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Review Sheet Flashcards

1
Q

Do Not Delegate:

A

“Do not delegate what you can EAT”

Evaluate
Assess
Teach

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2
Q

Difference between Addison’s and Cushing’s Disease:

A

Addison’s - Everything Hypo except HYPERKALEMIA

Cushing’s - Everything Hyper except HYPOKALEMIA

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3
Q

Assessment findings on Addison’s Disease:

A

HYPOnatremia

HYPOtension

HYPO Blood volume

HYPERkalemia

HYPOglycemia

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4
Q

Assessment findings on Cushing’s Disease:

A

HYPERnatremia

HYPERtension

HYPER Blood volume

HYPOkalemia

HYPERglycemia

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5
Q

No Pee - No K

A

Do not give Potassium without adequate urine output.

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6
Q

Limb positioning for better profusion:

A

EleVate Veins

DAngle Arteries

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7
Q

APGAR

A

A - Appearance (color pink, blue, or pale)

P - Pulse (>100, <100, absent)

G - Grimace (cough, grimace, no response)

A - Activity (flexed, flaccid, limp)

R - Respirations (strong cry, weak cry, absent)

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8
Q

TB precautions:

A

Airborne

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9
Q

Droplet precautions infections:

A

“SPIDERMAN”

Sepsis, scarlet fever, streptococcal pharyngitis, parvovirus, pneumonia, pertussis, influenza, diptheria, epiglottitis, rubella, mumps, meningitis, mycoplasma, adenovirus

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10
Q

Contact precaution infections:

A

“MRS. WEE”

multidrug resistant organism, respiratory infection, skin infection, wound infection, enteric infection (C. diff), eye infection (conjunctivitis)

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11
Q

Example of skin infections:

A

“VCHIPS”

varicella zoster, cutaneous diptheria, herpes simplex, impetigo, pediculosis, scabies

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12
Q

Signs and Symptoms of Air or Pulmonary Embolism:

A

Chest pain

Difficulty breathing

Tachycardia

Pale and cyanotic

Sense of impending doom

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13
Q

Nursing intervention for air or pulmonary embolism:

A

Turn patient to LEFT SIDE

LOWER head of the bed

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14
Q

Nursing intervention for woman in labor with unreassuring FHR:

A

Turn on LEFT SIDE

Give O2

Stop PITOCIN

INCREASE IV fluids

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15
Q

Nursing interventions for tube feeding with decreased LOC:

A

Position on RIGHT SIDE (promote gastric emptying)

Head of bed ELEVATED (prevent aspiration)

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16
Q

Patient positioning for epidural puncture:

A

Side-lying

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17
Q

Patient positioning following lumbar puncture:

A

Patient lies FLAT SUPINE (to prevent headache and leakage of CSF)

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18
Q

Patient positioning following oil-based Myelogram:

A

Patient lies FLAT SUPINE

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19
Q

Patient positioning following heat stroke:

A

Lie FLAT with LEGS ELEVATED

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20
Q

Patient positioning for continuous bladder irrigation (CBI):

A

Catheter is taped to the thigh, so LEG STRAIGHT. No other positioning restrictions

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21
Q

Nursing interventions following Myringotomy:

A

Position patient on side of AFFECTED EAR after surgery (allows for drainage of secretions)

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22
Q

Patient teaching following cataract surgery:

A

Patient to sleep on UNAFFECTED SIDE with a night shield for 1 - 4 weeks

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23
Q

Patient positioning following thyroidectomy:

A

Low or Semi-Fowler’s

Support head, neck, and shoulders

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24
Q

Patient positioning for infant with Spina Bifida:

A

Position PRONE (on abdomen) so that sac does not rupture

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25
Patient teach and nursing interventions for patient following Total Hip Replacement:
Don't sleep on operated side Don't flex hip more than 45-60 degrees Don't elevate HOB more than 45 degrees Maintain hip abduction by separating thighs with pillows
26
Patient positioning for prolapsed cord:
Knee-to-chest or Trendelenburg
27
Patient positioning for infant with Cleft Lip following surgery:
Position on BACK or in infant seat to prevent trauma to suture line. While feeding, hold in upright position.
28
Patient positioning following ulcer or gastric surgeries to prevent Dumping Syndrome:
Eat in reclined position Lie down after meals for 20 - 30 minutes Restrict fluids during meals Low CHO and fiber Offer small, frequent meals
29
Patient positioning following Above Knee Amputation:
ELEVATE LIMB for first 24 hours on pillows Position PRONE daily to provide hip extension (prevent contractures)
30
Patient positioning following Below Knee Amputation:
FOOT OF BED ELEVATED for first 24 hours Position PRONE daily to provide hip extension (prevents contractures)
31
Patient positioning for Detached Retina:
Area of detachment should be in the dependent position
32
Patient positioning for Administration of Enema:
Patient in LEFT SIDE LAYING (Sim's) with knee flexed
33
Patient teaching during internal radiation therapy:
BEDREST while implant is in place
34
Signs and Symptoms of Autonomic Dysreflexia (Hyperreflexia):
Pounding headache Profuse sweating Nasal congestion Goose flesh Bradycardia Hypertension
35
Patient positioning and nursing intervention for Autonomic Dysreflexia (Hyperreflexia):
Place client in SITTING POSITION (elevate HOB) first before any implementation
36
Nursing intervention and patient positioning for Head Injury:
ELEVATE HOB 30 degrees to decrease intracranial pressure
37
Nursing intervention for Peritoneal Dialysis with outflow is inadequate:
TURN patient from side-to-side before checking for kinks in tubing (according to Kaplan)
38
Nursing interventions following Lumbar Puncture:
AFTER procedure, the client should be placed in the SUPINE position for 4 - 12 hours as prescribed
39
Pain medication for PANCREATITIS:
DEMOROL | NOT Morphine Sulfate
40
Activity characteristics of Myasthenia Gravis:
WORSENS with exercise IMPROVES with rest
41
Cholinergic Crisis (for Myasthenia Gravis):
Caused by excessive medication - stop giving Tensilon medication because you're making it worse
42
Administration of medication for Head Injury:
MANNITOL (osmotic diuretic) *Crystalizes at room temperature so always use a filter needle
43
Lab to check prior to Liver Biopsy:
Prothrombin Time
44
Blood Acid-Base for diarrhea and vomitus:
From the ASS - ASSidosis From the mouth - Alkalosis
45
Clinical manifestations for Myxedema (severe hypothyroidism):
Slowed physical and mental function Sensitivity to cold Dry skin and hair
46
Clinical manifestations for Grave's Disease (severe hyperthyroidism):
Accelerated physical and mental function Sensitivity to heat Fine or soft hair
47
Clinical manifestations of Thyroid Storm:
Increased temperature Increased pulse Hypertension
48
Patient positioning and nursing intervention following Tyroidectomy procedure:
Semi-Fowler's position Prevent neck flexion or hyperextension Trach kit at bedside
49
Clinical manifestations of HYPO-parathyroid:
"CATS" Convulsions Arrhythmias Tetany Spasms and Stridor *Due to decreased calcium
50
Clinical manifestations of HYPER-parathyroid:
Fatigue Muscle weakness Renal calculi Back and joint pain *Due to increased calcium
51
HYPO-parathyroid diet:
High Calcium Low Phosphorus
52
HYPER-parathyroid diet:
Low Calcium High Phosphorus
53
Clinical manifestations of HYPO-volemia:
Increased temperature Rapid/weak pulse Increased respirations HYPO-tension Anxiety Urine specific gravity >1.030
54
Clinical manifestations of HYPER-volemia:
Bounding pulse Shortness of breath Dyspnea Crackles Peripheral edema HYPTER-tension Urine specific gravity s position
55
Clinical manifestations of Diabetes Insipidus:
Decreased ADH - Fluid loss Excessive urine output and thirst Dehydration Weakness *Administer PITRESSIN
56
Clinical manifestations of SIADH (Syndrome of Inappropriate ADH):
Increased ADH - Fluid retention Change in LOC Decreased deep-tendon reflexes Tachycardia Nausea/Vomiting Headache *Administer DECLOMYCIN and DIURETICS
57
Clinical manifestations of HYPO-kalemia:
Muscle weakness Dysrrhythmias *Increase K (raisins, bananas, apricots, oranges, beans, potatoes, carrots, celery)
58
Clinical manifestations of HYPER-kalemia:
"MURDER" Muscle weakness Urine (oliguria/anuria) Respiratory depression Decreased cardiac contractility ECG changes Reflexes
59
Clinical manifestations of HYPO-natremia:
Nausea Muscle cramps Increased ICP Muscular twitching Convulsions *Administer osmotic diuretics and fluids
60
Clinical manifestations of HYPER-natremia:
Increased temperature Weakness Disorientation/Delusions Hypotension Tachycardia *Administer HYPO-tonic solution
61
Clinical manifestations of HYPO-calcemia
"CATS" Convulsions Arrhythmias Tetany Spasms and Stridor
62
Clinical manifestations of HYPER-calcemia:
Muscle weakness Lack of coodination Abdominal pain Confusion Absent deep-tendon reflexes Sedative effect on CNS
63
Clinical manifestations of HYPO-Mg:
Tremors Tetany Seizures Dysrrhythmias Depression Confusion Dysphagia
64
Clinical manifestations of HYPER-Mg:
Depresses the CNS Hypotension Facial flushing Muscle weakness Absent deep tendon reflexes Shallow respirations *EMERGENCY SITUATION
65
Clinical manifestations of Addison's Disease:
HYPO-Na HYPER-K HYPO-glycemia Dark pigmentation Decreased resistance to stress and fractures Alopecia Weight loss GI Distress
66
Clinical manifestations of Cushing's Disease:
HYPER-Na HYPO-K HYPER-glycemia HYPER-tension Prone to infection Muscle wasting Weakness Edema Hirsutism Moonface/Buffalo hump
67
Clinical manifestations of Addisonian Crisis:
Nausea/Vomiting Confusion Abdominal pain Extreme weakness HYPO-glycemia Dehydration Decreased BP
68
Clinical manifestations of Pheochromocytoma:
Hypersecretion of Epinepherine and Norepinepherine Persistent HTN Increased HR HYPER-glycemia Diaphoresis Tremor Pounding headache
69
Nursing interventions for Pheochromocytoma:
Avoid stress Frequent bathing and rest breaks Avoid cold and stimulating foods *Requires surgery to remove tumor
70
Dangerous disease for fetus when pregnant:
"Don't get pregnant with a German" German measles (Rubella)
71
Sequence for drawing up Regular and NPH insulin together:
"RN" 1) Regular insulin 2) NPH Air NPH, air regular, draw regular, draw NPH.
72
Tetralogy of Fallot:
"HOPS" Hypertrophy of Right Ventricle Overriding Aorta Pulmonary Stenosis Septal Defect
73
MAOIs used as Antidepressants:
"Pirates say AR!" pARnate mARplan nARdil "PANAMA" PA-rnate NA-rdil MA-rplan
74
Nursing interventions for Autonomic Dysreflexia (hyperreflexia):
Elevate HOB to 90 degrees Loosen restrictive clothing Assess for bladder distention and bowel impaction (trigger) Administer hypertensive medications (prevent stroke, MI, seizure)
75
Nursing interventions for Digoxin:
Check pulse (hold for <60) Check Dig levels and Potassium levels
76
Adverse effect of Amphojel:
Constipation *For treatment of GERD and kidney stones
77
Vistaril:
Treatment of anxiety and itching *Watch for dry mouth, commonly given preoperatively
78
Versed:
Given for conscious sedation *Watch for respiratory depression and hypotension
79
Sinemet:
Treatment for Parkinsons Adverse effects: Sweat, saliva, and urine may turn reddish brown occasionally. Causes drowsiness.
80
Artane:
Treatment of Parkinsons Also has sedative effect
81
Cogentin:
Treatment of Parkinsons and Extrapyramidal effects of other drugs
82
Tigan:
Treatment of post-operative nausea and vomiting associated with gastroenteritis
83
Timolol (Timoptic):
Treatment of glaucoma
84
Bactrim:
Antibiotic Don't take if allergic to Sulfa drugs. Diarrhea is common side effect, drink plenty of fluids
85
Common medications for GOUT:
Probenecid (Benemid) Colchicine Allopurinol (Zyloprim)
86
Apresoline (hydralazine):
Treatment of hypertension or CHF Report flu-like symptoms. Rise slowly from sitting/lying position. Take medication with meals.
87
Bentyl:
Treatment of irritable bowel syndrome Assess for anticholinergic side effects.
88
Calan (Verapamil):
Calcium channel blocker for treatment of hypertension and angina. Assess for constipation.
89
Carafate:
Treatment of duodenal ulcers. Works by coating the ulcer so take before meals.
90
Theophylline:
Treatment of asthma and COPD. Therapeutic drug level 10-20.
91
Mucomyst:
Antidote to tylenol and administered orally.
92
Diamox:
Treatment of glaucoma and high-altitude sickness. Don't take if allergic to sulfa drugs.
93
Indocin:
NSAID treatment of arthritis (osteo, rheumatoid, gouty), bursitis, and tendonitis.
94
Synthroid:
Treatment of HYPO-thyroidism. May take several weeks to for therapeutic effects. Notify physician of chest pain. Take in the AM on an empty stomach. Could cause HYPER-thyroidism.
95
Librium:
Treatment of alcohol withdrawal. Don't take with alcohol, can cause serious nausea and vomiting.
96
Oncovin (Vincristine):
Treatment of leukemia. Given by IV ONLY.
97
Kwell:
Treatment of scabies and lice. Scabies - apply lotion once and leave on for 8-12 hours. Lice - use the shampoo and leave on for 4 minutes with hair uncovered then rinse with warm water and comb with a fine tooth comb.
98
Premarin:
Estrogen replacement for treatment after menopause.
99
Dilantin:
Treatment of seizures. Therapeutic drug level is 10 - 20.
100
Navane:
Treatment of schizophrenia. Assess for Extrapyramidal Symptoms.
101
Ritalin:
Treatment of ADHD. Assess for heart related side effects and report immediately. Child may need a drug holiday because it stunts growth.
102
Dopamine (Intropine):
Treatment of HYPO-tension, shock, low cardiac output, poor perfusion to vital organs. Monitor EKG (for arrhythmias) and blood pressure.
103
Fetal heart rate (FHR) patterns in OB:
"VEAL CHOP" VC - Variable decels; Cord compression EH - Early decels; Head compression AO - Accelerations; OK! No problem LP - Late decels; Placental insufficiency (can't fill)
104
Nursing intervention for pregnant mother for cord compression:
Place mother in TRENDELENBERG because this removes pressure of the presenting part off the cord.
105
Nursing intervention for cord prolapse:
Cover the cord with sterile saline gauze to prevent drying of the cord and to minimize infection.
106
Nursing intervention for LATE DECELERATIONS:
Position mother on LEFT SIDE to allow more blood flow to the placenta.
107
Nursing intervention for any kind of bad fetal heart rate pattern:
Give O2, often by mask.
108
For pregnancy, HYPO-tension, BRADY-pnea, BRADY-cardia:
Major risks and are emergencies.
109
Priority nursing actions when pregnant mother or fetus shows signs of distress:
NEVER check the monitor or a machine as a first action. ALWAYS assess the patient first, whether it's the mother or the child.
110
Baby presentation and sound locations:
Posterior - sounds heard at sides. Anterior - closer to midline, between umbilicus Breech - high up in the fundus near the umbilicus Vertex - a little bit above the symphysis pubis
111
Nursing interventions for ventilator alarms:
"HOLD" HO - High; Obstruction LD - Low; Disconnection High Pressure Alarm - Obstruction due to increased secretions, kink, patient coughs gags or bites. Low Pressure Alarm - Disconnection or leak in ventilator or in patient's airway cuff. Patient stops spontaneously breathing.
112
Clinical manifestations and blood sugars:
HYPER-glycemia; "Hot and dry, sugar high" HYPO-glycemia; "Cold and clammy, need some candy"
113
ICP and shock have opposite vital signs:
ICP - increased BP, decreased pulse, decreased respirations. Shock - decreased BP, increased pulse, increased respirations.
114
Cor Pulmonale:
Right sided heart failure caused by left ventricular failure. Occurs with bronchitis or emphysema. Presents with edema and JVD.
115
Clinical manifestations of heroin withdrawal in neonates:
Irritable Poor sucking
116
Dietary restrictions for Jews:
No milk and meat together.
117
How to obtain pulse on an infant:
Brachial pulse
118
Dietary sources of Potassium:
Bananas, potatoes, citrus fruits.
119
Why would patient with leukemia have epistaxis:
Low platelet count.
120
Best way to warm a newborn:
Skin-to-skin contact, with a blanket covering mom.
121
Priority nursing action when patient comes in active labor:
Listen to FHR or FHT.
122
Treatment for phobic disorders:
Systemic desensitization.
123
Technique for answer selection:
# Choose ASSESSMENT over intervention, except in an emergency or distress situation. Discard absolute answers; always, never, must, etc. Priority to answers that deal with patient's bodies, not the machines/equipment.
124
General feeding guidelines:
Small, frequent feedings are better than fewer, large ones.
125
Restricted from Unlicensed Assistive Personnel:
Assessment Teachings Medications Evaluations Unstable patients
126
LVN/LPN vs RN:
LVN/LPN cannot handle blood.
127
Adverse effects of Aminoglycosides (like Vancomycin):
Nephrotoxicity Ototoxicity
128
Technique for answer selection with family involved:
Family option can be ruled out UNLESS it's a child.
129
Patient treatment in emergency triage situation:
Patient with greatest chance of survival are treated first.
130
Cardinal sign of ARDS:
Acute Respiratory Distress Syndrome - fluids in alveoli, results in HYPO-xemia (low oxygen levels in tissues).
131
Organs of concern with pH regulation:
Lungs Kidneys
132
Location of fluid with edema:
INTERSTITIAL SPACE Not cardiovascular space.
133
Best indicator of dehydration:
Weight
134
Consequence of Aspirin to children:
Reye's Syndrome (encephalopathy)
135
Hot/Cold remedies for Acute and Chronic pain:
COLD - aCute pain (sprain) HOT - chronic (rheumatoid arthritis)
136
Poor answer selection for distressed patient:
Medication administration
137
Clinical manifestations of pneumonia:
Fever and chills are usually present. For elderly, confusion is often present.
138
Priority nursing interventions before administration of antibiotics:
Check for allergies (especially PCN) C/S done before first dose
139
Common respiratory diseases:
COPD is chronic Pneumonia is acute Emphysema and bronchitis are both COPD.
140
Administration of Epinephrine:
Always given in TB syringe.
141
Clinical manifestations of Prednisone Toxicity:
Cushing's syndrome. Buffalo hump, moon face, HYPER-glycemia, HYPER-tension.
142
Four options of cancer management:
Chemo Radiation Surgery Allow to die with dignity
143
Neutropenic precautions:
No live vaccines No fresh fruits No flowers No (possibly) infectious visitors
144
Chest tube drainage placement:
Pleural space
145
Difference between angina and MI:
Angina - low oxygen to heart tissues, no damaged tissue. MI - dead heart tissue.
146
Mevacor:
Anticholesterol medication. Must be given with evening meals if once per day.
147
Nitroglycerine protocol:
Administered q5 minutes 3 times. If chest pain does not stop, go to hospital. Hold for BP < 90/60. Unstable angina is not relieved by nitro.
148
Effect of Angiotensin II in the lungs:
Potent vasodilator.
149
Antidote for Heparin:
Protamine Sulfate
150
Antidote for Coumadin:
Vitamin K
151
Antidote for Ammonia:
Lactulose
152
Antidote for Acetaminophen (Tylenol):
n-Acetylcysteine (Mucomyst)
153
Antidote for iron toxicity:
Deferoxamine
154
Antidote for Digitoxin (digoxin) toxicity:
Digibind
155
Antidote for alcohol withdrawal:
Librium
156
Opiod analgesic used to detoxify and treat pain in narcotic addicts:
Methadone
157
Lab results for Coumadin:
PT and PTT are elevated.
158
Effects of dysrrhythmias on cardiac output:
Decreased. Dopamine increases BP.
159
Medication for V-Tachycardia:
Lidocaine
160
Medication for SVT (Supraventricular Tachycardia):
Adenosine or Adenocard
161
Medication for Asystole:
Atropine
162
Medication for CHF (Congestive Heart Failure):
ACE Inhibitor
163
Medication for Anaphylaxis:
Epinephrine
164
Medication for Status Epilepticus:
Valium
165
Medication for BiPolar Disorder:
Lithium
166
Amiodorone:
Effective in both ventricular and atrial complications.
167
Protonix:
Given prophylactically to prevent stress ulcers.
168
Priority nursing assessment following Endoscopy:
Check gag reflex.
169
Location of administration of TPN:
Total Parenteral Nutrition is given in the Subclavian Line.
170
Low residue diet:
Low fiber
171
Diverticulitis:
Inflammation of the diverticulum in the colon. Pain in the LLQ.
172
Appendicitis:
Inflammation of the appendix. Rebound tenderness and pain the LRQ.
173
Where is insulin produced?
Beta cells of the Pancreas
174
Contraindicated medication for Pancreatitis:
Morphine; causes spasms of the Sphincter of Oddi. Demerol should be given.
175
Signs observed in HYPO-calcemia:
Trousseau Tchovoski
176
Medication regiment for chronic pancreatitis:
Pancreatic enzymes given with meals.
177
Medication treatment for Addison's disease:
Mineral corticoids
178
Diabetic Ketoacidosis (DKA):
Condition where the body is breaking down fat instead of sugar for energy. By-products are ketones, which are acidic, that causes the pH to drop.
179
Clinical manifestation of Fat Embolism:
Petechiae; treat with Heparin.
180
Expected physician orders following knee total replacement surgery:
Continuous Passive Motion Machine
181
Consequence of glaucoma:
Loss of peripheral vision
182
Clinical manifestation of cataracts:
Cloudy, blurry vision. Treat by lens-removal surgery.
183
Effect of CO2 on vascular system:
CO2 causes vasoconstriction
184
Multiple Sclerosis:
Myelin sheath destruction, disruption in nerve impulse conduction.
185
Myasthenia Gravis:
Decrease in receptor sites for acetylcholine. Since smallest concentration of ACTH receptors are in cranial nerves, expect fatigue and weakness in eye, mastication, and pharyngeal muscles.
186
Tensilon Test:
Given if muscles are tense in Myasthenia Gravis.
187
Guillain-Barre Syndrome:
Ascending Paralysis (from the feet up). Monitor for respiratory distress.
188
Clinical manifestations of Parkinson's Disease:
"RAT" Rigidity Akinesia (loss of muscle movement) Tremors Treat with Levodopa
189
Transient Ischemic Attack (TIA):
Mini stroke with no dead brain tissue.
190
Cerebrovascular Accident (CVA):
Stroke with dead brain tissue.
191
Hodgkin's disease:
Cancer of lymph and curable in early stages.
192
Rule of NINES for burns:
Head and Neck = 9% Each Upper Extremity = 9% Each Lower Extremity = 18% Front Trunk = 18% Back Trunk = 18% Genitalia = 1%
193
Birth weight by age:
Doubles by 6 months Triples by 12 months
194
First signs of Cystic Fibrosis (in new borns):
Meconium ileus at birth. Baby is inconsolable, does not eat, and not passing meconium.
195
Consequence of Rheumatic Fever:
Cardiac valve malfunctions.
196
Cerebral Palsy:
Poor muscle control due to birth injuries and/or decreased oxygen to brain tissues.
197
Consequence of Dilantin Levels too high:
Gingival hyperplasia
198
Assessment in children for Meningitis:
Kernig's Sign Brudzinski's Sign
199
Presentation of Wilm's Tumor:
Usually encapsulated above the kidneys causing flank pain.
200
Hemophilia and genetics:
X-linked trait. Mother (carrier) passes disease to son.
201
Consequence of elevated Phenylalanine:
Affects brain function
202
Eclampsia:
Results in seizure
203
Why does mother receive RhoGam:
When mother is Rh- to protect the next baby.
204
When do fontanelles close?
Anterior - by 18 months Posterior - by 6 - 8 weeks
205
Pathological jaundice:
Occurs before 24 hours and lasts 7 days.
206
Physiological jaundice:
Occurs after 24 hours.
207
Placenta Previa:
There is no pain, there is bleeding.
208
Abrupto Placentae:
There is pain, but no bleeding.
209
Bethamethasone (Celestone):
Surfactant medication to aid in lung expansion.
210
Dystocia:
Baby can not make it down to the canal:
211
Pitocin:
Medication used for uterine stimulation.
212
Magnesium Sulfate:
Used to halt preterm labor. Contraindicated if deep-tendon reflexes are ineffective. If patient experiences seizures during magnesium sulfate administration, get baby out (emergency)!
213
Five interventions for psych patients:
Safety Set Limits Establish Trusting Relationship Medication Administration Least Restrictive Methods (Environment)
214
How long before you see effects of SSRI (Antidepressants)?
About 3 weeks to reach therapeutic effects.
215
Nursing interventions for Hallucinations vs. Delusions:
Hallucinations - Redirect the patient Delusions - Distract the patient
216
Adverse effects of Thorazine (Haldol):
Antipsychotic medication. Can lead to EPS (extrapyramidal side effects).
217
Characteristic od Alzheimer's Disease:
Chronic, progressive, degenerative cognitive disorder that accounts for >60% of all dementias.
218
Clinical manifestation of HYPER-thyroidism:
"Michael Jackson in Thriller!" Skinny, nervous, bulging eyes, up all night, tachycardia.
219
Medication used to decrease secretions:
Atropine
220
Antiemetic used to reduce nausea:
Phenergan
221
Commonly used tranquilizer given to reduce anxiety before surgery:
Diazepam
222
Pain control medication contraindicated for sickle cell crisis:
Demerol
223
Method for Fe (iron) injections:
Z-track, so it doesn't leak into SQ tissues.
224
Mnemonic for Cranial Nerves:
``` Oh - I - Olfactory Oh - II - Optic Oh - III - Oculomotor To - IV - Trochlear Touch - V - Trigeminal And - VI - Abducens Feel - VII - Facial A - VIII - Auditory Girls - IX - Glossopharyngeal Vagina - X - Vagus And - XI - Accessory Hymen - XII - Hypoglossal ```
225
Clinical manifestations for HYPER-natremia (greater than 145):
"SALT" S - skin flushed A - agitation L - low grade fever T - thirst
226
Significance with APGAR values:
8 - 10; Patient is OK 0 - 3; Resuscitate
227
Clinical manifestations of HYPO-xia:
Restless Anxious Cyanotic Tachycardia Tachypnea
228
Mnemonic for Addisons and Cushing's Syndrome:
ADDison's - need to ADD hormone CUSHINg's - have extra CUSHIN of hormone
229
Nursing interventions and medical management of Dumping Syndrome:
Increase fat and protein intake Small frequent meals Lie down after meals (to decrease peristalsis) Wait 1 hour after meals to drink
230
Precautions for Herpes Zoster:
Disseminated HZ - Airborne Precautions Localized HZ - Contact Precautions
231
Fat soluble Vitamins:
A D E K
232
Drugs to give with food:
NSAIDS Corticosteroids Bipolar drugs Cephalosporins Sulfonamides
233
Treatment of choice for Status Epilepticus:
Ativan
234
Sequence for bronchodilator in conjunction with glucocorticoid inhaler:
Bronchodilator first to open the passage way. Then Glucocorticoid. Then rinse mouth since Glucocorticoid is a steroid inhaler.
235
Considerations for Theophylline:
Increases the risk of Digoxin toxicity. Decreases the effects of Lithium and Dilantin.
236
Intal:
IN-tal is an inhaler used to treat allergy induced asthma. May cause bronchospasm. Think IN-to the asthmatic lung.
237
Adverse effects of Isoniazid:
Peripheral neuritis
238
Treatment of peptic ulcers caused by H. pylori:
Flagyl Prilosec Biaxin *Treatment kills bacteria and stops production of stomach acid, but does not heal the ulcer.
239
Correct use of a Diaphragm contraceptive:
Must stay in place for at least 6 hours after intercourse. They are also fitted and so must be refitted if you lose or gain a significant amount of weight.
240
Best time to take Growth Hormone:
PM
241
Best time to take Steroids:
AM
242
Best time to take Diuretics:
AM
243
Best time to take Aricept:
AM
244
Best time to take Carafate (Sulcrafate):
Before meals. It's a mucosal barrier. Watch for constipation.
245
Best time to take Tagamet:
With meals. H2 medication. *Interacts with a lot of things and screws with elderly, so watch out!
246
Consequence of long-term use of Amphogel:
Binds to phosphates, increases Ca in circulation by robbing the bones. Leads to increased Ca resorption from bones and WEAKENS BONES.
247
Medical management for Glaucoma:
Increased intraocular pressure (greater than the normal 22 mmHg). Give miotics to constrict iris (PILOCARPINE). ATROPINE is contraindicated.
248
Non-dairy sources of Calcium:
Rhubarb Sardines Collard Greens
249
Nursing intervention for irritated skin with plaster casts:
Petal the rough edges with tape.
250
Patient positioning to relieve lower back pain:
Bend knees
251
Allopurinol:
Flushes uric acid out of the system.
252
Adverse effects of INH:
Peripheral neuritis, take Vitamin B6 to prevent. *Also hepatotoxic.
253
Adverse effects of Rifampin:
Red orange tears and urine. Contraceptives won't work.
254
Adverse effects of Ethambutol:
Messes with your Eyes.
255
Procedure for administration of eye drops:
Apply to conjunctival sac. Apply pressure to nasolacrimal duct/inner canthus, to prevent systemic leakage.
256
Considerations when administering Kayexalate:
Worry about dehydration.
257
Why is yogurt contraindicated for immunosuppressed patients?
Yogurt contains live cultures.
258
Nursing intervention for treatment of itching under cast area:
Cool air via blow dryer Ice pack for 10-15 minutes *NEVER use Q-tip or anything to scratch the area.
259
Murphy's Sign:
Pain with palpation of gall bladder area seen with CHOLECYSTITIS.
260
Cullen's Sign:
Ecchymosis in umbilical area seen with PANCREATITIS.
261
Turner's Sign:
Flank grayish blue seen with PANCREATITIS.
262
McBurney's Point:
Pain in LRQ seen with APPENDICITIS.
263
Guthrie Test:
Tests for PKU in infants; baby should eat a source of protein first.
264
Shilling Test:
Test for PERNICIOUS ANEMIA; how well one absorbs Vitamin B12.
265
Allen's Test:
Occlude both wrist arteries until hand blanches. Release Ulnar artery. If hand pinks up then good and can carry on with ABG/radial stick.
266
Permissible observations during Peritoneal Dialysis:
Abdominal cramps Blood tinged outflow Leakage around the site *CLOUDY outflow never normal!
267
Indications of yellow amniotic fluid with particles:
Meconium stained
268
Rhogam administration schedule:
Given at 28 weeks gestation. Again 72 hours post-partum. *Only given to Coomb's negative and Rh- mother, by IM injection.
269
Order of Assessment:
``` NON-ABDOMINAL: Inspection Palpation Percussion Auscultation ``` ``` ABDOMINAL & CHILDREN: Inspection Auscultation Percussion Palpation ```
270
Related to Latex allergy:
``` Bananas Apricots Cherries Grapes Kiwis Passion Fruit Avocados Chestnuts Tomatoes Peaches ```
271
Tensilon:
Used to confirm diagnosis of Myasthenia Gravis.
272
Amyotrophic Lateral Sclerosis (ALS):
Degenerative condition of motor neurons for both upper and lower motor neuron systems.
273
Transesophageal Fistula (TEF):
Esophagus doesn't fully develop. This is a surgical emergency.
274
The 3 C's of TEF in the newborn:
Choking Coughing Cyanosis
275
How is MMR vaccine administered?
Given SQ, not IM.
276
Greek tradition with newborn baby:
Put an amulet or other protective charm around the baby's neck to avoid the "evil eye" or envy of others.
277
Children and relation to time:
4 year old kids cannot interpret TIME. They need to be explained in relationship to a known COMMON EVENT. "Mom will be back after supper"
278
Contraindication for Hepatitis B vaccine:
Anaphylactic reaction to baker's yeast.
279
Assessment question before administering vaccine:
Allergy to eggs.
280
What to monitor while on Nitroprusside:
Monitor thiocynate (cyanide) levels. Normal value should be 1 is heading toward toxicity.
281
Precautions for SARS (Severe Acute Respiratory Syndrome):
Airborne + Contact precautions
282
Hepatitis A precautions:
Contact precautions
283
Common infections that require Standard Precautions:
Tetanus Hepatitis B HIV
284
William's Position:
Semi-Fowler's with knees flexed to relieve lower back pain.
285
Physical signs of a fractured hip:
External rotation Shortening Adduction
286
Clinical manifestations of a fat embolism:
Blood tinged sputum (related to inflammation) Respiratory alkalosis Hypocalcemia Increased serum lipids "Snow Storm" effect on CXR
287
Complications of mechanical ventilation:
Pneumothorax Ulcers
288
Clinical manifestations of Paget's Disease:
Tinnitus Bone pain Enlargement of bone Thickened bones
289
Contraindicated with administration of Allopurinol:
NO VITAMIN C!
290
Acid Ash Diet:
Cheese, corn, cranberries, plums, prunes, meat, poultry, pastry, bread.
291
Alkaline Ash Diet:
Milk, veggies, rhubarb, salmon.
292
Side effect of thyroid hormones:
Insomnia; with increased metabolic rate, your body is "too busy to sleep". *With HYPO-throidism patients may report somnolence; decreased metabolic rate, the body becomes slow and sleepy.
293
Medical management and medication for Strabismus:
Botox. Patch GOOD EYE so that the weaker eye can get stronger.
294
O2 administration requirement for COPD patient:
2 L/min vis nasal cannula MAXIMUM.
295
Medication to reverse the effects of Pancuronium:
Neostigmine Atropine (Anticholinergics)
296
Assessment before administration of Asparginase:
Test for hypersensitivity
297
Dietary teaching while taking Vermox:
High-fat diet increases absorption.
298
Glucose threshold for kidney:
180
299
Anxiety related to children:
Stranger anxiety - 7 to 9 months old Separation anxiety - peaks at toddlerhood
300
Tardive Dyskinesia:
Involuntary movement of the tongue, face, and extremities. May happen after prolonged use of antipsychotics. Effects are irreversible.
301
Akathisia:
Motor restlessness, feels the need to keep going. Treat with anti-Parkinsons medications. Can be mistaken for agitation.
302
Procedure for drawing ABGs:
Put the blood in a heparinized tube. No bubbles. Put on ice immediately. Label indicating what type of air (O2, room).
303
Patient preparation before Pulmonary Function Test (PFT):
Bronchodilators and smoking are with-held for 4 hours.
304
Patient positioning for lung biopsy:
Side-laying with arms raised up on pillows over bedside table. Patient to hold breath mid-experation. CXR done immediately after to check for complications of pneumothorax, apply sterile dressing.
305
Medical management for lumbar puncture:
Patient positioned in lateral recumbent fetal position. Keep patient flat for 2-3 hours after with a sterile dressing over wound. Frequent Nero assessments.
306
Considerations for Dexedrine:
Medication used for treatment of ADHD. May alter insulin needs. Avoid taking with MAOIs, and take medication in the morning (possible side effect is insomnia).
307
Cytovene:
Used for treatment of retinitis caused by cytomegalovirus. Patient will need regular eye exams. Report dizziness, confusion, or seizures immediately.
308
INH:
Used in the treatment and prevention of TB. Do not mix with Dilantin. Can cause Phenytonin toxicity. Monitor LFT's. Give with Vitamin B6. HYPO-tension will occur initially then resolve.
309
Preferred anti-psychotic in the elderly:
Haldol *Has high-risk extrapyramidal side effects (dystonia, tardive dyskinesia, tightening of jaw, stiff neck, swollen tongue, swollen airway). Monitor for early signs of reaction and give IM Benadryl.
310
First line antipsychotic in children:
Risperdal *Doses over 6mg can cause tardive dyskinesia.
311
Levadopa:
Treatment of Parkinsons. Contraindicated for patients with glaucoma, and should avoid B6.
312
Sinemet:
Treatment of Parkinsons. Contraindicated with MAOI's.
313
Hydroxyurea:
Treatment of Sickle Cell. *Report GI symptoms immediately, as it could indicate toxicity.
314
Zocor:
Treatment of Hyperlipidemia. Take on an empty stomach to enhance absorption. Report any unexplained muscle pain, especially fever.
315
Decorticate vs. Decerebrit:
Decorticate - fists towards core (at sternum) Decerebrit - fists outward
316
Progression of Multiple Sclerosis disease:
Chronic, progressive disease with demyelinating lesions in the CNS which affect the white matter of the brain and spinal cord. Signs & Symptoms Motor: limb weakness, paralysis, slow speech Sensory: numbness, tingling, tinnitus Cerebral: nystagmus, ataxia, dysphagia, dysarthria
317
Huntington's Chorea:
50% genetic, autosomal dominant disorder. Signs & Symptoms Chorea - writhing, twisting, movements of face, limbs, and body. Gait deteriorates to no ambulation. No cure just palliative care.
318
Definitive diagnosis for Abdominal Aortic Aneurysm (AAA):
CT Scan
319
Patient contraindicated for Kayexalate:
HYPO-active bowel sounds
320
Uremic fetor:
Smell urine on the breath.
321
Hirschsprung's Disease:
Bile present - lower obstruction No bile present - upper obstruction Presents with ribbon like stools
322
Patient teaching before fecal occult stool blood test:
Cantaloupe causes a false positive. No fish. No red meat.
323
HYPO-spadias:
Abnormality in which urethral meatus is located on the ventral (back) surface of the penis, anywhere from the corona to the perineum. HYPO - lower surface of penis.
324
EPI-spadias:
Opening of the urethra on the dorsal (front) surface of the penis. EPI - top surface of penis.
325
Physical manifestations of Fetal Alcohol Syndrome (FAS):
Upturned nose Flat nasal bridge Thin upper lip SGA
326
IM administration sites for infants and children:
18 months - Ventrogluteal Children - Deltoid and gluteus maximus
327
Patient teaching for Cane walking:
"COAL" C - Cane O - Opposite A - Affected L - Leg
328
Procedure for Thoracentesis:
Take vital signs Shave area around needle insertion Position patient with arms on pillow over bed table or side laying No more than 1,000 CCs at one time After procedure listen for bilateral breath sounds, check vital signs, check for leakage, and apply sterile dressing
329
Patient preparation for cardiac catheterization:
NPO 8-12 hours Empty bladder Patient may have desire to cough with dye injection After procedure take vital signs and keep leg straight on bed rest for 6 - 8 hours.
330
Patient preparation for Cerebral Angiography:
Keep well hydrated Lie flat Site shaved After procedure keep flat for 12 - 14 hours, check site, vitals, and force fluids
331
Nursing interventions post-procedure for Lumbar puncture:
Neuro assessment q15-30 minutes until stable Lay flat for 2 - 3 hours Encourage fluids Oral analgesics for headache Observe dressing site
332
Patient preparation for EEG:
No sleep the night before Meals not with-held No stimulants for 24hours before Tranquilizer and stimulant meds held 24 - 48 hours before May be asked to hyperventilate 3-4 minutes and watch a bright flashing light
333
Laproscopic procedure:
CO2 used to enhance visual field General anesthesia used Patient on FOLEY CATH After procedure walk patient to decrease CO2 build up used for procedure
334
Nursing considerations for Sengstaken Blakemore Tube:
Used for treatment of esophageal varices Keep scissors at bedside
335
Classic signs and symptoms of PTB:
Low-grade afternoon fever
336
Classic signs and symptoms of Pneumonia:
Rusty sputum
337
Classic signs and symptoms of Asthma:
Wheezing on expiration
338
Classic signs and symptoms of Emphysema:
Barrel chest
339
Classic signs and symptoms of Kawasaki Syndrome:
Strawberry tongue
340
Classic signs and symptoms of Pernicious Anemia:
Beefy red tongue
341
Classic signs and symptoms of Downs Syndrome:
Protruding tongue
342
Classic signs and symptoms of Cholera:
Rice watery stool
343
Classic signs and symptoms of Malaria:
Stepladder like fever with chills
344
Classic signs and symptoms of Typhoid:
Rose spots in abdomen
345
Classic signs and symptoms of Diptheria:
Pseudo membrane formation
346
Classic signs and symptoms of Measles:
Koplik's spots
347
Classic signs and symptoms of Systemic Lupus Erthymatosus (SLE):
Butterfly rashes
348
Classic signs and symptoms of Liver Cirrhosis:
Spider-like varices
349
Classic signs and symptoms of Leprosy:
Lioning face
350
Classic signs and symptoms of Bulimia:
Chipmunk face
351
Classic signs and symptoms of Appendicitis:
Rebound tenderness
352
Classic signs and symptoms of Dengue:
Petechiae or positive Herman's sign
353
Classic signs and symptoms of Meningitis:
Positive Kernig's sign (leg flex then leg pain on extension) Positive Brudzinski sign (neck flex causes lower leg flexion)
354
Classic signs and symptoms of Tetany:
HYPO-calcemia Positive Trousseau's sign (carpopedal spasm) Chvostek sign (facial spasm)
355
Classic signs and symptoms of Tetanus:
Risus sardonicus
356
Classic signs and symptoms of Pancreatitis:
Cullen's sign (ecchymosis of umbilicus) Positive Grey turners spots
357
Classic signs and symptoms of Pyloric Stenosis:
Olive-like mass
358
Classic signs and symptoms of Patent Ductus Arteriosus (PDA):
Machine-like murmur
359
Classic signs and symptoms of Addison's Disease:
Bronze-like skin pigmentation
360
Classic signs and symptoms of Cushing's Syndrome:
Moon face appearance Buffalo hump
361
Classic signs and symptoms of HYPER-thyroidism (Grave's Disease):
Exopthalmus
362
Classic signs and symptoms of Intussusception:
Currant jelly stools Dance sign (empty portion of LRQ)
363
Classic signs and symptoms of Multiple Sclerosis:
Charcot's Triad (IAN)
364
Classic signs and symptoms of Myasthenia Gravis:
DESCENDING muscle weakness
365
Classic signs and symptoms of Guillian Barre Syndrome:
ASCENDING muscle weakness
366
Classic signs and symptoms of Deep Vein Thrombosis (DVT):
Positive Homan's sign
367
Classic signs and symptoms of Chicken Pox:
Vesicular rash (dew drop on rose petal)
368
Classic signs and symptoms of Angina:
Crushing stabbing pain relieved by Nitroglycerin
369
Classic signs and symptoms of Myocardial Infarction:
Crushing stabbing pain which radiates to left shoulder, neck, arms and unrelieved by Nitroglycerin
370
Classic signs and symptoms of Laryngotracheobronchitis (LTB):
Inspiratory stridor
371
Classic signs and symptoms of Tracheoesophageal Fistula (TEF):
4C's Coughing Choking Cyanosis Continuous drooling
372
Classic signs and symptoms of Epiglotitis:
3D's Drooling Dysphonia Dysphagia
373
Classic signs and symptoms of Hodgekin's Lymphoma:
Painless, progressive enlargement of spleen and lymph tissues. Presents with Reed-Sternberg cells.
374
Classic signs and symptoms of Infectious Mononucleosis (MONO):
Sore throat Cervical lymph adenopathy Fever
375
Classic signs and symptoms of Parkinson's:
Pill-rolling tremors
376
Classic signs and symptoms of Cystic Fibrosis:
Salty skin
377
Classic signs and symptoms of Diabetes Mellitus (DM):
Polyuria Polydipsia Polyphagia
378
Classic signs and symptoms of Diabetic Ketoacidosis (DKA):
Kussmaul's breathing (rapid deep breaths)
379
Classic signs and symptoms of Bladder Cancer:
Painless hematuria
380
Classic signs and symptoms of Benign Prostatic Hypertrophy (BPH):
Reduced size and force of urine stream
381
Classic signs and symptoms of Retinal Detachment:
Visual floaters, flashes of light, curtain vision
382
Classic signs and symptoms of Glaucoma:
Painful vision loss Tunnel vision Halo vision (Loss of peripheral vision)
383
Classic signs and symptoms of Cataract:
Painless vision loss Opacity of lens blurs vision
384
Classic signs and symptoms of Retino Blastoma:
Cat's eye reflex (grayish discoloration of pupil)
385
Classic signs and symptoms of Acromegaly:
Coarse facial features
386
Classic signs and symptoms of Duchennes's Muscular Dystrophy:
Gower's sign (use of hands to push one's self from the floor, making like a table shape)
387
Classic signs and symptoms of Gastroesophageal Reflux Disease (GERD):
Barrett's esophagus (erosion of the lower portion of the esophageal mucosa)
388
Classic signs and symptoms of Hepatic Encephalopathy:
Flapping tremors
389
Classic signs and symptoms of Hydrocephalus:
Bossing sign (prominent forehead)
390
Classic signs and symptoms of Increased ICP:
Cushing's Triad HYPER-tension BRADY-pnea BRADY-cardia
391
Classic signs and symptoms of Shock:
HYPO-tension TACHY-pnea TACHY-cardia
392
Classic signs and symptoms of Meniere's Disease:
Vertigo Tinnitus
393
Classic signs and symptoms of Cystitis:
Burning upon urination
394
Classic signs and symptoms of Ulcerative Colitis:
Recurrent bloody diarrhea
395
Classic signs and symptoms of HYPO-calcemia:
Positive Chvostek & Trosseau's signs
396
Classic signs and symptoms of Lyme Disease:
Bull's-eye rash
397
Therapeutic levels of Dilantin:
10-20
398
Therapeutic levels of Theophyline:
10-20
399
Therapeutic levels of Acetaminophen:
10-20
400
Therapeutic levels of Lithium:
0.5-1.5
401
Therapeutic levels of Digoxin:
0.5-2.0
402
Osteomyelitis:
Infectious bone disease. Blood cultures and deliver antibiotics. If necessary, surgery to drain abscess.
403
Nephrotic syndrome:
Presents with edema and HYPO-tension. Turn and reposition patient; risk for impaired skin integrity.
404
Normal serum Creatinine levels:
Men = 0.8-1.8 Women = 0.5-1.5
405
Medical interventions for Cystic Fibrosis:
Low fat, high sodium, fat-soluble Vitamins (ADEK) diet. Aerosol bronchodilators. Mucolytics and pancreatic enzymes.
406
Side effects of Zoloft:
Agitation, sleep disturbance, and dry mouth.
407
Side effects of Clozapine:
Agranulocytosis, tachycardia, and seizures.
408
Blood tests for Myocardial Infarction:
Myoglobin CK Troponin
409
Considerations for use of salt substitutes:
May contain Potassium
410
Assessment of Stomas:
Dusky - poor blood supply Protruding - prolapsed Sharp pain - peritonitis Rigidity - peritonitis Mucus in ileal conduit is expected
411
Side effects of Dilantin:
Rash (stop meds) Gingival hyperplasia
412
Clinical manifestations of Dilantin toxicity:
Poor gait and coordination Slurred speech Nausea Lethargy Diplopia
413
Anti-seizure medications during pregnancy:
Phenobarbital is Ok. Dilantin is contraindicated.
414
Steps for Incentive Spirometry:
1) Sit upright 2) Exhale 3) Insert mouthpiece 4) Inhale for 3 seconds 5) Hold for 10 seconds
415
Signs of allergy during blood transfusion:
1) Flank pain 2) Frequent swallowing 3) Rashes 4) Fever 5) Chills
416
Precautions for Thrombocytopenia:
Bleeding precautions Soft tooth brush Nothing inserted (douche, etc.) Minimize IM medications
417
Treatment for Iron Deficiency Anemia:
Iron PO with Vitamin C on an empty stomach Iron IM - Inferon via Z-track
418
Clinical manifestations of Burns:
1st Degree - red and painful 2nd Degree - blister and painful 3rd Degree - painless due to blocked and burned nerves
419
Triad for Meniere's Disease:
Vertigo Tinnitus Nausea & Vomiting
420
Pattern of pain associated with Gastric Ulcer:
Occurs 30 - 90 minutes after eating Doesn't occur at night Doesn't go away with food
421
Priority nursing interventions during Sickle Cell Crisis:
FLUID administration PAIN relief
422
Most important nursing assessment for Glomerulonephritis:
Blood pressure
423
Clinical manifestations of Pyloric Stenosis:
Mild vomiting that progresses to projectile vomiting
424
Cardiac consequence of Kawasaki Disease:
Coronary artery aneurysms; due to the inflammation of blood vessels
425
When are MMR and Varicella immunizations given?
15 months of age
426
Contraindicated procedure for head injuries or skull fracture:
Nasotracheal suctioning
427
Most common sites for metastasis:
Liver Brain Lungs Bone Lymph
428
Nursing priority for small bowel obstruction:
Maintaining fluid balance comes first because patient will be on oral fluid restrictions. Reestablishing a normal bowel pattern is not a priority.
429
What is released during an allergic response?
Basophils release histamine
430
Iatragenic:
Caused by treatment, procedure, or medication
431
Four-side rails up:
Considered a restraint and requires a doctors' orders.
432
Priority nursing concern for cancer patient receiving radiation:
Infection as leukopenia is caused by radiation and the patient is now immunocompromised.
433
Potassium and blood chemistries:
Alkalosis - al-K-a-LO-sis - Potassium is LOW
434
Priority vital sign to check with HIGH potassium:
Pulse; dysrhythmias are imminent.
435
Medication consideration for Myasthenia Gravis and eating:
Neostigmine is given 45 minutes before meals to help with chewing and swallowing.
436
Priority nursing intervention for Pulmonary Embolism (PE):
Oxygen (O2)
437
Action of Atropine:
Blocks acetylcholine (reduces secretions)
438
Diagnosis of Hirschsprung's Disease:
Rectal biopsy reveals absence of ganglionic cells. No innervation of intestinal muscles. Cardinal sign in infants is failure to pass meconium and later classic ribbon-like and foul smelling stools.
439
Indication by low magnesium and high creatinine:
Signals renal failure
440
Highest priority with Rheumatoid Arthritis (RA):
Usually pain
441
Priority nursing assessment with Status Epilepticus:
Level of consciousness
442
Priority nursing assessment for Addison's patient:
Blood pressure; disease can result in Addisonian crisis presenting with severe HYPO-tension.
443
Most accurate method for medication dosing for kids:
BSA
444
Action when observing nurse making mistake:
Talk to person first Then talk to management
445
Reportable (communicable) diseases:
TB Gonorrhea
446
Action of Vasopressin:
Vasoconstriction | Vaso-press-in
447
You have delegated care of a patient in restraints to a nursing assistant. How often should the nursing assistant assess skin integrity for this patient?
Every 30 minutes
448
You enter a patients room and find the patient not breathing, no pulse, and unresponsive. You have called for help. What is the next step?
1. ) Open airway | 2. ) Begin chest compressions
449
The most appropriate place to check the pulse on a 1-month-old infant is:
Brachial
450
A patient with COPD would most likely develop which acid-base imbalance?
Respiratory acidosis
451
Kussmaul respirations:
Abnormally deep, regular and increased respirations.
452
You are assisting the physician with removal of a chest tube. The nurse should instruct the patient to:
The nurse should instruct the patient to perform the Valsalva’s maneuver (take a deep breathe, exhale and bear down). Then the tube would be quickly removed and an airtight dressing placed. An alternative would be to ask the patient to take a deep breathe and hold the breath while the tube is removed.
453
Stridor:
The physician will need to be notified if the patient develops stridor. Stridor is a high-pitched, coarse sound heard over the trachea. This is an indication of airway edema, which puts the patient at risk for airway blockage.
454
Croup:
Worse symptoms at night that improve during the day. Usually, a child develops croup after several days of respiratory infection. Croup begins with a harsh, brassy cough, sore throat and inspiratory stridor. The patient may develop a low grade fever, but in some cases the fever will get as high as 104 degrees.

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