nclex cram Flashcards
Heart Rate
80-100
Respiratory Rate
12-20 rpm
Blood Pressure
110-120/60 mmHg
Temperature
36-39⚬C (98.6⚬F)
RBC
4.5-5.0 million
WBC
5,000-10,000
Platelets
150,000-400,000
Hemoglobin
12-18 gm
Hematocrit
37-54|(Remember 3 x the Hemoglobin)
Sodium
135-145
Potassium
3.5-5.0
Calcium
8.5-10.5
Chloride
95-105
Magnesium
1.5-2.5
Phosporus
2.5-4.5
pH
7.35-7.45
HCO3-
22-26
Co2+
35-45
PaO2
80%-100%
SaO2
95-100%
Acid-Base Balance
ROME|Respiratory Opposite |Metabolic Equal
Glucose
70-110
Specific Gravity
1.010-1.030
BUN
10-20
Serum Creatinine
0.6-1.2 mg/dL
LDH
100-190
Protein
6.2-8.1
Albumin
3.5-5
Bilirubin
<1.0
Total Cholesterol
130-200
Triglycerides
40-50
Uric Acid
3.5-7.5
CPK
21-232
Therapeutic Drug Level: Carbamazepine (Tegretol)
4-10 mpg/ml
Therapeutic Drug Level: Digoxin (Lanoxin)
0.8-2.0 ng/mL
Therapeutic Drug Level: Gentamycin
5-10 mcg/ml (peak)|<2.0 mag/ml (valley)
Therapeutic Drug Level: Lithium (Eskalith)
0.8-1.5 mEq/L
Therapeutic Drug Level: Phenobarbital (Solfoton)
15-40 mpg/mL
Therapeutic Drug Level: Phenytoin (Dilantin)
10-20 mcg/mL
Therapeutic Drug Level: Theopylline (Aminophylline)
10-20 mpg/dL
Therapeutic Drug Level: Tobramycin (Tobrex)
5—10 mcg/mL (peak), 0.5—2.0 mcg/mL (valley)
Therapeutic Drug Level: Valproic Acid (Depakene)
50-100 mcg/mL
Therapeutic Drug Level: Vancomycin (Vancocin)
20—40 mcg/ml (peak), 5 to 15 mcg/ml (trough)
Sodium warfarin (Coumadin)
PT: 10—12 seconds (control). ||The antidote is Vitamin K
INR
0.9-1.2 Coumadin
Heparin
PTT 30-45 seconds |The antidote is Protamine Sulfate
APTT
3-31.9 seconds
Fibrinogen Level
203-377 mg/dL
1 teaspoon (t)
5 mL
1 tablespoon (T)
3 teaspoons (t)|15 ml
1 oz
30 ml
1 cup
8 oz
1 quart
2 pints
1 pint
2 cups
1 gram
1000 mg
1 kg
2.2 lbs
1 lb
16 oz
Convert Celsius to Fahrenheit
F= C * 9/5 + 32
Convert Fahrenheit to Celsius
C = (F-32) 5/9
Fetal Heart Rate
120-160 bpm
Variability
6-10 bpm
Amniotic Fluid
500-1200 ml
Contractions
2—5 minutes apart with duration of < 90 seconds and intensity of <100 mmHg.
APGAR
Appearance (all pink, pink and blue, blue (pale)|Pulse (>100, <100, absent)|Grimace (cough, grimace, no response)|Activity (flexed, flaccid, limp)|Respirations (strong cry, weak cry, absent)||Done at 1 and 5 minutes
AVA
umbilical cord has two arteries and one vein (arteries carry deoxygenated blood and veins carry oxygenated blood)
STOP-Treatment for maternal hypotension after an epidural anesthesia:
- S- stop the pitocin if infusing|- T- turn the client on the left side|- O- Administer Oxygen|- P- push IV fluids
Pregnancy Category A
Controlled studies in animal and women have shown no risk in the 1st trimester, and possible fetal harm is remote
Pregnancy Category B
No risk in animal studies, and well-controlled studies in pregnant women are not available. It is assumed there is little to no risk in pregnant women.
Pregnancy Category C
Risk not excluded. Adequate studies lacking. Chance of fetal harm but benefits outweigh risks.
Pregnancy Category D
Positive evidence of human fetal risk BUT benefits outweigh risks
Pregnancy Category X
Contraindicated in pregnancy
Schedule I Drugs
These drugs have NO accepted medical use in the united states. These drugs have the highest abuse potential (heroin, LSD, MDMA)
Schedule II Drugs
- Drugs have high potential for abuse|- Drugs have currently accepted medical uses, although there may be serious restrictions|- Abuse of drug may lead to severe psychological or physical dependence|- may not be used unless directly dispensed by a practitioner|- refills not allowed –> must write multiple prescriptions at once|- must be stored in a safe, while other schedules can be stored throughout pharmacy
Schedule III Drugs
These drugs may be refilled 5 times in a six month period. These drugs have less potential for abuse/dependence than schedule I or schedule II drugs (codeine, testosterone, ketamine)
Schedule IV Drugs
Requires a new prescription after six months (example Darvon, xanax, valium)
Schedule V Drugs
dispensed as any other prescription or without prescription if state law allows (example antitussives)
Antacids
-oxide||Reduces hydrochloric acid in the stomach
Antianemic
epoeitin alpha (Epogen)||increases blood cell production
Anticholinergics
decrease oral secretions
Anticoagulant
slows coagulation and prevents new clots from forming
Anticonvulsants
used for the management of seizure disorder and treatment of bipolar disorder
Antidiarrheals
Decrease gastric motility and reduce water in bowel
Antihistamines
Block the release of histamine
Antihypertensives
Lower blood pressure and increase blood flow
Anti-infectives
used for the treatment of infections
Bronchodilators
dilates large air passages in asthma or lung diseases (e.g., COPD).
Diuretics
Decrease water/sodium from the Loop of Henle
Laxatives
promote the passage of stool
Miotics
Constrict the pupils
Mydriatics
dilate pupils
Narcotics/analgesics
relieves moderate to severe pain
Rule of Nines
Head and Neck= 9%|Each upper ext= 9%|Each lower ext= 18%|Front trunk= 18%|Back trunk= 18%|Genitalia= 1%
Digoxin(Lanoxin)
Assess pulses for a full minute, if less than 60bpm hold dose. ||Check digitalis and potassium levels
Aluminum hydroxide
Treatment of GERD and kidney stones. WOF (watch out for) constipation.
Hydroxyzine
Treatment of anxiety and itching. WOF dry mouth
Midazolam (Versed)
Given for conscious sedation. Watch out for (WOF) respiratory depression and hypotension.
Amiodarone (Cordarone)
WOF diaphoresis, dyspnea, lethargy. ||Take missed dose any time in the day or to skip it entirely. ||Do not take double dose.
Warfarin (Coumadin)
WOF for signs of bleeding, diarrhea, fever, or rash. ||Stress importance of complying with prescribed dosage and follow-up appointments.||–> PT
Methylphenidate
Treatment of ADHD. Assess for heart related side-effects and report immediately. Child may need a drug holiday because the drug stunts growth.
Dopamine
Treatment of hypotension, shock, and low cardiac output, ||Monitor ECG for arrhythmias and blood pressure
Rifampin
Can cause a harmless orange discoloration of body fluids (pee, sweat, tears). ||They inhibit RNA polymerase. TB can gain resistance by structural alteration of this RNA polymerase to no longer bind rifampin.
Ethambutol
causes problems with vision, liver problem.
Isoniazid
causes peripheral neuritis||take vitamin B6 to counter
Devlopmental Milestones ||2-3 Months
Able to turn head up and can turn side to side ||Makes cooing or gurgling noises and can turn head to sound
Devlopmental Milestones ||4-5 Months
Grasps, switch and roll over tummy to back. Can babble and can mimic sounds
Devlopmental Milestones ||6-7 Months
Sits at 6 months and waves bye bye ||Can recognize familiar faces and knows if someone is a stranger ||Passes things back and forth between hands
Developmental Milestones ||8-9 Months
Stands straight at 8 ||Has a favorite toy ||Plays peek a boo
Devlopmental Milestones ||10-11 Months
Belly to butt
Devlopmental Milestones ||12-13 Months
twelve and up drinks from cup ||Cries when parents leave ||Uses furniture to cruise
African Americans
May believe that illness is caused by supernatural causes and seek advice and remedies form faith healers; they are family oriented; have higher incidence of high blood pressure and obesity; high incidence of lactose intolerance with difficulty digesting milk and milk products.
Arab Americans
May remain silent about health problems such as STIs, substance abuse, and mental illness; a devout Muslim may interpret illness as the will of Allah, a test of faith; may rely on ritual cures or alternative therapies before seeking help from health care provider; after death, the family may want to prepare the body by washing and wrapping the body in unsewn white cloth; postmortem examinations are discouraged unless required by law. May avoid pork and alcohol if Muslim. Islamic patients observe month long fast of Ramadan (begins approximately mid-October); people suffering from chronic illnesses, pregnant women, breast-feeding, or menstruating don’t fast. Females avoid eye contact with males; use same-sex family members as interpreters.
Asian Americans
May value ability to endure pain and grief with silent stoicism; typically family oriented; extended family should be involved in care of dying patient; believes in “hot-cold” yin/yang often involved; sodium intake is generally high because of salted and dried foods; may believe prolonged eye contact is rude and an invasion of privacy; may not without necessarily understanding; may prefer to maintain a comfortable physical distance between the patient and the health care provider.
Latino Americans
May view illness as a sign of weakness, punishment for evil doing; may consult with a curandero or voodoo priest; family members are typically involved in all aspects of decision making such as terminal illness; may see no reason to submit to mammograms or vaccinations.
Native Americans
May turn to a medicine man to determine the true cause of an illness; may value the ability to endure pain or grief with silent stoicism; diet may be deficient in vitamin D and calcium because many suffer from lactose intolerance or don’t drink milk; obesity and diabetes are major health concerns; may divert eyes to the floor when they are praying or paying attention.
Western Culture
May value technology almost exclusively in the struggle to conquer diseases; health is understood to be the absence, minimization, or control of disease process; eating utensils usually consists of knife, fork, and spoon; three daily meals is typical.
Acute Renal Disease Diet
protein-restricted, high-calorie, fluid-controlled, sodium and potassium controlled.
Addisons Disease Diet
increased sodium, low potassium diet.
ADHD and Bipolar Diet
high-calorie and provide finger foods.
Burns Diet
high protein, high caloric, increase in Vitamin C.
Cancer Diet
high calorie, high protein
Celiac Disease Diet
gluten-free diet (no BROW: barley, rye, oat, and wheat).
Chronic Renal Disease Diet
protein-restricted, low-sodium, fluid-restricted, potassium-restricted, phosphorus-restricted.
Cirrhosis (stable) Diet
Normal Protein
Cirrhosis with hepatic insufficiency diet
restrict protein, fluids, and sodium.
Constipation diet
high-fiber, increased fluids
COPD Diet
soft, high-calorie, low-carbohydrate, high-fat, small frequent feedings
Cystic Fibrosis Diet
Increase in fluids
Diarrhea Diet
liquid, low-fiber, regular, fluid and electrolyte replacement
Gallbladder Disease Diet
low-fat, calorie-restricted, regular
Gastritis Diet
low-fiber, bland diet||BRATS diet
Hepatitis Diet
regular, high-calorie, high-protein
Hyperlipidemia diet
fat-controlled, calorie-restricted
Hypertension, heart failure, CAD diet
low sodium,|calorie-restricted, fat-controlled
Kidney Stones Diet
increased fluid intake, calcium-controlled, low-oxalate
Nephrotic Syndrome Diet
sodium-restricted, high-calorie, high-protein, potassium-restricted.
Obesity, overweight Diet
calorie-restricted, high-fiber
Pancreatitis Diet
low-fat, regular, small frequent feedings; tube feeding or total parenteral nutrition.
Peptic Ulcer Diet
bland diet||BRATS
Pernicious Anemia Diet
increase Vitamin B12 (Cobalamin), found in high amounts on shellfish, beef liver, and fish.
Sickle Cell Anemia Diet
increase fluids to maintain hydration since sickling increases when patients become dehydrated.
Stroke Diet
mechanical soft, regular, or tube-feeding.
Underweight Diet
high calorie, high protein
Vomiting Diet
fluid and electrolyte replacement
Asthma Position
Orthopneic position where patient is sitting up and bent forward with arms supported on a table or chair arms ||”tripod”
Post Bronchoscopy Position
flat on bed with head hyperextended
Cerebral Aneurysm Position
high fowlers
Hemorrhagic Stroke Position
HOB elevated 30 degrees to reduce ICP and facilitate venous drainage
Cardiac Cauterization Position
keep site extended
Ischemic Stroke Position
HOB flat
Epistaxis Position
to lean forward
Above Knee Amputation Position
elevate for first 24 hours on pillow, position prone daily to|provide for hip extension.
Tube feeding for patients with decreased LOC Position
position patient on right side to promote emptying of the stomach with HOB elevated to prevent aspiration
Air/Pulmonary Embolism Position
turn patient to left side and lower HOB
Postural Drainage Positioning
Lung segment to be drained should be in the uppermost position to allow gravity to work.
Post Lumbar Puncture Position
patient should lie flat in supine to prevent headache and leaking of CSF.
Continuous Bladder Irrigation (CBI) Positioning
Catheter should be taped to thigh so legs should be kept straight
After Myringotomy Position
Position on side of affected ear after surgery (allows drainage of secretions)
Post Cataract Surgery Position
Patient will sleep on unaffected side with night shield for 1-4 weeks
Detached Retina Position
area of detachment should be in the dependent position
Post Tyroidectomy Position
low or semi-fowlers, support head, neck and shoulders
Thoracentesis Position
sitting position, arms raised and resting overbed table (during procedure) ||Affected side up after procedure
Spina Bifida Position
position infant on prone so sac does not rupture
Bucks Traction Position
Elevate foot of bed for counter-traction
Post Total Hip Replacement Positioning
don’t sleep on operated side, don’t flex hip more than 45-|60 degrees, don’t elevate HOB more than 45 degrees. Maintain hip abduction by separating|thighs with pillows.
Prolapsed Cord Position
Knee-chest Position
Cleft-lip Position
Position on back or in infant seat to prevent trauma to the suture line. While feeding, hold in an upright position
Cleft Palat Position
Prone
Hemorrhoidectomy Position
assist to lateral position
Hiatial Hernia Position
Upright Position
Preventing Dumping Syndrome Position
Eat in reclined position, lie down after meals for 20-30 minutes(also restrict fluids during meals, low fiber diet, and small frequent meals)
Enema Administration Position
Position patient in left-side lying (Sims position) with knees flexed
Increase ICP Position
high Fowlers
Laminectomy Position
back as straight as possible; log roll to move and sand bag on sides
Spinal Cord Injury
Immobilize on spine board, with head in neutral position. Immobilize head with padded C-collar, maintain traction and alignment of head manually. Log roll client and do not allow client to twist or bend.
Liver Biopsy Position
right side lying with pillow or small towel under puncture site for at least 3 hours
Paracentesis Position
flat on bed or sitting
Intestinal tubes Position
place patient on right side to facilitate passage into duodenum
Nasogastric Tube Position
elevate HOB 30 degrees to prevent aspiration, Maintain elevation for continuous feeding or 1 hour after intermittent feedings
Pelvic Exam Position
lithotomy position
Rectal Exam Positon
Knee chest position. Sims or dorsal recumbent
During Internal Radiation Position
on bed rest while implant in place
Autonomic Dysreflexia Position
place client in sitting position (elevate HOB) first before any other implementation
Shock Position
bedrest with extremities elevated 20 degrees. knees straight, head slightly elevated (modified Trendelenberg)
Head Injury Position
30 to decrease ICP
Peritoneal Dialysis (when outflow is inadequate)
turn pt from side to side BEFORE checking for kinks in tubing
Oil-Based Dye Position
Flat on bed for at least 6-8 hours to prevent leakage of CSF
Air Dye
Trendelenburg
pulmonary tuberculosis (TB) S/S
low-grade afternoon fever
Pneumonia symptoms
Rust colored sputum
Asthma symptoms
Wheezing on expiration
Emphysema Symptoms
-barrel chest |-pursed lip breathing| -dypnea on exertion
Kawasaki Syndrome Symptom
Strawberry tongue
Pernicious Anemia Symptoms
red beefy tongue
Down Syndrome Symptoms
Protruding Tongue
Cholera Symptoms
rice water stool|washer women hands (wrinkled hands from dehydration)
Malaria Symptoms
Stepladder like fever with chills
Typhoid Symptoms
Rose Spots in the Abdomen
Dengue Symptoms
fever, rash, and headache. |positive hermans sign
Diptheria Symptoms
pseudomembrane formation
Measles Symptoms
Koplik spots
systemic lupus erythematosus (SLE) symptoms
butterfly rash
Leprosy Symptoms
leonine facies (thickened folded facial skin)
Bulemia Symptoms
Chipmunk Face (Parotid gland swelling)
Appendicitis Symptoms
Rebound Tnderness at McBurneys Point. Rovsing Sing (Palpation of LLQ elicits pain in RLQ) Psoas sign (pain from flexing the thigh to the hip)
Meningitis Symptoms
Kernigs sign (stiffness of hamstrings causing inability to straighten the leg when the hip is flexed to 90 degrees ||Brudzinskis sign (forced flexion of the neck elicits a reflex flexion of the hips)
Tetany Symptoms
hypocalcemia |(+) Trousseaus sign |Chvostek sign
Pancreatitis Symptoms
Cullens Sign (ecchymosis of the umbilicus) ||Grey Turners sign (bruising of the flank)
Pyloric Stenosis Symptoms
Olive like mass
patent ductus arteriosus (PDA) symptoms
washing machine like murmer
Addisons Disease symptoms
bronze like skin |(hypo)
Cushings Syndrome Symptoms
moon face appearance and buffalo hump
Graves Disease Symptoms
Exophthalmos (bulging of eyes)
Intussusception Symptoms
Sausage-shaped mass
MS Symptoms
Charcots Triad: nystagmus, intention tremor, and dysarthria
Myasthenia Gravis Symptoms
Progressive weakness and lack of muscle control with periodic acute episodes||Ptosis (drooping of eyelids)
Guillain-Barre syndrome
ascending muscle weakness
deep vein thrombosis (DVT)
Homan’s sign
Angina
crushing, stabbing chest pain relieved by nitro
MI
Crushing stubbing pain which radiates to left shoulder, neck, arms, unrelieved by NTG
Parkinson Disease
pill-rolling tremors
CMV Infection
Owls eye appearance of cells (huge nucleus in cells)
Glaucoma
tunnel vision
retinal detachment
Flashes of light, shadow with curtain across the vision
basilar skull fracture
Raccoon eyes (periorbital ecchymosis) and Battle’s sign (mastoid ecchymosis).
DKA
acetone breath
PIH Pregnancy Induced Hypertension
Proteinuria, hypertension, edema
DM
polyuria, polydipsia, polyphagia
GERD
heartburn
Hirschsprung disease
RIBBON LIKE STOOLS|low fiber and HIGH DIET
Herpes Simplex Type II
painful vesicles on genitalia
Genital Warts
warts 1-2 mm in diameter
Syphilis
painless chancres
Chancroid
painful, crater-like sores
Gonorrhea
green creamy discharge and painful urination
Chlamydia
milky discharge and painful urination
Candidiasis
white cheesy odorless discharge
Trichomoniasis
yellow, itchy, frothy, and foul-smelling vaginal discharges
______________ is the best indicator of dehydration
Weight
Neutropenic patients should not receive
vaccines, fresh fruits or flowers
Nitroglycerin Patch
administered up to 3 times in intervals of 5 minutes
Morphine is contraindicated in:
Pancreatitis. It causes spasm of the Sphincter of Oddi. Therefore Demerol should be given.
NEVER give ______ in IV push
Potassium
Infants born to HIV (+) moms
should receive all vaccines on schedule
Gravida
number of times a woman has been pregnant
Para
number of pregnancies that have reach viability
Lochia Rubra
Reddish or red-brown vaginal discharge that occurs immediately after childbirth; composed mostly of blood.
Lochia Serosa
Pinkish/brown, serosanguineous. Lasts day 4-10 postpartum
Lochia Alba
the vaginal discharge of decreased blood and increased leukocytes that’s the final stage of lochia. It occurs 7 to 10 days after childbirth.
RACE
rescue, alarm, contain, extinguish
Quadriplegic patient experiencing autonomic dyslexia
Elevate HOB as high as possible
Veracity
truthfulness, honesty
Beneficence
Doing good or causing good to be done; kindly action
Nonmaleficence
do no harm
Tyramine-rich foods
aged cheese, pepperoni, salami, avocados, figs, bananas, smoked fish, protein dietary supplements, soups, soy sauce, some beers, and red wine.
Projection
unconscious attribution of our negative characteristics to others
Sublimination
channeling socially unacceptable impulses and urges into socially acceptable behavior
Repression
unconsciously pushing unwanted memories out of awareness
obsessive-compulsive disorder
An anxiety disorder characterized by unwanted repetitive thoughts (obsession) and/ or actions (compulsions).||Realize behavior is unreasonable, but are powerless to control
toxic risk associated with clozapine (Clozaril) administration
blood dyscrasia
Adverse Effects of Haloperidol administration
drowsiness, insomnia, weakness, HA, extrapyramidal symptoms, such as akathisia, tardive dyskinesia, and dystonia
