Big Ati 2942x

ATI: NCLEX Live Review Study online at quizlet.com/_253wzq 1.

bronchdilator

hyperglycemia, hypoK

2.

Nurse should ister lidocaine IV bolus for a client who has ventricular dysrhythmia

R For a patient that is pulseless or not breathing

3.

Nurse should perform synchronized cardio version for a client with supraventricular tacycardia

the nurse should defibrillate for ventricular tachycardia and ventricular fibrillation

4.

1 unit of blood

4 hrs, stay first 15 min

5.

carbidopa/levodopa

orthostatic hypotension

6.

Crede's maneuver

technique used to void urine from the bladder , press on pubis symphasis

7.

insulin

NV, hypoglycemia, hangry, shaky, cold, clammy

8.

methotrexate

RA, psoriasis

9.

gabapentin

somnolence, dizziness, edema, most effective 3x day peaks, 2 hrs

10.

nitro and cialis

unsafe drop in BP

11.

no nitro without

IV

12.

tocolytic

relaxed uterus

13.

Protonix- PPI

alters gastric acid secretion, diarrhea, osteoporosis, pneumonia

14.

Risperidone- Risperdal

weight gain, dyslipidemia, EPS rate

15.

Solumedrol

N, headaches, cushings

16.

Lasix and gent together

even more ototoxic

17.

Cycline

skin infection, staph

18.

Antifungal

azole

19.

ARB's use when

ACE doesn't work

20.

BB=

decreased HR

21.

Calcium channel blockers

dipine, Amlodipine norvasc Diltiazem Cardizem, Tiazac Verapamil (Calan, Verelan, Covera-HS)

22.

ED drugs afil

I feel you up, sildenafil

23.

CNS stimulant

phetamine

24.

Antidiuretic - pressin

increase BP

25.

Anemia

PRBC, hgb WDL 12-16

26.

Thrombocytopenia

platelets, 150-400K

27.

Burns-

Plasma protein fraction, albumin, 3.5-5

28.

Hemophilia

cryoprecipitate Factor VIII

29.

hemophilia tests

ptt 30-40 sec, therapeutic 45-80 sec, want increased clotting time 1.5-2

30.

1 unit PRBC

Hgb and Hct both raise 1% per unit

31.

Central venous catheter

aspirate, IV brisk blood return, no resistance when flush with NS, confirm radiology report, should rest superior vena cava, dressing q2 days

32.

PICC

observe antecubital fossa for edema

33.

Triple lumen

1 meds, 1 blood draw etc, complications- pneumothorax, air embolism

34.

triple lumen dwelling complications

occlusion, infection

35.

TPN

change tubing q 24 hrs, dc lipid infusion after 12 hrs, clean iv port before and after

36.

insulin given via IV

regular

37.

DI

ADH deficient, polyuria, can give desmopressin intranasally

38.

Lantus

glargine, lonely lantus doesn't play well with others

39.

another word for A1C

glycosylated hgb

40.

inject 10U reg then 20U NPH

roll nph, clean stoppers, inject 20U air into NPH, inject 10U air into regular, WD 10U reg, then 20U NPH

41.

lanoxin, digoxin

hypoK

42.

Ambien, zolpidem

caution in elderly, opposite effect

43.

MMR hold

allergy to gelatin or neomycin

44.

RH - mom

28 wks, 72h rs after birth rogham, baby should be RH +

45.

methylergonovine (Methergin)

stop contraction, hemorrhage

46.

aqua mephton

vit K

47.

statin take

at night

48.

glucophage / metformin

increase lactic acid levels

49.

glucocorticoid

osteoporitis, cushings, puffy moon face

50.

addison's

high and dry, hypoglycemia, dehydration, bronze skin

51.

budesonide formsterol

prevent asthma, COPD, GI upset, infection

52.

levothyroxine synthroid

take 30 min before breakfast

53.

flagyl and vancomycin

cdiffe

54.

give vanc and gent

over 1 hr

55.

fentanyl

duragesic, change 72 hrs, no heat over site

56.

lithium

0.6-1.2, fine tremors are normal, increase salt, thirst s/s toxicity, lithium and salt compete for binding sites

57.

Clozapine- clozaril

2nd gen antipsychotic, agranulocytosis- dangerously low WBC, constipation, othro Hypotn

58.

typical antispsychotic

SEATANS- sedation, EPS, antocholinergic, tradive dyskinesia, agranulocytosis, neuroleptic malignant syndrome, seizures

59.

atypical like clozaril

decrease risk of eps, weight gain, diabetes, dyslipidemia, agrnaulocytosis, ortho htn

60.

benzo od

romazicon flumazenil

61.

avoid tyramine with MAOI

phenelzine or Nardil

62.

tyramine food

bacon eggs liver, pepperoni, bologna, sausage, pickeld herring, anchovies, shrimp, caviar, yeast, chocolate, alcoholic drinks

63.

tyramine problems

hypertensive crisis, foods are pickled, aged, smoked, fermented, marinated

64.

new trach at bedside

bag valve, 20 set up, suction, two trach tubes

65.

weak legs

hypoK

66.

chron's

corticosteriods, cobblestone

67.

HHNS hyperglycemic hyperosmolar nonketonic syndrom

> 600 CBG, dehydration, low grade temp, confusion, headaches

68.

normal IOP

10-21

69.

Ulcerative colitis

starts @ rectum, increased risk cancer, more women than meb

70.

PVD

painless ulceration

71.

HyperK

peaked tented T- wave

72.

Cane COAL

cane opposite affected limb, cane stron side

73.

radiation

visitors 6 ft, 30 min day, sign on door, educate r/t isolation, save linens in room

74.

propofol milk of anesthesia

allergy to eggs pharm

75.

vaccines

don't give if egg allergy

76.

brudinskis sign

lay down, tilt neck chich to chest, makes knee/hip flex

77.

Kernigs sign

lay down bend knee AT 90 angle, can't straighten leg, hamstring tight, pain

78.

meningitis

headache, stiff neck, photophobia, seizure precautions, private room, dehydration

79.

test to see if amnio fluid or pee

fern or nitrizine test

80.

smallpox

, face to face, body fluids, aerosol, dever, red spot tongue, rash, most contagious

81.

sepsis

vascular changes, resp compromise, renal, CNS

82.

neonatal sepsis

low ax temp, lethargy, poor suck reflex

83.

nits

lindane no longer used, pretherin creme

84.

ED

can cause MI blood pools in penis

85.

external/internal hemmrhoid

streaks in stool

86.

3rd degree heart block

p & QRS not related

87.

problem after prolonged vomiting

hypoK

88.

parkland formula

4xkgxTBSA, 1st 1/2 in 8 hrs, rest remainint 16 hrs, deduct what previously given and look at time

89.

assess buttocks in traction

never side to side, lift buttocks

90.

AV fistula

use after several weeks, BP in opposite arm, feel thrill no heavy carrying

91.

metabolic imbalance

usually throwing up diarrhea

92.

abrupto placentia

rigid abdomen

93.

mastitis

keep feeding affected side

94.

serotonin antagonist- serotonin tron to the rescue

dolasetron, ondansetron

95.

Continuous bubbling in water seal chamber

means there is a leak

96.

Bubbling in suction chamber

means suction is working

97.

NEURO

...

98.

closed head injury

possible csf leak (yellow ring around a clear moist area seen on pillow)

99.

closed head injury with increaed I

instruct client to exhale when turning and moving in bed

100.

head trauma develops increased I

do this first-hyperventilate the pt(CO2 increased I-this will decrease CO2 and I) -trendelenburg position will increase I-not a good position

101.

subdural hematoma, reduce the I interventions

30 degrees semi fowler, trendelenburg contraindicated

102.

concussion discharge education

call dr if repeated episodes of vomiting occur-sign of I going up no dietary restrictions no activity restrictions unless HA develops for pain, can give acetaminophen, but not sedating drugs

103.

pt taking antipsychotic drugs develops NMS

early sign of this: muscle stiffness, fever, sweating, tremors late signs: dysphagia, unstable BP, respiratory depression -this is an emergency

104.

pt scheduled for CT scan

tell pt that he might experience slight discomfort not exposed to magnetic field

105.

post frontal craniotomy interventions

watch for increased I fluids restricted to 1-2 L per day space out activities, don't cluster provide Oxygen at 2 LPM-will prevent hypoxia which can lead to cerebral edema give Dexamethasone-reduce or prevent cerebral edema raise HOB at 30 degrees don't place in trendelenburg-can cause too much blood flow to the brain

106.

spinal cord injury-bladder management

urinate on a timed schedule, encourage fluids, no need to avoid carbonated drinksthey can have these

107.

suspected spinal cord injury, unconscious

avoid using chin-tilt maneuver during r r-2 breaths for q 30 compressions

108.

complete C7 transection

plan of care might include ventilatory lesions above C6-risk of respiratory paralysis C1-C8 injury-risk of quadriplegia

109.

stroke pt with L side weakness, in order to avoid disuse syndrome

use boots to prevent foot drop, assist pt with ive and active ROM,

110.

stroke major risk factor

hypertension, diabetes mellitus, heart disease, nonvalvular Afib

111.

MRI contraindication

pacemaker, cerebral aneurysm clips, metal implants, orthopedic hardware, intrauterine devices, pacemaker, internal surgical clips remove jewelry before give a mild sedative before, if pt is claustrophobic

112.

Myasthenia Gravis

fluctuating muscle weakness that worsens with effort and improves with rest weakness fatigue drooling ptosis oropharyngeal weakness have suction ready ister Pyridostigmine airway clearance-primary attention

113.

Parkinson

give Carbidopa/Levodopa semisolid, thickened food small frequent feedings bath bars recommended ROM and posture exercises

114.

Acute Bacterial Meningitis

complications: hearing impairment, photophobia-put pt in a dim light room no specific diet s/s: HA, fever, nuchal rigidity, altered mental status rapid onset-develops oper hrs to 2 days droplet precautions start to on empiric antimicrobial therapy asap

115.

Meningitis

altered cerebral perfusion from I and inflammation provide care for high I, seizures and hyperthermia fever HA nuchal rigidity Kernig's sign Brudzinski's sign-flexion of the hip and knee in response to forward flexion of the neck opisthotonos -no seizures

116.

infratentorial craniotomy for a brain tumor

keep HOB flat place a small pillow under the nape of the patient's neck to promote venous return and reduce I post any craniotomy monitor q 30 min for neuro check don't flex the neck post procedure-strict I&O maintained, strict fluid intake fluids at 175 ml/hr too much

117.

infratentorial craniotomy

elevate HOB at 30-45 degrees

118.

sustained severe brain injury

interventions are to maintain a low I elevate HOB relaxing atmosphere limit suction don't cluster activities don't discuss pt status at bed side

119.

MS

double vision visual loss impaired sensation mood swings impaired motor function and cerebellar function impaired urination male-sexual impotence weakness numbness of hands fatigue tremors s/s worsening over the past several months nystagmus scanning speech ataxia muscular weakness incontinence common between 20-40 yrs old women

120.

MS discharge instructions

exposure to heat and cold can exacerbate symptoms teach how to avoid fatigue, infections no restrictions in diet, just eat nutritious well balanced meals hard exercise not recommended but physical therapy yes it is recommended failure to store in bladder or failure to empty bladder-common problems constipation-most common bowel complaint

121.

MS manifestations

urinary retention hyperreflexia of the extremities intestinal obstruction ataxia decreased concentration constipation

122.

ALS

muscle weakness atrophy fasciculations dysphagia spasticity of the flexor muscles

123.

Parkinson's

mask like appearance to the face drooling slow speech shuffling gate

124.

GBS

risk for respiratory muscles weakness-paralysis

125.

Bell's palsy

7th cranial nerve priority: assess for pain experience soft diet apply an eye shield over the affected eye-corneal abrasion with Bell's Palsy

126.

trigeminal neuralgia

nerve V

127.

swallowing and speaking

nerve X

128.

facial muscle movement and taste

VII

129.

brain tumor

HA, vomiting, papiledema, seizures, changes in mental status, altered vision

130.

encephalitis

HA, fever, vomiting, menigeal signs

131.

cerebral arteriogram (angiogram of the blood vessels of the brain) (femoral artery access)

pt just came back, interventions: pressure dressing over the site for 4 hrs at least flat for 4 to 24 hrs, bed rest keep the affected extremity straight and immobilized 6 to 8 hrs before-NPO assess for weak pulses after give fluids to excrete dye

132.

lumbar puncture

lie flat after procedure for 4-6 hrs, depends on facility

133.

CN II (optic nerve) assessment

use a Snellen chart

134.

CN III-oculomotor, IV-trochlear and VI-abducens assessment

use penlight,note for nystagmus

135.

CN V (trigeminal nerve) assessment

corneal reflex

136.

CN VIII (acoustic nerve)

Weber test and Rinne test-assess conductive and sensorineural hearing loss

137.

cerebellar and vestibular function

Romberg test

138.

visual acuity

Rosenbaun test

139.

Tonometry

measures intraocular pressure

140.

Glascow Coma Scale

eye opening, motor response, verbal response coma=8 or less lowest score is 3=deep coma 15=perfect score

141.

head injury pt, in order to monitor hypothalamic function

assess urinary output and temperature

142.

brainstem

control of heart rate/ HR, resp rate/ RR

143.

TIA

temporary loss of cognitive function that will probably resolve warning sign of impending CVA brief period of neurologic deficit such as loss of vision, hemiparesis and slurred speech does not have long term neurologic deficits

144.

CVA

may cause long term deficits

145.

Meniere's disease

vertigo tinnitus hearing loss inner ear affected

146.

Acoustic neuroma

unilateral involvement progress without improvement

147.

MATERNITY/OB

...

148.

Carboprost

used in OB bleeding don't give in asthma-contraindicated AE-wheezing

149.

INFECTIOUS

...

150.

airborne

tb, rubeola, chickenpox, varicella door closed negative air pressure room mask-N95

151.

droplet

larger than 5 mcg door can remain open,the droplets are larger so they don't spread face mask for nurse distance between client and family pneumonia, meningococal meningitis

152.



wound infection-like MRSA Cdif RSV-young children secretions are not contained in these infections private room clean gloves when entering room if with surfaces in room-wear gown keep equipment in room

153.

chickenpox children

airborne, direct 2 days before rash appears they are contagious keep nails short no aspirin in kids

154.

rubella

droplet isolate these kids from pregnant women antipyretics and analgesics if its congenital rubella (newborn)--until 12 months old or until negative swabs at 3 months of age

155.

mononucleosis

flu like fever sore throat lymph nodes enlarged avoid with saliva 3 months adolescents risk for rupture spleen-no sports-danger of ruptured spleen

156.

tonsilitis

from strep infection->(risk for glomerulonephritis and rheumatic fever) antibiotics

157.

TB

airborne-less than 5 mcg fatigue anorexia nightsweats low grade fever sputum purulent dyspnea x ray man 2 test/ppd-48-72 hrs induration (area hard, you feel the edges around it; greater than 10-pozitive-exposed and infected) immuncompromised patients-greater than 5-pozitive quatiferon tb gold-blood test-fater than sputum cultures-within 24 hrs results available-treatment earlier isolated 2-4 weeks if inpatient-isolated cannot work, isolated health dept notified teaching important dont isolate from family-impossible, already exposed, they should be tested and treated if necessary -teach to cover mouth when coughing and how to dispose tissues full range of meds-don't stop 3 negative sputum tests=go back to work Ethambutol Pyrazinamide-given to shorten treatment to 6 months assess for SE-client might stop meds-assess for nausea (take at night)

158.

Hepatitis

acute inflamatory jaundice RUQ pain tea color urine light color stool elevated ALT and AST A-fecal oral route, contaminated water or food B-parenteral, sexual C-bodily fluids mild or severe symptoms flu like symptoms rest liver to encourage regeneration, rest as much as possible, dont stop activities, but rest or standard precautions high carbs diet moderate fats and protein no alcohol careful with meds-break down in liver A-no treatment, just hand washing, their own towels no meds given, but in B,C-antivirals given

159.

Lyme

erythematous lesion-bulls eye flu like symtoms stage 2-cardiac and neuro problems stage 3-large t problems 3-4 weeks antibiotics

160.

syphillis

cupper color rash spread, mucus membranes congenital in baby Penicillin

161.

gonorrhea

thick disharge many times no symptoms in females-PID-sterility doxycycline, rocemphin

162.

genital herpes

painful vesicular genital lesions after outbreak, virus still there in skin, can reoccur with stress, menses spread to infants no vaginal birth sitz bath acyclovir-dont treat the virus, just decreases course pap spears oral antibiotics no sex-while lesions present use condoms in between

163.

chalamydia

urethritis-men thich discarge, odor-women mucus membrane Doxycycline

164.

Hiv

aids-from deffective immune system from opportunistic infection: sarcoma contaminated blood or needles sexual placental transmission breast milk transmission prevention: no share of needles while drug use standard precautions in hospital high protein calorie diet of family and client important

165.

poison control

prevention toddlers-common victims meds in locked cabinets check with the eyes of a children don't take meds in front of them dont keep meds in purses accidental poison s/s-sudden change of child behaviour, empty container around the child have number available for poison control save vomitus and urine contrai to vomiting-unconscious child, petroleum base substances, corrosive substances poison control will decide what to do dont give a large amount of fluids-will increase absorption

166.

led

neuro affection irritability, increased i identify the source-nurse role homes built before 70's, oil based, pottery with oil based

167.

hazardous waste contamination

decontaminate-first thing prevent spread clean up contamination monitor personnel that has been exposed if you have a contaminated patient-dont know what they are contaminated with-first thing find out what they are contaminated with,

168.

hemophyllia

mom transmits gene to her son sex linked disorder 50% chance that mom will it to each children affected male gets the gene from mother and can transmit it only to the doughter

169.

laryngotracheobronchitis

inspiratory stridor and restlessness edema and inflammation of upper airways elevated RR

170.

night terrors

normal between 4-7

171.

otitis meds common meds

antihistamines steroids

172.

crushing meds for children

what do you crush or not crush

173.

infant

safe crib car seat-rear face, until 20 lbs, after front faced seat, back seat not front seat bath temperature small pieces toys-chicking child proof home plugs covered plants that are poisonous-don't keep these

174.

preschoolers and school age

safety helmet for bicycles-important bikes and scooters- ride on sidewalk sports safety-stay active cause of obesity, but have appropriate equipment, appropriate age group activities

175.

teenager

males-teach them how to deal with anger safety while driving-ask if they wear seatbelt 100% of the time, no cell phone drugs-teach about it

176.

adults safety

talk about guns exercise old adults-are they safe while ambulating? shoes-are they appropriate, walker-do they need one?, stairs-up and down correct, hand rails, don't carry things upstairs, do they have a way to someone in case they fall

177.

disaster planning

red-unstable, immediate attention yellow-stable, ca wait green-stable, can wait longer, the walking wounded black-fatal injuries, unstable ---use these colors only if system is overwhelemed-question will say it

178.

bioterrorismanthrax

cutaneous/skin-skin , no person to person, animal workers; standard precautions inhalation-spores; no person to person ; resp failure, shock, hemorrhagic shock-doxycycline

179.

Tetralogy of Fallow

Right ventricular hypertrophy Overriding aorta Pulmonary stenosis Ventricular septal defect

180.

...

Right ventricular hypertrophy Overriding aorta Pulmonary stenosis Ventricular septal defect

181.

infants

exploratory play

182.

todlers

imitation

183.

school age

working with otherrs groups, collaborative play hobbies

184.

erikson stages

infant-trust vs mistrust-stable caregiver toddlers-18m-3 yrs-autonomy vs shame and doubt-toilet training, walking, muscular coordination, they want to do things by themselves-autonomy preschool-3-6 yrs-initiative vs guilt-constant discovery school age-industry vs inferiority-tasks are imp-teams and groups are present-inferiority possible if role not met adolescence-12-20 yrs-peers more important than parents-think of careers start; disease-cannot fit in with the group; eg diabetic teenager cannot meet with friends and eat what they want young adulthood-20-25-commitment, family start 45-64 yrs-middle adulthood-generativity vs stagnation 65 and over-integrity vs despair-progressing towards the end of life-feeling that their life was meaningful

185.

screening tests

Denver test-birth to 6 years

186.

growth and development

...

187.

muscular developmet

screen routine infant for muscular development teach parents about milestones progression

188.

1-2 months

poor head control frequent feeding needed gain 5-7 oz weekly first few months

189.

3-4 monts

head control get up with head smile 4 m-loose reflexes become more social, eye

190.

5-6 m

double weight grasping objects weight slows down-4 oz a week turn from back to stomach-dont leave alone on changing table-teach parents

191.

7-8 m

stranger anxiety fear of stranger, wants mom 8 m-separation-stages -protest -dispair-they dont want to eat, play -denial-when parent comes back-ignore

192.

9-10 m

more mobile sitting position lift can say gaga.. respond with anger crawling starts possible 10m-pull to standing house baby proof cause now they are more mobile

193.

11-12 m

weight triple can sit from standing position wat with fingers babinski reflex changes from baby fanning injury, failure to thrive, development problems injury-most at risk small pieces things-choking dont give candy, nuts, hot dogs-small falls-risk for injury car seats-teach-completely restraint burns-outlets, cords failure to thrive-not enough growth, physical defects, not good parenting nutritional feeding has to be met age appropriate toys-nclex loves these toys should stimulate, also think safety, no sharp edges introduction of solid foods-variety but not too many at once, one q 2 weeks, starting with 6 m rice cereal-first, can mix with formula or breast milk no fruit juices in bottles-teeth problems finger foods-watch for choking

194.

15-18 m-todler

lots of vocabulary walking alone anterior fontanelle closes at 18 m tumb sucking 4 blocks together-15 m old tantrums-18 start-normal-until 2

195.

24-30 m

increase vocabulary tippytoe walk sphincter control-2 1/2 around that time 30 m-4 times birth weight they like push pull toys, stuffed animals, dolls negativism-they say no, dont ask yes/no questions -routine important safety-active so risk for injuries; mva's-most at risk, car seat safety, restraint seat drowning abuse

196.

3-5 yrspreschooler

3-vocabulary exploring-1500 words; brushing teeth; discipline, limits important 5 yrs-2500 words-identity play, play like mom and dad; love to play; housekeeping toys-stoves, cars; trycicles; tolerate separation from parents fear of death at this age; give a shot showing on a doll; help with increasing separation from parents

197.

7 yrs

boys play with boys girls play with boys

198.

9

seeking friends starting conflict with parents on the go

199.

10-12

love conversation choosing friends more selectively interested in other sex reading sowing construction sports bicycle industry vs inferiority-accomplishment important should be dry at night-no bed wetting at 12 void before bedtime, there are meds available for bed wetting

200.

Verapamil

SVT

201.

CVA

corneal abrasion

202.

permethrin

for head lice repeat the application of cream-rinse in 7 days if nits still present, repeated only at 7 days after first application comb hair daily with a nit comb clean clothing with very hot water and RID special detergent

203.

ceftriaxone

its a cephalosporin in pt for postop infection monitor tongue and oral cavity for growth of microorganisms

204.

hiatal hernia and reflux

less likely to wake up at night from heartburn if stomach is emty

205.

hypothyroidism

client very sensitive to narcotics, barbiturates, anesthetics-avoid narcotic sedatives

206.

type 2 diabetic pt going for surgery is subscribed insulin postop instead of his usually oral meds-why

being npo inhibits blood sugar control

207.

pneumothorax, chest tube

lung has re-expanded=the fluid in the water seal chamber does not fluctuate with respirations air leak=continuous bubbling in the water chamber, gentle bubbling is normal

208.

elderly type 1 diabetic

blood glucose tests are better than urine because the renal glucose threshold in elevated in elderly

209.

US at 32 weeks

getting gestational age

210.

amniocentesis

LS ratio to assess baby's lungs determines if there are any problems with spinal cord determines early problems with baby's blood

211.

tracheostomy

...

212.

allnurses random facts

1. barium swallow for 3 month old infant - npo for three hours 2. temporary pacemaker for mi client - increase cardiac output is the primary purpose 3. plasma cholesterol screening - only sips of water for 12 hours 4. reminiscing group - primary goal is to review and share their life experience with the group member 5. miller-abbott tube - removes fluid and gas in the small intestine; provides intestinal decompression 6. levin or salem stump - decompresses the stomach; prevent fluid and gas accumulation in the stomach 7. promethazine hcl (phenergan) - check patency of the patient's vein before of drug, extravasation will cause necrosis 8. insulin dependent diabetic, unable to urinate -- autonomic neuropathy 9. overdose of aspirin will produce parkinsons dse type sx 10. do not erythromycin to multiple sclerosis pt

213.

Chlordiazepoxide (Librium)

-antianxiety used to tx symptoms of acute alcohol withdrawal

214.

terbutaline Brethine mag sulfate

tx for preterm labor

215.

Benzatropine (Cogentin)

-used to tx parkinsonian side effects of Chlorpromazine (Thorazine) (antipsychotic med)

216.

Methadone

hydrochloride-opiod analgesic; tx for narcotic withdrawal

217.

Nifedipine (Procardia)

antianginal med (CCB) decreases myocardial O2 demand.

218.

Digoxin

strengthens myocardial contractio0n & slows conduction thru AV node

219.

Warfarin (Coumadin)

inhibits prothrombin synthesis

220.

Aminocaproic acid (Amicar)

antifibrinolytic prevents recurrence of subarachnoid hemorrhage.

221.

Lithium

tx manic phase of bipolar

222.

Nimodipine

CCB decreases spasm in cerebral blood vessels

223.

diltiazem

CCB inhibits Ca+ influx vascular smooth muscle reduces myocardial O2 demand &decreases force of ventricular contraction

224.

clotrimazole

antifungal; treats rashes.

225.

sphincter control

18 months

226.

Buerger's disease

digital sensitivity to cold intermittent claudication (pain with exercise)

227.

aging

nocturia increase need to frequent urination

228.

gastric ulcer

pain half and hr or 1 hr after a meal pain rarely at night, not helped by ingestion of food

229.

duodenal ulcer

pain at night, 2-3 hrs after a meal, prior to ingestion of a meal

230.

lumbra laminectomy

Educate about exercise to strengthen the abdominal muscle

231.

promethazine

extravasation of vein, iv

232.

tetrahydrozoline

contrai in angle closure glaucoma

233.

recurrent uti

limit milk ordered Mandelamine

234.

miller abot tube

used for decompression of onstruction

235.

aids pts

get dementia, many of them

236.

hypoparathyroidism

low calcium be ready to deal with dysrhythmiaa

237.

iv placement

not close to t

238.

rsv

...

239.

Bun

7-18 (older)

240.

Creatinine

0.7-1.4

241.

PT

9.5-12

242.

autonomic dysreflexia

...

243.

graves disease

heat intolerance metabolic rate increased

244.

tetracycline

use sunscreen outdoors

245.

propanolol

s/e bronchospasm

246.

Transesophageal echocardiography (TEE)

npo-for several hrs lidocaine-numb the esophagus-risk for for aspiration possibly iv sedation

247.

Ankle brachial index

...

248.

Alteplase

...

249.

Ceftriaxone (Rocephin)

...

250.

Labs for Mi

...

251.

stress test

stop if pain

252.

Pepcid

report to dr if pt is about to be put on antiplatelets meds-it might not work

253.

Docusate

stool softner

254.

Omeprazole

makes the Clopidogrel not work

255.

30 months

able to jump

256.

18 months

walk up and down the stairs while holding self

257.

low K

risk for Dig toxicity call doc

258.

PSA

draw before digital rectal exam

259.

tube feeding

rinse the bag and change formula q 4 hrs

260.

ng tube, before feeding

check ph-3 is good-for the aspirated contents

261.

Ciprofloxacin

rash-stop drug and call dr

262.

iv K

if burning-decrease rate

263.

aPTT

1.5-2 x the therapeutic value is ok

264.

cerebellar tumor

losing balance easily

265.

CN IX (glossopharyngeal)

can tell difference in taste

266.

CN VIII (acoustic)

loss of hearing temporal lobe (auditory center)

267.

gravity drip IV

piggy bag has to be higher than primary bag

268.

before giving dopamine iv

check iv patency risk for extravasation

269.

GEMFIBROZIL

...

270.

PERPHENAZINE

...

271.

TERBUTALINE

...

272.

ZIDOVUDINE

...

273.

PROCAINAMIDE

...

274.

PROCHLOPERAZINE

...

275.

BROMPHENIRAMINE

...

276.

PHENYLPROPANOLAMINE

...

277.

Random meds

Carbamazepine therapeutic serum level is 4 - 12 mcg/dL Cycloserine is an antituburculan and needs weekly drug levels foscarnet (Foscavir) can be toxic to kidneys so creatinine is monitored. Therapeutic serum digoxin is 0.5 - 2 mg/dL morphine is contraindicated in acute pancreatitis because is causes the spasms but the demerol is the drug of choice. Dantrium (dantroline) common drug kept in the OR for Malignant Hyperthermia No birth control pills with antiseizure meds....lowers the B's effects Metylergonovine-to contract uterus. before giving check BP. dont give if vascular diseases are present. MgSo4-CNS Deppressant and Anticonvulsant = normal range 4-7.5, effective if no seizures. Adverse reactions: Flushing, decrease in RR, Muscle weakness filgrastim (neupogen) - increase neutrophil count epoietin alfa (epogen) - increase rbc/erythrocytes 1. prozac, zoloft, paxil- tx of depression. 2. sodium nitroprusside- sheild from light. wrap in foil 3. cephalosporins- check for allergies to penicillins. pt could be hypersensitive. 4. pts recieving lasix should be assessed for tinnitus and hearing loss 5. anticoagulants cant dissolve a formed thrombus but tpas can. PVC's -Lidocaine Verapamil - treatment of supraventricular tachycardias, check heart rate Clomiphene- induces ovulation by changing hormonal effect on the ovary DO NOT give a pregnant laboring patient on methadone STADOL (precipitates withdrawal) contractions > 90 seconds, FHR < after contraction peak. . .turn off the pitocin [oxytocin] (if running) give O2 by tight face mask, reposition on left side, increase IV fluid rate, notify caregiver, document Aminoglycosides (gentamycin, etc.) affect 8th cranial nerve function (hearing) and are nephrotoxic he adverse effects of Anti psychotics can be ed using this: SHANCE S-SUNLIGHT SENSITIVITY( Use hats and sunscreen) H-HEPATOTOXICITY( Monitor LFT) A-AGRANULOCYTOSIS( Characterised by fever and sore throat) N-NEUROLEPTIC MALIGNANT SYNDROME( Characterised by fever and muscular rigidity) C-CIRCULATORY PROBLEMS( Leukopenia and orthostatic hypotension) E-EXTRA PYRAMIDAL SYMPTOMS( ister anticholinergics and anti parkinsonian agents) SVT - Adenosine Atrial Flutter - Anticoagulants Atrial Fibrillation - Beta Blockers, Digoxin PVC - Amiodarone Ventricular Tachycardia - Amiodarone

Ventricular Fibrillation - Defibrillation Torsades de Pointes - Magnesium Sulfate 1st Degree AV Block - No treatment usually 2nd Degree AV Block Type I - Atropine 2nd Degree AV Block Type II - Pacemaker 3rd Degree AV Block Complete - Emergent Pacemaker, Atropine, Epinephrine, Dopamine Sinus Bradycardia - Atropine or Epinephrine Sinus Tachycardia - Beta Adrenergic or Calcium Channel Blocker digoxin 05-2.0 ng/ml lithium 0.6-1.5 meq/l dilantin 10-20 mcg/dl theophylline 10-20 mcg/dl lithium 0.5-1.5 meq/l coumadin pt: 12-20 sec....therapeutic range 1.5-2 times the control inr: 2-3 heparin ptt: 30-60 sec...therapeutic range 1.5-2 times the control 278.

Electrolytes

Hyperkalemia = narrow, peaked T waves on cardiac monitor Hypokalemia = Peaked P, Flat T, Depressed ST and Prominent U HYPOCALCEMIA (not enough sedatives) + trouseau and + chovstek's sign incr DTR stridor, laryngospasm swallowing problem=aspiration ALDOSTERONE insufficiency -Hypo-Na-emia, Hyper-K-emia, hypo-Volemia. WHEN Na decrease, K increase addisons= hyponatremia, hypotension, decreased blood vol, hyperkalemia, hypoglycemia cushings= hypernatremia, hypertension, incrased blood vol, hypokalemia, hyperglycemia 4. SIADH Na <120 Hx of lung cancer Specific gravity > 1.035 Diabetes Insipidus Na> 160 head injury Specific gravity <1.005

279.

Defense mechanisms

phobias include projection and displacement

280.

Delegation Rule of Thumb?

DO NOT delegate what you can EAT! E - evaluate A - assess T - teach

281.

VV and AA?

EleVate Veins; dAngle Arteries for better perfusion

282.

Apgar Scoring?

A= appearance (color all pink, pink and blue, blue [pale]) P= pulse (>100, < 100, absent) G= grimace (cough, grimace, no response) A= activity (flexed, flaccid, limp) R= respirations (strong cry, weak cry, absent)

283.

Airborne Transmission?

My - Measles Chicken - Chicken Pox/Varicella Hez - Herpez Zoster/Shingles TB

284.

Protocol for Airborne Transmission?

Private Room - negative pressure with 6-12 air exchanges/hr Mask, N95 for TB

285.

Droplet Precautions Transmission?

DROPLET think of SPIDERMAN! S - sepsis S - scarlet fever S - streptococcal pharyngitis P - parvovirus B19 P - pneumonia P - pertussis I - influenza D - diptheria (pharyngeal) E - epiglottitis R - rubella M - mumps M - meningitis M - mycoplasma or meningeal pneumonia An - Adenovirus

286.

Protocol for Droplet Precautions?

Private Room or cohort mask

287.

transmission precautions

PRECAUTION MRS.WEE M - multidrug resistant organism R - respiratory infection S - skin infections * W - wound infxn E - enteric infxn - clostridium difficile E - eye infxn - conjunctivitis

288.

What to do in the case of- an Air/Pulmonary Embolism?

S&S: chest pain, difficulty breathing, tachycardia, pale/cyanotic, sense of impending doom --> turn pt to left side and lower the head of the bed.

289.

What to do in the case of- A woman in labor with UnReassuring FHR?

(late decels, decreased variability, fetal bradycardia, etc) --> turn on left side (and give O2, stop Pitocin, increase IV fluids)

290.

What to do in the case of tube feeding with decreased LOC?

position pt on right side promotes emptying of the stomach with the HOB elevated to prevent aspiration

291.

During epidural puncture?

Side lying

292.

After lumbar puncture?

e (and also oil-based Myelogram)--> pt lies in flat supine (to prevent headache and leaking of CSF)

293.

What to in the case of- Pt with heat stroke?

Lie flat with legs elevated

294.

During CBI (continuous bladder irrigation)

(CBI) --> catheter is taped to thigh so leg should be kept straight. No other positioning restrictions.

295.

After Myringotomy?

Position on the side of the AFFECTED EAR after surgery to allow drainage of secretions

296.

After Cataract surgery?

pt will sleep on unaffected side with a night shield for 1-4 weeks.

297.

After Thyroidectomy?

low or semi-Fowler's, head, neck and shoulders.

298.

Infant with Spina Bifida?

position prone (on abdomen) so that sac does not rupture

299.

Buck's Traction?

(skin traction) --> elevate foot of bed for counter-traction

300.

After Total Hip Replacement?

don't sleep on operated side, don't flex hip more than 4560 degrees, don't elevate HOB more than 45 degrees. Maintain hip abduction by separating thighs with pillows.

301.

Prolapsed Cord?

knee-chest position or Trendelenburg

302.

Infant with Cleft lip?

position on back or in infant seat to prevent trauma to suture line. While feeding, hold in upright position.

303.

To prevent dumping syndrome?

(post-operative ulcer/stomach surgeries) --> eat in reclining position, lie down after meals for 20-30 minutes (also restrict fluids during meals, low CHO and fiber diet, small frequent meals)

304.

Above the knee amputation?

elevate for first 24 hours on pillow, position prone daily to provide for hip extension.

305.

Below the knee amputation?

foot of bed elevated for first 24 hours, position prone daily to provide for hip extension.

306.

Detached Retina?

area of detachment should be in the dependent position-- dependent meaning ed by something

307.

Enema positioning?

position pt in left side-lying (Sim's) with knee flexed

308.

After Supratentorial Surgery?

(incision behind hairline) --> elevate HOB 30-45 degrees

309.

After Infratentorial Surgery?

(incision at nape of neck)--> position pt flat and lateral on either side.

310.

During internal radiation?

on bedrest while implant in place

311.

Autonomic Dysreflexia/ Hyperreflexia?

S&S: pounding headache, profuse sweating, nasal congestion, goose flesh, bradycardia, hypertension place client in sitting position elevate HOB first before any other implementation.

312.

Shock?

bedrest with extremities elevated 20 degrees, knees straight, head slightly elevated (modified Trendelenburg)

313.

Head Injury?

elevate HOB 30 degrees to decrease intracranial pressure

314.

Peritoneal Dialysis when outflow is inadequate?

turn pt from side to side BEFORE checking for kinks in tubing (according to Kaplan)

315.

Lumbar Puncture?

AFTER the procedure, the client should be placed in the supine position for 4 to 12 hrs as prescribed. (Saunders 3rd ed p. 229)

316.

The difference between Myasthenia Gravis, Myastenia Crisis, and Cholinergic Crisis?

Myasthenia Gravis: worsens with exercise and improves with rest. Myasthenia Crisis: a positive reaction to Tensilon--will improve symptoms Cholinergic Crisis: caused by excessive medication-stop med-giving Tensilon will make it worse

317.

Prior to liver biopsy?

Its important to be aware of the lab result for prothrombin time

318.

From the ass? From the Mouth?

From the a** (diarrhea)= metabolic acidosis From the mouth (vomitus)=metabolic alkalosis

319.

Myxedema/ hypothroidism?

slowed physical and mental function, sensitivity to cold, dry skin and hair

320.

Graves disease/ Hyperthyroidism?

accelerated physical and mental function; sensitivity to heat, fine/soft hair

321.

Thyroid storm?

increased temp, pulse and HTN

322.

Post Thyroidectomy?

semi-Fowler's, prevent ncek flexion/hyperextension, trach at bedside

323.

Hypo-parathyroid?

CATS - convulsions, arrhythmias, tetany, spasms, stridor (decreased calcium), high Ca, low phosphorus diet

324.

Hyperparathyroid?

fatigue, muscle weakness, renal calculi, back and t pain (increased calcium), low Ca, high phosphorus diet

325.

Hypovolemia?

incrased temp, rapid/weak pulse, increase respiration, hypotension, anxiety, urine specific gravity >1.030

326.

Hypervolemia?

bounding pulse, SOB, dyspnea, rares/crackles, peripheral edema, HTN, urine specific gravity <1.010; Semi-Fowler's

327.

Diabetes Insipidus?

(decreased ADH): excessive urine output and thirst, dehydration, weakness, ister Pitressin

328.

SIADH?

(increased ADH): change in LOC, decreased deep tendon reflexes, tachycardia, n/v/a, HA; ister Declomycin, diuretics

329.

HypoKalemia?

muscle ewakness, dysrhythmias, increase K (raisins, bananas, apricots, oranges, beans, potatoes, carrots, celery)

330.

HyperKalemia?

MURDER - muscle weakness, urine (oliguria/anuria), respiratory depression, decreased cardiac contractility, ECG changes, reflexes

331.

Hyponatremia?

nausea, muscle cramps, increased I, muscular twitching, convulsion; osmotic diuretics, fluids

332.

Hypernatremia?

increased temp, weakness, disorientation/delusions, hypotension, tachycardia; hypotonic solution

333.

Hypocalemia?

CATS - convulsions, arrhythmias, tetany, spasms and stridor

334.

Hypercalemia?

muscle weakness, lack of coordination, abdominal pain, confusion, absent tendon reflexes, sedative effect on CNS

335.

HypoMg?

tremors, tetany, seizures, dyrshythmias, depression, confusion, dysphagia; dig toxicity

336.

HyperMg?

depresses the CNS, hypotension, facial flushing, muscle ewakness, absent deep tendon reflexes, shallow respirations, emergency

337.

Addisons?

hypoNa, hyperK, hypoglycemia, dark pigmentation, decreased resistance to stress, fractures, alopecia, weight loss, GI distress

338.

Cushings?

hyperNa, hypoK, hyperglycemia, prone to infection, muscle wasting, weakness, edema, HTN, hirsutism, moonface/buffalo hump

339.

Addisonian Crisis?

n/v, confusion, abdominal pain, extreme weakness, hypoglycemia, dehydration, decreased BP

340.

Pheochromocytoma?

hypersecretion of epi/norepi, persistent HTN, increased HR, hyperglycemia, diaphoresis, tremor, pounding HA; avoid stress, frequent bating and rest breaks, avoid cold and stimulating foods, surgery to remove tumor

341.

NMS?

-NMS is like S&M; -you get hot (hyperpyrexia) -stiff (increased muscle tone) -sweaty (diaphoresis) -BP, pulse, and respirations go up & -you start to drool

342.

Dangerous thing to get during pregnancy?

I kept forgetting which was dangerous when you're pregnant; regular measles (rubeola), or German measles (rubella), so : -never get pregnant with a German (rubella)

343.

Tetraology of Fallot?

Tetralogy of fallot; HOPS Think DROP(child drops to floor or squats) or POSH Defect, septal Right Ventricular hypertrophy Overriding aorts Pulmonary stenosis

344.

Autonomic Dysreflexia?

Autonomic dysreflexia: potentially life threatening emergency - elevate head of bed to 90 degree - loosen constrictive clothing - assess for bladder distention and bowel impaction (triger) - ister antihypertensive meds (may cause stroke, MI, seisure )

345.

FHR patterns in ob?

Have trouble ing fhr patterns in OB? Think VEAL CHOP VC EH AO LP V = variable decels; C = cord compression caused E = early decels; H = head compression caused A = accels; O = okay, not a problem! L = late decels = placental insufficiency, can't fill

346.

For cord compression in OB?

For cord compression, place the mother in the TRENDELENBERG position because this removes pressure of the presenting part off the cord. (If her head is down, the baby is no longer being pulled out of hte body by gravity) If the cord is prolapsed, cover it with sterile saline gauze to prevent drying of the cord and to minimize infection.

347.

Late Decels?

For late decels, turn the mother to her left side, to allow more blood flow to the placenta.

348.

Before Epidural?

Hydration is a big priority!

349.

Major risks of epidural?

Hypotension and bradypnea / bradycardia are major risks and emergencies.

350.

OB secret?

NEVER check the monitor or a machine as a first action. Always assess the patient first; for exmaple listen to the fetal heart tones with a stethoscope in NCLEX land. Sometimes it's hard to tell who to check on first, the mother or the baby; it's usually easy to tell the right answer if the mother or baby involves a machine. If you're not sure who to check first, and one of the choices involves the machine, that's the wrong answer.

351.

Hearing the baby in OB?

If the baby is a posterior presentation, the sounds are heard at the sides. If the baby is anterior, the sounds are heard closer to midline, between teh umbilicus and where you would listen to a posterior presentation. If the baby is breech, the sounds are high up in the fundus near the umbilicus. If the baby is vertex, they are a little bit above the symphysis pubis.

352.

Ventilator Alarms?

HOLD High alarm- Obstruction due to incr. secretions, kink, pt. coughs, gag or bites Low press alarm- Disconnection or leak in ventilatior or in pt. airway cuff, pt. stops spontaneous breathing

353.

To blood sugar?

hot and dry-sugar high (hyperglycemia) cold and clammy-need some candy (hypoglycemia)

354.

I and Shock have?

I AND SHOCK HAVE OPPOSITE V/S I-increased BP, decreased pulse, decreased resp. shock- decreased BP, increased pulse, increased resp.

355.

Cor Pulmonae?

right sided heart failure caused by left ventricular failure (so pick edema, jvd, if it is a choice.)

356.

Heroin withdrawl in a neonate?

Irritable, and poor sucking

357.

Jews?

No meat and milk together

358.

Brachial Pulse?

Pulse area r on infant

359.

What to check children for at age 12 months?

always check lead posioning levels

360.

Sources of potassium?

Bananas, potatoes, citrus fruits

361.

What is obtained before starting any iv antibiotic?

Cultures

362.

Why would a pt with leukemia have epistaxis?

b/c of low platelets

363.

Best way to warm a newborn?

skin to skin on mom with a blanket

364.

When a pt comes in and she is in active labor?

nurses FIRST action is to listen to fetal rate/tone

365.

How to treat phobic disorders?

systematic desensitization

366.

Best way to tube feed or feed kids?

small frequent is better than large

367.

With lower amputations?

place in prone position

368.

LVN/LPN cant?

Handle any blood

369.

Cardinal signs of ARDS?

Cardinal sign of ARDS is hypoxemia (low oxygen level in tissues).

370.

Best indicator of dehydration?

weight

371.

Besides sodium, water also follows?

Glucose

372.

Use of cold and hot?

Use cold for acute pain (sprained ankle) and heat for chronic pain (arthritis)

373.

Guided imagery is great for?

CHRONIC pain

374.

When patient is in distress?

Med istration is rarely a good choice

375.

Pneumonia?

pneumonia, fever and chills are usually present. For the elderly confusion is often present.

376.

COPD and Pneumonia?

COPD is chronic, pneumonia is acute. Emphysema and bronchitis are both COPD. in COPD patients the baroreceptors that detect the CO2 level are destroyed. Therefore, O2 level must be low because high O2 concentration blows the patient's stimulus for breathing.

377.

4 options for cancer?

chemo, radiation, surgery, allow to die with dignity.

378.

Nuetropenic patients?

no live vaccines, no fresh fruits, no flowers should be used for neutropenic patients.

379.

Where are chest tubes placed?

chest tubes are placed in the pleural space.

380.

Diff between angina and MI?

angina (low oxygen to heart tissues) = no dead heart tissues. MI= dead heart tissue present.

381.

Preload and Afterload?

Preload affects amount of blood that goes to the R ventricle. Afterload is the resistance the blood has to overcome when leaving the heart.

382.

CABG?

for a CABG operation when the great saphenous vein is taken it is turned inside out due to the valves that are inside.

383.

1 tsp= how many ml ?

1 t (teaspoon)= 5 ml

384.

1 tablespoon = how many ml?

1 T(tablespoon)= 3 t = 15 ml

385.

How many oz in a ml?

30 ml = 1 oz

386.

1 cup= how many oz?

1 cup= 8 oz

387.

1 quart = how many pints?

1 quart = 2 pints

388.

1 pint = how many cups?

1 pint= 2 cups

389.

1 gr= how many mg?

1 gr (grain)= 60 mg

390.

1 g = how many mg?

1 gram = 1000 mg

391.

1 kg= how many pounds?

2.2

392.

1 lb = how many ozs?

one pound equals 16 0z

393.

Temp conversion?

* To convert Centigrade to F. F= C+40, multiply 9/5 and substract 40 * To convert Fahrenheit to C. C= F+40, multiply 5/9 and substract 40.

394.

After Endoscopy?

after endoscopy check gag reflex.

395.

TPN is given in ?

TPN(total parenteral nutrition) given in subclavian line.

396.

Low Residue diet?

low residue diet means low fiver

397.

Diverticulitis?

diverticulitis (inflammation of the diverticulum in the colon) pain is around LL quadrant.

398.

Appendicitis

Appendicitis (inflammation of the appendix) pain is in RL quadrant with rebound tenderness.

399.

Cause of Ascites?

portal hypotension + albuminemia= Ascites.

400.

Who produces insulin?

beta cells of pancreas produce insulin

401.

s3 heart sound is normal? not?

Normal in CHF from the squishin'.. NOT normal in an MI patient

402.

Signs observed in hypocalemia?

Trousseau and Tchovoski signs observed in hypocalcemia

403.

DKA?

Diabetic ketoacidosis (DKA)= when body is breaking down fat instead of sugar for energy. Fats leave ketones (acids) that cause pH to decrease. 71. DKA is rare in diabetes mellitus type II because there is enough insulin to prevent breakdown of fats.

404.

s/s of a fat embolism?

petechiae. Treated with heparin.

405.

Knee replacement?

for knee replacement use continuous ive motion machine.

406.

Glaucoma patients loose?

glaucoma patients lose peripheral vision. Treated with meds

407.

c02 builds up and causes?

Co2 causes vasoconstriction.

408.

Where are most spinal cord injuries?

most spinal cord injuries are at the cervical or lumbar regions

409.

autonomic dysreflexia

autonomic dysreflexia ( life threatening inhibited sympathetic response of nervous system to a noxious stimulus- patients with spinal cord injuries at T-7 or above is usually caused by a full bladder.

410.

Myasthenia gravis?

myasthenia gravis= decrease in receptor sites for acetylcholine. Since smallest concentration of ACTH receptors are in cranial nerves, expect fatigue and weakness in eye, mastication, pharyngeal muscles.

411.

Guillian Barre?

Guillain-Barre syndrome= ascending paralysis. Keep eye on respiratory system.

412.

Parkisons?

parkinson's = RAT: rigidity, akinesia (loss of muscle mvt), tremors. Treat with levodopa.

413.

TIA?

TIA (transient ischemic attack) mini stroke with no dead brain tissue

414.

CVA?

CVA (cerebrovascular accident) is with dead brain tissue.

415.

Hodgkins disease?

Hodgkin's disease= cancer of lymph is very curable in early stage.

416.

Rule of nines?

Rule of NINES for burns Head and Neck= 9% Each upper ext= 9% Each lower ext= 18% Front trunk= 18% Back trunk= 18% Genitalia= 1%

417.

Peds weight ?

Birth weight doubles by 6 month and triple by 1 year of age.

418.

Dig rule for kids?

if HR is <100 do not give dig to children.

419.

First sign of cystic fibrosis?

first sign of cystic fibrosis may be meconium ileus at birth. Baby is inconsolable, do not eat, not ing meconium.

420.

Heart Defects?

heart defects. for cyanotic -3T's( Tof, Truncys arteriosus, Transposition of the great vessels). Prevent blood from going to heart. If problem does not fix or cannot be corrected surgically, CHF will occur following by death. 94. with R side cardiac

421.

Heart problems?

with R side cardiac cath=look for valve problems with L side in adults look for coronary complications

422.

What disease leads to cardiac valve malfunctions?

Rhematic fever

423.

Cerebral palsy?

poor muscle control due to birth injuries and/or decrease oxygen to brain tissues

424.

I?

I (intracranial pressure) should be <2. measure head circonference.

425.

Signs to look for in meningitis?

for Meningitis check for Kernig's/ Brudzinski's signs.

426.

Wilms tumor?

Wilm's tumor is usually encapsulated above the kidneys causing flank pain.

427.

Facts about hemophilia?

It is X-linked. Mother es the disease to her son

428.

What happens when phenylalanine increases?

brain problems occur

429.

Bucks traction =

knee immobility

430.

Russel Traction =

femur or lower leg instability

431.

Dunlap traction=

Skeletal or skin

432.

Bryant's traction=

Children <3yoa, <35 lbs with femur fx

433.

How to put on traction?

Place the apparatus first then place the weight (der)

434.

Where should placenta be?

Upper part of the uterus

435.

Eclampsia is a ?

seizure>

436.

A patient with vertical c- section will likely have?

another c section with any more kids

437.

Amniocentesis is performed? and why?

perform amniocentesis before 20 weeks gestation to check for cardiac and pulmonary abnormalities.

438.

Rh?

mothers receive rhogam to protect next baby.

439.

Fontanelles?

anterior fontanelle closes by 18 months. Posterior 6 to 8 weeks.

440.

caput succedaneum=

caput succedaneum= diffuse edema of the fetal scalp that crosses the suture lines. Swelling reabsorbs within 1 to 3 days.

441.

Pathological jaundice?

pathological jaundice= occurs before 24hrs and last7 days. Physiological jaundice occurs after 24 hours.

442.

Diff between placenta previa and placenta abrupto?

placenta previa = there is no pain, there is bleeding. Placenta abruption = pain, but no bleeding.

443.

Bethamethasone?

bethamethasone (celestone)=surfactant. Med for lung expansion.

444.

Dystocia?

dystocia= baby cannot make it down to canal

445.

Therapies?

milieu therapy= taking care of patient/environment cognitive therapy= counseling crisis intervention=short term.

446.

Rule of thumb for obsessions/distractions?

Osession is to thought. Compulsion is to action

447.

Rule of thumb for assisting pysch patients?

if patients have hallucinations redirect them. In delusions distract them.

448.

Alzheimers?

Alzheimer's disease is a chronic, progressive, degenerative cognitive disorder that s for more than 60% of all dementias

449.

Hyperthyroidism?

HYPERthyroidism think of MICHAEL JACKSON in THRILLER! SKINNY, NERVOUS, BULDGING EYES, Up all night, heart beating fast

450.

Awesome ing for cranial nerves?

Cranial Nerves: *I am sorry if this vulgar for some, but hey, it sticks Sensory=S Motor=M Both=B Oh (Olfactory I) Some Oh (Optic II) Say Oh (Oculomotor III) Marry To (Trochlear IV) Money Touch (Trigeminal V) But And (Abducens VI) My Feel (Facial VII) Brother A (Auditory VIII) Says Girls (Glossopharyngeal IX) Big Vagina (Vagus X) Bras And (Accessory XI) Matter Hymen (Hypoglassal XII) More

451.

Hypernatremia? SALT?

Hyper natremia (greater than 145) SALT! Skin flushed Agitation Low grade fever Thirst

452.

Developmental milestones?

Developmental 2-3 months: turns head side to side 4-5 months: grasps, switch & roll 6-7 months: sit at 6 and waves bye-bye 8-9 months: stands straight at eight 10-11 months: belly to butt (phrase has 10 letters) 12-13 months: twelve and up, drink from a cup

453.

Hepatitis?

Hepatitis Hepatitis: -ends in a VOWEL, comes from the BOWEL (Hep A) Hepatitis B=Blood and Bodily fluids Hepatitis C is just like B

454.

Apgar scores/scoring?

Apgar measures HR,RR,Muscle tone, Reflexes,Skin color each 0-2 point. 8-10 OK. 0-3 RESUSCITATE.

455.

Cute way to glascow coma?

GLASGOW COMA SCALE. EYES, VERBAL,MOTOR! It is similar to measuring dating skills...max 15 points -one can do it if below 8 you are in Coma. So, to start dating you gotta open your EYES first, if you albe to do that spontaneously and use them correctly to SEE whom you dating you earn 4. But if she has to scream on you to make you open them it is only 3....and 1 you dont care to open even if she tries to hurt you. if you get good EYE (4 points) then move to VERBAL. talk to her/ him! if you can do that You are really ORIENTED in situation she/he uncontiously gives you 4 points! if you like her try not to be CONFUSED (3), and of cause do not use INAPPROPRIATE WORDS (3), she will not like it)), try not to RESPOND WITH INCOMPREHENSIBLE SOUNDS (2), if you do not like herjust show no VERBAL RESPONSE(1) Since you've got EYE and VERBAL you can MOVE now using your Motor Response Points. THis is VERY important since Good moves give you 6!

456.

What to do for addisons/cushings?

Addison's disease (need to "add" hormone) Cushing's syndrome (have extra "cushion" of hormones)

457.

Dumping syndrome?

Dumping syndrome: increase fat and protein, small frequent meals, lie down after meal to decrease peristalsis, wait 1 hr after meals to drink.

458.

Blood typing?

For blood types: "O" is the universal donor ( "o" in donor) "AB" is the universal receipient

459.

Gross things to about nurses with herpes!!!!

Disseminated Herpes Zoster is AIRBORNE PRECAUTIONS, as to Localized Herpes Zoster is PRECAUTIONS. A nurse with a localized herpes zoster CAN care for patients as long as the patients are NOT immunosuppressed and the lesions must be covered!

460.

Birth control- Diaphram?

Diaphragm must stay in place 6 hours after intercourse. They are also fitted so must be refitted if you lose or gain a significant amount of weight.

461.

Cushing ulcers and cushings triad?

Cushings ulcers r/t BRAIN injury *Cushings triad r/t I in BRAIN (htn, bradycard, irr. resp)

462.

Thyroid storm and myxedema?

Thyroid storm is HOT (hyperthermia) *Myxedema coma is COLD (hypothermia)

463.

Nondairy sources of calcium?

Non dairy sources of calcium include RHUBARB, SARDINES, COLLARD GREENS

464.

Whats petaling?

You can petal the rough edges of a plaster cast with tape to avoid skin irritation.

465.

How do you teach someone to reduce back aches?

With low back aches, bend knees to relieve

466.

Koplick's spots?

* Koplick's spots are red spots with blue center characteristic of PRODROMAL stage of Measles. Usually in mouth.

467.

Pancreatitis pts>?

* Pancreatitis patients but them in fetal position, NPO, gut rest, prepare antecubital site for PICC cuz they'll probably be getting TPN/Lipids

468.

Trendelenberg's test?

Trendelenburg test - for varicose veins. If they fill proximally = varicosity.

469.

What can't you give to immunosupressed pts?

Yogurt has live cultures- dont give to immunosuppressed pt

470.

How to itch under a cast?

Itching under cast area- cool air via blow dryer, ice pack for 10- 15 minutes. NEVER use qtip or anything to scratch area

471.

Murphy's sign?

Murphy's sign - pain with palpation of gall bladder area seen with cholecystitis

472.

Cullens sign?

Cullen's sign - ecchymosis in umbilical area, seen with pancreatitis

473.

Turner's sign?

Turner's sign - flank grayish blue (turn around to see your flanks) pancreatitis

474.

Mcburney's point?

McBurney's Point - pain in RLQ indicative of appendicitis--RLQ - appendicitis, watch for peritonitis

475.

Pain in the LLQ indicative of?

LLQ - diverticulitis , low residue, no seeds, nuts, peas

476.

Guthrie test?

Guthrie Test - Tests for PKU, baby should have eaten source of protein first

477.

Shilling test?

Shilling Test - test for pernicious anemia/ how well one absorbs Vit b12

478.

Allen's test?

Allen's test - occlude both ulnar and radial artery until hand blanches then release ulnar. If the hand pinks up, ulnar artery is good and you can carry on with ABG/radial stick as planned. ABGS must be put on ice and whisked to the lab.

479.

Tenkhoff cath?

oIt's ok to have abdominal craps, blood tinged outflow and leaking around site if the Peritoneal Dialysis cath (tenkhoff) was placed in the last 1-2 wks. Cloudy outflow NEVER NORMAL.

480.

Meconium stained protocol?

oAmniotic fluid yellow with particles = meconium stained`

481.

Hyper reflexive? Absent reflexsive?

oHyper reflexes (upper motor neuron issue "your reflexes are over the top") oAbsent reflexes (lower motor neuron issue)

482.

When is Rhogam given and how?

oRhogam : given at 28 weeks, 72 hours post partum, IM. Only given to Rh NEGATIVE mother.

483.

Coomb's test?

Also if indirect Coomb's test is positive, don't need to give Rhogam cuz she has antibody only give if negative coombs

484.

Order of assessment?

Order of assessment: Inspection, Palpation, Percussion and Ausculation. EXCEPT with abdomen cuz you don't wanna mess with the bowels and their sounds so you Inspect, Auscultate, Percuss then Palpate (same with kids, I suppose since you wanna go from least invasive to most invasive sine they will cry BLOOD MURDER ! Gotta love them kids !)

485.

Latex allergies?

Latex allergies => Assess for allergies to bananas, apricots, cherries, grapes, kiwis, ion fruit, avocados, chestnuts, tomatoes, peaches

486.

ALS?

Amyotrophic lateral sclerosis ( ALS ) is a condition in which there is a degeneration of motor neurons in both the upper & lower motor neuron systems.

487.

TEF?

Transesophageal Fistula (TEF) - esophagus doesn't fully develop (this is a surgical emergency) The 3 C's of TEF in the newborn: 1) Choking 2) Coughing 3) Cyanosis

488.

MMR SHot?

The MMR vaccine is given SQ not IM.

489.

Color codes?

Red--unstable, ie, occluded airway, actively bleeding, see first Yellow---stable, can wait up to an hour for treatment, ie burns, see second Green---stable, can wait even longer to be seen, "walking wounded" Black--unstable clients that will probably not make it, need comfort measures

490.

Greeks?

Greek heritage - they put an amulet or any other use of protective charms around their baby's neck to avoid "evil eye" or envy of others

491.

4 year olds?

4 year old kids cannot interpret TIME. Need to explain time in relationship to a known COMMON EVENT (eg: "Mom will be back after supper").

492.

Hep B vaccine always ask?

Anaphylactic reaction to baker's yeast is contraindication for Hep B vaccine.

493.

Flu shot always ask?

allergic to eggs??? (Tristan D. ) !

494.

Before giving MMR>?

** Ask for anaphylactic rxn to eggs or neomycin before MMR

495.

If kid has a cold?

**If kid has cold, can still give immunizations

496.

SARS?

**SARS (severe acute resp syndrome) airborne + (just like varicella)

497.

Disease precautions?

** Hepatitis A is precautions ** Tetanus, Hepatitis B, HIV are STANDARD precautions

498.

Willam's position?

** William's position - Semi Fowlers with knees flexed (inc. knee gatch) to relieve lower back pain.

499.

Signs of a hip fracture?

SIGNS of a Fractured hip: EXTERNAL ROTATION, SHORTENING, ADDUCTION

500.

S/S of a fat embolism?

Fat Embolism: Blood tinged sputum (r/t inflammation), inc ESR, respiratory alkalosis (not acidosis r/t tachypnea), hypocalcemia,increased serum lipids, "snow storm" effect on CXR.

501.

Complications of mechanical ventilation?

Complications of Mechanical Ventilation: Pneumothorax, Ulcers

502.

Paget's disease?

Paget's Disease - tinnitus, bone pain, enlargement of bone, thick bones.

503.

Intravenous Pylogram requires?

** IVP requires bowel prep so they can visualize the bladder better

504.

ACID ash diet?

Acid Ash diet - cheese, corn, cranberries, plums, prunes, meat, poultry, pastry, bread

505.

Alkaline Ash diet?

Alk Ash diet- milk, veggies, rhubarb, salmon

506.

Orange tag in pysch

Orange tag in triage is non emergent Psych

507.

Greenstick fracture?

Greenstick fractures, usually seen in kids bone breaks on one side and bends on the other

508.

Side effects of thyroid hormones?

Insomnia is a side effect of thyroid hormones. Saunders confirms it. Makes sense though!Increased met. rate, your body is "too busy to sleep" as opposed to the folks with hypothyroidism who may report somnolence (dec. met rate, body is slow and sleepy).

509.

Botox?

** BOTOX for strabismus. Patch the GOOD eye so that the weaker eye can get stronger. Found a cool link about its use in peds pt with strabismus. I had to look it up cuz I heard it was important ah hem ah hem

510.

Tidal volume?

** TIDAL VOLUME is 7 - 10ml / kg

511.

COPD patients?

** COPD patients : 2LNC or less (hypoxic NOT hypercapnic drive), Pa02 of 60ish and Sa02 90% is normal for them b/c they are chronic CO2 retainers. ...

512.

Stranger Danger>?!?

Stranger anxiety is greatest 7 - 9 months, Separation anxiety peaks in toddlerhood

513.

Lymes mostly found in

Lymes is found mostly in Conneticuts

514.

Asthma and arthritis best excercise?

swimming

515.

What is a bad sign in asthma?

intercostal retractions=bad!

516.

ABG drawin?

When drawing an ABG, you need to put the blood in a heparinized tube, make sure there are no bubbles, put on ice immediately after drawing, with a lable indicating if the pt was on room air or how many liters of O2. to preform the Allen's Test prior to doing an ABG to check for sufficient blood flow

517.

Before a pft?

Before going for Pulmonary Fuction Tests (PFT's), a pt's bronchodilators will be with-held and they are not allowed to smoke for 4 hrs prior

518.

For a lung biopsy?

For a lung biopsy, position pt lying on side of bed or with arms raised up on pillows over bedside table, have pt hold breath in midexpiration, chest x-ray done immediately afterwards to check for complication of pneumothorax, sterile dressing applied

519.

For a lumbar puncture?

For a lumbar puncture, pt is positioned in lateral recumbent fetal position, keep pt flat for 2-3 hrs afterwards, sterile dressing, frequent neuro assessments

520.

For an EEG test?

EEG, hold meds for 24-48 hrs prior, no caffine or cigarettes for 24 hrs prior, pt can eat, pt must stay awake night before exam, pt may be asked to hyperventilate and watch a bright flashing light, after EEG, assess pt for seizures, pt's will be at increased risk

521.

Munchhausen Syndrome?

-Munchausen Syndrome is a psychiatric disorder that causes an individual to self-inflict injury or illness or to fabricate symptoms of physical or mental illness, in order to receive medical care or hospitalization. In a variation of the disorder, Munchausen by proxy (MSBP), an individual, typically a mother, intentionally causes or fabricates illness in a child or other person under her care.

522.

MS?

-Multiple Sclerosis is a chronic, progressive disease with demyelinating lesions in the CNS which affect the white matter of the brain and spinal cord. Motor S/S: limb weakness, paralysis, slow speech Sensory S/S: numbness, tingling, tinnitus Cerebral S/S: nystagmus, ataxia, dysphagia, dysarthria

523.

Huntington's Chorea?

Huntington's Chorea: 50% genetic, autosomal dominant disorder S/S: chorea --> writhing, twisting, movements of face, limbs and body -gait deteriorates to no ambulation -no cure, just palliative care

524.

Shift to the left means?

WBC shift to the left in a patient with pyelonephritis neutrophils kick in to fight infection

525.

How to Dx a AAA?

Definitive diagnosis for abd. aortic aneurysm (AAA) --> CT scan

526.

Uremic Fetor?

Uremic fetor --> smell urine on the breath

527.

Hirschsprungs?

-Hirschsprung's --> bile is lower obstruction, no bile is upper obstruction; ribbon like stools.

528.

No Cantalope?

Thank you, I finally realize why a person shouldn't have cantaloupe before a occult stool test, because cantaloupe is high in vit c and vit c causes a false + for occult blood. Now I just need to figure out why they can't have fish.

529.

Penis Problems?

Hypospadias: abnormality in which urethral meatus is located on the ventral (back) surface of the penis anywhere from the corona to the perineum ( hypo, low (for lower side or under side) Epispadias: opening of the urethra on the dorsal (front) surface of the penis Priapism: painful erection lasting longer than 6 hrs.

530.

When you see coffee brown emesis think?>

Peptic ulcer

531.

For PVD ?

For PVD DAVE (Legs are Dependent forArterial & for Venous Elevated)

532.

Traction rule?

Never release traction unless you have an order from an MD to do so

533.

Halo?

Questions about a halo? safety first, have a screwdriver nearby.

534.

Compartment syndrome?

compartment syndrome is an emergency situation. Paresthesias and increased pain are classic symptoms. Neuromuscular damage is irreversible 4-6 hours after onset.

535.

Behavior/Developmental-Peds

Behavior motivated by need to avoid anxiety and satisfy needs 1. Infancy 0-18 months others will satisy needs 2. childhood >6yrs learn to delay need gratification 3. juvenile 6-9 years learn to relate to peers 4. preadolescence 9-12 yrs learns to relate to friends of of opposite sex 5. early adolescence12-14yrs:learn independence and how to relate to opposite sex 6. late adolecence 14-21yrs: develop intimate relationship with person of opposite sex is this not about communication?....

536.

Fetal alcohol sydrome?

Fetal alcohol syndrome -upturned nose -flat nasal bridge -thin upper lip -SGA

537.

Immunizations rules?

vastus lateralis is IM istration site for 6month infants For toddlers above 18 months ventrogluteal The deltoid and gluteus maximus are appropriate sites for children`

538.

Eyes?

OU- both eyes OS- left eye OD- right eye ( dominent Right eye- just a tip to )

539.

Cane walking?

1. COAL (cane walking): C - cane O - opposite A - affected L - leg

540.

In depth- Color codes??

Red- Immediate: Injuries are life threatening but survivable with minimal intervention. Ex: hemothrax, tension pneumothorax, unstable chest and abdominal wounds, INCOMPLETE amputations, OPEN fx's of long bones, and 2nd/3rd degree burn with 15%-40% of total body surface, etc. Yellow- Delayed: Injuries are significant and require medical care, but can wait hrs without threat to life or limb. Ex: Stable abd wounds without evidence of hemorrhage, fx requiring open reduction, debridement, external fixation, most eye and CNS injuries, etc. Green- Minimal: Injuries are minor and tx can be delayed to hrs or days . Individuals in this group should be moved away from the main triage area. Ex: upper extremity fx, minor burns, sprains, sm. lacerations, behavior disorders. Black- Expectant: Injuries are extensive and chances of survival are unlikely. Seperate but dont abandoned, comfort measures if possible. Ex: Unresponsive, spinal cord injuries, woulds with anatomical organs, 2nd/3rd degree burn with 60% of body surface area , seizures, profound shock with multipe injuries, no pulse, b.p, pupils fixed or dilated.

541.

Thoracentesis?

Thoracentesis prep- Take v.s., shave area around needle insertion, position patient with arms on pillow on over bed table or lying on side, no more than 1000cc at a one time. Post- listen for bilateral breath sounds, v.s., check leakage, sterile dressing.

542.

Cath lab?

Cardiac cath- npo 8-12hr, empty bladder, pulses, tell pt may feel heat palpitations or desire to cough with dye injection. Post- Vital signs keep leg straight bedrest 6-8hr.

543.

MRI?

MRI- claustrophobia, no metal, assess pacemaker

544.

Cerebral angio prep?

cerebral angio prep- well hydrated, lie flat, sire shaved, pulses marked post- keep flat 12-14hr, check site, pulses,force fluids.

545.

More info on lumbar puncture?

Lumbar puncture- fetal postion. post- nuero assess q15-30 until stable, flat2-3hr, encourage fluids, oral anlgesics for headache, observe dressing

546.

More info on EEG?

EEG- no sleep the night before, meals not withheld, no stimulants for 24hr before, tranquilizer/stimulant meds held 24-48hr before, may be asked to hyperventilate 3-4min and watch a bright flashing light.

547.

Myelogram?

Myelogram- Npo 4-6hr, allergy hx, phenothiazines, cns depressants, and stimulants withheld 48hr prior, table will be moved to various postions during test. Post- neuro q2-4, water soluble HOB up, oil soluble HOB down, oral analgesics for h/a, encourage po fluids, assess for distended bladder, inspect site.

548.

Liver biopsy?

Liver biopsy- vit k , npo morning of exam 6hr, give sedative, Teach pt that he will be asked to hold breath for 5-10sec, supine postion, lateral with upper arms elevated. Post- postion on right side, frequent v.s., report severe ab pain stat, no heavy lifting 1wk.

549.

Paracentesis?

Paracentesis- semi fowlers or upright on edge of bed, empty bladder. Post- v.s., report elevated temp, observe for signs of hypovolemia.

550.

Laparoscopy?

Laparoscopy- CO2 used to enhances visual, general anesthesia, foley. Post- walk patient to decrease CO2 build up used for procedure.

551.

Sengstaken blakemore tube ?

Sengstaken blakemore tube used for tx of esophageal varices, keep scissors at bedside.

552.

Hemovac?

Hemovac- used after mastectomy, empty when full or q8hr, remove plug, empty contents, place on flat surface, cleanse opening and plug with alcohol sponge, compress evacuator completely to remove air, release plug, check system for operation.

553.

Common S/S of PTB?

Common Signs and Symptoms 01. PTB - low-grade afternoon fever.

554.

Common S/S of pneumonia?

Rusty sputum

555.

Common S/S of asthma

Wheezing on EXPIRATION

556.

Common S/S of emphysema?

Barrel chest

557.

Common S/S of Kawasaki syndrome?

Strawberry tongue

558.

Common S/S of pernicious anemia

red beefy tongue

559.

Common S/S of down syndrome

protruding tongue

560.

Common S/S of Cholera?

Rice watery stool

561.

Common S/S of Malaria?

Stepladder like fever with chills

562.

Common S/S of Thypohiod

Rose spots on abdomen

563.

Common S/S of Diptheria?

Psuedo membrane formation

564.

Common S/S of measles?

Kopliks spots

565.

Common S/S of SLE?

Butterfly rashes

566.

Common S/S of Liver cirrhoisis?

Spider like varices- Varices can be in stomach, esophagus or the skin! They are just spider/varicose veins! Ithcy on the skin

567.

Common S/S of leprosy?

Lioning face

568.

Common S/S of Bulimia?

chipmunk face

569.

Common S/S of appendicitis

rebound tenderness

570.

Common S/S of Dengue

petechiae or + Herman's sign

571.

Common S/S of Meningitis?

Kernigs Sign (leg flex then leg pain on extension) Brudinzski sign (neck flex= lower leg flex)

572.

Common S/S of Tetany?

Risus Sardonicus

573.

Common S/S of pancreatitis?

Cullens sign ( ecchymosis of umbilicus) (+) Grey Turner spots

574.

Common S/S of pyloric stenosis?

olive like mass

575.

Common s/s of PDA

Machine like murmur

576.

Common S/S of addisions?

bronze like skin pigmentation

577.

Common S/S of Cushings syndrome?

Moon face appearance and buffalo hump

578.

Common S/S of Intusseption?

Sausage shaped mass , Dance sign (empty portion of RLQ)

579.

Common S/S of MS>?

Charcot's Triad (IAN)

580.

Common S/S of MG?

Descending muscle weakness

581.

Common S/S of guillian Barre Syndrome

Ascending muscle paralysis.. dont confuse with MG

582.

Common S/S of chicken pox?

Vesicular rash (central to distal) dew drop on rose petal

583.

Common S/S of LTB?

inspiratory stridor.. LTB = croup!!!!

584.

Common S/S of TEF?

4 C'S- Coughing, Choking, Cyanosis and continuous droolings

585.

Common S/S of epiglottitis?

3 D'S --Drooling, Dysphonia, Dysphagia

586.

Common S/S of Hodgkins Disease/Lymphoma?

Painless, progressive englargement of spleen and lymph tissues, and Reedstenberg cells!

587.

Common S/S of Infectious Mononucleosis?

Hallmark= Sore throat, cervical lymph adenopathy, fever

588.

Common S/S of parkinsons?

Pilling rolling tremors

589.

Cmmon S/S Fibrin Hyalin?

Expiratory grunt-- Causes Infant respiratory distress!

590.

Common S/S of cystic fibrosis?

Salty skin

591.

Common S/S of DKA

Kussmauls breathing (deep rapid RR)

592.

Common S/S of Bladder Cancer?

painless hematuria... CA=Cancer ! Duhh

593.

Common S/S of BPH?

reduced size and force of urine

594.

Common S/S of Pemphigus Vulgaris?

Nilosky's sign (seperation of epidermis caused by rubbibng of the skin)

595.

Common S/S of retinal detachment?

Visual floaters, flashes of light, curtain vision

596.

Common S/S of glaucoma?

Painful vision loss, tunnel/gun barrel/ halo vision (peripheral vision loss)

597.

Common S/S of Cataract?

PainLESS vision loss, opacity of lens, blurring of the vision

598.

Common S.S of Retino Blastoma?

Cat's eye reflex (grayish discoloration of the pupil)

599.

Common S/S Acromegaly?

Coarse facial features

600.

Common S/S Duchennes Muscular Dystrophy?

Gower's sign (use of the hands to push ones self from the floor_) Looks EXACTLY like the Pilates Downward dog!!!!!!!

601.

Common S/S of GERD?

Barrets Esophagus (erosion of the lower portion of the esophageal mucosa)

602.

Common S/S Hepatic Encephalopathy ?

Flapping tremors

603.

Common S/S of Hydrocephalosis?

Bossing Sign (prominent forehead)

604.

Common S/S of Increased I?

HYPERTENSION, BRADYpnea, BRADYcardia (cushings triad)!

605.

Common S/S of Shock?

HYPERtension TACHYpnea and TACHYcardia

606.

Common S/S Meniere's Disease?

Vertigo, Tinnitus

607.

Common S/S of Cystitis?

Burning on urination

608.

Common S/S of hypocalcemia?

Chvostek and Trosseaus sign! Also hypomag!

609.

Common S/S of Ulcerative Colitis?

Recurrent bloody diarrhea

610.

Common S/S of Lyme's disease

Bull's eye rash

611.

Common S/S of Basilar Fracture?

Ottorhea

612.

Common S/S of orbital fracture?

Battles Sign and Racoon's eyes

613.

Osteomyeltitis?

Osteomyletitis is an infectious bone dz. Give blood cultures and antibiotics, then if necessary surgery to drain abscess.

614.

Nephrotic syndrome?

Nephrotic syndrome s/s edema + hypotension. Turn and reposition (risk for impaired skin integrity)

615.

Renal impairment labs?

Renal impairment: serum creatinine elevated and urine clearance decreased

616.

Normal Hemoglobin?

Hemoglobin Neonates 18-27 3 mos 10.6-16.5 3 yrs 9.4-15.5 10 yrs 10.7-15.5

617.

Glomerulonephritis?

Glomerulonephritis: take vs q 4 hrs + daily weights

618.

Age 4=5 year shots?

Age 4 to 5 yrs child needs DPT/MMR/OPV

619.

Cystic fibrosis?

Cystic Fibrosis give diet low fat, high sodium, fat soluble vitamins ADEK. Aerosal bronchodilators, mucolytics and pancreatic enzymes.

620.

More info on droplet precautions?

Droplet Precautions:sepsis, scarlet fever, streptococcal pharyngitis, parovirus B19, pnuemonia, pertusis, influenza, diptheria, epiglottis, rubella, mumps, meningitis, mycoplasma and adenovirus. Door open, 3 ft distance, private room or cohort, mask

621.

Meningeal irriatation>?

Meningeal irritation S/s nuchal rigidity, positive Brudzinski + Kernig signs and PHOTOPHOBIA too!

622.

Babinski sign?

toes curl= GREAT Toes fan = BAD

623.

GTT for preggos?

Glucose Tolerance Test for preggies result of 140 or highter needs further evaluation.

624.

Cranial nerves for Assessing extraocular eye movements?

3,4,6

625.

Stomas?

Stomas dusky stoma means poor blood supply, protruding means prolapsed, sharp pain + rigidity means peritonitis, mucus in ileal conduit is expected.

626.

Tension Pneumothorax?

Trachea shifts to the opposite side

627.

Change in color is ?

a LATE sign! Always~!

628.

Incentive Spirometry steps?

Incentive Spirometry steps:1) Sit upright 2) Exhale 3) Insert mouthpiece 4) Inhale for 3 seconds, and then HOLD for 10 seconds

629.

MRSA and VRSA precautions?

*MRSA - precaution ONLY *VRSA - AND airborne precaution (Private room, door closed, negative pressure)

630.

Thrombocyopenia- bleeding precautions

*Thrombocytopenia -Bleeding precautions! 1)Soft bristled toothbrush 2)No insertion of anything! (c/i suppositories, douche)

631.

Burn Degrees?

1st Degree - Red and Painful 2nd Degree - Blisters 3rd Degree - No Pain because of blocked and burned nerves

632.

Menieres's disease?

*Meniere's Disease - diuretics to decrease endolymph in the cochlea, restrict Na, lay on affected ear when in bed. Triad: 1)Vertigo 2)Tinnitus 3)N/V

633.

Gastric ulcer pain

*Gastric Ulcer pain occurs 30 minutes to 90 minutes after eating, not at night, and doesn't go away with food

634.

Med that can't be infused Intra osseously?

One medication that cannot be istered by intraosseous infusion is isoproterenol, a beta agonist.

635.

Sickle cell crisis?

During sickle cell crisis there are two interventions to prioritize: fluids and pain relief.

636.

Glomerulonephritis considerations

With glomerulonephritis you should consider blood pressure to be your most important assessment parameter. Dietary restrictions you can expect include fluids, protein, sodium, and potassium.

637.

Labs for congenital heart disease?

yesterday when I mentioned how congenital cardiac defects result in hypoxia which the body attempts to compensate for (influx of immature rbc's)? Labs ing this would show increased hematocrit, hemoglobin, and rbc count.

638.

Kidneys and ears?

Did you know there is an association between low-set ears and renal anomalies? Now you know what to look for if down's isn't there to choose. (just to expand on it a little, the kidneys and ears develop around the same time in utero. Hence, they're shaped similarly. Which is why when doing an assessment of a neonate, if the nurse notices low set or asymmetrical ears, there is good reason to investigate renal functioning. Knowing that the kidneys and ears are similar shapes helped me this).

639.

School aged kids and five year olds?

School-age kids (5 and up) are old enough, and should have an explanation of what will happen a week before surgery such as tonsillectomy.

640.

What if a toddler says no to medication?

If you gave a toddler a choice about taking medicine and he says no, you should leave the room and come back in five minutes, because to a toddler it is another episode. Next time, don't ask.

641.

First sign of pyloric stenosis in a baby?

The first sign of pyloric stenosis in a baby is mild vomiting that progresses to projectile vomiting. Later you may be able to palpate a mass, the baby will seem hungry often, and may spit up after feedings.

642.

Kawasaki disease causes?

We know Kawasaki disease causes a heart problem, but what specifically? Coronary artery aneurysms d/t the inflammation of blood vessels.

643.

A child with a ventriculoperitoneal shunt

A child with a ventriculoperitoneal shunt will have a small upper-abdominal incision. This is where the shunt is guided into the abdominal cavity, and tunneled under the skin up to the ventricles. You should watch for abdominal distention, since fluid from the ventricles will be redirected to the peritoneum. You should also watch for signs of increasing intracranial pressure, such as irritability, bulging fontanels, and high-pitched cry in an infant. In a toddler watch lack of appetite and headache. Careful on a bed position question! Bed-position after shunt placement is flat, so fluid doesn't reduce too rapidly. If you see s/s of increasing i, then raise the hob to 15-30 degrees.

644.

What could cause bronchopulmonary dysplasia?

What could cause bronchopulmonary dysplasia? Dysplasia means abnormality or alteration. Mechanical ventilation can cause it. Premature newborns with immature lungs are ventilated and over time it damages the lungs. Other causes could be infection, pneumonia, or other conditions that cause inflammation or scarring.

645.

How do children less than one breathe?

It is essential to maintain nasal patency with children < 1 yr. because they are obligatory nasal breathers.

646.

Milk for kids?

Watch out for questions suggesting a child drinks more than 3-4 cups of milk each day. (Milks good, right?) Too much milk reduces intake of other essential nutrients, especially iron. Watch for anemia with milk-aholics. And don't let that mother put anything but water in that kid's bottle during naps/over-night. Juice or milk will rott that kids teeth right out of his head.

647.

Traction in kids?

What traction is used in a school-age kid with a femur or tibial fracture with extensive skin damage? Ninety, ninety. Huh? I never heard of it either. The name refers to the angles of the ts. A pin is placed in the distal part of the broken bone, and the lower extremity is in a boot cast. The rest is the normal pulleys and ropes you're used to visualizing with balanced suspension. While we're talking about traction, a kid's hinder should clear the bed when in Bryant's traction (also used for femurs and congenial hip for young kids).

648.

Yeast infection in a babys mouth?

If you can remove the white patches from the mouth of a baby it is just formula. If you can't, its candidiasis.

649.

MMR and Varicella?

Just know the MMR and Varicella immunizations come later (15 months).

650.

Cryptoorchidism?

Undescended testis or cryptorchidism is a known risk factor for testicular cancer later in life. Start teaching boys testicular self exam around 12, because most cases occur during adolescence.

651.

Maslow for a guy who lost his house in a fire?

- A guy loses his house in a fire. Priority is using community resources to find shelter, before assisting with feelings about the tremendous loss. (Maslow).

652.

Kids pain relief in NCLEX land?

No aspirin with kids b/c it is associated with Reye's Syndrome, and also no nsaids such as ibuprofen. Give Tylenol.

653.

How will CSF look in meningitis?

CSF in meningitis will have high protein, and low glucose.

654.

Suctioning is good--except

No nasotracheal suctioning with head injury or skull fracture.

655.

Peds positioning for GERD?

Position prone w hob elevated with gerd. In almost every other case, though, you better lay that kid on his back (Back To Sleep - SIDS).

656.

When instilling eardrops?

Pull pinna down and back for kids < 3 yrs. when instilling eardrops.

657.

Kids with RSV?>

Kids with RSV; no lenses or pregnant nurses in rooms where ribavirin is being istered by hoot, tent, etc.

658.

Positioning with pneaumonia?

Positioning with pneumonia - lay on the affected side to splint and reduce pain. But if you are trying to reduce congestion the sick lung goes up. (Ever had a stuffy nose, and you lay with the stuff side up and it clears?)

659.

TB test confirmation?

A positive ppd confirms infection, not just exposure. A sputum test will confirm active disease.

660.

Asthmas and wheezers?

Coughing w/o other s/s is suggestive of asthma. Speaking of asthma, watch out if your wheezer stops wheezing. It could mean he is worsening.

661.

What treats tet spells?

Tet spells treated with morphine.

662.

Group-A strep?

Group-a strep precedes rheumatic fever. Chorea is part of this sickness (grimacing, sudden body movements, etc.) and it embarrasses kids. They have t pain. Watch for elevated antistreptolysin O to be elevated. Penicillin!

663.

Tylenol poisioining ?

Tylenol poisoning - liver failure possible for about 4 days. Close observation required during this time-frame, as well as tx with Mucomyst.

664.

Radioactive iodine?

Radioactive iodine - The key word here is flush. Flush substance out of body w/3-4 liters/day for 2 days, and flush the toilet twice after using for 2 days. Limit w/patient to 30 minutes/day. No pregnant visitors/nurses, and no kids.

665.

Main hypersensitivity for antiplatelet drugs?

broncospasm (anaphylaxis)

666.

Common sites for metastatsis?

liver, brain, lung, bone, and lymph

667.

Orthostatis is verfied by?

a drop in presssure with increasing heart rate... Orthostatis= orthostatic hypotension

668.

Bence Jones protein in urine?

confirms multiple myeloma

669.

How do you treat a small bowel obstruction?

Don't fall for 'reestablishing a normal bowel pattern' as a priority with small bowel obstruction. Because the patient can't take in oral fluids 'maintaining fluid balance' comes first.

670.

G tube and J tubes are usually?

Other than initially to test tolerance, G-tube and J-tube feedings are usually given as continuous feedings.

671.

Side rail rules?

Four side-rails up can be considered a form of restraint. Even in LTC facility when a client is a fall risk, keep lower rails down, and one side of bed against the wall, lowest position, wheels locked.

672.

Post spleenectomy?

Pneumovax 23 gets istered post splenectomy to prevent pneumococcal sepsis.

673.

Potassium lab importance?

Let's say every answer in front of you is an abnormal value. If potassium is there you can bet it is a problem they want you to identify, because values outside of normal can be life threatening. Normal potassium is 3.5-5.0. Even a bun of 50 doesn't override a potassium of 3.0 in a renal patient in priority.

674.

Every new ission needs?

You will ask every new ission if he has an advance directive, and if not you will explain it, and he will have the option to sign or not.

675.

Potassium and acid base balance?

A little trick regarding potassium: ALKALOSIS: K is LOW Acidosis is just the opposite: K is High The vital sign you should check first with high potassium is pulse (due to dysrhythmias).

676.

What is bleeding considered in ADPIE?

Bleeding is part of the 'circulation' assessment of the ABCD's in an emergent situation. Therefore, if airway and breathing are ed for, a compound fracture requires assessment before Glasgow coma scale and a neuro check (D=disability, or neuro check)

677.

What to do in a sucking stab wound?

The immediate intervention after a sucking stab wound is to dress the wound and tape it on three sides which allows air to escape. Do not use an occlusive dressing, which could convert the wound from open pneumo to closed one, and a tension pneumothorax is worse situation. After that get your chest tube tray, labs, iv.

678.

What to do if your patients chest tube accidently getes removed?

An occulsive dressing is used

679.

Labs in DKA>?

Serum acetone and serum ketones rise in DKA. As you treat the acidosis and dehydration expect the potassium to drop rapidly, so be ready, with potassium replacement. Fluids are the most important intervention with HHNS as well as DKA, so get fluids going first. With HHNS there is no ketosis, and no acidosis. Potassium is low in HHNS (d/t diuresis).

680.

Decorticate and Decerebrate?

Decorticate positioning in response to pain = Cortex involvement. Decerebrate in response to pain = Cerebellar, brain stem involvement

681.

Other S/S of MS?

Hyperactive deep tendon reflexes, vision changes, fatigue and spasticity are all symptoms of MS

682.

After removal of the pituitary gland what should you watch for?

After removal of the pituitary gland you must watch for hypocortisolism and temporary diabetes insipidus.

683.

After appendectomy?

position on the RIGHT side with legs flexed

684.

Hirschsprungs is dx how?

Hirschsprung's diagnosed with rectal biopsy looking for absence of ganglionic cells. Cardinal sign in infants is failure to meconium, and later the classic ribbon-like and foul smelling stools.

685.

More info on intussception?

Intussusception common in kids with CF. Obstruction may cause fecal emesis, currant jellylike stools (blood and mucus). A barium enema may be used to hydrostatically reduce the telescoping. Resolution is obvious, with onset of bowel movements.

686.

Omphalocele?

With omphalocele and gastroschisis (herniation of abdominal contents) dress with loose saline dressing covered with plastic wrap, and keep eye on temp. Kid can lose heat quickly.

687.

Hydrocele?

After a hydrocele repair provide ice bags and scrotal .

688.

PKU ?

No phenylalanine with a kid positive for PKU (no meat no dairy no aspartme

689.

When to test urine for ketones and glucose?

Second voided urine most accurate when testing for ketones and glucose.

690.

Nepphrotic syndrome?

Nephrotic syndrome is characterized by massive proteinuria (looks dark and frothy) caused by glomerular damage. Corticosteroids are the mainstay. Generalized edema common.

691.

Western blot test?

A positive Western blot in a child <18 months (presence of HIV antibodies) indicates only that the mother is infected. Two or more positive p24 antigen tests will confirm HIV in kids <18 months. The p24 can be used at any age.

692.

Kids with HIV?

For HIV kids avoid OPV and Varicella vaccinations (live), but give Pneumococcal and influenza. MMR is avoided only if the kid is severely immunocompromised. Parents should wear gloves for care, not kiss kids on the mouth, and not share eating utensils.

693.

What will alter the accuracy of o2 sats?

Hypotension and vasoconstricting meds

694.

Room air is?

Ambient air (room air) contains 21 % o2

695.

The first s/s of ards?

The first sign of ARDS is increased respirations. Later comes dyspnea, retractions, air hunger, cyanosis.

696.

PCWP

Normal PCWP (pulm capillary wedge pressure) is 8-13. Readings of 18-20 are considered high.

697.

First sign of pe?

First sign of PE is sudden chest pain, followed by dyspnea and tachypnea.

698.

Carbon dioxide narcosis?

High potassium is expected with carbon dioxide narcosis (hydrogen floods the cell forcing potassium out). Carbon dioxide narcosis causes increased intracranial pressure.

699.

Pulmonary sarcoidosis?

Pulmonary sarcoidosis leads to right sided heart failure..Sarcidosis is basically scar tissue build up

700.

NG tube rules?

An NG tube can be irrigated with cola, and should be taught to family when a client is going home with an NG tube.

701.

If your patient starts seeing bugs?

If your normally lucid patient starts seeing bugs you better check his respiratory status first. The first sign of hypoxia is restlessness, followed by agitation, and things go downhill from there all the way to delirium, hallucinations, and coma. So check the o2 stat, and get abg's if possible.

702.

Cold stress in a newborn?

The biggest concern with cold stress and the newborn is respiratory distress.

703.

A preggo in a minus station?

If your laboring mom's water breaks and she is any minus station you better know there is a risk of prolapsed cord.

704.

R in a five year old?

In a five-year old breathe once for every 5 compressions doing r.

705.

After Gtube placement?

After g-tube placement the stomach contents are drained by gravity for 24 hours before it can be used for feedings.

706.

Cephalhematoma (caput succinidanium)?

Cephalhematoma (caput succinidanium) resolves on its own in a few days. This is the type of edema that crosses the suture lines.

707.

Hep A precautions?

During the acute stage of Hep-A gown and gloves are required. In the convalescent stage it is no longer contagious.

708.

More labs suggestive of renal failure?

Low magnesium and high creatinine signal renal failure.

709.

Hightest priority for RA?

Pain is usually the highest priority with RA

710.

TB health risk?

If a TB patient is unable/unwilling to comply with tx they may need supervision (direct observation). TB is a public health risk.

711.

Highest priortiy in status elipticus?

Level of consciousness is the most important assessment parameter with status epilepticus.

712.

Crackles most likely are?

Crackles suggest pneumonia, which is likely to be accompanied by hypoxia, which would manifest itself as mental confusion, etc.

713.

Anorexia sucks because?

Absence of menstruation leads to osteoporosis in the anorexic.

714.

Low crit/hemoglobin?

A patient with a low hemoglobin and/or hematocrit should be evaluated for signs of bleeding, such as dark stools.

715.

More IVP info?

A laxative is given the night before an IVP in order to better visualize the organs.

716.

Pt with edema and walking?

A patient with liver cirrhosis and edema may ambulate, then sit with legs elevated to try to mobilize the edema.

717.

High priority in Addisons?

Managing stress in a patient with adrenal insufficiency (Addison's) is paramount, because if the adrenal glands are stressed further it could result in Addisonian crisis. While we're on Addison's, blood pressure is the most important assessment parameter, as it causes severe hypotension.

718.

Pancreatitis prioritys?

After pain relief, cough and deep breathe is important in pancreatitis, because of fluid pushing up in the diaphragm.

719.

Likely cause of cardiac arrest in child?

Prolonged hypoxemia is a likely cause of cardiac arrest in a child.

720.

What can also cause an s3 heart sound?

Fluid volume overload caused by IVC fluids infusing too quickly (or whatever reason) and CHF can cause an S3

721.

coarctation of the aaorta causes?

Coarctation of the aorta causes increased blood flow and bounding pulses in the arms

722.

If you THINK a patient has new HTN?

A newly diagnosed hypertension patient should have BP assessed in both arms

723.

Depression manifests itself?

Depression often manifests itself in somatic ways, such as psychomotor retardation, gi complaints, and pain.

724.

Chief concern in CF

Respiratory problems!

725.

More info on TB testing a positive result?

speaking of TB... PPD is positive if area of induration is: >5 mm in an immunocompromised patient >10 mm in a normal patient >15 mm in a patient who lives in an area where TB is very rare.

726.

Hba1c?

HbA1c - test to assess how well blood sugars have been controlled over the past 90-120 days. 46 corresponds to a blood sugar of 70-110; 7 is ideal for a diabetic and corresponds to a blood sugar of 130.

727.

Most accurate way to test kids for medication accuracy?

BSA is considered the most accurate method for medication dosing with kids. (I though it was weight, but apparently not)

728.

Placement of a wheelchair?

Place a wheelchair parallel to the bed on the side of weakness

729.

If you see a nurse make a mistake? Chain of command?

If one nurse discovers another nurse has made a mistake it is always appropriate to speak to her before going to management. If the situation persists, then take it higher.

730.

Besides meds and congenital problems .. what can lead to decreased preload ?

Sepsis and anaphylaxis (along with the obvious hemorrhaging) reduce circulating volume by way of increased capillary permeability, which leads to reduced preload (volume in the left ventricle at the end of diastole). This is a toughie...think about it.

731.

Nitrazine paper?

Amniotic fluid is alkaline, and turns nitrazine paper blue. Urine and normal vaginal discharge are acidic, and turn it pink.

732.

STD= gonnorrhea?

Gonorrhea is a reportable disease

733.

Crutch use?

the phrase "step up" when picturing a person going up stairs with crutches. The good leg goes up first, followed by the crutches and the bad leg. The opposite happens going down. The crutches go first, followed by the good leg.

734.

MORE info on DKA? ugh!

While treating DKA, bringing the glucose down too far and too fast can result in increased intracranial pressure d/t water being pulled into the CSF. Polyuria is common with the hypercalcemia caused by hyperparathyroidism.

735.

Nonfat milk?

Nonfat milk reduces reflux by increasing lower esophageal sphincter pressure

736.

Gerd again?

Patients with GERD should lay on their left side with the HOB elevated 30 degrees.

737.

To prevent dumping syndrome?

Unusual positional tip - Low-fowlers recommended during meals to prevent dumping syndrome. Limit fluids while eating.

738.

Emphysema?

In emphysema the stimulus to breathe is low PO2, not increased PCO2 like the rest of us, so don't slam them with oxygen. Encourage pursed-lip breathing which promotes CO2 elimination, encourage up to 3000mL/day fluids, high-fowlers and leaning forward.

739.

Kernigs sign?

One of the physically demonstrable symptoms of meningitis is Kernig's sign. Severe stiffness of the hamstrings causes an inability to straighten the leg when the hip is flexed to 90 degrees.

740.

Brudzinski's sign?

One of the physically demonstrable symptoms of meningitis is Brudzinski's sign. Severe neck stiffness causes a patient's hips and knees to flex when the neck is flexed ( The kid knees will fly up and he lift his bum off the table cause it hurts his neck)

741.

Phenalalanine?

It is an amino acid that is BAD for people with PKU. It is found in food only and is also found in aspartame

742.

Vertical C section?

Used in plus sized women or risky or emergency c sections. less chance of harm for the baby

743.

Dystocia?

Just means a difficult or abnormal delivery or birth... example.. shoulder dystocia

744.

Peritoneal dialysis?

On the other hand, peritoneal dialysis does not require that the patient's blood be pumped outside of his body. Instead, the blood is cleaned while still inside the body. The organs in the abdomen are surrounded by the peritoneum, which is a membrane that allows waste products to through it. Peritoneal dialysis uses a Tenckhoff catheter to run the dialysis fluid, a sugar solution with some salts, into the abdominal, or peritoneal, cavity. This allows the patient's blood to be filtered without pumping it through a dialysis machine. A Tenkhoff catheter is usually used in peritoneal dialysis

745.

Why would somone who is allergic to latex be allergic to food too?

CROSS REACTION! People who have a latex allergy may be allergic to some foods, as well. This is called a cross reaction. When this happens, your body responds with the same allergic symptoms that you would have if you were exposed to latex. Cross reactions differ from one person to another. Someone may have a reaction to all the foods noted to cause cross reaction while another may have no reaction at all. Likewise, if you are allergic to any of these foods, you may also be allergic to latex: •apples, bananas, kiwi, peaches, plums, figs, grapes, melons, papaya, ion fruit, cherries, nectarines, pears, pineapple and strawberries; •carrots, celery, raw potatoes, avocados and tomatoes; •chestnuts and hazelnuts; •wheat and rye.

746.

Acid/ ASH diet?

The acid ash diet has nothing to do with weight loss. It is a diet intended for health and may be prescribed by your physician to control illness or disease. Once your liver has metabolized the food you ingest, it leaves a mineral deposit, known as ash, which can be acidic or alkaline depending on its effect on the pH of your urine. Eating foods that create an acid ash may help to balance your system or create a hostile environment to inhibit bacterial growth. .... Acid/ ash diet is used to BALANCE the acid/alkaline ash in the body... Ash wiill affect the urinary system and even the nervous system. Imbalance will be diet modified

747.

PTB means?

Pumonary tuberculosis

748.

Psuedomembrane in DIptheria?

Diptheria is an upper respiratory tract infection. It is characterized by sore throat, low fever and the psuedomembrane! Which is just a capsule around the tonsils that you can see with your penlight... It just looks like a whiteish yellow capsule around the tonisils

749.

SLE?

Systemic Lupus Ethramoutus.... (Lupus)

750.

Dengue hemorrhagic fever?

Hermans sign= flushes and redness of skin with lighter color at the center of the rash.... It is a disease that comes from tropical and subtropical areas that are spread by misquotos

751.

Risus Sardonicus?

Risus sardonicus is a highly characteristic, abnormal, sustained spasm of the facial muscles that appears to produce grinning--- From Tetany! Sad and scary looking! Never Google image it again, Megan! Nightmares!

752.

Grey Turners sign?

Purple bruises around the belly button... Pancreatitis!

753.

PDA?

patent ductuous arteriousus in infants! Valve doesn't close!

754.

Dance Sign?

Dance's sign: RUQ mass (intussusception) with RLQ empty space (movement of cecum out of normal position).

755.

Charcots sign?

A. Charcot's triad for multiple sclerosis 1. Nystagmus 2. Intention tremor 3. Scanning or staccato speech

756.

MG and Guillian Barre?

Opposites! Nursing connection! Think about it!

757.

Chvostek and Trosseaus sign

Chvostek= Tapping on the face above the cheek bone will cause spams! Trosseaus= using a BP cuff and inflating it, and it will cause spasms of the wrist

758.

VRSA?

Staph infection that is resistant to Vancomycin treatement! Worse than MRSA

759.

Tet spells?

Children with tetralogy of Fallot may develop "tet spells". The precise mechanism of these episodes is in doubt, but presumably results from a transient increase in resistance to blood flow to the lungs with increased preferential flow of desaturated blood to the body. Tet spells are characterized by a sudden, marked increase in cyanosis followed by syncope, and may result in hypoxic brain injury and death. Older children will often squat during a tet spell, which increases systemic vascular resistance and allows for a temporary reversal of the shunt.

760.

HHNS Vs DKA

· Diabetic ketoacidosis (DKA) is a condition of DKA=insulin deficiency resulting in acidemia due to altered metabolism. · Hyperosmolar hyperglycemic nonketotic syndrome (HHNS) is primarily a disorder of dehydration due to hyperglycemia

761.

Pancreatitis

NPO, TPN May be used

762.

Diverticulitis

Clear liquids to high fiber

763.

Cholecystis

Low-fat diet

764.

Liver disease

Decreased protein intake

765.

Celiac disease

Avoid glutens

766.

Nausea and vomiting

Clear liquids

767.

Gout

Avoid purines

768.

Dumping syndrome

Small frequent meals

769.

GERD

Avoid large meals, eating late, alcohol caffeine

770.

Monitor for digoxin

Potassium

771.

Monitor for acetaminophen

Temperature

772.

Monitor for glipizide

Blood glucose

773.

Monitor for morphine

Respiratory rate

774.

Monitor for prednisone

Delayed wound healing

775.

Monitor for warfarin

INR

776.

Monitor for zolpidem

Sleep patterens

777.

Monitor for Olanzapine

Mood

778.

Monitor for Levoflaxacin

Culture and sensitivity

779.

Erikson stage 0-1, posterior fontanelle closes at 2 to 3 months, 1 to 5 m grasp rattle 6 m transfer between hands, 8-9 m uses pincer grasps, nine months bangs toys together, 3 m holds head, 5-6 m rolls, 9m sits up on own, 12 m stands alone

Trust vs mistrust, meet social and developemental needs

780.

Erikson stage 1-3, feeds self, anterior fentanyl closes, steady gait, draw stick figure, potty train, need routines and rituals

Autonomy vs shame and doubt, provide acceptable options

781.

Erikson stage 3-6, hopping, draws shapes, walking heel to toe

Initiative vs. guilt, provide age appropriate activities, stranger danger

782.

Erikson stage 6-12 or games, rides bicycle, build models, organize sports, puzzles games, video games

Industry vs inferiority, encourage participation in care

783.

Erikson stage 12-20 pure activities, music interest, career training, sexual maturiation, STI's, pregnancy, substance abuse

Identity vs role confusion, Provide groups of same age

784.

Erikson stage 20-35 leaves families and seeks relationships, growth ends childbearing, established career,

Intimacy vs isolation, provide private time with partner

785.

Erikson stage 35-65 bouncing life, aging parent, adult children, grandchildren, career transition, retirement, menopause, osteoporosis, decrease in visual and hearing

Generativity vs stagnation

786.

Erikson stage 65+, decreased skin elasticity, decreased cough reflects, lower cardiac output, peridontal disease

Integrity vs despair, use personal items were not home

787.

Antidote for opoids

Naloxone

788.

Antidote for warfarin

Vitamin K

789.

Antidote for acetaminophen

Acetylcystiene

790.

Antidote for heparin

Protamine sulfate

791.

Antidote for benzodiazepine

Flumaxenil

792.

Antidote for digitalis

Digoxin immune fab

793.

Antidote for lead

Succimer

794.

Antidote for magnesium

Calcium gluconate

795.

When mixed with regular insulin draw this medication up last, 4-6 hr peak time

NPH

796.

Have client eat as soon as this medication is given

Lispro

797.

Hold this medication 48 hours before and after use of contrast dye

Metformin

798.

Given subcutaneously and has no peak time

Glargine

799.

May be used to lower potassium levels, can be given IV, also for DKA

Regular insulin

800.

Type of solution for TPN

Hypertonic

801.

Routes TPN can be given

Picc line, tunneled catheter

802.

TPN is prepared how often

Daily

803.

TPN is hung every_ hours

24

804.

Standard precaution requirements

Nothing, gloves prn

805.

precaution requirements (body fluids)

Gloves and gown

806.

Droplet precaution requirements (air)

Mask

807.

Airborne precaution requirements (air)

Mask

808.

Normal sodium level

135-145

809.

Normal potassium level

3.5-5

810.

Normal calcium level

9-10.5

811.

Normal carbon dioxide level

35-45

812.

Normal hydrochloride level

21-28

813.

Normal hemoglobin level

14-18

814.

Normal Hct level

37-52%

815.

Normal WBC level

5,000-10,000

816.

Normal cholesterol level

<200

817.

Normal platelets

150,000-400,000 (enoxaparin sodium)

818.

Normal P T

11-12.5 sec, rx: 1.5-2x (Coumadin)

819.

normal aptt

30-40 sec rx 1.5-2x (heparin)

820.

Normal INR

0.7-1.8, rx 2-3x (Coumadin)

821.

Normal glucose fasting

70-105

822.

Normal HbA1c (glycosylated hgb)

4-6%

823.

Normal BUN level

10-20

824.

Normal creatinine level

0.5-1.2

825.

Arterial supply

Goes down in legs

826.

Venous supply

Goes up in legs

827.

Red tag

Emergent

828.

Yellow tag

Urgent within 1 to 2 hours

829.

Green tag

Non-urgent 2 to 4 hours

830.

Black tag

Not seen don't have survival potential

831.

LPNs cannot what

Evaluate Assess teach, can reinforce or reteach, iv therapy, blood therapy rhogam

832.

Medication to hold prior to ECT

Dilantin or other medications that alter brain activity

833.

How long post surgery to be on blood thinners

30 days

834.

Priority if chest tube comes out

Cover with Vaseline soaked gauze

835.

Ebola

Hemorrhagic fever, w/ out symptoms quarenteen for 21 days

836.

System affected by methotrexate (steroid)

Immune system, decreased white blood cells and decreased platelets

837.

System affected by sodium levels

Neurological system, seizures occur with low levels

838.

Anti-cholinergic drugs side effects

No see no Pee no stool no drool

839.

Versed

Pt cannot sign for anything after recieving

840.

16 y.o can be a majority if

Married, emancipated, or has child

841.

ED triage

Treat most severe injury first

842.

Mass casualty triage

Do the greatest good for the greatest number

843.

Magnesium

drip needs to have one-to-one, due to side effects (absent deep tendon reflexes), monitor BP, resp, DTR, used for preclampsia

844.

Meningitis

symptoms: Headache, Stiff neck and photosynthesis, Diagnostics: spinal fluid (lumbar puncture) blood cultures, Prevention: Hand washing, immunization, Assessments: Brudzinski (pain with Head to breast bone) Kernigs (Pain with knee up to chest) Living in close spaces can cause this.

845.

Priority for MI

Apply oxygen first

846.

2 pt gait

Partial weight-bearing on extremity walking with crutches right leg left crutch as if they were skiing

847.

3 pt gait

Nonweightbearing swing through crutches

848.

4 pt gait

Stability partial weight-bearing on both extremities right leg right crutch

849.

Walker

Step into it, arm's-length away, don't pull self up with device

850.

Cane

Always on the strong side

851.

Up stairs

Strong leg first

852.

Down stairs

Weak leg first

853.

Yogurt

Form of calcium for lactose intolerant patients

854.

Diet for Christianity

Don't eat meat on ash Wednesday or Fridays of light may have days of fasting

855.

Diet for Buddhism

Avoid beef pork seafood

856.

Judaism diet (Muslims)

Kosher- can't mix milk and meat no pork avoid fish that don't have scales

857.

Hinduism diet

No beef, may fast, many are vegetarian

858.

Interventions for dumping syndrome

Lay down after eating, avoid drinking one hour before and one hour after eating, avoid sugar and milk

859.

Interventions for eternal nutrition

Start slow increase rate every 8 to 12 hours, greater than 100 residue fluid hold fluid, head of bed 30° or higher, assess for signs of intolerance, first feeding have x-ray every other check pH.

860.

Lithium toxicity

Can occur if greater than two

861.

Zolpidem

(Ambien) sleepwalk and cannot

862.

Side affects of anti-psychotics (typical)

Sedation, EPS, and anti-cholinergic effects

863.

Adverse affects of antipsychotics

Tardive dyskinesia,such as thumb rolling And eye emovements, Agranulocytosis, neuroleptic malignment syndrome, siezures

864.

Risedronate

Don't lay down right away

865.

Fentanyl patch

Remove with temperature, one for three days, don't put heating pad over it

866.

Gentamicin

Don't use if damage to kidneys when used with furosemide can cause hearing loss at high doses

867.

Amoxicillin

Be aware with cephalosporins allergy

868.

Ceftriaxone

Can create C diff

869.

Adverse effects

Life-threatening

870.

varenicline

Only use up to 12 weeks for smoking cessation

871.

Calcium channel blocker's, beta blockers, ARBs, ace inhibitors

Blood-pressure medications

872.

Calcium channel blocker's side effects

Bradycardia, decreased contractility, peripheral edema

873.

Ace inhibitor side effects

Dry hacking cough, angioedema

874.

20 gauge catheter

Can be used for packed RBCs, dextrose 5%, 9% sodium chloride, not used for TPN, amirodone, vancomycin

875.

Clean wound with _ before getting culture

Saline or sterile water

876.

V tach

First action drug Amerodone then lidocaine then prepare for cardioversion

877.

CAGE

Screening tool for alcoholism, cutdown use of alcohol, ever felt anger when people tell you to cut down, ever feel guilty about how much you drink, eye-opener to quit

878.

Wilms tumor

On adrenal gland needs to be removed prior to bursting

879.

1 pound

3500 calories

880.

Intropic agents

Increases myocardial contraction, and cardiac output, digoxin, dopamine, dubotamine

881.

Digoxin toxicity

Halos around everything, <6

882.

Dopamine and dubotamine

Monitor heart rate urine output and blood pressure

883.

BNP

Diagnostic test for CHF, normal is lower than 100, 100 to 300 heart failure is possible, 300 to 600 heart failure is mild, 600-900 moderate heart failure, severe hf > 900

884.

Packed RBCs

Treat anemia, monitor hemoglobin

885.

Platelets

Treats thrombocytopenia, monitor platelets

886.

Plasma

Treats Burns, monitor albumin, 3.5-5

887.

Factor 8

Treats hemophilia, monitor ptt

888.

1 unit of blood

Expect 1g/dl increase in hgb ex. 7.8-8.8

889.

Kidneys

Monitor I&O, electrolytes, BUN, creatinine, Hgb, BP (BUN & creatinine increases with kidney failure)

890.

Complications with central lines

Pneumothorax, air embolism, occlusion, infection, with air embolism lay on left side and Trendelenburg position with insertion

891.

Hyperthyroidism

PTU & Tapazole, or remove thyroid (calcium at bedside) Think of Tigger orange and hyper

892.

Hypothyroidism

Levothyroxine, Think of eeyore, slow moving, depressed

893.

Affected system of potassium

Cardiac, cardiac arrest with severe levels

894.

Insulin withdrawal when mixing

Clear to cloudy (regular-NPH)

895.

Oxytocin

Monitor fhr, contractions, BP, hr, rr

896.

Quetiaphine fulmarate

Bipolar, monitor for suicidal thinking, dizziness, leukopenia

897.

Risperidone

Bipolar, monitor for sedation insomnia pseudoparkinsonism,

898.

Lithium carbonate

Bipolar, no levels of lithium,

899.

SSRI

Antidepressant that blocks reuptake of serotonin

900.

SNRI and tricyclics

Antidepressant that box reuptake of serotonin and norepinepherine

901.

MAOI

Focus on diet

902.

Atypical antidepressants

Selectively inhibits dopamine and stimulates CNS, side effects: seizures psychotic symptoms, Buproprion

903.

Developing cancer with birth control

Only with smoking

904.

Naegeles rule

1st day menstrual cycle-3 months, +7 days

905.

First stage of labor

Latent 0 to 3 cm, active 4 to 7, transition 8 to 10,

906.

Second stage of labor

Pushing stage

907.

Third stage of labor

Delivery of placenta

908.

Fourth stage of labor

Bonding with newborn

909.

Taking in phase

It's all about me

910.

Taking hold phase

It's all about the baby

911.

Letting go phase

Getting back to the new normal

912.

Anemia side effects

Weakness paler fatigue

913.

Anemia interventions

Food sources that contain red meat, organ meat, egg yolks, leafy green vegetables, use z track method for Iran dextran

914.

Blood compatibility

this by what factor they have a or B or both AB or neither o patient doesn't have that factor they can't receive the blood,

915.

Hemophilia signs and symptoms

Risk for bleeding, Hematomas, G.I. and G you bleeding, brain hemorrhage, and bleeding mucous membranes

916.

Hemophilia nursing interventions

Assess for t pain, monitor vitals, onister factor replacement, avoid injections and NSAIDs, assess LOC and bleeding

917.

MI diagnostic labs

Troponins

918.

Sickle cell anemia and crisis

Most common in African Americans, blood comes and causes severe pain, oxygen is limited to the cells of the body because cells cannot carry oxygen as well, don't do well in cold weather or high altitude

919.

Signs and symptoms of sickle cell anemia

Anemia, hypoxic damaged tissue, dehydration, susceptibility to infection, knowledge deficit and powerlessness

920.

Nursing interventions for sickle cell anemia

Oxygen as needed, manage pain, and her vitals, monitor H&H, Mr. fluids as needed, assess for signs and symptoms of infection, teach self-care, causes and prevention of crisis

921.

Cervical cancer

Contributing factors: HPV/ multiple partners, manifestations: abnormal bleeding, Dianosing: pap/DNA test, prevention: Gardisil

922.

Breast cancer

Contributing factors: family history, lifestyle, Manifestations: Lumps, thickening, Diagnosing: mammogram, Prevention: Diet, weight, excercise

923.

When is a colposcopy used?

abnormal pap test

924.

Stable angina

pt is awake and doing something when having chest pain. Pain is able to be treated with first nitro

925.

Unstable angina/ preinfarction

Moving around but not relieved with nitro.

926.

Prinemetal/ Coronary spasm

Sound asleep and woken up by pain in chest

927.

Protocol for American Heart Association regarding MI

Sit down take a nitro, wait 5 min, call 911, take another nitro, wait 5 min and take final nitro.

928.

Nursing interventions for MI

Morphine (decreases preload & afterload) Oxygen (First, treats ischemic myocardium) Nitro (increases coronary perfusion) Aspirin- (decreases clot formation) MONA

929.

Aortic femoral By (restoring blood supply to blocked area) interventions

peripheral pulses, skin temp, anticoags, avoid crossing legs, monitor site, KEEP BP LOW

930.

Heart sounds mnemonic

Ape to man Aortic, pulmonic, erbs point, tricuspid, mitral

931.

Where do I listen to S2?

aortic and pulmonic

932.

Where do I listen to S1?

tricuspid and mitral

933.

S3 and S4 sounds

kentucky (going into CHF) Tennessee (Angina)

934.

Angioplasty

NI: cardiac diet, check vitals every 15 min, cardiac monitor, pressure @ site. Complications: dysrhithmias, bleeding, hypovolemia

935.

P wave

atrium are contracting

936.

QRS

ventricles contract

937.

T wave

ventricles relax, Don't want PVC's to hit T wave

938.

Cardioversion

Use with unstable v tach, machine synchronizes with the heart rhythm because you do not want to hit the t wave

939.

v fib

whole ventricles are shaking like jello and not firing

940.

Common heart rhythm with anemia

Sinus tachycardia

941.

Left sided heart failure

Fluid backs up into lungs, crackles in lungs, dyspnea

942.

Right sided heart failure

Fluid backs up into heart, S3 gallop, peripheral edema

943.

Normal pulmonary wedge pressure

4-12

944.

Heart failure

NI: O2, fowlers, lung sounds, I&O, fluid restriction, daily weights, diuretics, ACE inhibitors, digitalis

945.

DKA

Symptoms include: kussmaul respirations, fruity breath

946.

Thyroidectomy

Check for positive Chvotesek sign

947.

Hyponatremia

Causes: Diuretics, renal disease, Treatment: SIADH, Symptoms: confusion-> seizures, muscle weakness, cramping

948.

Hypernatremia

Causes: Water deficit, Cushings, Symptoms: Confusion->siezures, muscle weakness

949.

Hypokalemia

Causes: Diuretics, corticosteriods, suctioning, diarhea. Symptoms: muscle weakness, shallow respirations, Dysrrhithmias

950.

Hyperkalemia

Causes: salt substitutes, renal failure, packed RBCs, Addisons Symptoms: Dysrhythmias, peaked T waves

951.

Addisons

Low cortisol

952.

Cushings

High cortisol (steroid symptoms)

953.

Kayexalate enema

pulls off potassium

954.

Hypocalcemia

Causes: hypoparathyroidism, renal failure, malabsorption Symptoms: Changes in HR, prolonged ST, tetany, changes in LOC, siezures

955.

Hypercalcemia

Causes: Hyperthyroidism, Excessive intake Symptoms: Dysrhithmias, cardiac arrest

956.

Isotonic

No fluid crosses the cell membrane 0.9%NS

957.

Hypotonic

fluid moves into the cell 0.45% NS

958.

Hypertonic

fluid moves out of the cell D5 NS

959.

Cirrhoises

Symptoms: hypertension, esophageal carices, clotting abnormalities, hepate encephalopathy, ascites, peritonitis. NI: Assess fluid balance, assess bleeding, safety precaustions, high calorie diet, fluid restrictions, low protien

960.

Rule of 9's

Each arm= 9%, Anterior leg=9%, Posterior leg=9% Head=9%, Back=18% Chest=18%, Perineum=1%

961.

Parkland formula

used for determining amount of lactated ringersfor burn patient. Begin time at time of burn. ister through central line and have foley cath. 4mL x kg x %TBSA= 1/2 total in first 8 hrs, 1/2 in remaining 16 hours

962.

Head injury

Signs: Changes in LOC, Increased I, Brady, tachypnea, hypo/hypertension, hyperthermia, bradycardia, posturing. Interventions: Assess neurostatus w/ glascow coma scale (higher the better), I & O, Elevate HOB, monitor electrolytes, decrease stimulation, monitor I, vitals, nutritional .

963.

Spinal shock

occurs right away, hypotension,

964.

Autnomic dyreflexia

Spinal injury, can occur after several weeks only in T6 or higher, hypertension, flushing, headache Treatment: lower BP and treat cause.

965.

Cervical spine

Top 8, worry about breathing

966.

Thoracic spine

Middle 12, quadroplegic

967.

Lumbar spine

Bottom 5, paraplegic

968.

Spinal cord injury

Intervention: Immobilization, assess respiratory status, assess vital signs, institue bowel sounds and bladder program, prevent DVT, urinary retention, constipation, skin break down.

969.

VEAL CHOP MINE

Menomic for decelerations Variable Cord compression Move patient Early Head compression Identify labor progress Accelearate Okay No action Late Placental insufficiency Execute STAT

970.

Precalampsia

NI: Monitor BP, protein in urine, weight, watch edema eclampsia occurs with seixures

971.

Uncompensated

pH is off and 1 other is off

972.

Partially compensated

pH is off as well as other two are off

973.

fully compensated

pH is normal other two are off

974.

Metabolic alkalosis

Vomiting loose acid and left with base

975.

Metabolic acidosis

Diarrhea loose base and left with acid

976.

High pressure with mechanical ventilation

NI: assess for need to suction, pt needs tomlet machine breath for them.

977.

Low pressure with mechanical ventilation

check tubes for leaks

978.

Cancer internal radiation

NI: visitors should maintain 6 feet away and visit no longer then 30 min, staff needs a dosimeter badge.

979.

Carseat

Middle of backseat for 2 years or 20 lbs

980.

Donning order

Gown-Mask- goggles-gloves-enter

981.

Doffing order

gloves- gown- goggles-mask

982.

Nasal Cannula

1-6 L/min over 2 needs humidifyer

983.

Simple face mask

6-8L/ min

984.

Venturi face mask

4-8L/min

985.

Non- Rebreather

12L/min

986.

RSV

contagious for 1 week after antibiotic

987.

C-Diff and VRE

use soap and water

988.

Droplet (infections)

measles, influenza, can cohort

989.

Airborne(infections)

chicken pox, TB, cant cohort

990.

(infections)

MRSA, C-diff can cohort

991.

Abuse phases

Tension building-> battering-> honeymoon-> tension building

992.

PTSD

symptoms are delayed, assess for irritibility, difficulty sleeping and concentration, decrease excessive stimulus, help evaluate coping mechanisms

993.

Bipolar disorder

Depression and mania, inflated self esteem, flight of ideas, buying sprees, decreased needs for sleep, coexist with substance abuse.

994.

Borderline personality disorder

Manipulative behavior

995.

Depression

R/f: female, unmarried, low socialeconomic class, postpartum period, medical illness, early child hood trauma. Symptoms: Insomnia, anergia, feelings of worthlessness decreased concentration.

996.

Grief

Denial-> Anger-> Bargaining-> Depression-> Acceptance

997.

Cluster A

Paranoid, schizoid, Schizotypal

998.

Cluster B

Antisocial, Borderline, Histronic, Narcissistic

999.

Cluster C

Avoidant, Dependent, Obsessive Compulsive

1000.

When patient hears voices

"What are the voices saying to your?"

1001.

What does clubbing of the fingers mean?

chronic hypoxia

1002.

Cap refill reveals what?

end-organ perfusion

1003.

#1 thing to do with edema

elevate

1004.

Where to check for skin turgor?

Adult - chest child - abdomen/thigh

1005.

HR over what is tachycardic

100

1006.

In acid/base balance, poop is? vomit is?

Poop is base Vomit is acid

1007.

Where is apex of heart found

6th intercostal space mid-axillary

1008.

Where is PMI found

4th intercostal space mid-clavicular

1009.

Where is 6 month fetal heart rate found

halfway between umbilicus and symphysis pubis

1010.

What cannot be taken with CCBs

Grapefruit juice

1011.

What does digoxin do

Makes the heart pump harder

1012.

How many cc's is 1 ounce

30 cc (30 ml)

1013.

LPN ramifications

No vents, can't do initial assessment, can't do initial teaching, can't discharge Can take phone orders, can do f/u assessment, can do reinforcement teaching, can do dry dressings

1014.

Hurts with eating/feels better with eating

Hurts with eating = gastritis Feels better with eating = PUD

1015.

Zantac and -dines are what?

H2 blocker

1016.

Prilosec, Prevacid, Nexium, and Protonix are what?

PPI

1017.

What to do with metabolic acidosis

...

1018.

What to do with metabolic alkalosis

...

1019.

What to do with respiratory acidosis

...

1020.

What to do with respiratory alkalosis

...

1021.

Aquamephytin

vitamin K

1022.

secretes vitamin K

liver

1023.

secretes bile

liver

1024.

bile stores

gallbladder

1025.

S/S of hepatitis

jaundice, foamy-tea colored urine (bile in urine - bile is soap), clay colored stool (no bile in stool)

1026.

Hepatitis needs in diet

increased protein and decreased fat

1027.

ESLD is caused by..

Liver dying, has lots of scar tissue, closing off biliary tree (same symptoms as hepatitis, but will not regenerate)

1028.

ESLD needs in diet

decreased protein (this creates more ammonia)

1029.

Secretes amylase/lipase

Pancrease

1030.

Crohn's

diarrhea inflammation of entire colon tx = anti-inflammatory drugs (steroids) malnourished

1031.

Ulcerative colitis

bloody diarrhea No steroids tx = complete removal of lg bowel w/ ileostomy malnourished

1032.

Why no morphine with bowel surgery or biliary pain

morphine can cause spasm at sphincter of Odi Give Demerol

1033.

RA

inflammatory response red, hot, swollen, bad deformities anti-inflammatories (NSAID, steroids) Rest t when inflamed

1034.

OA

t is wearing out - DJD Pain meds (tylenol, NSAIDS, narcotics) likes temp extremes (hot better) Keep t moving even when painful or will freeze

1035.

weight bearing for hip replacement

TOUCH weight bearing

1036.

weight bearing for hip fracture

NON weight bearing

1037.

Instructions when taking Fosamax

Empty stomach sit up for 30 minutes

1038.

Anterior pituitary gland

Growth hormone Too much = acromegaly Too little = Dwarfism

1039.

Posterior pituitary gland

ADH Too much = SIADH Too little = DI (DDAVP)

1040.

Thyroid gland

T3/T4 Too much = Increased metabolism (Graves) Too little = Decreased metabolism (thick nails, course hair, myxedema coma)

1041.

Parathyroid gland

Calcium Too much = hypercalcemia (somnolent) - tx diuretics/dialysis Too little = hypocalcemia (jittery, seizure, mouth tetany)

1042.

Adrenal gland

glucocorticoids Too much = like too many steroids (weight gain, increase infection, increase glucose, skinny limbs, moon face, buffalo hump) Too little = Addison's disease - tx is life long steroids (which causes Cushings)

1043.

Addisonian crisis

Not enough steroids Bronze pigment to skin d/t mineral corticoid steroids

1044.

Pancreas

Insulin Too much = hyperglycemia (dry, hot) Too little = hypoglycemia (pale, cold, clammy)

1045.

Diet for renal patient

Low protein, fluid restriction, low potassium, low phosphorus Phosphate binder given with meals

1046.

Bronchodilators

increased oxygen demand-myocardial

1047.

Intermittent claudication

think arterial vs venous-this is arterial-position leg dependently

1048.

arterial

skin shines

1049.

arterial issues

put your legs down-so blood flows down-like an A (artery)

1050.

venous issues

like a V-put them up-so blood can go up

1051.

Heart Failure

-pumping issue; give Lasix and Digoxin (help with pumping)

1052.

V tach

electrical conduction system issue

1053.

INFILTRATION

IV site painful and swollen

1054.

blood reaction

send blood and tubing to the lab

1055.

New Trach

DO NOT remove the ties before cleaning the tracheostomy-wrong-stoma is not formed yetrisk of stoma closing and airway impacted

1056.

all tracheostomies

dont cut the gauze; need a pre cut gauze

1057.

C3 spinal fracture

airway is your issue

1058.

if you see a presenting part for a baby for a labor pt in ER

prepare delivery room-priority

1059.

pt found on the floor

assess vital signs and LOC first, not injuries assessment first (if pt was conscious before the fall-vitals will tell us the most about the client; unconscious pt would not have been found on the floor-they cannot get up-most likely they rails are up)

1060.

NCLEX wont test

chemo drugs

1061.

NCLEX will test

Eriksson but not Piaget, high pressure alarms

1062.

obese client that vomits after surgery-will increase pressure in the abdomen, at more risk for

Adhehicence

1063.

Disaster prioritization

Priority pt-pt with burns on the face, with respiratory stridor; fixed pupil and agonal respirations-will not live, so not a priority

1064.

LPN

can give report during a transfer can take VS in a transfusion client, after RN has stayed with client for first 15 min or the necessary initial time

1065.

pt after MVA on balanced suspension traction

disorientation is a priority; not shallow respirations

1066.

ECT

before: withhold Dilantin; Atropine IS given- for its anticholinergic effects-will lower the secretions in the mouth; ECT causes seizures-we don't want them to have fluids in mouth-risk for aspiration; Methohexital- possible given for amesthesia; also Succinylcholine-possible given

1067.

knee arthroplasty-1 week ago

post op-for 4 to 6 weeks blood thinners are given throughout the recovery; also if pt was on blood thinners prior to arthroplasty, he won't be taken off these meds, because they are lying down (postop) so they are at risk for cloths; they won't be taking NSAIDs-they are on blood thinners; Motrin vs Lortab?

1068.

pt that had a catheter in before, now catheter is out and pt cannot peeintervention

assessment FIRST-so do a bladder scan first; (full bladder-dull sounds when you percuss); anesthesia can cause decreases ability to urinate

1069.

if chest tube is disconnected

immerse the end of chest tube in a bottle of sterile water-this will prevent the air going into the chestcreates a water sill

1070.

new dx of RA-Methotrexate order

this drug is used in CA patients as well-but its not a chemo drug associated with this drug: WBC low- possible 1200, stomatitis-sores and difficulty in the mouth-hard to eat, fever above 101 can be caused (fever is only above 101 F), increased urine specific gravity-they are not eating or drinking-dehydration occurs; low platelets; also pts are advised to take Folic Acid with this drug-it causes a depletion of dolic acid

1071.

three point crutches

unaffected leg first, then crutches 6 inches forward

1072.

2 point leg

R foot and the L crutch go first together; L foot and the R crutch after at same time-m0ve the other ones

1073.

swing through gait

crutches forward, lift both feet and swing forward

1074.

Tetralogy of Fallot

4 issues here: ventricular septal defect, right ventricular hypertrophy, pulmonic stenosis, overriding aorta, there is a whole in the septum; this will impact blood getting around the body

1075.

TPN pt- to prevent fluid volume deficit

monitor glucose q 4-6 hrs-if the glucose is up-dehydration (osmotic diuresis)

1076.

incident reports

risk management investigates these, they are not shared with non involved staff, include description of incidents in the reports

1077.

medication reconciliation

contains documented meds taken by client, comparrison of current and past meds list; this list is done at any change in care..not only at ission and discharge; the purpose is to avoid errors of duplication, missing some meds etc; also the pharmacy has a role in this, not only the RN

1078.

Autocratic manager

"do this, don't ask any questions"; employees have little to say; these managers are good in critical situations

1079.

Laissez Faire manager

disorganized floor, chaotic environment, employees make the decisions

1080.

Democratic manager

decisions are made as a group , employees ARE asked their opinions

1081.

UAP

CANNOT encourage to share feelings-this requires therapeutic communications-RN has the skills to do this CANNOT get a urine specimen from a indwelling catheter-this is sterile CAN assist with ambulating the client; CAN empty the suction container, but RN has to assess the fluid collected

1082.

LPN

CANNOT ister Rogham-its a blood product; they CAN hang the second bag for TPN, not the first one-RN they CANNOT do anything with titration they CANNOT stick the pt-no IV's start CAN hang a piggy pag as long as its not a titration and as long as its a second bag; always RN has to hang the first bag; LPN CAN give IM injections, they CAN hang the bag of fluid; when LPN hangs the second bag, she does not need the RN there CAN do wound care-dressing changes, irrigations, sterile techniques CAN listen for the lung sounds-for data collection only-not as an assessment-RN will go in there and listen to those heart sounds

1083.

UAP

new ission or post of fresh pt-RN has to do the vitals, not the UAP CAN do specimen collection but not something that require sterile specimens

1084.

IV antibiotics

30 min window

1085.

antidiarrheals

always PRN

1086.

acute glomerulonephritis

can lead to acute kidney failure-watch for decreased urine output

1087.

these CAN be disclosed/reported to DMV

uncontrolled seizure disorder of a school bus driver, if it is not controlled dx of TB or HIV someone with a gun in the hospital can be called to the cups right away

1088.

nonmaleficence

do not insert a contaminated catheter in after not sterile anymore

1089.

implied consent

unless you have a DNR, you do everything for them

1090.

living will WITHOUT a DNR order

you have resuccitate in a code

1091.

in an outbreak for STD's

tell sexually active students to trace outbreaks-in a high school (when addressing the community outbreak)

1092.

phone triage for a client exposed to EBOLA-client has no symptoms

tell client: "we will have to notify the health dept, HIPPA does not apply in this case"

1093.

Fire disaster

evacuate the ones can ambulate first-smoke kills before fire

1094.

NCLEX

increased number of questions about religions and cultures practices

1095.

when you need a translator

call a certified one; no family member should translate-HIPPA

1096.

Ebola

report immediately-fever, epistaxis, vomiting

1097.

AMA client

no need to call security but DO inform about possible complications if they leave

1098.

Amiodarone

should be given through a central line, not peripherally- because ph < 5

1099.

Vacomyocin

ph is <5-not given peripherally but PICC line ok

1100.

TPN

not given peripherally

1101.

narcotics (eg. Morphine)

can be taken out without a witness signature BUT needs second nurse when wasting it never take out a narcotic if drower count is incorrect LPN CAN sign a waste for narcotics

1102.

SEIZURES (precautions before a seizure, after an aura)

roll them on their side only if they lost consciousness; if not they CAN maintain their airway time it during a seizure-needs to be documented after: report it, document, determine LOC postdictal state: drowsy; ok for them to sleep on their side

1103.

chemo treatment

if it spills you call the biohazard, not the housekeeping-you put them at danger (not the housekeeping, not the laundry department) incident report done as well

1104.

smoking client on non smoking campus

give hime a patch

1105.

cane use left side weakness

cane opposite affected leg (COLL)-move cane and the bad leg forward first

1106.

crutches

arms flexed; 2-3 inches to underarmed cannot rest on crutches (underarm)

1107.

Parkinson client

walker with wheels-not ok for this client-safety problem should use the walker with tennis balls-he is shuffling he needs smooth sole shoes- not the non skid ones-he will fall

1108.

Shingles and TB

cannot share room

1109.

neutropenic pt

needs private room

1110.

DONT isolate

an HIV pt UNLESS he is neutropenic or he has an opportunistic infections

1111.

private room

productive cough and possible TB rash with possible varicella only airborne needs private room C-dif is -does not need private room but its recommended (its only in the stool-only way to get it-if you touch the stool)

1112.

Laryngectomy client with fresh trach, Hep C and HIV

need gloves, gown, mask, googles-all of these needed because the new tracheostomy

1113.

client with MRSA + client who's post op total knee replacement

you dont want them in the same room-knee rejection risk-MRSA might get in the knee

1114.

mammogram

after 40 annually

1115.

colorectal exam

should start at age of 50

1116.

prostate

discuss with p at 50

1117.

pap test

every 3 years starting at 21 if there is an abnormal pap->annual exam recommended

1118.

vaginal exam

has to be done annual in all patients

1119.

analgesia

cold and hot

1120.

hot

relaxes

1121.

emergency numbers

should be next to the phone, not the exit door

1122.

progressive macular degeneration

room free of clutter call light within rich

1123.

fall history

have bed alarm for client

1124.

purulent exudate drainage from wound

clean site first with sterile saline and water place specimen in biohazard bag

1125.

who is at risk for falls

over 65 yrs old bifocal glasses pt on Lasix

1126.

hypotonic pulls fluid INTO the cell

hypertonic pulls it OUT of the cell

1127.

to check for JVD

place in semi fowler

1128.

if you see JVD when client is standing

CHF R side

1129.

Calculate output

Assume-0.5 ml per kg output per hour if we dont know the weight then is 30 ml per hr

1130.

the lower the Na it goes

the higher the risk for seizures it is

1131.

kidney function decreased

creatinine increased

1132.

hyperventilation

blowing out CO2-give rebreather bag-client is in respiratory alkalosis

1133.

Atropine

metabolic acidosis

1134.

Narcan

risk for respiratory acidosis-they are not breathing

1135.

pt on Zofran

risk for metabolic alkalosis-they are vomiting

1136.

Insulin

metabolic acidosis-K is high

1137.

Dilaudid

respiratory acidosis or alkalosis

1138.

sputum specimen

collect in the morning- also provide oral care for this pt

1139.

bronchoscopy

they are looking for lung cancer assess gag reflex asks client if he has night sweats-lung CA pts has this particular symptom

1140.

Quantiferon Gold-TB

blood test definitive for TB results within 24 hrs ask for night sweats

1141.

Thoracentesis

place a chest tube in the room- pt at risk for pneumothorax during procedure check lung sounds on that side

1142.

pulmonary hygiene

T turn and cough bronchodilators steroids use bronchodilator first

1143.

suctioning

3 rounds before you hyper oxygenate again, max 15 secs rounds suction on exiting

1144.

TB

mucopurulent sputum, low grade fever, chest tightness, decreased appetite

1145.

chronic bronchitis

copious sputum cough for few months

1146.

emphysema

pursed lip breathing

1147.

asthma

bronchospasms careful with beta blockers

1148.

lung cancer

non specific s/s

1149.

pneumonia

pleuritic chest pain-that does not go down when you sit/lay down, movement hurts

1150.

anginal pain

pain goes away when you lay down

1151.

pneumothorax

O2 decreases, put pt on O2, semi high fowler position; give anxiolytics- if anxious they won't be breathing ok; give analgesics- because it hurts chest tube placed as well

1152.

Chest tubes components

right container-this is the drainage water seal-middle-red suction bubbles on the left if no bubbling- possible kick in the tube if drainage becomes purulent-check for fever, check when CBC was done last time, look at the insertion side for infection in case of crackles-these are in the pleural space-crackles mean fluid; check to see if a chest xray was done this morning 1153.

intubated client

nurse should do frequent hand wash provide oral decontamination clean oral suction device turn client q 2 hrs high fowler

1154.

preop clients

might take half of insulin

1155.

post op

respiratory, circulation, neuro, GU, GI, pain-these are all impaired by the surgery

1156.

dehisscence

put some stitches on high fowler

1157.

evisceration

lay pt down, bend knees, call for help, cover with sterile dressing 1158.

acute cholecystitis

low fat diet have rich in HDL food sources

1159.

NG tube

with x-ray first, gastric ph later empty when 1.5 to 3/4 full check residual in continuous feeding-check in q 4 hrs; if less than 100 ml-put it back; if more than 200-call provider; if more than 200 is taken out-metabolic alkalosis risk meds through NG tube are given liquid, if crushed you give the meds 1 at a time-you don't know how they interact when crushed and mixed in all together-also flush in between you don't give extended release meds through ng tube-they need liquid or non extended released

1160.

GERD

prokinetic agents- Reglan

1161.

Peptic ulcer

...

1162.

IBS

diarrhea and constipation LLQ pain cramps

1163.

Inflammatory bowel disorders (UC and Crohn's)

give immune modulators with the Ulcerative colitis-stool gets into the tissues?

1164.

Diverticulitis

they always have diverticulosis, but if something gets in a diverticula-then it becomes diverticulitis fluids only, rest the bowel later-low fiber and after, transition to high fiber

1165.

Dumping syndrome

dizziness, sweating, tachicardia post bariatric surgery-avoid lactose and high concentrated sugar, high fat and protein foods, turn to the L side not supine

1166.

Bariatric clients

they are obese- so high risk clients

1167.

Colostomy care teaching

include cranberry juice and yogurt to the diet-this will help with the odor empty bag when one third full clip hair surrounding the peristomal site

1168.

post up stoma care

pink and red is good the further in the colon the stoma is, the more solid the stool is emotional , lots of teaching required they will have an NG tube initially in for feeding stoma care and assessment-priorities

1169.

pancreatitis

need for intervention: 1.042 Urine specific gravity-severe dehydration (osmotic diuresis-started on TPN, sugar elevates) amylase, lipase, related to the exocrine function of the endocrine system

1170.

acute pancreatitis

possible hypocalcemia (Tressou sign)-hand spasms occurs during blood pressure monitoring with the auto digestion-Ca ends up in the bloodstream

1171.

Cirrhosis

low protein diet bleeding-esophageal varices they are breaking down protein-so they have high ammonia-this is toxic to neuro system

1172.

Hepatitis

liver impairment

1173.

Pancreatitis-malnutrition

put them far away from nurses station-so when food comes the smell wont create pancreatic enzymes

1174.

pancreatic cancer

immunosuppression present treatment: Whipple procedure and chemo many times its mehtastazied

1175.

OA

weather changes-barometric pressure chronic unilateral pain pain worsen after activity

1176.

Rheumatoid A

bilateral t inflammation morning stiffness and pain

1177.

Gout

men usually get it cannot put pressure on foot during acute episode multiple tophi excruciating pain with acute episode bed rest, avoid touch, increase fluids Allopurinol

1178.

SIADH

low sodium level seizure precautions

1179.

Arterial line

...

1180.

Clonidine

change position slowly, this is a BP drug take at night in case of a cough->don't stop the med, just call the dr

1181.

VTac

obtain VS don't defibrillate but cardiovert (if hemodynamically stable don't cardiovert) check carotid pulse give Amiodarone

1182.

Progressive MS

get rest and avoid stress major personality changes need speech therapist might lose ability to empty bladder eye patch given

1183.

Palliative care

improve quality of life meet physical and emotional needs

1184.

mental health pts to

treat based on developmental age, not chronologic age

1185.

amputation

first reaction-many times denial

1186.

Olanzepine/Zyprexa for Anxiety

antipsychotic-causes hyperglycemia and weight gain they can't eat whatever they want for the first two months-risk for agranulocytosis

1187.

Agoraphobia

intervention-desensitation-this is a slow process

1188.

OCD

intervention-allow the ritual-we are not allow to stop it without a physician order-we will send them into a panic attack

1189.

PTSD

intervention- groups

1190.

Hypochondriasis

intervention-limit rumination-will help them not thinking of it

1191.

Social Phobia

Intervention-GAD? intervention-reinforce coping

1192.

Schizophrenia

Paranoid-auditory hallucinations-know what the voices are telling them Disorganized-flat affect, disorganized behavior and speech Catatonic-stupor or extreme agitation, bizarre body posture-they can be in same position for a long timealteration of skin break down can happen

1193.

Prolixin

targets dyskenisia-repetitive involuntary facial and tongue motion

1194.

Aripiprazole

reduce daily delusional thoughts

1195.

Aricept

increase mental cognition

1196.

Haloperidol/Haldol

highest risk of EPS

1197.

Clozapine

agranulocytosis

1198.

Seroquel (for depression)

slipineess

1199.

Congentin

manages EPS

1200.

Risperdal

lowest risks gynecomastia is a major risk in young boys

1201.

Olanzapine/Zyprexa

hyperglicemia

1202.

Autism-alterations in

social skills-interventions-structured routines language-might talk late-interventions-foster independence behaviors-anger, frustration; intervention-safety cognition-depends where they fall-intervention-family health-frequent GI disorders-advised to be on gluten free diet-intervention-offer community resources

1203.

Niacin

flushing-normal

1204.

Rifampin (TB drug)

orange body fluids

1205.

Adenosine

flushing and chest pain, iv push

1206.

Protonix (PPI class)

antiulcer med

1207.

Pitocin

decreases bleeding uterine stimulant

1208.

Fentanyl (narcotic)

reversible agent is Nalaxone

1209.

Metothrexate

...

1210.

Palivizunab

prevents RSV

1211.

Methylprednisolone sodium succinate

given orally or IV IV push

1212.

Selective Estrogen Receptor Modulator (Evista)

given for postmenapausal osteoporosis

1213.

Lipitor

no grapefruit

1214.

Prostaglandin-Xalatan-Lantanoprost

...

1215.

Geodon

...

1216.

Indocin

ister with food, milk

1217.

Singulair, montelukast

bronchodilator

1218.

anti inflamatory-Nasonex

dont ister in clients with milk allergy

1219.

Flagyl-no alcohol first 3 days

...

1220.

Viagra-dont give with nitrates

...

1221.

slows osteoporosis-Premarin

...

1222.

avoid foods with tyramine-antibiotic-ZyvoxNeurontin-partial seizure and neuralgia given for these

...

1223.

-Methadone-monitor respiratory

...

1224.

-ster sq with evening meal or HS-Levemir; dont mix with other insulins (long acting insulin); doses must be 12 hrs apart

...

1225.

-antimicrobial-Zocyn-check allergy for penicillin

...

1226.

-for ADHD-available in po form only, taken once daily-Vyvanse-Lisdexamfetamine dimesylate

...

1227.

Coumadin

anticoagulant, intake of greens important for vitamin K

1228.

Ariprippazole

avoid grapefruit, alcohol, overheating, dehydration

1229.

Nemanda/Nemantine

avoid diet in fruits and vegetables

1230.

antibiotic

caution in colitis

1231.

Hydrochloride

ister po-moderate to severe dementia such as Alzheimer fresh fruits will cause alkalinity-low excretion of drug

1232.

Actonel

CI with esophageal disorder remain uprights for 30 min take with a full glass of water

1233.

Cardizem

...

1234.

Avodart

BPH drug females of age that might have kids should not handle this

1235.

Chantix-

nicotinic blocker

1236.

Paxil

antidepressant don't take St John Worth take at night time

1237.

Depression

Anhedonia-maintain ADLs sleep alteration-bedtime routine anergia-encourage exercise worthlessness-monitor safety poor concentration-clear directions suicidal ideation-giving away things

1238.

Severe Mania

Anorexia-provide finger foods Accelerated speech-calm demeanor Fragmented thoughts-redirect no impulse control-monitor safety

1239.

SSRI

weight gain therapeutic effect after 1 week

1240.

Lithium

AE with diuretics therapeutic effect after 1 week

1241.

MAOI-

therapeutic effect after 1 week

1242.

TCA

therapeutic effect after 1 week monitor for dysrhythmias

1243.

detoxification of cocaine

s/s several hrs later-poor concentrations

1244.

hypertention crisis

hrs after opiods

1245.

alcohol withdrawal

dont leave them alone Diaphoresis—fluid replacement hallucinations-decrease stimuli Wernicke-Korsakoff-Infuse IV Thiamine

1246.

Oxazepam (Serax)

Delirium Tremens Tachycardia-monitor VS

1247.

stages of Alzeimer

4 only, not 6 stage 2 is moderate-cannot balance checkbook, decline in daily basic hygiene needs,; leave the stove after cooking; stage 1 (mild)-discuss meaning of client's framed photo: integrity vs dispair stage; you want them to have personal things around

1248.

Dementia

decrease in cognition-safety is major problem they need their routine provide education to the whole team taking care of this pt dont rationalize with them

1249.

Anorexia

we don't focus on their weight, they do prepare fluid therapy and enteral feeding for them

1250.

Clozapine

...

1251.

mental health miscellaneous

pt can leave facility if at will involuntary ission occurs if people are deemed a threat to themselves or others clients can communicate with their attorney nurse cannot open postal packages prior to giving to client

1252.

Hcg test-why is important before surgery

a positive pregnancy test may require canceling surgery

1253.

Hcg

rises during pregnancy and maintains the pregnancy raises until about 12 weeks of pregnancy, then body recognizes it and then it drops again

1254.

prenatal examination

report if pt is on a vegetarian diet; usually they are pseudo anemic until 32 weeks, then the iron should become normal again

1255.

first semester

nausea, vomiting, nutrition

1256.

2nd semester

dyspnea, heartburn

1257.

3rd trimester

make sure she know how to recognize false vs true labor signs

1258.

prenatal care

assess at each exam-VS, weight, fundal height...

1259.

Mag Sufate IV

resp 10-priority

1260.

Chronic HTN

mom had HTN prior to pregnancy this pt may develop preeclampsia

1261.

Gestational HTN

mom gets HTN after 20th week of gestation NO protenuria

1262.

STI

higher risk for ectopic pregnancy

1263.

Placenta previa

no vaginal exam painless, bright red bleeding

1264.

abruption placenta

painful dark red bleeding

1265.

hyperemesis

whatch the weight and electrolytes

1266.

hydatidiform mole

avoid pregnancy until hCG returns to normal she can a grape like structure... ideally avoid pregnancy for 4 years ? she is at risk for cancer as well usually this only happens once

1267.

Cerclage

cervical insufficiency

1268.

ectopic pregnancy

unilateral, stabbing, abdominal pain ectopic pregnancy is never a livable pregnancy

1269.

danger signs during pregnancy

fever and chills (infection) decreased or absent fetal movement sudden weight gain (preeclampsia) severe HA ROM prior to 37 weeks gestation vaginal bleeding

1270.

Isotonic IV fluids

...

1271.

If contractions frequency is 90 secs

stop Pitocin check FHR assess pain and fatigue

1272.

severe back pain labor

give back massage place on all fours (legs and nands)

1273.

If baby has a longitudinal lie, with FHR above the umbilicus

prepare for US need to evaluate for breech

1274.

pain

associated with labor

1275.

stage 1 of labor

keep her active after 3-7 cm-help her breath assess FHR and UC comfort

1276.

stage 2 of labor

check FHR q 15 min assist pushing

1277.

stage 3 stage of labor

placenta delivered do newborn care

1278.

stage 4 of labor

priority-prevent bleeding

1279.

fetal monitoring late deceleration

reposition first on L side

1280.

fetal monitoring

VEAL CHOP (what causes it) MINE (what you do about it)-make sure you know where they are in the process

1281.

Late decels

uteroplacental insufficiency

1282.

Lenght of contractions

maximum length of contraction should be 90 secs if 90 secs or longer or FHR is lower than 11-stop Pitocin if a mom is on it

1283.

L&D meds tocolytics-Indomethacin and Terbutaline

stops labor

1284.

Pitocin

used to augment labor/assist labor

1285.

Beamethasone

2 doses 24 hrs apart help to mature fetal lungs

1286.

breastfeeding

don't feed if discomfort is present schedule feeding for breastfeeding q 2-3 hrs meds might transfer to milk if mom is breastfeeding

1287.

Rhogham istration

monitor labs: Indirect Coomb's for baby Direct Coomb's for mom

1288.

PP hemorrhage

priority

1289.

mom breastfeeding on heparin therapy

breast milk will not be affected, after breast feeding is over she can go back to Coumadin

1290.

Initial Newborn Care

at 1 and 5 min check Apgar after drying him off put him skin to skin with mom for thermoregulation evaporation when baby is wet when baby is dry-heat is loss through..

1291.

baby assessment

reflexes check-premie will not demonstrate all the reflexes

1292.

fetal alcohol syndrome

high pitch cry hard to console cognitive disabilities

1293.

tobacco/nicotine

vasoconstricor decreased O2 for baby-increased SIDS risk, asthma

1294.

hypoglycemia in babies

check glucose w/o an order; it takes some time for the baby to get used with the insulin production

1295.

phototerapy

cover eye with mask reposition newborn q 2 hrs cover scrotum take them off light only for feeding

1296.

Kernisterus

yellow baby, we only take the baby out of the light for feeding

1297.

Womens Health

...

1298.

cancers

...

1299.

menopause

hot flashes night sweats palpitations vaginal atrophy osteoporosis

1300.

over 35

increased risk of DVT with oral contraception

1301.

all these matter when choosing oral contraception

history of hypertension severe PMS hist of DVT

1302.

Diflucan

...

1303.

Rocephin

...

1304.

Flagyl

...

1305.

postmenaupausal- 57 yrs old- (on Climara)monitor BP, yearly mammogram, take with food, call provider if bleeding occurs

...

1306.

Methergine

CI in HTN and cardiac disease promotes uterine contractions

1307.

lyrics (Pregabalin)

dont stop abruptly, monitor for edema

1308.

Plavix

Prilosec and Nexium will decrease the effects of this

1309.

Synthroid

give in the morning increases HR

1310.

complicated UTI

give antibiotics CI with sensitivity to cephalosporins-Maxipime

1311.

Gentamicin

antibiotic for bacterial infections monitor UO and renal function

1312.

Antipshychotic-Risperdal

dont mix oral solution with cola or tea

1313.

Aricept

monitor for bradicardia, dont interupt abrutptly

1314.

Lidocaine

not effective against SVT, given IV

1315.

Bystolic

don't stop abrupt, weight daily, can impair thinking and reaction time

1316.

Oxycontin

highly abused-should not be taken within 2 weeks of istration of an MAOI

1317.

Dilaudid

causes spasms of sphincter of odi

1318.

Levaquin

can alter glucose level in diabetic client

1319.

Vancomycin

antibiotic for MRSA risk for Red man syndrome

1320.

Digoxin

assess AP for one min hypokalemia can lead to toxicity

1321.

Inderal

check BP and pulse before istration

1322.

PPI-Nexium (GERD)

don't crush or chew

1323.

Effexor

can increase ptinr, don't discontinue abruptly

1324.

Lithium

mantain Na levels normal

1325.

Lovenox

hold if platelets are less than 100,000 ister sq

1326.

Pradaxa

avoid use with drugs that prolong bleeding keep dry and in a dark bottle

1327.

Varivax vaccine

prevents chicken pox

1328.

Lasix

Diuretic monitor HR, BP monitor weight

1329.

Amiodarone

first line drug for...

1330.

Dilantin

therapeutic level 10-20

1331.

Novolog

...

1332.

Advair (Fluticasone)

long term for asthma

1333.

Concerta

contra with MAOI

1334.

Simvastatin and Zetia-Vytorin

its a combination drug

1335.

Gardasil

prevents HPV istered to both male and female-

1336.

Nitro

onset 1-3 min sublingual

1337.

regular Insulin

the only one istered IV

1338.

Haldol

monitor for EPS causes dry mouth

1339.

Ambien

rapid onset given for short term insomnia

1340.

PEDS-know

infants and children-common causes of death incorrect car seat placement or not being in the seat

1341.

Ritalin

side effects-Tics, nervousness, increased BP; can cause insomnia, don't give in the evening

1342.

pt that is on radiation

no lotion on the side, no scrubbing, just warm water

1343.

know back/spine safety for nurse

upper bod mechanics, position client in the correct way

1344.

1hr oral glucose tolerance test

positive results 145mg/dl, report to provider, adv. pt to avoid caffeine the morning of test because it can increase glucose levels

1345.

Abstract Thinking

Asking questions about similarities between objects or to explain a common proverb or saying

1346.

Acarbose

oral antidiabetic agent that postpones the absorption of glucose

1347.

Acute hemolytic reaction

low back pain due to age of hemolyzed blood cell through kidneys, increased respirations, tachycardia

1348.

ister regular and NPH insulin steps

swab top of both insulin bottles with alcohol wipe, insert air into NPH insulin equal to dose, remove and insert air in regular insulin equal to dose, then withdraw dose from regular insulin and ister then withdraw correct dose from NPH insulin and subcutaneously

1349.

Advance directives

allow client to make decisions and provide written instructions regarding end of life care

1350.

Agoraphobia

behavioral therapy technique pt teaching includes modeling, systematic desensitization, flooding...

1351.

Air travel

2nd trimester, airplane cabin humidity is low (approx.. 8%), which can result in water loss, teach pt to maintain increased hydration with water to compensate for loss

1352.

Akathisia

responds to anti-parkinsonian medication

1353.

Albuterol (Proventil)

activates beta2-adrenergic receptors in the heart, increase in heart rate is a side effect

1354.

Alcohol anonymous (AA)

helps abstinence and sobriety

1355.

Alcoholism

causes CNS depression, drowsiness, slurred speech, and impaired coordination, s/s withdrawal elevated BP/HTN

1356.

Alendronate (Fosamax)

on empty stomach with 8oz water, may cause esophageal ulcerations if lodged in esophagus, remain upright for 30min after

1357.

Altruism

helping meet the needs of others who have experienced similar loss

1358.

Amitriptyline (Elavil)

tricyclic antidepressant must be taken within 3hr of missed dose if not wait til next dose,

1359.

Amniocentesis

evaluate fetal lung maturity

1360.

Amphetamine intoxication

stimulant use, adv. Effect; paranoia

1361.

Amphotericin B

adverse reaction is ototoxicity (vertigo, tinnitus, hearing loss)

1362.

Ampicillin (Principen)

signs of allergic reaction hypotension, pruritus, flushing, wheezing

1363.

Anabolic steroids

in adolescence can lead to premature epiphyseal closure thus reducing height potential

1364.

Anaphylaxis Behavioral signs

apprehension, uneasiness, restlessness and anxiety

1365.

Anti-Hypertensives meds

contraindications caffeine

1366.

Antisocial personality disorder

impulse control, reminding client about expectations and providing clear boundaries and consequences of action will help promote client adherence

1367.

Atorvastatin (Lipitor) and fenofibrate (TriCor)

treats hypercholesterolemia, both meds may cause myopathy, pt has increased risk for myopathy than if either taken alone

1368.

Aversion therapy

uses punishment techniques to reduce inappropriate behaviors (alcoholism, aggression)

1369.

Avolition

lack of motivation

1370.

Baclofen (Lioresal)

antispasmodic, decreased muscle spasticity in client w/ MS, can cause urinary retention, drowsiness in early phase of therapy, hypotension

1371.

Benzodiazepine (Lorazepam)

withdrawal causes tremors and dizziness making ADL's difficult to perform

1372.

Bethanechol

muscarinic agonist that increases GI motility leading to abdominal cramps and diarrhea

1373.

Bi-Polar Disorder

increased energy and pressured speech, manic phase is treated with electroconvulsive therapy (ECT) if a course of medication is ineffective

1374.

Bladder distention

pushes uterus out of pelvis, can palpate fundus above umbilicus and to the right of midline,

1375.

Borderline personality disorder

development of manipulative behaviors that make establishing a meaningful relationship difficult

1376.

Boundary violation

when nurse engage in social relationship with client

1377.

Breastfeeding

baby should have at least 2 stools/day, may eat 8-12 times/ day, milk can be stored in freezer for up to 6mths, should have at least 6wet diapers per day, pt teaching; wake baby Q4hr at night for first 24-48 hr after birth

1378.

Bronchoscopy

post op; check for gag reflex,

1379.

Bulimia Nervosa

s/s tooth erosion, hand calluses, parotid swelling

1380.

Buprenorphrine

prevents withdrawal associated with opiate use, taking during pregnancy can improve maternal and neonatal outcomes

1381.

Bupropion

for nicotine use disorder

1382.

Caffeine (pregnancy)

consuming more than 200mg of caffeine/day increases risk of miscarriage and intrauterine growth restriction

1383.

Calcium carbonate (Tums)

...

1384.

Captopril (Capoten)

treat HTN, greatest risk to pt is infection r/t neutropenia therefore unexplained fever, sore throat, and fatigue can indicate and infection and provider should be notified, avoid ibuprofen or any other nonsteroidal antiinflammatory medication as it can reduce anti-hypertensive effects of medication

1385.

Carboprost

adv. effect fever

1386.

CD4 T-cell count

indicates the status of the pts immune system, a rise indicates return of immune function for HIV pt

1387.

CD4-T cell count

indicates the status of clients immune system, rise in cd4 counts indicates return of immune function of client w/ HIV

1388.

Cefotetan (Cefotan)

a cephalosporin, group of antibiotics hat are similar to penicillins (PCN), should be avoided in pt who is allergic to PCN

1389.

Celecoxib Celebrex

cyclo-oxygenase (COX-2) inhibitors act by suppressing inflammation and relieving pain, will allow pt to move more easily, increases risk of MI because of increased vasoconstriction and unimpeded platelet aggregation

1390.

Cervical laceration

is a slow, oozing trickle of blood, during which fundus can remain firm

1391.

Chest tube drainage device

may ambulate, keep collection device below the level of the pt chest to ensure drainage, only clamp device when checking for air leaks or changing drainage system

1392.

Chlordiazepoxide (Librium)

for alcohol use disorder, avoid getting pregnant, teratogenic to developing fetus

1393.

Chlorpromazine (Thorazine)

increases skins sensitivity to UV light pt should apply sunblock to counteract adverse effect

1394.

Chlorpromazine (Thorazine)

orthostatic hypotension risk for falls, treats schizophrenia

1395.

Chorionic villus sampling

involves removal of small amount of tissure from the fetal section of the placenta to detect genetic conditions

1396.

Cimetidine (Tagamet)

should be taken 1hr before or 2hr after antacid

1397.

Ciprofloxacin (Cipro)

pt should avoid products with cations such as antacids, iron salts, milk and other dairy products because they reduce the absorption of ciprofloxacin, in allergic reaction check for wheezing, diphenhydramine (Benadryl), possibly prep for IV catheter insertion, collect VS to determine pt status

1398.

Clang association

use of rhyming words

1399.

Clozapine (Clozaril)

can cause agranulocytosis, pt should have WBC evaluation

1400.

Cocaine intoxication

tachycardia, elevated BP, dilated pupils, display grandiosity and euphoria

1401.

Cocaine

CNS stimulant, may cause vomiting, dilated pupils and tachycardia

1402.

Coughing

incision with interlocked hands, pillow, towel or blanket to prevent excess stress on the incision when coughing

1403.

C-section

ambulate several times/day to increase circulation in lower extremities and prevent thrombophlebitis

1404.

Cystic Fibrosis

can have constipation should eat diet high in fiber, high calorie diet due to decreased intestinal absorption and increased work of breathing

1405.

Deep Vein Thrombosis (DVT)

bed rest with affected limb elevated to reduce swelling, fit with elastic stockings, to prevent venous congestion once pt can ambulate

1406.

Delusions

belief that one's thoughts can be heard by someone else, common w/schizophrenia

1407.

Dementia

memory impairment and loss of speech

1408.

Depression

lethargy and slowed speech

1409.

Digoxin and chlorothiazide

increase pt risk of developing digoxin toxicity due to chance of developing hypokalemia

1410.

Digoxin toxicity

nausea, vomiting, anorexia, and fatigue

1411.

Dimenhydrinate (Dramamine)

an antihistamine, has anticholinergic properties, anticholinergic meds can cause urinary retention thus compounding urinary tract symptoms associated with prostatic hypertrophy, is contraindicated in pt with benign prostatic hypertrophy (BPH)

1412.

Displacement

defense mechanism, emotionally transferring anger for one person to innocent victim

1413.

Disulfiram

for alcohol use disorder

1414.

Doxycycline (Vibramycin)

should be taken with a full glass of water to ensure it es into the stomach which will prevent esophageal ulcerations

1415.

Electroconvulsive therapy (ECT)

pt awake 15min after ECT, likely to be confused and disoriented, reorient frequently

1416.

Eplerenone

treat HTN, adverse effects; diarrhea, decreased sodium levels, vaginal bleeding, increased potassium levels cause of potassium retention effect

1417.

Erythromycin

apply medication starting from inner canthus to outer canthus, instill 1cm ribbon of medication in lower conjunctiva to ensure proper delivery of medication, medication prophylactically to protect newborn from ophthalmia neonatorum

1418.

Exenatide

treat DM, monitor for abd pain pt at risk for pancreatitis

1419.

Expected anticipatory grieving

statements indicating shock and disbelief, needing to get away from situation, anger against dying person or caregivers,

1420.

Eyedrop instillation

advise pt to look up during to protect cornea and decrease change of blinking, clean eyes starting from inner canthus moving outward,

1421.

Felodipine (Plendil)

grapefruit juice can inhibit metabolism raising level of medication in blood increasing risk of toxicity

1422.

Ferrous sulfate

treat iron deficiency anemia, improvement in hemoglobin levels increases oxygen transport to the tissues and increases activity tolerance

1423.

Fine crackles

continuous, musical sounds which are caused by narrowing of airways

1424.

Fluoxetine (Prozac)

monitor sleeping patterns, insomnia common side effect,

1425.

Fluoxetine

contraindicated with sumatriptan put pt at risk for serotonin syndrome causing tremors, confusion, hallucinations

1426.

Fluphenazine (Prolixin)

avoid sun exposure causes photosensitivity

1427.

Fundal Height

in pregnancy should be approximately the same as the number of weeks gestation plus or minus 2cm

1428.

Furosemide (Lasix)

loop diuretic, can lead to hypokalemia, can cause BP to drop, medication should be withheld if BP 85/60,

1429.

Gemfibrozil (Lopid)

myopathy is an adverse effect, report muscle weakness or tenderness

1430.

Gentamicin (Garamycin)

is nephrotoxic, monitor BUN and serum creatinine levels

1431.

Ginkgo Biloba

herbal supplement to treat a variety of conditions (dementia, vascular disease), may interfere with platelet production and increase the risk of bleeding in clients on anticoagulation therapy (warfarin/antiplatelet medications)

1432.

Glipizide

oral antidiabetic agent that stimulates insulin secretion

1433.

Gonorrhea

STI, can lead to pelvic inflammatory disease and tubal scarring which can result in infertility

1434.

Grief

community bereavement group may help cope with feelings of grief

1435.

Haloperidol (Haldol)

typical antipsychotic that decreases symptoms of psychosis and anxiety, adverse reactions tremors, shuffling gait, drooling pseudoparkinsonism

1436.

Heel stick in newborn

1st warm newborns heel

1437.

Heroin

causes CNS depression, drowsiness and slurred speech, pupillary constriction, effective treatment strategy is participation in a methadone maintenance program

1438.

Histrionic personality disorder

impulsive behavior, inappropriate sexual behavior

1439.

Human papillomavirus vaccine (HPV2)

3 doses of immunization over 6mths,

1440.

Hydrochlorothiazide (Hydrodiuril)

can cause hypokalemia from excessive potassium excretion, other adverse effects are hyperchloremia, hypernatremia, hypercalcemia.

1441.

Hyperemesis gravidarum

S/S persistent vomiting and ketonuria

1442.

Hypoglycemia (newborn)

hypothermia, twitching, tachypnea (respiratory distress)

1443.

Inhalants intoxication

s/s incoordination, nystagmus, blurred vision

1444.

Ipratropium (Atrovent)

an anticholinergic, contraindicated in pt who is allergic to peanuts or soybeans because medication may contain peanut oil and soy lecithin

1445.

Iron (foods)

beef liver, lentils, oysters

1446.

Isoniazid (INH)

can cause liver damage, important for nurse to determing the clients daily alcohol intake because alcohol use increase risk, pt should reduce or avoid all use of alcohol

1447.

Isotretinoin

pt teaching will need to have triglyceride levels monitored, may cause nosebleeds, due to nature of severe birth defects pt will need 2 negative pregnancy test prior to starting medication

1448.

IV Meds

medication that are water soluble can only be istered intravenously

1449.

Jaundice

should be reported within first 24hrs of life, physiologic jaundice can lead to severe cognitive disorders

1450.

Ketorolac (Toradol)

is nephrotoxic and can cause renal impairment, monitor serum creatinine level

1451.

Kosher dietary laws

avoid eating meat and dairy product together

1452.

Lactation suppression

frequent application of cold cabbage leaves to breast can prevent engorgement

1453.

Levodopa/carbidopa (Sinemet)

dopaminergic medication, works by activating dopamine receptors, restoring nerve transmission in the basal ganglia for pt with Parkinsons disease, allows client to move freely and resume ADL's

1454.

Lisinopril (Zestril)

ACE inhibitor, can result in buildup in bradykinin, resulting in nonproductive cough, pt should withhold medication and follup with provider for further evaluation, contraindicated w/ ibuprofen can decrease antihypertensive effect

1455.

Lithium Carbonate (Eskalith)

monitor lithium levels if dosage is changed

1456.

Lower extremity amputee

anchor residual limb dressing at the nearest t proximal to the amputation, cleanse residual limb with mild soap and carefully rinse and dry, maintain compression dressing following amputation in order to promote proper fit of prosthesis and reduce edema, wrap 3x day and prn

1457.

Lumbar laminectomy

pt teaching; involves removing a portion of vertebra to expose spinal cord which produces a sense of instability in spine, avoid twisting and bending, sit in straight back chair, sleep on firm mattress

1458.

Magnesium sulfate

depresses neuromuscular activity, leading to muscle weakness and paralysis

1459.

Magnesium toxicity

bradycardia, hyporeflexia, oliguria (urine output 30ml or less), respirations less than 12/min, increased BUN indicating renal impairment which can decrease excretion and cause magnesium to accumulate to toxic levels

1460.

Major Depression

monitor elevated mood, may be indication the pt plan to commit suicide

1461.

Maladaptive grieving

statements indicating shame and guilt, feelings of being overwhelmed

1462.

Manic behavior

unable to focus on a solitary activity w/o direction from another person, impacts other clients negatively,

1463.

MAOI

contraindications aged cheese

1464.

Marijuana

a hallucinogen, has depressant properties, euphoria, relaxation and paranoia

1465.

Maslow's Hierarchy

Physiological (hunger, thirst, bodily comforts, etc.), Safety/security (out of danger), Belongingness and Love ( with others, be accepted, loved), Esteem (to achieve, be competent, gain approval and recognition), Self-Actualization (morality, creativity, problem solving)

1466.

Mastitis

pump affected breast frequently

1467.

Meconium

develops in utero, first stool ed by newborn w/I first 24 hr, dark green and viscous, contains components of amniotic fluid, cells, intestinal secretions, occult blood

1468.

Medroxyprogesterone

adv effect; loss of bone mineral density advise pt to increase calcium intake while on medication

1469.

Mesalamine (Asacol)

maintenance therapy for inflammatory bowel disease and pt should take daily for at least 3-6 weeks

1470.

Metformin (Glucophage)

oral antidiabetic agent, used to treat DM II by decreasing glucose production in the liver, facilitates decreased glucose production; monitor for adverse effects muscle pain, agitation, GI manifestation such as bitter or metallic taste

1471.

Methamphetamine

expect high fever with overdose of CNS stimulant

1472.

Methotrexates (Rheumatrex)

pt should avoid alcohol due to risk for hepatic fibrosis and liver toxicity

1473.

Metoprolol (Lopressor)

slows the conduction through AV node therefore is contraindicated in pt who have AV block that is greater than first degree, caution in pt with diabetes mellitus because it can mask the manifestations of hypoglycemia

1474.

Milieu therapy

creates therapeutic community in which client has opportunities for learning and healing, inpatient therapy

1475.

Nasogastric tube (NG)

place pt in high fowlers position, determine which naris has greatest airflow, measure appropriate tube length, lubricate 3-4inches of end of tube, instruct client to hyperextend neck

1476.

Negligence

failing to respond to escalating behavior and prevent harm from others

1477.

Neologisms

words made up by the client

1478.

Nephrotic syndrome

with peripheral edema, low sodium diet to assist with diuresis of extracellular fluid

1479.

Nifedipine

causes vasodilation, resulting in decreased BP, can increase orthostatic hypotension and dizziness, change position slowly

1480.

Nitrates

cause relaxation of vascular smooth muscle, resulting in pooling of blood in veins and decreased venous return to heart, decreases cardiac output which causes blood pressure to fall and orthostatic hypotension to occur with change in position

1481.

Nitroglycerin (Nitrostat)

sublingual tablets, treat angina, can take up to 3doses 5min apart if chest pain persist

1482.

Nitroglycerin (TransdermNitro)

advise pt to place patch on different site for each application to prevent skin irritation, medication may cause orthostatic hypotension/dizziness should change position slowly to avoid injury

1483.

NonMaleficence

ethical concept of avoiding harm

1484.

Nonstress test (NST)

orange juice to increase the clients blood sugar and stimulate fetal movement, 2 FHR acceleration of 15/min over 20min period lasting at leatst 15 seconds indicate reactive non-stress test

1485.

Ondansetron (Zofran)

side effects headache and dizziness, pt should avoid driving or using heavy machinery

1486.

Operant conditioning

type of behavior modification that use positive reinforcement to promote a desired behavior

1487.

Oral contraceptives

contraindicated in pt who experience frequent headaches w/vision changes (can indicate cardiovascular condition) because combination can increase risk of CVA, MI, and thromboembolism

1488.

Orientation/preorientation relationship

plan for interactions with the pt

1489.

Oxycodone (OxyContin)

opioid analgesic, pain reliever, can cause CNS depression, contraindicated with diphenhydramine (Benadryl) put pt at risk for sedation, respiratory depression and injury

1490.

Paranoid schizophrenia

dominant symptoms hallucinations and delusions

1491.

Phenylephrine (NeoSynephrine)

may cause tachycardia and other cardiac arrhythmias

1492.

Phenytoin (Dilantin)

stimulates synthesis of hepatic drug metabolizing enzymes, can decrease effects of warfarin, providers (titration of medication) base dosage on therapeutic blood levels

1493.

Phytonadione

is ister via IM to newborn,

1494.

Pioglitazone (Actos)

oral antidiabetic agent, works by increasing the body's sensitivity to insulin, 8-12wks to experience full therapeutic effects of medication

1495.

Pleural rub sounds

loud grating sound caused by pleurisy

1496.

Postpartum diuresis

should begin 12hr after delivery, expected urine output of 3000ml/24hr

1497.

Prednisone (glucocorticoids)

suppress the body's immune response increasing risk of infections, pt should notify provider if they experience the following symptoms sore throat, black tarry stools (indicates GI bleed) due to the increased risk GI ulcers, white patches on tongue (increased risk for candida infections due to immunosuppression), hyperglycemia, weight gain

1498.

Propranolol (Inderal)

beta blocker, bradycardia is a common adverse effect, advice pt to withhold med if pulse rate less than 60bpm, can suppress tachycardia a warning sign of hypoglycemia in pt with DM, advise to rely on other signs

1499.

Propylthiouracil (Propyl-Thyracil)

desired effect HR WNL, reduction in serum T4 level, improved sleep patterns, increased attention span

1500.

PTSD

experience disrupted sleep

1501.

Quetiapine

pt at risk for abnormal glucose metabolism which may result in DM, serum glucose testing regularly

1502.

Reflection

communication technique that lets the client know that their concerns and feeling are heard and understood

1503.

Regular Insulin

clear in appearance, discard if appear cloudy

1504.

Religiosity

obsession with religious ideas and actions

1505.

Repaglinide (Prandin)

HbA1c lab test should be review to obtain information about long term therapeutic, measures blood glucose levels over past 2-3mths; glycosylated HbA1c

1506.

Repression

pt excludes unwanted ideas from conscious awareness

1507.

Respiratory distress (newborn)

S/S; nasal flaring, tachypnea, substernal retractions, grunting

1508.

Retention of placental fragments:

...

1509.

Rho(D) immunoglobin

given to Rh neg. mother who has Rh pos. newborn to prevent mother from developing antigens against the Rh factor

1510.

Risperidone

treat schizophrenia, atypical antipsychotic help to improve/minimize pt w/schizophrenia with difficulty interacting with others/maintaining relationships, put client at risk for developing diabetes due to metabolic effects of medication, obtain fasting glucose baseline prior to istration of first dose, and again, 12wks later, then annually

1511.

Schizophrenia

multiple pos & neg symptoms, flat affect & tangential speech, delusions (delusions of grandeur), appears stuporous, little to no movement at all, pt/family teaching; manage client stress to help control symptoms of illness

1512.

Schizotypal personality disorder

suspicious attitude

1513.

Scopolamine patch

treat motion sickness, should be placed behind the ear

1514.

Signs of Allergic reaction

hypotension, pruritus, flushing, wheezing

1515.

Simvastatin

notify provider if muscle pain or tenderness develops could indicate rhabdomyolysis

1516.

Social worker

help client build a structure to help promote and preserve mental health, including arrangements for employers, day treatments, financial and other community resources

1517.

Spironolactone (aldactone)

potassium sparing diuretic, salt substitutes are high in potassium can place pt at risk for hyperkalemia

1518.

Sumatriptan

contraindicated with use of fluoxetine can lead to excessive stimulation of serotonin receptor putting pt at risk for serotonin syndrome s/s tremor, confusion, hallucinations

1519.

Systematic desensitization

form of behavior modification that employs relaxation techniques in response to specific phobias

1520.

Tardive dyskinesia

lip smacking, tongue rolling, spastic facial expressions

1521.

Tetanus

booster recommended every 10yrs or sooner if injury occurs from a potentially contaminated object

1522.

Tetracycline hydrochloride (Sumycin)

causes photosensitivity and increased severity of sunburn

1523.

Therapeutic lithium level

1.2 meq/L serum lithium level

1524.

Therapeutic relationship:

...

1525.

Timolol eyedrops

treat glaucoma, press the nasolacrimal duct to prevent the medication from absorbing into systemic circulation

1526.

Tolbutamide (Orinase)

treat DM, contraindicated in pt with hypersensitivity to sulfonamide antibiotics that might also be allergic to sulfonylureas

1527.

Tonsillectomy

pt/child can chew gum to prevent throat and ear pain post-op

1528.

Topical decongestants

rebound congestion can occur with prolonged use congestion can become progressively severe

1529.

Tracheostomy child care

allow child to rest for 30-60 seconds after each aspiration to allow oxygen saturation to return to expected levels, suction as needed when there is indication of excessive secretion in airway, suction for no more than 5 sec w/each , hyperventilate w/100% oxygen before and after suctioning

1530.

Triamterene (Dyrenium)

inhibits exchange of (Na) and (K) in the distal nephron retaining (K) and excreting (Na) leading to hyperkalemia

1531.

Triple marker screening

done at 16-18wks gestation, identify chromosomal abnormalities

1532.

Uterine bleeding

relaxed, distended uterus with presence of blood and clots,

1533.

Vancomycin (Vancocin)

adverse reaction ototoxicity

1534.

Varicella (chickenpox vaccine)

hypersensitivity to neomycin is contraindicated for receiving vaccine

1535.

Veracity

duty to tell the truth

1536.

Vesicular sounds

soft, rustling sounds that occur as normal breath sounds

1537.

Vitamin K

needs to be at least 2hr after birth to prevent risk for hemorrhagic disease

1538.

Wheezes

continuous, musical sounds which are caused by narrowing of the airways