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NCLEX Flashcards

1
Q

Hemoglobin

A

Female 123-157
Male 140-174

Responsible for transporting O2

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2
Q

Hematocrit

A

Female 37-47%
Male 42-52%

Concentration of RBC in the body

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3
Q

RBC

A

4.5-5.5 million

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4
Q

WBC

A

5000-10000

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5
Q

Platelets

A

150000-400000

Help clot and stop bleeding

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6
Q

Partial thrombin time (PTT)

A

20-30 seconds

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7
Q

PTT on heparin

A

rate should be 1.5-2.5x patients normal

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8
Q

Prothrombin time (PT)

A

10-12 seconds

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9
Q

International normalized ratio (INR)

A

0.9-1.2

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10
Q

INR on warfarin

A

therapeutic INR 2-3

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11
Q

sodium normal

A

135-145

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12
Q

potassium normal

A

3.5-5.0

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13
Q

calcium normal

A

9-10.5

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14
Q

magnesium normal

A

1.5-2.5

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15
Q

chloride normal

A

98-106

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16
Q

phosphorous normal

A

2.5-4.5

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17
Q

BUN

A

10-20

*increases when kidneys do not filter urea waste

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18
Q

creatinine

A

0.6-1.2

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19
Q

troponin

A

0-0.4

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20
Q

BNP

A

<100

*when fluid retention is present, the heart senses the need to pump harder and release BNP

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21
Q

total cholesterol

A

<200

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22
Q

HDL normal

A

> 55

*responsible for cleaning out arteries and reduces plaque / build up

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23
Q

LDL normal

A

<130

*clogs arteries

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24
Q

Triglycerides (very LDL)

A

<160

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25
Q

urine specific gravity

A
  • 1.005-1.030
  • increased ; dehydration
  • decreased ; diluted urine
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26
Q

urine osmolarity

A
  • 300-900
  • number of particles in urine
  • increased ; dehydration
  • decreased ; diluted urine
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27
Q

urine WBC

A

0-4

*increased; inflammation, UTI

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28
Q

protein in urine

A

should be negative

*if positive; kidney disease, preeclampsia

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29
Q

ABG normals

A

pH normal ; (acidosis) 7.35 – 7.45 (alkalosis)
HC03 normal ; (acidosis) 22-28 (alkalosis)
CO2 normal ; (alkalosis) 35-45 (acidosis)

*fully compensated if pH is normal

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30
Q

causes of hypernatremia (HINT: models)

A
  • medications
  • osmotic diuretics
  • diabetes
  • excessive water loss
  • low water intake
  • sodium intake too high
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31
Q

signs and symptoms of hypernatremia (HINT: fried and salted)

A
  • fever
  • restlessness and agitation
  • increased fluid retention
  • edema
  • dry mouth
  • skin flushed
  • altered LOC
  • low urinary output
  • thirst
  • elevated BP
  • decreased energy
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32
Q

causes of hyponatremia (HINT: mobs fail)

A
  • meds – diuretics
  • oral gastric tube suctioning
  • burns
  • SIADH
  • Failure of kidney, heart, liver
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33
Q

signs and symptoms of hyponatremia (HINT: low sodium)

A
  • LOC altered
  • orthostatic hypoTNS
  • weak muscles
  • seizures
  • osmolarity low (serum)
  • diarrhea
  • increased ICP
  • urine osmolarity high
  • more bowel sounds
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34
Q

causes of hyperchloremia

A
  • dehydration
  • vomiting
  • sweating
  • excess steroids cause chloride retention
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35
Q

causes of hypochloremia

A
  • CHF
  • water intoxication
  • salt losses (burns, sweating, v&d)
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36
Q

cause of hyperkalemia

A
  • medication
  • acidosis
  • cellular destruction
  • hypoaldosteronism
  • intake
  • nephrons – renal failure
  • excretion impaired
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37
Q

causes of hypokalemia

A
  • drugs
  • inadequate K+ intake
  • too much water
  • Cushing’s disease
  • heavy fluid loss
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38
Q

causes of hypercalcemia

A
  • malignancy
  • diuretics
  • steroids
  • parathyroid
  • immobilization
  • endocrine
  • D vitamin
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39
Q

causes of hypocalcemia

A
  • celiac, chrons disease (malabsorption)
  • hypoparathyroidism
  • alcoholism
  • malnutrition
  • pancreatitis
  • renal failure
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40
Q

causes of hyperphosphatemia

A
  • hypocalcemia
  • tumor lysis
  • renal faliure
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41
Q

causes of hypophosphatemia

A
  • malnutrition
  • alcoholism
  • TPN
  • hypercalcemia
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42
Q

foods high in vitamin C

A
  • citrus fruits
  • strawberries
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43
Q

foods high in vitamin D

A
  • fortified milk and cereal
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44
Q

foods high in vitamin K

A
  • leafy greens
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45
Q

foods high in vitamin B12

A
  • protein
  • dairy
  • eggs
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46
Q

foods high in folic acid

A
  • dark green veggies
  • legumes
  • nuts
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47
Q

foods high in iron

A
  • meats
  • eggs
  • leafy greens
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48
Q

foods high in potassium

A
  • avocados
  • oranges
  • yogurt
  • milk
  • salmon
  • bananas
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49
Q

foods high in calcium

A
  • cheese
  • leafy greens
  • milk
  • salmon
  • almonds
  • tofu
  • yogurt
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50
Q

foods high in phosphorus

A
  • dairy
  • chocolate
  • cola
  • nuts
  • beans
  • meats
  • grains and seeds
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51
Q

foods high in sodium

A
  • soy sauce
  • condiments
  • canned food
  • processed meat
  • popcorn
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52
Q

renal diet

A
  • fluid restriction
  • low electrolytes
  • low protein
  • high calcium
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53
Q

grapefruit juice and medication contraindication

A

*inhibits enzyme in liver needed to metabolize these meds

  • nifedipine
  • verapamil
  • statins
  • midazolam
  • SSRIs
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54
Q

acetaminophen antidote

A

acetylcysteine

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55
Q

benzodiazepine antidote

A

flumazenil

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56
Q

heparin and enoxaparin antidote

A

protamine sulfate

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57
Q

warfarin antidote

A

phytonadione (vitamin K)

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58
Q

local anesthetics

A

*END IN -CAINE

  • indicated for painful procedures and localized pain and discomfort
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59
Q

opioid agonists

A

*END IN -INE OR -ONE

*example; morphine, oxycodone, fentanyl

*MONITOR FOR RESP. DEPRESSION

  • indicated for moderate to severe pain relief
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60
Q

opioid antagonist

A

*END IN -ONE

*exmaples; naloxone, methynaltrexone

  • indicated for opioid overdose
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61
Q

NSAIDs

A

*examples; naproxen, ibuprofen, ASA, ketorolac

  • indicated for inflammation, pain, fever
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62
Q

acetaminophen

A
  • no anti-inflammatory properties
  • indicated for pain and fever
  • taking with alc. can cause major liver damage
  • max dose is 4000 mg daily
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63
Q

COX-inhibitors

A

*RISK FOR
- renal impairment
- vasoconstriction
- bleeding
- gastric ulcers

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64
Q

ACE inhibitors

A

*END IN -PRIL

  • indicated for HTN, CHF
  • blocks conversion of angiotensin I to II
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65
Q

ARBs

A

*END IN -SARTAN

  • indicated for HTN, DM neuropathy, CHF
  • inhibits angiotensin II
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66
Q

Calcium channel blockers for heart and bv

A

*END IN -MIL

  • indicated for HTN, angina, afib/flutter
  • block calcium channels in BV (vasodilation) and heart (slow HR and decrease contraction force)
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67
Q

calcium channel blockers bv only

A

*END IN -DIPINE

*WILL NOT CAUSE CONSTIPATION

*INTERACTS WITH GRAPEFRUIT

  • indicated for HTN, angina
  • block calcium channels in BV (vasodilation)
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68
Q

sodium channel blockers

A

*PROCAINAMIDE, LIDOCAINE

  • indicated for dysrhythmias
  • slow impulse conduction and delays repolarization
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69
Q

beta blockers

A

*END IN -LOL

  • indicated for HTN, angina, arrhythmias, MI, anxiety, alc. Withdrawal
  • block beta 1 and 2 adrenergic receptors to slow HR
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70
Q

potassium channel blockers

A

*AMIODARONE, IBUTILIDE

  • indicated for dysrhythmias
  • block potassium currents to prevent repolarization, interfering with excitatory pathways
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71
Q

atropine

A
  • indicated for excessive secretions, sinus bradycardia, heart block
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72
Q

digoxin

A
  • cardiac glycoside
  • indicated for HF, afib, a flutter, CHF, cardiogenic chock
  • increases heart contractility and decreases the rate
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73
Q

adenosine

A

*GIVE IV PUSH CLOSE TO HEART AND QUICK

*WARN PT IT WILL FEEL LIKE A KICK TO THE CHEST

  • indication for SVT
  • interrupts re-entry pathways through AV node, restoring sinus rhythm
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74
Q

H1 antagonists

A

*END IN -INE

  • indicated for allergy, anaphylaxis, sedation
  • blocks H1 receptors, decreases flushing, edema, secretions, itching, pain
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75
Q

glucocorticoids

A

*END IN -IDE, -ONE

*INHALE CAN CAUSE THRUSH

*DO NOT USE ORAL FOR MORE THAN 10 DAYS

  • indicated for asthma, COPD, allergies
  • decreases inflammatory mediators, infiltration of inflammatory cells, and vascular permeability
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76
Q

Leukotriene receptor antagonists

A

*END IN -KAST

  • indicated for asthma, COPD, allergies
    • suppress leukotrienes to decrease smooth muscle constriction / edema
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77
Q

monoclonal antibodies

A

*END IN -ZUMAB

*ANAPHYLAXIS MAY OCCUR IF AMNIN SQ

  • indicated for asthma, COPD, allergies
  • reduce amount of IgE in blood to limit trigger of an inflammatory reaction
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78
Q

B2-adrenergic agonists

A

*END IN -OL

*USE SHORT ACTING THEN LONG IN 1 MIN INTERVALS

  • bind to beta2 receptors in airway leading to relaxation of smooth muscles
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79
Q

Methylxanthines

A

*END IN -LINE

*NARROW THERAPEUTIC WINDOW

  • relaxes bronchial smooth muscle
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80
Q

Anticholinergics

A

*END IN -IUM, -BROMIDE

  • block muscarinic receptors in bronchi causing less bronchoconstriction
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81
Q

Guaifenesin

A
  • indicated for excess mucus
  • stimulates flow of respiratory tract secretions making a more productive cough
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82
Q

Mucolytics

A

*HYPERTONIC SALINE, ACETYLCYSTEINE

  • indicated for excess mucus
  • reacts with mucus to make it more watery
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83
Q

decongestants

A

*PHENYLEPHRINE, PSEUDOEPHEDRINE

  • activates alpha 1 adrenergic receptors on nasal blood vessels causing vasoconstriction
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84
Q

alpha adrenergic agonists

A

*EPINEPHRINE, NOREPINEPHRINE, EPHEDRINE, PHENYLEPHRINE

  • indicated for cardiac arrest, shock, control bleeding anaphylaxis
  • activates alpha receptors resulting in vasoconstriction and pupil constriction
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85
Q

beta adrenergic agonists

A

*EPINEPHRINE, NOREPINEPHRINE, DOPAMINE, DOBUTAMINE, ISOPROTERENOL

  • indicated for AV block, cardiac arrest, shock, HF, preterm labor
  • activates beta receptors causing SNS stimulation resulting in increased HR (B1), bronchodilation (B2), uterine relaxation (B2)

*SIDE EFFECTS; tachycardia, HTN, CNS overstimulation

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86
Q

alpha adrenergic antagonists

A

*END IN -ZOSIN

  • block activation of alpha receptors in SNS causing vasodilation, decreased BP
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87
Q

beta adrenergic antagonists

A

*END IN OLOL

  • block activation of B1/B2 in SNS
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88
Q

cholinergic medications

A

*END IN -STIGMINE

  • cause REST AND DIGEST; increase GI secretions and motility, increase urination, pupil constriction, decrease HR
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89
Q

anticholinergic medications

A
  • block acetylcholine in PNS thereby blocking REST AND DIGEST
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90
Q

anti-parkinson’s medication

A

*LEVODOPA

  • increases dopamine synthesis and can decrease motor symptoms
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91
Q

cholinesterase inhibitors

A

*DONEPEZIL, RIVASTIGMINE, GALANTAMINE

  • indicated for Alzheimer’s, dementia
  • prevents acetylcholine breakdown which resulting in improved memory
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92
Q

long term anticonvulsants

A

*PHENYTONIN, PHENOBARBITAL, VALPROIC ACID

  • selectively inhibit sodium channels, suppressing action potentials in hyperactive neuros
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93
Q

rapid acting anticonvulsants

A

*LORAZEPAM, DIAZEPAM

  • causes CNS depression
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94
Q

H2 antagonists

A

*END IN -IDINE

  • block release of histamine which blocks acid secretions
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95
Q

Proton pump inhibitor

A

*END IN -ZOLE

  • prevent the transport of H ions into gastric lumen to decrease gastric acid production
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96
Q

GI protecetant

A

*SUCRALFATE

  • promotes healing of ulcers by providing barrier over them
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97
Q

Loop diuretics

A

*END IN -IDE

  • indicated for low urinary output, edema, CHF, BP management
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98
Q

thiazide diuretics

A

*END IN -THIAZIDE

  • indicated for HTN, edema
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99
Q

potassium sparing diuretics

A

*END IN -ONE

  • indicated for HTN, edema, HF
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100
Q

steroids

A

*END IN -SONE

  • indicated for Addison’s disease, inflammation, allergy, autoimmune disorders
  • suppresses inflammation in immune system
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101
Q

thyroid hormone replacements

A

*LEVOTHYROXINE

  • take every day, same time, empty stomach, separate from other medications
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102
Q

anti-thyroid medications

A

*IODINE, RADIOACTIVE IODINE, METHIMAZOLE

  • reduces size and vascularity of thyroid gland or kills thyroid cells
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103
Q

ADH (antidiuretic hromone)

A

*VASOPRESSIN, DESMOPRESSIN

  • indicated for DI, shock
  • causes body to retain water, increasing blood volume, decreasing UOP and increasing BP
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104
Q

thrombolytics

A

*END IN -ASE

  • enzyme that converts plasminogen to plasmin, plasmin destroys a clot
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105
Q

penicillins

A

*END IN -CILLIN

  • antibiotic
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106
Q

cephalosporin

A

*STARTS WITH CEP-

  • antibiotic
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107
Q

carapenems

A

*END IN -PENEM

  • antibiotic
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108
Q

tetracyclines

A

*END IN -CYCLINES

  • antibiotic
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109
Q

macrolides

A

*END IN -MYCIN

  • antibiotic
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110
Q

aminoglycosides

A

*END IN -CIN

  • antibiotic
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111
Q

sulfonamide

A

*START WITH SULF-

  • antibiotic
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112
Q

anti-tuberculosis agents

A

*ISONIAZID - kills mycobacteria that are actively dividing

*RIFAMPIN - bactericidal

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113
Q

amphotericin

A
  • for systemic fungal infections
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114
Q

azoles

A

*END IN -AZOLE

  • for systemic or topical fungal infections
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115
Q

fungins

A

*END IN -FUNGIN

  • antifungal medications
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116
Q

Benzodiazepines

A

*END IN -LAM, -PAM

  • indicated for anxiety
  • avoid alc., monitor for resp. depression
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117
Q

SSRIs

A

*END IN -INE

  • antidepressant
  • prevent reuptake of serotonin increasing availability

*MONITOR FOR SEROTONIN SYNDROME - HTN, confusion, anxiety, tremors, ataxia, sweating

*MONITOR FOR SUICIDE FOR 2-3 WEEKS

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118
Q

TCAs

A

*END IN -PTYLINE

  • antidepressant
  • prevent reuptake of serotonin / norepinephrine

*SIDE EFFECTS; tachycardia, cardiac effects, anticholinergic effects, sedation

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119
Q

MAOIs

A

*ISOCARBOXAZID, PHENELZINE

  • antidepressant
  • block enzymes to increase ALL neurotransmitters

*NO FOOD WITH TYRAMINE (aged cheese, wine, pickled meat). will cause HTN crisis

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120
Q

Lithium

A
  • mood stabilizer indicated for mania
  • inhibits excitatory neurotransmitters and promotes GABA

*DO NOT admin with NSAIDs
*THERAPEUTIC RANGE; 0.6-1.2

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121
Q

first generation antipsychotics

A

*HALOPERIDOL

  • indicated for schizophrenia, mania, aggression, agitation
  • inhibits dopamine

*MONITOR FOR tardive dyskinesia, slurred speech, tremors, neuroleptic malignant syndrome (high fever) prolonged QT wave

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122
Q

second generation antipsychotics

A

*END IN -APINE

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123
Q

tocolytics

A

*TERBUTALINE, MAGNEIUM SULFATE

  • binds to beta 2 adrenergic receptors to slow contractions

*SIDE EFFECTS; CNS overstimulation (terb.), hypermagnesemia (mag.)

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124
Q

oxytotics

A

*OXYTOCIN

  • stimulate contractions in labor or PPH
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125
Q

prostaglandin E1

A

*MISOPROSTOL

  • ripen cervix
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126
Q

prostaglandin E2

A

*DINOPROSTONE

  • ripen cervix
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127
Q

nitrous oxide

A
  • gas mixed with O2
  • reduces anxiety, causes feeling of well-being
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128
Q

narcotics used in labor

A
  • meperidine
  • butorphanol
  • morphine
  • nalbuphine

*CAN CROSS PLACENTA so monitor for resp. depression

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129
Q

epidural

A
  • regional anethesia
  • small catheter placed into lower spine and pain medication is given
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130
Q

spinal block

A
  • indicated for pain control during C-section
  • injected directly into fluid of the spinal cord and will block pain for a few hours
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131
Q

drugs to avoid in children

A
  • ASA (reye’s syndrome)
  • Ibuprofen before 6 mo. (immature liver)
  • tetracycline (tooth discolouration)
  • oseltamivir (hallucinations)
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132
Q

inotropes

A
  • go directly to the heart to increase myocardial contractility force
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133
Q

vasopressors

A
  • mimic SNS to cause vasoconstriction
  • indicated for MI, hypoTNS, shock
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134
Q

medication for septic shock

A

1st; dopa or norepi
2nd; epi or phenylephrine
3rd; vasopressin

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135
Q

milrione

A
  • indicated for cardiogenic chock, decreased CO, heart defects
  • causes systemic vasodilation decreasing after load and increasing contractility
  • inhibits phosphodiesterase
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136
Q

cardiac output formula

A

CO = stroke volume X heart rate

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137
Q

PICC

A

needed when several weeks of infusions are needed (chemo, antibiotics, TPN)

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138
Q
A
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139
Q

ECG normal findings

A
  • 1 P wave for every QRS
  • PR interval between 0.12-0.20
  • QRS less than 0.12 seconds
  • Rate between 60 and 100
  • Regular rhythm

*LITTLE BOXES 0.04

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140
Q

first degree heart block ECG

A

PR interval >0.20

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141
Q

second degree heart block (type 1) ECG

A

PR normal, then longer, then longer, then drops

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142
Q

second degree heart block (type 2) ECG

A

No P wave for every QRS

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143
Q

third degree heart block ECG

A

variable PR wave

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144
Q

tall peaked T waves indicate …

A

hyperkalemia

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145
Q

shallow / inverted T waves & U wave indicate ….

A

hypokalemia

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146
Q

tall, unpeaked T waves indicate …

A

Hypermagnesemia

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147
Q

beneficence

A

doing good

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148
Q

nonmaleficence

A

do no harm

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149
Q

accountability

A

accepting responsibility for your actions and accepting consequences

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150
Q

fidelity

A

keep your promises and be faithful

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151
Q

autonomy

A

encourage patient to make their own decisions without judgement or coercion

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152
Q

veracity

A

tell the truth and not withholding any part of the truth

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153
Q

orthodox jewish

A

*KOSHER DIET
- no shellfish
- no pork
- do not combine meats / dairy in same meal

*PT NEEDS WRAPPED PLASTIC UTENSILS / PREP THEIR OWN MEAL

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154
Q

Halal diet

A
  • no alc.
  • no pork
  • meat must be slaughtered religiously
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155
Q

seventh-day adventisit church

A
  • no alcohol
  • no caffeine
  • lacto-ovo vegetarians
  • no meat / pork
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156
Q

hinduism diet

A
  • no eggs
  • dairy ok
  • no meat - esp. beef
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157
Q

where are steroids produced

A

produced by adrenal cortex

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158
Q

glucocorticoids effects

A
  • mood
  • immunosuppression
  • break down fat and proteins
  • inhibit insulin
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159
Q

mineralcorticoids effects

A
  • retain sodium and water
  • excrete potassium

(example; aldosterone)

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160
Q

where are catecholamines from

A

secreted by adrenal medulla

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161
Q

antidiuretic hormone

A
  • secreted from pituitary gland
  • retains water but not sodium
  • medication replacement ends in -PRESSIN
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162
Q

thyroid hormone

A
  • provide energy for metabolism
  • TSH controls release of T3/T4
  • low T3/T4 cause high TSH
  • levothyroxine is T4 med. replacement
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163
Q

thyroid hormone negative feedback loop

A
  • blood has low T3/T4 levels
  • hypothalamus increases TRH
  • pituitary increased TSH
  • thyroid increases T3/T4
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164
Q

parathyroid hormone (PTH)

A

controls calcium levels by pulling from bones into blood

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165
Q

calcitonin

A
  • released when serum calcium levels increase
  • inhibit osteoclasts
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166
Q

metformin nursing considerations

A
  • do not give in renal and hepatic impairment
  • monitor BUN, Cr
  • take with food
  • hold 24hrs before and 48hrs after IV contrast studies
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167
Q

addison’s disease

A
  • TOO little steroids
  • low cortisol; fatigue, wt loss, hypoglycemia
  • low aldosterone; low sodium and water, potassium retention, hypoTNS
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168
Q

cushing’s disease

A
  • TOO much steroids
  • high cortisol; immunosuppression, mood alteration, fat redistribution
  • high aldosterone; fluid and sodium retention, potassium excretion

*remember moon face, buffalo hump, weight in abdomen

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169
Q

conn’s disease

A

too much aldosterone

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170
Q

pheochromocytoma

A
  • too much catcholamines due to tumour on adrenal gland
  • s&s; tachycardia, palpitations, HTN, diaphoresis

*DO NOT PALPATE ABDOMEN IF SUSPECTED DT RISK OF RUPTURING TUMOUR

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171
Q

diabetes insipidus

A
  • not enough ADH in the body
  • s&s; drying effects, tachycardia, hypoTNS
  • decreased USG
  • increased Na, HCT, serum osmolarity
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172
Q

what to monitor after parathyroidectomy

A
  • monitor for hypocalcemia
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173
Q

crackles

A
  • sounds like wood burning in a fire place, popping
  • air moving through mucous, fluid
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174
Q

rhonchi

A
  • low-pitched, snoring
  • secretions in airway
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175
Q

wheezes

A
  • high pitched musical sound
  • airway constriction
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176
Q

diminished

A
  • quiet
  • shallow or restricted breathing
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177
Q

stridor

A
  • high pitched inspiratory sound
  • upper airway obstruction
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178
Q

HIGH ventilator alarms

A

*HIGH PRESSURE
caused by;
- coughing
- gagging
- bronchospasm
- fighting ventilator
- ETT occlusion
- kink in tubing
- increased secretions
- thick secretions
- water in ventilator circuit

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179
Q

LOW ventilator alarms

A

*LOW PRESSURE
caused by;
- disconnected tubing
- loose connections
- leak
- extubation
- cuffed ETT or trach is deflated
- poorly fitted mask

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180
Q

why would a client need a chest tube?

A
  • pneumothorax
  • euffusions
  • abscess
  • cancer
  • hemothorax
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181
Q

drainage collection chamber (chest tube)

A
  • connected to patient
  • air, fluid, blood drains into here
  • no tidaling / bubbling
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182
Q

water seal chamber (chest tube)

A
  • tidaling (up when pt breaths in)
  • intermittent bubbling
  • ensures suction is a closed system
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183
Q

suction control chamber (chest tube)

A
  • connected to suction
  • no tidaling
  • gentle bubbling
  • replace with sterile water PRN
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184
Q

montelukast

A
  • leukotriene modifier
  • managed allergic rhinitis, allergies, asthma
  • long term to prevent attacks
  • regulate mass cells
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185
Q

guaifenesin

A
  • expectorant to loosen mucus and stimulate cough
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186
Q

assessment findings for COPD

A
  • barrel chest dt hyper-inflated lungs
  • accessory muscle use
  • congestion
  • diminished, crackles, wheezes
  • acidotic
  • hypercarbic
  • hypoxic
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187
Q

pneumonia diagnosis

A
  • CXR; patchy infiltrates
  • sputum culture identifies bacterial source
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188
Q

air embolism positioning

A

left lateral trendelenburg (durant’s maneuver)

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189
Q

pulmonary embolism positioning

A

high fowlers

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190
Q

cranial nerve I

A

olfactory - smell

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191
Q

cranial nerve II

A

optic - vision

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192
Q

cranial nerve III

A

oculomotor - pupil contriction

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193
Q

cranial nerve IV

A

trochlear - downward eye movement

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194
Q

cranial nerve V

A

trigeminal - jaw movement, sensation of face and neck

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195
Q

cranial nerve VI

A

abducens - lateral eye movement

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196
Q

cranial nerve VII

A

facial - facial movement, taste of 2/3 of tongue

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197
Q

cranial nerve VIII

A

vestibulocochlear - hearing and balance

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198
Q

cranial nerve IX

A

glossopharyngeal - swallowing, taste on posterior 1/3

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199
Q

cranial nerve X

A

vagus - swallowing, speaking

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200
Q

cranial nerve XI

A

spinal/accessory - flextion and rotation of head

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201
Q

cranial nerve XII

A

hypoglossal - tongue movements

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202
Q

normal ICP

A

5-15

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203
Q

ICP symptoms

A
  • vomiting
  • headache
  • mental status changes; LOC, confusion
  • eyes; pupillary changes, nystagmus
  • speech; slurring, pressured
  • cushing’s triad; increased systolic BP, decreased HR, altered respirations
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204
Q

decorticate posturing

A
  • abnormal flextion
  • arms pulled toward center
  • clenched fists
  • damage to midbrain
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205
Q

aphagia

A

inability to swallow

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205
Q

dysphagia

A

difficulty swallowing

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205
Q

aspirin and children

A
  • can cause Reye’s syndrome if pt has viral infection
  • commonly used in Kawasaki disease
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205
Q

decerebrate posturing

A
  • abnormal extension
  • arms and legs straight out
  • toes pointed downwards with arched back
  • damage to deep brain structures;pons
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205
Q

dysphasia / aphasia

A

impairment in comprehension or production of language
- receptive; damange to wernicke’s
- expressive; damage to broca’s

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206
Q

basilar skull fracture

A
  • battle’s sign; bruising over mastoid process
  • raccoon eyes; periorbital bruising
  • cerebralspinal rhinorrhea; halo test positive and positive for glucose on glucometer

*NEVER PUT ANYTHING IN NOSE AS IT CAN GO INTO BRAIN

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207
Q

epidural hematoma

A
  • dura peeled off skull
  • rapid expansion or blood between dura mater and skull
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208
Q

subdural hematoma

A
  • dura attached to skull
  • slow expansion of venous blood between arachnoid matter and dura matter
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209
Q

hypertensive crisis treatment

A
  • sit client up to lower BP
  • administer antihypertensives
  • tx underlying cause (ex. full bladder - cath, constipated - disimpact, pressure injury - reposition)
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210
Q

hemorrhagic stroke

A
  • vessel ruptures and bleeds into brain
  • increases ICP
  • “worst headache of my life”
  • tx; control bleeding, craniotomy
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211
Q

ishemic stroke

A
  • clot blocks blood flow to brain
  • thrombotic; in brain artery
  • embolic; clogs blood vessel leading to brain
  • tx; permissive HTN (ensures brain perfusion), antithrombotics (tPA), surgical removal
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212
Q

stroke symptoms

A
  • balance; dizziness, headache
  • eyes; blurry vision, unequal
  • face; unilateral drooping
  • arms; arm/leg weakness
  • speech; difficulty
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213
Q

menengitis assessment findings

A
  • nuchal (Neck) rigidity
  • photophobia
  • fever
  • kernig’s sign; pt supine, bend leg up, INTENSE PAIN
  • brudzinski’s sign; pt supine, passive neck flexion causes involuntary flexion of knees and hips
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214
Q

multiple sclerosis

A
  • autoimmune disorder
  • CNS inflammation
  • damages mylein sheath
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215
Q

guillain-barré

A
  • antibody immunologic response precipitated by viral or bacterial illness
  • causes ascending weakness and paralysis
  • 2 week peak, slow recovery
  • tx underlying illness
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216
Q

neuropathy

A

weakness, numbness and pain from nerve damage

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217
Q

botulism

A
  • toxin released by bacteria found in soil, dust, honey
  • after 1 year you can digest better
  • inhibits acetylcholine release
  • descending paralysis
  • tx antitoxin
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218
Q

myasthenia gravis

A
  • autoimmune disorder where communication between nerves and muscle are destroyed
  • diagnosed via TENSILON TEST
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219
Q

parkinsons

A
  • progressive
  • caused by degeneration of dopamine neurons
  • symptoms; tremor, rigidity, akinesia / ataxia, postural instability
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220
Q

T cells

A

coordinate attack and/or directly kill pathogens

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221
Q

B cells

A

produce antibodies

222
Q

memory cells

A

circulate to patrol of repeat threats

223
Q

monocytes

A

when activated become macrophages which “eat” antigen presenting cells

224
Q

antigen

A
  • protein marker on outside of cell
  • marks “self” vs. “other”
225
Q

antibody

A
  • locks on to antigen on cell
  • marks cell for destruction
226
Q

antivirals

A
  • END IN -VIR
227
Q

antifungals

A

*END IN -ZOLE

*nystatin is topical cream / powder. common med for thrush

228
Q

aminoglycosides - antibitoic

A
  • END IN -MYCIN
  • gram negative
  • inhibit bacterial protein synthesis

*monitor for tinnitus

*vancomycin mostly used for sepsis. can get red-man syndrome so GIVE SLOW

229
Q

fluroquinolones - antibiotic

A

*END IN -FLOXACIN

  • for UTI, resp. infections, etc.
  • inhibit bacterial protein synthesis

*monitor for prolonged QT, tendon rupture

230
Q

penicillins - antibiotic

A
  • END IN -CILLIN
  • indicated for infections
  • inhibits synthesis of bacterial cell wall
231
Q

immunosuppressants

A
  • TACROLIMUS, SIROLIMUS
  • indicated for autoimmune disorders and transplant recipients
232
Q

inactivated vaccines

A
  • hep A
  • flu
  • polio
  • rabies
233
Q

live-attenuated vaccines

A
  • MMR
  • rotavirus
  • smallpox
  • chicken pox
  • yellow fever
234
Q

immune globulins

A
  • IVIG, RhoGAM
  • indicated for immunodeficiency, autoimmune disorders

*high risk for sensitivity reaction so start LOW AND SLOW
*can pre medicate with acetaminophen and diphenhydramine

235
Q

airborne precaution infections

A
  • TB
  • rubeola (measles)
  • varicella (chickenpox)
  • SARS
  • small pox
236
Q

droplet precaution infections

A
  • influenza
  • pretussis
  • mumps
  • rhinovirus
  • adenovirus
  • meningitis
  • streptococcus aureus
  • rubella
  • diptheria
237
Q

contact precaution infections

A
  • MRSA
  • VRE
  • norovirus
  • rotavirus
  • conjunctivitis
  • herpes
  • lice
  • scabies
  • poliomyelitis
238
Q

sepsis

A
  • infection spread in bloodstream

causes;
- increased capillary membrane permeability
- massive vasodilation
- BP is not high enough to perfuse tissues

239
Q

signs and symptoms of sepsis

A
  • shiver, fever, very cold
  • extreme pain or general discomfort
  • pale or discoloured skin
  • sleepy, difficult to rouse
  • “i feel like i might die”
  • SOB
  • elevated lactic acid level
  • metabolic acidosis
  • tachycardia
  • tachypnea
240
Q

sepsis tx

A
  • blood culture
  • broad spectrum IV ABX within 1 hour
  • IV fluids
  • vasopressors
241
Q

systemic lupus erythematosus

A
  • immune system attacks joints, skin, brain, lungs, kidneys, blood vessels
  • flare ups and remissions

symptoms management;
- immunosuppressants
- steroids
- hydroxychloroquine

242
Q

rheumatoid arthritis

A
  • chronic systemic inflammatory disease
  • destruction of connective tissue and synovial membrane in joints
243
Q

psoriasis

A
  • T-cell mediated inflammatory skin disease
  • thickening of epidermis and dermis

symptom management;
- light therapy
- folic acid
- retinoids
- infliximab

244
Q

topical antimicrobials

A

applied directly to the skin to tx bacterial, fungal, or viral infections

245
Q

topical corticosteroids

A

reduce inflammation, redness, itching

246
Q

primary lesion

A

direct result of a disease process

247
Q

secondary lesion

A

developed as a consequence of the client’s activities

248
Q

stage 1 pressure ulcer

A
  • non blanchable
  • skin intact
249
Q

stage 2 pressure ulcer

A
  • PARTIAL THICKNESS
  • dermis exposed
250
Q

stage 3 pressure ulcer

A
  • FULL THICKNESS
  • exposed hypodermis
  • granulation tissue, eschar, necrotic
  • tunneling
251
Q

stage 4 pressure ulcer

A
  • through all hypodermis and exposes muscle, bone, cartilage
252
Q

unstageable pressure ulcer

A
  • too much eschar and cannot see base of wound
253
Q

dermatitis

A
  • inflammation of the dermis
  • contact; hypersensitivity when exposed to allergen
  • atopic (eczema); intense itching, flare ups
254
Q

stevens-johnson syndrome

A
  • cytotoxic t-cell drug reaction
  • keratinocyte cell death
  • causes extensive blistering
255
Q

bacterial skin infections

A
  • cellulitis; red, warm, swollen
  • impetigo; bullous, ulcerative
  • MRSA
256
Q

viral skin infections

A
  • HSV; type 1 (mouth), type 2 (genital). vesicles turn into pustules, rupture, and form crusts
  • herpes zoster; grouped lesions with weeping and crusting
257
Q

fungal skin infections

A
  • tinea; classified by location. annular patches with elevated borders and scaling
  • candidiasis; yeast infection causing burning and itching
258
Q

squamous cell carcinoma

A
  • very top layer of epidermis grow out of control
  • tx; remove
259
Q

basal cell carcinoma

A
  • most common
  • start in bottom layer of epidermis
  • tx; remove
260
Q

melanoma

A
  • melanocytes grow out of control
  • less common but more dangerous
  • appearance; dark brown or black
  • mostly on trunk / legs
  • tx; immunotherapy, chemo, radiation
261
Q

1st degree burn

A
  • superficial
  • skin remains intact
  • redness, no blisters
262
Q

2nd degree burn

A
  • partial thickness
  • blisters
  • moist and red skin
263
Q

3rd degree burn

A
  • full thickness
  • destroy nerve endings
  • red, tan or black
  • dry, leathery, eschar
264
Q

4th degree burn

A
  • involves bone and muscle underneath skin
  • dry and dull
265
Q

emergent burn phase

A
  • first 24-48 hours
  • high risk for hypovolemic shock, electrolyte imbalance, renal failure
  • PRIORITY FLUIDS
266
Q

rule of 9s for burn

A
  • entire head is 9%
  • front of chest is 9%
  • front of abdomen is 9%
  • back of chest is 9%
  • back of abdomen is 9%
  • front of EACH leg is 9%
  • back of EACH leg is 9%
  • front of EACH arm is 4.5%
  • back of EACH arm is 4.5%
  • groin area is 1%
267
Q

burn complications

A
  • hypovolemic shock
  • renal failure
  • hyperkalemia
  • hyponatremia
268
Q

burn fluid replacement

A
  • crucial in first 24 hours
  • LR

*want to output 30mL per hour

269
Q

parkland burn formula

A

4mL x % body surface area burned x body weight (kg)

*give first half of the solution over the first 8 hours
*second half over the next 16 hours

270
Q

pH of stomach

271
Q

functions of the liver

A
  • produce bile, albumin, cholesterol
  • converts glucose to glycogen
  • converts ammonia to urea
  • metabolizes bilirubin, drugs
272
Q

function of gallbladder

A
  • stores bile
  • releases bile into small intestine
273
Q

what is bile

A
  • green/yellow substance
  • alkaline
  • emulsifies lipids so they can be absorbed
274
Q

functions of the pancreas

A

produce and releases digestive enzymes into duodenum

275
Q

trypsin enzyme

A

break down proteins

276
Q

amylase enzyme

A

break down carbohydrates

277
Q

lipase enzyme

A

break down fats

278
Q

TPN contents

A
  • dextrose
  • amino acids
  • electrolytes
279
Q

TPN complications

A
  • infection (scrub the hub, change bag and tubing q24h)
  • fluid overload
  • hyper or hypoglycemia
  • embolism
280
Q

antiulcer agents

A
  • H2 receptor blockers (*END IN -INE). blocks acid secretion
  • PPI (*END IN -OLE). prevent H ion transport
  • antacids
  • GI protectant (sucralfate). provides barrier
281
Q

gastric residual

A

greater than 500mL, stop feed and notify provider

282
Q

blakemore tube

A
  • 3 ports
  • balloon is esophagus to stop bleeding varices

*KEEP SCISSORS AT BEDSIDE.

283
Q

esophageal varices

A
  • dilated veins in esophagus
  • can burst
  • dt liver disease, alcoholism
284
Q

GERD

A
  • acid refluxes from stomach into esophagus
  • tx; sit upright after meals, small frequent meals, H2, PPI
285
Q

gastric ulcer symptoms

A
  • pain 1-2 hrs after meal
  • pain aggravated by eating
  • vomiting
  • wt loss
  • hematemesis
286
Q

duodenal ulcer symptoms

A
  • pain 2-4 hrs
  • food may relieve pain
  • wt gain
  • melena
287
Q

chron’s disease

A

inflammation and erosion of the ileum anywhere along GI tract

288
Q

ulcerative colitis

A
  • inflammation of large intestine
  • causes ulceration
  • common in 20-40 and those of jewish descent
289
Q

diverticular disease

A
  • diverticula; herniation of mucosa through colon wall
  • diverticulosis; asymptomatic
  • diverticulitis; symptomatic
290
Q

tx chrons, ulcerative colitis, diverticular disease

A
  • low fiber
  • avoid cold and hot foods
  • no smoking
  • antidiarrheals
  • antibiotics
  • steroids
  • may need surgical removal of affected portion
291
Q

appendicitis

A
  • most common at 10 yrs

pain path;
- dull, steady pain
- over 4-6 hours pain progresses in RLQ
- sudden relief = rupture

292
Q

McBurney’s sign

A
  • indicated in appendicitis
  • significant pain when palpating 2/3 way from umbilicus in RLQ
293
Q

pancreatitis

A

digestive enzymes activate inside the pancreas causing auto-digestion

294
Q

pancreatitis assessment

A
  • cullen’s sign (c shape bruising above umbilicus)
  • grey turner’s sign
  • abdominal distention
  • ascites
  • rigid abdomen
  • jaundice
  • hypotension
295
Q

cholelithiasis

A
  • gallstones
  • hardened deposits of bile in gallbladder
  • dt hyperlipidemia/bilirubinemia
296
Q

cholelithiasis assessment

A
  • sudden, sharp RUQ pain
  • radiates to back and between shoulder blades
  • worse after fatty meal / at night
297
Q

cholecystitis

A
  • gallbladder inflammation
  • dt infection, blocked bile duct
298
Q

hepatitis

A
  • inflammation of liver
  • different types dt different viruses
299
Q

hepatitis A

A
  • transmitted via food or water
  • prevent by vaccine
  • tx; supportive
300
Q

hepatitis B

A
  • transmitted via contact with bodily fluids
  • prevent by vaccine, blood screening, improved hygiene
  • acute; supportive
  • chronic; antiviral therapy
301
Q

hepatitis C

A
  • transmitted via contact with bodily fluids
  • prevent by blood screening, sterile needles
  • tx; antivirals
302
Q

hepatitis D

A
  • transmitted via contact with bodily fluids (only if already infected with HBV)
  • prevent by
    blood screening, sterile needles
303
Q

hepatitis E

A
  • transmitted via food or water
  • prevent by improved hygiene
  • tx; supportive
304
Q

hepatic encephalopathy

A

protein in diet is broken down into ammonia but dt liver inflammation, it is not converted into urea

305
Q

how to decrease ammonia

A
  • lactulose; binds to ammonia - antibiotics (neomycin or rifaximin); reduces bacterial ammonia production
  • decrease protein in diet
306
Q

aldosterone effects on the body

A
  • sodium retained
  • water retained
  • potassium excreted
307
Q

glomerulonephritis

A
  • inflammation of kidney
  • dt antibodies lodged in glomerulus causing decreased filtering ability
308
Q

glomerulonephritis symptoms

A
  • sore throat
  • malaise
  • flank pain
  • HTN
  • edema
  • decreased UOP
  • sediment / blood in urine
  • increased BUN and Cr
309
Q

nephrotic syndrome

A

kidney disorder causing body to pass too much protein in the urine

causes;
- infection
- NSAIDs
- cancer
- lupus
- diabetes
- strep
- inflammation

310
Q

renal diet

A

LOW protein
LOW sodium
LOW phosphorus

*EXCEPT IN nephrotic syndrome, you want high protein

*AVOID DARK COLAS AND CHOCOLATE (high in phosphorus)

311
Q

anasarca

A

edema that starts in the face and spreads to the whole body

312
Q

pre renal failure

A

blood cannot get to the kidneys

313
Q

intra renal failure

A

damage inside the kidney

314
Q

post renal failure

A

something is blocking the urine from leaving the kidneys

315
Q

acute kidney injury

A
  • occurs suddenly
  • cause a build up of waste products in the blood
316
Q

chronic kidney disease

A

damage accumulates over time and the kidneys can no longer filter waste properly

317
Q

phases of acute injury

A
  • onset; UO decreases
  • oliguric; fluid overload
  • diuretic; can excrete waste but unable to concentrate urine
  • recovery
318
Q

diabetic nephropathy

A

chronic high blood glucose levels causes thickening of renal arterial wall and sclerosis of nephrons

319
Q

stages of chronic kindey disease

A

lower the GFR, more damage there is

320
Q

lab value in chronic kidney disease

A
  • increased BUN / Cr
  • metabolic acidosis
  • HIGH potassium and phosphorus
  • LOW calcium
321
Q

hemodialysis

A
  • client has fistula that is connected to machine to filter waste products
  • rapid fluid shift; monitor BP/electrolytes
  • must anticoagulant
322
Q

characteristics of a good hemodialysis fistula

A
  • palpate a thrill
  • auscultate a bruit
323
Q

peritoneal dialysis process

A
  • dialysate is infused into peritoneal cavity
  • dwells for 6 hrs
  • fluid is drained along with toxins
324
Q

peritoneal dialysis drainage

A
  • should be clear
  • ensure all comes out - turn to side if decreased fluid return
325
Q

BPH

A

prostate and surrounding tissue grow excessively and squeeze urethra

326
Q

BPH symptoms

A
  • dribbling after urination
  • excessive nocturnal urination
  • frequency
  • sense of incomplete bladder emptying
  • incontinence
327
Q

BPH diagnosis

A
  • digital rectal exam
  • urine test
  • blood test
  • PSA blood test
328
Q

BPH tx

A
  • alpha blockers; relax muscle fibers in prostate
  • 5-alpha reductase inhibitors; shrink prostate
  • tadalafil; relaxes smooth muscle
329
Q

gynecoid pelvic shape

A
  • normal
  • rounded or blunt
330
Q

anthropoid pelvic shape

A
  • oval
  • adequate outlet, narrow pubic arch
331
Q

android pelvic shape

A
  • angulated or heart shaped
  • not favorable for birth or labor
332
Q

platypelloid pelvic shape

A
  • flat with coal inlet
  • makes birth and labor difficult
333
Q

ovarian hormones

A

*FSH, LH
- released by anterior pituitary gland
- control menstrual cycle (28 days)

334
Q

estrogen

A
  • female
  • from ovaries
  • stimulates female secondary sex characteristics
  • repair uterus wall
  • control ovulation
335
Q

progesterone

A
  • female
  • from ovaries, placenta
  • prevents uterine wall breakdown
336
Q

testosterone

A
  • male
  • from testes
  • stimulates male secondary sex characteristics
337
Q

oral contraceptives

A
  • stop ovulation, prevent implantation
  • contain estrogen and progesterone
  • higher clotting risk
338
Q

education for cervix health

A
  • PAP
  • HPV vaccination
  • quit smoking
  • healthy eating
  • low stress
339
Q

endometriosis

A
  • tissue that lines uterus grows outside
  • pain in lower abdomen, back, pelvis, rectum, vagina
340
Q

toxic shock syndrome

A
  • accumulation of toxins that are produced by staph aureus
  • risks; tampons, cervical caps
341
Q

risk factors for STDs

A
  • multiple sex partners
  • breaks in skin
  • inadequate condom use
  • severity of partner infection
342
Q

gonorrhea

A

transmission; oral, anal, vaginal, mom to baby

testing; urine, secretions, blood

tx; abx (doxycycline)

343
Q

syphillis

A
  • 3 stages (most infectious 1/2)

transmission; direct contact with lesions, mom to baby

testing; secretions, blood

tx; abx (penicillin)

344
Q

chlamydia

A

transmission; oral, anal, vaginal, mom to baby

testing; urine, secretions

tx; abx (azithromycin, doxycycline)

345
Q

herpes

A
  • type 1; cold sores
  • type 2; genital

transmission; sex, mom to baby

testing; physical, confirmed with labs

tx; antivirals

346
Q

TORCH syndrome

A

infectious agents that can cause serious harm to developing fetus

  • toxoplasmosis
  • other agents
  • rubella
  • cytomegalovirus
  • herpes
347
Q

TORCH syndrome symptoms

A
  • fever
  • difficulty feeding
  • hepatomegaly
  • splenomegaly
  • jaundice
  • hearing impairment
  • eye abnormalities
348
Q

DMARD

A

*METHOTREXATE

indicated for RA

action; reduce joint destruction and slow disease progression by interfering in immune response

349
Q

hypouricemic agent

A

*ALLOPURINOL

indicated for gout

action; inhibits xanthine oxidase to prevent uric acid from forming

*AVOID food high in purine (beer, wine, cheese, beans, cream)

350
Q

bisphosphonate

A

*ALENDRONATE

indicated for osteoporosis

action; decrease bone resorption by osteoclasts

351
Q

centrally acting muscle relaxers

A

*BACLOFEN

indications; muscle spasticity, MS, CP, SCI

action; suppresses hyperactive reflexes involved in muscle movement regulation

352
Q

fracture treatment

A
  • rest
  • ice
  • compression
  • elevation
  • immobilization; cast, splint, etc
  • traction; temp. proper alignment
353
Q

osteoporosis

A
  • bone demineralization
  • bone resorption accelerates and bone formation slows
354
Q

osteoporosis risk factors

A
  • women
  • caucasian
  • early / post-menopause
  • smoking
  • family hx
  • excessive ETOH
  • thing, small frame
  • increased age
355
Q

rheumatoid arthritis

A
  • autoimmune disease
  • destruction of connective tissue and synovial joints
  • leads to dislocation and deformity
  • pannus forms causing necrosis
  • flares occur during fatigue and stress
356
Q

RA assessment findings

A
  • pain in morning
  • visible joint deformities
  • spongy, soft, boggy feeling joints
  • warm / reddened joints
  • elevated ESR
  • positive rheumatoid factor
357
Q

RA tx

A

NSAIDS, glucocorticoids, DMARD

358
Q

osteoarthritis

A
  • age related
  • cartilage decreases and bones become sclerosed causing bone spurs
359
Q

osteoarthritis assessment findings

A
  • outgrowths; heberdens (close to fingernail), bouchards (middle finger joint)
  • morning stiffness
  • hard, bony, tender joints
  • crepitus
  • pain with activity
  • no inflammation, redness, fever, fatigue
360
Q

gout

A
  • body cannot control uric acid production or exertion
  • acid crystallizes and deposits in connective tissues
  • inflammation and destruction of joints
361
Q

gout assessment

A
  • pain getting worse as day goes
  • inflammation
  • decreased mobility
  • tophi (white/yellow)
  • high uric acid levels
362
Q

gout tx

A
  • alternate cold and warm compress
  • allopurinol, NSAIDS, corticosteroids
  • avoid high purine foods
363
Q

foods high in purine

A
  • organ meats
  • red meats
  • anchovies
  • sardines
  • scallops
364
Q

contractures

A

permanent muscle shortening caused by muscle spasticity

365
Q

myopathy

A
  • muscle weakness and atrophy
  • decreased muscle strength and tone
  • dt drugs, ETOH, idiopathic
366
Q

rhabdomyolysis

A

severe injury to skeletal muscle causing the release of their intracelluar contents that can become toxic in circulation

367
Q

rhabdomyolysis assesment

A
  • dark urine (coca cola coloured)
  • vomiting
  • bruising
  • fatigue
  • muscle weakness
368
Q

rhabdomyolysis tx

A
  • fluids to protect kidneys
  • diuretics
  • bed rest
  • monitor electrolytes and CK
369
Q

fracture complications

A
  • avascular necrosi
  • compartment syndrome
  • fat embolism
  • infection
  • osteomyelitis
  • PE
370
Q

compartment syndrome

A
  • increased pressure in confined space
  • increased pressure compromises circulation
  • distal tissue becomes ischemic
371
Q

fat embolism symptoms

A
  • hypoxia
  • dyspnea
  • tachypnea
  • confusion
  • altered LOC
  • petechial rash
372
Q

anticoagulants

A
  • heparin
  • antiplatelet drugs
  • warfarin
  • factor Xa inhibitors
373
Q

heparin

A
  • thrombin inhibitor
  • PREVENTS clots
  • monitor aPTT
374
Q

heparin induced thrombocytopenia and thrombosis (HITT)

A
  • heparin complication
  • 5-10 days after exposure
  • platelet count drops

CM;
- skin lesions at injection sites
- chills
- fever
- chest pain
- DVT

375
Q

low molecular weight heparins

A

*END IN -PARIN

  • PREVENT clots
  • dose based on body size
  • always SC
  • can be given in pregnancy
376
Q

warfarin

A
  • disrupts liver synthesis of clotting factors
  • monitor PT and INR
  • avoid foods high in vitamin K (leafy greens)
377
Q

aspirin; acetylsalicylic acid

A
  • decreases platelet aggregation
  • don’t administer with other anticoags
  • d/c 5-7 days before surgery
378
Q

salicylism

A
  • ASA toxicity

CM;
- nausea
- tinnitus
- headache
- delirium
- hyperventilation
- pulmonary edema
- respiratory acidosis

379
Q

fibrinolytcis/thrombolytics

A
  • END IN -ASE
  • break up clots
  • converts plasminogen to plasmin
  • must be given ASAP
380
Q

coagulants

A
  • stop bleeding by forming clot
  • vitamain K
  • protamine sulfate
  • thrombin
381
Q

blood administration

A
  • 2 RN check
  • filtered blood tubing
  • large gauge IV (20, 18)
  • can only give with NS
  • vitals before, 30 min in, and end
382
Q

febrile transfusion reaction symptoms

A
  • fever
  • chills
  • tachycardia
  • tachypnea
  • hypoTNS
383
Q

hemolytic transfusion reaction symptoms

A
  • mild; fever, chills, headache
  • chest pain
  • tachycardia
  • tachypnea
  • hypoTNS
  • hemoglobinuria
  • apprehension
  • severe; DIC, circulatory collapse
384
Q

allergic transfusion reaction symptoms

A
  • rash
  • itching
  • bronchospams
385
Q

polycythemia vera

A
  • excessive erythrocytes, leukocytes and thrombocytes
  • hyper viscous blood causing poor perfusion
386
Q

iron deficiency anemia

A

dt;
- iron deficient diet
- chronic ETOH
- malabsorption
- rapid metabolic activity; pregnancy, adolescence, infection

387
Q

vitamin B12 deficiency anemia

A

dt;
- dietary deficiency
- malabsorption

388
Q

aplastic anemia

A
  • body stops producing enough new blood cells
  • dt damage to bone marrow
389
Q

anemia assessment findings

A
  • tachycardia
  • orthostatic hypoTNS
  • dyspnea on exertion
  • fatigue
  • pallor
  • cool skin
  • mottled
  • delayed cap refill
  • unable to tolerate cold
390
Q

sickle cell anemia

A
  • disorder causing RBC to “sickle” and break down
  • autosomal recessive
391
Q

sickle cell crisis

A
  • decreased blood flow to tissues leads to hypoxia, ischemia, infarction
  • severe joint pain
  • splenomegaly and tenderness

dt;
- hypoxia
- exercise
- high altitude
- fever

392
Q

sickle cell crisis tx

A
  • IV fluids; decreased sickled cell concentration
  • blood transfusion; provides normal RBC
  • oxygen; increase oxygenation
  • pain medications
  • hydroxyurea; increases production of fetal hemoglobin to reduce crises
393
Q

disseminated intravascular coagulation (DIC)

A

proteins that control blood clotting become overactive

394
Q

disseminated intravascular coagulation (DIC) cascade

A
  • precipitating event activates coagulation cascade
  • causes excess thrombin = excess clotting
  • too mich plasminogen turning into plasmin causing fibrinolysis and excess bleeding
395
Q

disseminated intravascular coagulation (DIC) cascade triggers

A
  • blood transfusion
  • cancer
  • pancreatitis
  • liver disease
  • severe tissue injury
  • pregnancy complication
  • sepsis
396
Q

disseminated intravascular coagulation (DIC) cascade lab findings

A

LOW
- platelet count
- fibrinogen

HIGH
- PT
- INR
- PTT
- D-dimer

397
Q

cancer stage 1

A
  • early stage
  • small, invasive mass or tumor
398
Q

cancer stage 2

A
  • localized stage
  • tumor spread to nearby tissue
  • mass grown in size
  • spreads to nodes near mass
399
Q

cancer stage 3

A
  • regional spread
  • affects more of surrounding tissues
  • spreads to nodes away from mass
400
Q

stage 4 cancer

A
  • distant spread
  • spread to other tissues/organs beyond initial location
401
Q

cancers classic warning signs

A
  • change in bowel or bladder habits
  • sore that does not heal
  • unusual bleeding or discharge
  • thickening or lump on skin
  • indigestion
  • obvious change in wart or mole
  • nagging cough or hoarseness
402
Q

chemotherapy

A

stops cancer cell growth and from metastasizing

403
Q

chemotherapy side effects

A
  • anemia
  • thrombocytopenia
  • neutropenia
  • GI upset
404
Q

chemotherapy precautions

A
  • wash hands before and after medication and wear gloves while handling
  • handle bodily fluids with care
405
Q

radiation

A
  • shrink and kill cancer cells
  • external or internal
406
Q

external radiation precautions

A
  • less time near source
  • stay behind shield when near the source
407
Q

internal radiation precautions

A
  • was laundry separately
  • flush toilet twice
  • use separate utensils, towels
  • drink lots of fluid
  • no kissing or sexual contact (1 week)
  • avoid infants, pregnant women, pets, public transportation, work, school
408
Q

neutropenic precautions

A

for those who are immunocompromised

  • private room with closed doors
  • no fresh fruits, veggies, flowers in room
  • no live vaccines
  • limit visitation
409
Q

leukemia

A

bone marrow produces increased numbers of immature leukocytes which suppress the production of normal blood cells

409
Q

leukemia assessment

A
  • wt loss
  • fatigue
  • bleeding
  • fever
  • pallor
  • bruising
  • arthralgia (joint stiffness)
410
Q

leukemia management

A
  • neutropenic precaution
  • antibiotics (IV)
  • antiemetics
  • enteral nutrition
  • blood product administration
411
Q

hodgkin’s lymphoma

A
  • localized, single node
  • reed-sternberg cells present
412
Q

non- hodgkin’s lymphoma

A
  • multiple nodes involved
413
Q

lymphoma assessment

A
  • painless swelling of lymph nodes
  • night sweats
  • fatigue
  • fever
  • infections
  • wt loss
  • enlarged liver of spleen
414
Q

lung cancer symptoms

A
  • wheezing
  • hemoptysis (coughing blood)
  • cough
  • SOB
  • difficulty swallowing
415
Q

esophagus cancer

A

dt reflux and long term exposure or irritants (ETOH, tobacco)

cm; chest pain, dysphagia

416
Q

stomach cancer

A

dt H.pylori infection, high salt intake, nitrates in pickled or salted food, low fruit and veggies intake, ETOH, tobacco

417
Q

breast cancer predisposing factors

A
  • female
  • 55+ yrs
  • menopause
  • BRCA1 and BRCA2 genes
418
Q

breast self exam

A
  • done monthly on SAME day
  • 3-7 days after period ends
419
Q

prostate cancer predisposing factors

A
  • african american males
  • 60+ yrs
  • family hx
  • ETOH abuse
  • high fat diet
  • farmers
  • painters
420
Q

prostate cancer screening

A
  • blood test for PSA
  • digital rectal exam (DRE) to feel prostate
421
Q

wilms tumor

A
  • most common childhood kidney tumor
  • nephroblastoma
422
Q

wilms tumor assessment

A
  • swelling or palpable mass in abdomen
  • abdominal pain
  • hematuria, anemia, HTN
423
Q

tumor lysis syndrom

A

many cancer cells die in short period of time and contents are released into bloodstream

causes;
- hyperkalemia (EKG changes)
- hyperuricemia (kindey damage)
- hyperphosphatemia (kidney damage)
- hypocalcemia (seizures, tremors)

424
Q

true or false; calcium has a sedating effects

425
Q

facial plethora

A

edematous, shiny, pink face dt superior vena cave syndrome (blood stuck in upper extremity)

426
Q

APGAR assessment

A
  • appearance
  • pulse
  • grimace
  • activity
  • respiration

*10 IS HIGHEST
* 7 OR ABOVE IS IDEAL
*DONE AT 1 AND 5 MIN

427
Q

newborn reflexes

A
  • rooting - could remain for 1yr
  • palmar grasp - diminish 3-4mo
  • babinksi (positive when toes fan out) - gone at 1yr
  • moro (startle) - gone at 6mo
428
Q

normal integumentary findings on a newborn

A
  • lanugo
  • milia
  • vernix caseosa
429
Q

meconium aspiration assessment

A
  • intense work of breathing
  • grunting
  • nasal flaring
  • tachypnea that can lead to bradypnea
430
Q

newborn physiological jaundice

A
  • appears on day 2-3 of life
  • expected
431
Q

newborn pathological jaundice

A
  • occurs within first 24 hrs
  • not expected
  • possible liver issue or ABO incombatibility
432
Q

kernicterus

A
  • brain damage resulting from high levels of bilirubin in the blood
  • tx; phototherapy (helps break down bilirubin). DO NOT EXPOSE EYES AND PRIVATE PARTS
433
Q

foramen ovale

A

opening between right and left atrium present in fetal circulation

434
Q

ductus arteriosis

A

opening between pulmonary artery and aorta present in fetal circulation

435
Q

risk factors for congenital heart defect in newborns

A
  • maternal viral infections
  • maternal diabetes
  • drug and ETOH use
  • advanced maternal age
436
Q

PDA

A
  • failure of ductus arteriosus to close
  • machine like murmur
437
Q

alprostadil

A

keeps suctus arteriosus open to allow blood to get out to newborn body when it otherwise couldn’t

438
Q

arterial septal defect

A
  • open between atria
  • more blood flow out to lungs
  • often asymptomatic until late childhood
  • murmur
439
Q

ventricular septal defect

A
  • opening between ventricles
  • too much blood to lungs
  • signs begin 2-8 weeks
  • loud murmur, pale, sweaty
440
Q

atrioventricular canal defect

A
  • opening between atria and ventricles
  • heart failure & failure to thrive
  • murmur
441
Q

tetralogy of fallot

A
  • large VSD
  • pulmonary stenosis
  • right ventricle hypertrophy
  • overriding aorta
  • sends deoxygenated blood out to body

cm; cyanosis, dyspnea, poor feeding, wt gain, tet spells

*KEEP BABY CALM - CRYING CAUSING TET SPELLS

442
Q

tricuspid atresia

A
  • tricuspid valve does not grow
  • deoxygenated blood out to body
443
Q

transposition of the great arteries

A
  • aorta and pulmonary artery are switched
  • oxygenated blood continuously circulating through pulmonary circuit. deoxygenated blood through systemic
444
Q

hypoplastic left heart syndrome

A
  • left sided structures are small
  • blood flows through ASD back to right side
  • when hole closes, very little blood gets out to body

*PUT ON PROSTAGLANDINS TO KEEP HOLE OPEN

445
Q

4 D’s of epiglottitis

A
  • dysphagia
  • dysphonia
  • drooling
  • distress
446
Q

meningocele

A
  • closed spina bifida
  • protrusion of spinal fluid-filled meninges through vertebral defect
447
Q

myelomeningocele

A
  • open spina bifida
  • protrusion of spinal fluid-filled meninges AND spinal cord through vertebral defect
448
Q

microcephaly

A

small head size

cm;
- impaired cognitive development
- delayed motor function and speech
- facial distortion
- dwarfism
- hyperactivity
- seizures

449
Q

cleft lip / palate management

A
  • surgical corrected
  • lip first at 3-6 mo
  • palate 6-24 mo
  • feed with specialized bottles
  • elbow restraints so they don’t pull sutures
  • prone positioning to drain secretions
  • nothing in mouth
450
Q

esophageal atresia

A
  • part of esophagus does not form
  • cannot swallow food
  • surgical repair
451
Q

pyloric stenosis

A

pylorus is narrow but food cannot pass from stomach through intestines

  • olive shaped mass
452
Q

omphalocele

A

abdominal contents protrude through the umbilicus while remaining in peritoneal sac

453
Q

intussusception

A

part of intestine slips inside the other intestine

cm;
- red currant jelly stools
- lots of pain
- green, bilious emesis
- sausage shaped mass in abdomen

454
Q

hirschsprung’s

A

absence of neurons in rectum and/or colon which leads to NO peristalsis and stool build up

cm;
- ribbon like stool
- swollen belly
- constipation
- gas
- irritation
- vomiting green or brown

455
Q

kawasaki disease

A

infectious agent triggers T cells to overproduce cytokines which cause activation of leukocytes to adhere to vascular walls and damage blood vessel lining

cm;
- strawberry tongue
- bilateral conjunctivitis
- red, swollen hands
- high fever
- elevated CRP, ESR, WBC, platelets

*ONLY TIME CAN GIVE ASPIRIN IN KIDS

456
Q

phenylketonuria

A

body is unable to break down phenylalainne cause damage to CNS

  • screening 24-48 hrs
  • heel stick
  • avoid foods high in protein, dairy products, aspartame
457
Q

rickets

A

softening and weakening of bones due to lack of vitamin D

  • bow legs
  • weakness
  • spine, pelvis, leg pain
458
Q

impetigo

A
  • bacterial disease in children
  • honey coloured crust forms
459
Q

burns in children

A

TBSA burned; lund and browder chart

fluid replacement;
3mL x TBSA x kg = LR in 24 hrs

OU;
at least 0.5 mL/kg/hr

460
Q

infants developmental stage

A

erkison; trust vs. mistrust (birth to 18 mo)

piaget; sensorimotor (birth to 2 yrs)

461
Q

3 mo. infant milestones

A
  • cooing sounds
  • smile at people
  • distinct cries
  • recognize voices
  • hold head up in tummy time
462
Q

6 mo. infant milestones

A
  • babble
  • gurgling sounds
  • giggle, laugh
  • voice to express pleasure
  • growing 1/2-1 inch per month
  • gain 5-7 oz per week
  • BIRTH WT SHOULD BE DOUBLE
463
Q

9 mo. infant milestones

A
  • sit without support
  • imitate speech, sounds
  • recognize own name
  • gaze shift to objects being spoken about
464
Q

12 mo. infant milestone

A
  • communicate with 1-2 words
  • recognize familiar words
  • standing
  • answer simple questions nonverbally
  • BIRTH WT SHOULD BE TRIPLED
465
Q

18 mo. infant milestone

A
  • walk
  • anterior fontanelle close
  • speak 18+ words
  • repeat overheard words
  • point to familiar objects
  • can follow simple commands
466
Q

toddler developmental stage

A

erikson; autonomy vs. shame and doubt (18mo - 3yrs)

piaget; preoperational (beings at 2yrs)

467
Q

2yr milestone

A
  • 2 word phrases
  • 2 step direction
  • 50+ words
  • speak well enough to be understood
  • can run and kick a ball
  • can go forward facing in car seat
  • parallel play
468
Q

preschooler developmental stage

A

erikson; initiative vs guilt (3-5yrs)

piaget; preoperational (until 7yrs)

469
Q

3yr milestone

A
  • 200+ words
  • use phrases
  • understand spatial concepts
  • use plurals
  • dress themselves
  • use forks
470
Q

4yr milestone

A
  • understand and ask “why and how”
  • identify colours
  • express own feelings and ideas
  • group objects together (ie food, animals)
  • catch balls
  • undo buttons
471
Q

school age developmental stage

A

erikson; industry vs. inferiority (5-13yrs)

piaget; concrete operational (7-11yrs)

472
Q

adolescent developmental stage

A

erikson; identity vs role confusion (13-21yrs)

piaget; formal operation stage (12+ yrs)

473
Q

young adult developmental stage

A

erikson; intimacy vs isolation (21-39 yrs)

474
Q

middle adults developmental stage

A

erikson; generativity vs stagnation (40-65yrs)

475
Q

old adults developmental stage

A

erikson; integrity vs despair (65+yrs)

476
Q

presumptive signs of pregnancy

A
  • amenorrhea (no period 3 mo)
  • really tired
  • enlarged breasts
  • sore breasts
  • urination frequency
  • movement perceived (quickening 16-20 weeks)
  • emesis and nausea
477
Q

probable signs of pregnancy

A
  • positive pregnancy test
  • return of fetus when tapped (ballottement)
  • outline of fetus palpable
  • braxton hicks
  • softening of cervix (goodell’s sign)
  • bluish cervix (chadwick’s sign)
  • lower uterine segment softens (hegar’s signs)
  • enlarged uterus
478
Q

positive signs of pregnancy

A
  • fetal movement seen/felt by HCP
  • electronic device detects fetal heart sounds
  • delivery of fetus
  • ultrasound detects fetus
479
Q

naegele’s rule

A

1st day of last period + 7 days - 3 months + 1 year = estimated due date

480
Q

first trimester

A

1 mo; fertilized egg, amniotic sac, primitive face, heart tubes

2 mo; neural tubes, HR at 6 weeks via ultrasound

3 mo; extremities fully developed, fully formed organs

481
Q

second trimester

A

4 mo; HR audible with doppler at 10 weeks, functional nervous system

5 mo; muscle development, hair, vernix caseosa

6 mo; eyelids open, movement response, may survive premature at 23 weeks

7 mo; body fat, hearing fully developed, respond to stimuli, likely survive premature

482
Q

third trimester

A

8 mo; kicking, see and hear

9 mo; lungs fully developed, coordinated reflexes

10 mo; labor can happen anytime, movement decreases

483
Q

pregnancy nutritional needs

A
  • proteins; lean, white meat
  • complex carbs; starchy veg, beans
  • fiber; plant foods, legumes
  • healthy fat; avocados, nuts, seed
484
Q

caloric needs during pregnancy

A

additional 300 calories a day if within normal BMI

*if lower BMI, maybe 500 calories

485
Q

additional supplements in pregnancy

A
  • folate / folic acid
  • calcium
  • vitamin D
  • iron
  • DHA (omega 3 fatty acid)
  • iodine
486
Q

foods to avoid in pregnancy

A
  • fish high in mercury
  • cold deli meats
  • hot dogs
  • raw meat and eggs
  • unpasteurized dairy products
  • pate, liver
  • unwashed produce
  • alcohol
  • caffeine (no more than 200mg / 12 oz)
487
Q

drugs to avoid in prgnancy

A
  • NSAIDS; aspirin, ibuprofen, advil, motrin
  • ACE inhibitors
  • sulfonamide/fluoroquinolone antibiotics
  • warfarin
  • benzodiazepines
  • castor and mineral oils
  • chloramphenicol
  • isotretinoin (acutane)
488
Q

routine pregnancy exams

A
  • blood type/Rh factor
  • STI testing
  • glucose challenge
  • urinalysis
  • anatomy ultrasound
  • non-stress test
  • group B strep
  • kick counts
489
Q

oral glucose tolerance test in pregnancy

A
  • at 28 weeks
  • mom drinks 50g of oral glucose
  • 1 hour later blood sugar is checked
  • > 140, 3 hours glucose test is performed
490
Q

3 hour glucose tolerance test in pregnancy

A
  • mom cannot eat or drink 8 hours before
  • fasting sugar checked
  • mom drinks 100g of oral glucose
  • sugar checked at 1, 2 and 3 hours
  • fails = gestational diabetes
491
Q

non-stress test in pregnancy

A

baby should have 2 accelerations in 20 min (reactive). not reactive can indicate baby may not tolerate labour

492
Q

FHR patterns and causes “VEAL CHOP”

A
  • variable deceleration = cord compression
  • early deceleration = head compression
  • accelerations = Okay!
  • late decelerations = placental insufficiency
492
Q

non reassuring FHR nursing interventions

A
  • lay mother on left side
  • increase IV fluids
  • oxygen
  • notify PCHP
  • discontinue oxytocin
493
Q

GTPAL

A
  • gravidity; number of pregnancies
  • term; number of pregnancies carried to 37 weeks
  • preterm; births between 20 and 36+6 weeks
  • abortions; pregnancy ends before 20 weeks
  • living children; number of alive children

*twins only count ONCE except L

494
Q

skin changes in pregnancy

A
  • melasma
  • dark spots
  • pregnancy glow
  • acne
  • linea nigra
  • stretch marks
  • PUPPP (puritic uticarial papules and plaques of preg.)
  • skin tags
495
Q

hyperemesis gravidarum

A
  • lasts entire pregnancy
  • cannot keep food or water down
  • wt loss, dehydration, electrolyte imbalances
  • tx; promethazine, TPN, IVF
496
Q

preeclampsia s&s

A
  • > 20 weeks
  • BP >140/90 2 times, 4hrs apart
  • protein in urine
  • facial puffiness
  • pedal edema
  • wt gain
497
Q

eclampsia

A

BP so high seizures can occur

498
Q

preeclampsia risk factors

A
  • multiple fetuses
  • chronic HTN
  • gestational HTN
  • obesity
  • increased age
  • african american
  • DM
  • use of in vitro fertilization
  • kidney disease
499
Q

HELLP syndrome

A

hemolysis, elevated liver enzymes and low platelet count

tx; corticosteroids, antihypertensives, blood products, delivery

500
Q

risk factors of gestational diabetes

A
  • overweight / obese
  • prediabetes hx
  • hx of baby wt greater than 9lbs
  • black, hispanic, american indian, asian
501
Q

cholestasis in pregnancy

A
  • bile acids enter bloodstream
  • causes itching in soles and palms
  • compromises fetal safety
502
Q

ectopic pregnancy

A
  • egg implants outside the uterine cavity
  • cm; dizziness, n&v, abdominal/pelvic pain, loss of appetite
  • tx; methotrexate (aborts fetus), surgical removal
503
Q

variability in FHR

A
  • absent; not good
  • marked; expected in labour otherwise a concern
  • moderate; good
504
Q

FHR normal

505
Q

FHR accelerations

A

FHR increases when a contraction occurs
- want 15 bpm increase for 15 secs

506
Q

early decelerations in FHR

A

when contraction occurs, FHR goes down.

*indicates head compression

*U shape on monitor

*not good or bad

507
Q

variable decelerations in FHR

A

when contraction occurs, FHR plummets and then spikes back up.

*indicates cord compression

*sharp V shape on monitor

508
Q

late decelerations in FHR

A

FHR drops after contraction occurs.

*placental insufficiency (baby not getting enough oxygen)

509
Q

true labor contractions

A
  • regular, interval getting shorter
  • contractions continue even with mother movement
  • increased intensity
  • start lower back and move to front of abdomen
510
Q

tocolytics

A

*TERBUTALINE, MAGNESIUM-SULFATE

  • slow contractions
511
Q

baby position lettering

A
  • L for if back is on mother’s left side
  • R for if back is on right side
  • O for occiput comes through birth canal first (head)
  • M for mentis (chin down)
  • S for sacral (butt down)
  • A for if back is anterior
  • P for if back is posterior
  • T for if back is directly towards one hip or the other (transverse)

*WILL HAVE 3 LETTERS

*L/R, O/M/S, A/P/T

512
Q

first stage of labor

A
  • cervical dilation to 10cm
  • latent; 0-6cm
  • active; 6-10cm
513
Q

second stage of labor

A
  • ends when fetus is delivered
  • 7 cardinal movements
  • pushing stage for 2-3 hours
514
Q

third stage of labor

A
  • ends when placenta is delivered
515
Q

signs of separation of placenta from uterine wall

A
  • gush of blood
  • umbilical cord lengthening
  • globular shape fundus
516
Q

fourth stage of labor

A
  • first 1-2 hrs after delivery
  • monitor for hemorrhage, infection
517
Q

placenta previa

A
  • placenta over birth canal
  • painless bright red bleeding
518
Q

abruptio placenta

A
  • placenta tears away from uterine wall
  • PAINFUL
  • partial; abdomen will feel hard has a board dt internal bleeding
  • complete; massive external bleeding
519
Q

prolapsed cord

A
  • elevate presenting part of fetus off the cord
  • knee to chest or trendelenburg
  • administer o2
  • emergency c-section
520
Q

shoulder dystocia

A
  • 1 min since head delivery with no shoulders
  • turtle’s sign; head delivered then pulls back
521
Q

shoulder dystocia interventions

A
  • call for help
  • evaluate for episiotomy
  • mcrobert’s maneuver; thighs to abdomen
  • supra pubic pressure
  • enter maneuvers
  • remove posterior arm
  • gasket maneuver; roll onto hands and knees
  • stop pushing
522
Q

chorioamnionitis

A

membranes around fetus are infected by bacteria

523
Q

risk factors for PPH

A
  • twins
  • macrosomic
  • preeclampsia
  • prolonged or precipitous labor
  • forceps or vaccuum
  • excessive amniotic fluid (polyhrdramnios)
524
Q

electroconvulsive therapy

A
  • 6 to 12 initial tx
  • maintenance tx
  • NPO night before
  • reorient pt when awake
  • cannot drive home
525
Q

purging via vomiting signs

A
  • esophageal varices
  • tooth enamel breakdown
  • russell’s sign on knuckles
526
Q

BMI formula

A

weight (kg) / height squared (m2)

527
Q

BMI weights

A
  • <18.5 = underweight
  • 18.5-24.9 = normal
  • 25.0-29.9 = overweight
  • > 30 = obese
528
Q

total client care model

A

RN is responsible for all aspects of care during a shift

529
Q

primary nursing model

A

RN is responsible for caseload of clients and provides care for same clients during their hospital stay

530
Q

team nursing

A

team members provide care under supervision of RN leader (1 nurse meds, 1 nurse bed baths, 1 nurse wound care, etc.)

531
Q

standard precauction

A
  • hand hygiene
  • PPE if you expect bodily fluid exposure
  • disinfect equipment
  • safe injection practices
532
Q

contact precautions

A
  • hand hygiene
  • gown
  • gloves
  • disposable equipment
  • private room or cohort

*FOR
- MRSA
- VRE
- diphtheria
- RSV
- herpes
- pediculosis
- scabies
- c. diff
- noro/rota virus

533
Q

droplet precaustions

A
  • hand hygiene
  • mask
  • private room or cohort

*FOR
- flu
- mumps
- pertussis
- rubella
- bacterial meningitis
- epiglottitis
- parvo
- diphtheria
- penumonia

534
Q

airborne precuations

A
  • hand hygiene
  • N95
  • private, negative pressure room
  • closed door
  • gown
  • gloves

*FOR
- TB
- measles
- varicella
- SARS
- Smallpox
- VZV

535
Q

donning PPE

A

*GROUND UP

  • gown
  • mask
  • goggles
  • gloves
536
Q

doffing PPE

A
  • gloves
  • goggles
  • gown
  • mask
537
Q

normal age changes

A

*DECREASED
- vision
- hearing
- liver and kidney function
- skin turgor and elasticity
- decalcification of bones

538
Q

primary prevention

A
  • intervene before individual has health issue

*Includes;
- education
- immunizations
- modifying risk behaviour

539
Q

secondary prevention

A
  • early disease identifications

*Includes;
- screenings
- health fair
- regular BP checks

540
Q

tertiary prevention

A
  • tx disease and prevent complications

*Includes;
- nutritional education for chronic illness
- outpatient therapy
- support groups

541
Q

birth immunization

542
Q

2 and 6 mo. immunizations

A
  • DTaP
  • Rotavirus
  • IPV
  • PCV13
  • Hib
  • Hep B
543
Q

4 mo. immunizations

A
  • DTaP
  • Rotavirus
  • IPV
  • PCV13
  • Hib
544
Q

12 mo. immunizations

A
  • Varicella
  • Hep A
  • MMR
  • PCV13
  • Hib
545
Q

4-6 yr immunizations

A
  • MMR
  • IPV
  • DTaP
  • varicella
546
Q

resonance percussion

A
  • hallow
  • over air filled space
  • ex. lung
547
Q

flatness percussion

A
  • loud boom
  • over solid things
  • ex. bone, muscle
548
Q

tympany percussion

A
  • drum like
  • over fluid
  • ex. abdomen
549
Q

wheeze

A

high pitched whistle caused by airway narrowing

ex. asthma, COPD

550
Q

stridor

A

high pitched INSPIRATORY wheeze dt blockage of airflow in trachea

ex. epiglottitis, foreign body, edema

551
Q

crackles

A

coarse rattling sounds caused by airway secretions

ex, pneumonia, edema, bronchitis

552
Q

rales

A

fine crackles that sound like bubbling, rattling, small clicking

ex. when air opens alveoli

553
Q

S3 heart sound

A

sloshing noise after S2 dt fluid overload

ex; CHF, pregnancy

sounds like “ken-tuck-y”

554
Q

S4 heart sound

A

extra beat before S1 due to stiff, failing, hypertrophic LV

ex; HTN, aortic stenosis, cardiomyopathy

sounds like “ten-ess-ee”

555
Q

medications that increase cardiac output

A
  • ACE Inhibitors
  • ARBs
  • Nitrates
  • Inotropes

NCLEX (1 decks)

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