assess before implementation!!
*remember to look at all theanswers first and decide what question is asking before giving a “knee jerkresponse”.
*kidney = kidney -make connections.
*recognize patterns, ex: give oxycodone,meperidine, fentanyl,and acetaminophen.
(heavy hitters-for3-4 days post-op).
*age of person in question isvery, important.
*tachycardia, tachypnea, andconfusion are signs of infection in the elderly.
*sentence ends in “expectsthe following” = approaching the norm….ex: if med iseffective=approaching norm.
*comma, comma, and segments = ifone segment of answer is wrong/then whole answer is wrong. no credit for mostof question is right. all have to be right.
*answer that is questioning “hashappened in the past/future” = eliminate it! stay in the now.
*”patient says” = isconsidered an assessment.
*post procedure = think worstcomplication…ex: hemorrhage, puncture, infection.
*30 mls = 1 oz. 8oz. = 1 cup.
*pick most definitive answer.
*who to see first = stable or unstableor becoming unstable
*nephrotic syndrome = proteinuria
*glomerulonephritis = hematuria
*pleuravac = the level in thewater seal chamber (chest tubes) fluctuates with respiration- no fluctuationindicates an obstruction and excessive bubbling indicates an air leak.
*client with dx of hyperparathyroidism = the most important symptom to reportto the next shift is – hematuria
note: hematuria is a sign of renal calculi: 55% of hyperparathyroid clientshave renal stones.
* low hemoglobin < 12 = oxygen2l
*coumaden and tylenol = not done!
*hypertension and cvacorrelation.
*goals for laryngectomy/trach =pt. self-suctioning.
*terminal care = “what can i dofor you?” = psychosocial/cannot fixphysiological.
*elderly-present hypoxia withconfusion. elderly-confusion = hypoxia.
*newborn head circumference =33-35cm > = icp or hydrocephalous
*management of care
rn = (t, e, a) = teaching, evaluation,assessment
lpn = stable pts.with expected out comes
pca = standard unchanging procedures
*nurse manager = staff andadministration.
*transfer and discharge = has tobe an rn due to assessing and teaching of pt. that is leaving your facility.
*never a pick an answer where youleave the patient.
*anything above the neck = priority and alwaysconsidered more unstable!
*transfer to a different floor(nurse) in nclex you cannot decline = give nurse most stable and least complex.
*restraints = still let clienttake over some care/independence.
*in pick all that apply = pick atleast 2 and never pick all.
*chest pain = physiological notpsychosocial.
*nclex = pca can do enteralfeedings. not realistic but nclex says yes they can.
*charting = with hx of or vaginalbleeding-“no vaginal exam”.
*management of care = rememberchain of command.
*don’t ever ask pt. why.
*rom- (rupture ofmembrane) = infection for mom/baby.
*clean with cleanand vulnerable with vulnerable.
*dirty with dirty and infect withinfect.
*crohns = <fat, <sugar,<fiber, and >protein.
*wt. gain during pregnancy = 2-5lbs. 1st semester and 1.1 lbs during 2nd, 3rd.
*liver dx = >carb,<protein,<na+.
*renal dx.= <ka+, <na+,<phos.
*initial dose =first dose.
*propranolol (inderal)(antianginals, antiarrhythmics) decreases the effectiveness of atorvastatin.(lipitor)
* meds = remember adverseaffects…. ex: insulin = hypoglycemia
ex: propanolol = hypotension.
*antidysrhythmics adverse affect= hypotension and bradycardia.
*calculate heartbeats/min. on ekg= count 0.4 boxes in r to r complex (represents beats) and divide into1500 (1500 = min.)
*severe burn injury = first 24hrs-risk for curlings ulcer = gastric ph 1-5 is acidic.
*cross allergy- penicillin andcephalosporin.
*cephalosporins and sulfonamidestaken with food.
*furadantin for uti-taken w/foodand s/e = asthma attacks-monitor pulm function.
*tetracyclines- expiration =toxic! also…stain teeth.
*lipitor andanticonvulsants(valium, pams, dilantin, mag sulf, depakote, neurontin) = nograpefruit juice!
*heparin-1.5-2.5x control-ptt-20-45 sec. = clotting too fast< 1.5-2.5 > bleeding out.
antagonist = protamine sulfate/no po…do not aspirate!
*coumadin/warfarin-1.5 x control, pt-9-12 sec. = clotting too fast<1.5 > bleeding out. s/e alopecia, vit c < effect,
antagonist = vit k= green veg, pork, rice,fish, cheese, milk, yogurt,
*kaopectate = absorbs pomeds….wait one hour.
*mag sulf = < cns (depressant)= oliguria
*patient before equipment, unless pt. is part/attached to equip.
*malnutrition = associated withedema
no protein molecules-fluid just leaks outinto the cell.
*pt’s chief complaint shouldalways be recorded in pt’s own words…ex: pt. states, “my stomach hurts afterlunch ”
psych = cannot fix!
*cannot fix problem can onlystabilize or diminish prob.
*aggitation/billigerant = lessstimulation, away from others, can’t calm/no talking or reasoning.
*lithium = fluids/well hydrated.
*rehab = manipulates- set rules.
*cocaine = cardiac.
*schizophrenia = reality based.