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NCLEX-RN > Set 4 > Flashcards

Set 4 Flashcards

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1
Q

Retinoblastoma

A

Retinal tumor common in children, typically under 2.
Signs:
-white glow of the pupil instead of red
-strabismus (misalignment of the eyes)

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2
Q

Characteristic of glaucoma

A

Fixed, mid dilated pupil

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3
Q

UAP role during blood transfusions

A

UAP can take vitals before transfusion and anytime AFTER the first 15 minutes of the transfusion. RN must do initial vital signs to monitor for reactions.

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4
Q

Suctioning and mechanical ventilation

A

Suction when REMOVING the catheter, not inserting.

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5
Q

Veracity

A

Duty to always tell the truth

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6
Q

Tetracycline administration

A

Used for acne

  • Take on empty stomach but with full glass of water
  • Avoid dairy or antacids
  • Wear sunscreen
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7
Q

Trigeminal Neuralgia

A

Sudden sharp pain along trigeminal nerve. Nerve ends are around eyes, nose and mouth. Pain can be triggered by washing face, brushing teeth, chewing food, talking, yawning, etc.

Drug of choice is Carbamazepine. This is a seizure medication but is effective for neuropathic pain. Increased infection risk with use of carbamazepine!

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8
Q

Filgrastim

A

Used to increase neutrophil count in clients with malignancies (cancer growth) and undergoing chemotherapy

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9
Q

Aminoglycosides

A

gentamicin, tobramycin, amikacin
Used to treat serious infections. Huge risk for irreversible nephrotoxicity, so monitor renal values during administration

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10
Q

When to shock

A

Only provide defibrillator shock when pt is in Vfib or pulseless Vtach

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11
Q

Asystole

A

Flat line. No electrical activity present

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12
Q

Benztropine

A

Used to treat extrapyramidal side effects such as:

pseudoparkinsonism and dystonia (abnormal movement of face, neck and trunk)

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13
Q

Nephrotic syndrome

A 
Caused by glomerular injury
4 classic manifestations:
-proteinurea
-hypoalbuminemia
-edema
-hyperlipidemia
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14
Q

Ankylosing spondylitis

A

Inflammatory disease affecting the spine. No known cause or cure. Characterised by stiffness and fusion of axial joints leading to restricted spinal mobility.
- sleep on your back with firm mattress to stretch out spine.

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15
Q

Insulin and IV push

A

Regular insulin is the only insulin allowed to be administered IV push!

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16
Q

Phenytoin therapeutic range

A

10-20

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17
Q

Eardrops in children administration

A

Pull DOWN AND BACK in children <3 years old
Up and back for all children >3.
Place children in supine or prone position with head turned to the side

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18
Q

Calcium gluconate

A

Antidote for magnesium toxicity.

Also used to treat sever hyperkalemia

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19
Q

BP during pregnancy

A

BP has a slight decrease during the first trimester and reaches the lowest point at 24-32 wks gestation then increases back to baseline during 3rd trimester.
An increase of BP >30 SBP or >15 DBP requires further assessment.

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20
Q

Herbal remedies that increase bleeding risk

A 
G's!
Ginko
Garlic
Ginseng
Ginger
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21
Q

Desquamation

A

Peeling skin - normal finding in newborns

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22
Q

Fluid of choice for burn victims

A

Lactated Ringers

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23
Q

Sildenifil

A

Viagra - Vasodilator

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24
Q

Neonatal abstinence syndrome

A

Opioid withdrawal in newborns. Manifestations:

  • Irritability, restlessness, high pitched cry
  • Sweating, sneezing, nasal congestion
  • poor feeding, vomiting, diarrhea
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25
Q

Signs of down syndrome (trisomy 21) in newborns

A

Floppy muscle tone

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26
Q

Cleft palate

A

Sign of early prenatal exposure to teratogenic agents: alcohol, cytomegalovirus, valproic acid

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27
Q

Hypothermia

A

Heart becomes prone to dysrhythmias - spontaneous V-fib could develop when moved or touched

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28
Q

ACE inhibitors and pregnancy

A

ACE inhibitors are the “prils”

CONTRAINDICATED in pregnancy

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29
Q

Albumin

A

3.5-5.0

Albumin is assessed to evaluate nutritional status

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30
Q

Preeclampsia

A

Development of HTN during pregnancy and proteinuria - must have both

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31
Q

Head tilt/chin lift maneuver

A

Do not use in pt with potential spine injury - use the JAW THRUST TECHNIQUE

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32
Q

Suctioning tracheostomy technique

A
  • Preoxygenate with 100% oxygen
  • Suction only while withdrawing the catheter!
  • Use sterile technique
  • Limit suctioning to <10 seconds
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33
Q

Acute pancreatitis

A

NPO!

-Use suction via nasogastric tube

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34
Q

Infectious MONOnucleosis

A

Caused by the Epstein-Barr virus (EBV)

Spleen rupture is a major complication. Watch for abdominal pain as that can indicate hepatomegaly and splenomegaly

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35
Q

Reye syndrome

A

Usually occurs after a viral infection such as the chicken pox or the flu, especially if they have been taking ASPIRIN.

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36
Q

Airborne precautions

A 
N95!!!
Varicella (chicken pox)
Herpes Zoster (shingles)
TB
Measles
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37
Q

Ankylosing spondylitis characteristic

A

Early morning low back stiffness

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38
Q

Scleroderma

A

Thickening of the skin

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39
Q

Foods high in Vit K

A

Spinach, Broccoli, Liver

Avoid foods high in vit K with blood thinner therapy

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40
Q

Gonorrhea and Chlamydia

A

Lead to pelvic inflammatory disease and infertility

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41
Q

Neonates and cold stress

A

Unable to shiver

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42
Q

Dextromethorphan

A

Cough suppressant

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43
Q

Lead poisoning

A

Affects the neurological system and the kidneys

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44
Q

Adenosine

A

Treats supraventricular tachycardia

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45
Q

Torsades de pointes

A

“Twisting of the points”
Ventricular tachycardia characterized by QRS complexes that change size and shape in a characteristic twisting pattern.
Treatment: IV Magnesium

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46
Q

Pt with epilepsy and an aura

A

An aura is a sensory perception that occurs prior to having a seizure

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47
Q

Acetylcysteine

A

Bronchodilator used to help loosen secretions when given via nebulizer

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48
Q

Synchronize button when performing cardioversion

A

Very important that you push the synchronize button so it delivers the shock at the appropriate time.
Turn it off when the pt is pulseless

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49
Q

Thiamine deficiency

A

Results in Wernicke Encephalopathy

Thiamine deficiency occurs in pt’s with alcohol intoxication

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50
Q

Myelomeningocele

A

Type of spina bifida

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51
Q

Airborne precautions

A 
Do not need to wear gown or googles/eye protection
Infections that are airborne:
TB
Rubella (Measles)
Herpes Zoster (shingles)
Varicella Zoster (chicken pox)
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52
Q

Calcium and iron administration

A

Do not administer Calcium or antacids within 1 hour Iron! Decreases absorption

53
Q

Bathing clients with MRSA

A

Use chlorhexidine solution in warm water or pre moistened cloths

54
Q

Saw palmetto
Hawthorn Extract
St. John’s Wort

A

Saw Palmetto: Herbal supplement used to treat BPH
Hawthorn Extract: Herbal supplement for HF.
St. John’s Wort: Herbal supplement for depression

55
Q

Caring for newly circumcised newborn

A

Clean with warm water (no soap, no alcohol-based wipes)

56
Q 
Lobes of the brain and what they control
Frontal
Parietal
Temporal
Occipital
A

Frontal: Behavior
Parietal: Sensory
Temporal: Hearing
Occipital: Vision

57
Q

Signs of increased intracranial pressure

A

Bulging fontanelles
Sunset eyes
Increased head circumference

58
Q

SSRI’s and MAOI’s

A

Do not take concurrently! Wait 2 weeks in between.

59
Q

Major SSRI’s

A

Fluoxetine
Sertraline
Paroxetine
Citalopram

60
Q

Growth hormone replacement therapy administration

A

Subcutaneous injection

61
Q

Decerebrate posturing

A

Toes pointed downwards… indicates severe brain damage

62
Q

Hepatitis A

A

Transmitted through fecal-oral route - WASH HANDS!

63
Q

Kosher diet

A

No dairy or meat within 3 hours of each other

64
Q

Lithium therapeutic index

A

0.6-1.2

>1.5 is considered toxic

65
Q

Fifth disease

A

Viral infection common in school age children. Red rash on face. Infectious before symptoms appear, not infectious once rash appears. Usually lasts 7-10 days

66
Q

Strabismus

A

Cross eye.

Treated by wearing patch over stronger eye

67
Q

Warfarin

A

Does not begin to take effect until 48-72 hours then takes even longer to reach maximum effect. Heparin may be given at the start of warfarin therapy.f

68
Q

Antidotes for warfarin and heparin

A 
Warfarin = Vitamin K
Heparin = Protamine Sulfate
69
Q

Ventricular tachycardia

A

Pulse = treat with medications such as amiodarone

No Pulse = treat with cardioversion

70
Q

Macular degeneration
Retinal detachment
Glaucoma

A

Macular degeneration is loss of central field of vision
Retinal detachment is seeing flashes of light
Glaucoma often causes tunnel vision (poor peripheral vision)

71
Q

Testicular torsion

A

Emergency situation. Twisting of the spermatic cord leading to testicular ischemia and necrosis. Must be untwisted within 4-6 hours.
Manifestations: Edema and severe pain

72
Q

IM injections in children

A

Do not use ventrogluteal site in children <3.

Vastus lateralis muscle preferred (anterolateral thigh)

73
Q

Trismus

A

Inability to open the mouth due to a tonic contraction of the muscles used for chewing

74
Q

Complete heart block

A

Same as 3rd degree heart block

Atria and ventricles contract independently

75
Q

Addison’s disease skin

A

Bronze hyperpigmentation
Vitiligo (white patches)
Patchy/blotchy skin

76
Q

Characteristics of cushing’s syndrome

A

Purple striae
hirsutism (increased body and facial hair)
Buffalo hump (supraclavicular fat pad)

77
Q

Risk factors for preterm birth

A

INFECTION (UTI, periodontal disease, etc)

78
Q

Cyanide poisoning

A

A bitter almond smell on patient’s breath is a classic sign.

79
Q

Synchronization button when delivering shock

A 
Delivers a shock on the R wave of the QRS complex. Do not turn on during Ventricular fibrillation as there is no QRS complex!
Turn on during:
-supraventricular vtach
-Vtach with a pulse
-Afib with rapid ventricular response
80
Q

Allergy to latex

A

Can be manifested by lip swelling when in contact with bananas, kiwis, or latex balloons

81
Q

Allergies to vaccine components

A

neomycin, gelatin, yeast

Latex allergies

82
Q

Lithium toxicity

A 
Therapeutic range: 0.6-1.2
>1.5 is considered toxic
Ways to prevent lithium toxicity:
Avoid sodium depletion 
Drink a lot of fluids
83
Q

Percussing lungs

A

Hyperressonance is heard with pneumothorax and emphysema

Dullness is heard with a pleural effusion, pneumonia, or atelectasis

84
Q

Stoma color

A

Pink! It should never be dusty or grey colored. That indicates inadequate oxygen

85
Q

Testing creatinine clearance

A

24 hr urine collection

86
Q

Urinalysis and culture and sensitivity tests

A

First AM void is preferred - more concentrated urine

Clean catch or midstream urine sample

87
Q

Meningitis precautions

A

DROPLET precautions
Bedrest with HOB 10-30 degrees
High risk for seizures - seizure precautions

88
Q

Status epilepticus

A

Prolonged seizure… longer than 5 minutes. Characterized by: dazed appearance, grunting, not responding. First intervention is to administer IV or rectal benzodiazepines (diazepam or lorazepam)

89
Q

Proton Pump Inhibitors

A 
PPI's
-esomeprazole
-omeprazole
-pantoprazole
Long term use decreases absorption of calcium and promotes osteoporosis
90
Q

Dumping syndrome

A 
After a partial gastrectomy... gastric contents empty too rapidly into the duodenum causing a fluid shift.... hypotension, tachycardia, sweating, pain, dizziness...
To prevent:
-Lay down after eating
-Eat small frequent meals 
-Eat high protein and high fat meals
-No fluids with meals
-Avoid simple carbs
91
Q

Primary cause of bladder cancer

A

Cigarette smoking or other tobacco use

Painless hematuria is the tell tale sign of bladder cancer

92
Q

Hepatitis B transmission

A

Blood, semen, vaginal secretions

93
Q

Duloxetine

A

SSRI

Has both antidepressant and pain-relieving effects

94
Q

Fibromyalgia

A

Chronic pain with multiple tender points throughout the body

95
Q

Ruptured appendix

A

Pain is relieved when ruptured, but full blown sepsis and peritonitis comes shortly after.

96
Q

Codeine

A

Cough suppressant!

97
Q

Filgrastim

A

Stimulates Neutrophil count

98
Q

Normal bilirubin

A

0.2-1.2

99
Q

Aphasia

A

Loss of ability to understand or express speech caused by brain damage

100
Q

One TBSP in ML

A

1 TBSP = 15 mL

101
Q

Lithium toxicity risk factors

A

Dehydration
Decreased renal function (in elderly)
Diet low in sodium
Drug-drug interactions with NSAIDS and thiazide diuretics

102
Q

24 hr urine collection

A

Use a dark jug with powder to collect to protect the urine from light

103
Q

Ace inhibitors and pregnancy

A

-prils

Do not take during pregnancy! Teratogenic

104
Q

Addison’s disease

A 
Not enough steroid hormones
Symptoms:
-weight loss
-muscle weakness
-low BP
-hypoglycemia
-hyperpigmented skin
105
Q

Polycythemia vera

A

Too many RBCs are produced increasing blood viscosity.

Thrombus formation a big risk

106
Q

Celiac disease… foods they can’t eat

A 
BROW
Barley
Rye
Oats
Wheat
107
Q

Levetiracetam

A

Treats and prevents seizures

108
Q

MMR vaccine fun fact

A

You can administer within 6 days of exposure to MMR.

Recommended for children ages 12-15 mo

109
Q

ACE-inhibitors

A

-prils

Can cause LIFE THREATENING angioedema

110
Q

Lactase deficiency

A

Lactose intolerant

111
Q

NSAIDS

A

Indomethacin and meloxicam are also NSAIDS.

NSAIDS increase bleeding risk!

112
Q

Fat embolism

A

Defining characteristic is a fat embolism

113
Q

Statin’s adverse reaction

A

Myopathy - Muscle aches and weakness

114
Q

BNP

A

Elevated in HF!

>100

115
Q

Meningitis

A

DROPLET precautions

116
Q

Glaucoma vs macular degeneration vs cataract

A

Glaucoma: Tunnel Vision
Macular degeneration: Loss of central vision
Cataract: Blurry vision

117
Q

Desmopressin

A

Synthetic form of ADH. Used to retain fluid

118
Q

Flumazenil

A

Antidote to reverse sedative effects of benzodiazepines

119
Q

Benzotropine

A

Treats extrapyramidal effects of antipsychotics

120
Q

Chronic CHF

A

Symptoms of both Right and Left HF!

121
Q

Amnioinfusion

A

Relieves VARIABLE decelerations

122
Q

Mannitol

A

DIURETIC

123
Q

Preterm labor risks

A 
Infection such as UTI or periodontal disease
History of spontaneous preterm birth
Previous cervical surgery
Tobacco or drug use
<17 or >35
Maternal undernutrition
124
Q

Asterixis

A

Flapping tremor of the hand seen in encephalopathy

125
Q

Meningocele

A

Type of Spina bifida

-Sac like protrusion coming from the spine containing CSF and meninges

126
Q

Hemophilia

A

BLEEDING DISORDER

127
Q

Codeine

A

Cough SUPPRESSANT

-You don’t want to suppress a cough when you want to get rid of secretions

128
Q

Hemorrhagic stroke

A

Blood vessel bursts in the brain causing bleeding into the brain

NCLEX-RN (6 decks)

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