does what
Always use how?
Induces labor / stops bleeding 🩸
Use with pump controller
91
Prostaglandin?
Ripens or softens cervix
92
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)
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
93
With epidural - client education?
Lay flat for 8 hours after delivery and increase fluids
Headache may occur with CSF-
Tx-blood patch
94
Patient teaching/ interventions after epidural
Lay supine for 8 hr after delivery and increase fluids
A headache may occur with spinal fluid leak- tx blood patch
95
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
Lochia
Serosa
Alba
96
May not have a bm for how long after birth
1-3 days
Encourage walking, fluids, etc
97
What does APGAR stand for?
0-2
Zero absent - 1- weak but present- 2 present
```
Appearance
Pulse
Grimace
Activity
Respirations
```
10 perfect
98
Rh in compatibility
What test results will see?
Tx?
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
99
Baby with jaundice tx
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
100
Mature lung sounds ratio =
2:1 ratio
101
Hyper somnolence
Sleepy
May be due to mag sulfate
102
Nursing interventions with hypotension with epidural
Increase IV normal Saline
Turn to side
103
Caput succedaneum
Edema that crosses suture line on scalp
104
Cephalohematoma
Blood that does not cross the suture line on head
105
Birth weight average
Doubles by
Triples by
7-9 pounds
6 months
A year
106
Average birth length
How fast do they grow per month
19 to 21 inches
1 inch per month for six months
107
Head circumference at birth
13-14 inches
108
Posterior fontanelle closes by?
Two months
109
Anterior fontanelle closes by when
18 months
Triangle shaped?
110
Moro reflex
Stretch arms out
111
Tonic neck reflex
Head side to side
112
Babinski reflex
Fanning toes
113
Stepping reflex
Bares weight
114
Rooting reflex
Stroke cheek - turns head to side and opens mouth
115
When are head and chest usually the same size
Which one is bigger at birth?
One year
Head is bigger at birth
116
Age baby can lift head and grasp and hold
1-3 m
117
Age baby can sit with support and lower incisors erupt
3-6m
118
When baby’s can start introducing new foods- every few days to a week apart
6months
119
Baby can sit with support, pull to stand, upper incisors erupt, say mama, crawl
9 months
120
Standing by self , turn book pages, 6-8 teeth erupt , blow kisses
12 months
121
Kick ball , wall up steps , build tower of 2-4 cubes , uses spoon , scribbles , uses push and pull toys , removes clothes , drink with cup
1 year- 18 months
122
Run, jump in place, throw ball overhead, knows 300 words
19-24 months
123
Balance on 1 foot, can ride a tricycle, potty trained, tiptoe, knows 900 words
2 to 3 years old
124
Can ride a tricycle
3 years
125
Can balance on 1 foot for five seconds, walk heel to toe, use scissors
4 years old
126
Skips and hops, catches ball, jump ropes, balances on feet, ties shoes, nose letters, copies shapes
5 years old
127
Eriksons theory
Learning to trust and to take care/feeding
Basic trust vs mistrust
Ages ?
0-1 year
128
Eriksons theory
Automony vs shame - Promote independence/potty train
Ages?
1-3 years
129
Eriksons
Initiative vs guilt - encourage decision making - explores things -
Ages?
3-6 years old
130
Eriksons
Industry vs inferiority - encourage questions and learning - school
Ages?
Ages 6-11
131
Identity versus role confusion/encouraged to be yourself/social relationships are important
Age?
12-18
132
Intimacy versus isolation/develop relationships
Age?
19-40
133
Generativity vs stagnation - work and parenthood are most important
Age?
40-65
134
Ego vs despair - reflection of life - need to feel sense of fulfillment
Ages?
Ages 65+
135
What to assess with cleft palate?
Tx? Why?
Assess mother/infant bonding and interaction
Lip repair should be done first to increase feeding of infant
Assess respiratory status of infant postoperatively
136
Multidisciplinary team for cleft palate
Pediatrician, plastic surgeon, nurse, orthodontist, speech therapist, language pathologist, social worker, otolaryngologists (ear and throat therapist)
137
Fever, bloody diarrhea, lethargic, emergent
Entercolitis
Don’t use tapwater, salt solutions, phosphate preps, can lead to water and Toxification if non-isotonic and dilute electrolytes
138
This is the most common Moscow skeletal disorder
DHD - hip dysplasia- and club foot
139
Foot in turned inward
Tx
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
140
What my increase Bilirubin indicate
Jaundice
Biliary atresia
141
Who is dhd most common in
How to correct/tx
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
142
Hot tubs may cause what in pregnancy
May cause neural tube defects -avoid
143
Spins bifida Nursing interventions post op
How soon to have surgery?
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
144
Signs and symptoms of meningitis in an infant
Increase temperature, poor feeding, High pitched cry, bulging fontanelles, Nausea and vomiting, headache, visual issues
145
Heart murmur with infants
When is it common to diagnose
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
146
Early signs and symptoms of CHF in infant
Increased pulse with sleep,
sweating on scalp or head,
irritability,
fatigued,
respiratory distress,
and WT gain
147
Tetralogy of fallot
Heart defect with child
Please child and he just position, providing oxygen
TOF may cause embolism, seizures, loss of consciousness, anoxia, death
148
Test for PKU- what is pku
Tx-
S/s
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
149
Galactosemia - what is it?
S/s
Tx
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
150
Acute otitis media sign and symptoms (ear infection) in child
Tx
What if child refuses to take schedule antibiotics regularly
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
151
Tonsillectomy postop nursing interventions/assessment
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
152
Laryngotracheobronchitis (croup) s/s
Tx
When to provide emergent care STAT
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
153
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?
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
154
How to treat Rsv /bronchiolitis
Who should not work with patients being treated for this? Why
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
155
How to diagnose cystic fibrosis
S/s
Tx
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
156
Gastroenteritis- what is it
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
157
Olive shape mass in upper right abdomen
Tx
Pyloric stenosis
Pyloromytomy
158
Sausage shaped mass in abdomen and jelly like stools
May cause abdominal pain, bloody stools, irritability, lethargic, vomiting, diarrhea, constipation, fever, dehydration, shock
Intussusception
159
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
Celiac disease
Sticking to proper diet can decrease development of small intestine lymphoma which is a serious issue
160
Group A streptococcus infection
Affects skin, joints, brain, heart, mitral valve
Signs and symptoms include murmur, swollen joints, turkey red rash,
Tx
Rheumatic fever
Treatment is to ensure good dental hygiene as well as medication
161
Damage to heart, arteries and results in aneurysm
Signs may include Increased fever, not responding to antibiotics or antipyretics
Kawasaki disease
162
Best place to check for skin turgor in the elderly
Sternum
163
What food can decrease effectiveness of tetracycline?
Milk and dairy (yogurt)
164
Wound dehiscence
Wound closure -opens up
165
Wound evisceration
Nursing interventions?
Wound opens up and insides protrude out
-apply sterile moist 4x4 gauze and then notify dr.
166
Steatorrhea
Fatty feces
167
Normal level of amylase (turns start haha/glycogen into simple sugars)
Organ it affects?
High or low with pancreatis
200 or below
Affects pancrease
Usually High
168
Gluten free diet- no grains such as pasta , beer, bread , rye, barley, wheat (can have rice)
Celiac diet
169
What confirms a fracture dx
X-ray
170
Fracture with open skin surface- increases risk of infection and osteomyelitis
Compound fracture
171
Type a fraction used with hip fractures
5 to 10 pound weights from feet hanging off the end of the bed
Bucks traction
172
Type of traction that uses 15 to 30 pound weights and is maintained by using pins or wires inserted into bone
Skeletal traction
173
Maintained by using more than one force of pole to establish alignment
Type of traction
Balanced suspension
174
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?
Pain, pallor (pale), paresis, (weakness) paralysis, (unable to feel) pulselessness, Polar (cool)
- watch for distal Pulselessness
- tx fasciotony
175
Inflammatory arthritis due to uric acid
Foods to avoid?
Tx for acute
Tx for chronic
Gout
High in purine - Fish, beans, meat, oatmeal, peas, spinach, asparagus
Acute- colchicine
Chronic -allopurinol
176
What is Tophi- where does it often form on the body?
Growth of irate crystals
*On outer ears*,
joints, skin, cartilage, hands/knuckles
177
When should one not take fish oil
With anticoagulants
178
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
CPM or continuous passive motion machine
179
Nursing interventions after amputation
Elevate the extremity for the first 24 to 48 hours, wrap extremity with figure 8 technique
180
Crutches patient education on how to use
Go up the stairs with good leg first and down the stairs with bad leg first
Up- good
Down-bad
181
Use of a cane- patient education
Hand grip level with trochanter (below hip)
Tip of cane to heel
Use gait belt with initiation of walker and cane
182
Fractured femur/long bone= risk of what
Fat embolism
183
Test used for carpel tunnel
Phalens maneuver
| -flexing the wrist to 90 degrees for 1 minute
184
Tests used for meningitis
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
185
Anti-diuretic hormones ADH that comes from the posterior pituitary
Vasopressin - used for DI
186
Comes from the posterior pituitary aids in uterine contractions and mammary function (Milk production and sweat )
Oxytocin
187
Too much antidiuretic hormone
Which causes stomach pain, anorexia, n/v, seizures
Tx?
Check labs
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
188
HDL levels (good cholesterol )
LDL levels
Total cholesterol normal level
50 or above
LDL- less than 100
Less than. 200 or 125-200
189
Type of fat that can improve cholesterol
Unsaturated
Saturated=bad
190
How to change Celsius to Fahrenheit
1.8 * C degree
+ 32
=F degree
191
ABGs
Bicarb HC3- alkalosis
CO2- acidosis
Ph -
Bicarb HC3- 22-26
CO2- 35-45
Ph -7.35-7.45
192
If PH is normal what does that mean?
if co2 or HCO3 is in normal range ?
if CO2 or Hco3 is abnormal (far apart)?
Normal ph - fully compensated
Uncompensated if co2 or HCO3 is in normal range
Partially compensated if CO2 or Hco3 is abnormal (far apart)
193
If BP decreases after epidural - use STOP acronym
S
T
O
P
Stop the oxytocin
Turn client to left side
Oxygen to face
Push IV fluids
194
TORCHs
A syndrome that includes toxoplasmosis, rubella, cytomegalovirus, Herpes, and syphillis
195
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
Hydatidiform mole
196
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?
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
197
Complications of magnesium sulfate
Decrease urine output
Decrease BP
DTR decrease (deep tendon reflexes)
Apnea
Hot flashes
Check levels every 6 hours
198
Normal DTR
2 +
199
Tx for pregnant client with only HTN
Bed rest
And or meds
200
Expelled umbilical cord with ruptured membranes
Tx?
Cord prolapse
Knee to chest position or trendelenburg position
Oxygen
IV fluids- NS/RL
C-section
201
How to dx HIV
Western blot test
202
How to dx chlamydia
Gram stain
203
T4N1MX =
T4N1M0=
Large tumor (1-4)
Single node
Unable to asses mastasis
T4N1M0= same + no mastasis
204
Drugs used for preterm labor?
Terbutaline (brethine) - can increase HR and BS
Magnesium sulfate-decreases Bp- May need cath For I &O
205
Preterm labor is considered when?
What will you see on baby?
Tx?
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
One with withdrawal from barbiturates should stop taking how? Why?
By tapering to avoid fatal seizure
207
Opiods do what to the pupils
Constrict
208
Stimulants or amphetamines do what to pupils
Dilate pupils
May have violent outbursts
209
Disorder
have great difficulty following rules, respecting the rights of others, showing empathy, and behaving in a socially acceptable way.
Provide them with what
Conduct disorder
Provide rules
210
Akathesia
Rocking back and forth
211
Dystonia
Abnormal postures / movement/tremor
212
Given for alcohol withdrawal
Tranxene (chlorazepate)
213
Give for opiod withdrawals
Methadone
214
Give for opioids and narcotic overdose
Narcan
215
Give for tx of alcoholism
Antabuse (disulfiram)
216
Presumptive signs of pregnancy
No period (Amenorrhea)
Breast sensitivity
Weight gain
Quickening
N/V
Polyuria
Fatigue
217
Probable signs of pregnancy
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
Positive s/s of pregnancy
Fetal heart tones
Leopolds maneuver
Ultrasound
219
B9 =
When to take with pregnancy
Folic acid
6months-1year before pregnancy
220
How much weight is ok to gain if not overweight
If overweight?
35 pounds
Over wt- 15-20 lbs
221
When is amniocentesis usually performed
What is it ?
Educate pt to do what b4 procedure ?
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
Vaginal ultrasound pt education
Void before exam
223
Abdominal ultra sound or education
Don’t void before exam
224
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
Narcissistic
225
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
Antisocial personality disorder
226
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
Borderline personality disorder
227
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.
Avoidant
228
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
Dependent
229
Perfectionist,Procrastinator, does good work but not very productive
Obsessive compulsive disorder
230
Schizophrenia - positive vs negative signs of it
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
What to monitor when starting 1st and second generation antipsychotics such as Thorazine (chlorpromazine) and clozaril (clozapine)
Fever or reactions
232
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
- parlodel (bronociotine)
| - severe- dantrium (dantrolene)
233
Med that treats bipolar 1 (full manic episodes), acute mania , and severe depression
Lithium
234
Lithium normal levels
How often to check levels
Toxicity s/s
Tx for toxicity
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
Don’t use SSRI with what other drugs? Why?
MAOIs
St. John’s Wort
Tryptophane
- serotonin syndrome may occur
236
S/s of serotonin syndrome
What to do?
```
Agitation
Confusion
Hot
Tremors
GI upset
```
D/c med ASAP
237
Alcohol with drawl can start as soon as when till when?
Stage 1,2,3,4
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
The withdrawal assessment that is used to assess the clients withdrawal status
CIWA (clinical institute withdrawal assessment)
239
Patient education if taking Antabuse (disulfiram)
Avoid alcohol or it can cause sx such as headache, nausea and vomiting , increased pulse , angina, convulsions, cardio respiratory collapse and death
240
A legal wrong against a person or their property
Tort
241
The intent to mislead one in any form
Fraud
242
Who determines the laws in each state
Nurse practice act
243
Do not assign a nursing assistant to
calculate hourly I&O
take post-op vitals
care for unstable patient
True
244
Cushings May suppress immune system due to what
Increased cortisone
245
Who should be notified of serious or narcotic med errors
BON
246
Digoxin levels
0.5-2.0
247
Lithium levels
0.6-1.5
248
Dilantin levels
10-20
249
Aminophylline levels
10-20
250
HR normal
80-100 bpm
251
Normal HR of newborn
100-180
252
Normal fetal HR
120-160
253
Normal variability of fetal HR
6-10
254
Normal respirations
12-20
255
Newborn normal respirations
30-60
256
Bp normal
110-120/
60-90
257
normal temp
98.6 + or - one degree.
258
Normal Coumadin-PT (protime)
11-13.8
259
Normal Coumadin INR (international normalizing ratio)
2-3 or 3-4.5
260
Antidote for Coumadin
Vitamin K
261
Heparin aPTT levels
Platelets on heparin
30-40 seconds
1.5-2.5 x the control
262
Heparin antidote
Protamine sulfate
263
Amniotic fluid amt normal
500-1200mL
264
Normal frequency of contractions
Every 2-5 minutes
265
Normal duration of contractions
Less than 90 seconds
266
Normal intensity of contractions-
Less than 100
267
Normal Amt of post partem bleeding
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
Anthrax tx
Antibiotics- cipro
269
Tularemia tx
Gentamicin 10-14 days
270
Smallpox tx
immune globulin IM
271
Botulism tx
Anti-toxin
272
Iron poisoning antidote
Deferoxamine
273
Nuclear warefare-
EXTERNAL:
Contamination:
Incorporation:
No isolation or contamination
Immediate medical management
Internals -kidneys, bones, liver , thyroid took up the radioactive material
274
Don’t assume one is angry if they are speaking loud or make no eye contact
True
275
Religion- Believe in reincarnation and being cold after giving birth
Asians
276
Religion -No meat on Fridays and priest is called at death
Christian ✝️
277
Cremation is preferred in this religion
Mormon
278
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
Hindu
279
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
Judaism
280
Religion - May refuse blood transfusions, surgery’s or tx
Prayer will save
Jehavah witness
281
During lent - all animal products including dairy are forbidden
Russian Orthodox Church
282
Restrict meats and do not eat beef
Chinese / buddhist
283
Don’t eat most fruits
Japanese
284
Don’t drink alcohol- May refuse cough syrup
Position facing homeland at death
Muslims/Arab
285
Believes that the left hand is very dirty and used for toileting
Right hand is clean and used for eating and touching others
Islam ☪️
286
Illegal wrongdoing such as carelessness with hot and cold packs, med error, failure to asses life threatening s/s
Malpractice
287
Gardisil vaccine decreases chAnces of what std
Age to get
Caution with what allergy
HPV
Ages 11-12 - can get as early as 9 years old - 3 doses with in 6months
Caution with latex or yeast allergy
288
Lab test to determine increased progression of cancer in prostate
Continued elevation require biopsy to assess cells
PSA
289
Skin lesions abnormalties
A
b
C
D
Asymmetrical shape
Borders irregular
Color are multicolored
Diameter more than 5mm
290
When to get Pap smear
Ages 21-65
Q 3years
291
When to get colonoscopy
Ages 50- q 10 years
292
When to get breast exams
Education
Q 3 years in 20s and 30s
No deodorant or powder b4 exam
Malignant areas are usually in upper areas
Biopsy for dx
293
Radiation implant education
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
ALOPECIA
Hair loss
295
What is required for TPN
- if behind on feeding do what?
- if infusion isn’t not available -do what for time being?
Central line and pump controller
Do not try to catch up and double dose
Hang D10W solution until obtaining TPN
296
If air enters central line-do what?
Clamp catheter
Lt trendelenburg
Give oxygen
297
How to D/C TPN
Taper off
298
Severe adverse affect of transplantation patient?
Increased temperature (even 0.5 degrees)
299
NSAIDs and steroids - give with what?
Steriod May increase what
Good
Bs
300
Ulcers - Eat What foods
Fiber
301
Gastric surgery : NG drainage post surgery 12-24 hours?
After 24 hours?
Education ?
Small but bright red
Dark
Do not irrigate or move NG tube after surgery
302
Rapid emptying of food from stomach into jejunum
Dumping syndrome
303
Prevent what with ileostomy patients
Skin breakdown
304
No seeds, nuts, grains, bareum , enema is contraindicated
Increased fluids and fiber (fruits and veggies)
Diverticulitis
305
Precancerous cells that may turn into esophageal cancer
Barrett’s esophagus
306
Fecal oral route - of hepatitis
No long-term effect or chronic effect
Hep A
307
Hepatitis transmitted by sex, IV drug users , HBV routine vaccination in children
Another is same but no vaccine
Hep B
Hep C
308
Only ppl with hep B can get ?
Hep D
309
What is restricted with end stage cirrhosis
Main causes?
Protein
(Liver failure) causes- hepatitis and alcohol
310
Chloelithiasis risk factors ?
Gallstones -
Four Fs:
Fat
Forty
Female
Fertile
311
Cdiff precautions
Private rooms
Soap and water
312
Under cooked meat , with fetal matter
E-coli
313
Raw eggs
| Contaminated food and drinks for 8/24 hours
Salmonella
314
Improperly canned fruits and veggies
Botulism
315
Development of physical symptoms in response to emotional distress
Conversion reaction
316
Failure to Regard an event or feeling
Denial
317
Transfer of emotions to another other than the intended
Displacement
318
Transferring of feelings to another
Projection
319
Dismissal of one’s responsibility by placing faults on another
Rationalization
320
Expression of feelings opposite to one’s true feelings
Reaction formation
321
Return to previous state of security
Regression
322
Forgetting unpleasant memories
Repression
323
Channeling unacceptable behaviors into behaviors that are socially acceptable
Sublimation
324
The conscience forgetting of undesirable memory
Suppression
325
Bone marrow transplant diet ?
Cool and peel and wash all foods
No salad bars or foods grown from the ground , cultured foods
Neutropenic ?
326
Celiac /gluten causes what
What can eat
What to avoid
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
1 dram = ? Grains
60
328
30 mL = ? Tbs or oz?
2 tbs
1oz
329
5 mL = ? Tsp
1
330
1 cup = ? Oz
8
331
1kg= ? Lbs?
2.2
332
1lb = ? Oz
16 oz
333
1grain= ? Mg
60 mg
334
Needles - info
Do not :
Recap
Bend
Break needles
Do:
Put in sharps container immediately
335
HIV patient info - transmission?
Can be transmitted through:
Can not be transmitted through unless blood is present :
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
Airborne Diseases?
Type of room?
PPE?
TB
Measles (rubella)
Chickenpox
Private room
HEPA or N95 mask
337
Droplet precautions ?
Diseases ?
Can travel how many feet
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
Contact precautions
Diseases
Type of room
Gloves and gown
Leave same equipment in room to use each time
Use antimicrobial soap
Rsv
Scabies
MRSA
VRE
Private room
339
Defense mechanisms
????
340
What is the first indication of a neurological issue
Changes in LOC
341
Posture that indicates brain stem dysfunction.
On back, hands to side and hands bent back and up facing head
Decerebrate
342
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.
Decorticate posture
343
Tx of decorticate posturing
S/s ?
What can mask signs and symptoms and make assessments inaccurate?
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
What scale to use with LOC/coma
Severe coma score?
Moderate coma?
Minor?
Normal?
Glasgow coma scale
Severe- 8 or below
Moderate- 9-12
Minor 13-14
Normal- 15 and up
345
What increases ICP
```
Coughing
Blowing nose
Bending
SneeZing
BM
Valsalva maneuver (forceful breath)
Sleeping flat
```
346
Contraindicated meds for client with hemorrhagic stroke
Anticoagulants and thromolytics
347
Primary cause of death in high level cord injuries
ARF
Acute respiratory failure
348
Proper spinal cord alignment if important in cord injuries
What is needed to turn the client?
A doctors order
349
Giuliani bare
Weakness / paralysis
350
Normal ICP rating is less than what?
If higher than this what to do?
20
Notify doctor
351
Carbidopa adverse effects
Spasmic eye winking
352
Myasthenia gravis
Condition causing Weakness in muscles
353
Gravida
Para
GTPAL
- 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
Check for what in spinal cord injuries
Urine retention
355
Epistaxis
Bleeding
356
Homework sign and symptoms of increased ICP
Papilledema
357
Sumatriptan can do what for someone with a migraine or angina
Make it worse because it is constrictive
358
Psychiatric disorder/use cognitive behavioral methods to decrease anxiety
OCD
359
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
PTSD
360
Acute versus delayed PSTD
Acute as within six months of event
Delayed is six months or more after the event
361
Don’t know how you got somewhere, multiple personalities
Dissociative
362
Appearance of physical symptoms when there is no psychological cause such as hypochondria and neurologic disorder
Somatic
363
Personality disorder where one has controlled anger, suspicious, delusions
Paranoid
364
Personality disorder or one is shy, withdrawn, distant (aloof), hermit, reality oriented but often daydreams
Schizoid
365
Females are more common in this personality disorder
Seductive, immature, theatrical emotions
Historionic
366
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
Glucose tolerance test
367
Type of glucose test were normal glucose is 70 to 110
Diagnosis of diabetes if 140 or above
Fasting
368
Ketonuria if BS is above what
240
Don’t exercise until decrease BS
369
Best indicator of average blood glucose within the last 90 to 120 days
What equals noncompliance in diabetics in diet and medication/insulin regimen?
A1C Glucosylated and hemoglobin assays (HBA1c)
An increase of 7%
370
Regular insulin peaks in how many minutes
90-120
371
NPH (long acting) peaks when?
8-12 hours
372
How to draw up insulin
Cloudy air, clear air , clear insulin , then cloudy insulin (NpH)
373
What insulin should never be mixed together? It would decrease bs significantly
Lantus (insulin glargine) and levemir
374
Hot and dry (skin dehydrated) sugar high
Increased BS
3 Ps - Polyphagia, polydipsia, and polyuria (hungry, thirsty, peeing)
High BS
375
Cold and clammy need some candy, decreased blood sugar, irritability, confused, pale, weak
Low BS
376
Decrease in blood sugar during the night around 2-3 am
Eat a snack at HS such as milk, peanut butter sandwich,
Somogyis effect
377
Glucose test before meals
Dextrostix
378
Med to help
| Lower bs -May affect kidneys - eat with med and report urinary changes
Metformin
379
Vitamin secreted by parathyroid
Vitamin D
380
Acromegaly
Bone pain, enlarged limbs , tongue , etc
381
Increased TSH levels
Decrease blood pressure and decreased pulse, decreased temperature/cool skin, tired, edema, hair loss, weight gain, thick skin
Hypothyroidism
382
Increased pulse and blood pressure, tremors, sweaty, increased activity, insomnia, a fib, weight loss, bulging eyes, thyroid storm which is a medical emergency
Hyperthyroidism
383
Where is the thyroid is located
Trachea
384
Monitor what in thyroid storm
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
Decreased calcium and phosphorus in the blood
Give forteo
Hypoparathyroidism
386
Increase calcium and phosphorus in the blood, ECG changes, increased urine output and stones, osteoporosis
Hyperparathyroidism
387
Bronze like pigmentation of skin, decrease blood sugar, weight loss, thin hair, increased urination, depression, decrease blood pressure, weakness
Addison’s disease
388
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
Cushing’s disease
389
Polyphagia
Increased hunger
390
Severe decreased blood pressure, cyanosis, shock
Addisons crisis
391
Polyuria
Increased urination
392
Oliguria
Decreased urination
393
Anuria
No urination
394
Polydipsia
Increased thirst
395
Increased bs contributes to what other issues in diabetes ?
Poor wound healing and insulin resistance
396
Normal bs
70-110
397
A balance test - Standing with feet together, eyes open, eyes closed
Romberg test
398
Hypertension without known cause
Primary HTN
399
High blood pressure due to contributing illnesses
Secondary HTN
400
Tx of HTN
Diuretics
Beta blockers (lol)
Calcium ch blockers (ipine, zem , amil)
Ace inhibitors (pril, sartans)
401
Pacemakers - education
Report hiccups
5 ft away from microwaves
Do not apply pressure to site
402
Temporary lack of O2 to myocardium- pain relieved by nitro, aspirin
Angina pectoris
403
Nitro - patient education
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
What ecg to defibrillate?
V-fib
v-tach with no pulse
405
Afib can lead to what?
Tx
CVA (heart attack)
Tx- anticoagulants to decrease clots
406
What lab to check with anticoagulants
Therapeutic level ?
No specific time for what? What to check before giving ? If air in syringe?
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
Heparin antidote
Protamine sulfate
408
Artificial valves for endocarditis
Porcine (pig) rejected by jewish
Bovine (cow) valve rejected by Hindu
409
If scheduled to have dental work with pericarditis or endocarditis what may be given prior
Prophylactic antibiotics to prevent exacberation of condition
410
INR normal range before tx of anticoagulants?
Normal
Range to observe for bleeding
Before- 1-2
Normal- 2-3
7 and up
411
Vascular issues related to cold exposure
Wear mittens outside and don’t smoke
Raynaud’s disease
412
Ballooning of artery
Rupture and bleeding risk
Aneurysm
413
Aortic aneurysm pt education
Do not palpate abdomen
414
Saturated fat good or bad?
Kind of food?
Bad= shrimp, beef, cheese
415
Unsaturated good or bad?
Type of food
Good= turkey
416
To absorb calcium you need what?
Vitamin D
417
Take your calcium and magnesium separately. How?
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
Is it okay to give diuretics and bp mess together such as ace inhibitors
Yes
419
Best method for evaluating amount of peripheral edema ?
Measure extremity
420
Best indicator for general edema
Daily weights
421
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
Aura
422
Type of seizure that can last up to 5 minutes
Tonic clonic
423
Tonic means what?
Clonic means what?
Tonic- stiffness
Clonic - jerking/twitching
424
Type of seizure - blank stare, mouth twitching
Absence seizure
425
Indicators of brain injury (CSF leakage)
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
Strawberry tongue, cracked lips, increased platelets
Assess for CHF and MI
In child
Kawasaki disease
427
```
Abdominal pain
Crying
Shock
Restless
Decreased urinary output
CHF
Increased pulse
```
Sx of what in infant ?
MI
428
Tx of MI in infant
Ensure what before giving
IV GG (gamma globulin) and aspirin
Ensure IV patency before giving IV GG because extravasation can cause tissue damage
429
Symptoms of aspirin toxicity
When to d/c it?
Tinnitus
Dizzy
HEADACHE
CONFUSIION
D/c if child is exposed to influenza or chickenpox.
430
Position to test for scoliosis
Adams position- bend at waist and arms hang and asses curve of spine
431
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
Muscular dystrophy
Encourage independence
432
Leading cause of death in kids below 15 years old
Cancer
433
renal cancer
To one side (unilateral)
Firm
Non tender
Encapsulated and responsive to chemotherapy
Do NOT palpate abdomen
Wilms tumor
434
Leukemia tx
Sx
Cytotoxic drugs and bone marrow transplantation
Monitor platelets
Watch for increased bloody noses
435
Cancer Most common in long bones (femur)
Osteogenic sarcoma
436
What to do before giving antidote when a child ingests hazardous substances
Call poison control first
437
Acid base imbalance -such as aspirin/salicylate overdose tx =
emesis , lavage , or charcoal
Sodium bicarbonate, diazepam, vitamin k, hemodialysis
438
Acetaminophen overdose tx
Sx
4 hours later
IV acetylcysteine
Sx- increases plasma levels
4 hours later- liver damage /hepatoxicity
439
Lead overdose tx
Houses from what year have lead
Cheltation therapy
1950
440
Iron overdose tx
If severe
Emesis or gastric lavage
Chelation therapy with deforoxamine
441
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.
Biliary atresia
442
Cystic fibrosis effects what in the body?
Exocrine glands (mucus secreting glands) of the body
443
Toy appropriate for a 15 month old with a heart defect?
Shape sorter
444
disease that can result from inadequately treated strep throat or scarlet fever. Group A
causes inflammation, especially of the heart, blood vessels, and joints.
Rheumatic Fever
445
Nephrectomy
Remove kidney - d/t wilms tumor -prevents UTIs
446
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
Sydenham chorea (SC)
447
For one with c-spine immobilization - what to do before opening airway of suspected injury?
Jaw thrust maneuver
448
What score on Glasgow coma scale do you need airway management
Less than 8
449
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
Contrecoup
450
Avoid what meds with head injury?
Avoid what with skull fracture
Opiods - depresses CNS
NG tube - with skull fracture
451
Multiple rib fractures, scapular fracture’s, and pulmonary contusion, unequal chest movement
Flail chest
452
Cullens sign
Bruising or discoloration due to bleeding around umbilicus
453
Turners sign
Bruising on flank into abdominal wall
454
Fullness over right flank may mean what?
Spleen rupture
455
Kehrs sign
Pain in left shoulder that may indicate ruptured spleen
456
If one is sexual assaulted, want to educate the patient?
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
Never induce vomiting with one who has ingested what?
Corrosive or petroleum distillates
458
Animal bites patient education
If the animal or snake is dead, you should bring it into the ER to help identify the species
459
What medication is contradicted in snakebites For the first 6 to 8 hours Because they interfere with the anti-venin
Corticosteroids
460
What to perform before giving anti-venin
Perform skin or eye test
461
Antidote for acetaminophen overdose
Mucomyst (acetylcholine)
462
Antidote for carbon monoxide poisoning
Oxygen
463
Antidote for opioid or narcotic overdose?
Nalaxone
464
Antidote for benzodiazepine overdose
Romazicon (flumazenil)
465
Digoxin toxicity antidote
Digibind (digoxin immune fab)
466
Cyanide overdose antidote
Amyl nitrate
467
Poisonous bites antidote
Antivenin
468
Nutrition for congestive heart failure
Food to avoid?
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
IBS/IBD diet
Avoid?
Eat meats, brands, fruits, veggies, dairy
Avoid whole grains, legumes, nuts, veggies with skins, prune juice, stringy meats
470
Full liquid diet’s-Require decreasing gastric mobility
Eat?
Avoid?
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
What consists of a lacovegetarian diet
Avoid what?
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
Lacto-ovo-vegetarians eat?
Avoid?
They do eat eggs and dairy products.
Avoid meat, poultry, or fish.
473
Peptic ulcer or hiatal hernia diet
Avoid?
Eat meats, brands, starches, fruits, veggies, dairy products
Avoid alcohol, coffee, chocolate, black red pepper, chili powder, peppermint/spearmint, garlic, onions, cinnamon
474
Renal transplant diet
Avoid?
Eat meats, dairy products, breads, starches, veggies, sweets
Avoid eggs, organ meats, fried or fatty foods, salty foods, dried foods, salt substitutes, fruits
475
Mineral that promotes bone density found in dairy, seaweed, Almonds, sesame, spinach, okra, quinoa
Calcium
476
Mineral that turns oxygen to hemoglobin
Foods include lentils, red meat, poultry, beans, leafy vegetables, sesame seeds, tofu
Iron
477
Supports neural functioning
Found in foods such as tomatoes, potatoes, oranges
Potassium
478
Generates energy and builds muscle found in foods such as legumes, nuts, greens, eggs, meat
Protein
479
Eat small amounts of saturated fat is recommended by who
Food such as dairy, meat, coconut oil, chocolate
The CDC in American heart Association
480
Combats blindness and promotes vision
Vitamin found in dairy, eggs, poultry, liver, fish
Vitamin A
481
Cobalamin =
B12
482
Riboflavin=
B2
483
Biotin =
B7
484
Niacin =
B3
485
Vitamin that promotes cell metabolism
Vitamin b
486
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
Vitamin c
487
Vitamin that promotes bone health which is found in liver, fish, daily sunlight
Vitamin d
488
Vitamin that decreases anemia
Found in foods such as nuts, greens, sesame seeds
Vitamin E
489
Vitamin that decreases bleeding produced by intestinal bacteria
Babies need this at birth so they do not bleed out
Vitamin K
490
Mineral -enzymatic reaction catalyst
Food - Lamb, beef, liver
Zinc
491
Normal BMI or body mass index
Underweight?
Overweight?
Obese?
Normal - 18.5-24.9
Under- less than 18.5
Over- 25-29.9
Obese- 30 and up
492
Prevent neural defects in pregnancy found in foods such as legumes , Asparagus, eggs, leafy greens, citrus fruit, beets
Folic acid
493
These prevent oxidation of other molecules found in fruits veggies, sesame seeds
Antioxidants
494
Triggered by foods and or food additives, air particles, aspirin or NSAIDs
Asthma
495
Chronic bronchitis, emphysema, asthma Are all considered what?
What type of mask is preferred
Copd
Venturi mask
496
Hep B immunization allergy?
Bakers yeast
