Nclex Prep Flashcards
Platelets normal value
150,000-450,000
WBC normal value
5,000-10,000
RBC normal value
4.5-6.0
Hemoglobin normal value
12-16
Hematocrit normal value
38-47%
INR normal value
0.8-1.2
PTT normal value
25-38 secs
PT normal value
11-15 secs
herbal meds that increase PT/INR, PTT (increase bleeding)
black cohosh, echinacea, garlic, ginger, gingko
herbal meds that decrease PT/INR, PTT (increase clotting)
ginseng, St. John’s wort, green tea, nettle
Foods high in Vit K
liver, broccoli, spinach, kale, cauliflower, cabbage, alfalfa, brussel sprouts, chick peas, green tea
S/S of complications of blood transfusion
BACK/CHEST PAIN, elevated temp, AP
What is polycythemia vera?
What is primary nursing care?`
- too many RBCs
- assess for clotting
B/P = VOLUME
What happens to BP when there’s more volume?
BP goes UP
B/P = VOLUME
What happens when there’s less volume?
BP goes down, HR goes up, RR goes up
Diabetes insipidus = ___ concentration of urine
LOW
GI fluid loss = ___ concentration of urine
High
Smoking is a r/f for what cancers
BOCELL
Bladder, Oral, Cervical, Esophageal, Lung, Laryngeal
Most common ending for steroid drugs
- lone
- sone
most common endings for NSAIDS
- in
- en
- ac
- cam
What does a low hematocrit reading mean?
bleeding
Liver Biopsy
What do you do, pre-test?
NPO for 6-8 hrs
Assess PT
Liver Biopsy
Procedure Positioning
flat, low fowlers, R arm extended above head, hold breath
Liver Biopsy
Post-Test
lay pt on RIGHT side with pressure, bedrest for 12-24 hours
Anti-Ulcer Meds
Histamine Antagonists most common suffix
- tidine
ex: Cimetidine (Tagamet), Ranitidine (Zantac), famotidine (Pepcid)
Anti Ulcer Meds
Histamine Antagonists
- administration
- adverse effects
- tagamet with food, all others without regard to food; cautiously use zantac in renal or liver pts
- HA
Anti Ulcer Meds
Proton Pump Inhibitors common suffix
- prazoles
ex: esomeprazole (Nexium), omeprazole (Prilosec), lansoprazole (Prevacid)
Anti Ulcer Meds
Proton Pump Inhibitors
- administration
- adverse
- no regards to meal times, use cautiously in renal or liver pts
- HA, cough, diarrhea
Anti Ulcer Meds
Antacids most common suffix
- gel
ex: Basagel, Alternagel, Amphogel
Anti Ulcer Meds
Antacids action
neutralize acids in stomach
S/S of Crohn’s Disease
RLQ pain, distension, diarrhea
NSG Care for Crohn’s Disease
low fiber diet, anti-diarrheals, avoid high roughage
NSG Care for Cirrhosis
moderate to high protein intake, lactulose, rest
NSG Care for Ascites
latulose, albumin p.o./p.r., Hi-Fowler’s (assess orthopnea), low sodium/low protein diet, fluid restriction
S/S of Cholecystitis/Cholelithiasis (inflammation of the gallbladder)
RUQ pain, n/v after high cholesterol intake
S/S of Pancreatitis
LUQ pain, n/v
tests results include: elv. lipase, amylase, BG, WBCs, K, BUN, and dec. Ca, Na, HCT, PTH
NSG Care for Pancreatitis
NO morphine sulfate, NPO, tetany assessments
R/F for Esophageal Cancer
Etoh, Elderly
Renal System Meds
Urecholine (Bethanechol) used to:
stimulate urination post-op
-have bed pan/urinal ready
How to obtain a urine specimen from foley
- clamp foley tubing for 30 min
- wash hands, don clean gloves
- ETOH port, insert 10-20 mL syringe needle with bevel up into port and aspirate sample
- inject into specimen container
- unclamp tubing
- remove gloves, wash hands
- label and send specimen to lab
What is the purpose of a bladder scan?
used to check for residual urine after voiding
Potassium normal value
3.5-5.0
HYPOkalemia is r/t
diarrhea, vomiting, Cushing’s
What will an ECG look like in a pt with HYPOkalemia?
flat (low) T waves, prominent U waves, tachycardia
Electrolyte Imbalances
LOW K+ = __ T wave, __ pulse
LOW, HIGH
Electrolyte Imbalances
HIGH K+ = __ T wave, __ pulse
High, Low
K+ Rich Foods
baked potato, melon fruits, bananas, raisins, beans, coffee, chocolate, avocados, tomato
Med tx for for arrythmias
Lidocaine, beta blockers ( “olol” )
Sodium normal value
135-145
S/S of HYPOnatremia
HA, n/v, cramps, CONFUSION, moist
S/S of HYPERnatremia
1: THIRST, dry
Magnesium normal values
1.7-2.2
S/S of HYPERmagnesemia
Tx
flushed, hot, inc perspiration, diarrhea, shallow respirations
Tx: Ca+ gluconate IVP
S/S HYPOmagnesemia
Tx
wt loss, muscle pain/twitches/cramps, fatty stools
Tx: Mg+ supplements
Magnesium Rich Foods
dark, leafy greens, CASHEWS, pecans, soy, brown rice, avocado, apricots
Calcium normal value
8.0-10.2
What medical condition is r/t HYPERcalcemia?
kidney stones
What causes HYPOcalcemia?
hypoparathyroidism, hypermagnesemia
S/S of HYPOcalcemia
paresthesias (numbness of fingertips and mouth), seizures, MUSCLE WEAKNESS, arrythmias
Tx of HYPOcalcemia
calcium supplements, calcium gluconate IVP
Calcium Rich Foods
sardines, dairy products, almonds, broccoli, okra
What conditions result in an elevated BUN level?
Gallbladder, Pancreatitis, Hepatits, Liver disease
BUN normal value
10-20
Creatinine normal value
0.5-1.5
Uric Acid normal value
3.5-7.0
Urine Specific Gravity normal value
1.010-1.025
Phosphorus normal value
2.5-7.4
A calcium reading less than 8 indicates…
….tetany
What position do you place a post-op renal biopsy pt?
prone
What is the priority nsg care for a urolithiasis pt? (stones)
pain management
Why would an MD order an antacid for a renal failure pt?
to help excrete phosphorus (aluminum binds to phosphorus) therefore elevating calcium levels (preventing tetany)
What meds are CI for a renal failure pt?
ace inhibitors (-pril, -ril, -vil)
Normal Effects of Iodine
- salty, seafood, metallic taste
- warm, flushed feeling
- tingling, numbness
NSG Care for brain scan pt: pre-test, post-test
- assess dye allergies (shellfish, cough syrup, multivitamin, betadine), instruct to void, lie still
- push fluids
S/S of increased intracranial pressure (ICP)
decreased LOC, Cushing’s triad (dec AP, irreg RR, widening pulse pressure)
Upper Motor Neuron Defect: SCI ___ T6
Consists of…
above
…spastic paralysis, need to stimulate elimination
Lower Motor Neuron Defect: SCI ___ T6
Consists of…
at/below
…flaccid paralysis, manual stool elimination
What is autonomic dysreflexia?
a reaction of the autonomic nervous system to overstimulation, occurring in pts with SCI about T6; characterized by high BP, flushing of the skin, sweating, HA
NSG Care for pt with autonomic dysreflexia
semi-fowlers, assess bladder/bowel, check person, check environment
NSG care for myasthenia gravis pt (severe muscle weakness)
assess resp status, gag reflex before meals
What is Parkinson’s disease?
dopamine deficiency causing stiffness, rigidity and tremors
S/S of Parkinson’s
mask-like expression, stooped shoulders, tremors, bradykinesia, micrographia (small handwriting), shuffling gait
Meds associated with Parkinson’s
levodopa, sinemet, congentin, eldepryl, stalevo
S/E of levodopa, carbidopa
lower BP (causing dizziness), constipation/diarrhea, blurred vision, arrythmias
S/S of detached retina
flashes of light, floaters, CURTAIN CLOSING
Meds associated with Glaucoma
Timolol, pilocarine eye gtts, stool softeners
S/S of Cataracts
CLOUDY lens, decreased vision
S/S of Meniere’s Disease (no drainage of fluid in ear)
Tx:
IRREVERSIBLE loss of hearing, tinnitus, vertigo
Tx: low sodium diet, dim/quiet environment
S/S of a frontal lobe brain tumor
where you make decisions, memory
HA, memory loss, impaired vision, impaired judgement, vision problems, emotional/behavioral changes
Posterior Pituitary Hormones
ADH
Antidiuretic hormone - tells kidney to hold onto H20
Posterior Pituitary Hormones
Glucocorticoids
ex: cortisol
sugar
Posterior Pituitary Hormones
Mineralocorticoids
ex: aldosterone
salt
Posterior Pituitary Hormones
Sex Steroids
ex: testosterone
Anterior Pituitary Hormones
ACTH
adrenal
S/S Cushing’s Disease (FVE)
inc RR, HR, BP; moon face, central obesity, striae, edema, facial hair
S/S of Addison’s disease
bronze/darkening of skin, n/v, dec HR, BP; weakness, fatigue, abdominal cramps
Blood Glucose normal value
70-110
Types of Insulin: CLEAR
Humolog, Lispro: onset, peak, duration
Rapid acting
15 min, 1 hr, 3 hrs
Types of Insulin: CLOUDY
NPH (intermediate acting): onset, peak, duration
1-1.5 hrs, 6-8 hrs, 16-20 hrs
Types of Insulin: CLOUDY
Lantus (LONG): onset, peak, duration
1 hr, NO PEAK, 24-30 hrs
S/S of HYPOglycemia
pale, cold, clammy, crabby, shaky, weak, HA
S/S of HYPERglycemia
polyuria, polydipsia, polyphagia (pee, thirst, hunger)
What is the BG level of a DKA pt?
> 250
What is a glycosylated hemoglobin (HGBA1c) test?
tests blood glucose levels over the past three months
desired value: <6%
What is the Somogyi Effect?
early am hyperglycemia that follows late pm episode of hypoglycemia; notify MD
What is the #1 risk factor for coronary artery disease?
high cholesterol
LDL normal value
<100
HDL normal value
> 35-60
What will the EKG look like in atrial fibrillation?
irregular P waves
S/S of atrial fibrillation (most common)
pulse deficit
What will the EKG look like during an atrial flutter?
SAWTOOTH P wave
S/S of atrial flutter
CHEST PAIN FIRST, followed by shortness of breath
Pt teaching for a Holter Monitor
24 hr EKG
- Do not remove or get wet
- keep diary of activites
What will the EKG look like during an MI?
Like a chair
-elevated ST segment
Treatment of MI
relief of pain is #1 priority, semi-fowlers, aspirin, nitroglycerin
Causes of Congestive Heart Failure
MI, thyroid storm, anemia, acidosis, ASHD
S/S of RIGHT sided CHF (venous side, veins)
cool edema in legs, jugular vein distension, hepatomegaly (enlarged liver), ASCITES, distention
S/S of LEFT sided CHF (arterial side, LUNGS)
crackles (rales), cough w/ pink, frothy sputum, dyspnea, SOB, orthopnea, cyanosis
Cardiac Meds
ACE inhibitors common suffix
- pril, -ril, -vil
ex: lisinopril, captopril, benazepril, accupril
If K+ is ___, then HR is ___
HIGH, LOW
Cardiac Meds
Alpha Blockers common suffix
- osin
ex: prazosin, terazosin, doxazosin
Cardiac Meds
Alpha Blockers uses
htn, BPH
Cardiac Meds
ACE Inhibitors uses
htn, CHF, post MI
Cardiac Meds
ACE Inhibitors NSG Care Key Points
- Don’t give with NSAIDS, K+ sparing diuretics/supplements
- Don’t give to renal failure pt
- Take on empty stomach; 1 hr before meals, 2 hrs after meals
Cardiac Meds
Alpha Blockers action
produces vasodilation
Cardiac Meds
ACE Inhibitors action
lowers BP
Cardiac Meds
Angiotensin Receptor Blockers common suffix
ARBs
- sartan
ex: valsartan, candesartan, losartan