NCLEX Flashcards
normal sodium
135-145
normal potassium
3.5-5.0
normal calcium
9.0-10.5
normal magnesium
1.3-2.1
normal phosphorous
3.0-4.5
normal BUN
10-20
normal creatinine
0.6-1.2 (males)
0.5-1.1 (females)
normal glucose
70-105
normal HgbA1c
<6.5%
normal WBC
5,0000-10,000 / mm3
normal RBC men
4.7-6.1 million/mm3
normal RBC women
4.2-5.4 million/mm3
normal hemoglobin men
14-18 g/100 ml
normal hemoglobin women
12-16 g/100 ml
normal hematocrit men
42-52%
normal hematocrit women
37-47%
normal platelets
150,000-400,000 / mm3
normal ph
7.35-7.45
normal CO2
35-45 mm hg
normal PO2
80-100 mmhg
normal HCO3
21-26 mmol/L
normal PT
11-12.5 seconds
normal INR
0.7-1.8
normal PTT
30-40 seconds
digoxin normal levels
0.5 - 2.0 ng/ml
normal lithium
0.8-1.4 meq/l
normal phenytoin levels
10-20 mcg/ml
normal theophylline
10-20 mcg/ml
airborne precautions
measles
chicken pox
herpes zoster
TB
how to manage airborne diseases
neg pressure room
private room
n-95 for TB
mask
droplet precautions
-Sepsis
-Scarlet Fever
-Strep
-Pertussis
-Pneumonia
-Parvovirus
-Influenza
-Diphtheria
-Epiglottitis
-Rubella
-Mumps
-Adenovirus
droplet mgmt
private room
mask
contact precautions
MRSA
VRSA
RSV
skin infections (impetigo)
wound infections
enteric infections (c. diff)
eye infections
management for contact precautions
gowns
gloves
goggles
private room
what kind of drug is amitriptyline
tricyclic antidepressant
anticholingeric
how often do you apply a new transdermal nitrate patches
every morning to a new site
how is vanc administered
IV, slowly over 60 mins
what is alosetron used for
IBD in women
what kind of drug is famotidine
H2 receptor antagonist
suppress gastric acid secretion
what do bile acid sequestrants do
decrease LDL cholesterol
what is a complication of bile acid sequestrants (the coles)
constipation
how does leuprolide work
prevents release of LH and FSH to prevent testosterone production
adverse effects of thionamides (methimazole)
hypothyroidism
agranulocytosis
hepatits/liver injury
what drugs can delay progression of diabetic nephropathy
ARBS (sartans)
what is bethanechol used for
muscarinic agonist
used for nonobstructive urinary retention
should you take ferrous sulfate with food?
no - decreases absoprtion
nitrofurantoin: what is it used for
treat UTIs
how does ginger impact blood sugar
decreases blood sugar
activated clotting time normal range
70 to 120
what is ciprofloxacin used for
UTIs
side effects of ciprofloxacin
GI discomfort, tendon rupture, photosensitivity, suprainfection
4 Es for angina precipitating factors
exertion
eating
emotional distress
extreme temperatures
4 Ps of arterial occlusion
pain
pulselessness
pallor
paresthesia
how to treat CHG (MADD DOG)
morphine
aminophylline
digoxin
dopamine
diuretics
oxygen
gasses (monitor ABGs)
heart murmur causes
stenosis of valve
partial obstruction
aneurysm
septal defect
mitral regurgitation
signs of stroke
facial drooping
arm weakness
speech slurred
time to call 911
5 ps of compartment syndrome
pain
pallor
pulselessness
paresthesia
paralysis
signs of shock (CORD ITEM)
cold clammy skin
hypotension
oliguria
rapid, shallow breathing
drowsiness, confusion
irritability
tachycardia
elevated or reduced CVP
multi-organ damage
signs of hypoglycemia
TIRED
tachycardia
irritability
restlessless
excessive hunger
depression and diaphoresis
hypocalcemia signs (CATS)
CATS
convulsions
arrhythmia
tetany
stridor and spasms
hypokalemia signs (6 Ls)
lethargy
leg cramps
limp muscles
low, shallow, respirations
lethal cardiac dysrhythmias
lots of urine
early warning signs of cancer (CAUTION UP)
Change in bowel or bladder
A lesion that does not heal
Unusual bleeding or discharge
Thickening or lump in breast or elsewhere
Indigestion or difficulty swallowing
Obvious changes in wart or mole
Nagging cough or persistent hoarseness
Unexplained weight loss
Pernicious Anemia
leukemia signs and symptoms (ANT)
Anemia and decreased hemoglobin
Neutropenia and increased risk of infection
Thrombocytopenia and increased risk of bleeding
patients who require dialysis
Acid base imbalance
Electrolyte imbalances
Intoxication
Overload of fluids
Uremic symptoms
asthma mgmt
Adrenergics: Albuterol and other bronchodilators
Steroids
Theophylline
Hydration: intravenous fluids
Mask: oxygen therapy
Antibiotics (for associated respiratory infections)
pneumothorax signs
Pleuritic pain
Tracheal deviation
Hyperresonance
Onset sudden
Reduced breath sounds (and dyspnea)
Absent fremitus
X-ray shows collapsed lung
dysphagia mgmt
Modifying the texture of foods and the consistency of liquids may enable the client to achieve proper nutrition.
Place the client in an upright or high-Fowler’s position to facilitate swallowing.
Provide oral care prior to eating to enhance the client’s sense of taste.
Allow adequate time for eating, utilize adaptive eating devices, and encourage small bites and thorough chewing.
Avoid thin liquids and sticky foods
what is dumping syndrome
occurs as a complication of gastric surgeries that inhibit the ability of the pyloric sphincter to control the movement of food into the small intestine.
This “dumping” results in nausea, distention, cramping pains, and diarrhea within 15 min after eating
how to manage dumping syndrome
Small, frequent meals are indicated.
Consumption of protein and fat at each meal is indicated.
Avoid concentrated sugars.
Restrict lactose intake.
Consume liquids 1 hr before or after eating instead of with meals (a dry diet)
lie down after meals
how to manage peptic ulcer disease
Avoid eating frequent meals and snacks, as they promote increased gastric acid secretion.
Avoid alcohol, cigarette smoking, aspirin and other NSAIDs, coffee, black pepper, spicy foods, and caffeine
during acute diverticulitis do you want a low or high fiber diet
a low-fiber diet is prescribed in order to reduce bowel stimulation.
high fiber diet may prevent in the long term
what is an early sign of shock
narrowing pulse pressure
increase in diastolic BP
cleft lip nursing care plan
Crying, minimize
Logan bow
Elbow restraints
Feed with Brecht feeder
Teach feeding techniques; two months of age (average age at repair)
Liquid (sterile water), rinse after feeding
Impaired feeding (no sucking)
Position—never on abdomen
HELLP syndrome: what is it
complication of severe pre-eclampsia
Hemolysis
Elevated Liver enzymes
Low Platelet count
4Ps of labor
Powers
Passageway
Passenger
Psych
5 infections during pregnancy
TORCH
Toxoplasmosis
Other (hepatitis B, syphilis, group B beta strep)
Rubella
Cytomegalovirus
Herpes simplex virus
potential problems with an IUD
PAINS
Period (menstrual: late, spotting, bleeding)
Abdominal pain, dyspareunia
Infection (abnormal vaginal discharge)
Not feeling well, fever or chills
String missing
what does APGAR stand for
Appearance
Pulse
Grimace
Activity
Respiratory effort
GTPAL
Gravida
Term
Preterm
Abortions (SAB, TAB)
Living children
signs of problems with oral contraceptives
ACHES
Abdominal pain (possible liver or gallbladder problem)
Chest pain or shortness of breath (possible pulmonary embolus)
Headache (possible hypertension, brain attack)
Eye problems (possible hypertension or vascular accident)
Severe leg pain (possible thromboembolic process)
anticipated problems with premature infants
Temperature regulation (poor)
Resistance to infections (poor)
Immature liver
Elimination problems (necrotizing enterocolitis [NEC])
Sensory-perceptual functions (retinopathy of prematurity [ROP])
VEAL CHOP
Variable decels => Cord compression (usually a change in mother’s position helps)
Early decels => Head compression (decels mirror the contractions; this is not a sign of fetal problems)
Accelerations => O2 (baby is well oxygenated–this is good)
Late decels => Placental utero insufficiency (this is bad and means there is decreased perfusion of blood/oxygen/nutrients to the baby).
postpartum assessment
B- Breasts
U- Uterus
B- Bladder
B- Bowel function
L- Lochia
E- Episiotomy
H- Hemorrhoids
E- Emotional Status
R- Respiratory System
placenta previa
low lying placenta
placenta abruptio
premature separation of the placenta
risk factors for placenta previa
Increased parity
Advanced maternal age
Past cesarean births
Past uterine curettage
Multiple gestation
risk factors for placenta abruptio
High parity
Advanced maternal age
A short umbilical cord
Chronic hypertensive disease
Pregnancy-induced hypertension
Direct trauma
Vasoconstriction from cigarette use
Thrombic conditions that lead to thrombosis such as autoimmune antibodies
does bleeding occur with placenta previa
always, bright red
does bleeding occur with placenta abruption
may or may not be present, will be dark red
is there pain during bleeding with placenta previa
never
is there pain during bleeding with placenta abrutpion
sharp, stabbing pain
can you perform pelvic or vaginal exams with placenta abruptions or previas?
NEVER
AEs of phenytoin
P - interactions
H irsutism
E nlarged gums
N ystagmus
Y ellow-browning of skin
T eratogenicity
O steomalacia
I nterference with B metabolism (hence anemia)
N europathies: vertigo, ataxia, headache
antiparksonian drugs (a cat does like milk)
A nticholinergic Agents
C OMT Inhibitors (catechol-O-methyltransferase); An enzyme involved in degrading neurotransmitters.
D opamine Agonists
L evodopa
M AO-B Inhibitors
what diet do patients with maternal PKU need to follow
low protein diet 3 months prior to pregnancy and throughout pregnancy
normal bilirubin levels for new born
24 hours: 2-6
48 hours: 6-7
3-5 days: 4-6
patent ductus arteriosus
the area between the pulmonary artery and aorta remains open, allowing the blood to flow through the patent ductus arteriosus and back to the pulmonary artery and lungs
signs of Intussusception
Normal comfort interrupted by periods of sudden and acute pain
- Palpable, sausage-shaped mass in the right upper quadrant of the abdomen and/or a tender, distended abdomen
- Stools that are mixed with blood and mucus that resemble the consistency of red currant jelly
conditions requiring droplet percautions
Hib, pertussis, mumps, rubella, plague, streptococcal pneumonia, meningococcal pneumonia
conditions requiring airborne precautions
measles, varicella, TB
what are 4 components of a mental status exam
Level of consciousness
Physical appearance
Behavior
Cognitive and intellectual abilities
classic symptoms of depression
change in sleep patterns,
indecisiveness,
decreased concentration,
or change in body weight
therapeutic lithium levels
0.8-1.4
cocaine intoxication symptoms
fevers, hallucinations, tachycardia, hypertension, chest pain, seizures, possible cardiac collapse and death
lithium AEs (therapeutic levels)
GI distress (nausea, diarrhea)
fine hand tremors
weight gain
polyuria
Assertiveness training
Teaches clients to express feelings and solve problems in a nonaggressive manner
Through therapy, this client can change their thinking to realize that they might have made some bad choices, but that they are not “a bad person.” The client learns to communicate in a more assertive manner in order to decrease psychological stressors. Therapy teaches the client to assert their feelings by describing a situation or behavior that causes stress, discussing feelings about the behavior or situation, and then making a change.
what is true about an incident report
a. risk mgmt investigates
b. include description of incident and actions taken
c. it is confidential
d. document completion in nurses’s notes
e. include in client’s health record
a, b, c
what is an early sign of hemorrhage
increased HR
how long are is a pt on blood thinners after a surgery?
usually about a month
five rights of delegation
person
task
circumstance
directions
supervision
can a UAP get a urine specimen from a catheter
no because it is sterile! only RN and LPNs can do sterile procedures
bladder is sterile
what type of patients can LPNs receive
stable patients w/ predictable outcomes
patients that need reinforcing of education
data collection
*they do not hang first bag of anything
UAPs can care for
ADLs
vital signs
weight
is & os
safety
what two patients are weighed everyday
heart failure
renal patients
which medications are priority
scheduled
what strategy is implemented when nurse gives patient medications prior to family visit
maslow’s
can uncontrollable seizures disorders be disclosed to DMV
yes
three types of consent
general
implied
informed
if there is a fire, who would you evacuate first
most mobile
whoever needs the most help - evacuate last
which culture believes health is achieved by restoring balance
asian american
which culture believes you can speed healing with soups and herbal teas
hispanic
when would you apply a tourniquet (iv complication)
catheter embolus
when would you apply light pressure (iv complication)
hematoma
when would you elevate and apply cold compress (iv complication)
infiltration
when would you aspirate a drug if possible (iv complication)
extravasation
when would you apply a warm compress (iv complication)
phlebitis
4 complications with central venous catheters
pneumothorax
air embolism
occlusion
infection
what drug can cause angioedema
Ace inhibitors
what drug can increase HF
CCBlockers
which drug should be used in caution with asthma
beta blockers
what drugs can cause rapid drop in BP
vasodilators
which drugs are contraindicated with anticoags
alpha 2 agonists
can you take an oral hypoglycemic while pregnant
no, need to to switch to insulin
what increases iron absorption
vit C
what decreases iron absorption
Ca and tannin
liquid iron: how should pts take?
use straw and rinse mouth
which 2 antibiotics are nephrotoxic
vancomycin
gentamicin
CIs for levodopa
MAOIs
narrow angle glaucoma
how far should someone be from someone with radiation therapy
6 ft
for a max of 30 mins
what are the steps of turning an immobile patient to right side
- place bed supine and move to side of the bed
- flex left knee and roll toward nurse
- place pillow under head and neck
- move right shoulder forward
- position pillows to maintain alignment
- position arms
what does the acrononym PRESSURE stand for
preventable
risk assessment
early skin observation
set up appropriate mattress
seat cushions
use wound assessment tools
reposition regularly
evaluate effectiveness
when using a cane, do you hold it on the side of weakness or stronger/unaffected side
use cane on stronger side to provide support
when using the cane do you move the cane with the stronger or weaker leg
w/ the weaker leg
when walking up stairs with crutches, do you move the unaffected or weaker leg first
unaffected , then crutches with weaker leg
when walking down the stairs, do you move unaffected or weaker leg first
weaker leg first with crutches then unaffected leg
what is the most effective spill mgmt technique for someone with AIDS
disinfect area with 10% bleach solution after initial cleaning
what lab values will elevate if a patient is dehydrated secondary to vomiting
serum ph
hct
urine osmolarity
urine specific gravity
therapeutic signs of KCL infusion for someone who was hypokalemic
reports leg cramps are no longer present
serum potassium is higher
peaked t waves - hypo or hyperkalemia
hyperkalemia
if you know patients weight, what is desired urine output
0.5 ml/kg/hr
would decreased insulin cause metabolic acidosis or alkalosis
acidosis
if you have diarrhea, are you losing acid or base
base - losing bicarb
will be metabolic acidosis
match symptoms:
chronic bronchitis
emphysema
asthma
lung cancer
TB
pneumonia
night sweats
pleuritic pain
pursed lip breathing
hemoptysis
bronchospasm
tenacious sputum
chronic bronchitis - tenacious sputum
emphysema - pursed lip breathing
asthma - bronchospasm
lung cancer - hemoptysis
TB - night sweats
pneumonia - pleuritic pain
what do you need to do before and after a bronchoscopy
assess gag reflex
is bubbling in suction chamber good or bad
good
what should you observe in the water seal chamber
tidaling with inspiration and expiration
if tidaling in the chamber stops, what might that indicate
kinks/obstruction
lung might have re-expanded
diet recommendation for acute cholecystitis
low fat diet with food rich in HDL
fats will cause more bile
how are meds given through NG tube
one at a time and flushing in between
what would be included in a low fiber and low residue diet
cream of wheat
puffed rice cereal
canned green beans
colostomy care instructions
clip hair around peristomal site
empty when 1/3 full
add cranberry juice and yogurt to your diet (help with odor)
match the symptom
cirrhosis
hepatitis
pancreatitis
pancreatic cancer
malnutrition
fatigue and anorexia
bleeding
flu like symptoms
cirrhosis - bleeding
hepatitis - flu like symptoms
pancreatitis - malnutrition
pancreatic cancer - fatigue and anorexia
fat emoli are most common with fractures in which types of bones
pelvis and long bones
s/s of fat emboli
confusion
tachycardia
chest pain
tachypnea
hemoptysis
petechiae over neck, upper arms, chest and abdomen (late sign)
6 ps of compartment syndrome
pain
pallor
pressure
paresthesia
paralysis
pulselessness
what are the levels of phosphorous and calcium in hypoparathyroidism
hyperphosphatemia
hypocalcemia
normal phosphorous
3.0-4.5
left sided HF manifestations (4)
left = lungs
dyspnea
frothy sputum
crackles
cough
right sided HF
right = rest of the body
JVD
weight gain
edema
what is the primary cause of right sided HF
left sided HF
s/s of venous insufficiency
painless ulcers
lower leg edema
hyperpigmentation
s/s of arterial insufficiency
claudication
delayed CRT
hair loss on legs
cyanotic extremities
early s/s of shock
pallor
tachypnea
confusion
tachycardia
late s/s of shock
cold, moist skin
weak/thready pulse
anuria
metabolic acidosis
hypotension
s/s of DKA
confusion
tachycardia
hematocrit level increased
decreased LOC
s/s of HHS
confusion
tachycardia
increased HCT
gradual sympton onset
decreased LOC
s/s of hypoglycemia
confusion
tachycardia
decreased LOC
what do you do if only half the dialysate is returned after PD
reposition client by turning side to side
actions to prevent autonomic dysreflexia
promote high fiber diet and use of stool softeners
monitor patency of indwelling bladder catheter
which procedure tells the type of CVA
Ct scan
teaching for patients wtih WBC of 1000
rinse toothbrush in bleach solution
wash dishes in hot, soapy water or dishwasher
report fever over 100.0
avoid fluids that have been unrefrigerated more than 1 hour
what would indicate effective response to therapy for ADIS patient
lack of pulmonary infiltrates
parkland formula
LR
4 ml x kg x % TBSA
1/2 of that total goes in first 8 hours
1/2 in remaining 16 hours
sickle cell priorities
HOP
hydrate
oxygenate
treat pain
valerian root
used to prevent insomnia or reduce anxiety related restlessness
additive when combined with barbs or benzos
how does garlic impact cholesterol
lowers triglycerides and LDL
raises HDL
*increases risk for bleeding
benefits of ginko biloba
increases blood flow to brain
improve memory
decrease pain
black cohost
estrogen substitue
shouldn’t be taken for more than 6 months
which 5 herbal supplements interfere with anticoagulants/bleeding risk
garlic
ginger
ginkgo
ginseng
saw palmetto
what kind of drug is olanzapine
atypical / SG antipyschotic
early signs of lithium toxicity
lethargy
dehydration
slurred speech
late signs of lithium toxicity
blurred vision
normal lithium levels
0.4-1.4
cluster A personality disorders
paranoid
schizoid
schizotypal
cluster B personality disorders
antisocial
borderline
narcisstic
histrionic
cluster c personality disorders
dependent
ocd
avoidant
what can bupropion be used for
nicotine
amphetamines
manifestations of opioid withdrawal
yawning
insomnia
panic
diaphoresis
cramps
N/V
chills
fever
diarrhea
sources of b 12
animal products
(yogurt, liver)
signs of cold stress in baby
cool, cyanotic extremities with warm trunk
what is important when admitting a child to a hopsital
knowing their routines and rituals
who can sit unsupported with crude pincer grasp
8 months
how old: solid foods introduced and separation anxiety begins
4 months
posterior fontanel closes: when
6-8 weeks
receives first flu vaccine
6 months
when does anterior fontanel close
12-18 months
how old: birth weight doubles and rolls from front to back
5 months
when does birth weight triple and they can walk with help
12 months
how old: ritualism and separation anxiety peaks
toddler (1-3 yrs)
how old: rides a tricycle and alternates feet going up and down steps
3 years
how old: can jump rope and tie shoelaces
5 years
how old: pretend play and magical thinking
preschooler (3-6 years)
how old: walks independently and can use a cup well
15 months
how old: skips and hops, throws ball over head, catches ball reliably
6 years
tet spells triggers
upon awakening
during feeding
after crying
during painful procedures
what is the best way to measure hydration?
weight
a loss of 0.5kg body weight is equal to ____ of water
500 ml
a nurse assess a toddler who has a 36 hour history of vomiting and diarrhea. what should be reported to provider?
absence of tears
skin cool and clammy
6% loss of body weight
blood pressure 78/52
tonsillectomy sign of hemorrhage
frequent swallowing
frequent throat clearing
hematemesis
tonsillectomy: when is hemorrhage most likely to occur
first 2 days and again approx one week
what is the most common mode of transmissoin
airborne
what is the desired effect of pancrelipase powder
steady weight/height gain
can an lpn administer albumin
no considered a blood product
can an lpn hang the first bag of fluids/meds
no
what is the triad of fat embolism syndrome
hypoxemia
neurological symptoms
petechiae
how do steroids impact serum calcium levels
decreases GI absorption of Ca
why does corticosteriods cause hypervolemic hypernatremia
aldosterone - helps retain Na (and water)
causes of hypernatremia
MODELS
medications (corticosteriods)
osmotic diuretics
diabetes insipidus
excessive H2O loss
low H2O intake
sodium intake too high
hypernatremia s/s (fried & salted)
fever (low grade)
restlessness & agitation
increased fluid retention
edema
dry mouth
skin flushed
altered loc & confusion
low UO
thirst
elevated BP
decreased energy (lethargy)
mgmt of hypernatremia - FLAG
free water
loop diuretics
agent causing (remove)
give fluids IV
causes of hyponatremia (MOBS FAIL)
meds (diuretics)
oral gastric tube suctioning
burns
SIADH
failure: heart, kidney, liver
s/s of hyponatremia (LOW SODIUM)
LOC altered
orthostatic hypotension
weak muscles
seizures
osmolality low
diarrhea
increased ICP
urine osmolality high
more bowel sounds
normal chloride levels
96-108
what medications elevate K+
ace inhibitors
K+ sparing diuretics
causes of hyperkalemia (MACHINE)
medication
acidosis
cellular destruction
hypoaldosteronism
intake
nephrons failure
excretion impaired
hyperkalemia s/s (MURDER)
muscle cramping
urine abnormalities
resp distress
decreased cardiac contractility
ekg changes
reflexes (depressed/ absent)
3 tx that drive potassium into cells
d5w with regular insulin
albuterol
bicarb
3 tx that reduce total body potassium
kayexalate
diuretics
dialysis (only in severe cases)
hyperkalemia management (CRIED)
calcium IV
remove sources of K+
increase K+ secretion
enhance K+ uptake into cels
dialysis
casues of hypokalemia (DITCH)
drugs (diuretics, corticosteroids)
inadequate K+ intake
too much water
cushing’s disease
heavy fluid loss
EKG change with hypokalemia?
prominent u-wave (after t wave)
hypokalemia mgmt (POD)
potassium IV (never IV PUSH)
oral potassium
diet rich in potassium
causes of hypercalcemia (MD spied)
malignancy
diuretics
steroids (causes bone breakdown –> Ca released into blood)
parathyroid (hyper)
immobilization
endocrine (Addison’s)
vitamin D
causes of hypocalcemia CHAMP
celiac, crohn’s
hypoparathyroid, hyperphos
alcoholism
malnutrition, malabsorption
pancreatitis
hypocalcemia s/s (CATS)
convulsions (irritable)
arrythmias
tetany
spasms
causes of hyperphosphatemia
malnutrition
alcoholism
TPN
tumor lysis syndrome
hyperparathyroidism –> hypercalcemia –> hypophosphatemia
s/s of hypercalcemia
sedated! it slows things down
weakness
flaccidity
decreased peristalsis
hypoactive bowel sounds
bradycardia
decreased LOC
causes of hypomagnesemia
alcoholism
malnutrition
malabsorption
hypoparathyroidism
hypocalcemia
diarrhea
what electrolyte imbalance can cause torsade de pointes
hypomagnesemia
does renal failure increase or decrease magnesium
increase – causes retention of magnesium
normal urine specific gravity
1.005-1.030
what is simethicone and what is it used for
relives cramping and promotes gas release
what happens to progesterone and estrogen when the placenta is delivered
decrease –> results in increase in prolactin
risk factors for ovarian cancer
nulliparity
advancing age
family history
early menarche
BRCA variants
when should you take corticosteroids
morning with food
s/s of hepatitis A
nausea, vomiting, abdominal pain, fever, anorexia, dark urine, scleral icterus, pale stools, jaundice, and pruritus
what is scleral icterus
yellowing of sclera
what is the most accurate way to determine if a patient is infectious with TB
sputum culture
what does a quantiferon gold test do?
serum test that results in approximately 24 hours. This also would determine if the client was exposed and not an active infection
what kind of foods are high in PKU
foods with protein or dairy
what is Isosorbide
nitrate medication
what is therapeutic aPtt on heparin
1.5-2.5x normal which is 30-40 seconds
normal INR
0.9-1.2
therapeutic INR on warfarin
2-3
normal alaklinezymes increase when there is an issue
alkaline phosphatase
asparatate aminotransferance (AST)
alanine aminotransfer (ALT
normal alkaline phosphatase
30-120
normal AST
0-35
normal ALT
4-36
normal albumin
3.5-5
normal ammonia
15-110
normal residual from NG tube
<500 ml in an adult
first, second and third line medications in shock
dopamine
phenylephrine
vasopressin
do you perspire in heat stroke or heat exhaustion
both!
how is heat stroke different from heat exhastuion
heat stroke has temp above 104 + lethargy and confusion
5 signs of transfusion reaction
low back pain
SOB
apprehension
chills
itching
side effect of amphotericin b
hypokalemia
nephrotoxic
what two conditions are associated with reye syndrome
influenza
varicella
3 lab values to monitor with lithium
creatinine (d/t being nephrotoxic)
TSH (can cause hypothyroidism)
sodium (hyponatremia can lead to lithium toxicity)
what is Sevelamer
a phosphate binder indicated for individuals with chronic kidney disease (CKD).
This medication inhibits phosphorus absorption, thereby increasing the calcium level.
what is the target for H1Ac for diabetcis
less than 7%
what is macewan’s sign
Macewen’s sign is an indication of hydrocephalus. This sign is positive when the nurse percusses the skull bones and hears a ‘cracked-pot’ sound. This sound is due to thin, widely separated skull bones with hydrocephalus.
when is hospice offered
when life expectancy is less than 6 months
kubler stages of grief
denial
anger
bargaining
depression
acceptance
is NPO appropriate on palliative care
yes
what does black triage tag mean
expectant
deceased or not likely to survive
agonal breathing or brain matter exposed
what does red triage tag mean
see first! needs immediate intervention
what does yellow triage tag mean
see second
delayed attention
what does green triage tag mean
see last
non-urgent
can send to urgent care, lacerations, anxious
what is performance improvement
establishes a system of formal eval for job performance and recommends ways to improve perf
what is quality mgmt
act of overseeing all activities and tasks needed to maintain excellence
can you delegate obtaining pt history
yes
what is licorice extract used for
ulcers, bronchitis
what are risks associated w/ licorice extract
acts like aldosterone
HTN
hypokalemia
what does resonance mean for percussion
dullness, hollow
should hear over air in the lungs
what goes tympany indicate for percussion
fluid
usually over abdomen
s1
mitral and tricuspid valves close
systole
s2
aortic and pulmonic valves close
diastole
when does s3 occur
after s2
volume overload like CHF
when does s4 occur
before s1
due to stiff failing hypertrophic left ventricle
how do you assess visual acuity
snellen chart
what does a snellen chart score of 20/200 mean
can read at 20 feet what normal people can read at 200 feet
poor vision
what is hyphema
bleeding in anterior chamber of the eye
does nulliparity increase risk for breast cancer
yes
what culture would require wrapped plastic utensils and would want to unwrap their own
jewish
when do living wills go into effect
when client is terminally ill
what is battery
unconsented physical contact
assault
act that threatens physical harm even when actual harm is not done
what is andexanet
antidote to apixaban
which vaccines can you not get while pregnant
MMR
✓ Varicella
✓ Zoster
✓ HPV
✓ Polio
✓ Any live vaccine
what is the major ae of isoniazid (INH)
peripheral neuropathy
tx with b complex vitamin
how do you give ear drops to a child
For a child younger than the age of three, pull the pinna down and back
what is akathisia and how do you treat it
sense of motor restlessness and is one of the most common EPS
tx with propanolol
what is Presbycusis
ensorineural hearing loss associated with aging
what fluid should be used for hypernatremia
d5w
who should not receive bupropion
anorexics - causes weight loss
pts with epilepsy
what is Variant angina (Prinzmetal’s angina)
occurs at about the same time every day, usually at rest. Variant angina is treated with calcium channel blockers
what increases risk for DIC
infection/injury
sepsis
what does warfarin prolong
INR & PT
what could lead to labor dystocia
Maternal fatigue
Uterine overdistention such as with multiple gestation
Maternal inactivity
Uncontrolled maternal pain
Fluid and electrolyte imbalance
Hypoglycemia
Excessive analgesia or anesthesia
can LPNs do sterile dressing changes
yes
what vitamin do vegans need to supplmement
b12
what is Oprelvekin
stimulates platelet production
indicated to prevent chemotherapy-induced severe thrombocytopenia and avoid the need for platelet transfusions
how long can troponin be elevated after MI
2 weeks
do platelets require ABO compatability?
no
is inhalation anthrax spread from person to person
no! so no need for a mask
are loop diuretics nephrotoxic
yes
does enoxaparin (LMWH) require monitoring aptt
no!
would be more concerned about platelets for HIT
what type of precautions is mono
standard
what would help a patient with dailysate that won’t come out during peritoneal dialysis
encourage bowel mvmt
what position would you put a pt in for removal of IJ central cath?
supine or trendelenburg to avoid air embolism
how to treat hyper parathyroidism / hypercalcemia
0.9% saline infusion followed by furosemide
who should not receive beta blockers
cardiogenic shock
How do you prevent fat embolism
Immobilization!
D dimer
Indicates if you have a blood clot or blood clotting problem
