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NCLEX STUDY > Fundamentals > Flashcards

Fundamentals Flashcards

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1
Q

Hypomagnesia

A

Opposite of the prefix (high)

Tachycardia, hyperreflexia, etc

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2
Q

Hypocalcemia

A

Do the opposite of the prefix

Agitation, Irritability, 3+ or 4+ reflexes, spasm, Chvostek sign (tap the cheek) or Trousseau (inflate BP cuff)

Managed with calcitonin

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3
Q

Hypokalemia (+ Txt)

A

Symptoms go low with hypo except HR /UO

Lethargy, bradypnea, hyporeflexia (+1), tachycardia & polyuria

Txt using K+, NEVER IV PUSH K+
K+ order less than 40 mEq/L of IV fluid, more should be questioned

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4
Q

Hyponatremia

A

HypOnatremia = Overload

Crackles, distended neck veins

TXT:
Fluid restriction, Lasix

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5
Q

Hyperkalemia (+ Txt)

A

Symptoms go HIGH with hyper except HR/UO

Seizures, diarrhea, hyperreflexia (+3,+4), bradycardia, oliguria

Fastest way to lower K levels:
Give D5W, Regular Insulin, and Kayexalate

D5W, and Regular insulin draw potassium into cells and out of blood, but only temporary

Kayexalate will treat long term but takes HOURS to kick in, will cause hypernatremia managed by IV fluids

K exits LATE

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6
Q

Hypercalcemia

A

Opposite of prefix

Sedative with heavy use (hyper-)

Bradycardia, bradypnea, hypoactive reflexes, lethargy, constipation

To txt hypercalcemia, use phosphates to exchange. Calcitonin is typically given as well to compensate for overuse

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7
Q

Hypernatremia

A

hypErnatremia = dEhydration

Hot, flushed, dry skin, thready pulse, rapid HR

TXT: Give FLUIDS

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8
Q

Hypermagensia

A

Opposite of the prefix

Acts as a sedative with heavy use (hyper-)

Low symptoms: Bradycardia, bradypnea, hyporeflexia, constipation

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9
Q

Normal pH

A

7.35 - 7.45

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9
Q

Normal bicarb + symbol

A

HCO3, 22 - 26
(2 + 2 + 2 = 6)

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10
Q

If _ and _ move both in the same direction, then the acid-base imbalance is _

A

If pH and bicarb move both in the same direction, then the acid-base imbalance is metabolic

Bicarb Both Bolic

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11
Q

S/Sx of low pH

A

Acidotic; Everything low -> body shuts down

Hyporeflexia (+1), bradycardia, coma, lethargy,

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12
Q

S/Sx of high pH

A

Alkalosis; Systems are irritable

hyperreflexia (+3/+4), tachypnea, febrile

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13
Q

As the _ goes, so goes my patient except _

A

As the (pH) goes, so goes my patient except (K+)

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14
Q

MAC Kussmaul

A

Metabolic ACidosis is the only metabolic imbalance to lead to kussmaul respirations

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15
Q

If imbalance is LUNG related, it is

A

Respiratory

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16
Q

OVER-ventilating is low/high pH?

A

Alkalosis - pH is high

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17
Q

UNDER-ventilating is low/high pH?

A

Acidotic - pH is low

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18
Q

High Pressure Alarms mean what? Caused by?

A

Increased Resistance to air flow

Kinks in tubing, buildup of water in the tube, mucus plugs

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19
Q

Steps to fix high pressure alarms

A

1) Unkink
2) Empty water from tubing
3) Turn pt, ask to cough/deep breathe
4) Suction

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20
Q

Low pressure alarms mean what? Caused by?

A

Decreased resistance to air flow

1) Main tubing d/c
2) O2 sensor tubing d/c

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21
Q

Solutions for disconnects

A

Reconnect them unless tubing is on the floor, then bag patient and contact RT

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22
Q

Lithium (Indications, Therapeutic Range, Toxicity)

A

Used for bipolar disorder

Therapeutic Range = 0.6 to 1.2

Toxic > 2.0

(2s: Low # Lithium & Lanoxin)

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23
Q

Lanoxin (Indications, Therapeutic Range, Toxicity)

A

Used for A-fib/CHF (Digoxin)

Therapeutic Range = 1 to 2

Toxic > 2.0

(2s: Low # Lithium & Lanoxin)

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24
Aminophylline (Indications, Therapeutic Range, Toxicity)
Muscle spasm relaxer for the airway (paradoxical bronchospasm) (If bronchodilator do not work -> Aminophylline Therapeutic = 10 - 20 Toxic >= 20 Non-therapuetic = less than 10 If not therapeutic, increase dose and assess compliance 20s: High # (Aminophylline, Dilantin, Bilirubin)
25
Dilantin (Indications, Therapeutic Range, Toxicity)
Seizure medication Therapeutic: 10-20 Toxic >= 20 20s: High # (Aminophylline, Dilantin, Bilirubin)
26
Bilirubin (Indications, Therapeutic Range, Toxicity)
Breakdown product of RBC's Normal levels in adults: 0.2 - 1.2 In newborns, much HIGHER Elevated level 10-20 Toxicity > 20 Hospitalize around 10-15 20s: High # (Aminophylline, Dilantin, Bilirubin)
27
Jaundice
Yellowing of the skin from excess bilirubin in blood Visible at > 20 levels
28
Pathological Jaundice vs Physiological Jaundice
Pathological - Born yellow Physiological - Turns yellow after 1-2 days
29
Dumping syndrome (S/Sx, Txt)
Gastric content dumped too quickly Right direction - wrong rate Drunk + Shock + Acute Abdominal Distress = Dumping Impaired judgement, cold/clammy, tachy, N/V, diarrhea, borborygmi, guarding Txt: Lower HOB during meals and turn patient Decrease fluid content 1/2 hours before/after meals Decrease amount of carb content Everything LOW HIGH Protein diet
30
Protein in digestion
Opposite of carbs; longer digestion High protein diet - dumping Low protein diet - hiatal hernia
31
Hiatal Hernia (S/Sx, txt)
Regurgitation of gastric acid upward or backward into esophagus Wrong direction, right rate S/Sx similar to GERD; heartburn, indigestion on lying down after eating Txt: Elevate HOB during + 1 hour after meals Increase amount of fluids with meals Increase the amount of carb content HIGH-anal hernia = Everything HIGH (except protein)
32
Memorize these 3 sentences: _ do the same as the prefix (hypo-, hyper-) except _ and _, which go opposite _ do the opposite as the prefix _ do the opposite as the prefix
Kalemias do the same as the prefix (hypo-, hyper-) except HR and UO (urine output), which go opposite Calcemias do the opposite as the prefix Magnesimia do the opposite as the prefix
33
What two electrolyte imbalances are possible in DKAs
Hyperkalemia Hypernatremia
34
Earliest sign of electrolyte imbalance
Numbness and tingling = paresthesia
35
Universal sign of electrolyte imbalance
Muscle weakness = Paresis
36
HELLP Syndrome
Hemolysis, Elevated Liver Enzymes, Low Platelets Definitive txt is giving birth
37
Kawasaki Disease
Systemic inflammation of arterial walls Txt: IV Immunoglobulin & Aspirin (Peds exception)
38
Tumor Necrosis Factor (meds, considerations)
Immunosupprresing medications Should not have any active infections, test for TB prior to starting as latent TB can become active TB Ex: Adalimumab (suffix -mab)
39
Live Vaccines
Polio, Rotavirus, Measles Mumps & Rubella, Varicella, Yellow Fever
40
Preconception Counseling
Folic acid supplements (400 mcg/daily) Rubella immunity Dentist appt for peridontal disease
41
Sjoren Syndrome
Chroic autoimmune disorder where moisture-producing exocrine glands are attacked by WBCs
42
Angiotensin-Converting Enzyme (ACE) inhibitors
"-pril" Used for treatment of high BP by inhibiting Angiotensin 2 production May cause hyperkalemia Used for kidney protection but still can cause harm
43
Purpura
Small blood vessels under skin (red dots)
44
Sunburn txt
Fluids, cool compress, no aspirin for peds
45
Complications with digoxin (other name)
Lanoxin - Digoxin toxicity (greater than 2) Monitor for hypokalemia
46
Sulfalazine
Used to treat IBD and rheumatoid arthritis S;Sx: Crystalluria, photosensitivity, folic acid deficiency, SJ syndrome
47
Beta-Blockers
"-olol" suffix Like vallium for your heart, measure BP and HR prior to admin Used for diabetes w hypertension & proteinuria Decreased C/O Negative chronotrope & inotrope (slows HR and strength of HR contraction) Anti-arrythmic
48
Serotonin Syndrome
Life-threatening condition caused by excess serotonin in the CNS S/Sx: Mental status change (anxiety), autonomic dysregulation (tachy, htn, diaphoresis), neuromuscular hyperactivitiy Txt: D/C sertraline agents -> administer benzodiazepines to prevent seizure onset
49
Angiotensin Receptor Blockers (ARBs)
("-sartans") Treats high blood pressure and heart failure, can be used for CKD Considerations: Can cause hyperkalemia
50
Intussception
Occus when one section of bowel telescopes over another S/Sx: Inconsolable crying, legs to abdomen, "currant jelly" stools (blood/mucus), palpable sausage-shaped mass in abdomen Can lead to bowel resection, perforation, decreased blood supply
51
Impetigo
Rash with red base and honey-colored crusts Highly infectious bacterial infection in children
52
Low platelets _ chance of bleedings
Increases (less likely to clot)
53
Herpes Type 1
Life-long virus, periods of dormancy/flares Contagious during flares Tingling sensation Ereythamous skin lesions -> rupture -> crust
54
1 mg = _ mcg
1000 mcg
55
1 kg = _ lbs
2.2 lbs
56
Rheumatoid arthritis
Autoimmune inflammatory response in synovial joints, symmetric Systemic Sx: Fever, Fatigue, Weight loss Small joints of hands/feet first -> wrists/elbows/shoulders/knees Med: Methotrexate + NSAIDs
57
Thrombolytics
Used to lyse thrombi (clots) and restore perfusion tPA is commonly used Contraindicated if major surgery last 2 weeks, can cause life-threatening bleeds
58
Methatrexate
Antirheumatic - immunosuppressing
59
Osteoarthritis
Ages 40+ Asymmetric and non-inflammatory that worsens over time No systemic Sx Mainly weight-bearing joints (hips, knees)
60
Noncomediogenic
Does not clog pores
61
Narcissistic Personality Disorder (NPD)
Recurrent pattern of grandiosity, need for admiration, and lack of empathy Fragile self-esteem AND fear of abandonment
62
Heart Failure Symptoms
Elevated B-type natiuretic peptides S1/S2/S3 heart sounds Crackles (PE)
63
Skin Cancer Examination Rules
ABCDE Asymmetry Border Irregularity Color changes + Variation Diameter of 6 mm or larger (pencil eraser) Evolving (changing aspects)
64
Minimizing GERD in pregnant patients
Small, frequent meals Eliminating fried/fatty foods do NOT lie down after meals Cluster fluid intake between meals
65
Tricyclic Antidepressant OD Sx
"-tyline" suffix Tachy, orthostatic hypotension, AMS, hypoactive bowel sounds, pupillary dilation Causes QRS + QT elongation -> cardiac arrest
66
Sodium Bicarbonate use via IV
Narrows QT interval
67
Hyperemesis leads to which electrolyte imbalance?
Hypokalemia
68
Indication for Activated Charcoal
Needs to be given within 1-2 hours of toxin ingestion to be effective
69
Nitrazine pH test
Turns blue when exposed to amniotic fluid/alkalytics Semen and blood can trigger false positives
70
Vitamin C & Iron Relationship
Vitamin C increased iron absorption
71
Use of laxatives in pregnancy
Not indicated d/t risk of electrolyte imbalance, stool softener should be used instead
72
Chest drainage rate concern
Greater than 100 mL/hr
73
Approximate normal urine output
~ 30 mL/hr

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