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Normal Values > Nclex Prep > Flashcards

Nclex Prep Flashcards

0
Q

Platelets normal value

A

150,000-450,000

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1
Q

WBC normal value

A

5,000-10,000

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2
Q

RBC normal value

A

4.5-6.0

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3
Q

Hemoglobin normal value

A

12-16

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4
Q

Hematocrit normal value

A

38-47%

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5
Q

INR normal value

A

0.8-1.2

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6
Q

PTT normal value

A

25-38 secs

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7
Q

PT normal value

A

11-15 secs

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8
Q

herbal meds that increase PT/INR, PTT (increase bleeding)

A

black cohosh, echinacea, garlic, ginger, gingko

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9
Q

herbal meds that decrease PT/INR, PTT (increase clotting)

A

ginseng, St. John’s wort, green tea, nettle

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10
Q

Foods high in Vit K

A

liver, broccoli, spinach, kale, cauliflower, cabbage, alfalfa, brussel sprouts, chick peas, green tea

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11
Q

S/S of complications of blood transfusion

A

BACK/CHEST PAIN, elevated temp, AP

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12
Q

What is polycythemia vera?

What is primary nursing care?`

A
  • too many RBCs

- assess for clotting

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13
Q

B/P = VOLUME

What happens to BP when there’s more volume?

A

BP goes UP

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14
Q

B/P = VOLUME

What happens when there’s less volume?

A

BP goes down, HR goes up, RR goes up

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15
Q

Diabetes insipidus = ___ concentration of urine

A

LOW

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16
Q

GI fluid loss = ___ concentration of urine

A

High

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17
Q

Smoking is a r/f for what cancers

A

BOCELL

Bladder, Oral, Cervical, Esophageal, Lung, Laryngeal

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18
Q

Most common ending for steroid drugs

A
  • lone

- sone

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19
Q

most common endings for NSAIDS

A
  • in
  • en
  • ac
  • cam
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20
Q

What does a low hematocrit reading mean?

A

bleeding

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21
Q

Liver Biopsy

What do you do, pre-test?

A

NPO for 6-8 hrs

Assess PT

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22
Q

Liver Biopsy

Procedure Positioning

A

flat, low fowlers, R arm extended above head, hold breath

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23
Q

Liver Biopsy

Post-Test

A

lay pt on RIGHT side with pressure, bedrest for 12-24 hours

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24
Q

Anti-Ulcer Meds

Histamine Antagonists most common suffix

A
  • tidine

ex: Cimetidine (Tagamet), Ranitidine (Zantac), famotidine (Pepcid)

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25
Q

Anti Ulcer Meds

Histamine Antagonists

  • administration
  • adverse effects
A
  • tagamet with food, all others without regard to food; cautiously use zantac in renal or liver pts
  • HA
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26
Q

Anti Ulcer Meds

Proton Pump Inhibitors common suffix

A
  • prazoles

ex: esomeprazole (Nexium), omeprazole (Prilosec), lansoprazole (Prevacid)

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27
Q

Anti Ulcer Meds

Proton Pump Inhibitors

  • administration
  • adverse
A
  • no regards to meal times, use cautiously in renal or liver pts
  • HA, cough, diarrhea
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28
Q

Anti Ulcer Meds

Antacids most common suffix

A
  • gel

ex: Basagel, Alternagel, Amphogel

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29
Q

Anti Ulcer Meds

Antacids action

A

neutralize acids in stomach

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30
Q

S/S of Crohn’s Disease

A

RLQ pain, distension, diarrhea

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31
Q

NSG Care for Crohn’s Disease

A

low fiber diet, anti-diarrheals, avoid high roughage

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32
Q

NSG Care for Cirrhosis

A

moderate to high protein intake, lactulose, rest

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33
Q

NSG Care for Ascites

A

latulose, albumin p.o./p.r., Hi-Fowler’s (assess orthopnea), low sodium/low protein diet, fluid restriction

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34
Q

S/S of Cholecystitis/Cholelithiasis (inflammation of the gallbladder)

A

RUQ pain, n/v after high cholesterol intake

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35
Q

S/S of Pancreatitis

A

LUQ pain, n/v

tests results include: elv. lipase, amylase, BG, WBCs, K, BUN, and dec. Ca, Na, HCT, PTH

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36
Q

NSG Care for Pancreatitis

A

NO morphine sulfate, NPO, tetany assessments

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37
Q

R/F for Esophageal Cancer

A

Etoh, Elderly

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38
Q

Renal System Meds

Urecholine (Bethanechol) used to:

A

stimulate urination post-op

-have bed pan/urinal ready

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39
Q

How to obtain a urine specimen from foley

A
  • 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
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40
Q

What is the purpose of a bladder scan?

A

used to check for residual urine after voiding

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41
Q

Potassium normal value

A

3.5-5.0

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42
Q

HYPOkalemia is r/t

A

diarrhea, vomiting, Cushing’s

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43
Q

What will an ECG look like in a pt with HYPOkalemia?

A

flat (low) T waves, prominent U waves, tachycardia

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44
Q

Electrolyte Imbalances

LOW K+ = __ T wave, __ pulse

A

LOW, HIGH

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45
Q

Electrolyte Imbalances

HIGH K+ = __ T wave, __ pulse

A

High, Low

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46
Q

K+ Rich Foods

A

baked potato, melon fruits, bananas, raisins, beans, coffee, chocolate, avocados, tomato

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47
Q

Med tx for for arrythmias

A

Lidocaine, beta blockers ( “olol” )

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48
Q

Sodium normal value

A

135-145

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49
Q

S/S of HYPOnatremia

A

HA, n/v, cramps, CONFUSION, moist

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50
Q

S/S of HYPERnatremia

A

1: THIRST, dry

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51
Q

Magnesium normal values

A

1.7-2.2

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52
Q

S/S of HYPERmagnesemia

Tx

A

flushed, hot, inc perspiration, diarrhea, shallow respirations

Tx: Ca+ gluconate IVP

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53
Q

S/S HYPOmagnesemia

Tx

A

wt loss, muscle pain/twitches/cramps, fatty stools

Tx: Mg+ supplements

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54
Q

Magnesium Rich Foods

A

dark, leafy greens, CASHEWS, pecans, soy, brown rice, avocado, apricots

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55
Q

Calcium normal value

A

8.0-10.2

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56
Q

What medical condition is r/t HYPERcalcemia?

A

kidney stones

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57
Q

What causes HYPOcalcemia?

A

hypoparathyroidism, hypermagnesemia

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58
Q

S/S of HYPOcalcemia

A

paresthesias (numbness of fingertips and mouth), seizures, MUSCLE WEAKNESS, arrythmias

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59
Q

Tx of HYPOcalcemia

A

calcium supplements, calcium gluconate IVP

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60
Q

Calcium Rich Foods

A

sardines, dairy products, almonds, broccoli, okra

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61
Q

What conditions result in an elevated BUN level?

A

Gallbladder, Pancreatitis, Hepatits, Liver disease

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62
Q

BUN normal value

A

10-20

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63
Q

Creatinine normal value

A

0.5-1.5

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64
Q

Uric Acid normal value

A

3.5-7.0

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65
Q

Urine Specific Gravity normal value

A

1.010-1.025

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66
Q

Phosphorus normal value

A

2.5-7.4

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67
Q

A calcium reading less than 8 indicates…

A

….tetany

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68
Q

What position do you place a post-op renal biopsy pt?

A

prone

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69
Q

What is the priority nsg care for a urolithiasis pt? (stones)

A

pain management

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70
Q

Why would an MD order an antacid for a renal failure pt?

A

to help excrete phosphorus (aluminum binds to phosphorus) therefore elevating calcium levels (preventing tetany)

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71
Q

What meds are CI for a renal failure pt?

A

ace inhibitors (-pril, -ril, -vil)

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72
Q

Normal Effects of Iodine

A
  • salty, seafood, metallic taste
  • warm, flushed feeling
  • tingling, numbness
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73
Q

NSG Care for brain scan pt: pre-test, post-test

A
  • assess dye allergies (shellfish, cough syrup, multivitamin, betadine), instruct to void, lie still
  • push fluids
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74
Q

S/S of increased intracranial pressure (ICP)

A

decreased LOC, Cushing’s triad (dec AP, irreg RR, widening pulse pressure)

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75
Q

Upper Motor Neuron Defect: SCI ___ T6

Consists of…

A

above

…spastic paralysis, need to stimulate elimination

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76
Q

Lower Motor Neuron Defect: SCI ___ T6

Consists of…

A

at/below

…flaccid paralysis, manual stool elimination

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77
Q

What is autonomic dysreflexia?

A

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

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78
Q

NSG Care for pt with autonomic dysreflexia

A

semi-fowlers, assess bladder/bowel, check person, check environment

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79
Q

NSG care for myasthenia gravis pt (severe muscle weakness)

A

assess resp status, gag reflex before meals

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80
Q

What is Parkinson’s disease?

A

dopamine deficiency causing stiffness, rigidity and tremors

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81
Q

S/S of Parkinson’s

A

mask-like expression, stooped shoulders, tremors, bradykinesia, micrographia (small handwriting), shuffling gait

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82
Q

Meds associated with Parkinson’s

A

levodopa, sinemet, congentin, eldepryl, stalevo

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83
Q

S/E of levodopa, carbidopa

A

lower BP (causing dizziness), constipation/diarrhea, blurred vision, arrythmias

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84
Q

S/S of detached retina

A

flashes of light, floaters, CURTAIN CLOSING

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85
Q

Meds associated with Glaucoma

A

Timolol, pilocarine eye gtts, stool softeners

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86
Q

S/S of Cataracts

A

CLOUDY lens, decreased vision

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87
Q

S/S of Meniere’s Disease (no drainage of fluid in ear)

Tx:

A

IRREVERSIBLE loss of hearing, tinnitus, vertigo

Tx: low sodium diet, dim/quiet environment

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88
Q

S/S of a frontal lobe brain tumor

where you make decisions, memory

A

HA, memory loss, impaired vision, impaired judgement, vision problems, emotional/behavioral changes

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89
Q

Posterior Pituitary Hormones

ADH

A

Antidiuretic hormone - tells kidney to hold onto H20

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90
Q

Posterior Pituitary Hormones

Glucocorticoids

A

ex: cortisol

sugar

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91
Q

Posterior Pituitary Hormones

Mineralocorticoids

A

ex: aldosterone

salt

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92
Q

Posterior Pituitary Hormones

Sex Steroids

A

ex: testosterone

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93
Q

Anterior Pituitary Hormones

ACTH

A

adrenal

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94
Q

S/S Cushing’s Disease (FVE)

A

inc RR, HR, BP; moon face, central obesity, striae, edema, facial hair

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95
Q

S/S of Addison’s disease

A

bronze/darkening of skin, n/v, dec HR, BP; weakness, fatigue, abdominal cramps

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96
Q

Blood Glucose normal value

A

70-110

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97
Q

Types of Insulin: CLEAR

Humolog, Lispro: onset, peak, duration
Rapid acting

A

15 min, 1 hr, 3 hrs

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98
Q

Types of Insulin: CLOUDY

NPH (intermediate acting): onset, peak, duration

A

1-1.5 hrs, 6-8 hrs, 16-20 hrs

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99
Q

Types of Insulin: CLOUDY

Lantus (LONG): onset, peak, duration

A

1 hr, NO PEAK, 24-30 hrs

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100
Q

S/S of HYPOglycemia

A

pale, cold, clammy, crabby, shaky, weak, HA

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101
Q

S/S of HYPERglycemia

A

polyuria, polydipsia, polyphagia (pee, thirst, hunger)

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102
Q

What is the BG level of a DKA pt?

A

> 250

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103
Q

What is a glycosylated hemoglobin (HGBA1c) test?

A

tests blood glucose levels over the past three months

desired value: <6%

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104
Q

What is the Somogyi Effect?

A

early am hyperglycemia that follows late pm episode of hypoglycemia; notify MD

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105
Q

What is the #1 risk factor for coronary artery disease?

A

high cholesterol

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106
Q

LDL normal value

A

<100

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107
Q

HDL normal value

A

> 35-60

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108
Q

What will the EKG look like in atrial fibrillation?

A

irregular P waves

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109
Q

S/S of atrial fibrillation (most common)

A

pulse deficit

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110
Q

What will the EKG look like during an atrial flutter?

A

SAWTOOTH P wave

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111
Q

S/S of atrial flutter

A

CHEST PAIN FIRST, followed by shortness of breath

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112
Q

Pt teaching for a Holter Monitor

A

24 hr EKG

  • Do not remove or get wet
  • keep diary of activites
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113
Q

What will the EKG look like during an MI?

A

Like a chair

-elevated ST segment

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114
Q

Treatment of MI

A

relief of pain is #1 priority, semi-fowlers, aspirin, nitroglycerin

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115
Q

Causes of Congestive Heart Failure

A

MI, thyroid storm, anemia, acidosis, ASHD

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116
Q

S/S of RIGHT sided CHF (venous side, veins)

A

cool edema in legs, jugular vein distension, hepatomegaly (enlarged liver), ASCITES, distention

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117
Q

S/S of LEFT sided CHF (arterial side, LUNGS)

A

crackles (rales), cough w/ pink, frothy sputum, dyspnea, SOB, orthopnea, cyanosis

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118
Q

Cardiac Meds

ACE inhibitors common suffix

A
  • pril, -ril, -vil

ex: lisinopril, captopril, benazepril, accupril

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119
Q

If K+ is ___, then HR is ___

A

HIGH, LOW

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120
Q

Cardiac Meds

Alpha Blockers common suffix

A
  • osin

ex: prazosin, terazosin, doxazosin

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121
Q

Cardiac Meds

Alpha Blockers uses

A

htn, BPH

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122
Q

Cardiac Meds

ACE Inhibitors uses

A

htn, CHF, post MI

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123
Q

Cardiac Meds

ACE Inhibitors NSG Care Key Points

A
  • 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
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124
Q

Cardiac Meds

Alpha Blockers action

A

produces vasodilation

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125
Q

Cardiac Meds

ACE Inhibitors action

A

lowers BP

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126
Q

Cardiac Meds

Angiotensin Receptor Blockers common suffix
ARBs

A
  • sartan

ex: valsartan, candesartan, losartan

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127
Q

Cardiac Meds

Angiotensin Receptor Blockers action

128
Q

Cardiac Meds

Angiotensin Receptor Blockers uses

129
Q

Cardiac Meds

Beta Blockers common suffix

A
  • lol, -olol

ex: propanolol, metoprolol, atenolol, carvedilol

130
Q

Cardiac Meds

Beta Blockers action

A

decrease HR, BP and contractility

131
Q

Cardiac Meds

Beta Blockers NSG Care Key Points

A
  • use with caution w/ oral hypoglycemics/bronchodilators (can exacerbate emphysema/asthma)
  • Give with food
  • avoid hot baths, saunas, jacuzzis
132
Q

Cardiac Meds

Calcium Channel Blockers common suffix

A
  • dipine

ex: nimodipine, amlodipine, nifedipine, DILTIAZEM, VERAPAMIL

133
Q

Cardiac Meds

Calcium Channel Blockers action

A
  • decreases contractility and oxygen demand; decreases AP and BP
  • NOT for acute MI, flutter, shock
134
Q

Cardiac Meds

Calcium Channel Blocker uses

A

htn, angina

135
Q

Cardiac Meds

Calcium Channel Blocker NSG Care Key Points

A

-don’t give with BETA BLOCKERS, GINKO, GINSENG

136
Q

What can you never give to a patient taking any type of cardiac medication?

A
  • GRAPEFRUIT (or grapefruit juice)
  • antibiotics
  • cancer meds
137
Q

Cardiac Meds

Antilipemics common suffix

A
  • statin

ex: simvastatin, lovestatin, pravastatin, GEMFIBROZIL

138
Q

Cardiac Meds

Antilipemics uses

A

lower LDL, raise HDL

139
Q

Cardiac Meds

Antilipemics Key Points

A

take same time every day, usually with evening meal

140
Q

S/S of Pericarditis

A

CHEST PAIN; can result in cardiac tamponade (pressure)

141
Q

Cause of Endocarditis

A

untreated or partially treated infection (strep is most common)

142
Q

S/S of Endocarditis

Tx of Endocarditis

A
  • SOB, new heart murmur (S3)

- bed rest and antibiotics for up to 6 months

143
Q

S/S of Peripheral Vascular Disease (PVD)

A

Intermittent Claudication (pain in the lower extremities when walking), dusky/cool/hairless lower legs

144
Q

How is HYPERtension diagnosed?

A

BP > 135/85 on 2 separate occasions

145
Q

NSG Care for pt with HTN

A

Monitor K+ levels whenever pt is on diuretics, monitor daily weight, teach pt to rise slowly (to prevent postural hyotension), diet and exercise

146
Q

What pts will have respiratory acidosis?

A

COPD, pneumonia, Guillan-Barre, myasthenia gravis, Addison’s, thyroid crisis, sleep apnea

147
Q

What patients will have metabolic acidosis?

A

renal failure, DKA, diarrhea

148
Q

What patients will have respiratory alkalosis?

A

pain, panic, hyperventilation

149
Q

What patients will have metabolic alkalosis?

150
Q

What does an ABG test do?

A

measures the oxygen in arterial blood, identifies acid-base imbalances

151
Q

pH normal value

152
Q

pCO2 normal value

153
Q

HCO3 normal value

154
Q

pO2 normal value

155
Q

What is ASA toxicity?

A

aspirin overdose

156
Q

S/S of ASA toxicity

A

tinnitus, n/v, diuresis, vertigo, convulsions

157
Q

What is a pneumothorax?

A

air or fluid in the pleural space of lung

158
Q

What is the treatment for a pneumothorax?

A

thoracentesis or chest tube placement

159
Q

S/S of Pneumothorax

A

sudden sharp chest pain with dyspnea, absence of breath sounds over area, asymmetry of chest movements with breathing, tracheal deviation towards unaffected side

160
Q

What would you do if there were bubbling in the water seal chamber of a closed drainage test tube system?

A

nothing; mild bubbling is normal

161
Q

What is asthma?

A

a bronchial constriction/spasm preventing the exhalation of air

162
Q

Tx for asthma

A

direct bronchodilator, Methylxanthine, steroids, leukotriene antagonists

163
Q

S/S of emphysema

A

AIR TRAPPING, barrel chest, impaired oxygen and carbon dioxide gas exchange, RESPIRATORY ACIDOSIS

164
Q

Why can’t you give an emphysema pt more than 2 liters of oxygen by nasal cannula?

A

low oxygen level gives the pt the drive to breathe; pt can become oxygen dependent if given more

165
Q

Tx for emphysema

A
  • take bronchodilator before steroid inhaler

- rinse mouth well after

166
Q

What is Cor Pulmonale?

A
  • right sided CHF r/t COPD
  • an enlargement of the right ventricle due to high BP in the arteries of the lungs usually caused by chronic lung disease
167
Q

What happens first to a pt with a pulmonary embolism?

What is immediate nsg care?

A
  • pt suddenly has dyspnea and CHEST PAIN

- sit pt in high fowlers, put oxygen on, get help

168
Q

When can an air embolism occur?

A

it can occur during a central line cap or a tubing change

169
Q

How do you position an air embolism pt?

A

LEFT lateral with HEAD LOWER than the body

170
Q

What is a pneumonectomy?

A

removal of lung

171
Q

Nsg care of pneumonectomy

How do you position pt post op and why?

A

position pt on the OPERATIVE side to prevent the heart and other organs from compressing the remaining lung

172
Q

What is lobectomy?

A

removal of lobe of lung (wedge resection, segmentectomy)

173
Q

NSG Care of lobectomy

How do you position pt post-op and why?

A

on UNAFFECTED side to allow affected lung expansion

174
Q

What is an early S/S for laryngeal cancer?

A

c/o pain in throat when drinking hot, acidic, carbonated liquids

175
Q

What is an early S/S for lung cancer?

A

persistent DRY cough

176
Q

What is Superior Vena Cava Syndrome and what is its prominent sign?

A

pulmonary tumor compresses the SVC causing UPPER BODY EDEMA

177
Q

What is the #1 tx for pulmonary edema?

A

morphine sulfate

diuretics are given after morphine

178
Q

What is PARITY?

A

the number of pregnancies that have reached viability

179
Q

What is NULLIGRAVIDA?

A

never been pregnant

180
Q

What is NULLIPARITY?

A

never had a viable pregnancy

181
Q

What is PRIMIGRAVIDA?

A

first pregnancy

182
Q

What is PRIMIPARITY?

A

first viable pregnancy

183
Q

What is MULTIGRAVIDA?

A

second viable pregnancy

184
Q

What is MULTIPARA?

A

two or more viable pregnancies

185
Q

What is viability?

A

fetal gestation at 22 weeks with fetal weight 500 grams (1lb 1oz)

186
Q

What is GTPAL?

A

of gravida, term, parity, aborted, live births

of pregs, term, preterm, aborted, live births

187
Q

What is Goodell’s Sign?

A
  • soft cervix

- PROBABLE sign of pregnancy

188
Q

What is Chadwick’s sign?

A
  • chance in color of membranes
  • PROBABLE sign of pregnancy

*C = *COLOR

189
Q

What is the normal range for a fetal heartbeat?

190
Q

When can an amniocentesis be preformed?

What is it’s early use for?

A

15-18 weeks (2nd-3rd trimester)

to identify chromosomal abnormalities, alpha-feta protein levels

191
Q

What is a Chorionic Villus Sampling used for?

When can it be done?

A

to identify chromosomal/genetic abnormalities

can only be done in the 1st trimester and you need a documented family history of defect

192
Q

What are the different weights you should gain during pregnancy?

A

Normal weight: 25-35
Underweight: 27-39
Overweight: 15-25
Obese: 15

193
Q

Can you take oral hypoglycemics when you’re pregnant?

Why?

A

NO

they can cause birth defects

194
Q

What meds are CI during pregnancy and why?

A

beta blockers (“olol”) - intrauterine growth restriction
oral hypoglycemics - birth defects
oral anticoagulants - facial defects, bleeding (heparin OK)
antibiotics - liver damage in mother, dark teeth in baby
OTCs
Herbals

195
Q

Why is magnesium sulfate therapy used in pregnant women?

A

for the prevention and treatment of convulsions in preeclampsia

196
Q

What is the antidote for magnesium sulfate if MgSO4 toxicity occurs?

A

Calcium Gluconate slow IV

197
Q

What is the usual dose of MgSO4?

A

4-6 g bolus over 15-30 minutes, then 1-3g/hr

198
Q

When do S/S of preeclampsia and eclampsia usually resolve?

A

within 48 hours after delivery

199
Q

What is placenta previa?

A

placenta implanted in lower uterine segment or over internal cervix

PAINLESS bleeding

200
Q

What is placenta abruptio?

A

premature separation of the placenta >30 weeks

PAINFUL bleeding

201
Q

When is a baby born in pre-term considered VIABLE?

A

22-37 weeks

202
Q

Signs of TRUE labor

A
  • Regular (frequent, intense, duration) contractions
  • progressive cervical changes (dilation)
  • back to front discomfort intensified with activity
  • increasing bloody show
203
Q

What is FALSE labor?

A
  • irregular contractions
  • NO cervical changes
  • lower abdomen discomfort relieved by walking
  • no increase in bloody show
204
Q

FHR Normal Values

Norm

205
Q

FHR Normal Values

Tachycardia

206
Q

FHR Normal Values

Bradycardia

207
Q

What is the Postpartum BUBBLE check?

A
  • Breasts
  • Uterus/fundus
  • Bladder
  • Bowels
  • Lochia
  • Episiotomy/laceration/incision
  • Emotional
208
Q

What color should the lochia be 3-4 days, 4-10 days, 10 days through 2-6 weeks?

A

Rubra (red) 3-4 days
Serosa (H2O) 4-10 days
Alba (white) 10 days through 2-6 weeks

209
Q

Most common secondary S/S of Syphilis

A

palmar/sole RASH

210
Q

Most common S/S of Syphilis in neonate

A

rhinorrhea, RASH

211
Q

How much weight is normal for a baby to lose after birth?

A
  • may lose up to 7% in first few days
  • regain birth weight by 2 weeks
  • gaining 4 oz a week is the minimum norm
212
Q

OK meds for breastfeeding moms

A
  • Tylenol, Ibuprofen, Aleve
  • Sudafed
  • Cough suppressant/expectorant
213
Q

Terms:

Newborn

A

0 days, baby at birth

214
Q

Terms:

Neonate

A

first 28 days

215
Q

Terms:

Infant

A

first year of life up to 15 months

216
Q

Terms:

Toddler

A

1 - 3 years

217
Q

Terms:

Preschooler

A

3 to 6 years

218
Q

Terms:

School Age

A

6 to 12 years

219
Q

Terms:

Adolescent

A

12 to 18-19 years

220
Q

NSG care measures to meet for the infant?

A

cuddle, meet oral needs, involve parents in care

221
Q

What is the Denver Developmental Screening Test (DDST)?

A

It assess the child’s developmental skills up to 6 years of age

-gross motor, fine motor, personal skills, language

222
Q

What is the last natural reflex to disappear and when?

A

Babinski, after 1 year

223
Q

When do the fontanels close?

A
  • Ant. fontanel: 6-8 weeks; first to close

- Post. fontanel: 18 months

224
Q

How do you manage Celiac disease?

A 
-Eliminate high -gluten foods *BROW*
Barley, Rye, Oat, Wheat
-Identify hidden sources (read food lable)
-Substitue
rice, corn, quinoa, potato
225
Q

In what sequence should you introduce foods to a baby to distinguish allergies?

A 
rice cereal
oat cereal
fruits
veggies
meats
226
Q

Immunizations:

Hep B

A

birth/1 month –> 2 months –> 6 months

227
Q

Immunizations:

DTap (diptheria, tetanus, pertussis), IPV (polio)

A

2 months –> 4 months –> 6 months –> wait one year from last shot –> 18 months (IPV optional) –> 4-6 years

228
Q

Immunizations:

MMR

229
Q

What types of pts are CI for immunizations?

A

fever, egg allergy (flu vaccine), neomycin sulfate allergy (rubella)

230
Q

What does a positive TB test look like?

A

15 mm induration (hardening of the skin)

231
Q

When does a 5 mm induration indicate a positive TB test?

A
  • In a pt with HIV/AIDS
  • Chest x-ray shows fibrosis
  • if exposed to active TB
232
Q

What are the appropriate sites to administer an IM injection in an adult?

A

deltoid, gluteus minimus/medius (ventral/dorsal), rectus femoris

233
Q

What is the appropriate site to administer an IM injection in an infant?

A

vastus lateralis

234
Q

Types of play:

Infant

235
Q

Types of play:

toddler

236
Q

Types of play:

preschooler

A

group play, dramatic

237
Q

Types of play:

school age

A

group play, competitive

238
Q

Types of play:

adolescence

A

sports; adult type

239
Q

What is the appropriate site to administer an IM injection in children?

A

rectus femoris

240
Q

S/E of Atropine (Probanthine)

A

dry mouth, urinary retention, blurring of vision, flushing, restlessness

241
Q

What are the manifestations of pyloric stenosis?

A
  • projectile vomiting (no bile)
  • metabolic alkalosis
  • gastric peristaltic wave that you can see on abdomen
242
Q

Tx and NSG care for pyloric stenosis

A
  • right side positioning
  • thickened feeding (pre-op)
  • pylorectomy
243
Q

What is normal gastric pH?

244
Q

What is epiglotittis?

A

life threatening bacterial infection

245
Q

S/S of epiglotittis

A

SORE THROAT, DROOLING, dysphagia, high fever

246
Q

Tx and NSG care of epiglotittis

A

endotracheal tube (ET), emergency cart, antibiotics

247
Q

What is the earliest sign of increased intracranial pressure in an infant?

248
Q

Spina Biffida Occulta S/S

A

dimpling of skin, enlarged pore, hair tuft in large pore

249
Q

Spina Biffida Cystica

Meningocele S/S

A

nerve roots intact

250
Q

Spina Biffida Cystica

Myelomeningocele

A
  • nerve roots in sac
  • bowel/bladder incontinence
  • weakness of lower extremities
251
Q

Which types of Hepatitis are transmitted via the GI tract?

A

Hep A and E

252
Q

Which types of Hepatitis are blood born?

A

Hep B, C, D

253
Q

All types of Hepatitis utilize standard precautions, except which one?

A

Hep A, contact precautions

254
Q

What is the therapeutic level for digoxin?

255
Q

What is the toxic level of digoxin?

256
Q

Signs of digoxin toxicity

A

diarrhea, n/v, anorexia, HA, visual halos, bradycardia

257
Q

When do you NOT administer digoxin to an infant?

A

When AP is below 90-110

258
Q

When do you NOT administer digoxin to a newborn/neonate?

A

When AP is lower than 100

259
Q

When do you NOT administer digoxin to an older child?

A

When AP is lower than 70

260
Q

When do you NOT administer digoxin to an adult?

A

When AP is lower than 60

261
Q

What is the maintenance dose of digoxin?

A

0.125 - 0.5 mg/daily

262
Q

What is a common nursing diagnosis for a pt with cystic fibrosis?

A

Ineffective airway clearance r/t thick mucous secretions

263
Q

Pathophysiology of Cystic Fibrosis

A
  • Unknown defect; Exocrine Gland Dysfunction; abnormal mucous secretion and obstruction
  • SALTY KISS (around 6 mos)
  • Meconium Ileus
  • fatty stools
  • decrease in weight
264
Q

What is Cromolyn Sodium and when is it used?

A
  • inhaled bronchodilator

- taken PRN; 30 minutes before strenuous activity to PREVENT asthma attack

265
Q

S/S of Meningitis

A

irritabilitly, HA, neck rigidity, opisthotonus position (arcing of the body), fever, vomiting

266
Q

How do you diagnose meningitis?

A
  • spinal tap (CSF)
  • Kernig Sign (inability to completely straighten leg when flexed at the knee/hip)
  • Brudskinski Sign (neck flexed toward chest)
267
Q

Tx and NSG Care of meningitis

A
  • penicillin, chloromycetin
  • quiet environment, dim room
  • decrease fluids
  • droplet precaution
268
Q

What is the incubation period of chicken pox virus?

A

14-21 days

269
Q

What precaution is a chicken pox pt placed under?

270
Q

How long is a chicken pox pt contagious?

A

from the start of eruption of lesions until the lesions have dried

271
Q

What are Kroplik spots? (measles)

A

small, red spots with white center found in mucosa 1-2 days before eruptions occur

272
Q

What kind of precautions is a measles pt placed under?

273
Q

What is the tx and nsg care for a TB pt?

A
  • 6-12 months

- combo of 2-3 drugs (INH, ethambutol, rifampin )

274
Q

S/S of Kawasaki Disease

A

fever and erythema, lymphadenopathy, dry/fissured lips, strawberry tongue

275
Q

What kind of precaution is used for pts with diseases that are transmitted via coughing, sneezing, talking, suctioning?

A

droplet

ex: mumps, rubella, flu, meningitis, pertussis

276
Q

What kind of precaution would you use for pts with diseases that are transmitted via direct physical transfer of microorganisms or indirect contact with contaminated objects?

A

Contact

ex: VRE, MRSA, C Diff, Lice, scabies, impetigo

277
Q

PPE requirements for airborne precautions

A
  • neg pressure room
  • door closed at all times
  • N95 surgical mask for staff and visitors
  • surgical mask on pt during transport
278
Q

PPE requirements for droplet precautions

A
  • private room or cohorting
  • surgical mask when entering room or within 3 ft distance
  • surgical mask on pt during transport
279
Q

PPE requirements for contact precautions

A
  • private room
  • gloves when entering the room at all times
  • gowns when entering the room at all times
  • leave clinical equipment in the pts room
280
Q

What is Rota Virus and what type of precaution is used?

A
  • highly contagious diarrhea in infant

- contact

281
Q

What kind of precaution do you use with a pt with the bubonic plague?

282
Q

What kind of precaution do you use with a pt who has pneumonic plague?

283
Q

What are the infections transmitted during pregnancy?

A

TORCH

Toxoplasmosis, RSV, Rubella, Cytomegalovirus, Herpes

284
Q

S/S of Sickle Cell Anemia

A

pain, fever, vomiting, chronic jaundice

285
Q

Factors in sickling

A
  • dec in O2 concentration
  • infection
  • dehydration
  • inc in altitude
286
Q

Tx and NSG Care of Sickle Cell pt

A
  • inc fluids
  • analgesic
  • infection prevention (#1 factor for sickling)
287
Q

In hemophilia, who are the carriers and who are affected?

A

female = carriers

male = affected

288
Q

What is leukemia?

A

malignancy of blood forming organs (spleen, bone marrow, lymph nodes)

289
Q

What are s/s that a pt is having a hemolytic reaction to a blood transfusion?

A

chills, HA, nausea, backache, chest tightness

290
Q

Key Points for Religions

Muslims

A
  • NO pork

- bed faces east

291
Q

Key Points for Religions

Jehovah’s Witness

A

no blood transfusions

292
Q

Key Points for Religions

Mormons

A

no alcohol

293
Q

Key Points for Religions

Hindus

A
  • no circumcision

- no beef

294
Q

What do you do if you see late decelerations on a fetal heart monitor?

A
  • REPOSITION LEFT LATERAL
  • oxygen 6-10 L
  • IV bolus
  • notify MD
295
Q

Most common anti anxiety meds

A

Ativan, Buspar, Xanax

296
Q

Common antidepressants

A

Prozac, Paxil, Zoloft

297
Q

Common antipsychotic

A

Haldol, Prolixin, Thorazine, Clozaril, Zyprexa, Abilify, Risperdal, Seroquel

298
Q

Common Anti-Eps/Anticholenergics

A

Benedryl, Artane, Cogentin

299
Q

Common antimanics

A

lithium, depakote, tegretol

300
Q

common alzheimer meds

A

aricept, namenda, cognex

301
Q

common meds for substance abuse

A

valium, librium, antabuse

302
Q

Signs of Infection

A

DERT

Discharge/drainage, Edema, Redness, Temp (#1 sign)/Tenderness

303
Q

What is SIADH?

A
  • Syndrome of inappropriate (too much) ADH
  • body is retaining ALL the water
  • dec in urine output
304
Q

S/S of SIADH

A
  • FVE
  • inc BP, HR, RR
  • crackles
  • edema
  • weight gain
305
Q

S/S HYPERparathyroidism

A

bone/joint pain, n/v, inc urine output

306
Q

S/S of HYPOparathyroidism

A

BRITTLE NAILS, dry coarse skin, twitching/muscle spasms

307
Q

NSG implications for tetracyclines

A

DON’T give with milk, antacids

308
Q

Herbal Drugs

Echinacea

A
  • enhances immune system

- if used with coumadin, may cause bleeding

309
Q

Herbal Meds

Ginkgo Biloba

A
  • used for dementia and alzheimers
  • antioxidant
  • if used with coumadin, may cause bleeding
310
Q

Herbal Meds

St. John’s Wort

A
  • antidepressant

- CI if used with major prescription antidepressant

311
Q

Herbal Meds

Saw Palmetto

A
  • used in BPH and prostatitis

- if used with anti-coagulant, may cause bleeding

312
Q

Herbal Meds

Black Cohosh

A

-alleviates menopausal symptoms

313
Q

Herbal Meds

Bilberry

A

-relieves mouth irritation and diarrhea

314
Q

Herbal Meds

Valerian

A

-used for sleep disorder and nervousness

315
Q

Herbal Meds

Mahuang

A

diet pill for energy, contains ephedrine

316
Q

Herbal Meds

Kava Kava

A
  • sedative, anti anxiety

- anti-convulsant

317
Q

Herbal Meds

Garlic

A

-lowers cholesterol

318
Q

Herbal Meds

Ginger

A

-prevents dizziness in motion sickness

Normal Values (1 decks)

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