NCLEX PN Notes 2 Flashcards
- NMS is like S&M;
- you get hot (hyperpyrexia)
- stiff (increased muscle tone)
- sweaty (diaphoresis)
- BP, pulse, and respirations go up &
- you start to drool
Neuroleptic malignant syndrome (NMS):
I kept forgetting which was dangerous when you’re pregnant; regular measles (rubeola), or German measles (rubella), so remember:
-never get pregnant with a German (rubella)
When drawing up regular insulin & NPH together, remember:
-RN (regular comes before NPH)
Tetralogy of fallot; remember HOPS
Think DROP(child drops to floor or squats) or POSH
- Defect, septal
- Right Ventricular hypertrophy
- Overriding aorts
- Pulmonary stenosis
MAOI’s that are used as antidepressants: weird way to remember, I know. pirates say arrrr, so think; pirates take MAOI’s when they’re depressed.
- explanation;
MAOI’s used for depression all have an arrr sound in the middle (Parnate, Marplan, Nardil)
easy way to remember MAOI’S! think of PANAMA! PA - parnate
NA - nardil
MA - marplan
Autonomic dysreflexia: potentially life threatening emergency
- elevate head of bed to 90 degree
- loosen constrictive clothing
- assess for bladder distention and bowel impaction (triger)
- Administer antihypertensive meds (may cause stroke, MI, seisure )
-check pulse, less than 60 hold, check dig levels and potassium levels.
Digoxin
tx of GERD and kidney stones….watch out for contipation.
Amphojel:
tx of anxiety and also itching…watch for dry mouth. given preop commonly
Vistaril:
given for conscious sedation…watch for resp depression and hypotension
Versed:
- prevention of thyroid storm
PTU and Tapazole
tx of parkinson…sweat, saliva, urine may turn reddish brown occassionally…causes drowsiness
Sinemet:
tx of parkinson..sedative effect also
Artane:
tx of parkinson and extrapyramidal effects of other drugs
Cogentin:
tx of postop n/v and for nausea associated with gastroenteritis
Tigan:
-tx of gluacoma
Timolol (Timoptic)
antibiotic..dont take if allergic to sulfa drugs…diarrhea common side effect…drink plenty of fluids
Bactrim:
Probenecid (Benemid), Colchicine, Allopurinol (Zyloprim)
Gout Meds:
-tx of HTN or CHF, Report flu-like symptoms, rise slowly from sitting/lying position; take with meals.
Apresoline(hydralazine)
tx of irritable bowel….assess for anticholinergic side effects.
Bentyl:
calcium channel blocker: tx of HTN, angina…assess for constipation
Calan (verapamil):
tx of duodenal ulcers..coats the ulcer…so take before meals.
Carafate:
tx of asthma or COPD..therap drug level: 10-20
Theophylline:
is the antedote to tylenol and is administered orally
Mucomyst
tx of glaucoma, high altitude sickness…dont take if allergic to sulfa drugs
Diamox:
(nsaid) tx of arthritis (osteo, rhematoid, gouty), bursitis, and tendonitis.
Indocin:
tx of hypothyroidism..may take several weeks to take effect…notify doctor of chest pain..take in the AM on empty stomach..could cause hyperthyroidism.
Synthroid:
tx of alcohol w/d…dont take alchol with this…very bad nausea and vomiting can occur.
Librium:
tx of leukemia..given IV ONLY
Oncovin (vincristine):
tx of scabies and lice…(scabies)apply lotion once and leave on for 8-12 hours…(lice) use the shampoo and leave on for 4 minutes with hair uncovered then rinse with warm water and comb with a fine tooth comb
kwell:
tx after menopause estrogen replacement
Premarin:
tx of seizures. thera drug level: 10-20
Dilantin:
tx of schizophrenia..assess for EPS
Navane:
tx of ADHD..assess for heart related side effects report immediately…child may need a drug holiday b/c it stunts growth.
Ritalin:
tx of hypotension, shock, low cardiac output, poor perfusion to vital organs…monitor EKG for arrhythmias, monitor BP
dopamine (Intropine):
Have trouble remembering fhr patterns in OB? Think VEAL CHOP VC EH AO LP
V = variable decels; C = cord compression caused E = early decels; H = head compression caused A = accels; O = okay, not a problem! L = late decels P = placental insufficiency, can't fill
For cord compression, place the mother in the TRENDELENBERG position because this removes pressure of the presenting part off the cord.
(If her head is down, the baby is no longer being pulled out of hte body by gravity)
If the cord is prolapsed, cover it with sterile saline gauze to prevent drying of the cord and to minimize infection.
For late decels,
turn the mother to her left side, to allow more blood flow to the placenta.
For any kind of bad fetal heart rate pattern,
you give O2, often by mask…
When doing an epidural
anesthesia hydration before hand is a priority.
Hypotension and bradypnea / bradycardia are major risks and emergencies.
NEVER check the monitor or a machine as a first action. Always assess the patient first; for exmaple listen to the fetal heart tones with a stethoscope in NCLEX land. Sometimes it’s hard to tell who to check on first, the mother or the baby; it’s usually easy to tell the right answer if the mother or baby involves a machine. If you’re not sure who to check first, and one of the choices involves the machine, that’s the wrong answer.
If the baby is a posterior presentation, the sounds are heard at the sides. If the baby is anterior, the sounds are heard closer to midline, between teh umbilicus and where you would listen to a posterior presentation.
If the baby is breech, the sounds are high up in the fundus near the umbilicus. If the baby is vertex, they are a little bit above the symphysis pubis.
Also for ventilator alarms
HOLD
- High alarm
- Obstruction due to incr. secretions, kink, pt. coughs, gag or bites
- Low press alarm
- Disconnection or leak in ventilatior or in pt. airway cuff, pt. stops spontaneous breathing
hot and dry-sugar high
(hyperglycemia)
cold and clammy-need some candy
(hypoglycemia)
ICP AND SHOCK HAVE OPPOSITE V/S
ICP-increased BP, decreased pulse, decreased resp.
shock- decreased BP, increased pulse, increased resp.
right sided heart failure caused by left ventricular failure (so pick edema, jvd, if it is a choice.)
cor pulmonae:
irratable poor sucking
herion withdrawal neonate:
no meat and milk together
Jews:
pulse area cpr on an infant.
Brachial pulse:
Test child for lead poisioning around
12 months of age
Cultures are obtained
before starting IV antibiotics
a pt with leukemia may have epitaxis b/c
of low platelets
bananas, potatoes, citrus fruits
source of potassium
best way to warm a newborn:
skin to skin contact covered with a blanket on mom.
when a pt comes in and she is in active labor…nurse first action is
to listen to fetal heart tone/rate
phobic disorders…
use systematic desensitiztion.
