2nd Time Around Passed here is how MUST READ

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    i passed after taking nclex this past monday/ pearson trick immediately after getting home. kaplan takes months to fully get all out of it. not weeks, it works. review all content review and write it all out. takes months. it took many 7 months to fully absorb all of kaplan and i kept changing my class in order to get more time. i highly recomend th live on line course, not the in person course. you must cover all the course content review which is huge. do all the q-trainers and know all the rationales, i never got to the q-bank and still passed. write it all out if you are slow like me.

    priority and delegation by charity is a must.

    i get tired very easily. i ate breakfast, went back to bed for 3 hours. got ready downed a red bull ate chocolate and was fully charged for the nclex. the brain uses lots of sugar when you are concentrating this kept me going.

    below are also a must know that i had copied pasted from different posts. i must emphasize this is a must know:

    1. varicella (chickenpox) requires use of airborne precautions and contact precautions as well.
    2. if a patient is on contact precautions, have family members and other visitors wear a gown and gloves as outlined by your facility (hospital).
    1) droplet room assignment: preferably private, if not available roomate with same illness and same pathogen. and if thats not an option 3 feet away from roomate with the curtain pulled.

    2) when transporting a patient with airborne precautions (for essential purposes only) they must wear a surgical mask.

    for contact precautions
    diseases/conditions include: c. diff, e. coli, scabies
    room needs to be private unless room has another patient infected with the same organism

    for droplet precautions
    diseases/conditions include: meningitis, pneumonia, pertussis (whooping cough), rubella, mumps
    room needs to be private unless room has another patient infected with the same organism. maintain spacial distance of 3 feet when near patient.

    also remember standard precautions apply to all patients regardless of diagnosis when in contact with any bodily fluid, blood, secretions/excretions, nonintact skin, and mucous membranes

    #1. when wearing gown and/or gloves, make sure to take them off and properly dispose of them, before leaving the patien'ts room.

    #2. pt's with herpes zooster (shingles) that is active should have the same precautions as a patient with chicken pox---airborne and contact

    #3. pt's on droplet precaution can have their room door left open.

    #4. instruct visitors for pt's with droplet precautions to try to keep a distance of three feet between them and the pt.

    #5. pt's with croup should be on contact precautions

    bacterial meningitis is transmitted via droplets, and when suctioning pt, wear goggles, eyewear, mask, and gloves. pt should wear a face mask when being transported.

    cdc recommends airborne precautions against varicella/rubeola.

    measles, chicken pox (varicella), disseminated varicella zoster, tuberculosis

    barrrier protection: single room maintained under negative pressure
    door kept closed except when someone is entering
    exiting the room
    negative airflow pressure used in room, (min of 6 - 12 air exchanges per hour depending on the facility
    ultraviolet germicide irradiation or high-efficiency
    particulate air filter used in the room
    mask or personal respiratory protection device used
    mask placed on the client when client needs to
    leave the room; client only leaves only if necessary!

    rsv is contact precautions. so wear gloves and a gown. it is a respiratory infection that is transmited through contact with the secretions.


    when you put your protective gear on start from top to bottom : mask-> gown-> and gloves. when you take them off start from bottom to top: gloves->gown->mask. (i tried to research this part just to make sure it is what i remember it to be, but found nothing so im not 100% certain)

    wash hands between patients and whenever visibly soiled.

    donning ppe (personal protective equipment)

    gown
    fully cover torso from neck to knees, arms to end of wrist, and wrap around the back
    fasten in back at neck and waist

    mask or respirator
    secure ties or elastic band at middle of head and neck
    fit flexible band to nose bridge
    fit snug to face and below chin
    fit-check respirator

    goggles/face shield
    put on face and adjust to fit

    gloves
    use non-sterile for isolation
    select according to hand size
    extend to cover wrist of isolation gown

    safe work practices
    keep hands away from face
    work from clean to dirty
    limit surfaces touched
    change when torn or heavily contaminated
    perform hand hygiene

    removing ppe

    remove ppe at doorway before leaving patient room or in anteroom

    gloves
    outside of gloves are contaminated!
    grasp outside of glove with opposite gloved hand; peel off
    hold removed glove in gloved hand
    slide fingers of ungloved hand under remaining glove at wrist

    goggles/face shield
    outside of goggles or face shield are contaminated!
    to remove, handle by “clean” head band or ear pieces
    place in designated receptacle for reprocessing or in waste container

    gown
    gown front and sleeves are contaminated!
    unfasten neck, then waist ties
    remove gown using a peeling motion; pull gown from each shoulder toward the same hand
    gown will turn inside out
    hold removed gown away from body, roll into a bundle and discard into waste or linen receptacle

    mask or respirator
    front of mask/respirator is contaminated – do not touch!
    grasp only bottom then top ties/elastics and remove
    discard in waste container

    hand hygiene
    perform hand hygiene immediately after removing all ppe!


    chicken pox(13-17 days)--prodromal, child have malaise, fever, anorexia.

    rash is pruritic, and starts out as a macule then papule then a vesicle.

    spread by direct contact, droplet and contaminated object.

    isolate till all vesicles are crusted; it can be spread from 2 days before the rash begins.

    avoid use of aspirin due to reye's syndrome, use tylenol.

    airborn--door can be closed..measles (rubeola), m. tuberculosis, disseminated zoster(shingles), varicella(chicken pox)--again can cohort and place in same room with the same infective organism.
    droplet--door may be open---streptococcus pharyngitis, meningitis, pnemonia...private room or pt with same infection--involves contact with mucous membranes of nose or mouth...happens during talking, coughing, suctioning. maintain 3feet between infected patients and visitors.

    rubella--there's a maculopapular rash on face and all over the body. prodromal: malaise and fever which is followed by cough.
    sread by droplets and contaminated objects. placed on contact precautions, isolate child from pregnant women.

    tuberculosis, pt is on isolation for 2-4 weeks (until there are 3 negative sputum cultures.)

    syphilis--painless chancre that fades within 6 weeks...on palms and soles there is a copper colored rash...spread by contact with mucous membranes and also congenitally...tx with penicillin g im


    heres how i remember that rubella is droplet and rubeola is airborne...rubella sounds like umbrella and umbrellas protect you from raindrops...


    transmission-based precautions: adc
    a - airborne
    d - droplet
    c - contact

    airborne precaution (credit goes to the one who posted this on april thread, sorry can't remember your name)

    my - measles
    chicken - chickenpox
    hez - herpes zoster (disseminated)
    tb - tb

    private room
    negative pressure with 6-12 air exchanges per hour
    uv
    mask
    n95 mask for tb

    droplet precaution
    think of spiderman!
    s - sepsis
    s - scarlet fever
    s - streptococcal pharyngitis
    p - parvovirus b19
    p - pertussis
    p - pneumonia
    i - influenza
    d - diptheria (pharyngeal)
    e - epiglottitis
    r - rubella
    m - mumps
    m - meningitis
    m - mycoplasma or meningeal pneumonia
    an - adenovirus

    private room
    mask


    contact precaution
    mrs.wee
    m - multidrug resistant organism
    r - respiratory infection - rsv
    s - skin infections
    w - wound infections
    e - enteric infections - clostridium defficile
    e - eye infections

    skin infections:
    v - varicella zoster
    c - cutaneous diptheria
    h - herpes simplex
    i - impetigo
    p - pediculosis
    s - scabies, staphylococcus

    private room
    gloves
    gown

    wash your hands before patient care and after patient care.
    when in doubt, wash your hands again.
    gloves needed when passing meds to pt. with mrsa, if you'll be close to patient need gown too.( just in case you touch anything that might be contaminated )
    my preceptor at work likes to say," better to have on too much ppe than not enough."
    ppe = personal protective equipment


    in removing ppe:
    1. gloves
    2. goggles/face shield
    3. gowns
    4. last will be the mask

    from: cdc
    yes you are right!

    donning ppe:

    -gown
    -mask
    -goggles
    -gloves

    removing ppe:

    -gloves
    -goggles
    -gown
    -mask

    for tb skin test, if client has 5mm induration, assess if patient is immunocompromised, if yes, positive.
    if not, 10mm/greater induration = positive

    for treatment of tb and major side effects:
    rifampicin (red-urine, tears, sweat)
    inh (the n is for neurological


    , h is for hepatic)
    pyrazinamide (hyperurecimia)

    ethambutol (optic neuritis)

    [color=#444444]for hepatitis, you get the vowels from the bowels (hepa a and e-"fecal-oral route)


    [color=#444444]according to cdc, patients infected with anthrax do not generally pose a transmission risk. standard (universal) precautions are required though...



    [color=#444444]vre = vancomycin resistant enterococcus

    [color=#444444]localized herpes zooster is also known as a cold sore[color=#444444]. it's not airborne, and is not spread by touching, so standard precautions is all that is needed.

    [color=#444444]mumps is respiratory precautions.
    rubella


    [color=#444444]is keep away from pregnant women.
    [color=#444444]scarlet fever is respiratory precautions till 24 hr after therapy is started.

    [color=#444444]german measles ( rubella ) requires standard precautions and droplet precautions.


    [color=#444444]rsv is contact precautions. so wear gloves and a gown. it is a respiratory infection that is transmited through contact with the secretions.

    [color=#444444]mmr immunization[color=#444444]:
    [color=#444444]1st vaccine dose given at age 12-15 mo.
    [color=#444444]2nd dose at age 4-6 yrs
    [color=#444444]before administration; ask if allergic to eggs

    [color=#444444]mumps: incubation period 14-21 days
    [color=#444444]communicable period, immediately before and after the swelling begins
    [color=#444444]transmitted via airborne droplets, saliva, and possibly by contact with
    [color=#444444]infected person's urine
    [color=#444444]respiratory precaution; isolation for 9 days following the onset of parotid swelling
    [color=#444444]most common complication; aseptic meningitis, signs include- nuchal rigidity, lathargy, & vomiting
    [color=#444444]other complications; orchitis (red swollen tender testicles)

    rubella[color=#444444] (german measles): hospitalized child-contact isolation; mask, gown,and gloves
    [color=#444444]incubation period: 14-21 days
    [color=#444444]communicable period: 7 days before to ~ 5 days after rash appears
    [color=#444444]source: nasophryngeal secretions, virus present in blood, stool, & urin
    [color=#444444]transmission: airborne or direct contact with infectious droplets,
    [color=#444444]indirect via articles freshly contaminated with nasopharyngeal secreations, feces, or urin
    [color=#444444]assessment: low grade fever, malaise, pinkish-red maculopapular rash[color=#444444] that begins on the face and spreads to entire body, petecheae may occur on the soft palate
    [color=#444444]implementation: supportive care
    [color=#444444]transplacental: isolate from pregnant women

    [color=#444444]rubeola (measles)
    [color=#444444]koplik's spot (sm blue/white spots with a red base on the buccal mucosa
    [color=#444444]transmission: via airborne particles or contact with infectious droplets
    [color=#444444]precautions: mask and gloves

    [color=#444444]sars severe acute respiratory syndrome= it's droplet precaution...so mask.

    [color=#444444]-remember to tuck the gown cuffs inside each glove..and not over the gloves

    [color=#444444]-hiv/aids clients, you should always practice standard precautions (on all patients[color=#444444])...hiv/aids patients are not required to state that they have hiv/aids and the healthcare providers will not know which patient has what unless specify in their charts.


    [color=#444444]to those wondering about the n95 respirator with infectious tb patient..

    [color=#444444]-use n95 but during bronchoscopy on the same patient (with infectious tb), use a stronger respirator such as a powered air-purifying respirator or papr.

    [color=#444444]-to do a respirator fit check: during inhalation, the respirator should collapse, and during exhalation, check for leakage around the face

    [color=#444444]-removing the respirator, you will want to lift the bottom elastic over your head prior to the top elastic. remember to do it slowly because you don't want it to snap off your face.

    [color=#444444]-remember you would want to remove the respirator outside the patient's room after the door has been closed. all other ppes should be removed inside the patient's room at the doorway or in an anteroom. but if the procedure only requires that you use gloves, then you can remove your gloves in the patient room followed by hand hygiene

    [color=#444444]-there are three types of respirator, n95, n99, n100 but the n95 is used for infectious tb.


    [color=#444444]hepatitis b is something that if we are not careful, we can make a mistake very easy, this is a standard precaution unless we are suctioning the pt, then it becomes droplet




    http://www.youtube.com/results?searc...rch_type=&aq=f

    [color=#444444]keep those hands off that mouse!!!!!!!!!!!!!!!!!!!!!!!!!!!!

    [color=#444444]side note one: while you are practicing your nclex style questions, practice, practice, practice, critical thinking, by taking your time and trying to narrow down your answer and deciding between two possible correct answers. don’t get the quick mouse hand, take your hand off the mouse and don’t answer the question until you are confident that it’s the one you want to choose!!!!!!! i guarantee you that if your practice this you will become a better nclex test-taker. i personally like to keep my hand in my lap while deciding my answer. it kind of helps to keep you calm.



    low ph, high co2, high hco3 = resp. acidosis

    high ph, low co2, low hco3 = resp. alkalosis

    low ph, low co2, low hco3 = metabolic acidosis

    high ph, high co2, high hco3= metabolic alkalosis








    ph goes to the left= acid ph goes to the right=alkine
    acid<<<<<7.35-7.45>>>>>>>alkine
    hco3 22-26 co2 35-45
    so if ph is 7.55(up)& hco3 is 28 (up) both are up = met alkalosis

    ph hco3 both up = met alkalosis
    ph hco3 both down = met acidosis
    ph down co2 up = resp acidosis
    ph up co2 down =resp alkalosis


    rome:

    respiratory= opposite:
    · ph is high, pco2 is down (alkalosis).
    · ph is low, pco2 is up (acidosis).

    metabolic= equal:
    · ph is high, hco3 is high (alkalosis).
    · ph is low, hco3 is low (acidosis).




    acidosis alkalosis

    ph <7.35 >7.45

    pco2 >45 <35

    co2 <18 >22

    co2 might be hco3 in some labs and the 18 or 22 might be 1-2 numbers different.

    just write down this down and then circle which ones apply to your abg results. then what it is called is the one that caused the acidosis or alkalosis. pco is resp and co2 is metabolic

    ex your pt abgs are ph 7.30, pco2, 40 co2 10 this is metabolic acidosis.






    pharmacology - know indication/action/effect


    prefix/suffix


    -ase = thrombolytic
    -azepam = benzodiazepine
    -azine = antiemetic; phenothiazide
    -azole = proton pump inhibitor, antifungal
    -barbital = barbiturate
    -coxib = cox 2 enzyme blockers
    -cep/-cef = anti-infectives
    -caine = anesthetics
    -cillin = penicillin
    -cycline = antibiotic
    -dipine = calcium channel blocker
    -floxacin = antibiotic
    -ipramine = tricyclic antidepressant
    -ine = reverse transcriptase inhibitors, antihistamines
    -kinase = thrombolytics
    -lone, pred- = corticosteroid
    -mab = monoclonal antibiotics
    -micin = antibiotic, aminoglycoside
    -navir = protease inhibitor
    nitr-, -nitr- = nitrate/vasodilator
    -olol = beta antagonist
    -oxin = cardiac glycoside
    -osin = alpha blocker
    -parin = anticoagulant
    -prazole = ppi’s
    -phylline = bronchodilator
    -pril = ace inhibitor
    -statin = cholesterol lowering agent
    -sartan = angiotensin ii blocker
    -sone = glucocorticoid, corticosteroid
    -stigmine = cholinergics
    -terol = beta 2 agonist
    -thiazide = diuretic
    -tidine = antiulcer
    -trophin = pituitary hormone
    -vir = anti-viral, protease inhibitors
    -zosin = alpha 1 antagonist
    -zolam = benzo/sedative
    -zine = antihistamine





    pharm facts


    ·don’t give non-selective beta-blockers to patients w/respiratory problems
    ·vitamin c can cause false +ive occult blood
    ·avoid the ‘g’ herbs (ginsing, ginger, ginko, garlic) when on anti-clotting drugs (coumadin, asa, plavix, etc)
    ·asa toxicity can cause ringing of the ears
    ·no narcotics to any head-injury victims
    ·mg2+ toxicity is treated with calcium gluconate
    ·do not give calcium-channel blockers with grapefruit juice
    ·oxytocin is never administered through the primary iv
    ·lithium patients must consume extra sodium to prevent toxicity
    ·maoi patients should avoid tyramine:
    oaacados, bananas, beef/chicken liver, caffeine, red wine, beer, cheese (except cottage cheese), raisins, sausages, pepperoni, yogurt, sour cream.
    ·don’t give atropine for glaucoma – it increases iop
    ·don’t give ant-acids with food -- b/c it delays gastric emptying.
    ·don’t give stadol to methadone/heroin preggo’s -- cause instant withdrawal symptoms
    ·insulin – clear before cloudy
    ·don’t give meperidine (demerol) to pancreatitis patients
    ·always verify bowel sounds when giving kayexelate
    ·hypercalcemia = hypophosphatemia (and vice versa)
    ·radioactive dye – urine excretion
    ·signs of toxic ammonia levels is asterixis (hands flapping)
    ·d10w can be substituted for tpn (temporary use)
    ·dopamine and lasix are incompatible
    ·hypoglycemic shivers can be stopped by holding the limb, seizures cannot (infants)
    ·common symptom of aluminum hydroxide – constipation
    ·thiazide diuretics may induce hyperglycemia
    ·take iron with vit c – it enhances absorbtion – do not take with milk
    ·b1 - for alcoholic patients (to prevent wernicke’s encephalopathy & korsakoff’s synd)
    ·b6 - for tb patients
    ·b9 - for pregnant patients
    ·b12 - pernicious anemia, vegetarians.
    ·complications of coumadin - 3h’s - hemorrhage, hematuria & hepatitis
    ·ffp is administered to dic b/c of the clotting fx
    ·mannitol (osmtic diuretic [head injury]) crystallizes at room temp – use a filter needle
    ·antianxiety medication is pharmacologically similar to alcohol –used for weaning tx
    ·administrate glucagon when pt is hypoglycemia and unresponsive
    ·phenazopyridine ( pyridium)--urine will appear orange
    ·rifampicin -- red-urine, tears, sweat)
    ·hot and dry = sugar high (hyperglycemia)
    ·cold and clammy = need some candy (hypoglycemia)
    ·med of choice for v-tach is lidocaine
    ·med of choice for svt = adenosine or adenocard
    ·med of choice for asystole = atropine
    ·med of choice for chf is ace inhibitor.
    ·med of choice for anaphylactic shock is epinephrine
    ·med of choice for status epilepticus is valium.
    ·med of choice for bipolar is lithium.
    ·give ace inhibitors w/food to prevent stomach upset
    ·administer diuretics in the morning
    ·give lipitor at 1700 since the enzymes work best during the evenin
    ·common tricyclic meds - 3 syllabes (pamelor, elavil)
    ·common maoi’s - 2 syllables (nardil, marplan)
    ·tpn has a dedicated line & cannot be mixed ahead of time
    ·rhogam -- given at 28 weeks & 72 hrs postpartum
    ·do not administer erythromycin to multiple sclerosis pt
    ·benadryl and xanax taken together will cause additive effects.
    ·can't take lasix if allergic to sulfa drugs.
    ·acetaminophen can be used for headache when the client is using nitroglycerin.
    ·dilantin - can not give with dextrose. only give with ns.



    addison is skinny ( hypoglycemic, you get weight loss, you got weakness, and you get postural hypotn) cushing is fat ( hyperglycemic, you get moon face big cheeks, and you retain a lot of na and fluid)
    ·never give via ivp:
    okcl
    oheparin
    oibuprofen
    oinsulin
    odobutamine
    oasa
    oalbumin
    oacetaminophen

    ·insulin:
    orapid: lispro – onset <15 min. peak: 1 hr. duration 3hr
    oshort: regular – onset ½ - 1 hr. peak: 2-3hr. duration: 4-6 hr
    oint: nph or lente – onset: 2 hr. peak 6-12 hr. duration: 16-24hr
    olong: ultralente – onset 4-6 hr. peak: 12-16 hr. duration: >24hr
    ov.long: lantus – onset 1 hr. peak: none. duration: 24 hr continuous



    ·anticholergic side effects:
    ocan’t see
    ocan’t pee
    ocan’t spit
    ocan’t sh*t
    ·hypocalcemia – cats
    oconvulsions
    oarrythmias
    otetany
    ospasms & stridor





    ·hyper kalemia causes: ‘machine’
    omedicationa (ace inhibitors, nsaids)
    oacidosis (metabolic & repiratory)
    ocellular destruction (burns, traumatic injuy)
    ohypoaldosteronism, hemolysis
    onephrons, renal failure
    oexcretion (impaired)

    ·signs of increased k ‘ murder’
    omuscle weaknes
    ourine – olyguria, anuria
    orespiratory distress
    odecreaed cardiac contractility
    oecg changes
    oreflexes – hyperreflexia, or flaccid

    ·substance poisoning and antidotes
    omethanol -- ethanol
    oco2 -- oxygen
    odopamine -- phentolamine
    obenzo’s (versed) -- flumazenil
    olead -- succimer, calcium disodium
    oiron -- deferoxamine
    ocoumadin -- vitamin k
    oheparin -- protamine sulfate
    othorazine -- cogentine
    owild mushrooms - atropine
    orat poison - vit k

    ·parkland formula: 4cc * kg * bsa burned = total volume necessary
    o1st 8hrs – ½ total volume
    o2nd 8hrs – ¼ total volume
    o3rd 8 hrs – ¼ total volumes



    nclex drugs??? most-prescribed meds in the us!


    generic name (trade name) major concerns
    analgesic
    acetaminophen (tylenol) watch for liver and kidney problems
    hydrocodone with acetaminophen addictive
    (lortab)
    ibuprofen (motrin) can lead to hpn and kidney disease
    naproxen (aleve) can lead to hpn and kidney disease

    antianxiety
    alprazolam (xanax) this drug can be addictive
    diazepam (valium) watch for allergies, *also anticonvulsant*
    lorazepam (antivan) sedation
    promethazine hci (phenergan) *also antiemetic*

    antibiotic
    amoxicilline (augmentin) watch for allergic reactions
    azithromycin (zithromax z-pak) watch for allergies
    cephalexin (keflex) if you are allergic to cephalosporins, you might also be allergic to penicillin
    doxycycline hyclate (vibramycin) avoid for pregnant clients
    penicillin v potassium (penicillin) watch for allergies
    sulfamethoxazole (septra, bactrim) can cause gi diturbance

    anticoagulant
    warfarin sodium (coumadin) teach the client to limit the intake of green leafy vegetables
    watch for signs of bleeding
    anticonvulsant
    clonazepam (klonopin) should not be stoppe abruptly
    diazepam (valium) watch for allergies, also antianxiety
    lorazepam (antivan) sedation

    antidepressant
    sertraline (zoloft) sedation
    amitriptyline hci (elavil)
    trazodone hci (desyrel)

    antidiabetic
    glipizide (glucotrol) watch for hypoglycemia
    metformin (glucophage) thi drug should be stopped prior to a dye study such as cardiac catheterization

    antihistamine
    cetirizine (zyrtec)
    fexofenadine (allegra) dry mouth

    antihypertensive
    amiodipine (norvasc) hypertension
    atenolol (tenormin) cause drop in pulse rate, check pr daily
    doxazosin mesylate (cardura)
    lisinopril (zestril) cause postural hpn, remain supine for at least 30mins
    metoprolol succinate (toprol xl) teach the client to check his pulse rate
    metoprolol tartrate (lopressor,toprol) teach the client to check his pulse rate

    antihypertensive/antianginal
    verapamil hci (calan)

    anti-inflammatory
    ibuprofen (motrin) can lead to hypertension and kidney disease
    prednisone (deltasone) can cause cushing’s syndrome and gi problems

    antigout
    allopurinol (zyloprim) drink a least 8 glasses of water per day


    antilipidemic – usually ends in statin
    simvastatin (zocor) can cause liver problems & muscle soreness
    do not take this drug with grape-fruit juice
    antiulcer/histamine blocker
    ranitidine hci (zantac) best to take this drug with meals

    antiulcer/proton pump inhibitor
    lansoprazole (prevacid) take this drug prior to meals
    omeprazole (prilosec)

    bronchodilator
    albuterol (proventil) tachycardia, md check blood levels for toxicity

    diuretic
    furosemide (lasix) hypokalemia
    hydrochlorothiazide (hctz) hypokalemia

    hormone replacement
    estrogen (premarin) can ↑ blood clots
    levothyroxine (levoxyl) can ↑ blood clots
    levothyroxin (synthyroid) teach the clients to check his pulse rate

    muscle relaxant
    cyclobenzaprine hci (flexeril) sedation

    oral contraceptive
    necon (ortho-novum 7/7/7) can ↑ blood clots
    trinessa (ortho triclen) can ↑ blood clots

    osteoporosis
    alendronate (fosamax) remain upright for at least 30mins after taking to prevent gerd.
    take wit water

    potassium supplement
    potassium chloride (k-lyte) check for renal function before giving this drug

    sleep aid
    zolpidem (ambien) allow at least 8hrs of sleep time to prevent daytime drowsiness


    i highly recomend this link it is organized and less confusing and not over done as cdc website which can be over whelming:

    http://info.med.yale.edu/ynhh/infection


    this is sir silas he kept me company during this long journey. he wants me to find a job now. yet another hurdle


    hope it helps!!! good luck!
    Last edit by UNIVERSAL NURSE on Mar 31, '10
    gyuzeel, stacievlz, kaila731, and 1 other like this.
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  4. 8 Comments so far...

  5. 0
    Thanks! This will help those who are still studying for the NCLEX.
  6. 0
    and many thanks for consolidating a lot of useful info!
  7. 2
    Quote from universal nurse
    i passed after taking nclex this past monday/ pearson trick immediately after getting home. kaplan takes months to fully get all out of it. not weeks, it works. review all content review and write it all out. takes months. it took many 7 months to fully absorb all of kaplan and i kept changing my class in order to get more time. i highly recomend th live on line course, not the in person course. you must cover all the course content review which is huge. do all the q-trainers and know all the rationales, i never got to the q-bank and still passed. write it all out if you are slow like me.

    priority and delegation by charity is a must.

    i get tired very easily. i ate breakfast, went back to bed for 3 hours. got ready downed a red bull ate chocolate and was fully charged for the nclex. the brain uses lots of sugar when you are concentrating this kept me going.

    below are also a must know that i had copied pasted from different posts. i must emphasize this is a must know:

    1. varicella (chickenpox) requires use of airborne precautions and contact precautions as well.
    2. if a patient is on contact precautions, have family members and other visitors wear a gown and gloves as outlined by your facility (hospital).
    1) droplet room assignment: preferably private, if not available roomate with same illness and same pathogen. and if thats not an option 3 feet away from roomate with the curtain pulled.

    2) when transporting a patient with airborne precautions (for essential purposes only) they must wear a surgical mask.

    for contact precautions
    diseases/conditions include: c. diff, e. coli, scabies
    room needs to be private unless room has another patient infected with the same organism

    for droplet precautions
    diseases/conditions include: meningitis, pneumonia, pertussis (whooping cough), rubella, mumps
    room needs to be private unless room has another patient infected with the same organism. maintain spacial distance of 3 feet when near patient.

    also remember standard precautions apply to all patients regardless of diagnosis when in contact with any bodily fluid, blood, secretions/excretions, nonintact skin, and mucous membranes

    #1. when wearing gown and/or gloves, make sure to take them off and properly dispose of them, before leaving the patien'ts room.

    #2. pt's with herpes zooster (shingles) that is active should have the same precautions as a patient with chicken pox---airborne and contact

    #3. pt's on droplet precaution can have their room door left open.

    #4. instruct visitors for pt's with droplet precautions to try to keep a distance of three feet between them and the pt.

    #5. pt's with croup should be on contact precautions

    bacterial meningitis is transmitted via droplets, and when suctioning pt, wear goggles, eyewear, mask, and gloves. pt should wear a face mask when being transported.

    cdc recommends airborne precautions against varicella/rubeola.

    measles, chicken pox (varicella), disseminated varicella zoster, tuberculosis

    barrrier protection: single room maintained under negative pressure
    door kept closed except when someone is entering
    exiting the room
    negative airflow pressure used in room, (min of 6 - 12 air exchanges per hour depending on the facility
    ultraviolet germicide irradiation or high-efficiency
    particulate air filter used in the room
    mask or personal respiratory protection device used
    mask placed on the client when client needs to
    leave the room; client only leaves only if necessary!

    rsv is contact precautions. so wear gloves and a gown. it is a respiratory infection that is transmited through contact with the secretions.


    when you put your protective gear on start from top to bottom : mask-> gown-> and gloves. when you take them off start from bottom to top: gloves->gown->mask. (i tried to research this part just to make sure it is what i remember it to be, but found nothing so im not 100% certain)

    wash hands between patients and whenever visibly soiled.

    donning ppe (personal protective equipment)

    gown
    fully cover torso from neck to knees, arms to end of wrist, and wrap around the back
    fasten in back at neck and waist

    mask or respirator
    secure ties or elastic band at middle of head and neck
    fit flexible band to nose bridge
    fit snug to face and below chin
    fit-check respirator

    goggles/face shield
    put on face and adjust to fit

    gloves
    use non-sterile for isolation
    select according to hand size
    extend to cover wrist of isolation gown

    safe work practices
    keep hands away from face
    work from clean to dirty
    limit surfaces touched
    change when torn or heavily contaminated
    perform hand hygiene

    removing ppe

    remove ppe at doorway before leaving patient room or in anteroom

    gloves
    outside of gloves are contaminated!
    grasp outside of glove with opposite gloved hand; peel off
    hold removed glove in gloved hand
    slide fingers of ungloved hand under remaining glove at wrist

    goggles/face shield
    outside of goggles or face shield are contaminated!
    to remove, handle by “clean” head band or ear pieces
    place in designated receptacle for reprocessing or in waste container

    gown
    gown front and sleeves are contaminated!
    unfasten neck, then waist ties
    remove gown using a peeling motion; pull gown from each shoulder toward the same hand
    gown will turn inside out
    hold removed gown away from body, roll into a bundle and discard into waste or linen receptacle

    mask or respirator
    front of mask/respirator is contaminated – do not touch!
    grasp only bottom then top ties/elastics and remove
    discard in waste container

    hand hygiene
    perform hand hygiene immediately after removing all ppe!


    chicken pox(13-17 days)--prodromal, child have malaise, fever, anorexia.

    rash is pruritic, and starts out as a macule then papule then a vesicle.

    spread by direct contact, droplet and contaminated object.

    isolate till all vesicles are crusted; it can be spread from 2 days before the rash begins.

    avoid use of aspirin due to reye's syndrome, use tylenol.

    airborn--door can be closed..measles (rubeola), m. tuberculosis, disseminated zoster(shingles), varicella(chicken pox)--again can cohort and place in same room with the same infective organism.
    droplet--door may be open---streptococcus pharyngitis, meningitis, pnemonia...private room or pt with same infection--involves contact with mucous membranes of nose or mouth...happens during talking, coughing, suctioning. maintain 3feet between infected patients and visitors.

    rubella--there's a maculopapular rash on face and all over the body. prodromal: malaise and fever which is followed by cough.
    sread by droplets and contaminated objects. placed on contact precautions, isolate child from pregnant women.

    tuberculosis, pt is on isolation for 2-4 weeks (until there are 3 negative sputum cultures.)

    syphilis--painless chancre that fades within 6 weeks...on palms and soles there is a copper colored rash...spread by contact with mucous membranes and also congenitally...tx with penicillin g im


    heres how i remember that rubella is droplet and rubeola is airborne...rubella sounds like umbrella and umbrellas protect you from raindrops...


    transmission-based precautions: adc
    a - airborne
    d - droplet
    c - contact

    airborne precaution (credit goes to the one who posted this on april thread, sorry can't remember your name)

    my - measles
    chicken - chickenpox
    hez - herpes zoster (disseminated)
    tb - tb

    private room
    negative pressure with 6-12 air exchanges per hour
    uv
    mask
    n95 mask for tb

    droplet precaution
    think of spiderman!
    s - sepsis
    s - scarlet fever
    s - streptococcal pharyngitis
    p - parvovirus b19
    p - pertussis
    p - pneumonia
    i - influenza
    d - diptheria (pharyngeal)
    e - epiglottitis
    r - rubella
    m - mumps
    m - meningitis
    m - mycoplasma or meningeal pneumonia
    an - adenovirus

    private room
    mask


    contact precaution
    mrs.wee
    m - multidrug resistant organism
    r - respiratory infection - rsv
    s - skin infections
    w - wound infections
    e - enteric infections - clostridium defficile
    e - eye infections

    skin infections:
    v - varicella zoster
    c - cutaneous diptheria
    h - herpes simplex
    i - impetigo
    p - pediculosis
    s - scabies, staphylococcus

    private room
    gloves
    gown

    wash your hands before patient care and after patient care.
    when in doubt, wash your hands again.
    gloves needed when passing meds to pt. with mrsa, if you'll be close to patient need gown too.( just in case you touch anything that might be contaminated )
    my preceptor at work likes to say," better to have on too much ppe than not enough."
    ppe = personal protective equipment

    in removing ppe:
    1. gloves
    2. goggles/face shield
    3. gowns
    4. last will be the mask

    from: cdc
    yes you are right!

    donning ppe:

    -gown
    -mask
    -goggles
    -gloves

    removing ppe:

    -gloves
    -goggles
    -gown
    -mask

    for tb skin test, if client has 5mm induration, assess if patient is immunocompromised, if yes, positive.
    if not, 10mm/greater induration = positive

    for treatment of tb and major side effects:
    rifampicin (red-urine, tears, sweat)
    inh (the n is for neurological


    , h is for hepatic)
    pyrazinamide (hyperurecimia)

    ethambutol (optic neuritis)

    [color=#444444]for hepatitis, you get the vowels from the bowels (hepa a and e-"fecal-oral route)


    [color=#444444]according to cdc, patients infected with anthrax do not generally pose a transmission risk. standard (universal) precautions are required though...



    [color=#444444]vre = vancomycin resistant enterococcus

    [color=#444444]localized herpes zooster is also known as a cold sore[color=#444444]. it's not airborne, and is not spread by touching, so standard precautions is all that is needed.

    [color=#444444]mumps is respiratory precautions.
    rubella


    [color=#444444]is keep away from pregnant women.
    [color=#444444]scarlet fever is respiratory precautions till 24 hr after therapy is started.

    [color=#444444]german measles ( rubella ) requires standard precautions and droplet precautions.


    [color=#444444]rsv is contact precautions. so wear gloves and a gown. it is a respiratory infection that is transmited through contact with the secretions.

    [color=#444444]mmr immunization[color=#444444]:
    [color=#444444]1st vaccine dose given at age 12-15 mo.
    [color=#444444]2nd dose at age 4-6 yrs
    [color=#444444]before administration; ask if allergic to eggs

    [color=#444444]mumps: incubation period 14-21 days
    [color=#444444]communicable period, immediately before and after the swelling begins
    [color=#444444]transmitted via airborne droplets, saliva, and possibly by contact with
    [color=#444444]infected person's urine
    [color=#444444]respiratory precaution; isolation for 9 days following the onset of parotid swelling
    [color=#444444]most common complication; aseptic meningitis, signs include- nuchal rigidity, lathargy, & vomiting
    [color=#444444]other complications; orchitis (red swollen tender testicles)

    rubella[color=#444444] (german measles): hospitalized child-contact isolation; mask, gown,and gloves
    [color=#444444]incubation period: 14-21 days
    [color=#444444]communicable period: 7 days before to ~ 5 days after rash appears
    [color=#444444]source: nasophryngeal secretions, virus present in blood, stool, & urin
    [color=#444444]transmission: airborne or direct contact with infectious droplets,
    [color=#444444]indirect via articles freshly contaminated with nasopharyngeal secreations, feces, or urin
    [color=#444444]assessment: low grade fever, malaise, pinkish-red maculopapular rash[color=#444444] that begins on the face and spreads to entire body, petecheae may occur on the soft palate
    [color=#444444]implementation: supportive care
    [color=#444444]transplacental: isolate from pregnant women

    [color=#444444]rubeola (measles)
    [color=#444444]koplik's spot (sm blue/white spots with a red base on the buccal mucosa
    [color=#444444]transmission: via airborne particles or contact with infectious droplets
    [color=#444444]precautions: mask and gloves

    [color=#444444]sars severe acute respiratory syndrome= it's droplet precaution...so mask.

    [color=#444444]-remember to tuck the gown cuffs inside each glove..and not over the gloves

    [color=#444444]-hiv/aids clients, you should always practice standard precautions (on all patients[color=#444444])...hiv/aids patients are not required to state that they have hiv/aids and the healthcare providers will not know which patient has what unless specify in their charts.


    [color=#444444]to those wondering about the n95 respirator with infectious tb patient..

    [color=#444444]-use n95 but during bronchoscopy on the same patient (with infectious tb), use a stronger respirator such as a powered air-purifying respirator or papr.

    [color=#444444]-to do a respirator fit check: during inhalation, the respirator should collapse, and during exhalation, check for leakage around the face

    [color=#444444]-removing the respirator, you will want to lift the bottom elastic over your head prior to the top elastic. remember to do it slowly because you don't want it to snap off your face.

    [color=#444444]-remember you would want to remove the respirator outside the patient's room after the door has been closed. all other ppes should be removed inside the patient's room at the doorway or in an anteroom. but if the procedure only requires that you use gloves, then you can remove your gloves in the patient room followed by hand hygiene

    [color=#444444]-there are three types of respirator, n95, n99, n100 but the n95 is used for infectious tb.


    [color=#444444]hepatitis b is something that if we are not careful, we can make a mistake very easy, this is a standard precaution unless we are suctioning the pt, then it becomes droplet




    http://www.youtube.com/results?searc...rch_type=&aq=f

    [color=#444444]keep those hands off that mouse!!!!!!!!!!!!!!!!!!!!!!!!!!!!

    [color=#444444]side note one: while you are practicing your nclex style questions, practice, practice, practice, critical thinking, by taking your time and trying to narrow down your answer and deciding between two possible correct answers. don’t get the quick mouse hand, take your hand off the mouse and don’t answer the question until you are confident that it’s the one you want to choose!!!!!!! i guarantee you that if your practice this you will become a better nclex test-taker. i personally like to keep my hand in my lap while deciding my answer. it kind of helps to keep you calm.



    low ph, high co2, high hco3 = resp. acidosis

    high ph, low co2, low hco3 = resp. alkalosis

    low ph, low co2, low hco3 = metabolic acidosis

    high ph, high co2, high hco3= metabolic alkalosis








    ph goes to the left= acid ph goes to the right=alkine
    acid<<<<<7.35-7.45>>>>>>>alkine
    hco3 22-26 co2 35-45
    so if ph is 7.55(up)& hco3 is 28 (up) both are up = met alkalosis

    ph hco3 both up = met alkalosis
    ph hco3 both down = met acidosis
    ph down co2 up = resp acidosis
    ph up co2 down =resp alkalosis


    rome:

    respiratory= opposite:
    · ph is high, pco2 is down (alkalosis).
    · ph is low, pco2 is up (acidosis).

    metabolic= equal:
    · ph is high, hco3 is high (alkalosis).
    · ph is low, hco3 is low (acidosis).




    acidosis alkalosis

    ph <7.35 >7.45

    pco2 >45 <35

    co2 <18 >22

    co2 might be hco3 in some labs and the 18 or 22 might be 1-2 numbers different.

    just write down this down and then circle which ones apply to your abg results. then what it is called is the one that caused the acidosis or alkalosis. pco is resp and co2 is metabolic

    ex your pt abgs are ph 7.30, pco2, 40 co2 10 this is metabolic acidosis.






    pharmacology - know indication/action/effect


    prefix/suffix


    -ase = thrombolytic
    -azepam = benzodiazepine
    -azine = antiemetic; phenothiazide
    -azole = proton pump inhibitor, antifungal
    -barbital = barbiturate
    -coxib = cox 2 enzyme blockers
    -cep/-cef = anti-infectives
    -caine = anesthetics
    -cillin = penicillin
    -cycline = antibiotic
    -dipine = calcium channel blocker
    -floxacin = antibiotic
    -ipramine = tricyclic antidepressant
    -ine = reverse transcriptase inhibitors, antihistamines
    -kinase = thrombolytics
    -lone, pred- = corticosteroid
    -mab = monoclonal antibiotics
    -micin = antibiotic, aminoglycoside
    -navir = protease inhibitor
    nitr-, -nitr- = nitrate/vasodilator
    -olol = beta antagonist
    -oxin = cardiac glycoside
    -osin = alpha blocker
    -parin = anticoagulant
    -prazole = ppi’s
    -phylline = bronchodilator
    -pril = ace inhibitor
    -statin = cholesterol lowering agent
    -sartan = angiotensin ii blocker
    -sone = glucocorticoid, corticosteroid
    -stigmine = cholinergics
    -terol = beta 2 agonist
    -thiazide = diuretic
    -tidine = antiulcer
    -trophin = pituitary hormone
    -vir = anti-viral, protease inhibitors
    -zosin = alpha 1 antagonist
    -zolam = benzo/sedative
    -zine = antihistamine





    pharm facts


    ·don’t give non-selective beta-blockers to patients w/respiratory problems
    ·vitamin c can cause false +ive occult blood
    ·avoid the ‘g’ herbs (ginsing, ginger, ginko, garlic) when on anti-clotting drugs (coumadin, asa, plavix, etc)
    ·asa toxicity can cause ringing of the ears
    ·no narcotics to any head-injury victims
    ·mg2+ toxicity is treated with calcium gluconate
    ·do not give calcium-channel blockers with grapefruit juice
    ·oxytocin is never administered through the primary iv
    ·lithium patients must consume extra sodium to prevent toxicity
    ·maoi patients should avoid tyramine:
    oaacados, bananas, beef/chicken liver, caffeine, red wine, beer, cheese (except cottage cheese), raisins, sausages, pepperoni, yogurt, sour cream.
    ·don’t give atropine for glaucoma – it increases iop
    ·don’t give ant-acids with food -- b/c it delays gastric emptying.
    ·don’t give stadol to methadone/heroin preggo’s -- cause instant withdrawal symptoms
    ·insulin – clear before cloudy
    ·don’t give meperidine (demerol) to pancreatitis patients
    ·always verify bowel sounds when giving kayexelate
    ·hypercalcemia = hypophosphatemia (and vice versa)
    ·radioactive dye – urine excretion
    ·signs of toxic ammonia levels is asterixis (hands flapping)
    ·d10w can be substituted for tpn (temporary use)
    ·dopamine and lasix are incompatible
    ·hypoglycemic shivers can be stopped by holding the limb, seizures cannot (infants)
    ·common symptom of aluminum hydroxide – constipation
    ·thiazide diuretics may induce hyperglycemia
    ·take iron with vit c – it enhances absorbtion – do not take with milk
    ·b1 - for alcoholic patients (to prevent wernicke’s encephalopathy & korsakoff’s synd)
    ·b6 - for tb patients
    ·b9 - for pregnant patients
    ·b12 - pernicious anemia, vegetarians.
    ·complications of coumadin - 3h’s - hemorrhage, hematuria & hepatitis
    ·ffp is administered to dic b/c of the clotting fx
    ·mannitol (osmtic diuretic [head injury]) crystallizes at room temp – use a filter needle
    ·antianxiety medication is pharmacologically similar to alcohol –used for weaning tx
    ·administrate glucagon when pt is hypoglycemia and unresponsive
    ·phenazopyridine ( pyridium)--urine will appear orange
    ·rifampicin -- red-urine, tears, sweat)
    ·hot and dry = sugar high (hyperglycemia)
    ·cold and clammy = need some candy (hypoglycemia)
    ·med of choice for v-tach is lidocaine
    ·med of choice for svt = adenosine or adenocard
    ·med of choice for asystole = atropine
    ·med of choice for chf is ace inhibitor.
    ·med of choice for anaphylactic shock is epinephrine
    ·med of choice for status epilepticus is valium.
    ·med of choice for bipolar is lithium.
    ·give ace inhibitors w/food to prevent stomach upset
    ·administer diuretics in the morning
    ·give lipitor at 1700 since the enzymes work best during the evenin
    ·common tricyclic meds - 3 syllabes (pamelor, elavil)
    ·common maoi’s - 2 syllables (nardil, marplan)
    ·tpn has a dedicated line & cannot be mixed ahead of time
    ·rhogam -- given at 28 weeks & 72 hrs postpartum
    ·do not administer erythromycin to multiple sclerosis pt
    ·benadryl and xanax taken together will cause additive effects.
    ·can't take lasix if allergic to sulfa drugs.
    ·acetaminophen can be used for headache when the client is using nitroglycerin.
    ·dilantin - can not give with dextrose. only give with ns.



    addison is skinny ( hypoglycemic, you get weight loss, you got weakness, and you get postural hypotn) cushing is fat ( hyperglycemic, you get moon face big cheeks, and you retain a lot of na and fluid)
    ·never give via ivp:
    okcl
    oheparin
    oibuprofen
    oinsulin
    odobutamine
    oasa
    oalbumin
    oacetaminophen

    ·insulin:
    orapid: lispro – onset <15 min. peak: 1 hr. duration 3hr
    oshort: regular – onset ½ - 1 hr. peak: 2-3hr. duration: 4-6 hr
    oint: nph or lente – onset: 2 hr. peak 6-12 hr. duration: 16-24hr
    olong: ultralente – onset 4-6 hr. peak: 12-16 hr. duration: >24hr
    ov.long: lantus – onset 1 hr. peak: none. duration: 24 hr continuous



    ·anticholergic side effects:
    ocan’t see
    ocan’t pee
    ocan’t spit
    ocan’t sh*t
    ·hypocalcemia – cats
    oconvulsions
    oarrythmias
    otetany
    ospasms & stridor





    ·hyper kalemia causes: ‘machine’
    omedicationa (ace inhibitors, nsaids)
    oacidosis (metabolic & repiratory)
    ocellular destruction (burns, traumatic injuy)
    ohypoaldosteronism, hemolysis
    onephrons, renal failure
    oexcretion (impaired)

    ·signs of increased k ‘ murder’
    omuscle weaknes
    ourine – olyguria, anuria
    orespiratory distress
    odecreaed cardiac contractility
    oecg changes
    oreflexes – hyperreflexia, or flaccid

    ·substance poisoning and antidotes
    omethanol -- ethanol
    oco2 -- oxygen
    odopamine -- phentolamine
    obenzo’s (versed) -- flumazenil
    olead -- succimer, calcium disodium
    oiron -- deferoxamine
    ocoumadin -- vitamin k
    oheparin -- protamine sulfate
    othorazine -- cogentine
    owild mushrooms - atropine
    orat poison - vit k

    ·parkland formula: 4cc * kg * bsa burned = total volume necessary
    o1st 8hrs – ½ total volume
    o2nd 8hrs – ¼ total volume
    o3rd 8 hrs – ¼ total volumes



    nclex drugs??? most-prescribed meds in the us!


    generic name (trade name) major concerns
    analgesic
    acetaminophen (tylenol) watch for liver and kidney problems
    hydrocodone with acetaminophen addictive
    (lortab)
    ibuprofen (motrin) can lead to hpn and kidney disease
    naproxen (aleve) can lead to hpn and kidney disease

    antianxiety
    alprazolam (xanax) this drug can be addictive
    diazepam (valium) watch for allergies, *also anticonvulsant*
    lorazepam (antivan) sedation
    promethazine hci (phenergan) *also antiemetic*

    antibiotic
    amoxicilline (augmentin) watch for allergic reactions
    azithromycin (zithromax z-pak) watch for allergies
    cephalexin (keflex) if you are allergic to cephalosporins, you might also be allergic to penicillin
    doxycycline hyclate (vibramycin) avoid for pregnant clients
    penicillin v potassium (penicillin) watch for allergies
    sulfamethoxazole (septra, bactrim) can cause gi diturbance

    anticoagulant
    warfarin sodium (coumadin) teach the client to limit the intake of green leafy vegetables
    watch for signs of bleeding
    anticonvulsant
    clonazepam (klonopin) should not be stoppe abruptly
    diazepam (valium) watch for allergies, also antianxiety
    lorazepam (antivan) sedation

    antidepressant
    sertraline (zoloft) sedation
    amitriptyline hci (elavil)
    trazodone hci (desyrel)

    antidiabetic
    glipizide (glucotrol) watch for hypoglycemia
    metformin (glucophage) thi drug should be stopped prior to a dye study such as cardiac catheterization

    antihistamine
    cetirizine (zyrtec)
    fexofenadine (allegra) dry mouth

    antihypertensive
    amiodipine (norvasc) hypertension
    atenolol (tenormin) cause drop in pulse rate, check pr daily
    doxazosin mesylate (cardura)
    lisinopril (zestril) cause postural hpn, remain supine for at least 30mins
    metoprolol succinate (toprol xl) teach the client to check his pulse rate
    metoprolol tartrate (lopressor,toprol) teach the client to check his pulse rate

    antihypertensive/antianginal
    verapamil hci (calan)

    anti-inflammatory
    ibuprofen (motrin) can lead to hypertension and kidney disease
    prednisone (deltasone) can cause cushing’s syndrome and gi problems

    antigout
    allopurinol (zyloprim) drink a least 8 glasses of water per day


    antilipidemic – usually ends in statin
    simvastatin (zocor) can cause liver problems & muscle soreness
    do not take this drug with grape-fruit juice
    antiulcer/histamine blocker
    ranitidine hci (zantac) best to take this drug with meals

    antiulcer/proton pump inhibitor
    lansoprazole (prevacid) take this drug prior to meals
    omeprazole (prilosec)

    bronchodilator
    albuterol (proventil) tachycardia, md check blood levels for toxicity

    diuretic
    furosemide (lasix) hypokalemia
    hydrochlorothiazide (hctz) hypokalemia

    hormone replacement
    estrogen (premarin) can ↑ blood clots
    levothyroxine (levoxyl) can ↑ blood clots
    levothyroxin (synthyroid) teach the clients to check his pulse rate

    muscle relaxant
    cyclobenzaprine hci (flexeril) sedation

    oral contraceptive
    necon (ortho-novum 7/7/7) can ↑ blood clots
    trinessa (ortho triclen) can ↑ blood clots

    osteoporosis
    alendronate (fosamax) remain upright for at least 30mins after taking to prevent gerd.
    take wit water

    potassium supplement
    potassium chloride (k-lyte) check for renal function before giving this drug

    sleep aid
    zolpidem (ambien) allow at least 8hrs of sleep time to prevent daytime drowsiness


    i highly recomend this link it is organized and less confusing and not over done as cdc website which can be over whelming:

    http://info.med.yale.edu/ynhh/infection


    this is sir silas he kept me company during this long journey. he wants me to find a job now. yet another hurdle


    hope it helps!!! good luck!
    thx for sharing this information. i too took exam today not good pop up but lolts of prioritization and infection control . congrates. i will pass too soonnnn
    kaila731 and StarMatrix17 like this.
  8. 0
    Hello Everyone , I took my NCLEX today and I was wondering if anyone knows how long it takes before the unofficial results are posted on Pearson Vue?

    Thanks
  9. 0
    Good info!
  10. 0
    thank you for sharing this.. im gonna copy this now on my notes.. thank you so much!!1
  11. 0
    Thank You so much for sharing your info with us, Congrats on your passing nclex. I will ve attempting for the third time at the end of may. Going to byuy the Charity book tomorrow...
  12. 0
    Universal Nurse--

    All I can say is THANK YOU! You obviously put alot of time and effort into posting all of this very valuable info on to us. I graduate in May 5 more weeks and then am planning on taking a Review Course. This is AMAZING stuff! I will pass it on to my buddies as well. Congratulations to you on passing! Woo-Hoo!


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