NCLEX Flashcards
(334 cards)
1
Q
normal sodium
A
135-145
2
Q
normal potassium
A
3.5-5.0
3
Q
normal calcium
A
9.0-10.5
4
Q
normal magnesium
A
1.3-2.1
5
Q
normal phosphorous
A
3.0-4.5
6
Q
normal BUN
A
10-20
7
Q
normal creatinine
A
0.6-1.2 (males)
0.5-1.1 (females)
8
Q
normal glucose
A
70-105
9
Q
normal HgbA1c
A
<6.5%
10
Q
normal WBC
A
5,0000-10,000 / mm3
11
Q
normal RBC men
A
4.7-6.1 million/mm3
12
Q
normal RBC women
A
4.2-5.4 million/mm3
13
Q
normal hemoglobin men
A
14-18 g/100 ml
14
Q
normal hemoglobin women
A
12-16 g/100 ml
15
Q
normal hematocrit men
A
42-52%
16
Q
normal hematocrit women
A
37-47%
17
Q
normal platelets
A
150,000-400,000 / mm3
18
Q
normal ph
A
7.35-7.45
19
Q
normal CO2
A
35-45 mm hg
20
Q
normal PO2
A
80-100 mmhg
21
Q
normal HCO3
A
21-26 mmol/L
22
Q
normal PT
A
11-12.5 seconds
23
Q
normal INR
A
0.7-1.8
24
Q
normal PTT
A
30-40 seconds
25
digoxin normal levels
0.5 - 2.0 ng/ml
26
normal lithium
0.8-1.4 meq/l
27
normal phenytoin levels
10-20 mcg/ml
28
normal theophylline
10-20 mcg/ml
29
airborne precautions
measles
chicken pox
herpes zoster
TB
30
how to manage airborne diseases
neg pressure room
private room
n-95 for TB
mask
31
droplet precautions
-Sepsis
-Scarlet Fever
-Strep
-Pertussis
-Pneumonia
-Parvovirus
-Influenza
-Diphtheria
-Epiglottitis
-Rubella
-Mumps
-Adenovirus
32
droplet mgmt
private room
mask
33
contact precautions
MRSA
VRSA
RSV
skin infections (impetigo)
wound infections
enteric infections (c. diff)
eye infections
34
management for contact precautions
gowns
gloves
goggles
private room
35
what kind of drug is amitriptyline
tricyclic antidepressant
anticholingeric
36
how often do you apply a new transdermal nitrate patches
every morning to a new site
37
how is vanc administered
IV, slowly over 60 mins
38
what is alosetron used for
IBD in women
39
what kind of drug is famotidine
H2 receptor antagonist
suppress gastric acid secretion
40
what do bile acid sequestrants do
decrease LDL cholesterol
41
what is a complication of bile acid sequestrants (the coles)
constipation
42
how does leuprolide work
prevents release of LH and FSH to prevent testosterone production
43
adverse effects of thionamides (methimazole)
hypothyroidism
agranulocytosis
hepatits/liver injury
44
what drugs can delay progression of diabetic nephropathy
ARBS (sartans)
45
what is bethanechol used for
muscarinic agonist
used for nonobstructive urinary retention
46
should you take ferrous sulfate with food?
no - decreases absoprtion
47
nitrofurantoin: what is it used for
treat UTIs
48
how does ginger impact blood sugar
decreases blood sugar
49
activated clotting time normal range
70 to 120
50
what is ciprofloxacin used for
UTIs
51
side effects of ciprofloxacin
GI discomfort, tendon rupture, photosensitivity, suprainfection
52
4 Es for angina precipitating factors
exertion
eating
emotional distress
extreme temperatures
53
4 Ps of arterial occlusion
pain
pulselessness
pallor
paresthesia
54
how to treat CHG (MADD DOG)
morphine
aminophylline
digoxin
dopamine
diuretics
oxygen
gasses (monitor ABGs)
55
heart murmur causes
stenosis of valve
partial obstruction
aneurysm
septal defect
mitral regurgitation
56
signs of stroke
facial drooping
arm weakness
speech slurred
time to call 911
57
5 ps of compartment syndrome
pain
pallor
pulselessness
paresthesia
paralysis
58
signs of shock (CORD ITEM)
cold clammy skin
hypotension
oliguria
rapid, shallow breathing
drowsiness, confusion
irritability
tachycardia
elevated or reduced CVP
multi-organ damage
59
signs of hypoglycemia
TIRED
tachycardia
irritability
restlessless
excessive hunger
depression and diaphoresis
60
hypocalcemia signs (CATS)
CATS
convulsions
arrhythmia
tetany
stridor and spasms
61
hypokalemia signs (6 Ls)
lethargy
leg cramps
limp muscles
low, shallow, respirations
lethal cardiac dysrhythmias
lots of urine
62
early warning signs of cancer (CAUTION UP)
Change in bowel or bladder
A lesion that does not heal
Unusual bleeding or discharge
Thickening or lump in breast or elsewhere
Indigestion or difficulty swallowing
Obvious changes in wart or mole
Nagging cough or persistent hoarseness
Unexplained weight loss
Pernicious Anemia
63
leukemia signs and symptoms (ANT)
Anemia and decreased hemoglobin
Neutropenia and increased risk of infection
Thrombocytopenia and increased risk of bleeding
64
patients who require dialysis
Acid base imbalance
Electrolyte imbalances
Intoxication
Overload of fluids
Uremic symptoms
65
asthma mgmt
Adrenergics: Albuterol and other bronchodilators
Steroids
Theophylline
Hydration: intravenous fluids
Mask: oxygen therapy
Antibiotics (for associated respiratory infections)
66
pneumothorax signs
Pleuritic pain
Tracheal deviation
Hyperresonance
Onset sudden
Reduced breath sounds (and dyspnea)
Absent fremitus
X-ray shows collapsed lung
67
dysphagia mgmt
Modifying the texture of foods and the consistency of liquids may enable the client to achieve proper nutrition.
Place the client in an upright or high-Fowler’s position to facilitate swallowing.
Provide oral care prior to eating to enhance the client’s sense of taste.
Allow adequate time for eating, utilize adaptive eating devices, and encourage small bites and thorough chewing.
Avoid thin liquids and sticky foods
68
what is dumping syndrome
occurs as a complication of gastric surgeries that inhibit the ability of the pyloric sphincter to control the movement of food into the small intestine.
This “dumping” results in nausea, distention, cramping pains, and diarrhea within 15 min after eating
69
how to manage dumping syndrome
Small, frequent meals are indicated.
Consumption of protein and fat at each meal is indicated.
Avoid concentrated sugars.
Restrict lactose intake.
Consume liquids 1 hr before or after eating instead of with meals (a dry diet)
lie down after meals
70
how to manage peptic ulcer disease
Avoid eating frequent meals and snacks, as they promote increased gastric acid secretion.
Avoid alcohol, cigarette smoking, aspirin and other NSAIDs, coffee, black pepper, spicy foods, and caffeine
71
during acute diverticulitis do you want a low or high fiber diet
a low-fiber diet is prescribed in order to reduce bowel stimulation.
high fiber diet may prevent in the long term
72
what is an early sign of shock
narrowing pulse pressure
increase in diastolic BP
73
cleft lip nursing care plan
Crying, minimize
Logan bow
Elbow restraints
Feed with Brecht feeder
Teach feeding techniques; two months of age (average age at repair)
Liquid (sterile water), rinse after feeding
Impaired feeding (no sucking)
Position—never on abdomen
74
HELLP syndrome: what is it
complication of severe pre-eclampsia
Hemolysis
Elevated Liver enzymes
Low Platelet count
75
4Ps of labor
Powers
Passageway
Passenger
Psych
76
5 infections during pregnancy
TORCH
Toxoplasmosis
Other (hepatitis B, syphilis, group B beta strep)
Rubella
Cytomegalovirus
Herpes simplex virus
77
potential problems with an IUD
PAINS
Period (menstrual: late, spotting, bleeding)
Abdominal pain, dyspareunia
Infection (abnormal vaginal discharge)
Not feeling well, fever or chills
String missing
78
what does APGAR stand for
Appearance
Pulse
Grimace
Activity
Respiratory effort
79
GTPAL
Gravida
Term
Preterm
Abortions (SAB, TAB)
Living children
80
signs of problems with oral contraceptives
ACHES
Abdominal pain (possible liver or gallbladder problem)
Chest pain or shortness of breath (possible pulmonary embolus)
Headache (possible hypertension, brain attack)
Eye problems (possible hypertension or vascular accident)
Severe leg pain (possible thromboembolic process)
81
anticipated problems with premature infants
Temperature regulation (poor)
Resistance to infections (poor)
Immature liver
Elimination problems (necrotizing enterocolitis [NEC])
Sensory-perceptual functions (retinopathy of prematurity [ROP])
82
VEAL CHOP
Variable decels => Cord compression (usually a change in mother’s position helps)
Early decels => Head compression (decels mirror the contractions; this is not a sign of fetal problems)
Accelerations => O2 (baby is well oxygenated–this is good)
Late decels => Placental utero insufficiency (this is bad and means there is decreased perfusion of blood/oxygen/nutrients to the baby).
83
postpartum assessment
B- Breasts
U- Uterus
B- Bladder
B- Bowel function
L- Lochia
E- Episiotomy
H- Hemorrhoids
E- Emotional Status
R- Respiratory System
84
placenta previa
low lying placenta
85
placenta abruptio
premature separation of the placenta
86
risk factors for placenta previa
Increased parity
Advanced maternal age
Past cesarean births
Past uterine curettage
Multiple gestation
87
risk factors for placenta abruptio
High parity
Advanced maternal age
A short umbilical cord
Chronic hypertensive disease
Pregnancy-induced hypertension
Direct trauma
Vasoconstriction from cigarette use
Thrombic conditions that lead to thrombosis such as autoimmune antibodies
88
does bleeding occur with placenta previa
always, bright red
89
does bleeding occur with placenta abruption
may or may not be present, will be dark red
90
is there pain during bleeding with placenta previa
never
91
is there pain during bleeding with placenta abrutpion
sharp, stabbing pain
92
can you perform pelvic or vaginal exams with placenta abruptions or previas?
NEVER
93
AEs of phenytoin
P - interactions
H irsutism
E nlarged gums
N ystagmus
Y ellow-browning of skin
T eratogenicity
O steomalacia
I nterference with B metabolism (hence anemia)
N europathies: vertigo, ataxia, headache
94
antiparksonian drugs (a cat does like milk)
A nticholinergic Agents
C OMT Inhibitors (catechol-O-methyltransferase); An enzyme involved in degrading neurotransmitters.
D opamine Agonists
L evodopa
M AO-B Inhibitors
95
what diet do patients with maternal PKU need to follow
low protein diet 3 months prior to pregnancy and throughout pregnancy
96
normal bilirubin levels for new born
24 hours: 2-6
48 hours: 6-7
3-5 days: 4-6
97
patent ductus arteriosus
the area between the pulmonary artery and aorta remains open, allowing the blood to flow through the patent ductus arteriosus and back to the pulmonary artery and lungs
98
signs of Intussusception
Normal comfort interrupted by periods of sudden and acute pain
* Palpable, sausage-shaped mass in the right upper quadrant of the abdomen and/or a tender, distended abdomen
* Stools that are mixed with blood and mucus that resemble the consistency of red currant jelly
99
conditions requiring droplet percautions
Hib, pertussis, mumps, rubella, plague, streptococcal pneumonia, meningococcal pneumonia
100
conditions requiring airborne precautions
measles, varicella, TB
101
what are 4 components of a mental status exam
Level of consciousness
Physical appearance
Behavior
Cognitive and intellectual abilities
102
classic symptoms of depression
change in sleep patterns,
indecisiveness,
decreased concentration,
or change in body weight
103
therapeutic lithium levels
0.8-1.4
104
cocaine intoxication symptoms
fevers, hallucinations, tachycardia, hypertension, chest pain, seizures, possible cardiac collapse and death
105
lithium AEs (therapeutic levels)
GI distress (nausea, diarrhea)
fine hand tremors
weight gain
polyuria
106
Assertiveness training
Teaches clients to express feelings and solve problems in a nonaggressive manner
Through therapy, this client can change their thinking to realize that they might have made some bad choices, but that they are not "a bad person." The client learns to communicate in a more assertive manner in order to decrease psychological stressors. Therapy teaches the client to assert their feelings by describing a situation or behavior that causes stress, discussing feelings about the behavior or situation, and then making a change.
107
what is true about an incident report
a. risk mgmt investigates
b. include description of incident and actions taken
c. it is confidential
d. document completion in nurses's notes
e. include in client's health record
a, b, c
108
what is an early sign of hemorrhage
increased HR
109
how long are is a pt on blood thinners after a surgery?
usually about a month
110
five rights of delegation
person
task
circumstance
directions
supervision
111
can a UAP get a urine specimen from a catheter
no because it is sterile! only RN and LPNs can do sterile procedures
bladder is sterile
112
what type of patients can LPNs receive
stable patients w/ predictable outcomes
patients that need reinforcing of education
data collection
*they do not hang first bag of anything
113
UAPs can care for
ADLs
vital signs
weight
is & os
safety
114
what two patients are weighed everyday
heart failure
renal patients
115
which medications are priority
scheduled
116
what strategy is implemented when nurse gives patient medications prior to family visit
maslow's
117
can uncontrollable seizures disorders be disclosed to DMV
yes
118
three types of consent
general
implied
informed
119
if there is a fire, who would you evacuate first
most mobile
whoever needs the most help - evacuate last
120
which culture believes health is achieved by restoring balance
asian american
121
which culture believes you can speed healing with soups and herbal teas
hispanic
122
when would you apply a tourniquet (iv complication)
catheter embolus
123
when would you apply light pressure (iv complication)
hematoma
124
when would you elevate and apply cold compress (iv complication)
infiltration
125
when would you aspirate a drug if possible (iv complication)
extravasation
126
when would you apply a warm compress (iv complication)
phlebitis
127
4 complications with central venous catheters
pneumothorax
air embolism
occlusion
infection
128
what drug can cause angioedema
Ace inhibitors
129
what drug can increase HF
CCBlockers
130
which drug should be used in caution with asthma
beta blockers
131
what drugs can cause rapid drop in BP
vasodilators
132
which drugs are contraindicated with anticoags
alpha 2 agonists
133
can you take an oral hypoglycemic while pregnant
no, need to to switch to insulin
134
what increases iron absorption
vit C
135
what decreases iron absorption
Ca and tannin
136
liquid iron: how should pts take?
use straw and rinse mouth
137
which 2 antibiotics are nephrotoxic
vancomycin
gentamicin
138
CIs for levodopa
MAOIs
narrow angle glaucoma
139
how far should someone be from someone with radiation therapy
6 ft
for a max of 30 mins
140
what are the steps of turning an immobile patient to right side
1. place bed supine and move to side of the bed
2. flex left knee and roll toward nurse
3. place pillow under head and neck
4. move right shoulder forward
5. position pillows to maintain alignment
6. position arms
141
what does the acrononym PRESSURE stand for
preventable
risk assessment
early skin observation
set up appropriate mattress
seat cushions
use wound assessment tools
reposition regularly
evaluate effectiveness
142
when using a cane, do you hold it on the side of weakness or stronger/unaffected side
use cane on stronger side to provide support
143
when using the cane do you move the cane with the stronger or weaker leg
w/ the weaker leg
144
when walking up stairs with crutches, do you move the unaffected or weaker leg first
unaffected , then crutches with weaker leg
145
when walking down the stairs, do you move unaffected or weaker leg first
weaker leg first with crutches then unaffected leg
146
what is the most effective spill mgmt technique for someone with AIDS
disinfect area with 10% bleach solution after initial cleaning
147
what lab values will elevate if a patient is dehydrated secondary to vomiting
serum ph
hct
urine osmolarity
urine specific gravity
148
therapeutic signs of KCL infusion for someone who was hypokalemic
reports leg cramps are no longer present
serum potassium is higher
149
peaked t waves - hypo or hyperkalemia
hyperkalemia
150
if you know patients weight, what is desired urine output
0.5 ml/kg/hr
151
would decreased insulin cause metabolic acidosis or alkalosis
acidosis
152
if you have diarrhea, are you losing acid or base
base - losing bicarb
will be metabolic acidosis
153
match symptoms:
chronic bronchitis
emphysema
asthma
lung cancer
TB
pneumonia
night sweats
pleuritic pain
pursed lip breathing
hemoptysis
bronchospasm
tenacious sputum
chronic bronchitis - tenacious sputum
emphysema - pursed lip breathing
asthma - bronchospasm
lung cancer - hemoptysis
TB - night sweats
pneumonia - pleuritic pain
154
what do you need to do before and after a bronchoscopy
assess gag reflex
155
is bubbling in suction chamber good or bad
good
156
what should you observe in the water seal chamber
tidaling with inspiration and expiration
157
if tidaling in the chamber stops, what might that indicate
kinks/obstruction
lung might have re-expanded
158
diet recommendation for acute cholecystitis
low fat diet with food rich in HDL
fats will cause more bile
159
how are meds given through NG tube
one at a time and flushing in between
160
what would be included in a low fiber and low residue diet
cream of wheat
puffed rice cereal
canned green beans
161
colostomy care instructions
clip hair around peristomal site
empty when 1/3 full
add cranberry juice and yogurt to your diet (help with odor)
162
match the symptom
cirrhosis
hepatitis
pancreatitis
pancreatic cancer
malnutrition
fatigue and anorexia
bleeding
flu like symptoms
cirrhosis - bleeding
hepatitis - flu like symptoms
pancreatitis - malnutrition
pancreatic cancer - fatigue and anorexia
163
fat emoli are most common with fractures in which types of bones
pelvis and long bones
164
s/s of fat emboli
confusion
tachycardia
chest pain
tachypnea
hemoptysis
petechiae over neck, upper arms, chest and abdomen (late sign)
165
6 ps of compartment syndrome
pain
pallor
pressure
paresthesia
paralysis
pulselessness
166
what are the levels of phosphorous and calcium in hypoparathyroidism
hyperphosphatemia
hypocalcemia
167
normal phosphorous
3.0-4.5
168
left sided HF manifestations (4)
left = lungs
dyspnea
frothy sputum
crackles
cough
169
right sided HF
right = rest of the body
JVD
weight gain
edema
170
what is the primary cause of right sided HF
left sided HF
171
s/s of venous insufficiency
painless ulcers
lower leg edema
hyperpigmentation
172
s/s of arterial insufficiency
claudication
delayed CRT
hair loss on legs
cyanotic extremities
173
early s/s of shock
pallor
tachypnea
confusion
tachycardia
174
late s/s of shock
cold, moist skin
weak/thready pulse
anuria
metabolic acidosis
hypotension
175
s/s of DKA
confusion
tachycardia
hematocrit level increased
decreased LOC
176
s/s of HHS
confusion
tachycardia
increased HCT
gradual sympton onset
decreased LOC
177
s/s of hypoglycemia
confusion
tachycardia
decreased LOC
178
what do you do if only half the dialysate is returned after PD
reposition client by turning side to side
179
actions to prevent autonomic dysreflexia
promote high fiber diet and use of stool softeners
monitor patency of indwelling bladder catheter
180
which procedure tells the type of CVA
Ct scan
181
teaching for patients wtih WBC of 1000
rinse toothbrush in bleach solution
wash dishes in hot, soapy water or dishwasher
report fever over 100.0
avoid fluids that have been unrefrigerated more than 1 hour
182
what would indicate effective response to therapy for ADIS patient
lack of pulmonary infiltrates
183
parkland formula
LR
4 ml x kg x % TBSA
1/2 of that total goes in first 8 hours
1/2 in remaining 16 hours
184
sickle cell priorities
HOP
hydrate
oxygenate
treat pain
185
valerian root
used to prevent insomnia or reduce anxiety related restlessness
additive when combined with barbs or benzos
186
how does garlic impact cholesterol
lowers triglycerides and LDL
raises HDL
*increases risk for bleeding
187
benefits of ginko biloba
increases blood flow to brain
improve memory
decrease pain
188
black cohost
estrogen substitue
shouldn't be taken for more than 6 months
189
which 5 herbal supplements interfere with anticoagulants/bleeding risk
garlic
ginger
ginkgo
ginseng
saw palmetto
190
what kind of drug is olanzapine
atypical / SG antipyschotic
191
early signs of lithium toxicity
lethargy
dehydration
slurred speech
192
late signs of lithium toxicity
blurred vision
193
normal lithium levels
0.4-1.4
194
cluster A personality disorders
paranoid
schizoid
schizotypal
195
cluster B personality disorders
antisocial
borderline
narcisstic
histrionic
196
cluster c personality disorders
dependent
ocd
avoidant
197
what can bupropion be used for
nicotine
amphetamines
198
manifestations of opioid withdrawal
yawning
insomnia
panic
diaphoresis
cramps
N/V
chills
fever
diarrhea
199
sources of b 12
animal products
(yogurt, liver)
200
signs of cold stress in baby
cool, cyanotic extremities with warm trunk
201
what is important when admitting a child to a hopsital
knowing their routines and rituals
202
who can sit unsupported with crude pincer grasp
8 months
203
how old: solid foods introduced and separation anxiety begins
4 months
204
posterior fontanel closes: when
6-8 weeks
205
receives first flu vaccine
6 months
206
when does anterior fontanel close
12-18 months
207
how old: birth weight doubles and rolls from front to back
5 months
208
when does birth weight triple and they can walk with help
12 months
209
how old: ritualism and separation anxiety peaks
toddler (1-3 yrs)
210
how old: rides a tricycle and alternates feet going up and down steps
3 years
211
how old: can jump rope and tie shoelaces
5 years
212
how old: pretend play and magical thinking
preschooler (3-6 years)
213
how old: walks independently and can use a cup well
15 months
214
how old: skips and hops, throws ball over head, catches ball reliably
6 years
215
tet spells triggers
upon awakening
during feeding
after crying
during painful procedures
216
what is the best way to measure hydration?
weight
217
a loss of 0.5kg body weight is equal to ____ of water
500 ml
218
a nurse assess a toddler who has a 36 hour history of vomiting and diarrhea. what should be reported to provider?
absence of tears
skin cool and clammy
6% loss of body weight
blood pressure 78/52
219
tonsillectomy sign of hemorrhage
frequent swallowing
frequent throat clearing
hematemesis
220
tonsillectomy: when is hemorrhage most likely to occur
first 2 days and again approx one week
221
what is the most common mode of transmissoin
airborne
222
what is the desired effect of pancrelipase powder
steady weight/height gain
223
can an lpn administer albumin
no considered a blood product
224
can an lpn hang the first bag of fluids/meds
no
225
what is the triad of fat embolism syndrome
hypoxemia
neurological symptoms
petechiae
226
how do steroids impact serum calcium levels
decreases GI absorption of Ca
227
why does corticosteriods cause hypervolemic hypernatremia
aldosterone - helps retain Na (and water)
228
causes of hypernatremia
MODELS
medications (corticosteriods)
osmotic diuretics
diabetes insipidus
excessive H2O loss
low H2O intake
sodium intake too high
229
hypernatremia s/s (fried & salted)
fever (low grade)
restlessness & agitation
increased fluid retention
edema
dry mouth
skin flushed
altered loc & confusion
low UO
thirst
elevated BP
decreased energy (lethargy)
230
mgmt of hypernatremia - FLAG
free water
loop diuretics
agent causing (remove)
give fluids IV
231
causes of hyponatremia (MOBS FAIL)
meds (diuretics)
oral gastric tube suctioning
burns
SIADH
failure: heart, kidney, liver
232
s/s of hyponatremia (LOW SODIUM)
LOC altered
orthostatic hypotension
weak muscles
seizures
osmolality low
diarrhea
increased ICP
urine osmolality high
more bowel sounds
233
normal chloride levels
96-108
234
what medications elevate K+
ace inhibitors
K+ sparing diuretics
235
causes of hyperkalemia (MACHINE)
medication
acidosis
cellular destruction
hypoaldosteronism
intake
nephrons failure
excretion impaired
236
hyperkalemia s/s (MURDER)
muscle cramping
urine abnormalities
resp distress
decreased cardiac contractility
ekg changes
reflexes (depressed/ absent)
237
3 tx that drive potassium into cells
d5w with regular insulin
albuterol
bicarb
238
3 tx that reduce total body potassium
kayexalate
diuretics
dialysis (only in severe cases)
239
hyperkalemia management (CRIED)
calcium IV
remove sources of K+
increase K+ secretion
enhance K+ uptake into cels
dialysis
240
casues of hypokalemia (DITCH)
drugs (diuretics, corticosteroids)
inadequate K+ intake
too much water
cushing's disease
heavy fluid loss
241
EKG change with hypokalemia?
prominent u-wave (after t wave)
242
hypokalemia mgmt (POD)
potassium IV (never IV PUSH)
oral potassium
diet rich in potassium
243
causes of hypercalcemia (MD spied)
malignancy
diuretics
steroids (causes bone breakdown --> Ca released into blood)
parathyroid (hyper)
immobilization
endocrine (Addison's)
vitamin D
244
causes of hypocalcemia CHAMP
celiac, crohn's
hypoparathyroid, hyperphos
alcoholism
malnutrition, malabsorption
pancreatitis
245
hypocalcemia s/s (CATS)
convulsions (irritable)
arrythmias
tetany
spasms
246
causes of hyperphosphatemia
malnutrition
alcoholism
TPN
tumor lysis syndrome
hyperparathyroidism --> hypercalcemia --> hypophosphatemia
247
s/s of hypercalcemia
sedated! it slows things down
weakness
flaccidity
decreased peristalsis
hypoactive bowel sounds
bradycardia
decreased LOC
248
causes of hypomagnesemia
alcoholism
malnutrition
malabsorption
hypoparathyroidism
hypocalcemia
diarrhea
249
what electrolyte imbalance can cause torsade de pointes
hypomagnesemia
250
does renal failure increase or decrease magnesium
increase -- causes retention of magnesium
251
normal urine specific gravity
1.005-1.030
252
what is simethicone and what is it used for
relives cramping and promotes gas release
253
what happens to progesterone and estrogen when the placenta is delivered
decrease --> results in increase in prolactin
254
risk factors for ovarian cancer
nulliparity
advancing age
family history
early menarche
BRCA variants
255
when should you take corticosteroids
morning with food
256
s/s of hepatitis A
nausea, vomiting, abdominal pain, fever, anorexia, dark urine, scleral icterus, pale stools, jaundice, and pruritus
257
what is scleral icterus
yellowing of sclera
258
what is the most accurate way to determine if a patient is infectious with TB
sputum culture
259
what does a quantiferon gold test do?
serum test that results in approximately 24 hours. This also would determine if the client was exposed and not an active infection
260
what kind of foods are high in PKU
foods with protein or dairy
261
what is Isosorbide
nitrate medication
262
what is therapeutic aPtt on heparin
1.5-2.5x normal which is 30-40 seconds
263
normal INR
0.9-1.2
264
therapeutic INR on warfarin
2-3
265
normal alaklinezymes increase when there is an issue
alkaline phosphatase
asparatate aminotransferance (AST)
alanine aminotransfer (ALT
266
normal alkaline phosphatase
30-120
267
normal AST
0-35
268
normal ALT
4-36
269
normal albumin
3.5-5
270
normal ammonia
15-110
271
normal residual from NG tube
<500 ml in an adult
272
first, second and third line medications in shock
dopamine
phenylephrine
vasopressin
273
do you perspire in heat stroke or heat exhaustion
both!
274
how is heat stroke different from heat exhastuion
heat stroke has temp above 104 + lethargy and confusion
275
5 signs of transfusion reaction
low back pain
SOB
apprehension
chills
itching
276
side effect of amphotericin b
hypokalemia
nephrotoxic
277
what two conditions are associated with reye syndrome
influenza
varicella
278
3 lab values to monitor with lithium
creatinine (d/t being nephrotoxic)
TSH (can cause hypothyroidism)
sodium (hyponatremia can lead to lithium toxicity)
279
what is Sevelamer
a phosphate binder indicated for individuals with chronic kidney disease (CKD).
This medication inhibits phosphorus absorption, thereby increasing the calcium level.
280
what is the target for H1Ac for diabetcis
less than 7%
281
what is macewan's sign
Macewen’s sign is an indication of hydrocephalus. This sign is positive when the nurse percusses the skull bones and hears a ‘cracked-pot’ sound. This sound is due to thin, widely separated skull bones with hydrocephalus.
282
when is hospice offered
when life expectancy is less than 6 months
283
kubler stages of grief
denial
anger
bargaining
depression
acceptance
284
is NPO appropriate on palliative care
yes
285
what does black triage tag mean
expectant
deceased or not likely to survive
agonal breathing or brain matter exposed
286
what does red triage tag mean
see first! needs immediate intervention
287
what does yellow triage tag mean
see second
delayed attention
288
what does green triage tag mean
see last
non-urgent
can send to urgent care, lacerations, anxious
289
what is performance improvement
establishes a system of formal eval for job performance and recommends ways to improve perf
290
what is quality mgmt
act of overseeing all activities and tasks needed to maintain excellence
291
can you delegate obtaining pt history
yes
292
what is licorice extract used for
ulcers, bronchitis
293
what are risks associated w/ licorice extract
acts like aldosterone
HTN
hypokalemia
294
what does resonance mean for percussion
dullness, hollow
should hear over air in the lungs
295
what goes tympany indicate for percussion
fluid
usually over abdomen
296
s1
mitral and tricuspid valves close
systole
297
s2
aortic and pulmonic valves close
diastole
298
when does s3 occur
after s2
volume overload like CHF
299
when does s4 occur
before s1
due to stiff failing hypertrophic left ventricle
300
how do you assess visual acuity
snellen chart
301
what does a snellen chart score of 20/200 mean
can read at 20 feet what normal people can read at 200 feet
poor vision
302
what is hyphema
bleeding in anterior chamber of the eye
303
does nulliparity increase risk for breast cancer
yes
304
what culture would require wrapped plastic utensils and would want to unwrap their own
jewish
305
when do living wills go into effect
when client is terminally ill
306
what is battery
unconsented physical contact
307
assault
act that threatens physical harm even when actual harm is not done
308
what is andexanet
antidote to apixaban
309
which vaccines can you not get while pregnant
MMR
✓ Varicella
✓ Zoster
✓ HPV
✓ Polio
✓ Any live vaccine
310
what is the major ae of isoniazid (INH)
peripheral neuropathy
tx with b complex vitamin
311
how do you give ear drops to a child
For a child younger than the age of three, pull the pinna down and back
312
what is akathisia and how do you treat it
sense of motor restlessness and is one of the most common EPS
tx with propanolol
313
what is Presbycusis
ensorineural hearing loss associated with aging
314
what fluid should be used for hypernatremia
d5w
315
who should not receive bupropion
anorexics - causes weight loss
pts with epilepsy
316
what is Variant angina (Prinzmetal’s angina)
occurs at about the same time every day, usually at rest. Variant angina is treated with calcium channel blockers
317
what increases risk for DIC
infection/injury
sepsis
318
what does warfarin prolong
INR & PT
319
what could lead to labor dystocia
Maternal fatigue
Uterine overdistention such as with multiple gestation
Maternal inactivity
Uncontrolled maternal pain
Fluid and electrolyte imbalance
Hypoglycemia
Excessive analgesia or anesthesia
320
can LPNs do sterile dressing changes
yes
321
what vitamin do vegans need to supplmement
b12
322
what is Oprelvekin
stimulates platelet production
indicated to prevent chemotherapy-induced severe thrombocytopenia and avoid the need for platelet transfusions
323
how long can troponin be elevated after MI
2 weeks
324
do platelets require ABO compatability?
no
325
is inhalation anthrax spread from person to person
no! so no need for a mask
326
are loop diuretics nephrotoxic
yes
327
does enoxaparin (LMWH) require monitoring aptt
no!
would be more concerned about platelets for HIT
328
what type of precautions is mono
standard
329
what would help a patient with dailysate that won't come out during peritoneal dialysis
encourage bowel mvmt
330
what position would you put a pt in for removal of IJ central cath?
supine or trendelenburg to avoid air embolism
331
how to treat hyper parathyroidism / hypercalcemia
0.9% saline infusion followed by furosemide
332
who should not receive beta blockers
cardiogenic shock
333
How do you prevent fat embolism
Immobilization!
334
D dimer
Indicates if you have a blood clot or blood clotting problem
