Nclex Prep Flashcards
(319 cards)
0
Q
Platelets normal value
A
150,000-450,000
1
Q
WBC normal value
A
5,000-10,000
2
Q
RBC normal value
A
4.5-6.0
3
Q
Hemoglobin normal value
A
12-16
4
Q
Hematocrit normal value
A
38-47%
5
Q
INR normal value
A
0.8-1.2
6
Q
PTT normal value
A
25-38 secs
7
Q
PT normal value
A
11-15 secs
8
Q
herbal meds that increase PT/INR, PTT (increase bleeding)
A
black cohosh, echinacea, garlic, ginger, gingko
9
Q
herbal meds that decrease PT/INR, PTT (increase clotting)
A
ginseng, St. John’s wort, green tea, nettle
10
Q
Foods high in Vit K
A
liver, broccoli, spinach, kale, cauliflower, cabbage, alfalfa, brussel sprouts, chick peas, green tea
11
Q
S/S of complications of blood transfusion
A
BACK/CHEST PAIN, elevated temp, AP
12
Q
What is polycythemia vera?
What is primary nursing care?`
A
- too many RBCs
- assess for clotting
13
Q
B/P = VOLUME
What happens to BP when there’s more volume?
A
BP goes UP
14
Q
B/P = VOLUME
What happens when there’s less volume?
A
BP goes down, HR goes up, RR goes up
15
Q
Diabetes insipidus = ___ concentration of urine
A
LOW
16
Q
GI fluid loss = ___ concentration of urine
A
High
17
Q
Smoking is a r/f for what cancers
A
BOCELL
Bladder, Oral, Cervical, Esophageal, Lung, Laryngeal
18
Q
Most common ending for steroid drugs
A
- lone
- sone
19
Q
most common endings for NSAIDS
A
- in
- en
- ac
- cam
20
Q
What does a low hematocrit reading mean?
A
bleeding
21
Q
Liver Biopsy
What do you do, pre-test?
A
NPO for 6-8 hrs
Assess PT
22
Q
Liver Biopsy
Procedure Positioning
A
flat, low fowlers, R arm extended above head, hold breath
23
Q
Liver Biopsy
Post-Test
A
lay pt on RIGHT side with pressure, bedrest for 12-24 hours
24
Anti-Ulcer Meds
Histamine Antagonists most common suffix
- tidine
| ex: Cimetidine (Tagamet), Ranitidine (Zantac), famotidine (Pepcid)
25
Anti Ulcer Meds
Histamine Antagonists
- administration
- adverse effects
- tagamet with food, all others without regard to food; cautiously use zantac in renal or liver pts
- HA
26
Anti Ulcer Meds
Proton Pump Inhibitors common suffix
- prazoles
| ex: esomeprazole (Nexium), omeprazole (Prilosec), lansoprazole (Prevacid)
27
Anti Ulcer Meds
Proton Pump Inhibitors
- administration
- adverse
- no regards to meal times, use cautiously in renal or liver pts
- HA, cough, diarrhea
28
Anti Ulcer Meds
Antacids most common suffix
- gel
| ex: Basagel, Alternagel, Amphogel
29
Anti Ulcer Meds
Antacids action
neutralize acids in stomach
30
S/S of Crohn's Disease
RLQ pain, distension, diarrhea
31
NSG Care for Crohn's Disease
low fiber diet, anti-diarrheals, avoid high roughage
32
NSG Care for Cirrhosis
moderate to high protein intake, lactulose, rest
33
NSG Care for Ascites
latulose, albumin p.o./p.r., Hi-Fowler's (assess orthopnea), low sodium/low protein diet, fluid restriction
34
S/S of Cholecystitis/Cholelithiasis (inflammation of the gallbladder)
RUQ pain, n/v after high cholesterol intake
35
S/S of Pancreatitis
LUQ pain, n/v
tests results include: elv. lipase, amylase, BG, WBCs, K, BUN, and dec. Ca, Na, HCT, PTH
36
NSG Care for Pancreatitis
NO morphine sulfate, NPO, tetany assessments
37
R/F for Esophageal Cancer
Etoh, Elderly
38
Renal System Meds
Urecholine (Bethanechol) used to:
stimulate urination post-op
-have bed pan/urinal ready
39
How to obtain a urine specimen from foley
- clamp foley tubing for 30 min
- wash hands, don clean gloves
- ETOH port, insert 10-20 mL syringe needle with bevel up into port and aspirate sample
- inject into specimen container
- unclamp tubing
- remove gloves, wash hands
- label and send specimen to lab
40
What is the purpose of a bladder scan?
used to check for residual urine after voiding
41
Potassium normal value
3.5-5.0
42
HYPOkalemia is r/t
diarrhea, vomiting, Cushing's
43
What will an ECG look like in a pt with HYPOkalemia?
flat (low) T waves, prominent U waves, tachycardia
44
Electrolyte Imbalances
LOW K+ = __ T wave, __ pulse
LOW, HIGH
45
Electrolyte Imbalances
HIGH K+ = __ T wave, __ pulse
High, Low
46
K+ Rich Foods
baked potato, melon fruits, bananas, raisins, beans, coffee, chocolate, avocados, tomato
47
Med tx for for arrythmias
Lidocaine, beta blockers ( "olol" )
48
Sodium normal value
135-145
49
S/S of HYPOnatremia
HA, n/v, cramps, CONFUSION, moist
50
S/S of HYPERnatremia
#1: THIRST, dry
51
Magnesium normal values
1.7-2.2
52
S/S of HYPERmagnesemia
Tx
flushed, hot, inc perspiration, diarrhea, shallow respirations
Tx: Ca+ gluconate IVP
53
S/S HYPOmagnesemia
Tx
wt loss, muscle pain/twitches/cramps, fatty stools
Tx: Mg+ supplements
54
Magnesium Rich Foods
dark, leafy greens, CASHEWS, pecans, soy, brown rice, avocado, apricots
55
Calcium normal value
8.0-10.2
56
What medical condition is r/t HYPERcalcemia?
kidney stones
57
What causes HYPOcalcemia?
hypoparathyroidism, hypermagnesemia
58
S/S of HYPOcalcemia
paresthesias (numbness of fingertips and mouth), seizures, MUSCLE WEAKNESS, arrythmias
59
Tx of HYPOcalcemia
calcium supplements, calcium gluconate IVP
60
Calcium Rich Foods
sardines, dairy products, almonds, broccoli, okra
61
What conditions result in an elevated BUN level?
Gallbladder, Pancreatitis, Hepatits, Liver disease
62
BUN normal value
10-20
63
Creatinine normal value
0.5-1.5
64
Uric Acid normal value
3.5-7.0
65
Urine Specific Gravity normal value
1.010-1.025
66
Phosphorus normal value
2.5-7.4
67
A calcium reading less than 8 indicates...
....tetany
68
What position do you place a post-op renal biopsy pt?
prone
69
What is the priority nsg care for a urolithiasis pt? (stones)
pain management
70
Why would an MD order an antacid for a renal failure pt?
to help excrete phosphorus (aluminum binds to phosphorus) therefore elevating calcium levels (preventing tetany)
71
What meds are CI for a renal failure pt?
ace inhibitors (-pril, -ril, -vil)
72
Normal Effects of Iodine
- salty, seafood, metallic taste
- warm, flushed feeling
- tingling, numbness
73
NSG Care for brain scan pt: pre-test, post-test
- assess dye allergies (shellfish, cough syrup, multivitamin, betadine), instruct to void, lie still
- push fluids
74
S/S of increased intracranial pressure (ICP)
decreased LOC, Cushing's triad (dec AP, irreg RR, widening pulse pressure)
75
Upper Motor Neuron Defect: SCI ___ T6
Consists of...
above
...spastic paralysis, need to stimulate elimination
76
Lower Motor Neuron Defect: SCI ___ T6
Consists of...
at/below
...flaccid paralysis, manual stool elimination
77
What is autonomic dysreflexia?
a reaction of the autonomic nervous system to overstimulation, occurring in pts with SCI about T6; characterized by high BP, flushing of the skin, sweating, HA
78
NSG Care for pt with autonomic dysreflexia
semi-fowlers, assess bladder/bowel, check person, check environment
79
NSG care for myasthenia gravis pt (severe muscle weakness)
assess resp status, gag reflex before meals
80
What is Parkinson's disease?
dopamine deficiency causing stiffness, rigidity and tremors
81
S/S of Parkinson's
mask-like expression, stooped shoulders, tremors, bradykinesia, micrographia (small handwriting), shuffling gait
82
Meds associated with Parkinson's
levodopa, sinemet, congentin, eldepryl, stalevo
83
S/E of levodopa, carbidopa
lower BP (causing dizziness), constipation/diarrhea, blurred vision, arrythmias
84
S/S of detached retina
flashes of light, floaters, CURTAIN CLOSING
85
Meds associated with Glaucoma
Timolol, pilocarine eye gtts, stool softeners
86
S/S of Cataracts
CLOUDY lens, decreased vision
87
S/S of Meniere's Disease (no drainage of fluid in ear)
Tx:
IRREVERSIBLE loss of hearing, tinnitus, vertigo
Tx: low sodium diet, dim/quiet environment
88
S/S of a frontal lobe brain tumor
| where you make decisions, memory
HA, memory loss, impaired vision, impaired judgement, vision problems, emotional/behavioral changes
89
Posterior Pituitary Hormones
ADH
Antidiuretic hormone - tells kidney to hold onto H20
90
Posterior Pituitary Hormones
Glucocorticoids
ex: cortisol
sugar
91
Posterior Pituitary Hormones
Mineralocorticoids
ex: aldosterone
salt
92
Posterior Pituitary Hormones
Sex Steroids
ex: testosterone
93
Anterior Pituitary Hormones
ACTH
adrenal
94
S/S Cushing's Disease (FVE)
inc RR, HR, BP; moon face, central obesity, striae, edema, facial hair
95
S/S of Addison's disease
bronze/darkening of skin, n/v, dec HR, BP; weakness, fatigue, abdominal cramps
96
Blood Glucose normal value
70-110
97
Types of Insulin: CLEAR
| Humolog, Lispro: onset, peak, duration
Rapid acting
15 min, 1 hr, 3 hrs
98
Types of Insulin: CLOUDY
NPH (intermediate acting): onset, peak, duration
1-1.5 hrs, 6-8 hrs, 16-20 hrs
99
Types of Insulin: CLOUDY
Lantus (LONG): onset, peak, duration
1 hr, NO PEAK, 24-30 hrs
100
S/S of HYPOglycemia
pale, cold, clammy, crabby, shaky, weak, HA
101
S/S of HYPERglycemia
polyuria, polydipsia, polyphagia (pee, thirst, hunger)
102
What is the BG level of a DKA pt?
>250
103
What is a glycosylated hemoglobin (HGBA1c) test?
tests blood glucose levels over the past three months
desired value: <6%
104
What is the Somogyi Effect?
early am hyperglycemia that follows late pm episode of hypoglycemia; notify MD
105
What is the #1 risk factor for coronary artery disease?
high cholesterol
106
LDL normal value
<100
107
HDL normal value
>35-60
108
What will the EKG look like in atrial fibrillation?
irregular P waves
109
S/S of atrial fibrillation (most common)
pulse deficit
110
What will the EKG look like during an atrial flutter?
SAWTOOTH P wave
111
S/S of atrial flutter
CHEST PAIN FIRST, followed by shortness of breath
112
Pt teaching for a Holter Monitor
24 hr EKG
- Do not remove or get wet
- keep diary of activites
113
What will the EKG look like during an MI?
Like a chair
| -elevated ST segment
114
Treatment of MI
relief of pain is #1 priority, semi-fowlers, aspirin, nitroglycerin
115
Causes of Congestive Heart Failure
MI, thyroid storm, anemia, acidosis, ASHD
116
S/S of RIGHT sided CHF (venous side, veins)
cool edema in legs, jugular vein distension, hepatomegaly (enlarged liver), ASCITES, distention
117
S/S of LEFT sided CHF (arterial side, LUNGS)
crackles (rales), cough w/ pink, frothy sputum, dyspnea, SOB, orthopnea, cyanosis
118
Cardiac Meds
ACE inhibitors common suffix
- pril, -ril, -vil
| ex: lisinopril, captopril, benazepril, accupril
119
If K+ is ___, then HR is ___
HIGH, LOW
120
Cardiac Meds
Alpha Blockers common suffix
- osin
| ex: prazosin, terazosin, doxazosin
121
Cardiac Meds
Alpha Blockers uses
htn, BPH
122
Cardiac Meds
ACE Inhibitors uses
htn, CHF, post MI
123
Cardiac Meds
ACE Inhibitors NSG Care Key Points
- Don't give with NSAIDS, K+ sparing diuretics/supplements
- Don't give to renal failure pt
- Take on empty stomach; 1 hr before meals, 2 hrs after meals
124
Cardiac Meds
Alpha Blockers action
produces vasodilation
125
Cardiac Meds
ACE Inhibitors action
lowers BP
126
Cardiac Meds
| Angiotensin Receptor Blockers common suffix
ARBs
- sartan
| ex: valsartan, candesartan, losartan
127
Cardiac Meds
Angiotensin Receptor Blockers action
lowers BP
128
Cardiac Meds
Angiotensin Receptor Blockers uses
HTN
129
Cardiac Meds
Beta Blockers common suffix
- lol, -olol
| ex: propanolol, metoprolol, atenolol, carvedilol
130
Cardiac Meds
Beta Blockers action
decrease HR, BP and contractility
131
Cardiac Meds
Beta Blockers NSG Care Key Points
- use with caution w/ oral hypoglycemics/bronchodilators (can exacerbate emphysema/asthma)
- Give with food
- avoid hot baths, saunas, jacuzzis
132
Cardiac Meds
Calcium Channel Blockers common suffix
- dipine
| ex: nimodipine, amlodipine, nifedipine, DILTIAZEM, VERAPAMIL
133
Cardiac Meds
Calcium Channel Blockers action
- decreases contractility and oxygen demand; decreases AP and BP
- NOT for acute MI, flutter, shock
134
Cardiac Meds
Calcium Channel Blocker uses
htn, angina
135
Cardiac Meds
Calcium Channel Blocker NSG Care Key Points
-don't give with BETA BLOCKERS, GINKO, GINSENG
136
What can you never give to a patient taking any type of cardiac medication?
- GRAPEFRUIT (or grapefruit juice)
- antibiotics
- cancer meds
137
Cardiac Meds
Antilipemics common suffix
- statin
| ex: simvastatin, lovestatin, pravastatin, GEMFIBROZIL
138
Cardiac Meds
Antilipemics uses
lower LDL, raise HDL
139
Cardiac Meds
Antilipemics Key Points
take same time every day, usually with evening meal
140
S/S of Pericarditis
CHEST PAIN; can result in cardiac tamponade (pressure)
141
Cause of Endocarditis
untreated or partially treated infection (strep is most common)
142
S/S of Endocarditis
Tx of Endocarditis
- SOB, new heart murmur (S3)
| - bed rest and antibiotics for up to 6 months
143
S/S of Peripheral Vascular Disease (PVD)
Intermittent Claudication (pain in the lower extremities when walking), dusky/cool/hairless lower legs
144
How is HYPERtension diagnosed?
BP > 135/85 on 2 separate occasions
145
NSG Care for pt with HTN
Monitor K+ levels whenever pt is on diuretics, monitor daily weight, teach pt to rise slowly (to prevent postural hyotension), diet and exercise
146
What pts will have respiratory acidosis?
COPD, pneumonia, Guillan-Barre, myasthenia gravis, Addison's, thyroid crisis, sleep apnea
147
What patients will have metabolic acidosis?
renal failure, DKA, diarrhea
148
What patients will have respiratory alkalosis?
pain, panic, hyperventilation
149
What patients will have metabolic alkalosis?
vomiting
150
What does an ABG test do?
measures the oxygen in arterial blood, identifies acid-base imbalances
151
pH normal value
7.35-7.45
152
pCO2 normal value
35-45
153
HCO3 normal value
22-26
154
pO2 normal value
80-100
155
What is ASA toxicity?
aspirin overdose
156
S/S of ASA toxicity
tinnitus, n/v, diuresis, vertigo, convulsions
157
What is a pneumothorax?
air or fluid in the pleural space of lung
158
What is the treatment for a pneumothorax?
thoracentesis or chest tube placement
159
S/S of Pneumothorax
sudden sharp chest pain with dyspnea, absence of breath sounds over area, asymmetry of chest movements with breathing, tracheal deviation towards unaffected side
160
What would you do if there were bubbling in the water seal chamber of a closed drainage test tube system?
nothing; mild bubbling is normal
161
What is asthma?
a bronchial constriction/spasm preventing the exhalation of air
162
Tx for asthma
direct bronchodilator, Methylxanthine, steroids, leukotriene antagonists
163
S/S of emphysema
AIR TRAPPING, barrel chest, impaired oxygen and carbon dioxide gas exchange, RESPIRATORY ACIDOSIS
164
Why can't you give an emphysema pt more than 2 liters of oxygen by nasal cannula?
low oxygen level gives the pt the drive to breathe; pt can become oxygen dependent if given more
165
Tx for emphysema
- take bronchodilator before steroid inhaler
| - rinse mouth well after
166
What is Cor Pulmonale?
- right sided CHF r/t COPD
- an enlargement of the right ventricle due to high BP in the arteries of the lungs usually caused by chronic lung disease
167
What happens first to a pt with a pulmonary embolism?
What is immediate nsg care?
- pt suddenly has dyspnea and CHEST PAIN
| - sit pt in high fowlers, put oxygen on, get help
168
When can an air embolism occur?
it can occur during a central line cap or a tubing change
169
How do you position an air embolism pt?
LEFT lateral with HEAD LOWER than the body
170
What is a pneumonectomy?
removal of lung
171
Nsg care of pneumonectomy
How do you position pt post op and why?
position pt on the OPERATIVE side to prevent the heart and other organs from compressing the remaining lung
172
What is lobectomy?
removal of lobe of lung (wedge resection, segmentectomy)
173
NSG Care of lobectomy
How do you position pt post-op and why?
on UNAFFECTED side to allow affected lung expansion
174
What is an early S/S for laryngeal cancer?
c/o pain in throat when drinking hot, acidic, carbonated liquids
175
What is an early S/S for lung cancer?
persistent DRY cough
176
What is Superior Vena Cava Syndrome and what is its prominent sign?
pulmonary tumor compresses the SVC causing UPPER BODY EDEMA
177
What is the #1 tx for pulmonary edema?
morphine sulfate
| diuretics are given after morphine
178
What is PARITY?
the number of pregnancies that have reached viability
179
What is NULLIGRAVIDA?
never been pregnant
180
What is NULLIPARITY?
never had a viable pregnancy
181
What is PRIMIGRAVIDA?
first pregnancy
182
What is PRIMIPARITY?
first viable pregnancy
183
What is MULTIGRAVIDA?
second viable pregnancy
184
What is MULTIPARA?
two or more viable pregnancies
185
What is viability?
fetal gestation at 22 weeks with fetal weight 500 grams (1lb 1oz)
186
What is GTPAL?
of gravida, term, parity, aborted, live births
| of pregs, term, preterm, aborted, live births
187
What is Goodell's Sign?
- soft cervix
| - PROBABLE sign of pregnancy
188
What is Chadwick's sign?
- chance in color of membranes
- PROBABLE sign of pregnancy
*C = *COLOR
189
What is the normal range for a fetal heartbeat?
110-160
190
When can an amniocentesis be preformed?
What is it's early use for?
15-18 weeks (2nd-3rd trimester)
to identify chromosomal abnormalities, alpha-feta protein levels
191
What is a Chorionic Villus Sampling used for?
When can it be done?
to identify chromosomal/genetic abnormalities
can only be done in the 1st trimester and you need a documented family history of defect
192
What are the different weights you should gain during pregnancy?
Normal weight: 25-35
Underweight: 27-39
Overweight: 15-25
Obese: 15
193
Can you take oral hypoglycemics when you're pregnant?
Why?
NO
they can cause birth defects
194
What meds are CI during pregnancy and why?
beta blockers ("olol") - intrauterine growth restriction
oral hypoglycemics - birth defects
oral anticoagulants - facial defects, bleeding (heparin OK)
antibiotics - liver damage in mother, dark teeth in baby
OTCs
Herbals
195
Why is magnesium sulfate therapy used in pregnant women?
for the prevention and treatment of convulsions in preeclampsia
196
What is the antidote for magnesium sulfate if MgSO4 toxicity occurs?
Calcium Gluconate slow IV
197
What is the usual dose of MgSO4?
4-6 g bolus over 15-30 minutes, then 1-3g/hr
198
When do S/S of preeclampsia and eclampsia usually resolve?
within 48 hours after delivery
199
What is placenta previa?
placenta implanted in lower uterine segment or over internal cervix
PAINLESS bleeding
200
What is placenta abruptio?
premature separation of the placenta >30 weeks
PAINFUL bleeding
201
When is a baby born in pre-term considered VIABLE?
22-37 weeks
202
Signs of TRUE labor
- Regular (frequent, intense, duration) contractions
- progressive cervical changes (dilation)
- back to front discomfort intensified with activity
- increasing bloody show
203
What is FALSE labor?
- irregular contractions
- NO cervical changes
- lower abdomen discomfort relieved by walking
- no increase in bloody show
204
FHR Normal Values
Norm
110-160
205
FHR Normal Values
Tachycardia
> 160
206
FHR Normal Values
Bradycardia
< 110
207
What is the Postpartum BUBBLE check?
- Breasts
- Uterus/fundus
- Bladder
- Bowels
- Lochia
- Episiotomy/laceration/incision
- Emotional
208
What color should the lochia be 3-4 days, 4-10 days, 10 days through 2-6 weeks?
Rubra (red) 3-4 days
Serosa (H2O) 4-10 days
Alba (white) 10 days through 2-6 weeks
209
Most common secondary S/S of Syphilis
palmar/sole RASH
210
Most common S/S of Syphilis in neonate
rhinorrhea, RASH
211
How much weight is normal for a baby to lose after birth?
- may lose up to 7% in first few days
- regain birth weight by 2 weeks
- gaining 4 oz a week is the minimum norm
212
OK meds for breastfeeding moms
- Tylenol, Ibuprofen, Aleve
- Sudafed
- Cough suppressant/expectorant
213
Terms:
Newborn
0 days, baby at birth
214
Terms:
Neonate
first 28 days
215
Terms:
Infant
first year of life up to 15 months
216
Terms:
Toddler
1 - 3 years
217
Terms:
Preschooler
3 to 6 years
218
Terms:
School Age
6 to 12 years
219
Terms:
Adolescent
12 to 18-19 years
220
NSG care measures to meet for the infant?
cuddle, meet oral needs, involve parents in care
221
What is the Denver Developmental Screening Test (DDST)?
It assess the child's developmental skills up to 6 years of age
-gross motor, fine motor, personal skills, language
222
What is the last natural reflex to disappear and when?
Babinski, after 1 year
223
When do the fontanels close?
- Ant. fontanel: 6-8 weeks; first to close
| - Post. fontanel: 18 months
224
How do you manage Celiac disease?
```
-Eliminate high -gluten foods *BROW*
Barley, Rye, Oat, Wheat
-Identify hidden sources (read food lable)
-Substitue
rice, corn, quinoa, potato
```
225
In what sequence should you introduce foods to a baby to distinguish allergies?
```
rice cereal
oat cereal
fruits
veggies
meats
```
226
Immunizations:
Hep B
birth/1 month --> 2 months --> 6 months
227
Immunizations:
DTap (diptheria, tetanus, pertussis), IPV (polio)
2 months --> 4 months --> 6 months --> wait one year from last shot --> 18 months (IPV optional) --> 4-6 years
228
Immunizations:
MMR
15 months
229
What types of pts are CI for immunizations?
fever, egg allergy (flu vaccine), neomycin sulfate allergy (rubella)
230
What does a positive TB test look like?
15 mm induration (hardening of the skin)
231
When does a 5 mm induration indicate a positive TB test?
- In a pt with HIV/AIDS
- Chest x-ray shows fibrosis
- if exposed to active TB
232
What are the appropriate sites to administer an IM injection in an adult?
deltoid, gluteus minimus/medius (ventral/dorsal), rectus femoris
233
What is the appropriate site to administer an IM injection in an infant?
vastus lateralis
234
Types of play:
Infant
solitary
235
Types of play:
toddler
parallel
236
Types of play:
preschooler
group play, dramatic
237
Types of play:
school age
group play, competitive
238
Types of play:
adolescence
sports; adult type
239
What is the appropriate site to administer an IM injection in children?
rectus femoris
240
S/E of Atropine (Probanthine)
dry mouth, urinary retention, blurring of vision, flushing, restlessness
241
What are the manifestations of pyloric stenosis?
- projectile vomiting (no bile)
- metabolic alkalosis
- gastric peristaltic wave that you can see on abdomen
242
Tx and NSG care for pyloric stenosis
- right side positioning
- thickened feeding (pre-op)
- pylorectomy
243
What is normal gastric pH?
4
244
What is epiglotittis?
life threatening bacterial infection
245
S/S of epiglotittis
SORE THROAT, DROOLING, dysphagia, high fever
246
Tx and NSG care of epiglotittis
endotracheal tube (ET), emergency cart, antibiotics
247
What is the earliest sign of increased intracranial pressure in an infant?
lethargy
248
Spina Biffida Occulta S/S
dimpling of skin, enlarged pore, hair tuft in large pore
249
Spina Biffida Cystica
Meningocele S/S
nerve roots intact
250
Spina Biffida Cystica
Myelomeningocele
- nerve roots in sac
- bowel/bladder incontinence
- weakness of lower extremities
251
Which types of Hepatitis are transmitted via the GI tract?
Hep A and E
252
Which types of Hepatitis are blood born?
Hep B, C, D
253
All types of Hepatitis utilize standard precautions, except which one?
Hep A, contact precautions
254
What is the therapeutic level for digoxin?
0.8-2.0
255
What is the toxic level of digoxin?
> 2.0
256
Signs of digoxin toxicity
diarrhea, n/v, anorexia, HA, visual halos, bradycardia
257
When do you NOT administer digoxin to an infant?
When AP is below 90-110
258
When do you NOT administer digoxin to a newborn/neonate?
When AP is lower than 100
259
When do you NOT administer digoxin to an older child?
When AP is lower than 70
260
When do you NOT administer digoxin to an adult?
When AP is lower than 60
261
What is the maintenance dose of digoxin?
0.125 - 0.5 mg/daily
262
What is a common nursing diagnosis for a pt with cystic fibrosis?
Ineffective airway clearance r/t thick mucous secretions
263
Pathophysiology of Cystic Fibrosis
- Unknown defect; Exocrine Gland Dysfunction; abnormal mucous secretion and obstruction
- SALTY KISS (around 6 mos)
- Meconium Ileus
- fatty stools
- decrease in weight
264
What is Cromolyn Sodium and when is it used?
- inhaled bronchodilator
| - taken PRN; 30 minutes before strenuous activity to PREVENT asthma attack
265
S/S of Meningitis
irritabilitly, HA, neck rigidity, opisthotonus position (arcing of the body), fever, vomiting
266
How do you diagnose meningitis?
- spinal tap (CSF)
- Kernig Sign (inability to completely straighten leg when flexed at the knee/hip)
- Brudskinski Sign (neck flexed toward chest)
267
Tx and NSG Care of meningitis
- penicillin, chloromycetin
- quiet environment, dim room
- decrease fluids
- droplet precaution
268
What is the incubation period of chicken pox virus?
14-21 days
269
What precaution is a chicken pox pt placed under?
airborne
270
How long is a chicken pox pt contagious?
from the start of eruption of lesions until the lesions have dried
271
What are Kroplik spots? (measles)
small, red spots with white center found in mucosa 1-2 days before eruptions occur
272
What kind of precautions is a measles pt placed under?
airborn
273
What is the tx and nsg care for a TB pt?
- 6-12 months
| - combo of 2-3 drugs (INH, ethambutol, rifampin )
274
S/S of Kawasaki Disease
fever and erythema, lymphadenopathy, dry/fissured lips, strawberry tongue
275
What kind of precaution is used for pts with diseases that are transmitted via coughing, sneezing, talking, suctioning?
droplet
ex: mumps, rubella, flu, meningitis, pertussis
276
What kind of precaution would you use for pts with diseases that are transmitted via direct physical transfer of microorganisms or indirect contact with contaminated objects?
Contact
ex: VRE, MRSA, C Diff, Lice, scabies, impetigo
277
PPE requirements for airborne precautions
- neg pressure room
- door closed at all times
- N95 surgical mask for staff and visitors
- surgical mask on pt during transport
278
PPE requirements for droplet precautions
- private room or cohorting
- surgical mask when entering room or within 3 ft distance
- surgical mask on pt during transport
279
PPE requirements for contact precautions
- private room
- gloves when entering the room at all times
- gowns when entering the room at all times
- leave clinical equipment in the pts room
280
What is Rota Virus and what type of precaution is used?
- highly contagious diarrhea in infant
| - contact
281
What kind of precaution do you use with a pt with the bubonic plague?
standard
282
What kind of precaution do you use with a pt who has pneumonic plague?
droplet
283
What are the infections transmitted during pregnancy?
TORCH
| Toxoplasmosis, RSV, Rubella, Cytomegalovirus, Herpes
284
S/S of Sickle Cell Anemia
pain, fever, vomiting, chronic jaundice
285
Factors in sickling
- dec in O2 concentration
- infection
- dehydration
- inc in altitude
286
Tx and NSG Care of Sickle Cell pt
- inc fluids
- analgesic
- infection prevention (#1 factor for sickling)
287
In hemophilia, who are the carriers and who are affected?
female = carriers
male = affected
288
What is leukemia?
malignancy of blood forming organs (spleen, bone marrow, lymph nodes)
289
What are s/s that a pt is having a hemolytic reaction to a blood transfusion?
chills, HA, nausea, backache, chest tightness
290
Key Points for Religions
Muslims
- NO pork
| - bed faces east
291
Key Points for Religions
Jehovah's Witness
no blood transfusions
292
Key Points for Religions
Mormons
no alcohol
293
Key Points for Religions
Hindus
- no circumcision
| - no beef
294
What do you do if you see late decelerations on a fetal heart monitor?
- REPOSITION LEFT LATERAL
- oxygen 6-10 L
- IV bolus
- notify MD
295
Most common anti anxiety meds
Ativan, Buspar, Xanax
296
Common antidepressants
Prozac, Paxil, Zoloft
297
Common antipsychotic
Haldol, Prolixin, Thorazine, Clozaril, Zyprexa, Abilify, Risperdal, Seroquel
298
Common Anti-Eps/Anticholenergics
Benedryl, Artane, Cogentin
299
Common antimanics
lithium, depakote, tegretol
300
common alzheimer meds
aricept, namenda, cognex
301
common meds for substance abuse
valium, librium, antabuse
302
Signs of Infection
DERT
| Discharge/drainage, Edema, Redness, Temp (#1 sign)/Tenderness
303
What is SIADH?
- Syndrome of inappropriate (too much) ADH
- body is retaining ALL the water
- dec in urine output
304
S/S of SIADH
- FVE
- inc BP, HR, RR
- crackles
- edema
- weight gain
305
S/S HYPERparathyroidism
bone/joint pain, n/v, inc urine output
306
S/S of HYPOparathyroidism
BRITTLE NAILS, dry coarse skin, twitching/muscle spasms
307
NSG implications for tetracyclines
DON'T give with milk, antacids
308
Herbal Drugs
Echinacea
- enhances immune system
| - if used with coumadin, may cause bleeding
309
Herbal Meds
Ginkgo Biloba
- used for dementia and alzheimers
- antioxidant
- if used with coumadin, may cause bleeding
310
Herbal Meds
St. John's Wort
- antidepressant
| - CI if used with major prescription antidepressant
311
Herbal Meds
Saw Palmetto
- used in BPH and prostatitis
| - if used with anti-coagulant, may cause bleeding
312
Herbal Meds
Black Cohosh
-alleviates menopausal symptoms
313
Herbal Meds
Bilberry
-relieves mouth irritation and diarrhea
314
Herbal Meds
Valerian
-used for sleep disorder and nervousness
315
Herbal Meds
Mahuang
diet pill for energy, contains ephedrine
316
Herbal Meds
Kava Kava
- sedative, anti anxiety
| - anti-convulsant
317
Herbal Meds
Garlic
-lowers cholesterol
318
Herbal Meds
Ginger
-prevents dizziness in motion sickness
