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NCLEX-RN > Set 3 > Flashcards

Set 3 Flashcards

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1
Q

1st degree AV block

3rd degree AV block

A

1st. .. Prolonged PQ interval >0.2 sec

3rd. .. Atria and Ventricles contract independently

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2
Q

Corticosteroid therapy teaching

A
  • Do not stop abruptly
  • Infection can come on quickly, report low grade temp to HCP
  • Increase dose during times of stress
  • Hyperglycemia is a side effect
  • Diet high in calcium and protein, low in carbs and fat is recommended for increased muscle weakness and osteoporosis
  • Cataracts are side effect. See eye doc yearly
  • Do not take on empty stomach. Cause gastric irritation
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3
Q

Expected side effects of lithium therapy

A 
Lithium is used to treat bipolar disorder
Side effects:
-dry mouth
-drowsiness
-weight gain
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4
Q

Chlorthalidone

A

Diuretic!!

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5
Q

MAOI diet

What drugs are MAOI’s

A 
No tyramine 
MAOI's include:
-isocarboxazid
-phenelzine
-tranylcypromine
-selegiline
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6
Q

Clonidine

A

Do not stop taking abruptly.. taper over 2-4 days. Can cause rebound HTN

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7
Q

Hydroxychloroquine adverse reaction

A

Retinal toxicity and visual disturbances

See eye doc every 6-12 months

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8
Q

Clopidogrel

A

Anti-platelet (blood thinner)

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9
Q

Contraceptive use adverse reactions

A 
ACHES
Abdominal pain - ischemic bowel
Chest pain - PE or MI
Headaches - stroke
Eye problems - retinal blood vessel ischemia
Severe leg pain - DVT
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10
Q

Vancomycin and aminoglycosides adverse reactions

A

Ototoxicity and nephrotoxicity

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11
Q

Aminoglycosides

A

gentamicin
amikacin
tobramycin

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12
Q

Specific gravity

A

1.005-1.030

Elevated levels indicates concentrated urine and dehydration

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13
Q

Calcium channel blockers

A 
Promote relaxation of vascular smooth muscle.... decrease HTN
nifedipine
amlodipine
felodipine
nicaridipine
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14
Q

Sulfonylurea drugs

A

Diabetic meds
glyburide
glipizide
glimepiride

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15
Q

Manifestations of Neurogenic shock

A

Massive Vasodilation

  • Hypotension
  • Bradycardia

Warm dry skin common in neurogenic shock due to blood pooling in venous circulation

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16
Q

Terazosin

A 
Medication to treat BPH
Side effect:
-Orthostatic hypotension
Teaching:
-Take medication at bedtime to avoid dizziness
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17
Q

Normal male hematocrit

Normal male hemoglobin

A

39-50%

13.2-17.3

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18
Q

Symptoms of increased ammonia

A

Confusion
Give LACTULOSE. Lactulose decreases ammonia levels, so a therapeutic outcome of lactulose would be improved mental status

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19
Q

Syphillis and pregnancy

A

STI
Crosses the placenta and can have teratogenic effects on the fetus
Prenatal treatment is IM penicillin
If pt has penicillin allergy, pt will have penicillin desensitization

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20
Q

Doxycycline and pregnancy

A

Contraindicated in pregnancy. Can impair fetal bone mineralization and discolor permanent teeth

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21
Q

Varicella

A

Chicken pox!!!
Not infectious once lesions are crusted over
Give Acyclovir
Can have a topical antihistamine such as benadryl applied to lesions

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22
Q

UTI prevention

A

Do not use bubble bath or scented soaps. They cause irritation to urethra.
No bathing in antibacterial soap - reduce presence of normal flora
Use COTTON underwear! - Absorbs moisture (No nylon or spandex or tight clothing!)

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23
Q

Expected weight loss for newborns after birth

A

5-6% of birth weight is lost within the first 3-4 days of life

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24
Q

Expected findings at birth

A

Newborns tend to have cracked, peeling skin.

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25
Q

Steroids and BG

A

Steroids such as methylprednisolone will increase blood glucose

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26
Q

Seizure disorders and driving

A

Pt’s with seizure disorders should avoid driving or operating heavy machinery until they have permission from their Dr.

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27
Q

Infant CPR

A

Deliver chest compressions with either two thumbs or two fingers on the sternum, just below the nipple line.
Check the brachial pulse for no longer than 10 seconds
Single rescuer should do a 30:2 compression to breath ratio
Two rescuers should do a 15:2 compression to breath ratio
If single rescuer to unwitnessed collapse, perform 2 min of CPR before getting AED

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28
Q

Agoraphobia vs social anxiety disorder

A

Fear or anxiety about being in or anticipating certain situations like a new job, being in a crowd, traveling on a bus or train, being in a tunnel or bridge, open or closed spaces. They are concerned about having “trouble escaping” or getting help if they have a panic attack.

Social anxiety disorder is fear of being embarrassed, observed, scrutinized in social settings.

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29
Q

Milk is rich in what two nutrients

A

Calcium and Vit D

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30
Q

Battery

A

Intentional touching of person without their consent.
Ex: administering morphine to a confused pt by telling them it is saline
Ex: putting in a needed catheter to a competent pt who is refusing it.

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31
Q

Tetralogy of Fallot

A

Put in knee chest position during hypercyanotic episodes

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32
Q

Tidaling occurs in what chamber of the chest tube

A

Water seal chamber. Tidaling occurs during the inspiration and expiration of the pt

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33
Q

Therapeutic magnesium level in a pt with eclampsia/preeclampsia

A

4.7 mEq/L

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34
Q

Drugs to prolong labor

A

Terbutaline, Magnesium Sulfate, Indomethacin, Nifedipine

Suppress uterine contractions prolonging labor for 2-7 days

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35
Q

Ebola (viral hemorrhagic fever

A

Extremely contagious disease with high mortality rate
Standard, contact, droplet, and airborne precautions
- N95
-shoe covers
-face shield
-etc
Visitors are prohibited unless necessary. All visitors are logged and monitored for symptoms
Must be in airborne isolation room. Pt doesn’t have to wear PPE but all visitors and staff do.

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36
Q

Low-residue diet

A

NO fiber

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37
Q

Megacolon

A 
Common, life threatening complication of Inflammatory bowel disease
Manifestations
-Abdominal pain/distention
-Bloody diarrhea
-Shock
-fever
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38
Q

Blood thinners and surgery

A

Must discontinue 5-7 days before surgery

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39
Q

What is clopidogrel

A

Anti-platelet! So blood thinner

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40
Q

12 mo old vaccine schedule

A

Hib, PCV, MMR, Varicella, Hep A

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41
Q

Live vaccines

A

MMR, Varicella, Influenza nasal spray
Children who are immunocompromised should not receive live vaccines
Pregnant women should also not receive live vaccines

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42
Q

Goal A1c for diabetic clients

A

<7%

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43
Q

Vancomycin adverse effect

A

Can cause nephrotoxicity

-Monitor creatinine levels daily

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44
Q

Contraindications for knee replacements

A

Recent or current infections!

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45
Q

Hemophilia

A

Hemophilia is a disorder characterized by a deficiency in the production of coagulation proteins

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46
Q

Tdap (Tetanus, diptheria, pertussis) during pregnancy

A

Pregnant women should receive between 27 wks and 36 wks

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47
Q

Epistaxis

A

Nose bleed

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48
Q

Drawing up insulin

A

Okay to mix NPH and regular insulin

RN- draw up REG before NPH to avoid mixing

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49
Q

Atropine

A

Treats symptomatic bradycardia.

50
Q

Hepatic encephalopathy

A

Complication of end stage liver disease
Result of inadequate detoxification of ammonia from the blood
Manifestations
-Confusion and lethargy
-Slurred speech
-Asterixis - flapping hand tremor that is found in hepatic encephalopathy

51
Q

Rifaximin

A

ABX used to treat hepatic encephalopathy and IBS

52
Q

Thyroid storm

A 
Life threatening!
Immediately report any symptoms:
- Fever
- Anxiety
- tachycardia
53
Q

IV opioid administration in pregnant women

A

Do not give when birth is imminent. May cause respiratory depression in baby!
May give when birth is still 2-4 hours out

54
Q

Statin drug serious adverse affect

A

Rhabdomyolysis (pieces of muscle break off into the blood stream… may be fatal and cause kidney damage)
Report any muscle aches or weakness immediately

55
Q

Normal PTT

Therapeutic PTT

A

PTT is the lab value we monitor for heparin therapy
Normal 25-35
Therapeutic 46-70

56
Q

Rifampin

A

Used to treat TB

Side effect is that bodily fluids turn red-orange

57
Q

Drugs that promote uterine tone after birth

A

Misoprostol, carboprost, methylergonovine
Methylergonovine is contraindicated in a pt with HTN
These drugs are used second line if fundal massage and oxytocin don’t work

58
Q

Carbidopa Levodopa fun fact

A

Turns urine and saliva colors (red, brown, black)
Dyskinesia (facial or eyelid twitching, tongue protrusion, facial grimacing) indicates an overdose of carbidopa levodopa and should be reported immediately

59
Q

Theophylline

A

Bronchodilator with a low therapeutic index
Toxicity occurs at levels >20
Can cause seizures and life threatening arrhythmia’s

60
Q

Blood transfusions and voiding

A

Pt should void right before transfusion because if a reaction occurs, a fresh urine specimen will need to be collected to check for blood

61
Q

Continuous IV drug infusions

A

RN not LPN

62
Q

Antipsychotic side effects

-Extrapyramidal side effects

A
  • Acute dystonic reaction: sudden onset, sustained muscle contractions
  • Akathisia: Subjective restlessness with inability to sit still
  • Drug-induced parkinsonism: tremor, rigidity, masked face, brady kinesia
63
Q

Antipsychotic side effects

-Tardive dyskinesia

A

Involuntary movement after chronic use

  • lip smacking
  • stiff, jerky movements of arms
  • rapid blinking
64
Q

Antipsychotic side effects

- Neuroleptic malignant syndrome

A

Fever, rigidity, mental status changes, autonomic instability

65
Q

Preeclampsia

A

Characterized by:
-proteinuria 300 mg/24 hr period or protein to creatine ratio of 0.3

Frequent urination common in pregnancy in general, not preeclampsia

66
Q

Thrombolytic therapy

A 
used to dissolve blood clots
Contraindicated in :
-pt with recent surgery (within 14 days)
-pt with onset of symptoms >4 hours ago. Thrombolytic therapy is not effective if not administered within a 3-4.5 hour window from onset of symptoms.
-Thrombocytopenia (platelets <100,000)
-coagulation disorders
67
Q

Celecoxib

A

NSAID!

68
Q

NSAIDS

A

Increase risk of thrombotic events (MI, stroke) especially in patients with cardiovascular diseases (such as coronary artery disease)

69
Q

Nitroglycerin action

A

Dilates blood vessels

Headache is an expected side effect from vasodilation

70
Q

Lithium toxicity

A 
Narrow therapeutic index (0.6-1.2)
Levels >1.5 considered toxic 
Drugs that can cause increased lithium levels:
-thiazide diuretics
-NSAIDS
-antidepressants
Low sodium precipitates lithium toxicity
71
Q

ST segment elevation myocardial infarction (STEMI)

A

Occurs when coronary artery is completely occluded

72
Q

HIV precautions

A

Standard

  • no extra precautions are needed.
  • HIV spreads when nonintact skin comes in contact with blood, breast milk, semen, or vaginal secretions
73
Q

N95 mask

A

Should be used with tuberculosis and varicella-zoster

74
Q

PaO2 levels

A

<60 indicates hypoxemia in COPD. Contact HCP!

75
Q

Preeclampsia report to HCP

A

Hyperreflexia (3+ or greater) and clonus (rhythmic jerking beats of the foot) may indicate worsening and likely seizure activity

76
Q

Assessing petechiae, jaundice, and cyanosis in dark skinned patients

A

Petechiae: conjunctiva of eyes and buccal mucosa
Jaundice: Palms of hands and soles of feet
Cyanosis: nail beds of fingers and toes

77
Q

Stridor

A

Harsh, high pitched breathing

Due to obstruction or constriction of large upper airway

78
Q

Infections that can cause fetal abnormalities

A 
TORCH
Toxoplasmosis
Other - parvovirus B19/varicella zoster virus
Rubella 
Cytomegalovirus
Herpes
79
Q

AED use

A

The quicker an AED is used, the higher the outcome. Do not delay use!
Remove transdermal patches and wipe the chest of the medication
Dry the chest area if wet before applying. The patient does not need to be completely dry. They can be lying in a small pool of water.

80
Q

Care for patient with increased intracranial pressure

A
  • Position the HOB 30 degrees (not on lots of pillows)
  • Keep body midline
  • Give stool softeners to prevent straining
81
Q

Adenosine

A

Used to treat supraventricular tachycardia

82
Q

Risk factors for pelvic inflammatory disease

A

Multiple sex partners
History of STI (specifically ghonorrhea or chlamydia) or PID
Partner with STI
Lack of consistent barrier method contraception
Age 15-25

83
Q

Left or right lateral recovery position

A

Used for an unconscious patient who is still breathing

84
Q

Hyperkalemia EKG

Hypokalemia EKG

A

Hyper: Tall peaked T waves
Hypo: Inverted T wave

85
Q

Diabetic Ketoacidosis treatment

A

Administer NS first! Then insulin. DKA patients are very dehydrated and need fluid replacement

86
Q

First signs of fetal movement occur when

A

16-20 weeks, beginning to middle of of 2nd trimester

87
Q

Allen’s test

A

Test used to determine patency of ulnar artery to see if radial artery is good to use to draw blood gases.
Occlude both arteries, open fist, fist should be pale, release pressure from ulnar artery, if blood returns to the hand, test Is positive and radial artery is good to use.

88
Q

Placental abruptions vs placental previa

A

Placental abruption occurs when the placenta detaches from the uterine wall causing hemorrhage.
Placental previa occurs when the placenta attaches over the cervical opening

89
Q

Amnesia

A

Partial or total loss of memory

90
Q

Gluten free foods

A

Rice, corn and potatoes are OKAY!

No BROW
Barley
Rye
Oats
Wheat
91
Q

Cervical cancer ethnic most common

A

African americans
Hispanics
American Indians

92
Q

HTN, Ischemic stroke and African Americans

A

African Americans have the highest incidence of HTN in the world. They also have higher rates of ischemic stroke.

93
Q

Hodgkins lymphoma

A 
Cancer that begins in the lymphatic system
Characterized by:
-enlarged, painless lymph node
-fever
-weight loss
-night sweats
-itching
-fatigue
94
Q

Trazadone

A

Treats major depressive disorder, specifically insomnia associated with MDD.
Priapism (prolonged erection) is a common side effect

95
Q

Normal fasting cholesterol

A

<200

96
Q

Breastfeeding/newborns and HIV

A

Contraindicated in developed countries where good formula is available.
Infants born to HIV positive clients should receive antiretroviral therapy for 4-6 wks after birth

97
Q

Holter monitor

A

Records a clients EKG for 24-48 hours
Things to note when using:
-Keep log of activities you are doing that day with any symptoms
-No bathing or showering during test period

98
Q

Serotonin Syndrome

A 
Caused by SSRI's
Manifestations:
-Clonus
-Tremors
-Diarrhea
-HTN
-Tachycardia
-Agitation
-Diaphoresis
99
Q

NSAIDS

A

Ibuprofen
Naproxen
Ketorolac
Indomethacin
Meloxicam
NEPHROTOXIC - do not use in pt with kidney disease
Increase risk of thrombotic events (stroke, heart attack) in pt with cardiovascular disease!

100
Q

Bell’s Palsy

A

Just affects the face. Vision, Balance, Consciousness and extremity motor function are not affected

101
Q

Rheumatic Fever

A

Acute inflammatory disease of the heart

Occurs 2-3 weeks after streptococcal pharyngitis

102
Q

Pleural effusion

A

Build up of fluid between lungs and lung sac

103
Q

Regular insulin

A 
Short acting (not rapid)
Peaks between 2-5 hours
104
Q

Isosorbide dinitrate

A

Used to prevent angina in patients with coronary artery disease

105
Q

Nystatin oral suspension

A

Soak dentures in nystatin solution

106
Q

Common Respiratory tract infections in children

A

Croup - barking cough and stridor
Epiglottitis - dysphagia and drooling, sitting up and leaning forward
Bronchiolitis - wheezing
^^^ Common manifestations for each

107
Q

Epiglottitis

A

Pediatric emergency
Requires intubation and possible tracheostomy
Characterized by dysphagia, drooling, sitting up and leaning forward

108
Q

Croup

A

Characterised by barking cough and stridor

Requires nebulized epinephrine with anesthesiologist standing by

109
Q

Manifestations of septic shock

A
  • fever or hypothermia
  • hypotension
  • prolonged cap refill
  • tachycardia
  • increased WBC
  • decreased urine output
110
Q

Cataract surgery post op teaching

A 
Visual acuity won't improve for 1-2 wks
Common to experience itching, photophobia and pain in affected eye for several days 
Avoid exercises that could increase intraocular pressure
-bending
-lifting more than 5 pounds
-straining 
-sneezing
-coughing
-rubbing or placing pressure on eye
111
Q

Phenytoin

A

Seizure medication
Therapeutic levels are 10-20
Early signs of toxicity: Gait unsteadiness and nystagmus (eye makes repeated uncontrolled movements)
Gingival hyperplasia (puffy and red gums) is an expected side effect

112
Q

Oligohydramnios

A

Low amniotic fluid
Complications:
-undeveloped lungs
-umbilical chord compression

113
Q

Hypomagnesemia

A

Can cause a lethal cardiac arrhythmia called torsades de pointes

114
Q

Hemorrhagic stroke

A

Occurs when a blood vessel ruptures in the brain causing a bleeding into the brain

115
Q

Opioid withdrawal vs use/overdose

A

Opioid use: constipation, lethargy, constricted pupils

Withdrawal: tachycardia

116
Q

Erythropoietin administration

A

Erythropoietin is what makes RBC’s. It is a hormone produced by the kidneys.
Major ASE is HTN, uncontrolled HTN is a contraindication for erythropoietin administration.

117
Q

CPR for pregnant client

A

Perform compressions slightly higher on sternum than usual.
Manually move uterus to the L, you may place pillows or blankets under pt to have them laying slightly on their L side to move the uterus.
If circulation does not return with 4 minutes, emergency C section, baby should be out within 5 minutes.

118
Q

Oliguria

A

Very low urine output!

119
Q

MAOI’s and SSRI’s

A

Should not be given together. Increased risk of life threatening adverse reactions

120
Q

Atropine and adenosine

A

Atropine INCREASES heart rate. Given for bradycardia.

Adenosine DECREASES heart rate. Given for SVT.

121
Q

Bishop score

A

System that predicts if a pregnant patient will have a successful induction. A score of >6-8 indicates a successful induction.

122
Q

Nonstress test

A

Test to determine if the fetus is well oxygenated. Reactive nonstress test means that the Fetus HR is 110-160, with moderate variability,

NCLEX-RN (6 decks)

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