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NCLEX Review Deck > NCLEX - Kaplan Ch 2 > Flashcards

NCLEX - Kaplan Ch 2 Flashcards

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1
Q

Snellen test: what is it?

How is it done?

A

Test of visual acuity

Pt stands 20 ft from chart and covers one eye at a time reading the smallest letter visible

What does the normal eye see at 20 ft

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2
Q

Myopia =

Hyperopia =

Presbyopia =

Astigmatism =

A

Near sighted

Far sighted

Aging (after 35 yrs usually)

Uneven curve of the cornea leading to blurred vision

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3
Q

Tx for conjunctivitis

A

Warm, moist compress

Topical antibiotics

Hydrocortisone opthalmic ointment

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4
Q

What is Retinopathy of prematurity?

A

Cause of blindness is premies

High concentration of O2 cause the retinal vessels to constrict leading to blindness

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5
Q

Tx for strabismus

A

Occlusion of unaffected eye to strengthen the weaker eye (begin this before age 6)

Corrective lenses

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6
Q

What are cataracts

A

Objects look distorted / blurred
Decreased color perception
Double vision
Pupil changes color to gray / milky white

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7
Q

What is glaucoma?

Causes?

A

Abnormal increase in intraocular pressure –> visual disability / blindness

Trauma, tumor, hemorrhage, aging, allergies

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8
Q

Tx for glaucoma

A

Prostaglanin agonist

Adrenergic agonists

BBs

Cholinergic agonists

Surgery - laser traberculoplasty

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9
Q

When giving ear drops what is the difference in ear positioning between adults and kids?

A

Adults: Pull outer ear upward and backwards (3+ yrs)

Children: pull outer eary downwards and back

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10
Q

Pt has incapacitating vertigo, tinnitus and a pressure of fullness in the ear. They have progressively worsened hearing. What do you suspect?

A

Meniere’s disease

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11
Q

Tx Meniere’s disease

A

Antihistamines (epinephrine, Diphenhydramine)

Antiemetics (prochlorperazine)

Antivertigo meds (Meclizine, Diazepam)

Diuretics (thiazine, triamterene)

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12
Q

Bell’s Palsy s/s

A

Inability to close eye

Increased lacrimation

Speech difficulty

Loss of taste

Distorted single side of face

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13
Q

What CN does Bell’s Palsey involve?

How long does recovery take?

A

7th

3-5 w

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14
Q

In what direction does the motor loss associated with Guillan-Barre Syndrome typically occur?

A

Begins: lower extremities, extends upward (leading to respiratory muscle compromise)

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15
Q

How long does it take for GB to peak? How long is recovery?

A

2-4 weeks, average 10 days

several months - yr

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16
Q

Tx for GB

A

Intervention = symmtomatic

Steroids, acute phase

Plasmapheresis
IV immunoglobulins
Adrenocorticotropic hormones
Corticosteroids

Mechanical ventilation / Elevate HOB / Suctioning

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17
Q

What is Kernig’s sign? What is Brudzinski’s sighn?

What do positives of these indicate?

A

Kernigs = when hip is flexed to 90, complete extension of the knee is restricted and painful

Brudzinski = attemps to flex the neck also produces flexion at knee and thigh

Meningitis

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18
Q

What vaccine in infants can help prevent meningitis?

What IV antibiotic can be used to treat meningitis?

A

HIB

PCN, Ceph, Vanco

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19
Q

What meds are for migraines?

A

BBs

Triptans

Topiramate

Ergotamines

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20
Q

Normal range of FBG level:

A

70-99

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21
Q

Which should be drawn up first: Regular or NPH insulin?

What are injection sites for insulin?

A

Regular (clear to cloudy)

Abd
Posterior arms
Anterior thighs
Hips

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22
Q

What are the sick day rules for diabetics

A
  1. Take insulins as ordered
  2. Check BG and urine ketones q3-4 hrs
  3. If lots of vomitting or diarrhea, take liquids every 1/2 hr to 1 h
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23
Q

BG less than ____ is considered hypoglycemia

What are the s/s?

A

50-60

Irritability
Confusion
Tremors
Blurred vision
Hypotension
Tachycardia
Skin is COOL + CLAMMY
DIAPHORESIS

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24
Q

HyperG is a BG greater than ______

What are the s/s

A

300-800

HA
Drowsy
Weak / stupor
Skin is WARM + DRY
Elevated temp
Polyuria
Polydipsia
Polyphagia
Kussmauls (rapid and deep)
Fruity breath

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25
Q

HHNKS is a BG greater than _____

What type of Diabetic does this occur in?

What does NOT occur with this?

A

800

Type 2

NO: Ketosis or acidosis

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26
Q

Your pt is unconcious and they are hypoglycemic, what are the two tx for them?

A

Dextrose 50% IV

1mg glucagon IM or SQ

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27
Q

What is the Tx for hyperglycemia?

A

1 L of NS q 1 hr and then 0.45% NS and then D5W

Regular IV insulin 5 u/hr

K+ replacement + check q 2-4 hrs

EKG q 2-4 hrs

Asses VS q 15 min until stable

28
Q

What is the tx for HHKNS? (3)

A

NS or 0.45% NS

Regular insulin

K+ as soon as urine output is good

29
Q

What is the diet for a pt with renal failure?

A

High calories
Low protein

30
Q

What is the tx for hiatal hernia?

A

H2 receptor blockers (Cimetadine, Ranitidine)

Antacids

Cytoprotective meds (Sucralfate)

PPIs (Pantoprazole)

Surgery: Fundoplication (tightens the cardiac sphincter)

Don’t lie down for at least 1 hr after meals and elevate HOB when sleeping

31
Q

A pyloromyotomy can help treat what?

A

Pyloric stenosis in infants

32
Q

When does pain occur in a pt with a duodenal ulcer vs a gastric ulcer?

What relieves the pain?

A

Dodenal :

  • 2-3 hrs after meal / nighttime / early sleeping hrs
  • Eating relieves pain

Gastric - 0.5 - 1h after food
- Relief from vomit

33
Q

Meds for duodenal / gastric ulcers?

A

Antacids (magnesium / aluminum hydroxide)

Cimetidine / Ranitidine

Anticholinergics (Propantheline)

Sucralfate

Omeprazole
(PPI)

34
Q

Chron’s vs UC:

Fatty sool?
Rectal bleeding?
Abd pain occurance?
Diarrhea?

A

Fatty stool = Chrohns

Rectal bleeding - UC

Abd pain:
- Chrons is after meals
- UC is pre-poop

Diarrhea = UC (often 10-20 a day and bloody)

35
Q

Where is the inflammation found in Crohns vs UC?

A

Crohns = non-continuous segment (ileum / right colon)

UC = continuous segment (rectum, left colon)

36
Q

Diet rec for Crohns and UC

A

High protein
High calorie

Low fat
Low fiber

37
Q

Should you have heating pad for pain for appendicitis?

A

No - ice bag to abd

38
Q

Where is pain for diverticular disease? What relieved the pain?

What will their bowel pattern be?

A

LLQ relieved by stool or farting

Constipation alternating with diarrhea

39
Q

What is typically the cause of diverticular disease?

A

Deficiency in dietary fiber

40
Q

What is hirschsprung in an newborn vs a child?

A

Newborn = failure to pass mec / refusal to suck / abd distention

Child = failure to gain weight, constipation alt with diarrhea, foul-smelling stools, abd distention and visible peristalsis

41
Q

What are the s/s of intussusception?

A

Colicky abd pain

Causes child to bring knees to abd

Vomit

Currant jelly like stools

Palpable mass in URQ

Typically 3 m - 3 yrs old

42
Q

What is the non-surgical tx for intussusception?

A

Contrast medium / air pressure. to push the telescoped portion out

43
Q

What will the bowel sounds be above the area of intestinal obstruction? What will the pain likely be describled as?

A

High pitched above

colicky

44
Q

At what age is it useful to allow a child to play with models of equipment and encourage them to express their feelings?

A

Preschool

45
Q

Fears:

Toddler =

Preschooler =

School age =

Adolescent =

A

Toddler = separation

Preschooler = mutilation

School age = loss of control

Adolescent = loss of independence / diff from peers

46
Q

What is the major risk with midazolam or diazepam?

A

Resp depression *** (never leave pt alone)
Apnea
Hypotension
Brady

47
Q

Post op- how freq should VS be done?

A

q 15 x4
q 30 x 2
q1 h x2
PRN

48
Q

How would you teach proper use of an incentive spirometer?

A

exhale normally
inhale slowly and deeply
Keep ballsor elevated for 2-3 seconds

49
Q

After surgery what is a normal bowel sound?

Should the pt be NPO?

A

High pitched tympany

Yes NPO until bowel sounds are present

50
Q

What day post op might you expect atelectasis? What are the s/s?

A

Day 2

dyspnea
cyanosis
Tachy
Fever
pain on affected side

51
Q

Dehiscence =

When does this happen?

Evisceration =

A

Disrution of surgical incision or wound

5-6 days post op

Evisceration = protrusion of wound contents (days 5-6 post op)

52
Q

Urinary retention is ____ hrs post op

A

8-12

53
Q

WBC therapeutic

A

5,000-11,000

54
Q

ANC therapeutic

A

500 +

55
Q

CD4 therapeutic.

What does a low CD4 mean?

A

200+

AIDS

56
Q

HCT levels

A

36-54

57
Q

CO2 levels nml

A

35-45

58
Q

Hgb nml

A

12-18

59
Q

PLT nml

A

150,000-450,000

60
Q

Angiography

A

contrast dye injected into the arteries and x-ray films are taken of the vascular tree

Shows: abnormalities in blood flow d/t arterial obstruction or narrowing

61
Q

What should you do after obtaining an ABG sample?

A

Appy pressure for 5 min to prevent hematoma

Send sample on ice

62
Q

What is a thoracentesis?

A

Asiration of fluid or air from the pleural space

Obtain specimen for analysis
Revlieve lung compression
Tissue for biopsy
Place meds into pleural space

63
Q

After a cardiac cath how freq are VS done?

How long is best rest maintained?

A

q 15 min for 2 hrs

q 30 min for 1 hr

6-8 hrs bedrest with insertion site straight

64
Q

Normal PaO2

Normal PaCo2

Normal bicarb

A

80 - 100 mmHg

35-45 mmHg

22-26 mEq/L

65
Q

What can a pt expect with their stool after a barium swallow for an upper GI test?

A

Stool will be white

66
Q

Normal urine specific gravity

A

1.010 - 1.030

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