NCLEX review

Question 1

pH

Answer 1

7.35 - 7.45

Question 2

CO2

Answer 2

35 - 45

Question 3

HCO3

Answer 3

22 - 26

Question 4

pH < 7.35

Answer 4

acidosis

Question 5

pH > 7.45

Answer 5

alkalosis

Question 6

ROME

Answer 6

respiratory
opposite
metabolic
equal

Question 7

pH is low…

Answer 7

everything is low, EXCEPT potassium (high)

Question 8

pH is high…

Answer 8

everything is high, EXCEPT potassium (low)

Question 9

pH > 7.45 s/s

Answer 9

everything is up:
-tachycardia
-tachypnea
-HTN
-seizures
-irritability
-diarrhea
-increased bowel sounds
-hyperreflexia

Question 10

ph < 7.35 s/s

Answer 10

everything is down :
-bradycardia
-bradypnea
-low BP
-absent bowel sounds
-constipation
-lethargy
-coma hyporeflexia
-flaccid

Question 11

MAC Kussmaul

Answer 11

Metabolic ACidosis = Kussmaul respirations

Question 12

underventilation leads to

Answer 12

respiratory acidosis

Question 13

overventilation leads to

Answer 13

respiratory alkalosis

Question 14

high pressure vent alarms

Answer 14

-kink in tubing
-condensed water in dependent tube
-mucus plug
-pneumothorax
-pt anxiety
-pt biting tube

Question 15

low pressure vent alarms

Answer 15

-tubing disconnection
-cuff leak
-deflated cuff
-pt stops breathing / decreased breathing

Question 16

too high of ventilation leads to…

Answer 16

respiratory alkalosis (think hyperventilation)

Question 17

too little of ventilation leads to…

Answer 17

respiratory acidosis (retaining CO2)

Question 18

ABG interpretation of ventilated pt shows respiratory acidosis…

Answer 18

they are NOT ready to be weened from the vent, they require higher settings

Question 19

lithium

Answer 19

used for bipolar disorder
-therapeutic level = 0.6-1.2
-TOXIC level = >2.0

Question 20

digoxin

Answer 20

used to treat a-fib and CHF
-therapeutic level = 1 - 2
-TOXIC = > 2

Question 21

aminophylline

Answer 21

muscle relaxer for airway
-therapeutic level = 10 - 20
-TOXIC = > 20
-nontherapeutic level = < 10

Question 22

phenytoin (dilantin)

Answer 22

seizure medication
-therapeutic = 10 - 20
-TOXIC = > 20

Question 23

bilirubin adult level

Answer 23

0.2 - 1.2

Question 24

bilirubin child level

Answer 24

10 - 20
TOXIC = > 20

**hospitalized at 14 - 15

Question 25

kernicterus

Answer 25

excess bilirubin in the brain!!
- happens when level is > 20
-CAN BE DEADLY

**opisthotonic position will occur

Question 26

pathological jaundice

Answer 26

newborn comes out with jaundice

**CONCERNING jaundice

Question 27

physiological jaundice

Answer 27

newborn turns yellow 2-3 days after delivery

**this one is okay

Question 28

thyroid gland

Answer 28

regulates metabolism

**change word to metabolism

Question 29

hyperthyroidism

Answer 29

hyperMETABOLISM
-weight loss
-HR up, BP up
-they have heat intolerance… can tolerate cold
-exophthalmos : bulging eyes

Question 30

what is also seen in hyperthyroidism that’s in Grave’s disease

Answer 30

exophthalmos!!!!

Question 31

hyperthyroidism

Answer 31

1. nuke it with radioactive iodine
2. PTU - put thyroid under
3. thyroidectomy - most common

Question 32

what will total thyroidectomy need…

Answer 32

lifelong hormone replacement!!!
-at risk for hypocalcemia

Question 33

hypocalcemia s/s

Answer 33

paresthesia
tetany
twitching
clonus
seizure
tremor
Chvostek and Trousseau sign

Question 34

thyroid storm s/s

Answer 34

fever!!! > 105
high BP –> stroke level 210 / 180
severe tachycardia
delirium

Question 35

thyroid storm interventions

Answer 35

1. BRING temp DOWN : ice packs, cooling blanket
2. O2 at 10L

Question 36

hypothyroidism

Answer 36

hypoMETABOLISM
-obesity
-HR decrease, BP decrease
-personality flat, boring, dull
-cold intolerance!!
-academically challenged

Question 37

myxedema coma

Answer 37

severe hypothyroidism
-decreased mental status
-hypothermia
-slowing of multiple organs

**DO NOT SEDATE these pts!!!