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NCLEX PN Study > NCLEX PN Notes 5 > Flashcards

NCLEX PN Notes 5 Flashcards

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1
Q

To remember how to draw up INSULIN think: Nicole Richie RN (a teacher taught us this is school, thought it was funny and never forgot it!!!)
Air into NPH, then air into regular, draw up regular then draw up NPH

A

HYPERthyroidism
think of MICHAEL JACKSON in THRILLER!
SKINNY, NERVOUS, BULDGING EYES, Up all night, heart beating fast

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2
Q 
Hyper natremia (greater than 145) 
S 
A
L
T
A

Skin flushed
Agitation
Low grade fever
Thirst

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3
Q 
Developmental
2-3 months: turns head side to side 
4-5 months: grasps, switch & roll 
6-7 months: sit at 6 and waves bye-bye 
8-9 months: stands straight at eight 
10-11 months: belly to butt (phrase has 10 letters) 12-13 months: twelve and up, drink from a cup
A

Hepatitis Hepatitis: -ends in a VOWEL, comes from the BOWEL (Hep A)
Hepatitis B=Blood and Bodily fluids
Hepatitis C is just like B

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4
Q

GLASGOW COMA SCALE. EYES, VERBAL,MOTOR! It is similar to measuring dating skills…max 15 points -one can do it if below 8 you are in Coma.
So, to start dating you gotta open your EYES first,

if you albe to do that spontaneously and use them correctly to SEE whom you dating you earn 4. But if she has to scream on you to make you open them it is only 3….and 1 you dont care to open even if she tries to hurt you.

if you get good EYE contact (4 points) then move to VERBAL.
talk to her/ him! if you can do that You are really ORIENTED in situation she/he uncontiously gives you 4 points! if you like her try not to be CONFUSED (3), and of cause do not use INAPPROPRIATE WORDS (3), she will not like it)), try not to RESPOND WITH INCOMPREHENSIBLE SOUNDS (2), if you do not like her- just show no VERBAL RESPONSE(1)

A

Since you’ve got EYE and VERBAL contact you can MOVE now using your Motor Response Points.

THis is VERY important since Good moves give you 6!

The person who hyperventilates is most likely to experience respiratory alkalosis.

avoid salt substitutes when taken dig and k-supplements because many are potassium based

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5
Q

Signs of hypoxia: =>

A

restless, anxious, cyanotic tachycardia, increased resps. (also monitor ABG’s)

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6
Q

Apgar measures HR,RR,Muscle tone, Reflexes,Skin color each 0-2 point. 8-10 OK. 0-3 RESUSCITATE.

A

Addison’s disease (need to “add” hormone)

Cushing’s syndrome (have extra “cushion” of hormones)

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7
Q

Dumping syndrome: =>

A

increase fat and protein, small frequent meals, lie down after meal to decrease peristalsis, wait 1 hr after meals to drink.

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8
Q

For blood types: “O” is the universal donor (remember “o” in donor)

“AB” is the universal recipient

A

Disseminated Herpes Zoster is AIRBORNE PRECAUTIONS, as to

Localized Herpes Zoster is CONTACT PRECAUTIONS.

A nurse with a localized herpes zoster CAN care for patients as long as the patients are NOT immunosuppressed and the lesions must be covered!

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9
Q

Fat soluble vitamins are Vitamins A, D, E, K

A

Give NSAIDS, Corticosteroids, drugs for Bipolar, Cephalosporins, and Sulfonamides
WITH food.

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10
Q

Ativan is the treatment of choice for status epilepticus

A

When using a bronchodilator inhaler inconjuction with a glucocorticoid inhaler, administer the bronchodilator first

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11
Q

Theophylline increases the risk of digoxin toxicity and decreases the effects of lithium and Dilantin

A

INtal, an inhaler used to treat allergy induced asthma may cause bronchospasm, think… INto the asthmatic lung

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12
Q

Isoniazid causes peripheral neuritis

A

Peptic ulcers caused by H. pylori are treated with Flagyl, Prilosec and Biaxin.

This treatment kills bacteria and stops production of stomach acid, but does not heal ulcer. Weighted NI (Naso intestinal tubes) must float from stomach to intestine.

Don’t tape the tube right away after placement, may leave coiled next to pt on HOB. Position patient on RIGHT to facilitate movement through pylorus.

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13
Q

Diaphragm must stay in place 6 hours after intercourse. They are also fitted so must be re- fitted if you lose or gain a significant amount of weight.

A

Best time to take Growth Hormone PM, Steroids AM, Diuretics AM, Aricept AM.

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14
Q

Carafate (Sulcrafate) before meals (mucosal barrier; constipation)

A

Tagamet with food (H2; messes with elderly ppl be careful ! Interacts with alot of things)

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15
Q

Antacids after meals

A

Long term use of amphogel (binds to phosphates, increases Ca, robs the bones…leads to increased Ca resortion from bones and WEAK BONES)

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16
Q

Cushings ulcers r/t BRAIN injury =>

A

Cushings triad r/t ICP in BRAIN (htn, bradycard, irr. resp)

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17
Q

Thyroid storm is HOT (hyperthermia)

A

Myxedema coma is COLD (hypothermia)

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18
Q

Glaucoma intraocular pressure is greater than the normal (22 mm Hg), give miotics to constrict (pilocarpine)
NO ATROPINE.

A

Non dairy sources of calcium include RHUBARB, SARDINES, COLLARD GREENS

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19
Q

You can petal the rough edges of a plaster cast with tape to avoid skin irritation.

A

With low back aches, bend knees to relieve

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20
Q

Push fluids with Allopurinol - flush the uric acid out of system

A

Koplick’s spots are red spots with blue center characteristic of PRODROMAL stage of Measles. Usually in mouth.

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21
Q

INH can cause peripheral neuritis, take Vit B6 to prevent also hepatotoxic

A

Rifampin - Red orange tears and urine, also contraceptives don’t work as well

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22
Q

Ethambutol - messes with your Eyes =>

A

Apply eye drop to conjunctival sac and after wards apply pressure to nasolacrimal duct / inner canthus

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23
Q

Pancreatitis patients but them in fetal position, NPO, gut rest, prepare antecubital site for PICC cuz they’ll probably be getting TPN/Lipids

A

Trendelenburg test - for varicose veins. If they fill proximally = varicosity.

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24
Q

Rule of nines, 9 = head, 18 = arms, 36 = torso, 36 =legs, and 1= perineum = 100%

A

When giving Kayexalate we need to worry about dehydration ( K ha ineverse relationship with Na)

25
Q

Yogurt has live cultures- dont give to immunosuppressed pt

A

Itching under cast area- cool air via blow dryer, ice pack for 10- 15 minutes.
NEVER use qtip or anything to scratch area

26
Q

– pain with palpation of gall bladder area seen with cholecystitis =>

A

Murphy’s sign

27
Q

– ecchymosis in umbilical area, seen with pancreatitis =>

A

Cullen’s sign

28
Q

– flank grayish blue (turn around to see your flanks) pancreatitis =>

A

Turner’s sign

29
Q

– pain in RLQ indicative of appendicitis =>

A

McBurney’s Point

30
Q

– diverticulitis , low residue, no seeds, nuts, peas =>

A

LLQ

31
Q

– appendicitis, watch for peritonitis =>

A

RLQ

32
Q

– Tests for PKU, baby should have eaten source of protein first =>

A

Guthrie Test

33
Q

– test for pernicious anemia/ how well one absorbs Vit b12 =>

A

Shilling Test

34
Q

Allen’s test
– occlude both ulnar and radial artery until hand blanches then release ulnar. If the hand pinks up, ulnar artery is good and you can carry on with ABG/radial stick as planned. ABGS must be put on ice and whisked to the lab.

A

o It’s ok to have abdominal craps, blood tinged outflow and leaking around site if the Peritoneal Dialysis cath (tenkhoff) was placed in the last 1-2 wks. Cloudy outflow NEVER NORMAL. oAmniotic fluid yellow with particles = meconium stained
o Hyper reflexes (upper motor neuron issue “your reflexes are over the top”)
o Absent reflexes (lower motor neuron issue)

35
Q

o Rhogam : given at 28 weeks, 72 hours post partum, IM. Only given to Rh NEGATIVE mother. Also if indirect Coomb’s test is positive, don’t need to give Rhogam cuz she has antibody only give if negative coombs
o Vit K is to coumadin as Protamine Sulfate is to Heparin as Ca Glu is to MgSo4 as Mucomyst is to Acetominophen as Amicar is to TPA…get it? Antidotes/treatments for overdose

A 
Order of assessment: 
Inspection, 
Palpation, 
Percussion and 
Auscultation.

EXCEPT with abdomen cuz you don’t wanna mess with the bowels and their sounds so you
Inspect,
Auscultate,
Percuss then
Palpate
(same with kids, I suppose since you wanna go from least invasive to most invasive sine they will cry BLOOD MURDER ! Gotta love them kids !)

36
Q

Latex allergies =>

A

Assess for allergies to bananas, apricots, cherries, grapes, kiwis, passion fruit, avocados, chestnuts, tomatoes, peaches

37
Q

Tensilon is used in myesthenia gravis to confirm the diagnosis.

A

Myesthenia gravis is caused by a disorder in the transmission of impulses from nerve to muscle cell.

38
Q

Amyotrophic lateral sclerosis ( ALS ) is a condition in which there is a degeneration of motor neurons in both the upper & lower motor neuron systems.

A 
Transesophageal Fistula (TEF) - esophagus doesn't fully develop (this is a surgical emergency) 
The 3 C's of TEF in the newborn: 
1) Choking 
2) Coughing
3) Cyanosis
39
Q

The MMR vaccine is given SQ not IM.

A

Red–unstable, ie, occluded airway, actively bleeding, see first

40
Q

Yellow—stable, can wait up to an hour for treatment, ie burns, see second

A

Green—stable, can wait even longer to be seen, “walking wounded”

41
Q

Black–unstable clients that will probably not make it, need comfort measures

A

DOA—dead on arrival

42
Q

Greek heritage - they put an amulet or any other use of protective charms around their baby’s neck to avoid “evil eye” or envy of others

A

4 year old kids cannot interpret TIME. Need to explain time in relationship to a known COMMON EVENT (eg: “Mom will be back after supper”).

43
Q

Anaphylactic reaction to baker’s yeast is contraindication for Hep B vaccine.

A

Ask for allergy to eggs before Flu shot

44
Q

Ask for anaphylactic rxn to eggs or neomycin before MMR

A

When on nitroprusside, monitor thiocynate (cyanide). Normal value should be 1, >1 is heading toward toxicity

45
Q

If kid has cold, can still give immunizations

A

SARS (severe acute resp syndrome) airborne + contact (just like varicella)

46
Q

Hepatitis A is contact precautions

A

Tetanus, Hepatitis B, HIV are STANDARD precautions

47
Q

William’s position - Semi Fowlers with knees flexed (inc. knee gatch) to relieve lower back pain.

A

SIGNS of a Fractured hip: EXTERNAL ROTATION, SHORTENING, ADDUCTION

48
Q

Fat Embolism: Blood tinged sputum (r/t inflammation), inc ESR, respiratory alkalosis (not acidosis r/t tachypnea), hypocalcemia,increased serum lipids, “snow storm” effect on CXR.

A

Complications of Mechanical Ventilation: Pneumothorax, Ulcers

49
Q

Paget’s Disease - tinnitus, bone pain, enlargement of bone, thick bones.

A

NO VITAMIN C with Allopurinol

50
Q

IVP requires bowel prep so they can visualize the bladder better

A

Acid Ash diet - cheese, corn, cranberries, plums, prunes, meat, poultry, pastry, bread

51
Q

Alk Ash diet- milk, veggies, rhubarb, salmon

A

Orange tag in triage is non emergent Psych

52
Q

Greenstick fractures, usually seen in kids bone breaks on one side and bends on the other

A

Insomnia is a side effect of thyroid hormones. Saunders confirms it. Makes sense though! Increased met. rate, your body is “too busy to sleep” as opposed to the folks with hypothyroidism who may report somnolence (dec. met rate, body is slow and sleepy). Ok some more facts.

53
Q

BOTOX for strabismus. Patch the GOOD eye so that the weaker eye can get stronger. Found a cool link about its use in peds pt with strabismus. I had to look it up cuz I heard it was important ah hem ah hem

A

TIDAL VOLUME is 7 – 10ml / kg

54
Q

COPD patients REMEMBER: 2LNC or less (hypoxic NOT hypercapnic drive), Pa02 of 60ish and Sa02 90% is normal for them b/c they are chronic CO2 retainers. …

A

Neostigmine/Atropine (anticholinergic) to reverse effect of pancuronium.

55
Q

Ampho B causes hypokalemia (amongst many other things..gotta premedicate before giving. Pts will most likely get a fever)

A

Test 4 hypersensitivity before the administration of asparginase

56
Q

Take Vermox with high fat diet (increases absorption)

A

Kidney Glucose threshold is 180

57
Q

Amphogel and Renegal take with meals

A

Stranger anxiety is greatest 7 - 9 months, Separation anxiety peaks in toddlerhood

58
Q

MMR is a SQ shot

A

1

NCLEX PN Study (7 decks)

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