Random Questions Flashcards
Air/Pulmonary Embolism name 3 signs and symptoms, and turn patient to the ____ side and ____ the head of the bed
chest pain, difficulty breathing, tachycardia, pale/cyanotic, sense of impending doom. (left, lower)
Women in labor with un-reassuring FHR (late decals, decreased variability, fetal bradycardia). What to do? 3 things
Turn on left side
stop Pitocin
increase IV fluids
Tube feeding w/ decreased LOC. Place patient on ___ side (promotes emptying of stomach) with the HOB ____ (to prevent aspiration
right, elevated
During an epidural position how to place the patient ?
side-lying
After a lumbar puncture ( and an oil-based myelogram) pt lies _____ to prevent ____ and leaking of ______
supine, HA & CSF
Pt w/ heat stroke? _____ with legs ____
flat, elevated
During continuous bladder irrigation ? catheter is taped to ____ so leg should be kept ____, no other positioning restrictions
thigh, straight
After myringotomy- position patient on side of _____ ear after surgery to allow?
affected , to allow drainage of secretions
After cataract surgery-> patient will sleep on ______ side with a ____ _____ . How long ?
unaffected side, night shield 1-4 weeks
After thryoidectomy-> low or _______, support head, neck, shoulders
semi-fowlers
Infant with spin bifida? Position them ____ so that sac does not rupture
prone
Bucks tractions ? Positioning ? for counter-traction
elevate foot of bed
After total hip replacement -> don’t sleep on which side? don’t flex hip more than ___ degrees. Maintain hip ___ by separating ___ with pillows
affected
45
abduction
thighs
Positioning gor prolapsed cord?
knees to chest
Trendelenburg
Infant with cleft lip - position on ___ or in ___ ___ to prevent trauma to suture line, while feeding hold baby in ____ ____
back, infant seat , upright position
To prevent dumping syndrome( post-op ulcer/stomach surgeries) eat in ___ position , lie down after meals (how long?) also restrict ? low ___ and ____ diet, with small frequent meals
reclining , 20-30 mins, fluids, CHO & fiber
Above the knee amputation-> first 24 hours? how to position daily to provide for hip extension ?
elevate on pillow, prone
Below the knee amputation -> first 24 hours? how to position daily to provide for hip extension ?
elevate foot of bed, prone
Detached retina-> area of detachment should be in what position ?
dependent
Administration of enema? (positioning)
left-side lying with knees flexed (SIMs)
After supratentorial surgery (incision behind hairline) -> positioning?
elevate HOB 30-45 degrees
After infratentorial surgery (incision at nape of the neck)-> position pt ____ and ____ on either side
flat & lateral
During internal radiation -> on _____ while implant is in place
bedrest
Autonomic Dysrefelxia/ Hypereflexia : s/s HR? BP? pounding headache , profuse sweating , nasal congestion, goose flesh, how to position ?
bradycardia, hypertension, elevate HOB first before any other implementation
Shock-> ____ with extremities elevated _____ degrees, knees ____, head _____ ____ (modified trendelenburg)
bedrest , 20 , straight, slightly elevated
Head Injury : HOB ? to decrease intracranial pressure
30 degrees
Peritoneal Dialysis when outflow is inadequate-> turn patient ??? Before checking for kinks in tubing
side to side
Lumbar puncture- AFTER the procedure , the client should be placed in what position for how long?
supine, 4-12 hours as prescribed
_____ for pancreatitis not ____ ____
demoral, morphine sulfate
1) Worsens with exercise and improves with rest
2) A + reaction to Tensilon- will improve symptoms
3) Causes by excessive medication- STOP MEDS- giving Tensilon will make it worse
myasthenia gravis
myasthenia crisis
cholinergic crisis
Given for head injury patients (osmotic diuretic) crystalizes at room temp so always use ___ needle
mannitol , filter
Prior to a liver biopsy its important to be aware of what lab result?
prothrombin time
From the ass- diarrhea - ?
From the mouth - vomiting - ?
metabolic acidosis
metabolic alkalosis
Myxedema/ hypothyroidism : slowed ___ and ____ function, sensitivity to ? ___ skin & hair
mental and physical, cold, dry hair and skin
Another name for hyperthyroidism ? mental & physical functioning is? sensitive to ? hair type?
Graves Disease , accelerated, heat, fine/soft
Thyroid Storm -> INCREASED (3 things)
BP, pulse, temp
Post-thyroidectomy: positioning to prevent neck flexion/hyperextension, what at bedside?
semi-fowlers
Hypo-parathyroidism - CATS and diet?
convulsions, arrythmia, tetany, spasms, stridor, high CA and low phosphorus diet
Hyper-parathyrodism- Think sedations, a lot of calcium , name 3 symptoms and their diet
fatigue, muscle weakness, renal calculi, back and joint pain , low CA and high phosphorus diet
Hypovolemia -> pulse? BP? temp? resp? Urine Specific Gravity
increased temp, rapid/weak pulse, increase resp. , hypotension, anxiety , urine specific gravity >1.030;
Hypervolemia -> pulse? BP? temp? Urine Specific Gravity
bounding pulse, SOB, dyspnea, rales/crackles, peripheral edema, HTN, USG
Diabetes Insipidus is an _____ in _____? Name some symptoms? what drug to admin?
decrease ADH, polyuria, excessive thirst, dehydration , admin Pitressin
SIADH is a ____ in _____? s/s and meds
increase in ADH, change in LOC, decreased DTR , tachycardia, n/v, HA, admin declomycin & diuretics
Hypokalemia - name two s/s what foods to eat other than bananas?
muscle wekaness, dysrythmia ( apricot, rasins, oranges, beans, potatoes, carrots, celery)
Hyperkalemia- MURDER
muscle weakness, urine (oliguria, anuria), respiratory depression, decreased cardiac contractility, ecg changes, reflexles
Hyponatremia- name some s/s
How to treat?
nausea, muscle cramps, increased ICP, muscular twitching , convulsion - osmotic diuretic and fluids
Hypernatremia - name some s/s and treatment
increased temp, weakness, disorientation/delusion, hypotension, tachycardia, HYPOTONIC
Hypocalcemia- CATS
convulsions, arythmia, tetany, spasms, stridor
Hypercalcemia- s/s
muscle weakness, lack of coordination, abdominal pain, confusion, absent deep tendon reflexes , shallow respirations, EMERGENCY
HypoMg- think non sedation
tremors, tetany, seizures, dysrythmia, depression, confusion, dysphagia, dig toxicity
HyperMg- think sedation
depresses the CNS, hypotension, fascial flushing, muscle weakness, absent deep tendon reflexes, shallow respirations, EMERGENCY
Addison’s: hypo___, hyper___, ___ pigmentation , decreased resistance to ___, fractures, hair?, weight? GI distress
hypoNA, hyperK, dark, stress, alopecia,
Cushings: hypo____, hyper_____, prone to ? muscle ____ and ______ , edema , BP?, (2 other specific symptoms)
hypoK, hyperNA, infection, weakness/wasting, HTN, hirsutism, moonface/buffalo bump
Addisonian crisis: blood sugar? bp? other symptoms
nausea/vomiting, confusion, abdominal pain, extreme weakness, hypoglycemia , dehydration, decreased BP
Hypersecretion of epi/norepi , persistent HTN, increased HR, hyperglycemia, diaphoresis, tremor, pounding HA, avoid stress, frequent bathing and rest breaks, avoid cold and stimulating foods, surgery to remove this tumor
pheochromocytoma
a rare, but life-threatening, idiosyncratic reaction to neuroleptic medications that is characterized by fever, muscular rigidity, altered mental status, and autonomic dysfunction. Often occurs shortly after the initiation of neuroleptic treatment, or after dose increases.
Neuroepileptic syndrome - you get hot, stiff, sweaty, BP, pulse, and respirations increases, you start to drool
Danger : Never get pregnant with a german
german measles dangerous when you’re pregnant
What comes first when drawing up regular insulin and NPH together ?
regular
Tetralogy of fallot : DROPS
child drops to floor or squats: 1) defect, septal 2) right ventricular hypertrophy 3) overriding aorta 4) pulmonary stenosis
Parnate, Marplan, Nardil
MAOIs used for depression thing Arrrrr like a pirate
Autonomic dysreflexia: potentially life threatening emergency. 1) what do you do first ? 2) loosen constrictive clothing 3) assess for bladder distention and bowel impaction 4) administer what meds ?
elevate head of bed 90 degrees , admin antihypertensives (may cause stroke, MI, seizure
MAOI’s go !! ( PANAMA) - what they taste like ?
parnate, marplan, nardil -> metallic
Digoxin 1) Check 3 things . 2) Hold meds
check pulse, check dig levels, check K+ , hold if BP is less than 60
Amphojel
Tx of GERD and kidney stones. watch out for constipation
Vistaril- use? watch for? given when ?
Tx of anxiety and itching, watch for dry mouth , given prep commonly
Versed- use? watch for?
conscious sedation , hypotension and resp. depression
PTU and Tapazole- use?
prevention of thyroid stom
Sinemet- use? s/s?
Tx of parkinson, sweat, saliva, urine may turn red/brown , and causes drowsiness
Artane - use? effect?
Tx of parkinson.. sedative effect
Cogentin- use? effect?
x of parkinson and extrapyramidal effects of other drugs T
Tigan - use? effect?
Tx of post-op n/v and for nausea associated with gastroenteritis
Timolol (Timpotic)- use?
Tx of glaucoma
Bactrim
antibiotic, don’t take if allergic to sulfa drugs, diarrhea is a common side effect , drink plenty of fluids
Gout meds - tuPAC
Probenecis (benemid) , Colchicine , Alluopurinol (Zyloprim)
Apresoline (hydralazine)
txt for HTN and CHF , report flu-like sx, rise slowly from sitting to lying position , take with meals
Bentyl
txt if irritable bowel disease, asses for anticholinergic effects
Calan( verapamil)
CCB, txt of HTN, angina, assess for constipation
Carafate
tx of duodenal ulcers, coats the ulcer , so take before meals
Theophylline
tx of asthma and COPD, therapeutic drug level 10-20
Mucomyst is the antidote for? admin ?
tylenol, orally
Diamox
tx of glaucoma, high altitude sickness, don’t tale if allergic to sulfa drugs
Indocin
NSAID, tx of arthritis ( osteo, rheumatoid, gouty) , bursistis, tendonitis
Synthroid
tx of hypothyroidism, may take several weeks to take effect, notify the doctor of chest pain, take in the morning on empty stomach, can cause hyperthyroidism
Librium
tx of alcohol w/d, don’t tale alcohol with this , very bad nausea and vomiting can occur
Oncovin ( vincristine )
tx of leukemia, given IV only
Kwell
tx of scabies and lice, apply lotion and leave on 8-12 hours (lice) , use the shampoo and leave on for 4 mins with hair uncovered then rinse with warm water and comb with a fine tooth comb
Premarin
tx of menopause estrogen replacement
Dilantin
tx of seizures, therapeutic level 10-20
Navane
tx of schizophrenia, asses for EPS
Ritalin
ADHD, asses for heart related side effects (report immediately) child may need a drug holiday, could stunt growth
Dopamine ( Intropine )
tx for hypotension, shock, low cardiac output, poor perfusion to vital organs, monitor EKG for arrhythmias, monitor BP.
Fetal HR Patterns
VEAL CHOP
V-variable dcels c-cord compression
E-early decals h- head compression (cause)
A- accels O-okay !
L- late decels P- placental insufficiency , can’t fill
For cord compression, place the mother ______ position
Trendelenburg, because this removes the pressure of the presenting part off the cord. (If her head is down, the baby is no longer being pulled by gravity).
Prolapsed cord…
cover it with sterile gauze to prevent drying of the cord and to minimize infection
For late decals… place mother ?
on her left side to allow more blood flow to the placenta
For any bad FHR, give ?
O2 by masks
When doing an epidural anesthesia what is a priority ?
Hydrate patient first
What are major risks in pregnancies?
hypotension, bradypnea, bradycardia
NCLEX tip about prego question
Never check the monitor or machine first. Always assess first; for example listen to the fetal heart tones with the stethoscope in NCLEX land. Sometimes its hard to tell who to check on first, the mother or the baby, its usually easy to tell the right answer if the mother or baby involves a machine. If you’re not sure who to check first, and one of the choices involves a mating, that is the wrong answer
If the baby is in the posterior position….
the sounds are heard at the sides
If the baby is in the anterior position….
the sounds are heard closer to the midline, between the umbilicus and where you would listen to a posterior presentation.
If the baby is breeched the sounds are heard…
high up in the funds near the umbilicus
If the baby is vertex..
the sounds are a little bit above the symphysis pubis
Also for ventilator alarms ( HOLD)
High alarm- Obstruction due to increase secretions, kink, pt. coughs, gag, or bites. Low press alarms - Disconnection or leak in ventilator or in pt. airway cuff, pt. stops spontaneous breathing
Hot and Dry Sugar High
Cold and Clammy need some candy
hyperglycemia, hypoglycemia
ICP and shock have opposite vitals.. go !
ICP- hypertension, decreased pulse, decreased resp.
Shock - hypotension, increased pulse, increased resp
What is Cor Pulmonale ?
right sided heart failure caused by left ventricular failure
(so pick edema, jvd, if it is a choice)
Heroin withdrawal with neonate will have…
irritable poor sucking
Jews- NO and NO
milk and meat together
Pulse area for cpr on infant?
brachial
When to test child for lead poising?
12 months
3 sources of K+
bananas, potatoes, citrus fruits
before starting IV antibiotics?
cultures are obtained
Pt with leukemia may have ?
epitaxis b/c of low platelets
Best way to warm newborn
skin to skin contact covered with blanket on mom
When patient comes in and she is in active labor… nurse first action is to ??
listen to fetal HR and tone
Phobic d/o use…
systematic desensitization
NCLEX TIP
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.
NCLEX TIP
Key words are very important. Avoid answers with absolutes like: always, never, must
With lower amputations patient is placed..
prone
Small frequent feeding are…
better than large ones
What can not be delegated to UAP?
assessment, teaching, meds, evaluation, unstable patient
LVN/LPN cannot..
handle blood
Amynoglycosides (like Vancomycin) cause ( 2 things )
nephrotoxicity, ototoxicity
IV push should go over..
2 mins
NCLEX TIP
If the patient is not a child an answer with family option can be ruled out easily
In an emergency who is treated first?
patient with greater chance to live are treated first
ARDS (define) DIC (define) are always….
fluids in the alveoli, disseminated intravascular coagulation , secondary to another disease
Cardinal sign for ARDS?
hypoxemia ( low O2 in the tissues )
In pH regulation what are the two organs of concern?
lungs and kidneys
Edema is located?
in the interstitial space not the cardiovascular space
Best indicator of dehydration?
weight
Where ever there is glucose what follows?
water
What can reduce Reye’s syndrome in children ?
aspirin
When aspirin is given once a day, it acts like…
an antiplatelet
What to use for acute and chronic pain ?
acute(sprained ankle)- cold chronic(rheumatoid arthritis)-hot
Guided imagery is great for ?
chronic pain
When patient is in distress..
medication admin is rarely a good choice
With pneumonia 1) and 2) are present… with the elderly ___ is present
fever, chills
confusion
Always check for allergies when admin antibiotics especially _____, make sure culture and sensitivity has been done before admin. of first dose of antibiotic
PNC
Cor pulmonale - s/s _____ ______ . ____ heart failure caused by ____ disease, occurs with 1) and 2)
fluid overload
rt. heart failure
pulmonary
bronchitis and emphysema
COPD is _____ (2 types of COPD)
Pneumonia is ______
chronic emphysema, bronchitis
acute
In COPD patients the baroreceptors that detect ____ levels are ____. Therefore ____ levels must be ___ because high O2 concentrations blows the patient’s stimulus for breathing
CO2 , destroyed
O2, low
Exacerbation =
acute, distress
EPI is always given with
TB syringe
Prednisone toxicity: ________ _________
cushings syndrome : buffalo hump, moon face, high glucose, hypertension.
Cancer management
chemo, radiation, surgery, allow to die with dignity
Neutropenic patients : No ____, ____, _____
live vaccines, fresh fruits, no flowers
Chest tubes are placed…
in the pleural space
Angina..
low oxygen to heart tissues - no dead tissue
MI..
dead heart tissue
Mevacor
anticholesterol med - must be given with evening meal if it is QD per day
Nitroglycerin is admin up to ____ times a day, ever ___ mins. If chest pain does not stop go to the hospital. do not give when…
3 times a day
5 mins
less than 90/60
Preload affects…
Afterload is the..
the amount of blood that goes through the R. ventricle
the resistance the blood has to overcome when leaving the heart
CCB affect
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 nitroglycerin
Dead tissues can not have PVCs, but if left untreated pvc’s can lead to ?
ventricular fibrillation
1 t = how many mL
5
1T = how many t and mL
3, 15
1 oz = how many mL
30
1 cup = ___ oz
8
1 quart = ___ pints
2
1 pint = ____ cups
1
1 gr = ____ mg
60
1 g = ____ mg
1000
1 kg= ____ lbs
2.2
1 lb = ___ oz
16
How to convert C to F
How to covert F to C
F= C+40, multiply 9/5 and subtract 40 C= F+40 , multiply 5/9 and subtract 40
Angiotensin 2 in the lungs = ______ ______, Aldosterone attracts?
Potent vasodialator
sodium
Reverse Agent= Heparin
protamine sulfate
Reverse Agent=Coumadin
Vitamin K
Reverse Agent= Ammonia
lactulose
Reverse Agent=Acetaminophen
n-Acetylcysteine
Reverse Agent=Iron
deferoxamine
Reverse Agent=Digoxin
Digibind
Reverse Agent=Alcohol Withdraw
Librium
An opioid analgesic used to detoxify / treat pain in narcotic addicts
methadone
What electrolyte potentiates dig toxicity ?
K+
Heparin prevents
PTT/PT
What is elevated when patient is on Coumadin ?
PTT/PT
Cardiac output decreases with ?
Dopamine does?
dysryhtmias
increases BP
Med of choice for vtach?
lidocane
Med od choice for SVT
adenosine or adenocard
Asytole ?
Med of choice?
no heart beat, atropine
Med of choice for CHF
ace inhibitor
Med of choice for anaphylactic shock
epi
Med of choice for status epilepticus
valium
Med of choice for bipolar d/o
lithium
Amiodorone is effective in 1) and 2) complications
atrial and ventricular complications
What sound is normal in CHF but not an MI
S3
When to give Carafate?
Before meals to coat the stomach
Protonix is given….
prophylactically to prevent stress ulcers
After and endoscopy check?
gag reflex
How is TPN given ?
subclavian line
What does low residue diet mean ?
low fiber
What is diverticulitis ? and where is the pain ?
Inflammation of the diverticulum , LL quadrant
What is appendicitis and where is the pain with rebound tenderness?
inflammation of the appendix, RL quadrant
______ + ______ = ascities
portal hypertension + albuminemia
What produces insulin ?
beta cells of the pancreas
What is contraindicated in pancreatitis? And what should be given instead?
Morphine- causes spasm of the Sphincter of ODDI
Give Demerol
Trousseau and Tchovoski signs are observed in ?
hypocalcemia
What is given with meals with pancreatitis
pancreatic enzymes
