NCLEX PN Notes 3 Flashcards
- When getting down to two answers, choose the assessment answer (assess, collect, auscultate, monitor, palpate) over the intervention except in an emergency or distress situation. If one answer has an absolute, discard it. Give priority to answers that deal directly to the patient’s body, not the machines/equipments.
- Key words are very important. Avoid answers with absolutes for example: always, never, must, etc.
with lower amputations patient is placed in prone position.
small frequent feedings are better than larger ones.
Assessment, teaching, meds, evaluation, unstable patient cannot be delegated to an Unlicensed Assistive Personnel.
LVN/LPN cannot handle blood.
Amynoglycosides (like vancomycin) cause nephrotoxicity and ototoxicity.
IV push should go over at least 2 minutes.
If the patient is not a child an answer with family option can be ruled out easily.
In an emergency, patients with greater chance to live are treated first
ARDS (fluids in alveoli), DIC (disseminated intravascular coagulaton) are always secondary to something else (another disease process).
Cardinal sign of ARDS is hypoxemia (low oxygen level in tissues).
in pH regulation the 2 organs of concern are lungs/kidneys.
edema is in the interstitial space not in the cardiovascular space.
weight is the best indicator of dehydration
wherever there is sugar (glucose) water follows.
aspirin can cause Reye’s syndrome (encephalopathy) when given to children
when aspirin is given once a day it acts as an antiplatelet.
use Cold for acute pain (eg. Sprain ankle) and Heat for chronic ( rheumatoid arthritis)
guided imagery is great for chronic pain.
when patient is in distress, medication administration is rarely a good choice.
with pneumonia, fever and chills are usually present. For the elderly confusion is often present.
Always check for allergies before administering antibiotics (especially PCN). Make sure culture and sensitivity has been done before adm. First dose of antibiotic.
Cor pulmonale (s/s fluid overload) is Right sided heart failure caused by pulmonary disease, occurs with bronchitis or emphysema.
COPD is chronic, pneumonia is acute. Emphysema and bronchitis are both COPD.
in COPD patients the baroreceptors that detect the CO2 level are destroyed. Therefore, O2 level must be low because high O2 concentration blows the patient’s stimulus for breathing.
exacerbation: acute, distress.
epi always given in TB syringe.
prednisone toxicity: cushing’s syndrome= buffalo hump, moon face, high glucose, hypertension.
4 options for cancer management: chemo, radiation, surgery, allow to die with dignity.
no live vaccines, no fresh fruits, no flowers should be used for neutropenic patients.
chest tubes are placed in the pleural space.
angina (low oxygen to heart tissues) = no dead heart tissues. MI= dead heart tissue present.
mevacor (anticholesterol med) must be given with evening meal if it is QD (per day).
Nitroglycerine is administered up to 3 times (every 5 minutes). If chest pain does not stop go to hospital. Do not give when BP is < 90/60.
Preload affects amount of blood that goes to the R ventricle. Afterload is the resistance the blood has to overcome when leaving the heart.
Calcium channel blocker affects the afterload.
for a CABG operation when the great saphenous vein is taken it is turned inside out due to the valves that are inside.
unstable angina is not relieved by nitro.
dead tissues cannot have PVC’s(premature ventricular contraction. If left untreated pvc’s can lead to VF (ventricular fibrillation).
1 t (teaspoon)=
5 ml
1 T(tablespoon)= 3 t =
15 ml
1 oz=
30 ml
1 cup=
8 oz
1 quart=
2 pints
1 pint=
2 cups
1 gr (grain)=
60 mg
1 g (gram)=
1000 mg
1 kg=
2.2 lbs
1 lb=
16 oz
- To convert Centigrade to F. F= C+40, multiply 9/5 and substract 40
- To convert Fahrenheit to C. C= F+40, multiply 5/9 and substract 40.
angiotensin II in the lungs=
potent vasodialator. Aldosterone attracts sodium.
REVERSE AGENTS FOR TOXICITY
heparin=
protamine sulfate
REVERSE AGENTS FOR TOXICITY
coumadin=
vitamin k
REVERSE AGENTS FOR TOXICITY
ammonia=
lactulose
REVERSE AGENTS FOR TOXICITY
acetaminophen=
n-Acetylcysteine.
REVERSE AGENTS FOR TOXICITY
Iron=
deferoxamine
REVERSE AGENTS FOR TOXICITY
Digitoxin, digoxin=
digibind.
REVERSE AGENTS FOR TOXICITY
Alcohol withdraw=
Librium.
REVERSE AGENTS FOR TOXICITY
- methadone is an opioid analgesic used to
detoxify/treat pain in narcotic addicts.
REVERSE AGENTS FOR TOXICITY
- Potassium potentiates
dig toxicity.
heparin prevents platelet aggregation.
PT/PTT are elevated when patient is on coumadin
cardiac output decreases with dysrythmias. Dopamine increases BP.
Med of choice for Vtach
is lidocaine
Med of choice for SVT
is adenosine or adenocard
Med of choice for Asystole (no heart beat)
is atropine
Med of choice for CHF
is Ace inhibitor.
Med of choice for anaphylactic shock
is Epinephrine
Med of choice for Status Epilepticus
is Valium.
Med of choice for bipolar
is lithium.
Amiodorone is effective in both ventricular and atrial complications.
S3 sound is normal in CHF, not normal in MI.
give carafate (GI med) before meals to coat stomach
Protonix is given prophylactically to prevent stress ulcers.
after endoscopy check gag reflex.
TPN(total parenteral nutrition) given in subclavian line.
low residue diet means low fiver
portal hypotension + albuminemia= Ascites.
Appendicitis (inflammation of the appendix) pain is in
RL quadrant with rebound tenderness.
diverticulitis (inflammation of the diverticulum in the colon) pain is around
LL quadrant.
beta cells of pancreas produce insulin
Morphine is contraindicated in Pancreatitis. It causes spasm of the Sphincter of Oddi. Therefore Demerol should be given.
Trousseau and Tchovoski signs observed in hypocalcemia
with chronic pancreatitis, pancreatic enzymes are given with meals.
Never give K+ in IV push.
mineral corticoids are give in Addison’s disease.
Diabetic ketoacidosis (DKA)= when body is breaking down fat instead of sugar for energy. Fats leave ketones (acids) that cause pH to decrease.
DKA is rare in diabetes mellitus type II because there is enough insulin to prevent breakdown of fats.
Sign of fat embolism is petechiae. Treated with heparin.
for knee replacement use continuous passive motion machine.
give prophylactic antibiotic therapy before any invasive procedure.
glaucoma patients lose peripheral vision. Treated with meds
cataract= cloudy, blurry vision. Treated by lens removal-surgery
Co2 causes vasoconstriction.
most spinal cord injuries are at the cervical or lumbar regions
spinal shock occurs immediately after spinal injury
