OK I know this sounds stupid but I have a friend that gets really freaked out before big tests like finals, HESI, NCLEX, and usually we get together and a few days before I start throwing out random facts at her. On 2 different tests she said the only way she got several questions was from the random facts that I threw at her that she never would have thought of!
SOOOOO..... I thought that if yall wanted to do this we could get a thread going and try to throw out 5 random facts or "things to remember". NCLEX is coming and the more I try to review content the more I realize that I have forgotten so......here are my 5 random facts for ya:
OH and BTW these came from rationales in Kaplan or Saunders no made up stuff:
1️⃣ A kid with Hepatitis A can return to school 1 week within the onset of jaundice.
2️⃣ After a patient has dialysis they may have a slight fever...this is normal due to the fact that the dialysis solution is warmed by the machine.
3️⃣ Hyperkalemia presents on an EKG as tall peaked T-waves
4️⃣ The antidote for Mag Sulfate toxicity is ---Calcium Gluconate
5️⃣ Impetigo is a CONTAGEOUS skin disorder and the person needs to wash ALL linens and dishes seperate from the family. They also need to wash their hands frequently and avoid contact.
Oh, ohh, one more...
? Vasopressin is also known as antidiuretic hormone
* Remember the Ch in Chvostek and in cheek to help remember how Chvostek's sign is manifested.
* The pH is like the center of a seesaw; it wants to stay balance
* Carbon dioxide (CO2) acts as an acid in the body. It is also the indicator of how the respiratory system is functioning
* Bicarbonate (HCO3-) acts as a base in the body. It is also the indicator of how the metabolic system is functioning
* Interpret ABGs by looking first at the pH, then at the CO2, then at the HCO3- Determine first whether there is acidosis or alkalosis, then evaluate whether the imbalance is respiratory (CO2) or metabolic (HCO3-) in origin. The cause will be the value that matches or correlates with the change in the direction of the pH. I
* The pH is like a seesaw. The CO2 and the HCO3 are like riders on the ends of the seesaw. When one side goes up, the other tries to go up to compensate. When one side goes down, the other side also tries to go down to compensate and bring the pH back toward normal.
* If CO2 and HCO3 are both abnormal, again look to see which one has a change that matches the direction of the change in the pH (e.g., CO2 acts as an acid; HCO3 acts as a base). This match will be the primary imbalance, while the other system is compensating. If the pH is back in normal range, the value will be a number that is nearer to the side of the primary imbalance (e.g., 7.43 is nearer to alkalosis than acidosis, while 7.36 is nearer to acidosis than alkalosis). Remember that the body does not overcompensate!
* Acidosis of any origin tends to be a CNS depressant.
* Alkalosis of any origin tends to have an excitatory effect on the CNS.
* Remember respiratory distress in a premature infant by the mnemonic SIN:
o S- Substernal retractions
o I – Inspiratory grunting
o N – Nasal flaring
* Remember that a low-birth weight infant weighs 2500 grams (5 pounds 8 ounces) at birth or less.
* Remember that natural light is best for assessing jaundice; apply slight pressure to blanche the forehead (preferred), tip of nose or gum line and watch for yellow discoloration when pressure is released.
* Remember that infants are jittery during withdrawal. Create a soothing environment by keeping the room dark and quiet
* The cardiovascular comprises the heart and the blood vessels and is responsible for the transport of oxygen and nutrients to organ systems of the body.
Managing the Client with Hypertension
* Calcium channel blockers are more effective for the elderly and African American because they provide a better control blood pressure without many of the side effects associated with other categories of drug.
Management of a Client with Myocardial Infarction
* Anticoagulants such as heparin are used to decrease the potential for clothing. The nurse should check the partial thromboplastin time (PTT). The therapeutic bleeding time should be from one and a half to two times the control. The medication should be injected in the abdomen 2” from the umbilicus using a tuberculin syringe. Do not aspirate or massage. The antidote for heparin derivatives is protamine sulfate. Anticoagulants should be stopped at least 24 hours prior to surgery and are usually restarted 12-24 hours following surgery.
* If Coumadin (sodium warfarin ) is ordered, the nurse should check or prothrombin time (PT). The control level for a prothrombin time is 10-12 seconds. The therapeutic level for Coumadin should be from one and a half to two times the control. The antidote for Coumadin is Vitamin K. The international normalizing ration (INR) is done for oral anticoagulants. The therapeutic range is 2-3. If the level exceeds 7, watch for spontaneous bleeding.
Echocardiography
* The gag reflex is stimulated by placing a tongue blade on the back of the throat. Absence of the gag reflex increases the chances of aspirating liquids.
Endocrine Disorders
Diabetes Mellitus
* Regular insulin is the only insulin that can be administered intravenously
Genitourinary Disorders
Cystitis
* Although the client with interstitial cystitis experiences the same symptoms of cystitis as the client with other forms, the uterine is negative for bacteria.
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Integumentary Disorders
* Remember the alphabet –ABCD- to remember the adverse changes in skin lesions that need to be reported: asymmetry, border, color and diameter
Sensory Disorders
Intraocular Disorders
* The normal intraocular pressure ranges from 10-21mm Hg.
Disorder of the Ears
* Hearing loss of 50 decibels affects the client’s ability to distinguish parts of speech. Presbycusis affects the ability to hear high-frequency, soft consonant sounds (t,s, th, ch, sh, b,f, and pa)
Gastrointestinal Disorders
Peptic Ulcer Disease
* Administer NSAIDs with food, milk or antacids to reduce the likelihood of GI upset
Treatment of Ulcer
* Aciphex and Protonex are enteric-coated and cannot be crushed for administration
Inflammatory Bowel Disorders
* Clients learn to control crampy abdominal pain (which usually occurs with food intake) associated with Chron’s disease by not eating.
Management of the Client with Diverticulitis
* A low-fiber diet is recommended during the acute stage of diverticulitis.
* Morphine is contraindicated due to the increase in intraluminal pressure caused by this drug.
Appendicitis
* Rebounded tenderness can occur upon release of pressure in the epigastric or periumbilical area and indicates peritoneal inflammation.
* A positive Rovsing’s sign can also occur. This happens when the client experiences pain on the right lower quadrant of the abdomen when the examiner palpates the left lower quadrant.
Intestinal Obstruction
* Pain medications might be withheld initially to determine the client’s problem.
GERD
* Due to the surgical procedures, the stomach size is smaller and cannot accommodate large meals. Caffeine and alcohol might need to be restricted or eliminated from the diet.
Disease of the Liver
* Remember that hepatitis A has no long term effects and is not chronic
* Symptoms of hepatitis C are similar to those of hepatitis B. Some say the symptoms are mild and variable. The reason so many people are predicted to have hepatitis C is because of the lack of symptoms and vagueness. Consequently, those infected often do not seek assistance. A great deal of people with hepatitis C are carriers of the disease but do not know they have it.
Treatment of Hepatitis
* Not all hepatitis are reported. Hepatitis A is widespread with approximately 250,000 occurring in the US annually. Hepatitis C causes much concern because it can lead to cirrhosis and liver cancer. Due to the increased number of clients with hepatitis C, the most common type of hepatitis in the US, the need for liver transplants is increasing, as is the number of deaths from liver disease.
Treatment of Cirrhosis
* If the client has advanced liver disease or portal-systemic encephalopathy (PSE), protein sources are restricted due to the liver’s inability to convert protein to urea for excretion.
Acute Pancreatitis
* Cullen’s sign is recognized as periumbilical bluish discoloration of the skin. When the ecchymosis is noted on the flank area it called Turner’s sign. These signs may indicate intraperitoneal hemorrhage.
Diagnosis of Pancreatitis
* Amylase levels elevate in 12-24 hours after inflammation and stay elevated for 3-4 days. Lipase levels are more specific for pancreatitis and remain elevated for up to 2 weeks.
* Hypocalcemia and hypomagnesia indicate that fat necrosis has occurred.
Cholecystitis
* An easy way to remember who usually develops gallstones is to remember these four Fs of gallbladder disease:
o Female (sex)
o Forty (normal age)
o Fat (usually obese)
o Fertile (usually have children)
Treatment of Cholecystitis
* Morphine is not given for pain because it can cause spasms of the sphincter of Oddi.
* Clients with colostomies will have formed stool because the water is absorbed in the colon, whereas, ileostomy clients have liquid stools because the water has not been absorbed in this area.
Hematological Disorders
* The hematologic system consists of blood, blood cells, and blood forming organs. Because circulation of blood provides oxygen and nutrients to all body systems, a functioning hematological system is essential to health and well being. A disorder in the system might result from a lack of function, a reduction in production or an increase in the destruction of blood cells.
Sikle Cell Anemia
* The vaso-occlusive crisis is the primary crisis type that causes the client to have pain.
Iron Deficiency Anemia
* Intramuscular iron (Imferon) is given through the IM Z track method.
Polycythemia Vera
* This disorder is characterized by thicker than normal blood. There is an increase in the client’s hemoglobin to levels of 18 g/dL, RBC of 6 million/mm or hematocrit at 55% or greater and increased platelets)
Transfusion Therapy
* If a client is receiving blood components, assess the chart for a physician order, identify the patient by armband numbers, blood bag label, attached tag, requisition slip, and blood expiration date. Each identification should be checked by two registered nurses with documented signatures of the assessment by both.
Neurological Disorders
* Remember the mnemonic APQRST to trigger recall of all import points to access whenever the client has an acute onset symptom
o A – any associated symptoms with chief compliant
o P – what provokes (makes worse) or palliates (makes better) symptoms
o Q- quality of pain
o R – region and radiation
o S- severity of pain on a scale of 1 to 10
o T- timing: when it stops and starts, whether it is intermittent or constant its duration
* Recall that the words Kernig’s and knee both begin with K while Brudzinki’s and brain both begin with B. This will aid in recalling how to conduct each test.
Neoplastic Disorders
* Remember to use CAUTION to recall risk factors for cancer
* American Cancer Society’s Seven Warning Signs of Cancer
o Changes in a wart or mole
o A sore that does not heal
o Changes in bowel or bladder habits
o A new lump or the thickening of an existing lump
o A persistent cough
o Indigestion or difficulty in swallowing
o Unusual bleeding or discharge
The Four Major Categories of Cancer
* The different types of cancers are classified according to the tissue from which they originate. The following list identifies the major cancer groups:
o Carcinoma – cancer arising from epithelial tissue (for example, basal cell carcinoma)
o Sarcoma – cancer arising from connective tissue, muscle or bone (for example, osteosarcoma)
o Lymphoma – cancer arising from lymphoid tissue (for example, Burkitt’s lymphoma)
o Leukemia – cancer of the blood-forming cells in the bone marrow (for example, acute lymphocytic leukemia
Risk Factors for Specific Cancers
o Bladder- Risk factors include smoking and environmental carcinogens such as dyes, paint, rubber, ink and leather
o Breast – Risk factors include a family history in first-degree relatives, the birth of the first child after age 30, abnormality in genes BRCA-1 and BRCA-2, menarche before age 12 and menopause after age 55, obesity, the use of birth control pills and hormonal replacement, alcohol intake, and a diet high in fat.
o Cervical – Risk factors include early sexual activity, early childbearing, multiple partners, human papillomavirus (HPV) or human immunodeficiency virus (HIV) infection, smoking, using of DES by the mother during pregnancy and chronic cervical infections.
Risk Factors for Specific Cancers
* The FDA has licensed a vaccine (Gardasil) for use in girls/women ages 9-26 that protects against four HPV types responsible for 70% of all cervical cancers and 90% of genital warts. Three shots are administered over a six-month period.
* Cancer of the colon is the second most common form of cancer in the United States.
Breast Cancer
* The TNM classification system is commonly used cancer staging system that allows description of the severity of the cancer based on the T (description of the extent of the tumor), N (the spread to lymph nodes) and M (the spread beyond the area to the other parts of the body).
* It is normal for the patient to have post-surgical transient edema. This is not lymphedema.
Radiation
* While the implant is in place, the client emits radiation but the client’s body fluids are not radioactive
Total Parenteral Nutrition
* A central line is required for TPN administration
* If the TPN is not immediately available and the infusion is empty, the nurse should give D10W until the solution is obtained
Musculoskeletal Disorders
* Use the phrase “good leg up; bad leg down” to help remember which leg to place first when going up and down stairs with crutches
* Use the 5 P’s to remember the neurovascular assessment findings; pain, pallor, paresthesia, pulselessness (or decreased pulses) and paralysis
* Use RICE for musculoskeletal injuries (rest, ice, compression, and elevation)
Maternal and Neonatal Client
* Remember to “protect the head” during the precipitous birth. Apply enough pressure to guide the descent and prevent rapid intracranial pressure changes within the infant’s molded skull
* Remember that the umbilical cord could choke the fetus and is dangerous. If during delivery the umbilical cord can’t be loosened and slipped away from the infant’s neck, two clamps should be applied to the cord and the cord should be cut between the clamps.
Burns
The Consensus Formula
* Enteral feedings help meet the client’s increased caloric needs and maintains the integrity of the intestinal mucosa, thereby minimizing systemic sepsis.
The Intermediate Phase
* The normal central venous pressure (CVP) is 4-12 mm H20. Increased CVP indicates fluid volume overload; decreased CVP indicates fluid volume deficit.
Immunological Disorders
* Human Immunodeficiency Virus (HIV) leads to depletion of the CD4 +T4 helper cells. This depletion causes an inability to fight off opportunistic infections. Infected CD4 + (T4) helper cells are targeted by Human Immunodeficiency Virus CD8+ killer cells. Acquired immune deficiency syndrome (AIDS) is caused by the HIV virus. AIDS was first identified in the 1980s, and is believed to derive from infections found in the green monkey of Africa. It is thought that some reason the virus mutated and became a virus that affects human beings. There are 2 types of HIV:
o Type 1 (HIV-1) found in Western Europe and Asia
o Type 2 (HIV-2) found in West Africa
* HIV results in an abnormal cell that cannot fight infection. That abnormal cell duplicates producing more of the virus. The result is a decrease in the helper cells and an increase in the suppressor cells.
HIV Prevention
* Body fluids likely to transmit blood-borne disease include blood, semen and lady partsl/cervical secretions, tissues, cerebral spinal fluid, amniotic fluid, synovial fluid, pleural fluid, peritoneal fluid, pericardial fluid, and breast milk.
* Body fluids not likely to transmit blood-borne disease unless blood is visible include feces, nasal secretions, sputum, vomitus, sweat, tears, urine, and saliva (with the exception of during oral surgery or dentistry)
Legal and Ethical Nursing Practices
Managing Client Care
* Nursing Practice Acts varies from state to state. The nurse is responsible for knowing the laws in which he/she will practice. It is the responsibility of the nurse to contact the board of nursing to obtain a copy of the Nursing Practice Act. The state board of nursing has been authorized to take action against a nurse found guilty of failure to comply with rules and regulations set forth by the law. These examples are not a comprehensive list of all the skills registered nurses/licensed practical nurse can do.
Psychiatric Disorders
Dissociative Identity Disorder
* The following films offer good depictions of dissociative identity disorder: the Three Faces of Eve, Sybil, and Identity.
Obsessive Compulsive Disorder
* The main character in the movie As Good As It Gets is an excellent example of the client with OCD
Schizophrenia
* This disorder is most often diagnosed in late adolescence or early adulthood, although symptoms might have been present at a much earlier age. The disorder equally affects both males and females; however, males seem to have an earlier onset of symptoms. Theories offered regarding the cause of schizophrenia include genetics, environmental factors, and biological alterations in the neurotransmitters serotonin and dopamine.
* Clients with schizophrenia are best known for their odd appearance and behavior, which sometimes summarized by the 4 A's. The 4 A's include
o Affect—Described as flat, blunted, or inappropriate
o Autism—Preoccupation with self and a retreat into fantasy
o Association—Loosely joined unrelated topics
o Ambivalence Having simultaneous opposing feelings
Memory Support
* It is best to avoid challenging activities that can confuse and overwhelm the client.
* The mainstay in the management of the client with schizophrenia is medication.
* Unlike the EPSE of akathisia, akinesia and dystentonias, tardive dyskinesia is not caused by a dopamine
Anxiety
* Anxiety-related disorders are sometimes referred to as neurotic disorders and include the following categories:
o Generalized anxiety disorder
o Post-traumatic stress disorder
o Dissociative identity disorder
o Somatoform disorder
o Panic disorder
o Phobic disorder
o Obsessive-compulsive disorder
* Anxiety disorders are characterized by feelings of fear and apprehension accompanied by a sense of powerlessness. Anxiety-related disorders are listed on Axis I of the DSM-IV-TR.
Substance Abuse
* When a client has a problem with substance abuse or addiction, carefully screen for other mental health disorders as well which may be comorbidities
* Use the initials of the CAGE questionnaire to trigger the memory of what each question refers to
* It is just as important to screen for psychosocial data as for physical assessment data during admission for treatment for addiction
* Development of an emergency plan is high priority before discharge to home so that the client is better empowered to act on own behalf when the urge to abuse occurs
this question , i have different opion with my friend , between answer 1and 2 ,my opion : answer 1, toxic shock syndrome ----standard precaution ( should wear gown , gloves , mask ), answer 2, rubella ----droplet precaution ( should wear mask only ) , so the answer ahould be option 1 ,
the correct answer is option 2,
is there anyone can explain why ?
as i know rubella is german measles and as you said it is a droplet precution, "rubella" is categorize as a communicable disease. hehehe, it was just my opinion. but better ask those with expertise. im just classified as novice.
thank you for correcting me on the difference between libel & slander, with slander being spoken & libel being written, such as in a letter. (please forgive!)
lady_anne76
59 Posts
Fluid and Electrolytes and Acid/Base Balance
* Remember the Ch in Chvostek and in cheek to help remember how Chvostek's sign is manifested.
* The pH is like the center of a seesaw; it wants to stay balance
* Carbon dioxide (CO2) acts as an acid in the body. It is also the indicator of how the respiratory system is functioning
* Bicarbonate (HCO3-) acts as a base in the body. It is also the indicator of how the metabolic system is functioning
* Interpret ABGs by looking first at the pH, then at the CO2, then at the HCO3- Determine first whether there is acidosis or alkalosis, then evaluate whether the imbalance is respiratory (CO2) or metabolic (HCO3-) in origin. The cause will be the value that matches or correlates with the change in the direction of the pH. I
* The pH is like a seesaw. The CO2 and the HCO3 are like riders on the ends of the seesaw. When one side goes up, the other tries to go up to compensate. When one side goes down, the other side also tries to go down to compensate and bring the pH back toward normal.
* If CO2 and HCO3 are both abnormal, again look to see which one has a change that matches the direction of the change in the pH (e.g., CO2 acts as an acid; HCO3 acts as a base). This match will be the primary imbalance, while the other system is compensating. If the pH is back in normal range, the value will be a number that is nearer to the side of the primary imbalance (e.g., 7.43 is nearer to alkalosis than acidosis, while 7.36 is nearer to acidosis than alkalosis). Remember that the body does not overcompensate!
* Acidosis of any origin tends to be a CNS depressant.
* Alkalosis of any origin tends to have an excitatory effect on the CNS.